妊娠中の２孔式腹腔鏡下卵巣腫瘍手術の検討

抄録

　It has been suggested that laparoscopic surgery for adnexal masses during pregnancy has similar or better perinatal outcome compared to open surgery, and the advantages of laparoscopic surgery are similar for pregnant and nonpregnant women. Although there have been some reports on single-site laparoscopic surgery as minimal invasive surgery during pregnancy, disadvantages of single-site laparoscopic surgery include interference between forceps, difficulty in camera work, and difficulty in applying countertraction to the tissue, which requires high surgical skill and a long learning curve. We present some cases of two-port laparoscopic surgery for adnexal masses during pregnancy and evaluate its usefulness. We have experienced 10 cases of adnexal surgery during pregnancy between 2016 to 2021, all of which were performed as laparoscopic surgery, 7 by conventional 3-port and 3 by 2-port surgery. There were 8 standby and 2 emergency surgeries. The surgical procedures included cystectomy in 9 cases and adnexal torsion release in 1 case. All surgeries were performed between 10 and 15 weeksʼ gestation, with no perioperative complications, and all patients gave birth at full-term. The histological types of ovarian tumors were mature cystic teratoma in 7 cases and ovarian endometriotic cyst in 2 cases. The 2- and 3-port surgeries showed no significant differences in operative time, blood loss, or postoperative hospital stay. The 2-port surgery is feasible without compromising safety compared to conventional laparoscopic surgery, and may be applicable to more cases by more surgeons compared to the single-site surgery.