Njira zamakono zamakono zochiritsira zimaphatikizapo kufunika kochita zinthu zazikulu, zomwe zimatheka chifukwa cha chipangizo chapadera - chotchedwa endoscope, ndipo amatchedwa thandizo lotere. Laparoscopy ndi imodzi mwa mitundu yambiri ya endoscopy. Tiyeni tione, ndi chiyani - laparoscopy, m'zochitika ziti zomwe zingagwiritsidwe ntchito.
Laparoscopy - ndi chiyani?
Ntchito zogwiritsira ntchito ziwalo za mkati, zomwe zimayendetsedwa ndi njira yotseguka, zimafuna zambiri kuti zithetse vutoli. Ntchito zotsiriza zimagwiritsidwa ntchito mosiyana: kuti munthu apite kuchipatala amayenera kupanga punctures zing'onozing'ono kapena kuchita popanda kuvulaza minofu, poyambitsa mapeto ake pogwiritsa ntchito njira zachirengedwe. Endoscope yachipatala ndi phukusi lalitali, pamapeto pake komwe gwero lamakono likugwirizanitsidwa ndi kamera kakang'ono kamene kamasonyeza chithunzi pazeng'onoting'ono. Kuphatikiza apo, zipangizo zoyenera pa ntchito zimabweretsedwa ku limba kudzera m'mapapu abwino.
Kuchita opaleshoni yoperewera kumapereka ntchito zosiyanasiyana mmadera alionse a zamankhwala. Laparoscopy ndi njira yomwe imagwirira ntchito m'mimba ndi m'mimba. Endoscope mu nkhaniyi imatchedwa laparoscope. Pali mitundu yambiri ya laparoscopy: zachipatala, zogonana ndi zowonongeka. Kuchiza - kusokoneza kochepa, komwe kungakhale kosamalitsa (mankhwala a mankhwala) kapena opaleshoni. Njira zogwiritsira ntchito ndi zowonetsera zimagwiritsidwa ntchito kuti ziwonekere momwe ziwalo za thupi zimakhalira.
Kufufuza kwa laparoscopy
Kugwiritsiridwa ntchito kwa laparoscope kuti azindikire ndilo gawo lomalizira pakuzindikira za matenda ndi zifukwa zomwe zimapangitsa kuti maphunziro ochiritsira achilendo alephera. Kawirikawiri, izi zimafunika pochita zosiyanitsa. Kawirikawiri phunziro limasankhidwa ndi:
- ziphuphu pamimba pamimba, dera lamapiri;
- matenda opweteka osapitirira a majeremusi osadziwika;
- kusabereka ndi zifukwa zomveka;
- kusinkhasinkha kwa ectopic mimba ;
- Matenda opatsirana opaleshoni a m'mimba ndi zizindikiro zokayikitsa.
Kawirikawiri, matenda a laparoscopy omwe ali ndi infertility amachititsa kuti munthu akhale ndi chidaliro chokwanira kuti adziwe, popeza dokotala amatha kuona zochepa chabe. Nthaŵi zina machitidwe opatsirana amatha kuphatikizapo opaleshoni ya mankhwala omwe amavumbulutsidwa (kuchotsa zotupa, kulumikizana, kusakanikirana ndi endometrium yambiri ndi zina zotero).
Opaleshoni ya Laparoscopy
Zochita za laparoscopic zikuchitika, ngati kuti zili pansi pa microscope, ndipo zimawoneka bwino, chifukwa zipangizo zomwe amagwiritsidwa ntchito zimapanga kuwonjezeka kwa makumi anayi, ndipo chifukwa cha optics, bungwe loyendetsa ntchito limayang'aniridwa pamagulu osiyanasiyana. Laparoscopy, monga njira yachikhalidwe, ikhoza kuchitidwa mwadongosolo (mwachitsanzo, kuchotsa bile ) kapena kukhala mwadzidzidzi (laparoscopy of appendicitis).
Tiyenera kukumbukira kuti laparoscopy ndizochita zomwe zimachitidwa ndi kuchepa kwa magazi komanso zofooka. Chifukwa cha zochepa zomwe zimachitika, zipsinjo za postoperative sizioneka zosaoneka, zomwe ndizofunikira makamaka kwa atsikana. Mosiyana ndi ntchito zogwiritsira ntchito magetsi, laparoscopy sikutanthauza kuti munthu azikhala m'chipatala kwa nthawi yayitali komanso kuti azitsatira bedi.
Laparoscopy - zizindikiro
Kugwiritsidwa ntchito kwa laparoscopy kumachitika pazifukwa zotsatirazi:
- kutupa kwa ndulu, kukhalapo kwa concrete mmenemo;
- ovarian cysts;
- kutukusira kwa zowonjezereka;
- hernia wa inguinal;
- umbilical hernia;
- chiphuphu cha kutsegula kwa mimba;
- khungu la chiwindi;
- kuthandizidwa kwa miyendo yamoto ;
- uterine myoma;
- endometriosis ;
- kuchotsa chiberekero, umaliseche;
- malonda a adrenal;
- ndondomeko yomatira;
- chotsitsa;
- magawo oyambirira a khansa;
- pancreatic necrosis;
- kunenepa kwambiri.
Laparoscopy - zotsutsana ndi zochitika
Zovomerezeka za laparoscopy ndi izi:
- purulent peritonitis;
- chiwindi chodzidzimutsa kapena kusowa kwapadera;
- kusokonezeka kwakukulu kwa kufalikira kwa ubongo;
- Kusiyanitsa kwakukulu mu ntchito ya mtima kapena kupuma;
- matumbo a m'mimba;
- ntchito yotsegulidwa posachedwa;
- kuchepetsa kutaya;
- kuwopsya kwa magazi;
- ndondomeko yowonjezera ya pelvic;
- mphumu yamphuno yowonongeka;
- zovuta kwa anesthesia.
Laparoscopy - kukonzekera opaleshoni?
Ngati wodwala atchulidwa laparoscopy, angakonzekere bwanji, akufotokoza dokotala yemwe akupezekapo. Asanayambe kugwira ntchito, njira zosiyanasiyana zoyeretsera (magazi ndi mkodzo kusanthula, electrocardiogram, X-ray kupima, ultrasound, etc.) nthawi zambiri zimachitidwa, wodwala amafunsidwa za matenda, osagwira ntchito, osokonezeka. Kukonzekera kuchitapo kanthu kungaphatikizepo zotsatirazi:
- masiku angapo asanathenso kupopera mankhwalawa - kutsatira zakudya zopanda mafuta, zomwe sizikuphatikizapo kudya mafuta, zokazinga, maswiti, carbonated ndi zakumwa zoledzeretsa;
- kukana kudya ndikumwa maola 12 asanachitire opaleshoni;
- kuyeretsa matumbo kudzera mu enema (musanayambe kugona kapena m'mawa musanagwire ntchito);
- pa tsiku lokhazikitsidwa - kutenga malo osambira ndi malo osokoneza, omwe adzagwiritsidwe ntchito.
Kodi laparoscopy imachitidwa bwanji?
Laparoscopy, njira yopangira zinthu zovuta, imangopangidwa ndi madokotala odziwa bwino kwambiri omwe adziphunzira bwino. Izi ziyenera, mwa zina, kuti pawindo mawonekedwe onse ali ndi zosiyana, komanso amapanga malingaliro opotoka a kukula kwa malo ochiritsidwa. The laparoscopist ayenera kumvetsetsa bwino njirayi, chifukwa nthawi zina munthu ayenera kusintha njirayi pamene mavuto amayamba kapena njira imabweretsa.
Asanayambe opaleshoni, wodwalayo amafufuzidwa ndi munthu wodwalayo, yemwe amasankha mtundu wa anesthesia. Kawirikawiri ankachitidwa ndi anesthesia kapena anesthesia. Kenaka, pneumoperitoneum imagwiritsidwa ntchito - kudzaza mimba pamimba ndi mpweya womwe umaperekedwa kudzera mu singano yomwe ikulamulidwa ndi mphamvu ndi kuthamanga msangamsanga. Izi ndizofunika kuti mukwezere khoma la m'mimba, kuti muthe kugwira ntchito, kukhudza ziwalo zina.
Gawo lotsatira ndilo kuyambika kwa galimoto yoyamba (chubu) kupyolera mu khoma la m'mimba, kumene malo osungirako malo amasankhidwa malingana ndi malo omwe liwalo likugwiritsidwira ntchito. Kupyolera mu chubu ichi, laparoscope imayikidwa, pansi pa zomwe magalimoto ena amabweretsa-kwa zida. Pambuyo pofufuza bwinobwino ziwalo zamkati, mankhwala amachitidwa, pambuyo pake kutsuka kwa malo ogwiritsira ntchito, kutulutsa mpweya, kusoka kwa zofunikila ndi zina zotero zikuchitika.
Cholecystectomy ya laparoscopic
Opaleshoni yochotsa ndulu, yomwe imagwiritsidwa ntchito kudzera mu laparoscopic, imagwiritsidwa ntchito kwambiri mu cholelithiasis ndi polyps, yomwe imaganiziridwa kukhala yabwino kutsegula ("golide"). Malingana ndi zovuta za mkhalidwewu, laparoscopy ya ndulu imapangidwa kudzera m'matumba atatu, anayi kapena asanu. Nthawi zina, pamakhala kusintha kwa ntchito yotseguka:
- kuwonongeka kwa chilengedwe cha malo opitilira;
- kulumikizana mwamphamvu;
- kukula kwa mavuto.
Laparoscopic appendectomy
Ndi kutukusira kwazowonjezereka, laparoscopy, njira yomwe imagwiritsidwa bwino bwino, ikuchitidwa molingana ndi zizindikiro zotsatirazi:
- Kuchulukitsa kwambiri tsiku loyamba chiyambireni matendawa;
- chithandizo chamakono;
- kutupa kwakukulu kwazowonjezereka kuphatikizapo kuchuluka kwa kunenepa kwambiri kapena matenda a shuga;
- chokhumba cha wodwalayo kuchotsa choonjezera ndi njira yofatsa.
Pogwiritsa ntchito njira zonse, zimayenera kupanga katatu m'mimba mwa m'mimba, mfundo zomwe zimasankhidwa malinga ndi zomwe zimachitika m'matumbo. Opaleshoniyi ikhoza kuchitidwa pansi pa anesthesia. Kufunika kochita ntchito yotseguka kumawonekera pazochitika zoterezi:
- kuzindikira kwa peritonitis;
- malo apamwamba a zowonjezereka;
- kupuma, kupotoza;
- zovuta zosiyanasiyana.
Laparoscopy m'maganizo a amai
Poganizira mmene ntchitoyi imayendera m'maganizo a amayi omwe ali ndi matenda opatsirana pogonana, tiyenera kuzindikira kuti izi ndi njira yomwe nthawi zambiri imateteza ziwalo zoberekera: chiberekero ndi myomas, mazira m'magazi, mazira a ectopic pregnancy. Kawirikawiri, timangoti tizilombo tating'ono ting'ono timene timayenera, kuti chotsitsika chokwera chimakwaniritsidwe.
Ndi zizindikiro zina, laparoscopy ndi hysteroscopy zikuchitidwa panthawi imodzi. Kugwiritsira ntchito mankhwala osokoneza bongo, omwe amatha kudziŵa kapena kugwira ntchito, amachitidwa kuti aunike chiwalo cha uterine, atenge mankhwala, asamalire mbali ya chiwalo ichi (mwachitsanzo, kuchotsa mapuloteni). Chipangizo chogwiritsira ntchito - nthenda yotchedwa hysteroscope - imayikidwa kudzera m'chiberekero. Kuphatikiza kwa laparoscopy ndi hysteroscopy kumaphatikizapo mwayi wothetsera zifukwa zomwe zimayambitsa matenda ndi kuthetsa kwawo popanda kugwiritsa ntchito anesthesia kawiri.
Zovuta za laparoscopy
Zingakhale zovuta pambuyo pa laparoscopy:
- kuwonongeka ndi zitsulo za trocar za mitsempha ya magazi;
- kupweteka kwa ziwalo;
- chithandizo;
- mapangidwe a thrombi;
- zovuta mu mtima ndi dongosolo la kupuma;
- magazi;
- kupanga mapangidwe.
Kubwezeretsa pambuyo pa laparoscopy
Ngakhale kuti laparoscopy ndi njira yowonongeka, ndipo odwala amatha kumasulidwa patatha masiku angapo, zina zowonjezera zimafunika kuti tipewe mavuto aakulu. Choncho, pambuyo pa laparoscopy ndikofunikira:
- Gwiritsani ntchito mpumulo wogona (kuchokera maola angapo kufikira masiku angapo).
- Onetsetsani kuchita zochitika zapakhomo kwa miyezi isanu ndi umodzi.
- Gwiritsani ntchito zakudya zoyenera zomwe adokotala adalonjeza.
- Onetsetsani mpumulo wogonana kwa milungu iwiri.
- Mimba sayenera kukonzedwa kale kuposa miyezi 6-8.