樋口式横切割法を応用した単孔式腹腔鏡手術にて卵巣組織凍結を行った２例

抄録

Introduction: Ovarian tissue cryopreservation is a fertility-preserving technique for young women whose ovarian reserve is expected to be greatly reduced by cancer treatment. It may be achieved via oophorectomy, which for this purpose is generally performed by single- or multi-port laparoscopic surgery. In our hospital, ovarian cystectomy is performed by low-position single-incision laparoscopic surgery (L-SILS) with Higuchi’s transverse incision. We report two cases in which oophorectomy for ovarian tissue cryopreservation was performed with L-SILS.

Method: Higuchi’s transverse incision is made at a lower position than Pfannenstiel transverse incision, and is superior in terms of cosmetic outcomes. It involves a T-shaped incision made in the rectus abdominis sheath for the purpose of avoiding bladder injury and securing the surgical field. Single-port L-SILS with Higuchi’s transverse incision was performed with a 2-3 cm skin incision to achieve unilateral oophorectomy for ovarian tissue cryopreservation.

Cases: Case 1 was a 39-year-old breast cancer patient who requested embryo and ovarian tissue cryopreservation. Right oophorectomy was performed with L-SILS, and 22 ovarian tissue pieces were frozen. Case 2 was a 33-year-old breast cancer patient who requested ovarian tissue cryopreservation. Left oophorectomy was conducted with L-SILS, and 29 ovarian tissue pieces were frozen.

Discussion: L-SILS is minimally invasive, has excellent cosmesis, and can be performed straightforwardly for oophorectomy.