NOTESにおける至適な送気法

DOI Web Site 被引用文献1件 参考文献8件
  • 中島 清一
    大阪大学大学院医学系研究科外科学講座消化器外科学
  • 高橋 剛
    大阪大学大学院医学系研究科外科学講座消化器外科学
  • 相馬 大人
    大阪大学大学院医学系研究科外科学講座消化器外科学
  • 西村 潤一
    大阪大学大学院医学系研究科外科学講座消化器外科学
  • 西田 俊朗
    大阪大学大学院医学系研究科外科学講座消化器外科学

書誌事項

タイトル別名
  • Optimal Insufflation for Natural Orifice Translumenal Endoscopic Surgery (NOTES)
  • NOTES ニ オケル シテキナ ソウキホウ

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抄録

Natural orifice translumenal endoscopic surgery (NOTES), in its “pure” form without assistant use of any transabdominal cannulae, will require fast and steady insufflation of both intraluminal and intraabdominal spaces through a flexible gastrointestinal endoscope. The use of rapid absorptive carbon dioxide (CO2) as an insufflating agent, is strongly recommended from the initial step of NOTES, since conventional insufflation using atmospheric air may cause prolonged distension of the downstream bowel and subsequently obstruct the intraabdominal surgical exposure. A dedicated CO2 insufflator for flexible endoscope (UCR, Olympus) has recently become available in the market. The UCR, however, willnot be applicable for NOTES, since the intraabdominal pressure may be fluctuated with manual “ on-and-off” insufflation. The insufflation may be too slow to perform advanced NOTES procedures, even when using a pressure controlled surgical insufflator. This is simply because the insufflation channel of endoscope is much narrower than the standard insufflation tube. A modified insufflation system specifically designed for NOTES is therefore considered indispensable. A continuous R & D effort, together with meticulous basic/clinical research, is needed to bring this cutting edge technology in the minimally invasive patient care.

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