臍部における腹壁の厚さの検討

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書誌事項

タイトル別名
  • Safe Laparoscopic Entry
  • Analysis of Umbilical Thickness for Primary Port Entry
  • ～腹腔鏡下手術における安全なアプローチ法を目指して～

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説明

Blind insertion of the Veress needle and of the first trocar is a significant cause of complications in laparoscopic surgery. Despite this risk, the closed technique is more popular than the open technique. The aim of this study was to determine the thickness of abdominal wall at the umbilicus for more safety entry into the abdominal cavity. We retrospectively studied 253 patients who underwent laparoscopic gynecologic surgery between September 2006 and December 2007.<BR>The thickness of the abdominal wall was measured intra-operatively. We then determined the relationship between the thickness of the abdominal wall and the BMI. The mean thickness of abdominal wall was 15.2 ± 5.6 mm. There was no significant correlation between the thickness of the abdominal wall and the BMI.<BR>It has generally been thought that the entry of the first trocar from the umbilical area is comparatively safe. However, blind entry may cause serious vascular injuries. Our data suggest that there was no significant correlation between the thickness of the abdominal wall and the BMI, so caution should be exercised with trocar insertions when the abdominal wall exceeds 30 mm.

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