腹腔鏡下腎固定術

Laparoscopic Nephropexy

　腹腔鏡下腎固定術は，侵襲が少なく術後回復が早いことから，腎下垂に対する手術術式として推奨される．経腹膜到達法と後腹膜到達法があるが，前者のほうが手技として容易である．腎の固定法には，腎筋膜による支持，メッシュによる固定，腎被膜と腹壁筋膜の縫合などの方法がある．われわれの経験をもとに，腹腔鏡下腎固定術の適応と術式を解説した．

The laparoscopic approach is an ideal method for nephropexy because it produces less postoperative painand allows an early recovery. A transperitoneal approach is technically easier than the retroperitoneal one.There are a variety of methods for fixing the kidney, including holding the kidney with Gerota's fascia,fixation of the kidney with foreign materials, and suturing the renal capsule and the fascia of the abdominalwall. According to our experiences of two cases, the indication and surgical methods for laparoscopicnephropexy are discussed.