より低侵襲な恥骨上腹腔鏡補助下卵巣嚢腫核出術（体外法）の試み

抄録

Introduction: A laparoscopic-assisted ovarian cystectomy is commonly indicated for a mature cystic teratoma. We report the surgical outcome of our recently-developed novel surgical technique that requires only a suprapubic skin incision.
Methods: We set up an Alexis™ Wound Protector/Retractor (size: XS) in a 2-3 cm suprapubic incision and mounted a sterile glove. Three 5 mm trocars were inserted into the glove for the subsequent insertion of one 5 mm rigid endoscope and two forceps. After establishing a pneumoperitoneum, beginning at the glove, we used forceps to perform adhesiolysis, application of anti-adhesive material, and relocation of the ovary.
Results: This surgical procedure was completed successfully in 62 patients (mean age: 28 years; body mass index: 21.5 kg/m²) from February 2009 through July 2013. The mean tumor diameter was 7.7 cm and the mean incision length was 2.8 cm. Dense adhesions were observed in three cases, two of which required insertion of an additional trocar.
Conclusions: Because this surgical procedure provides good aesthetic results and enables intraperitoneal manipulation, diversified simultaneous surgeries and broader indications for the technique are expected.