シングルポートアクセス法による婦人科腹腔鏡下手術についての検討

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  • The study on Single Port Access(SPA™)gynecologic laparoscopic surgery

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In general gynecological laparoscopic surgery using multi port technique, three trocars were placed through three separate skin incisions, for two accessory ports in addition to a monitoring port. As lower degree of invasiveness is considered to be desirable for laparoscopic surgery, we underwent Single Port Access (SPA™) utilizing a single incision at the umbilicus with multi channel port. Three 5mm trocars were all inserted thorough separate sites of the single skin incision. A 30-degree 5 mm scope was inserted through the central trocar. Utilization of a clear central long trocar allows visualization of inserting process of the lateral two trocars into the abdomen. Two additional 5 mm trocars were placed thorough separate facial entry points to make triangle port formation. The tumors were extracted with an Endo bag device by exchanging the central 5 mm trocar for a 12 mm trocar and inserting a retrieval bag. This technique allows for the entire procedure such as salpingo oohorectomy, ovarian tumor cystectomy and the other surgery, to be performed in the standard fashion similar to the multi port technique. The use of Single Port Access (SPA™) for surgery was useful for gynecologic laparoscopic surgery and improved cosmetics with only one inconspicuous incision within the umbilicus.

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