腹腔鏡下胆嚢摘出術および総胆管結石症手術に対する laparolift を用いた腹壁吊り上げ法の有用性 Usefulness of abdominal wall lifting by laparolift in laparoscopic cholecystectomy and choledocholithiasis surgery

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我々は,1996年9 月より腹腔鏡下手術にOrigin社製laparoliftを用いた腹壁吊り上げ法(以下, 吊り上げ法) を導入し, 基本術式としている. 胆嚢摘出術74例と総胆管結石症手術13例の計87例を経験した.腹筋の弱い症例では,横隔膜を十分挙上できないため,横隔膜下に広い空間がえられなかった.このような症例は胆嚢頸部を垂直に挙上出来ないことが多く, 87例中58例(66.7%) が胆嚢頸部を左右に挙上して, 胆嚢体部から底部の剥離を行った.しかし,胆嚢頸部から総胆管周囲の視野は良好であり,ポートよりガス漏れの心配がないため鉗子の出し入れ, 洗浄吸引が非常に容易で, 胆嚢頸部の剥離, 総胆管切開,砕石,総胆管縫合をスムーズに行えた.87例中81例(93.1%)が吊り上げ法で手術を完遂できたが,6例(6.9%)が気腹および開腹術に移行した.うち2例は,laparoliftによる吊り上げ法では困難と思われた.Laparoliftを用いた吊り上げ法は,操作が簡便で非常に有用であった.

We introduced abdominal wall lifting which use laparolift (Origin Company) for laparoscopic surgery in September,1996, and we use it as basic laparoscopic operation now. We performd 74cases of cholecystectomy and 13 cases of choledocholithiasis surgery,87 cases in total. On cases of weak abdominal muscle, it was difficult to get enough cavity under the diaphragm, because it was not lifted diaphragm fully. In these cases, we performed to exfoliate the fundus from the body of the gallbladder by lifting to right or left direction the neck of the gallbladder in 58 cases of 87 cases (66.7%), because of lifting perpendicularly the neck of the gallbladder was almost difficult. Bu t the sight of choledochus circumference from the neck of the gallbladder was good, and taking forceps in and out, washing and aspiration were very easy for nothing anxiety about gas leakage, and we performed smoothly to exfoliate the neck of gallbladder, cut the choledochus, take the stones and suture the choledochus. About 81 cases of 87 cases (93.1%), we could performed operations completely by abdominal wall lifting, but 6 cases (6.9%) changed over pneumoperitoneum or laparotomy. We thought that abdominal wall lifting by laparolift was difficult about 2 cases. The handling of abdominal wall lifting by laparolift was simple and easy, and it was very useful.

収録刊行物

  • 胆道 = Journal of Japan Biliary Association

    胆道 = Journal of Japan Biliary Association 16(1), 19-25, 2002-03-25

    日本胆道学会

参考文献:  13件中 1-13件 を表示

被引用文献:  2件中 1-2件 を表示

各種コード

  • NII論文ID(NAID)
    10008363330
  • NII書誌ID(NCID)
    AN10062001
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    09140077
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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