腹腔鏡内視鏡合同手術（Laparoscopy and Endoscopy Cooperative Surgery；LECS） を施行したＳ状結腸膀胱瘻の1例

We performed laparoscopic and endoscopic cooperative surgery (LECS) for partial colectomy with partial cystectomy in an 80-year-old woman with sigmoidovesical fistula secondary to sigmoid diverticulitis. LECS was designed for local resection of the stomach for gastric submucosal tumors using the endoscopic submucosal dissection (ESD) technique. While conventional open abdominal surgery is very invasive, LECS has enabled surgeons to perform minimally invasive surgery. Although there have been no reported cases in which the bladder was laparoscopically resected after sigmoidovesical fistula division, we were able to safely resect the fistula and preserve the urethral opening by performing laparoscopic and cystoscopic cooperative surgery. There are no previously reported cases in which LECS was performed for partial sigmoidectomy and partial cystectomy ; therefore, we report this as a valuable case, with a review of the literature. We hope that further studies involving more patients will lead to the establishment of this procedure.