GelPOINT miniTMを用いた単孔式内視鏡下乳房温存術

Single-incision endoscopic breast conserving surgery using the GelPOINT miniTM

◆要旨：内視鏡外科手術手技は，近年手術器具の進歩もあり飛躍的に発展してきたが，乳腺領域においては，未だ十分普及していないのが現状である．筆者らは，2015年3月までに乳癌症例10例に気囊法を用いた単孔式内視鏡下乳房温存術を施行した．適応は，皮膚・大胸筋浸潤がない単発症例である．腋窩を約3cm切開しGelPOINT mini^TM（Applied Medical社）を装着した後，CO₂送気（8mmHg）にて気囊し内視鏡下に乳房温存術を施行した．平均手術時間は210分，平均出血量は66 mlであった．本術式は乳癌に対する乳房温存術後の整容性を向上させる有用な術式と考えられた．

Endoscopic surgery has rapidly spread throughout the world. Single-port surgery is one of the newest methods of minimally invasive surgery. We have performed single-incison endoscopic breast conserving surgery using the GelPOINT mini^TM for breast cancer in 10 patients. The GelPOINT mini^TM was inserted from the axillary wound and the anterior surface of the pectoralis major muscle was detached. After sentinel lymph node biopsy dissection, construction of a skin flap and partial mastectomy were performed. The median operation time was 210（167-256） minutes and the amount of blood loss during operation was 66（5-143） ml. All the resected margins were histologically negative. The single-incision endoscopic breast conserving surgery is a useful, well-tolerated technique from our experiences. This procedure appears to be a new approach to improve the patient's cosmetic effect, for the treatment of breast cancer.