Iindlela zonyango zonyango zanamhlanje zingabandakanyi isidingo sokwenza izinto ezinkulu, ezifezelelwe kwisixhobo esikhethekileyo - i-endoscope, kwaye ibizwa ngokuba ngoncedo olungapheliyo. I-Laparoscopy yenye yezona ntlobo eziqhelekileyo ze-endoscopy. Makhe siqwalasele, yintoni - i-laparoscopy, ngaziphi iimeko ezinokusetyenziswa.
I-Laparoscopy - yintoni na?
Ukusebenza kwizitho zangaphakathi, eziqhutywe yindlela evulekile, zidinga ukuchithwa ngaphezulu kweyodwa ukufikelela kwingqwalasela yengqondo. Imisebenzi ye-Endoscopic yenziwa ngokuhlukileyo: kuba ukufikelela emzimbeni kuyadingeka ukwenza ii-punctures ezincinci okanye ukwenze ngaphandle kokulimaza izicubu, ukuzisa i-endoscope ngeendlela zemvelo. I-endoscope yezokwelapha yiphubhu ende, ekupheleni kwayo umthombo wokukhanya uqhotyoshelweyo kunye nekhamera encinci ebonisa umfanekiso kwi-esweni. Ukongezelela kuyo, izixhobo eziyimfuneko ekusebenziseni ziziswa kwiqumrhu ngokusebenzisa iibhola ezincinci.
Utyando lwe-Endoscopic lunika uluhlu olubanzi lwemisebenzi kuyo nayiphi na indawo yeliyeza. I-Laparoscopy yindlela esebenza kwizitho zangasese kunye neengcambu. I-endoscope kule meko ibizwa ngokuba yi-laparoscope. Kukho iintlobo ezininzi ze-laparoscopy: unyango, ukuxilonga nokulawula. Ukunyanga - ukunyanzeliswa okungaphantsi kweminye, okungayigcinayo (ukulawulwa kwamachiza) okanye ugqirha. Izindlela zokuxilonga kunye nokulawula zisetyenziselwa ukubona ngeso simo imeko zangaphakathi.
Laparoscopy yokuxilonga
Ukusetyenziswa kwe-laparoscope yokuxilongwa kwinqanaba lokugqibela ekufumaneni iimeko zezilwanyana kunye nezizathu zazo kwiziganeko apho izifundo eziqhelekileyo zeklinikhi zihluleka ukwenza njalo. Ngokuqhelekileyo, le mfuneko ivela xa kuqhutyelwa ukuxilongwa ngokuhlukileyo. Ngokuqhelekileyo uvavanyo luqeshwe kunye:
- iindawo ezinobungxoworho kwisigxina esiswini, kwingingqi ye-pelvic;
- iintlungu eziqhubekayo zesifo se-genesis esingachazwanga;
- ukungabi nantlungu kunye nezizathu ezicacileyo;
- ukukrokra kokukhulelwa kwe- ectopic ;
- izifo eziphambili zokuhlinzwa zesisu esiswini kunye neempawu ezingathandabuzekiyo.
Kwiimeko ezininzi, i-laparoscopy yokuxilonga nokungabikho kwengqondo ivumela ikhulu leepesenti ukuzithemba, ukuba ugqirha uyakwazi ukubona ukuphambuka okuncinci. Ngamanye amaxesha ukusetyenziswa koxilongo kuhlanganiswe nokunyangwa ngonyango lwezinto ezibonakalisiweyo (ukususwa kweemvumi, ukubambelela, ukuchithwa kwe-endometrium engaphezulu kunye nokunye).
Iiparoscopy yokugada
Ukusebenza kwe-laparoscopic kwenziwa, njengokungathi phantsi kwe-microscope, kwaye kubonelela ngokubonakala okukhulu, kuba izixhobo ezisetyenziswayo zidala ukwanda kwamashumi amane, kwaye ngenxa yombono we-optics, ilungu eliqhutywayo lihlolwe kwii-angles ezahlukeneyo. I-Laparoscopy, njengokwenziwa kobugcisa bendabuko, inokwenziwa ngendlela ehleliweyo (umzekelo, ngokususwa kwe-bile ) okanye kube yimeko engxamisekileyo (i-laparoscopy ye-appendicitis).
Kufuneka kuqatshelwe ukuba i-laparoscopy yongenelelo eyenziwa ngokulahleka kwegazi kunye nentlungu ebuthathaka. Ngombulelo kwiincinci ezincinci, iziqholo zangemva zibonakala zingabonakali, nto ibaluleke ngakumbi kubasetyhini abaselula. Ngokungafani nemisebenzi yokuqhubela i-cavitary, i-laparoscopy ayifuni ukulaliswa kwezibhedlele ezide kunye nokuthotyelwa kokuphumla kombhede.
Iiparoscopy - izibonakaliso
Ukusebenza kwe-laparoscopy kwenziwa kwimeko elandelayo:
- ukuvuvukala kwe-gallbladder, ubukho beentsimbi kulo;
- ii-ovarian cysts;
- ukuvutha kwesihlomelo;
- i-hernia ingininal;
- hernia;
- i-hernia yokuvulwa kwe-esophageal yesithintelo;
- i-cyst yesibindi;
- ukuphazamiseka kwamathambo ;
- i-myoma uterine;
- endometriosis ;
- ukushiywa kwesisu, isondo;
- izidumbu ze-adrenal gland;
- inkqubo yokubambelela;
- ukungabikho komchamo;
- izigaba zokuqala zomhlaza;
- i-pancreatic necrosis;
- ukunyanya.
I-Laparoscopy - ingqinano yokufeza
Iingqinisiso zeLaparoscopy zilandelayo:
- puritent peritonitis;
- i-renal acute okanye i-hepatic insufficiency;
- ukuphazamiseka kanzima kokusabalalisa kwe-cerebral;
- ukuphambuka okukhulu kwimisebenzi yesifo senhliziyo okanye yokuphefumula;
- isithintelo esiswini;
- dlu liselwa kutshanje;
- ukuthotyelwa kwesantya;
- tshutshiswa;
- Inkqubo yokubambelela ebalulekileyo yeepilvis;
- i-asthma ye-bronchial kunye nokunyuka kwamaxesha amaninzi;
- ukuthintela i-anesthesia.
I-Laparoscopy - njani ukulungiselela ukuhlinzwa?
Ukuba isigulane sichazwe i-laparoscopy, indlela yokuyilungiselela ngayo, ichaza ugqirha oya kwiiyo. Ngaphambi kokusebenza, iindlela ezahlukeneyo zokuxilonga (ukuhlaziywa kwegazi kunye nomchamo, i-electrocardiogram, uvavanyo lwe-X-ray, i-ultrasound, njl.) Zidlalwa rhoqo, isigulane sibuzwa malunga nezifo ezithintelekileyo, imisebenzi, ukuphendula okuthe tye. Ukulungiselela ukungenelela kungabandakanya oku kulandelayo:
- iintsuku ezimbalwa ngaphambi kokuba i-laparoscopy - ukuthotyelwa kokutya okungaxhasi, okungekho ukusetyenziswa kwamanqatha, i-adikiweyo, iipekese, i-carbonated kunye neziyobisi;
- ukwala ukutya nokusela izure ezili-12 phambi kokuhlinzwa;
- Ukuhlanjululwa kwamathumbu ngokusebenzisa i-enema (ngaphambi kokulala okanye kusasa ngaphambi kokusebenza);
- ngosuku olumiselweyo - ukuthatha ishahla kunye nommandla wokuhlalisa, oya kusebenza.
I-laparoscopy yenziwa njani?
I-Laparoscopy, ubuchule bokusebenza obuyinkimbinkimbi, lwenziwa kuphela oogqirha abaqeqeshe kakhulu abaqeqeshekileyo. Oku kubangelwe, phakathi kokunye, kwinto yokuba kwiskrini konke ukunyakaza kunonxibelelwano oluchaseneyo, kwaye kwakha imbono ephosakeleyo yobunzulu bendawo ephathwayo. I-laparoscopist kufuneka iphumelele ngokucacileyo icandelo lobugcisa, ngokuba ngamanye amaxesha umntu kufuneka atshintshele kule nkqubo xa kuvela iingxaki okanye ubuchule buziswa.
Ngaphambi kokusebenza, isigulane sihlolwe ngu-anesthesiologist, okhetha uhlobo lwe-anesthesia. Ngokuqhelekileyo yenza i-anesthesia engapheliyo okanye i-anesthesia ehlangeneyo. Emva koko, i-pneumoperitoneum yenziwa - ukuzalisa isisu esiswini kunye negesi enikezwa ngedaliti phantsi kolawulo lokunyanzeliswa kunye nokuhamba kwexesha. Oku kuyimfuneko ukuphakamisa udonga lwesisu, ukuze usebenze, uthinte ngokuthe ngenye ezinye izitho.
Isinyathelo esilandelayo kukungeniswa kwe-trocar yokuqala (ityhubhu) ngodongeni lwesisu, apho indawo ekhethiweyo ikhethiweyo kuxhomekeke kwindawo eqhutywe kuyo. Ngalolu bhubhu i-laparoscope injected, phantsi kokulawulwa kwee-trocars ezongezelelweyo-zezixhobo. Emva kokuvavanywa ngokucokisekileyo kwezitho zangaphakathi, ukuphathwa kwezonyango kwenziwa, emva koko ukuhlamba kwintsimi yokusebenza, ukukhutshwa kwegesi, ukuthungwa kwezinto ezenziwayo kunye nokunye kwenziwa.
Cholecystectomy yaseLaparoscopic
Umsebenzi wokususa i-gallbladder, eyenziwe ngokufikelela kwe-laparoscopic, isetyenziswa kakhulu kwi-cholelithiasis kunye ne-polyps, kuthathwa njengento ekhethekileyo ukuvula ukungenelela ("imilinganiselo yegolide"). Ngokuxhomekeke kwinkimbinkimbi yimeko, i-laparoscopy ye gallbladder yenziwa ngamathathu, amane okanye amahlanu amapulctures eludongeni lwesisu. Kwezinye iimeko, kukho isidingo sokutshintshwa kwintsebenzo evulekile:
- ukungafihleki kwendawo yokusebenza yommandla;
- Ukunamathela okunamandla;
- uphuhliso lweengxaki.
Appendectomy ye Laparoscopic
Ngo kuvutha kwesithasiselo, i-laparoscopy, ubuchule obusebenza ngokugqibeleleyo, lwenziwa ngokwemiqathango elandelayo:
- i-appendicitis enkulu ngosuku lokuqala emva kokuqala kwesi sifo;
- appendicitis engapheliyo;
- ukuvuvukala okukhulu kwesithasiselo ngokudibanisa neqondo eliphezulu lokukhuluphala okanye isifo sikashukela;
- umnqweno wesigulane ukususa isihlomelo ngesindlela esincinane.
Kuzo zonke izixhobo, kuyafuneka ukuba wenze iiplctures ezintathu kwidonga lesisu, amacandelo akhethiweyo ngokuxhomekeka kwiimpawu ze-anatomiki. Lo msebenzi ungenziwa phantsi kwe-anesthesia yendawo. Imfuneko yokuya kwindawo evulekileyo ibonakala kwiimeko ezinjalo:
- ukufumana i-peritonitis;
- indawo yendawo ephezulu ye-appendix;
- ukungabikho, ukuchithwa;
- ezahlukeneyo iingxaki.
I-laparoscopy kwimizimba yezintlu
Ukuqwalasela isicelo kwi-laparoscopy ye-gynecology, kubalulekile ukuba kuqaphele ukuba le nto yindlela egcinwa ngayo kwiimeko ezininzi zokuzala: iimbindi kunye ne-myomas, i-ovari kwi-cysts, i-fallopian tubes ekukhulelwe kwe-ectopic. Ngokuqhelekileyo, kufuneka iip punctures ezincinane ezintathu kuphela, ukwenzela ukuba igalelo eliphakamileyo eliphezulu lifezekiswe.
Ngezinye izibonakaliso, i-laparoscopy kunye ne-hysteroscopy zenziwa kanyekanye. I-Hysteroscopy-manipulation, ekwazi ukuxilonga okanye yokusebenza, eyenziwa ukuhlolisisa i-uterine cavity, ukuthatha impahla ye-biopsy, unyango lwe-pathologies kwinxalenye yelungu (umzekelo, ukususwa kwe-polyps). Isixhobo sokunyanga - i-hysteroscope - ifakwe kwi-cervix. Ukudibanisa i-laparoscopy kunye ne-hysteroscopy kwandisa amathuba okuseka izizathu zeemeko zentsholongwane kunye nokupheliswa kwazo ngaphandle kwemfuneko yokusebenzisa i-anesthesia kabini.
Iingxaki ze-laparoscopy
Iingxaki ezinokwenzeka emva kwe-laparoscopy:
- umonakalo ngeempahla ze-trocar zeemithambo yegazi;
- ukuphazamiseka kwezitho zangaphakathi;
- i-hypothermia;
- ukwakheka kwe-thrombi;
- izibandezelo entliziyweni kunye neenkqubo zokuphefumula;
- kuphuma;
- ukwakheka kwamanyathelo .
Ukubuyiswa emva kwe-laparoscopy
Nangona ukuba i-laparoscopy iyindlela yokungahambi kakuhle, kwaye izigulana ziyakhululwa emva kweentsuku ezimbalwa, ezinye iingcebiso zifunekayo ukuze zikhuphe iingxaki zesikhathi eside. Ngoko, emva kwe-laparoscopy kuyimfuneko:
- Hlanganisa nokuphumla kokulala (ukusuka kwiiyure eziliqela ukuya kwiintsuku eziliqela).
- Ncitshiswe umsebenzi wokusebenza ngokomzimba kwiinyanga ezintandathu.
- Ukuhambelana nokutya okuchanekileyo okumiselwe ngugqirha.
- Qaphela ukuphumla ngokwesondo malunga neveki ezingama-2-3.
- Ukukhulelwa akufanele kucetywe ngaphambi kweenyanga ezi-6-8.