変位腎を有する子宮腺筋症症例に対し腹腔鏡下子宮全摘術を施行し得た1例

抄録

  An ectopic kidney is a congenital anomaly characterized by an abnormal location of the kidney. In this report, we describe total laparoscopic hysterectomy (TLH) in a patient with an ectopic kidney. A 42-year-old gravida 0 para 0 woman was referred to our hospital for management of uterine adenomyosis with persistent genital bleeding and low abdominal pain. Magnetic resonance imaging revealed uterine adenomyosis and a right ectopic kidney. Drip infusion pyelography revealed a short right ureter without any other urinary tract malformations. She underwent four-port TLH. A 12-mm navel port was placed using the open method, and a 5-mm port was placed on the right side of the lower abdomen with the help of laparoscopic forceps. The muscular layer of the bladder was accidentally injured but was successfully repaired using single-layer closure, and routine TLH was performed. The estimated blood loss was 50 mL, and the operation time was 111 min. A urinary catheter was placed for one week. No postoperative complications were observed, and the patient was discharged on the 7^th postoperative day.

  Detailed preoperative evaluation is warranted to confirm the location of the urinary tract prior to TLH in patients with an ectopic kidney.