当院の腹腔鏡下手術における第一穿刺の改良と成績 ―コッヘル鉗子を用いたオプティカル・ダイレクト法について―

概要

論文の詳細を見る
Objective: The aim of this study was to determine whether the optical direct trocar insertion technique using Kocher clamps can be used to establish a safe and rapid mode of entry during laparoscopic surgery. Design: The study was performed retrospectively Setting: The study was carried out at the Department of Obstetrics and Gynecology, Kobe City Medical Center General Hospital. Patients: The study included 242 patients who underwent laparoscopic surgery between October 2009 and September 2010, and 278 patients who underwent laparoscopic surgery between October 2010 and September 2011. Interventions: In October 2010, the method for performing the first puncture for trocar insertion was changed from lifting the abdominal wall by hands to raising the umbilicus using Kocher clamps. With this new modification, the bottom of the umbilicus is sufficiently exposed to appropriately insert the first trocar with ease. Methods: The entry time was measured and compared between the conventional method and the new method. Result: The entry time was shorter for the new method compared with that for the conventional method (3.5±2.2min vs. 5.6±3.7min). No remarkable complications were observed. Conclusion: The new method was faster and safer than the conventional method.
日本産科婦人科内視鏡学会の論文