ニードルガイダンス機能を利用した心囊内伏針摘出術

Successful Removal of Intrapericardial Needle using Needle Guidance System

体内異物としての伏針はしばしば遭遇するが，心囊まで達するものは比較的まれである．心臓周辺の伏針は心臓・大血管の損傷の可能性もあり，摘出が望ましい1）．われわれは，多量の心囊水貯留をきたした心囊内伏針の症例に対して，syngo Needle Guidance（ARTIS pheno：Siemens Healthineers社，Forchheim）を利用し，ハイブリッド手術室で低侵襲に伏針を摘出したので報告する．

A 41-year-old man stuck himself with needle through his pericardium during suicide attempt. Chest radiography revealed several needles in the bilateral lung fields as well. Computed tomography （CT） and echocardiography showed massive pericardial effusion and a needle penetrating the pericardium. The patient was initially treated conservatively, including pericardial drainage, and, seven days later, we removed the needle using syngo Needle Guidance in hybrid operating room. The length of skin incision was only 2 cm, and the postoperative course was uneventful. No previous studies, to the best of our knowledge, have shown the use of syngo Needle Guidance to remove a needle in the pericardial cavity. This surgical procedure is minimally invasive for the patient.