牽引糸を駆使した単孔式腹腔鏡下結腸切除術における体腔内吻合

Use of traction sutures for intracorporeal anastomosis in single incision laparoscopic colectomy

◆要旨：単孔式腹腔鏡下手術の利点は創の縮小による整容性の向上である．筆者らは単孔式腹腔鏡下結腸切除術において手術創の最小化を目指した体腔内吻合を施行した3例を経験したので，手術手技の要点と治療成績を報告する．すべての操作を臍に装着したマルチチャンネルポートのみから行い，必要に応じて縫合糸による牽引を行った．トロッカー追加はなく，体腔内吻合に要した平均時間は42分で，平均創長は26.7mmであった．縫合不全，腹腔内膿瘍の発症はなかった．単孔式腹腔鏡下結腸切除術においても牽引糸を有効に用いることで安全かつ腹腔内汚染を最小限に抑えた体腔内吻合が可能である．

The advantage of single incision laparoscopic surgery is the improvement of cosmesis by reducing the incision size. We performed three cases of intracorporeal anastomosis aiming to minimize the surgical incision in single incision laparoscopic colectomy, and we report the main points and outcomes of the surgical procedure. With this technique, the entire operation was conducted through a single multi-channel port that was inserted at the umbilicus, and we used traction sutures as needed. Additional trocars were not necessary, and the average time for intracorporeal anastomosis was 42 minutes and the average incision length was 26.7 mm. There were no incidences of anastomotic leak or intra-abdominal abscess. By using traction sutures effectively in the single incision laparoscopic colectomy, it is possible to safely perform intracorporeal anastomosis while minimizing intra-abdominal contamination.