Ukuqonda iinkqubo zePaparotomy neLaparoscopy

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I-laparotomy kunye neLaparoscopy

I-Laparotomy yinto yegulana jikelele yonyango eyenziwa kwisisu esisetyenziselwa ukuchithwa kwetyala eliqhelekileyo, kunokuba kungene indlela encinci. Olunye igama lo msebenzi oqhelekileyo luyi-coeliotomy.

I-laparotomy isebenzisa ukuzaliswa okupheleleyo kwendawo kwaye inguqu encinci ye-nkqubo ibizwa ngokuba yi-laparoscopy kwaye isebenzisa iziganeko ezincinane ezincinane.

Inkqubo yendabuko - i-laparotomy - idlalwa ngokuba yindlela "evulekile", ngenxa yokuba isiqalo senza umvulo ovumela ugqirha ukuba acinge iilungu, imithwalo yegazi kunye neetiski kwisigxina esiswini. I-laparotomy isebenzisa izixhobo ze-laparoscopic kuquka nekhamera efakwe kwizinto ezincinci ukuvumela ukuba ugqirha ukuba zibonise izakhiwo zangaphakathi kunye nezixhobo zokucoca.

Isigqibo sokwenza inkqubo evuliwe okanye i-laparoscopically ihlala kunye nodokotela ogqirha kwaye yintoni na, ukuba yintoni na, ukuba ulindele ukufumana ngexesha lotyando. Ukuba utyando lwenziwe njengengxamiseko, ugqirha unokwenza i-laparotomy ngokuphathelele i-laparotomyomy laparoscopic kuba inika umbono omkhulu kwaye ihamba ngokukhawuleza kunokugqithiseleyo. Xa kubalwa imizuzu, inkqubo evulelekileyo inkqubo iya ngokukhawuleza kwinqanaba lokuqala lokuhlinzwa.

Kwimeko ezininzi inkundla evulekileyo igcinelwe kwiimeko apho ixesha lihlala litshintsho, isigulane asiqiniseki okanye xa inkqubo ifuna ukukhutshwa okukhulu, njengokwenza utyando olufuna ukuba inxalenye enkulu yamathumbu ibonakale kwaye ifumaneke.

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I-Laparotomy yokuHlola kunye neLaparoscopy ehlolisayo

I-laparotomy yokuhlolisisa ligama elinikezwa ukuhlinzwa ngokuvulwa kwesisu esisetyenziselwa ukuhlola izitho kunye nezicubu zesisu xa ukungaxilongo kukwenziwanga. Ukuba umthombo weengxaki zesisu akusobala, uvavanyo olubonakalayo lwesigxina singasinceda.

Kwixesha elidlulileyo, i-laparotomy yokuhlolisisa yayivame ukuqhutyelwa "intlungu yesisu yomvelaphi engaziwayo," xa ukuvavanywa akuphumelelanga ekunqumeni isizathu sokuba intlungu. Kwakhona kwenziwa nezinye izizathu ezininzi, kuquka ukuhlukumeza, ukukhunjulwa ngumhlaza okanye ezinye iimeko ezivavanywayo.

Namhlanje, indlela yokunciphisa i-minimally invasive isetyenziswa ngokuphindaphindiweyo kunendlela evulekile. Xa inkqubo yenziwa ngeendlela ezincinci ezingenayo, kuthiwa i-laparoscopy yokuhlola

Ukuhlinzwa ngokucetywayo, ngokuqhelekileyo, kunzima kakhulu kunokuba kwakunjalo ngexesha elidlulileyo ngenxa yokukwazi ukufumana imifanekiso yomzimba usebenzisa i-Magnetic Resonance Imagine (MRI), i-Computer Tomography (CT Scans) kunye nezinye iindlela. Singahlala siqwalasela izinto ngaphandle kokubheka kwaye sibone utyando, kwaye iingxaki ezininzi zingaphathwa ngamachiza kunokuba i-scalpel.

Kwezinye iimeko, ugqirha unokufumana isizathu seengxaki zesisu kunye nokugqiba inkqubo yokuhlola ngaphandle kwonyango. Ezi ziphumo ziza kuxutyushwa xa isigulane siphephile kwaye siphapheme, kwaye isicwangciso sonyango senziwe. Ngokomzekelo, ukuba ibhinqa ifunyenwe i-cysts enamandla kwixesha leparotomy, ugqirha unokwenza isigqibo sokuxubusha inkqubo kunye nezinye iindlela kunye nesigulane ngaphambi kokuba uphuphe unyango.

Ngethuba lokuhlaziywa kwe-laparotomy, iisampuli zamathambo nazo zingathathwa kwinkqubo ebizwa ngokuba yi- biopsy . Oku kwenziwa ukwenzela ukuxilongwa ngeengxaki zesisu njengoko izicubu zinokuhlolwa ngaphantsi kwe-microscope kwaye umba unokufunyaniswa ngale ndlela.

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Izizathu Ze-Laparotomy okanye iLaparoscopy

Izizathu Ze-Laparotomy

I-laparotomy igama eliqhelekileyo lenkqubo yokuhlinzwa eyenziwa kwisisu. Ixesha lokuhlola i-laparotomy ngokuqhelekileyo lisetyenziselwa ukuchaza inkqubo esetyenziswayo ukuchonga uhlobo lwesifo. Ngokomzekelo, ukuba isiguli sinesisu esiswini kwaye umthombo wale ntlungu ayicacile, ugqirha uya kuqulunqa i-laparotomy yokuhlola.

Izizathu Eziqhelekileyo Ze-Laparotomy:

Intestine Enkulu Neyincinci : I-perforation emathunjini, ukukhutshwa kwesisu, umhlaza,

Ubundlobongela : I-Trauma, i-cirrhosis, ukwandiswa kwesibindi, imfuno yokugubha.

I-Urinary System-IiNtonga, ii-Ureters kunye ne-Bladder : Iibhloko ezifana neentso zeengtso, umhlaza, ukuxhwaleka

Inkqubo yokuzala yesifazana: Endometriosis, umdlavuza, ukukhulelwa kwe-ectopic, ukuvutha

I-Gallbladder : Ngokuqhelekileyo eyenziwe ngokusebenzisa indlela encinci ye-invasive, kwiimeko ezinqabileyo zingasuswa ngokusetyenziswa kwendlela

Ipenethi : I-Trauma, ukwandiswa kwebhere, ukuphuka

Iipancreas : Ukuvuvukala kwepascreas, umhlaza

Izikhalazo eziqhelekileyo zesisu : Izifo ezinjenge- abscess , umhlaza, ukuxhwalaza, ukuvutha kwezicubu, ukuchonga inkqubo yesifo, ukubambelela kwiinkqubo zangaphambili

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Uphulo oluphuthumayo lwe-Laparotomy

I-laparotomy ingenziwa ngokukhawuleza, oku kuthetha ukuba isigulane sibhekene nesimo esisongela ubomi kunye ne-laparoscopy iyadingeka ukuze ichonge uhlobo lwengxaki, ukunyanga ingxaki okanye zombini. Ingxaki inokuphuma kumthombo ongaziwayo, umonakalo kwilungu okanye kuphuma igazi elingenakulawulwa nangona isizathu siyaziwa.

Inkqubo edlalwa rhoqo emva kokulimala okubuhlungu okubangelwa intlungu esiswini kuya kuhlamba i-peritoneal (DPL). Le yilapho i-incision encinci eyenziwa kwisisu kwaye isisu esiswini sisishushu. Ukuba umkhuhlane uphuma emzimbeni enexabiso elikhulu legazi, i-laparotomy ingaboniswa. I-DPL ayixilisi umthombo wenzakalo kodwa ibonisa ukuphuma kwegazi. I-laparotomy iya kuhlolisisa ukulimala kwaye ugqirha unako ukulungisa loo ngxaki.

Ingozi, njengengozi yemoto okanye ukulimala okungenayo (ukugwaza okanye ukulimala kwesigxina) yimbangela yezihlandlo zesisu esisemthethweni kufuneka zifumaneke okanye ziphathwe nge-laparotomy. Kule meko kungabonakala ukuba kukho isilonda esikhulu esiswini, nangona kunjalo, izitho, iinqanawa kunye nezicubu ezibandakanyekayo zingenakucaca. Kule meko, ugqirha unokwazi ukubonisisa ukulimala nokuxilonga ingxaki, kwaye kwiimeko ezininzi, uphathe ingxaki.

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I-Laparotomy: Iingozi kunye neengxaki

Ukongeza kwimingcipheko ngokubanzi yokuhlinzwa kunye neengozi ze-anesthesia , zombini i-laparoscopy kunye ne-laparotomy zibeka ingozi yazo. Ingozi ihluka ngokusekelwe kwisingqinisiso okanye isifo esenza ukuba inkqubo iyimfuneko, kodwa ingozi ecacileyo kwinkqubo yile:

• Sulelo
• I-hernia engabonakaliyo
• Ukuhlamba kwiindawo zokuhlinzwa

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Ngexesha lePararotomy ne-Laparoscopy Procedures

I-laparotomy okanye i-laparoscopy iqala ngolawulo lwe-anesthesia jikelele. Emva kokuba i-anesthesia isebenza kakuhle, isikhumba sesisu sisilungiselelwe isisombululo sokulwa nesifo sengqondo sokuthintela ukusuleleka kwisayithi yokuqapha.

Ugqirha uya kwenza uqeqesho. Ukuba intlungu isezantsi kwesisu kwi-appendix, i-incision iya kufakwa kuloo ndawo.

Ukuba inkqubo ecwangcisiweyo ye-laparoscopy isicwangciso esingaphantsi kwe-laparoscopy, icebo elide elingaphantsi kwe-intshi elide liza kwenziwa, ukuba i-laparotomy icwangcisiwe, kuya kwenziwa enye incision enkulu.

Ukuba i-incision enkulu iya kusetyenziswa, mhlawumbi iya kuba yinkqubo ye-midline incision, okuyi-incision incision ebeka phakathi kwetaski ye-pubic kunye nezantsi kwe-sternum, kunye nokuchithwa okutshintshiweyo, okubekwe kwindawo ephezulu.

Kwezinye iimeko, ukukhangela kungahle kube ncinane ekuqaleni kokuhlinzwa kwaye kwandiswe njengoko kuyimfuneko ukugqiba iinkqubo emva kokuxilongwa. Kwezinye iimeko inkqubo enokungenwa yinto encinci ingaba yinkqubo evulekileyo ukuba ugqirha udinga igumbi elingakumbi ukujonga ngolu hlobo okanye umsebenzi.

Emva kokufakwa, izitho kunye nezicubu ziya kuhlolwa kwiimpawu zesifo, ukusuleleka okanye ukuvutha. I-Biopsies inokuthathwa ngamathambo ahlukeneyo njengoko kuyimfuneko. Kwamanye amaxesha, isithintelo esisisu sisenokuthi "sihlambuluke," apho utywala oluthile lufakwa kwisisu, kwaye luqokelelwe ukuqhubela phambili ukufundisisa.

Emva kokuba izitho kunye nezicubu zesisu sezihlolwe, "khangela kwaye ubone" inxalenye yale nkqubo iphelile; Nangona kunjalo, kwiimeko ezininzi, inkqubo yokongeza iya kwenziwa. Ngokomzekelo, i-laparotomy eyenziwa ukufumana umthombo wesisu esiswini, kunye ne-appendix evuliwe, ifumaneka, inkqubo ye- appendectomy iya kudibaniswa ne-laparotomy.

Isibhengezo singavalwa ngeendlela ezahlukeneyo. Iziphumo ezinkulu zivaliwe nge-sutures okanye kwi-staples, ezincinci zingavalwa ngamacwecwe okubamba okubizwa ngokuba yi-steri-strips okanye iglue. I-incision ihlanganiswe ngophethiloli olungumzimba ongeyinyumba. I-Anesthesia igqityiwe kwaye unyango lunikezelwa ukuvusa isigulane, oya kuthiwa athathwe kwindawo yokubuyisela.

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Ukubuyisela kwiLaparotomy

Ukubuyiswa kwenkqubo ye-laparotomy iyahluka kakhulu ukusuka kwisigulane ukuya kwisigulane. Oku kubangelwa inani elikhulu leengxaki ezenza ukuba utyando luyimfuneko. Ngokuqhelekileyo, inqubo engahambelaniyo yileparotomy kwaye akukho nqubo eyongezelelweyo idinga iiveki ezi-2 ukuya kwe-6 zokubuyisela ixesha ngaphambi kokubuyela kwimisebenzi eqhelekileyo. Oku kunokubaluleka kakhulu ngeenkqubo eziyimfuneko emva kokuxilongwa.

Izigulane ezinama-laparotomi kwaye zinemiqathango engakumbi (isigulane esasengozini yemoto ngamathambo aphukileyo kunye nokuphuma kwangaphandle okudinga i-laparotomy) kunokuthatha ixesha elide ukuphilisa ukusuka ekutyunjweni. Umzimba usebenza ukuphulukisa amanxeba amaninzi kanye, ngoko ke ixesha lokuphilisa elipheleleyo liyakwandiswa. Ezinye iingxaki ezenza i-laparotomy iyimfuneko inokuphuza ukuphulukisa. Isigulane esinomdlavuza sinokufumana ukululama ngakumbi njengoko unyango lomhlaza lunokuthi lube lukhulu. Kuyafana okufanayo xa unesicatshulwa esongezelelweyo kunye ne-laparotomy.

Emva kokukhutshwa esibhedlele ukuze abuyele ekhaya, kubalulekile ukuba unyango olulodwa luthathelwa ukukhusela intsholongwane kunye nokunyamekela okufanelekileyo. Usulelo luyinto enye yeengxaki eziqhelekileyo zalo msebenzi, ngoko ukwazi indlela yokuchonga iimpawu zentsholongwane kubalulekile. Cwangcisa ukunyaniseka kwakho xa usuka ekuhlaleni okanye nayiphi na imisebenzi eyenza uxinzelelo lwesisu sokuthintela intlungu, dehiscence kunye nokunciphisa umngcipheko we-hernia engavumelekanga.

_Imithombo:

> Ukuhlola Ubomi. AmaZiko eZiko lezeMpilo. 2006. http://www.nlm.nih.gov/medlineplus/ency/article/002928.htm