Asang'ambe opaleshoni: zipatala ndi malo

achipatala si chilili; chitukuko kwambiri zambiri mwayi - onse sitepe matenda ndi achire.

Makamaka chifukwa cha chitukuko yogwira njira endoscopic chimagwiritsidwa kufalitsa opaleshoni asang'ambe. Taonani chimene icho chiri, m'nkhani ino.

N'chifukwa chiyani ndikufunika opaleshoni asang'ambe

ndi subtleties zonse njira imeneyi umalimbana kuchepetsa zotsatira zoopsa pa thupi la mtima, amene ali mbali ya alowererepo aliyense opaleshoni.

Zitsanzo njira kungakhale endoscopy opaleshoni laparoscopic.

Kuphatikiza laparoscopy ndi njira zina kulumikiza ziwalo akhoza amati ndi opaleshoni asang'ambe.

kutchuka kwake ndi zovuta kufotokoza.

Njira iyi ikukwaniritsa zinthu za wodwalayo (zotsatira za ntchito awa kochepa), ndi zinthu umoyo ndi zachuma (pogwiritsa ntchito opaleshoni asang'ambe, n'zotheka kuchepetsa nthawi anakhala wodwala kuchipatala.

Laparoscopy wakhala chimagwiritsidwa ntchito opaleshoni Dokotala m'mimba: ana ambiri ntchito pa ziwalo m'mimba kumachitika ndi laparotomy. Laparoscopic opaleshoni n'zotheka ana a misinkhu yonse. Ndipo kwa odwala pang'ono za mibadwo yosiyana lili chida zida chifukwa laparoscopy, ndi diameters osiyana.

Mu amayi apakati, n'zotheka opaleshoni laparoscopic bwinobwino.

ubwino

• Kuwonongeka kwa thupi wodwala pa opaleshoni, anachita mogwirizana ndi njira opaleshoni asang'ambe, ndi kwambiri poyerekeza yachibadwa ntchito ankalamulira.
• The yaitali bedi zina pambuyo opaleshoni asang'ambe Sikuti. mwai otere zimagwiridwa mu zipatala apadera opaleshoni asang'ambe (otchedwa zipatala tsiku limodzi).
• opaleshoni Nizkotravmaticheskie bwino analekerera ndi odwala.
• Mlingo zoopsa zimakhala mu mwai izi ndi zayamba m'munsi chifukwa kuchepetsa alowererepo nthawi; ndi mlingo wochepa wa nsautso angadwale zotsatira achire ndi zodzikongoletsera.

Zitsanzo nkhani ya mmene onse anayamba

Woyambirira laparokopicheskaya ntchito zinachitikadi mu France mu 80s kwa zaka za m'ma 20. Patapita zaka zingapo, njira imeneyi akhala akuyendera ntchito misa.

Pambuyo chiyambi cha ntchito mwadongosolo njira imeneyi walandira chitukuko mofulumira ndi nthawi yochepa wakhala wotchuka kwambiri.

Kuipa zikunena asang'ambe

• Maopaleshoni anachita pogwiritsa ntchito njira endoscopic, musalole palpation a minofu.
• Kufunika kukhazikitsa chamagetsi mu chipatala kapena chilengedwe malo apadera opaleshoni asang'ambe; kukwera mtengo kwa zipangizo zimenezi.
• Kufunika kupeza luso ogwira ntchito kuchipatala ntchito ndi chamagetsi.

laparoscopy

Mtundu wa opaleshoni asang'ambe ingagwiritsidwe zinthu zotsatirazi:

• Female osabereka.
• Chithandizo cha endometriosis.
• Yamchiberekero cysts.
• uterine fibroids.
• Ectopic mimba.
• Kuchotsa ndulu ya.
• Kuchotsa zotupa ka ziwalo.
• Kuchotsa mwanabele.
• Muzilemekeza ena pathologies mtima.

Opaleshoni alowererepo limayamba ndi chakuti mu zapambuyo khoma m'mimba, kupanga atatu kapena anayi puncture. Kenako therethrough mu thupi jekeseni wa carbon dioxide chofunika kuonjezera buku la M'mimbamo ndi mapangidwe malo okwanira ntchito. Kenako, kudzera imodzi punctures anakhazikitsa kamera, omwe amasonyeza pa polojekiti ya m'munda opaleshoni, ziwalo ndi zida mpheto athandizira mwa punctures otsala.

Mini-laparotomy (mini-mwayi)

Ndipotu, mu nkhani iyi, ochiritsira ntchito opaleshoni, koma kupyolera ang'ambe thupilo laling'ono kwambiri kuti chimatheka ntchito akonzedwa wapadera zipangizo. Mu njira imeneyi, anthu popanga munthu opaleshoni ziwalo m'mimba angathe kuchitidwa.

endoscopy

Njira imeneyi ntchito tione ziwalo, ndi dongosolo dzenje, ndipo anachita mothandizidwa ndi zipangizo wapadera - endoscopes.

Endoscopic opaleshoni asang'ambe, mosiyana laparoscopy amagwiritsa punctures kapena mabala; zida zamankhwala anaikapo mu ziwalo dzenje kudzera orifices achilengedwe. Choncho, kumasuka ku mpheto amenewa amapezeka zayamba mosavuta.

Choncho, zipatala ndi opaleshoni endoscopic ndipo asang'ambe endoscopic m'madipatimenti kuchipatala maofesi anafufuza zotsatirazi ziwalo:

• kum'mero;
• m'mimba;
• matumbo;
• m'phuno;
• trachea;
• bronchi;
• chikhodzodzo.

Kuwonjezera bwinobwino endoscopy ndiponso limapereka mwayi njira achire, monga oyima muzituluka magazi, kuchotsa kukula ka mimba ndi zotupa m'mimba. mwai otero, mu zipatala wamba mu zipatala apadera (mwachitsanzo, chipatala Coloproctology ndipo asang'ambe Opaleshoni).

nthawi konzanso

Chifukwa mlingo wochepa wa traumatization wa zimakhala ndi ziwalo mu ntchito ikuchitika malinga ndi mfundo za opaleshoni asang'ambe, ndi konzanso nthawi pambuyo opaleshoni amakhala osachepera nthawi ndi bwino analekerera ndi odwala.

Kusankhidwa kwa nthawi yaitali bedi zina pogwiritsa ntchito njira opaleshoni malotravmaticheskih Sikuti.

Ululu syndrome kwambiri zochepa kutchulidwa pa ntchito yaing'ono, mfundo imeneyi limachititsa kupewa kugwiritsira ntchito mankhwala, cha gulu la analgesics, motero zotsatira zawo mbali.

Pamene asang'ambe opaleshoni siyabwino

Ngakhale ubwino onse njira opaleshoni asang'ambe ingagwiritsidwe milandu onse. Ena maopaleshoni kumasulira mu gulu la nizkotravmatichnyh kwalephera.

1. Pamaso pa adhesions mu zonse m'mimba. Zimenezi ndi chopinga mbali ya ntchito zimenezi. Makamaka mabvuto milandu komwe wodwalayo mbiri ya zikunena angapo opaleshoni, zikubweretsa mapangidwe adhesions. Komabe, nthawi zina, pamene wodwala akukana laparoscopic opaleshoni mu zonse m'mimba chifukwa kukhalapo kwa adhesions opaleshoni amalephera kubala otchedwa mini-mwayi. Palibe aligorivimu umodzi kulibe; Iwo anaganiza pa nkhani iliyonse payokha.
2. Matenda a dongosolo mtima ndi mapapo mu siteji ya decompensation. Ichi ndi chifukwa chakuti kwa laparoscopy amafuna oyamba mu zonse m'mimba mpweya woipa; ndi uyu, nayenso, kutsogolera ndi kuwonjezeka mu kuthamanga kwapakati pa-m'mimba ndi kulenga kuthamanga zina pa chifundamtima ndipo chotero, pa ziwalo chifuwa patsekeke. Odwala cardio-m'mapapo mwanga insufficiency kukhudzana ngati kumabweretsa kuwonongeka.
3. Kuwonjezeka lakuthwa kulemera kwa wodwalayo. Kunenepa lachitatu ndi digiri chachinayi angakhalenso contraindication kwa opaleshoni laparoscopic chifukwa chakuti kulumikiza kwa ziwalo mkati mwa milandu sangakhale zokwanira zida kutalika. Komanso, chifukwa misa mkulu wa m'mimba khoma odwala zapambuyo amenewa nthawi zambiri sangathe kulenga pneumoperitoneum.
4. Ocular oopsa, mu khungu makamaka. Pneumoperitoneum zingachititse kuwonjezeka kuthamanga intraocular, akuchuluka za matenda ndi mavuto (mwachitsanzo, retinal detachment).
5. The digiri yapamwamba ya myopia - mpaka diopters asanu ndi limodzi (pachifukwa chomwechi - kuteteza retinal detachment). Komabe, nthawi zina pangakhale kuchotserapo, mwachitsanzo pamene yochepa kukhudzana kapena malogazovoy laparoscopy Pamene mavuto m'mimba limatuluka pang'ono.
6. Matenda a dongosolo magazi, amakhala ndi makutu umatha aumirira. limati amenewa ndi zinadzala ndi magazi ochuluka, lomwe liri losayenera.

Mu ukalamba zambiri analemba lonse osiyanasiyana mavuto ndi contraindication opaleshoni laparoscopic. Zikatero, odwala opaleshoni kuti mini-kupeza njira ndi zayamba palibe contraindications wamba.