パラレル法で行う単孔式腹腔鏡下手術とダイレクト穿刺鉗子の使用経験

概要

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Single-port surgery utilizing a solitary incision at the umbilicus, but with multichannel access, improves cosmetic results. Initially, we grasp the lower umbilicus and edge of fascial defect together, using an Endopath XCEL 5.0 mm extra long (150.0 mm) sleeve as we optically puncture the fascia. The trocar tip is positioned 1.0 cm from the abdominal wall. A 30-degree 5.0 mm scope is then inserted through the central long trocar. Use of a clear central long trocar enables visualization of the two additional lateral trocars and Babcocks forceps that are subsequently inserted into the abdomen. The second and third punctures, each via Endopath XCEL 5.0 mm with long (100.0 mm) and short (75.0 mm) sleeves, are placed symmetrically 20.0 mm from the point at 5.0 mm closer to the focus from the camera port. We next insert Babcock forceps (5.0 mm diameter), without use of trochars, into the direct abdominal puncture along the inner detached opening. Insertion should be 10.0 mm from the camera port, oriented towards 12 oclock. These forceps help maintain sufficient field of view. By implementing the above port arrangement, complete with direct puncture forceps, the need for trochars is reduced, thus promoting a safe single-port procedure.
日本産科婦人科内視鏡学会の論文
2010-12-01