Intraoperative Management of Right Diaphragmatic Endometriosis during Laparoscopic Partial Resection of Liver Segment 8

Shota Ikeda, Tomokazu Tanaka, Kotaro Ito, Takao Ide, Hirokazu Noshiro
In: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) · 2024 · vol. 85(1) , pp. 88–92 · doi:10.3919/jjsa.85.88 · W4401106060
article OA: diamond CC0
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-11 ⓘ

This report details the intraoperative management of diaphragmatic endometriosis during laparoscopic liver resection, addressing challenges posed by paradoxical diaphragm movement due to multiple small holes.

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Abstract

患者は71歳，女性．肝細胞癌S8病変に対して腹腔鏡下肝S8部分切除を予定した．肝右葉と横隔面の癒着剥離中に右横隔膜の奇異性運動が起こり，横隔膜面に右肺が視認されるメッシュ状の多数の小孔が確認され，横隔膜の胸腔子宮内膜症と診断した．奇異性運動のため安定した気腹状態が保てず手術操作が困難であったため，小孔を湿潤ガーゼで被覆，適助手鉗子で頭側へ圧排して術野を確保し，手術終了時に小孔へPGAシートを貼付した．横隔膜の胸腔子宮内膜症による小孔のため横隔膜の奇異性運動が起こり，術野維持が困難であった腹腔鏡下肝切除症例の報告はこれまでになく，術中の問題点や対処について，文献的考察を含めて報告する．

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Condition tags

endometriosisthoracic_endometriosis

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last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK