Nzira dzekuvhiya dzemazuva ano dzekurapa dzinongobvisa kukosha kwekuita zvinhu zvakakura, izvo zvinogadziriswa nekuda kwechigadzirwa chakakosha - endoscope, uye yakadana maitiro akadai endoscopic. Laparoscopy ndeimwe yemhando dzakawanda zvikuru dzekupedzisira. Ngationei, chii ichocho-laparoscopy, mune zviitiko zvipi zvinogona kushandiswa.
Laparoscopy - chii ichocho?
Kushanda kune nhengo dzomukati, kunotungamirirwa nenzira yakasununguka, kunoda kudarika imwechete kwekutsvaga kusvika pakuisa pfungwa. Endoscopic maitiro anoshandiswa zvakasiyana-siyana: kuti kuwanika mumuviri kunofanirwa kuita madiki punctures kana kuita zvakakwana pasina kukuvadza mishonga, kuunza endoscope kuburikidza nemakwara evanhu. Izvozvo zvinonzi endoscope yehutano ndeyeiyo yakareba tube, pamagumo ayo chiedza chechiedza chinosungirirwa uye micro-kamera inoratidza chifananidzo pane chekuona. Pamusoro pazvo, zvishandiso zvinodiwa pakuvhiya zvinounzwa kune nhengo kuburikidza nehutete tubha.
Kuvhiyiwa kwenguva refu kunopa maitiro akasiyana-siyana emabasa mune imwe nzvimbo yemishonga. Laparoscopy inzira inoshandiswa kumakumbo uye nhengo dzemuviri. Endoscope munyaya iyi inonzi laparoscope. Kune mhando dzakasiyana-siyana dze laparoscopy: kurapwa, kuongorora uye kutonga. Kurapa - zvishoma nezvishoma zvinokanganisa kushandiswa, izvo zvinogona kunge zvichichengetedza (mishonga yehutano) kana chirwere. Maitiro ekuongorora uye ekudzivirira anoshandiswa kufungidzira mamiriro ezvinhu emukati.
Kuongorora kurasikorora
Kushandiswa kwelaparoscope yekuongorororwa ndiyo danho rokupedzisira mukuona kwemaitiro emararamiro uye zvikonzero zvadzo mumamiriro ezvinhu apo zviongorori zvidzidzo zvekliniki zvakakundikana kuzviita. Kazhinji, izvi zvinodiwa apo paine hutano hwakasiyana. Kazhinji chidzidzo chinogadzwa ne:
- hupombwe mumakumbo emimba, pelvic region;
- kushungurudzika kurwadziwa syndromes kwekusatsanangurwa kwechimiro;
- kusabereka nezvisizvo zvisingaoneki;
- kunyunyuta kwe ectopic pamuviri ;
- zvirwere zvakanyanya zvekuvhiya zvemuviri mutsva uye kusava nechokwadi zviratidzo.
Muzviitiko zvakawanda, kuongororwa kweparapofyrti nehupereta inobvumira mazana zana zvevimbiso kuvimba, sezvo chiremba anoona kuona zvishoma zvachose. Dzimwe nguva kuongororwa kwemaitiro kunosanganiswa nekurapwa kwokuvhiya kwezvirwere zvinoratidzika (kubviswa kwemakumbo, kubatana, kusagadzikana kweendometrium yakanyanya uye zvichingodaro).
Kushandura Laparoscopy
Maitiro eparoscopic anoitwa, sekunge ari pasi pe microscope, uye kupa hunoonekwa zvikuru, nokuti zvishandiswa zvakashandiswa zvinokura makumi mana-kuwedzerwa, uye nokuda kwe optics, nhengo inoshandiswa inoongororwa pamakona akasiyana. Laparoscopy, kufanana netsika yemagariro, inogona kuitwa nenzira yakarongeka (somuenzaniso, nekubviswa kwe bile ) kana kuva dambudziko (laparoscopy ye appendicitis).
Izvo zvinofanira kuonekwa kuti laparoscopy inopindira iyo inoitwa nekurasikirwa kweropa nekurasikirwa. Vongai zviduku zviduku, zvipembenene zvemashure zvinenge zvisingaonekwi, izvo zvinonyanya kukosha kuvasikana vechidiki. Kusiyana nemashandiro emagetsi, laparoscopy haifaniri kutora nguva yakareba yekurapa uye kutarisana nemubhedha wezororo.
Laparoscopy - zviratidzo
Kuitwa kwe laparoscopy kunoitwa mune zviitiko zvinotevera:
- kuvhuvhuta kweguruvladder, kuvapo kwezvipfeko mairi;
- ovarian cysts;
- kuputika kwezvinyorwa;
- inguinal hernia;
- umbilical hernia;
- hernia wekutsvaga kwesophageal yechipfupa;
- cyst chiropa;
- kugadziriswa kwemawere ane tambo ;
- uterine myoma;
- endometriosis ;
- kusabatwa kwechibereko, mukadzi;
- adrenal gland tumors;
- adhesive process;
- urinary incontinence;
- mapoka ekutanga emukenza;
- pancreatic necrosis;
- kuneta.
Laparoscopy - zvinopesana nezviitiko zvekuita
Mapepanoscopy zvinopesana zvinotevera:
- purulent peritonitis;
- acute renal kana hepatic insufficiency;
- kushungurudzika kwakanyanya kwepfungwa yepamusoro;
- kukanganisa kwakakomba mubasa remwoyo kana kupemha system;
- matumbo okudzivirira;
- kushandurwa kwave kubudiswa kushanda;
- kunonoka kunonoka;
- hemorrhagic shock;
- kunyanya kusungirirwa kwemafuro;
- bronchial asthma uye kazhinji kunowedzera;
- kurwisa kune anesthesia.
Laparoscopy - sei kugadzirira kuvhiyiwa?
Kana murwere akarayirwa laparoscopy, sei kugadzirira iyo, anotsanangura chiremba anoenda. Pamberi pekuvhiya, zvakasiyana-siyana zvirwere zvinoshandiswa (ropa uye urine analysis, electrocardiogram, X-ray kuongorora, ultrasound, nezvimwewo) zvinowanzoitwa, murwere anobvunzwa pamusoro pezvirwere zvinotapurirwa, maitiro, zvinogadziriswa. Kugadzirira kupindira kunogona kusanganisira zvinotevera:
- kwemazuva mashomanana vasati vasvika-laparoscopy - kuteverwa kwekudya kusina-slag, iyo inosanganisa kushandiswa kwemafuta, yakakangwa, sweets, carbonated nemidhakwa;
- Kuramba kudya uye kunwa maawa gumi nemaviri vasati vambovhiyiwa;
- kunatswa kwematumbo kuburikidza nenzira yeemaema (vasati varara kana mangwanani kusati kwaitwa);
- pazuva rakagadzwa - kutora mvura uye nzvimbo yekuderedza, iyo inoshandiswa.
Ko laparoscopy inoitwa sei?
Laparoscopy, nzira yekuita iyo yakaoma, inoitwa chete nevarapi vane ruzivo vane ruzivo avo vakambodzidziswa zvakananga. Izvi zvinokonzerwa, pakati pacho, kune chokwadi chokuti pane chinyorwa zvose zvinofamba zvakasiyana, uyewo zvinoumba maonero akatsauka ekudzika kwenzvimbo yakarapwa. The laparoscopist inofanira kunyatsogadzirisa nzira yakagadzirwa, nokuti pane dzimwe nguva munhu anofanira kutendeukira kune nzira iyi apo zvinetso zvichibuda kana nzira inounzwa.
Pamberi pekushanda, murwere anoongororwa neanesthesiologist, anosarudza rudzi rweaneshesia. Inowanzoitwa endotracheal anesthesia kana kusanganiswa anesthesia. Zvadaro, pneumoperitoneum inoshandiswa - kuzadza dumbu remuviri negasi rinopiwa nenzira yenzano pasi pesimba rekudzvinyirira uye kutsika velocity. Izvi zvakakosha kusimudza mudumbu, kuitira kuti iwe ugone kushanda, zvishoma kubata mamwe nhengo.
Nhanho inotevera ndiyo kuiswa kwetatu trocar (tube) kuburikidza nemadziro emuviri, apo nzvimbo yekunyura inosarudzwa zvichienderana nenzvimbo yechiri inoshandiswa. Kuburikidza nei tube iyi laparoscope inorovedzwa, pasi pekutungamirirwa kwekuti mitoro yakawedzerwa inounzwa-yezviridzwa. Pashure pokunyatsoongorora nhengo dzomukati, kurapwa kwechiremba kunoitwa, mushure mokunge kushambwa kwebasa rekushanda, kusunungurwa kwegesi, kusona kwezvakaitwa uye nezvimwe zvakadaro zvinoitwa.
Laparoscopic cholecystectomy
Kuvhiya kubvisa nduru, yakagadzirwa kuburikidza neparparcopy access, inowanzoshandiswa mu'cholelithiasis uye mapuropiti, zvichionekwa sechinhu chakanaka kuzarura kupindira (iyo "yegoridhe"). Zvichienderana nekuoma kwemamiriro acho ezvinhu, laparoscopy ye gallbladder yakaitwa kuburikidza nematatu, mana kana mashanu mavhapiti mukati memadziro emimba. Mune zvimwe zviitiko, pane chido chekushandurirwa kushanda rakasununguka:
- kusvibiswa kwemaitiro emharaunda inoshandiswa;
- kubatana kwakasimba kwekubatanidza;
- kukura kwezvinetso.
Laparoscopic appendectomy
Nekuputika kwezvinyorwa, laparoscopy, nzira iyo yakanyatsogadzirwa, inoitwa maererano nezviratidzo zvinotevera:
- akaoma appendicitis muzuva rokutanga mushure mokutanga kwechirwere;
- chisingagumi appendicitis;
- kuputika kukuru kwezvinyorwa zvinosanganiswa nehupamhi hwekuwedzera kuneta kana chirwere cheshuga mellitus;
- murwere ane chido chokubvisa zvinyorwa nenzira ine unyoro.
Pamusoro pezvinhu zvose zvinoshandiswa, zvinotarisirwa kuita zvitatu zvepamu mumadziro emadziro, pfungwa dzayo dzakasarudzwa zvichienderana nematomu. Basa iri rinogona kuitwa pasi peanesthesia yemo. Chido chekuenda kushanda rakasununguka chinowanikwa mumamiriro ezvinhu akadaro:
- kuonekwa kwe peritonitis;
- nzvimbo inypical ye appendix;
- chifukidzo, kukanganisa;
- zvinetso zvakasiyana-siyana.
Laparoscopy mune gynecology
Tichifunga nezvekushanda mumunda wegynecology laparoscopy, zvakakosha kuziva kuti iyi inzira inowanzochengetedza nhengo dzinobereka: chibereko neyomumas, maovari mu cysts, fallopian tubes mu ectopic pamuviri. Kazhinji, zvitatu chete zviduku zvinotarisirwa, kuitira kuti kuve nekugadzirwa kwepamusoro kunowanikwa.
Neimwe zviratidzo, laparoscopy uye hysteroscopy inoitwa panguva imwe chete. Hysteroscopy - kudzvinyirira, izvo zvinogona kuongororwa kana kushanda, zvinoitwa kuti zviongorore uterine cavity, kutora biopsy, kugadzirisa zvirwere pane chikamu chechirongwa ichi (somuenzaniso, kubviswa kwema polyps). Chigadziro chekugadzirisa - hysteroscope - inoiswa mumuromo wechibereko. Kubatanidzwa kwe laparoscopy uye hysteroscopy inowedzera mikana yekugadzira zvikonzero zvehutachiona uye kubviswa kwavo pasina chidimbu chekushandisa anesthesia kaviri.
Zvinetso zve laparoscopy
Zvinokonzerwa nezvinetso mushure mokunge laparoscopy:
- kukanganisa nematokari emidziyo yemidziyo yeropa;
- kunyoresa kwenyama;
- hypothermia;
- kugadzira thrombi;
- kukanganisa mukati memwoyo uye kupemha system;
- kubuda ropa;
- kuumbwa kwekubatanidza .
Kudzorera pashure pe laparoscopy
Pasinei nezvo kuti laparoscopy inzira inopesana, uye varwere vanogona kusunungurwa mushure memazuva mashomanana, mamwe mazano anodiwa kuti arege kutarisana kwenguva refu. Saka, mushure mokunge laparoscopy inokosha:
- Bata pamubhedha wekuzorora (kubva maawa akawanda kusvikira mazuva akawanda).
- Deredza kushanda muviri kwemwedzi mitanhatu.
- Kuteerera kudya kwakakodzera kunorayirwa nachiremba.
- Chengeta zororo zvepabonde kwemavhiki maviri.
- Kuberekwa hakufaniri kurongwa mberi kwemwedzi 6-8 gare gare.