The abdominal cavity is usually observed by insertion of a
12mm trocar into the umbilical part, and 5mm trocars
into the left abdomen and the suprapubic region, and
pneumoperitoneum. In the case that the appendix can
not be detached by laparoscopic instruments due to high
adhesion to the retroperitoneum, a 12mm trocar is
additionally inserted immediately above the appendix at
the right abdomen for appendicitis which the wall of the
appendix is probably damaged by the laparoscopic
instrument due to embrittlement. The trocar is removed,
the right second finder is inserted, the appendix is
laparoscopically detached, and mobilization is conducted.
腹腔は通常12mmのトロカールを臍部に、5mmのトロカールを左側腹部・恥骨上部に挿入し、気腹することで観察する。虫垂が腹膜後腔に高度癒着し腹腔鏡等による剥離が不可能である場合、脆化し腹腔鏡等で虫垂壁を損傷するおそれのある虫垂炎には、右側腹部虫垂上に12mmのトロカールを即時に追加挿入する。このトロカールを抜去し右示指を挿入し、腹腔鏡を用いて虫垂を剥離し、受動を行う。
