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-Report on Experiments and Clinical Cases-
Use of an Endoscopic Surgical Spacer during Laparoscopic Pancreatic Tumor Enucleation
1Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School
2HOGY MEDICAL Co., Ltd.
A number of recent reports have highlighted the usefulness of laparoscopic surgery for pancreatic surgery; however, the procedure is not yet standard because of its technical challenges. Using an endoscopic surgical spacer (SECUREATM) that we developed, we performed laparoscopic enucleation of a pancreatic tumor in a patient with pancreatic mucinous cystadenoma. The SECUREA is a polyurethane sponge with a radiopaque marker. It is elliptic-cylindrical and measures 6.5 cm on the major axis, 3.5 cm on the minor axis, and 2 cm in height. Herein, we report the intraoperative findings and examine the usefulness of SECUREA for laparoscopic enucleation. The spacer was introduced into the abdominal cavity through a 12-mm trocar, and was grasped with forceps to isolate or extend organs and tissues, thereby ensuring a safe and relatively uncontaminated surgical field. In addition, the high absorptiveness and water-holding capacity of the sponge facilitated removal of exudate, which created a clearer operative field and reduced the technical challenges of drainage manipulation. Indeed, replacement of the sponge was unnecessary because it returned to its original state after the liquid it contained had been aspirated. Our findings suggest that the SECUREA increases safety and reduces the technical difficulties of laparoscopic enucleation.
J Nippon Med Sch 2010; 77: 106-110
Keywords
surgical spacer, sponge, laparoscopic pancreatic tumor enucleation, laparoscopic surgery, endoscopic surgery
Correspondence to
Yoshiharu Nakamura, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
keishun@nms.ac.jp
Received, November 24, 2009
Accepted, December 18, 2009
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