伸縮式ストラップを用いた開頭術中の吸引管落下防止

Extendable Cords to Prevent Tumbling of a Suction Device during Craniotomy

Ⅰ．はじめに

　脳神経外科手術における吸引管の使用頻度は高く，本器具の清潔野からの不意の落下は手術進行を妨げ，術者にストレスを与える．この落下は，器具の持ち替えのため頻回に収納容器に出し入れする開閉頭時に好発し，背景には非利き手で扱うため注意が疎かになりやすいこと（特に長時間手術・深夜における術者の疲労時），非使用時も器械出し看護師に返却せずに術者側の管理となること，ホースの自重により容器内で吸引管が傾き抜け落ちてしまうことなどがある．この看過されてきた術中トラブルへの対策として，伸縮式ストラップによる吸引管の懸吊を考案・試行した．

　Objective:Suction is necessary during craniotomy, and intraoperative tumbling of the suction device interrupts operative procedures. To avoid this, we developed a technique that would fasten the device to an extendable cord as is used to secure cell phones.

　Surgical Technique:We used this technique in more than 300 craniotomies at the specific point of time when the suction device tends to tumble, i. e., during the opening and closure of a wound, which requires frequent instrument exchanges. Extendable cords fastened to the tip of the suction hose using a gift tie were attached to the drapes to secure the suction device next to the operative field. During the operation, the extendable cord followed the suction device manipulations. Consequently, although there was some tension in the cord during its extension, the maneuverability of the suction device was maintained. As the hanging suction device was closer to the operative field than devices stored in conventional pockets, its manipulation was easier and quicker. Upon release, the suction device automatically returned to its original position without distracting the surgeon. Tumbling of the device was prevented, and there were no procedure-related complications.

　Conclusions:Our simple modification using extendable cords prevented tumbling, avoided unnecessary replacements, and eased the manipulation of a suction device.