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◆要旨:卵管間質部妊娠の腹腔鏡下手術においては大出血のリスクがあり,出血軽減のための工夫が必要である.筆者らは今回,子宮筋腫核出術を開腹で行う際に用いられる,ネラトンカテーテルによる子宮頸部絞扼法を用いて駆血し手術を完遂した.ネラトンカテーテルはHem-o-lok®を用いて容易に固定でき,術中出血はきわめて少量で術野も良好に保たれた.癒着や腫瘍などの因子によって実施困難な場合もあるが,本法は出血軽減策の選択肢の1つとして,他の方法や薬物使用を回避できる可能性があり有用と考えられた.
Laparoscopic surgery of interstitial tubal pregnancy is associated with a risk of massive hemorrhage, necessitating hemorrhage reduction strategies. Herein, we applied a uterine cervix strangulation method using a Nelaton catheter, which is employed for myomectomy, to achieve avascularization, and were able to carry out the surgery. The Nelaton catheter was easily fixed using a Hem-o-lok®, intraoperative hemorrhage was minimal, and the surgical field was well maintained. Although this method is potentially difficult because of factors such as adhesion and tumors, it may be a useful option for hemorrhage reduction due to the use of other methods or drugs being circumvented.
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