Reduced port surgery手技による腹腔鏡下仙骨腟固定術

Laparoscopic sacrocolpopexy using reduced port surgery technique

◆要旨：腹腔鏡下仙骨腟固定術（LSC）は骨盤臓器脱の標準治療の1つだが，当科では2017年からreduced port surgery手技によるLSC（RPS-LSC）を開始したので報告する．ポートは臍部縦切開25mm部位にGelPoint^® miniを留置し，その左側に5mmポートを挿入して，さらにEndo Close^TMを用いた体外牽引で術野作製補助を行った．LSCでは体腔内深部における運針や結紮の腹腔鏡手技が高難度であるが，RPS-LSCは従来のLSC手技の難易度に準じ，かつ整容性に優れる点で女性良性疾患手術として有用と思われた．

　Laparoscopic sacrocolpopexy （LSC） is one of the standard treatments for pelvic organ prolapse. We herein report our LSC procedures using reduced port surgery （RPS） technique which we have experienced since 2017. The GelPoint^® mini multichannel platform was placed through a vertical 25-mm umbilical skin incision. Subsequently another 5-mm port was placed on the left flank region. To keep a clear surgical field, extracorporeal traction of sigmoid colon and rectum was performed using Endo Close^TM trocar site closure device. Though laparoendoscopic single-site surgery LSC（LESS-LSC） demands more technical difficulties than multiport LSC, by adding just another 5-mm port to LESS-LSC we can perform RPS-LSC with the same level of difficulties and less invasiveness compared with multiport LSC. RPS-LSC was supposed to be a useful technique for female surgery which showed cosmetical superiority to multiport LSC.