胃十二指腸潰瘍穿孔に対する腹腔鏡下大網被覆術に際しての高圧洗浄吸引器の導入効果

Effectiveness of High-pressure Irrigation and Suction Pump during Laparoscopic Omental Patch Repair for Perforated Gastroduodenal Ulcer

　胃十二指腸潰瘍穿孔に対する腹腔鏡下大網被覆術中の短時間での十分な腹腔内洗浄を目的にHydrodissection Pump Ⅱ（HP Ⅱ）を導入し，パルス波，給水圧1,600mmHg以下で使用した．手術時間に対する腹腔内洗浄に要した時間の比率，ならびに腹腔内洗浄に費やされた生理食塩水量をHP Ⅱ使用症例12例と，HP Ⅱ導入以前のマンシェット式加圧バッグを用いて洗浄した10例を比較した．洗浄時間／手術時間比はHP Ⅱ使用群が有意に短く，洗浄量はHP Ⅱ使用群が有意に多かった．HP Ⅱ使用に起因する合併症は認められなかった．胃十二指腸潰瘍穿孔に対する腹腔鏡下大網被覆術に際してのHP Ⅱの導入は，短時間での十分な腹腔内洗浄に有用と考えられた．

Hydrodissection Pump Ⅱ (HP Ⅱ) was used with the pulsatile irrigation pressure less than 1600 mmHg for rapid and sufficient intraabdominal irrigation during laparoscopic omental patch repair for perforated gastroduodenal ulcer. The ratio of irrigating time against operating time and the irrigation volume were com-pared between 12 cases with HP Ⅱ and 10 cases with the traditional bag-irrigating system. The irrigating time /operating time ratio in cases with HP Ⅱ was significantly lower and the irrigation volume in cases with HP Ⅱ was significantly higher than those in cases with the traditional bag-irrigating system.