クマキリ　ジユン   熊切　順    所属   医学部 医学科（東京女子医科大学病院）    職種   教授
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Safe primary approach using a micro-laparoscope via the posterior vaginal fornix for patients with previous upper laparotomy: a report of five cases.
掲載誌名	正式名：The journal of obstetrics and gynaecology research 略　 称：J Obstet Gynaecol Res ISSNコード：14470756/13418076
掲載区分	国外
巻・号・頁	36(1),pp.195-8
著者・共著者	Kumakiri Jun†*, Takeuchi Hiroyuki, Kitade Mari, Kikuchi Iwaho, Kumakiri Yuko, Kuroda Keiji, Jinushi Makoto, Takeda Satoru
担当区分	筆頭著者,責任著者
発行年月	2010/02
概要	In order to reduce the risk of visceral injury for patients with upper abdominal adhesions, we devised an alternative to the umbilical approach. Five patients who had undergone a previous upper abdominal laparotomy and were scheduled for gynecologic laparoscopic surgeries at our hospital were evaluated. A micro-trocar was inserted via the posterior vaginal fornix and the periumbilicus was observed using a micro-laparoscope inserted in the micro-trocar. A trocar for conventional laparoscopy was inserted into the umbilicus under micro-laparoscopic observation in the cul-de-sac to avoid visceral organ adherent to the periumbilicus. Four cases had adhesions of the transverse colon, small bowel or omentum to the upper abdomen due to previous surgery; however, we were able to accomplish laparoscopic surgery without injury to adhesive organs in all patients. The micro-laparoscopic primary approach via the posterior vaginal fornix is a safe primary approach for patients who have undergone a previous upper abdominal laparotomy.
DOI	10.1111/j.1447-0756.2009.01095.x
PMID	20178551