腹腔鏡下子宮筋腫核出術のモルセレーションに際して子宮筋腫の腹腔内への飛散防止にMorSafeTMを使用した1例

A case of using MorSafeTM to prevent dissemination of myoma during morcellation of laparoscopic myoma surgery

◆要旨：子宮筋腫核出術では，異所性子宮筋腫や子宮肉腫の腹腔内への播種に関する報告があり，子宮筋腫の体外への搬出方法が問題となっている．今回筆者らは，腹腔鏡下での筋腫搬出に，モルセレーション専用に開発されたMorSafe^TMを用いてモルセレーションを行った症例を経験した．MorSafe^TM挿入からモルセレーション終了までの時間は55分であった．通常の気腹圧で十分な視野が得られ，安全にモルセレーションを実施できた．バッグ内に飛散した破片を可能な限り除去したが，バッグ内には微少な破片が散在していた．MorSafe^TMは，鉗子操作で破損することはなかった．MorSafe^TMは，子宮筋腫の体外への搬出方法として有用と考えられた．

Extraction of uterine myoma has become an important issue for gynecologists because of the concerns for disseminated parasitic leiomyomatosis and occult malignancies. To date, many gynecologists have sought a useful way to safely extract myoma. Some contained tissue extraction techniques are being modified in an effort to minimize the risks of tissue dissemination. To investigate a new contained technique for morcellation, we used MorSafe^TM during laparoscopic myoma surgery. The time for insertion of MorSafe^TM, morcellation, and MorSafe^TM removal was 55.0 minutes. The morcellator could be safely used with expanded visualization within MorSafe^TM. During laparoscopic surgery, there was no tear or puncture of MorSafe^TM. The feasibility of contained power morcellation within MorSafe^TM needs to be proved to reduce the risk of disseminated malignant tissue and myoma during morcellation in laparoscopic surgery.