日本産科婦人科内視鏡学会雑誌
Online ISSN : 1884-5746
Print ISSN : 1884-9938
原著
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
逸見 博文東口 篤司斎藤 学板橋 詠子北城 秀司山中 郁仁木谷 保遠藤 俊明斎藤 豪
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ジャーナル フリー

2010 年 26 巻 2 号 p. 580-584

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抄録
  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 o'clock. 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.
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© 2010 日本産科婦人科内視鏡学会
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