妊娠16週に単孔式腹腔鏡下虫垂切除術を施行した1例

A case of single site laparoscopic appendectomy for a pregnant woman

◆要旨：妊娠16週の妊婦の虫垂炎に対し単孔式腹腔鏡下虫垂切除術を施行した1例を経験したので報告する．患者は26歳，女性．妊娠13週に心窩部痛のため近医経由で当院を受診した．急性虫垂炎の診断で入院のうえ，保存的に加療し軽快した．妊娠中の再燃のリスクなどを考慮し，妊娠16週3日に待機的に単孔式腹腔鏡下虫垂切除術を施行した．手術時間は1時間，気腹時間は23分，出血量は少量であった．妊娠中の虫垂切除術のアプローチ法は妊娠週数や母体，胎児両者への影響を考慮して決定する必要があるが，単孔式腹腔鏡下虫垂切除術は整容性に優れるのみならず，子宮に対する影響を最小限にできる有用な術式である可能性が示唆された．

We report a case of single site laparoscopic appendectomy for a pregnant woman. A 26-year-old woman, who was 13 weeks pregnant, had a complaint of epigastralgia. We diagnosed as an acute appendicitis by ultrasonography and clinical findings. We performed single site laparoscopic appendectomy at 16 weeks of gestational age. Operative time was 60 minutes, pneumoperitoneum time was 23 minutes, and intraoperative blood loss was minimal. Single site laparoscopic surgery for a pregnant woman has not only a cosmetic advantage but also averts injuries to the enlarged uterus in pregnant women more effectively than conventional laparoscopic methods.