消化管用軟性内視鏡を用いた単孔式腹腔鏡下アプローチ（single port endoscopic approach）により腹腔内の断裂した脳室腹腔シャントカテーテルを摘出した1例

Laparoscopic removal of a dislocated ventriculoperitoneal shunt by a single-port endoscopic approach : a case report

◆要旨：患者は79歳，男性．正常圧水頭症で脳室腹腔短絡術（ventriculoperitoneal shunt）を施行後，約1年でカテーテルの離断が確認され，本学脳神経外科より離断したカテーテルの摘出術の依頼があった．低侵襲的にカテーテル摘出術を行うことを目的に，単孔式で消化管用軟性内視鏡を用いたsingle port endoscopic approachでカテーテルを摘出した．消化管用軟性内視鏡を使用することで，鉗子孔から把持鉗子を用いて処置を行うことが可能であった．本法は通常の単孔式腹腔鏡下手術よりも小さな創部で手術が可能であった．

We describe our experience with a 79-year-old man who underwent laparoscopic removal of a dislocated ventriculoperitoneal（VP） shunt catheter through a single-port endoscopic approach. A VP shunt catheter had been inserted because of normal pressure hydrocephalus. One year after catheter placement, disconnection of the abdominal catheter was noted, and the dislocated VP shunt catheter was removed through a single-port endoscopic approach. The removal of the catheter was performed with grasping forceps through a forceps hole. The procedure could be performed through a smaller incision than in conventional laparoscopic surgery.