ロボット支援胃切除術におけるdual incision robotic surgeryの手術手技

Surgical technique of dual incision robotic surgery for robotic gastrectomy

◆要旨：ロボット胃切除術が2018年4月に保険収載され，全国的に手術件数が増加傾向にある．われわれは腹腔鏡下胃切除術においてreduced port surgery（RPS）としてsingle incision laparoscopic surgery（SILS）を積極的に施行してきた．da Vinci Xi^®などロボット支援手術機器の発達に伴い，その手術手技の経験を生かしてロボット胃切除術でのRPSとしてdual incision robotic surgery（DIRS）を考案し導入した．DIRSとしてロボット支援幽門側胃切除術7例を経験し，合併症なく安全に施行できた．

　Minimally invasive surgery has been associated with less blood loss, less pain, faster recovery, shorter hospital stays and better cosmetic results. After the insurance coverage of robotic gastrectomy was covered by insurance in April 2018, there tends to be an increase in the number of robotic gastrectomy. With the improvement of robot-assisted surgical equipment such as da Vinci Xi^®, we developed a novel technique of reduced port robotic surgery which was named Dual Incision Robotic Surgery（DIRS）based on our experience of single-port laparoscopic gastrectomy. We describe our technique of DIRS in detail.