臍窩単一創からの単孔式腹腔鏡下尿膜管遺残症手術

Resection of urachal remnant by single umbilical incision laparoscopic surgery

◆要旨：尿膜管遺残症は若年者に発生することが多いため，腹腔鏡下手術は整容性の観点から非常に優れていると考えられる．筆者らは，術式を工夫することにより，臍窩単一創からの単孔式腹腔鏡下尿膜管遺残症手術を3例に施行した．症例はいずれも繰り返す臍炎にて来院した男性で，平均年齢は25.6歳．炎症消退後に手術を施行した．臍底部の輪状切開を先行させ腹腔内と交通させた後，筋膜を仮閉鎖した．臍窩単一創から3本の5mmポートを筋膜直刺し挿入して遺残尿膜管の剝離・摘出を行った．平均手術時間は129分，術後在院日数は平均3.3日であった．根治性，整容性の観点から十分標準術式になりうると考えられた．

Laparoscopic resection of urachal remnant is more beneficial than traditional open surgery. We performed resection of the urachal remnant by single umbilical incision laparoscopic surgery in three patients. The patients visited the hospital because of intractable omphalitis. The average age of the patients was 25.7 years. The operation was performed after the omphalitis had ceased. After cutting the bottom part of the umbilicus, three 5-mm ports were inserted in the single umbilical incision. The mean operative time was 129 minutes and the average postoperative hospital stay was 3.3 days. Resection of the urachal remnant by single umbilical incision laparoscopic surgery should be the standard approach since it is a curative operation and a cosmetically beneficial technique.