ロボット支援下enhanced-view totally extraperitoneal（eTEP）access Rives-Stoppa（R-eTEP Rives-Stoppa）法で行った腹壁瘢痕ヘルニアの1例

A case of incisional hernia repair using robot-assisted enhanced-view totally extraperitoneal（eTEP）access Rives-Stoppa（R-eTEP Rives-Stoppa）technique

◆要旨：症例は43歳女性．腹壁瘢痕ヘルニアで当院紹介となった．EHS分類M3-5 W2の腹壁瘢痕ヘルニアに対し，新規医療技術審査および臨床倫理委員会の承認を得て，ロボット支援下enhanced-view totally extraperitoneal（eTEP）access Rives-Stoppaを行った．手術支援ロボットは関節機能，3D拡大視，motion scalingなど，従来の腹腔鏡手術の限界を補完する機能をもち，腹壁縫合（天井縫い）など高難度手技が必要なeTEPアクセスアプローチの一般化に有用であると考える．

　今回，本邦初のロボット支援下腹壁瘢痕ヘルニア修復術を経験したので報告する．

　A 43-year-old female patient was referred to our hospital for an incisional hernia. The hernia was diagnosed as M3-5 W2 according to the EHS classification. After obtaining approval from the new medical technology review and clinical ethics committee, we performed robot-assisted enhanced-view totally extraperitoneal（eTEP）access Rives-Stoppa（R-eTEP Rives-Stoppa）repair for the incisional hernia.

Robotic surgical platform provides a joint function, 3D magnifying vision, motion scaling, and complements the limitation of conventional laparoscopic surgery. This platform enables the surgeon to facilitate difficult abdominal wall suturing during eTEP access approach. We believe that it would be useful for the generalization of eTEP access approach technique. We report the first case of robot-assisted eTEP Rives-Stoppa in Japan.