単孔式腹腔鏡下脾固定術を施行した遊走脾の1例

A case report of single-incision laparoscopic splenopexy for wandering spleen

◆要旨：近年，遊走脾に対する腹腔鏡下脾固定術の報告が散見されるが，単孔式腹腔鏡下脾固定術の報告はない．今回，臍部の創から左側腹部に腹膜外パウチを作成した後に，同創部直下の腹膜を切開し，脾動静脈の捻転を解除しつつ脾固定術を施行した．遊走脾に対する単孔式腹腔鏡下脾固定術は，脾機能が温存でき，整容性にも優れており，有用であると考えられたので文献的考察を加えて報告する．

　Recently, there has been reports of laparoscopic splenopexy for wandering spleen. However, to our knowledge, single-incision laparoscopic splenopexy has never been reported. We performed a single-incision laparoscopic splenopexy for a case of wandering spleen with torsion of the splenic vessels. We first created a retroperitoneal pouch via umbilical incision to the left lateral abdomen. We then entered the abdominal cavity from the umbilicus and released the torsion of the splenic vessels. Incision was made in the peritoneum of the pouch through which the spleen was inserted. The peritoneal incision was closed with suturing. We conclude that single-incision laparoscopic splenopexy is feasible, preserves functions of spleen and has cosmetic benefit.