Izindlela zokwelashwa zanamuhla zokufaka ukwelashwa azifaki isidingo sokwenza izinto ezinkulu, okutholakala ngenxa yedivayisi ekhethekile - i-endoscope, futhi ibizwa ngokuthi ukungenelela okuphela kwesikhathi. I-laparoscopy ingenye yezinhlobo ezivame kakhulu ze-endoscopy. Ake sicabangele, siyini - i-laparoscopy, yiziphi izimo ezingasetshenziswa.
I-Laparoscopy - iyini?
Ukusebenza ezingxenyeni zangaphakathi, ezenziwa ngendlela evulekile, kudinga ukufakwa okungaphezu kokukodwa ukufinyeleleka ekugxilweni kwezempilo. Ukusebenza kwe-Endoscopic kwenziwa ngokuhlukile: ukuze kufinyeleleke emzimbeni kuyadingeka ukuba wenze ama-punctures amancane noma wenze ngaphandle kokulimaza izicubu, ukwethula i-endoscope ngokusebenzisa izindlela zemvelo. I-endoscope yezokwelapha iyishubhu elide, ekugcineni lapho kutholakala khona umthombo wokukhanya kanye nekhamera encane ebonisa isithombe kumqapha. Ngaphezu kwalokho, izinsimbi ezidingekayo ekusebenzeni zilethwa esithombeni ngokusebenzisa amashubhu amancane.
Ukuhlinzeka okungapheliyo kunikeza ububanzi obuningi bokusebenza kunoma iyiphi insimu yemithi. I-laparoscopy iyindlela esebenzayo ezithombeni zesisu nesisu. I-endoscope kulokhu ibizwa ngokuthi i-laparoscope. Kunezinhlobo eziningana ze-laparoscopy: ukwelashwa, ukuxilongwa nokulawula. Ukwelashwa - ukuxhaphazwa okuncane okungenasidingo, okungahle kube yilapho (ukuphathwa kwemithi) noma ukuhlinzwa. Amasu wokuhlola nokulawula asetshenziselwa ukubona ngeso lengqondo isimo sezitho zangaphakathi.
I-laparoscopy yokuxilonga
Ukusetshenziswa kwe-laparoscope yokuxilongwa kuyisigaba sokugcina ekutholeni izimo zokugula kanye nezimbangela zabo ezimweni lapho izifundo ezivamile zemitholampilo zihluleka ukwenza kanjalo. Ngokuvamile, lokhu kudingekile uma kutholakala ukuhlonza okuhlukile. Ngokuvamile isifundo sikhethwe nge:
- ukwakheka kwesisu emgodini wesisu, esifundeni sesifuba;
- izinkinga zokuphikisana eziqhubekayo zengqondo engacacisiwe;
- ukungabi nalutho ngezimbangela ezicacile;
- ukusola nge- ectopic pregnancy ;
- izifo ezithathelwanayo eziphuthumayo zesikhumba esiswini ngezimpawu zokungabaza.
Ezimweni eziningi, i-laparoscopy yokuxilonga ene-infertility ivumela ukuzethemba okungamaphesenti angama-100 ukuthi ihlolwe, njengoba udokotela ekwazi ukubona ukuphambana okuncane. Ngezinye izikhathi ukuxhaphazwa kokuxilongwa kuhlanganiswa nokuhlinzeka ukwelashwa kwe-pathologies eveziwe (ukususwa kwezicubu, ukunamathela, ukungaziqondi nge-endometrium egcwele nokunye).
I-Laparoscopy yokuhlinzeka
Ukusebenza kwe-laparoscopic kwenziwa, njengokungathi ngaphansi kwe-microscope, futhi kuhlinzeke ukubonakala okukhulu, ngoba imishini esetshenzisiwe yenza ukwanda kwamashumi amane, futhi ngenxa ye-optics, isitho esisebenzayo sihlolwe ngama-angles ahlukene. I-laparoscopy, njengendlela yendabuko, ingenziwa ngendlela ehleliwe (isibonelo, nokususwa kwe-bile ) noma kube yizimo eziphuthumayo (laparoscopy of appendicitis).
Kumele kuqashelwe ukuthi i-laparoscopy yindlela yokungenelela eyenziwa ngokulahlekelwa kwegazi okuncane kanye nobuhlungu obuthakathaka. Ngenxa yokucubungula okuncane kunazo zonke, amacembe emva kokusebenza ayabonakali, okubaluleke kakhulu kwabasikati abasebasha. Ngokungafani nokusebenza kwe-cavitary, i-laparoscopy ayidingi ukuhlala esibhedlela isikhathi eside nokuhambisana nokuphumula kombhede.
I-Laparoscopy - izinkomba
Ukusebenza kwe-laparoscopy kwenziwa kulezi zimo ezivamile:
- ukuvuvukala kwe-gallbladder, ukutholakala kwezithako kulo;
- ama-cysts ovarian;
- ukuvuvukala kwesithasiselo;
- hernia inguinal;
- hernia umbilical;
- i-hernia yokuvulwa kwe-esophageal ye-diaphragm;
- i-cyst yesibindi;
- ukuvinjelwa kwamatayipi okulala ;
- uterine uterine;
- i-endometriosis ;
- ukushiywa kwesibeletho, isisu;
- izidumbu ze-adrenal gland;
- inqubo yokunamathisela;
- ukungabikho komchamo;
- izigaba zokuqala zomdlavuza;
- i-necrosis ye-pancreatic;
- ukukhuluphala.
I-Laparoscopy - ukungqubuzana kokusebenza
Ukuphikisana kwe-Laparoscopy kunalokhu okulandelayo:
- i-peritonitis ye-purulent;
- u-renal ojulile noma ukungakwazi ukusebenza kwe-hepatic;
- ukuphazamiseka okukhulu kokusakaza kwe-cerebral;
- ukwephulwa okukhulu emisebenzini ye-cardiac noma uhlelo lokuphefumula;
- ukuvimbela emathunjini;
- idluliselwe imisebenzi esanda kuvulwa;
- ukukhulelwa kwesikhathi;
- ukuphazamiseka okukhulu;
- inqubo ebalulekile yokunamathela kwesikhumba;
- i-asthma ye-bronchial ne-exacerbations ejwayelekile;
- ukungahambi kahle kwe-anesthesia.
I-Laparoscopy - indlela yokulungiselela ukuhlinzwa?
Uma isiguli sinikezwe i-laparoscopy, singayilungiselela kanjani, kuchaza udokotela oya khona. Ngaphambi kokuhlinzwa, ukuhlukumeza okuhlukahlukene (ukuhlaziywa kwegazi kanye nomchamo, i-electrocardiogram, ukuhlolwa kwe-X, i-ultrasound, njll.) Kuvame ukwenza, isiguli sibuzwa ngezifo ezidlulisiwe, ukusebenza, ukubhekana nokugula. Ukulungiselela ukungenelela kungafaka lokhu okulandelayo:
- ezinsukwini ezimbalwa ngaphambi kwe-laparoscopy - ukuhambisana nokudla okungena-slag, okungabandakanyi ukusetshenziswa kwamanoni, okugcoziwe, amaswidi, iziphuzo ezidakayo nezidakwa;
- ukwenqaba ukudla nokuphuza amahora angu-12 ngaphambi kokuhlinzwa;
- Ukuhlanzwa kwamathumbu nge-enema (ngaphambi kokulala noma ekuseni ngaphambi kokusebenza);
- ngosuku olunqunywe - ukuthatha indawo yokugeza nesimo sokuthutha, okuzosebenza.
I-laparoscopy yenziwa kanjani?
I-laparoscopy, inqubo yokwenza okuyinkimbinkimbi, yenziwa kuphela odokotela abaqeqeshelwe kakhulu abaqeqeshiwe abaye baqeqeshwa ngokukhethekile. Lokhu kubalulekile, phakathi kokunye, ukuthi esibukweni konke ukunyakaza kunomqondo ohlukile, futhi kudala umbono ophikisayo wokujula kwendawo ephathwayo. I-laparoscopist kufanele ikwazi ukuqonda kahle ikhono lezinsika, ngoba ngezinye izikhathi umuntu kufanele aguqule kule nqubo uma kuphakama izinkinga noma inqubo ihanjiswa.
Ngaphambi kokuhlinzwa, isiguli sihlolwe yi-anesthesiologist, ekhetha uhlobo lwe-anesthesia. Ngokuvamile kwenziwa i-anesthesia endotracheal noma i-anesthesia ehlangene. Okulandelayo, i-pneumoperitoneum yenziwa - ukugcwalisa isigxobo esiswini ngegesi enikezwa ngendlwana ngaphansi kokulawulwa kwengcindezi nokuhamba kwegeyimu. Lokhu kuyadingeka ukuphakamisa udonga lwesisu, ukuze usebenze, uthinte kancane ezinye izitho.
Isinyathelo esilandelayo yisingeniso se-trocar yokuqala (ithubhu) ngodonga lwesisu, lapho indawo yokuhlanza ikhethwe khona ngokuya kwendawo esetshenziswa ngayo. Ngalesi tube i-laparoscope ijojowe, ngaphansi kokulawulwa kwezintambo ezengeziwe-zezinsimbi. Ngemva kokuhlolwa ngokucophelela kwezitho zangaphakathi, ukuphathwa kwezokwelapha kwenziwa, emva kwalokho ukuhlanzwa kwensimu yokusebenza, ukukhululwa kwegesi, ukuthunga kwezingxoxo nokunye okunjalo kwenziwa.
Cholecystectomy ye-Laparoscopic
Ukusebenza ukukhipha i-gallbladder, eyenziwe ngokusebenzisa i-laparoscopic, isetshenziselwa kabanzi ku-cholelithiasis ne-polyps, kubhekwa njengokukhetha ukuvula ukungenelela ("izinga legolide"). Kuncike ebuchosheni besimo, i-laparoscopy ye-gallbladder yenziwa ngamapultures amathathu, amane noma amahlanu emdongeni wesisu. Kwezinye izimo, kunesidingo sokushintshela ekusebenzeni okuvulekile:
- ukungafihli komzimba wesifunda osebenzayo;
- ukunamathela okunamandla okunamathela;
- ukuthuthukiswa kwezinkinga.
Appendectomy ye-Laparoscopic
Ngokuvuvukala kwesithasiselo, i-laparoscopy, inqubo eyenziwe ngokugcwele, yenziwa ngokusho kweziqondiso ezilandelayo:
- i-appendicitis enkulu ngosuku lokuqala emva kokuqala kwesifo;
- appendicitis engapheliyo;
- ukuvuvukala okukhulu kwesithasiselo ngokuhambisana nesilinganiso esiphakeme sokukhuluphala noma isifo sikashukela;
- isifiso sesiguli sokususa isithasiselo ngendlela elula.
Kuzo zonke izindlela zokubambisana, kudingeka ukuba wenze amaphuzu amathathu emdongeni wesisu, amaphuzu akhethiwe kuye ngezici zesimo. Lo msebenzi ungenziwa ngaphansi kwe-anesthesia yendawo. Isidingo sokuya emsebenzini ovulekile sibonakala ezimweni ezinjalo:
- ukutholakala kwe-peritonitis;
- indawo esesidlangalaleni yesithasiselo;
- i-abscess, i-perforation;
- izinkinga ezihlukahlukene.
I-laparoscopy ekuguleni kwegazi
Uma sicabangela isicelo ensimini ye-laparoscopy yobunjane, kufanele kuqaphele ukuthi lokhu kuyindlela yokwelapha izitho zokubeletha ezimweni eziningi: isibeletho esinama-myomas, ama-ovari ema-cysts, amashubhu ama-fallopian ekukhulelweni kwe-ectopic. Ngokuvamile, kuyadingeka amaphuzu amancane amathathu kuphela, ukuze kutholakale umonakalo omkhulu wezithokozi.
Ngezinye izinkomba, i-laparoscopy ne-hysteroscopy zenziwa ngesikhathi esisodwa. Ukuxhaphazwa kwe-hysteroscopy, okungatholakala ukuxilongwa noma ukusebenza, kwenziwa ukuze kuhlolwe i-uterine cavity, ukuthatha impahla ye-biopsy, ukuphatha i-pathologies engxenyeni yalesi sitho (isibonelo, ukususwa kwe-polyps). Idivaysi yokuxhaphaza - i-hysteroscope - ifakwe emlonyeni wesibeletho. Ukuhlanganiswa kwe-laparoscopy kanye ne-hysteroscopy kwandisa amathuba okusungula izimbangela zezimo ze-pathological kanye nokuqedwa kwazo ngaphandle kwesidingo sokusebenzisa i-anesthesia kabili.
Izinkinga ze-laparoscopy
Izinkinga ezingenzeka emva kwe-laparoscopy:
- ukulimala kwemikhumbi ye-trocar yemithambo yegazi;
- ukuguqulwa kwamalungu angaphakathi;
- i-hypothermia;
- ukwakheka kwe-thrombi;
- ukuphazamiseka enhliziyweni nasesimweni sokuphefumula;
- ukuphuma kwegazi;
- ukwakheka kokunamathela .
Ukubuyiswa ngemuva kwe-laparoscopy
Naphezu kokuthi i-laparoscopy iyindlela yokwelapha encane, kanti iziguli zingasuswa emva kwezinsuku ezimbalwa, ezinye izincomo ziyadingeka ukuze zigweme izinkinga zesikhathi eside. Ngakho, emva kwe-laparoscopy kuyadingeka:
- Landela ukuphumula kombhede (kusuka emahoreni ambalwa kuya ezinsukwini ezimbalwa).
- Nciphisa umsebenzi womzimba izinyanga ezingu-6.
- Ukunamathela ekudleni okunembile okushiwo udokotela.
- Qaphela ukuphumula ngokobulili amasonto angu-2-3.
- Ukukhulelwa akufanele kuhlelwe ngaphambi kwezinyanga ezingu-6-8.