Hysterectomy laparoscopic njira: pambuyo ntchito nthawi, zotsatira ndemanga. Kuchotsa fibroids uterine laparoscopically: Ndemanga

Panopa, ife anayamba umisiri wotsogola kuti mpata zosiyanasiyana za phukusi la matenda ndi mavuto kochepa ndi digiri otsika zoopsazo. Laparoscopic hysterectomy mwa - mmodzi wa iwo.

Laparoscopy ngati njira yatsopano

Laparoscopic opaleshoni akhala kwa zaka zoposa 20. Mu nthawi iyi wakhazikitsa yokha ngati njira asang'ambe komanso zothandiza ndi mavuto kochepa pambuyo ntchito.

njira Laparoscopic ku matenda achikazi zinatchuka kwambiri. Poyamba, njira yotero anachita matenda opaleshoni mabuku ang'ono. Koma m'zaka zaposachedwapa mu zipatala zambiri ndiponso zipatala, anthu wamba. Imodzi mwa ntchito zimenezi ndi kuchotsa fibroids uterine laparoscopically. Reviews odwala akusonyeza kuti pali kubwezeretsa mofulumira mphamvu ntchito, chiopsezo cha matenda oyamba ndi adhesions cha kuwonongeka ang'ono ndi pang'ono khungu si kusokoneza maonekedwe a akazi.

Ntchito pamafunika ogwira oyenerera ndi ozindikira. Alowererepo ndi koyenera mu nkhani iyi, zosokonezeka kochepa. Nthawi zina, osakaniza laparoscopic opaleshoni ochiritsira basi ayenera kupulumutsa moyo wa wodwalayo. katswiri Izi kusankha njira yolondola kuchiza odwala awo pa nkhani iliyonse payokha.

Zipatala zambiri kugwira kuchotsa fibroids uterine laparoscopically. Mu Moscow, pafupifupi dipatimenti matenda ali okonzeka ndi zida zina zofunika ndipo ali akatswiri yokwaniritsira mpheto izi. Kuchokera opaleshoni onse matenda 50-60% umachitika mwa laparoscopy.

Ubwino waukulu njira:

• digiri otsika zoopsazo;

• mwamsanga kuchira ntchito ziwalo zonse;

• Kuchepetsa ululu pambuyo ntchito;

• kochepa adhesions ;

• kanthawi wa m'chipatala;

• anakhala ku wosamalira;

• kuchepetsa mawu a kulumala;

• osachepera hernias postoperative;

• nthawi yochepa chifukwa konzanso ya;

• kupulumutsa mankhwala.

Wachisoni mphindi laparoscopy

awa mbali zonse zabwino mu njira ya opaleshoni ndi kuchiritsa akazi kuphimba kuipa onse amene chibadidwe opaleshoni iliyonse laparoscopic:

• makina ndi kuphunzitsa akatswiri oyenerera amafuna ndalama kwambiri;

• dokotala uyenera kukhala njira laparoscopic opaleshoni mwambo;

• Zovuta ndi kuphwanya ntchito ziwalo kugwirizana ndi jekeseni wa mafuta mu zonse m'mimba, koma kudzudzulidwa ndi kukonza kupewa mavuto amenewa zikhoza kupewedwa;

• Kodi sadzalamulira zingatheke kuwonongeka mawotchi ziwalo zosiyanasiyana, zimakhala ndi nyumba.

Ntchito mu matenda achikazi

Zochita matenda laparoscopy ambiri. Kuwonjezera pa matenda milandu chosadziwika wa pamimba pachimake, kudziwa zimayambitsa osabereka, laparoscopic ndondomeko ntchito mu zochitika monga:

1. Ectopic mimba.

2. kusiyana kwa chubu.

3. Zopangira yolera yotseketsa.

4. Endometriosis.

5. zomatira matenda.

6. matenda osiyanasiyana a cysts yamchiberekero, sklerokistoz, yamchiberekero enaake owononga.

7. chosaopsa mapangidwe chiberekero (hysterectomy laparoscopic njira amachepetsa chiopsezo cha matenda oyamba postoperative).

8. njira hyperplastic, osati amenable mankhwala ndiwofatsa.

Posachedwapa gynecologists amagwiritsidwa ntchito laparoscopic hysterectomy ngakhale zotupa zilonda. Amene anayambitsa njira zambiri chifukwa ntchito imeneyi, malinga ndi kukula kwa chiberekero, udindo wake ndi okhudzidwa mu ndondomeko ziwalo wapafupi. Chimagwiritsidwa ntchito fibroids opaleshoni pa localizations osiyana.

fibroids uterine

Uterine fibroids - chosaopsa matenda omwe Chiwabwerere mahomoni amapezeka kuchuluka kwa minofu fibrous ndi mapangidwe mfundo. Iwo anati kufala mkulu wa matenda - pafupifupi 25% ya mavuto onse matenda. fibroids uterine ndi mbali yaikulu pa gulu lonse la akazi. Myomectomy chimaonedwabe "golide muyezo" mankhwala matenda.

Hysterectomy laparoscopically. mitundu

Posankha njira opaleshoni chithandizo cha fibroids ndi n'komwe zifukwa zambiri: malo ndi kukula kwa mfundo, magwiridwe, kapena imfa ziwalo pafupi, mmene ambiri a mkazi. Malinga uterine ndi zotupa zokhudzana muli mitundu yambiri ya opaleshoni ziwalo zoberekera.

Zochita amagwiritsa:

- okwana hysterectomy pamene akachotse thupi ndi khomo pachibelekeropo; subtotal - chiberekero atachotsedwa thupi. Ngati pamodzi ndi chiberekero udulidwe chitoliro - gistertubektomiya, ndipo ngati mapaipi ndi Yachnik, ntchito amenewa amatchedwa gistertubovarioektomiya. Kuti ntchito mopitiriza monga pangisterektomii - kuchotsa maliseche zonse za mkati pamodzi ndi mwanabele kapena zopangitsa ozungulira zimakhala za nyini mwina agwiritsa njira oncological.

- Pamene wochepa mayunitsi ndi kusunga kubala akazi madokotala ablative. Mmodzi wa awa ndi kuchotsa subserous uterine fibroids laparoscopically. Ndi pang'ono uterine chotupa anagwira mfundo enucleation, i.e. husking minofu fibrous ndi wotsatira kupulumutsiramo limba. Pambuyo ntchito izi, mkazi akhoza kutenga mimba patapita nthawi yina ndi kubereka.

contraindications

Pali contraindications kwa opaleshoni kuti achotse fibroids chiberekero laparoscopically. Reviews Gynecologists zikusonyeza kuti nthawi zambiri opaleshoni angathe kuchitidwa onse, kupatulapo akazi amene amadwala mtima kwambiri, kulephera kupuma, ndi chophukacho, mavuto ndi dongosolo magazi coagulation kapena marasmus

Wachibale contraindications - chikhalidwe limene opaleshoni n'zotheka, koma akupereka mavuto ena. Ali:

• kwambiri kutchulidwa subcutaneous mafuta;

• Matenda Popanda kuchitapo kanthu opatsirana;

• adhesions;

• effusion kapena pamaso pa madzimadzi mu zonse m'mimba ya lita oposa 1.

Koma gynecologists ano, ndi ndondomeko laparoscopic, pambuyo kupenda matenda Kwalamulidwa njira ya chithandizo, sanitize foci matenda ndi kuchita opaleshoni. Pa nthawi yomweyo kufufuza "ubwino" ndi "kuipa" pamaso panu amathera ntchito laparoscopic.

Kukonzekera opaleshoni

Reviews wa akazi amene akhala akukonza hysterectomy laparoscopically, amadziwika kuti odwala sakusangalala ndi chabe kukonzekera: opareshoni kumatenga Mphindi 40, ndi kukonzekera - 2 masabata ndi zambiri.

Pa ntchito mkazi ayenera kudza pambuyo mayesero ndi zotsatira analandira adzaperekedwa:

• MAGAZI (okwana amuzolengedwa, mtundu magazi ndi RH chinthu, kwa chiwindi, chindoko ndi clotting HIV, mtima wa shuga);

• mayesero mkodzo - ambiri ndi mtima wa shuga;

• smears;

• electrocardiogram;

• x-ray;

• ultrasound;

• colposcopy;

• anayendera akatswiri: ndikuphunzitsidwa, ngati n'koyenera, ndi cardiologist ndi ena.

Pamaso pa ntchito kwa odwala fibroids uterine amafuna osiyana matenda curettage la chiberekero ndi kupeza zotsatira histological. Izi ndi zofunika pofuna kuthana ndi vuto la kuchuluka kwa opaleshoni ndi kuthetsa ndi kuteteza pofuna kukwaniritsa njira khansa.

Onse mayeso - ndondomeko zofunika, ndipo patapita kufufuza zonse za opaleshoni ya adzatha kugwira kuchotsa chiberekero laparoscopically.

Chadzulo opaleshoni ya tikulimbikitsidwa kuti asadye, muyenera amete tsitsi obisika.

Matendawa, mkazi amadzadza kunja chilolezo mawonekedwe ndi mankhwala, ndipo payokha kuti ntchito. Ngati ndi kotheka, kupereka kukonzekera mankhwala kapena psychoprophylactic kwa opaleshoni.

ntchito Technology

opaleshoni kuchotsa chiberekero laparoscopically anachita pamene myomas zamitundu kwa masabata 16 a mimba, amene kobvuta ndi magazi, yodziwika ndi kukula mofulumira kapena chiopsezo kusinthika zilonda. Ngakhale ena akatswiri odziwa kwathunthu kuchotsedwa chiberekero, kukula kwa amene ali pafupifupi 20 masabata. Koma nthawi zambiri anapatsidwa zaka mkazi, wopereka kuchotsa fibroids uterine laparoscopically kusiya gawo laling'ono la chiberekero cha kusamba.

Ntchito atatu kapena anayi puncture khoma m'mimba (a - pafupi Mchombo ndi ena awiri - mbali) ndi trocars kutumikiridwa. chipangizo ili ndi kamera ya polojekiti kuwala kapena ndi supercharger unsembe wa carbon dioxide kapena nitrous oxide ndi zida.

Pambuyo kuchotsa kuyenderako anachita fibroids laparoscopically uterine. Kwa mitsempha izi excised, ziwiya ligated kuligaŵa ku chiberekero ndi khoma nyini ndi kuchotsedwa kupyolera nyini mwa amacheka anawasema lapansi. Opaleshoni imeneyi wotchedwa laparoscopically anathandiza ukazi myomectomy. Muzicheza suturing amacheka nyini. Ntchito limodzi angathe kuchotsa mfundo angapo popanda kachiwiri alowererepo.

Pambuyo odalyayut magazi kapena madzi, anapeza pa opaleshoni, kuyendera ikuchitika kachiwiri matupi ndi mpanda wa zonse m'mimba. Mosamala fufuzani ngati bwino mabandeji ndi ligated ziwiya, kaya propotevanie magazi kapena madzimadzi lymphatic. Kuthetsa mpweya ndi kuwonetsera zipangizo. Ndiye stitches limapezeka pa khungu ndi subcutaneous minofu pa malo trocar, khungu sutured sutures zodzikongoletsera.

Kutalika kwa ntchito zingakhale za Mphindi 15 maola 1.5 malinga ndi buku la alowererepo anakhala opaleshoni.

Analgesia mu ntchito monga kuchotsa chiberekero laparoscopically: Ndemanga

Kodi mankhwala ochititsa dzanzi bwino? Funso ayenera kuthetsedwa pamodzi ndi dokotala ndi dzanzi, amapatsidwa chikhalidwe onse wodwala, ndi zizindikiro za maphunziro choyezera, pafupifupi buku ntchito. Nthawi zambiri, ophatikizana ochititsa dzanzi endotracheal. Reviews akazi kunena kuti bwino analekerera, palibe mutu. Female kudzuka pambuyo 15-20 Mphindi pambuyo opareshoni monga kuchotsa chiberekero laparoscopically.

Nthawi postoperative ndi ochititsa dzanzi yake kumabweretsa zotsatira zabwino pambuyo phukusi la: ululu sichikunditsutsa, pali chabe kusapeza wakupambana m'masiku 2. Nthawi zina zingakhale nseru, koma atazikocheza "metoclopramide". Tsiku loyamba mukhoza kumwa madzi okha. Madzulo, mukhoza kale kudzuka ndi kudzuka. Pa tsiku lachiwiri mukhoza kudya, zomwe si limakhumudwitsa matumbo, monga phala, soups, mkaka. The Tingafinye ikuchitika pa tsiku lachiwiri kuchokera alowererepo, ndipo chodwala anatseka patapita masiku 30. Pambuyo kuti mkaziyo akhoza bwinobwino kupita ku ntchito, koma ndi kuletsa ntchito yakalavulagaga thupi kwa mwezi umodzi. Sutures amachotsedwa pa postoperative tsiku 5.

Pambuyo pa opaleshoni, mavuto zotheka, amene ali osowa: ichi choipa trocar ziwalo, magazi kuchokera pansi pa zotengera ligated, subcutaneous ndiko kumayambitsa. Zonsezi zikhoza kupewedwa ngati mosamalitsa kutsatira zipangizo ntchito ndi kuchita kafukufuku wa zinthu zonse m'mimba mosamala.

zotsatira

Tikumbukenso kuti pambuyo opareshoni monga hysterectomy njira laparoscopic, zotsatira amakonda kupeza. Kuchira zikadzatha masabata 2 konzanso. masiku 30 pambuyo opaleshoni mkazi akhoza kupita pa ntchito zawo monga mwa nthawi zonse. Analimbikitsa zotheka thupi. Koma patatha mwezi umodzi, ndi osafunika kutsegula minofu m'mimba, zolemera dzuwa.

Mu masiku oyambirira angakhale nayo zazing'ono zowawa kulongolola m'mimba. Izi si zachilendo ndipo ayenera kudali masiku 1-2. Mapangidwe adhesions n'zotheka, koma malingana ndi kuwerengera izi zimachitika kawirikawiri ndi kokha kutengera za kumtundu wa chamoyo kapena pansi anasonyeza endometriosis.

kumaliseche pang'ono kuchokera thirakiti maliseche. Izi zimachitika ngati mazira a zimasungika. Iwo amapitiriza kubala mahomoni kuti chifukwa anachita ichi.

Nthawi njira yotupa pambuyo opaleshoni laparoscopic n'zochepa, chifukwa mankhwala a Amasankhidwa yomweyo pambuyo alowererepo ndi kupitiriza kwa masiku 5. Pa nthawi yomweyo kudzudzulidwa madzi ndi electrolyte zikuchokera magazi.

Kubwezeretsedwa chonde mtima pafupifupi nthawi yomweyo, koma zina akuwonjezeka libido. mkazi akhoza kukhala ndi moyo wogonana ndi mwezi 1 pambuyo opaleshoni. Ngati thupi kusungidwa, ndipo mukhoza kupeza pakati pasanathe miyezi sikisi pambuyo alowererepo pa.

Ndingapite kugwira opaleshoni?

Zipatala zambiri lingapereke hysterectomy laparoscopically. Mu Moscow zipatala mumzinda kuti zili ndi zida ndipo ndi akatswiri amene amadziwa njira imeneyi adzadzipereka inu misonkhano imeneyi. Mtengo ndikupeleka ndi adapangana ndi dokotala nawo.

kafukufukuyu zingachitike mu ofesi kapena nyumba yogonamo chisanadze kuchipatala. Kuchita ntchito n'zotheka kulembetsa kuumba. Mtengo wa hysterectomy laparoscopic ndi za 45 70 chikwi.