腹腔鏡下子宮筋腫核出術におけるin-bag morcellationの検討

Laparoscopic myomectomy with in-bag morcellation technique

◆要旨：［目的］腹腔鏡下子宮筋腫核出術におけるin-bag morcellation（IBM）の手技を検討し，手術成績について従来のuncontained morcellation （uncontained）と比較した．［対象・方法］IBM50例とuncontained50例を対象とし，回収バッグにリトリーバルシステムを使用した．［結果］モルセレーションの時間はIBM群がuncontained群より約5分延長していた（15.5分 vs 10.9分; P＝0.01）．IBM群では全例でバッグの損傷や組織の飛散は認めなかった．［結論］リトリーバルシステムを用いたIBMは再現性が高く，安全に施行しうると思われた．

［Purpose］ The aim of this study was to evaluate techniques for in-bag morcellation at the time of laparoscopic myomectomy and to compare operative outcomes between uncontained and in-bag morcellation. ［Method］ The study consisted of 50 patients who underwent in-bag morcellation and 50 uncontained morcellation. In this technique the retrieval was conducted in the typical fashion. ［Result］ The mean morcellation time was prolonged about 5 minutes with in-bag morcellation（15.5 vs 10.9; P＝0.01）. There were no cases of visible bag disruption or dissemination of uterine tissue in the group of in-bag morcellation. ［Conclusion］ We believe that in-bag morcellation with a retrieval system is a highly reproducible and safe technique.