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The Laser Bipolar Dissector(LBD, SLT Japan, Co., Ltd.) hemostatically cut through veins up to 5 mm and arteries up to 3 mm in diameter. The interluminal bursting pressure was above 346 mm Hg after transection. It was clear during laparoscopic procedure that avoiding rebleeding was necessary to observe the operative goals. This report describes the use of the LBD that was attached to a newly developed Kelly clamb to perform a laparoscopic splenectomy. The LBD hemostatically cut the short gastric vessels and the vessels in the attaching ligaments of spleen without clipping. In the LBD procedure, one action, in which the laser energy is initiated through the bipolar probes with simultaneous compression of vessel with them, is necessary to accomplish the transection of vessels. Because the goal of laparoscopic surgery is to be a minimum of operative techniques, it i s therefore reasonable to attempt to use the LBD in laparoscopic surgery. I.緒 言 近年、急速に普及 した腹腔鏡下手術では血管 を安全かっ確実に処理することが手術のポイン トである。現在行なわれている血管処理には(1) 糸 ・クリップを用いるもの、(2)高周波電流を用 いるもの(電 気メス)、(3)レ ーザーを用いるも の、(4)超音波振動による摩擦熱を利用 したもの (ハーモニ ックスカルペル)な どがあるが、出 血を最小限にするための新 しい周辺機器の開発 が望まれている。 レーザーバイポラダイセクタ ー(以 下、LBDと 略す)は ピンセッ ト型をし たNd:YAGコ ンタク トレーザー(波 長1064nm)で

The Effectiveness of the Nd: YAG Laser Bipolar Dissector in Laparoscopic Surgery