新規開発された発光式尿管カテーテルInfrared illumination systemを用いて腹腔鏡下子宮体癌手術を行った1例

抄録

Objective: Ureteral injury is a devastating complication in gynecologic surgery. The prevalence of ureteral injury is higher in laparoscopic surgery than in laparotomy. That is because, unlike in laparotomy, it is difficult to identify the ureter by tactile sense in laparoscopic surgery. It is also well known that the prevalence of ureteral injury becomes higher especially in malignant or severe endometrioma operation. Lighted ureteral stents help gynecologists recognize ureter visually. Lighted ureteral stent is inserted prior to the surgery. Infrared Illumination System (IRIS) is a new lighted ureteral stent, which does not inhibit the function of the ureter or generate heat because of using near infrared light. In this case, we used IRIS to protect the ureter during laparoscopic surgery of endometrial cancer of uterine corpus.

Patient: A 50-year-old woman with genital bleeding was referred to our hospital. She was diagnosed with stage IA endometrioid carcinoma of uterine corpus, Grade 1 and taken laparoscopic surgery with lymph node dissection. To protect the ureter, we inserted IRIS prior to the laparoscopy. It took only 4 minutes. During operation, we were able to identify the position of the ureter very easily because the lighted stents were clearly visible. No complications associated with the ureter occurred during the operation and the patient was discharged seven days after the operation.

Conclusion: Infrared illumination system is thought to be very useful to identify ureter and prevent ureter injury in gynecologic laparoscopy.