肺縦隔の単孔式手術

Uniportal Pulmonary and Mediastinal Video-assisted Thoracic Surgery Procedure

呼吸器外科領域における手術アプローチは大きくかわりつつある．現在，従来行われていた開胸手術にかわり，胸腔鏡手術が積極的に行われるようになった．近年，より低侵襲な手術を行うことを目的に一つの創からすべての手術手技を行う単孔式手術が広まりつつある．本稿では，単孔式肺葉切除と剣状突起下アプローチによる胸腺摘出術の歴史と手術手技を紹介する．

In recent years, uniportal video-assisted thoracoscopic surgery, which performs all surgical procedures from 1 wound, has been spreading for the purpose of performing less invasive surgery. The uniportal surgery requires a device because it interferes with instruments, but is a surgical technique that is cosmetically excellent and can be expected to reduce postoperative pain. This new minimally invasive surgical technique is now widely spread, especially in Asia and Europe. In addition, uniportal surgery using the subxiphoid approach has attracted attention.

This method has an advantage that intercostal neuropathy does not occur because it does not pass through the intercostal space, and is a useful method for patients. These uniportal surgery is expected to be further developed as a new minimally invasive surgery. In the future, it is necessary to develop more operable devices and instruments, including robot systems, and to prove the usefulness of uniportal surgery.