Kuvhiyiwa kwemazuva mashoma: makiriniki uye nzvimbo

Mishonga yezvokurapa haina kumira; Kubudirira kwavo kunonyanya kuwedzera mikana - zvose kuongororwa nekurapa.

Kunyanya, pamusana pekushanda kwakasimba kwemaitiro endoscopic, chirwere chiduku chisina kuvhiringidzika chave chakapararira zvikuru. Funga kuti chii, munyaya ino.

Chikonzero Nei Chiitiko Chinowanzokonzera Chichidiwa

Zvose zvisinganzwisisiki zvegadziriro iyi zvinotarirwa kuderedza kushungurudza kunokonzera mitezo mumuviri wevarwere, izvo zvisingadzivisiki mukati mekupindira kupi zvayo.

Mienzaniso yemaitiro inosanganisira endoscopy uye chirwere cheparapore.

Kubatanidzwa kwe laparoscopy nemamwe nzira dzekuwanika kune nhengo dzomukati kunogonawo kutumidzwa sekuvhiyiwa kwechidiki.

Kuzivikanwa kwemuitiro kunotsanangurwa zviri nyore.

Iyi nzira inofanirwa nevarwere (migumisiro yezviitiko izvi haisi zvishoma) uye nharaunda dzezvemagariro evanhu (nekuda kwekushandiswa kwekuvhiya kusinganzwisisiki kunowanzoita kuti kupfupika kwenguva yekugara kwechiremba kuchipatara.

Laparoscopy yakawana kushandiswa kwakawanda mukuvhiya kwevana mucheche: muvana, zvakawanda zvinoshanda pamakumbo emimba zvinowanikwa neparparotomy. Mapapososcopic maitiro anoshandiswa kune vana veanenge makore ose. Uye nekushanda nevaduku vaduku vezera rakasiyana, pane zviyero zvezviridzwa zve laparoscopy dzine mazamu akasiyana.

Mumadzimai ane pamuviri, mikana yekuita basa re laparoscopic haikwanisi.

Batsirwa

• Kukuvara kwomuviri wevarwere panguva yekuvhiyiwa kunoitwa maererano nezvinoitwa zvishoma zvishoma zvinoshandiswa pakuvhiya zvakanyanya kuderera kudarika kushandiswa kwemazuva ose.
• Mukurara kwenguva yakareba mushure mushure mekushanda kusina kuitika, hapana chikonzero. Kuita kwakadaro kunogona kuitwa mumakiriniki chaiwo ekuvhiya kwechidiki kusinganzwisisiki (anonzi makiriniki ezuva rimwe).
• Kuvhiyiwa kwepamusoro-kutambudzika kunobvumirwa zvakanaka nevarwere.
• Nhamba yekushungurudza kwemasumbu emuviri pasi pekuita kwakadaro kwakanyanya kuderera nekuda kwekuderedzwa munguva yekupindira; Uye uwandu hutsika hwekutambudzika hunogona kuwedzera kurapwa uye zvinokonzera zvinokonzera.

Mienzaniso kubva munyaya yacho: kuti yakatanga sei

Iyo yekutanga yaparasopopic yakaitwa muFrance mumakore ekuma80 ezana remakore rechi20. Makore anoverengeka gare gare, iyo nzira inenge yasati yatorwa mukushandiswa kukuru.

Mushure mokutanga kwemashandisirwo emashandisirwo emhando iyi yakagamuchira kukurumidza kukurumidza uye kwenguva pfupi yakave yakakurumbira zvikuru.

Maminitsi ekupindira kwepabonde

• Kupindira kwekushanda kunoitwa nekubatsirwa kwemaitiro endoscopic haubvumiri kutakura kwemashutu.
• Chido chekuisa zvinhu zvepamusoro-tech mune imwe sangano rezvokurapa kana kugadzirwa kwezvivako zvakakosha zvekuvhiyiwa kwechidiki; Mari yakakwirira yemidziyo yakadaro.
• Chido chekuwana unyanzvi hwehutano mukushanda nemichina yakakwirira.

Laparoscopy

Urwu ruzhinji rwekuvhiya rusingaoneki runogona kushandiswa mumamiriro ezvinhu anotevera:

• Kusununguka kwechikadzi.
• Kurapa kwe endometriosis.
• Ovarian cysts.
• Uterine fibroids.
• Ectopic pregnancy.
• Kubviswa kwegorobladder.
• Kubviswa kwemadiki mashoma emakumbo emunhengo dzomukati.
• Kubviswa kwe lymph nodes.
• Kurapa kweimwe zvirwere zvevascular.

Kupindira kwebasa kunotanga nekuti mukati memadziro emadziro emukati munobudisa zvitatu kana zvine punctures. Nokudaro, kuburikidza navo, carbon dioxide inowanikwa mumuviri, iyo inofanirwa kuwedzera kuwanda kwemukati uye kugadzira nzvimbo yakakwana yekushanda. Zvadaro, kuburikidza neimwe yemapctures, kamera inowanikwa, iyo inoratidzira pachitarisiko chebasa rinoshandiswa, nhengo dzomukati uye zvishandiso zvakatangwa mukunyengedza kuburikidza nemapctures akasara.

Mini-laparotomy (mini-access)

Chaizvoizvo, munyaya iyi, chirwere chekuvhiya chinowanzoitwa, asi kuburikidza nekunyanya kudukusa, kunoitwa nekugadzirwa kwechinhu chakakosha chezviridzwa. Nenzira iyi, kupindira kwakawanda kwezvikamu zvemuviri kunogona kuitwa.

Endoscopy

Iyi nzira inoshandiswa kuongorora nhengo dzomukati dzine chimiro chisina kukwana, uye dzinoitwa pamwe nekubatsirwa kwezvinhu zvakasarudzwa - endoscopes.

Endoscopic chirwere chinoputika chisingaoneki, kusiyana nechaparoscopy, haishandisi punctures kana kusarudzwa; Zvirwere zvinoshandiswa zvinoshandiswa muzvikamu zvisina kuvhara kuburikidza nekuvhura kwezvisikwa. Saizvozvowo, kuporeswa mushure mekunge kushandiswa kwakadaro kuri nyore zvikuru.

Nokudaro, mumakiriniki ekuvhiya kwepasoscopic uye zvishoma zvisingasviki uye maitiro ekupedzisira ematare echipatara, nhengo dzinotevera dzinoongororwa:

• Esophagus;
• Dumbu;
• Intestines;
• Larynx;
• Trachea;
• Bronchi;
• Urinary chikwama.

Pamusoro pekuongororwa, endoscopy inopawo mikana yekuita maitiro ekurapa, somuenzaniso, kumira gastric bleeding, kubvisa uwandu hudiki hwemudumbu uye mimba yemukumbo. Maitiro akadaro anowanikwa muzvipatara zvemazuva ose uye mumakiriniki chaiwo (somuenzaniso, kliniki ye coloproctology uye chirwere chisina kuwanikwa chisingaiti).

Nguva yekudzorera

Pamusana pehutachiona hwehutachiona hwezviviri uye nhengo mumabasa akashandiswa maererano nemitemo yekuvhiya kwechidiki kusinganzwisisiki, nguva yekuvandudza mushure mekunge kupindira kwakadaro kune nguva shoma uye inoremekedzwa nevarwere.

Mukugadzwa kwebhedha refu kwenguva refu nekushandiswa kwepasi-kunetseka nzira dzekuvhiya hazvidiwi.

Iyo kurwadziwa chirwere pamabasa mashoma inoratidzirwa zvishoma, mamiriro ezvinhu aya anoita kuti zvibvirire kudzivisa kushandiswa kwezvinodhaka zveboka revargesics, uye nekuda kweizvozvo, migumisiro yavo.

Kana chirwere chisina kuitika chisingaiti chinoshanda

Pasinei nezvose zvinobatsira, nzira shoma dzisina kuvhiringidzika dzekuvhiya hadzigoni kushandiswa mumamiriro ese ezvinhu. Mamwe mapurogiramu ekuvhiya haagoni kuendeswa kune chikamu chepasi-chinotyisa.

1. Kuvapo kwekutevedza mushandi mumakumbo emimba. Ichi chiitiko chigumbuso kune zvimwe zvekushanda. Zvinetso zvakakomba zvinokonzera apo murwere ane nhoroondo yekupindira kwakapetwa kakawanda kwakatungamirira pakuumbwa kwekubatira. Zvisinei, pane dzimwe nguva, apo murwere anorega kurapwa kweparoscopic pamakumbo emimba nekuda kwekuvapo kwekubatanidza, kupindira kwekuvhiya kunogona kuitwa kubva kune izvo zvinonzi mini-access. Shanduro imwe chete yegoridhethi haisipo; Chisarudzo chinoitwa munyaya imwe neimwe.
2. Zvirwere zve cardiovascular system nemapapu mumutsara wekudzikinura. Izvi zvinokonzerwa nekuti iyo ye laparoscopy inoda kuiswa kwemuviri mudumbu carbon dioxide; Uye izvi, zvakare, zvichaita kuti kuwedzerwa mukati memukoma kwekumanikidzwa uye kusikwa kwezvimwe zvinodzvinyirira pamusoro pechipfupa uye, sechiguma, kune nhengo dzedumbu re thoracic. Mune varwere vane kukanganisa kwechirwere chema cardiopulmonary, zvakadaro zvinokonzera kuipa kwechiitiko chacho.
3. Kuwedzera kukura kwechiremba. Kuwedzera kwechidimbu chechitatu uye chechina kunogonawo kuva kupesana kwekuita kurapwa kweparoscopic nekuda kwekuti kuwanika nhengo dzomukati mumatambudziko aya zvingange zvisina kukwana kwenguva yezviridzwa. Mukuwedzera, zvichienderana nehupamhi hwakawanda hwomukati wepamuviri mudumbu, mumamiriro ezvinhu akadaro, mune dzimwe nguva, hazvibviri kugadzira pneumoperitoneum.
4. Ophthalmic hypertension, kunyanya, ne glaucoma. Pneumoperitoneum inogona kukonzera kuwedzera kwekuwedzera kwepisocular, kuwedzera kwechirwere chechirwere ichi chakanyanya uye kukura kwezvinetso (somuenzaniso, retinal detachment).
5. High degree of myopia - pamusoro pezvitanhatu diopters (nokuda kwezvikonzero zvakafanana - kudzivisa kusungwa kwetina). Zvisinei, mune zvimwe zviitiko, kusarudzwa kunogona kuitika, somuenzaniso, munyaya yekutsvaga kwenguva pfupi kana kuti malologic laparoscopy, apo kuvharwa mukati memimba kunokwira zvishoma.
6. Zvirwere zveropa system, inoratidzirwa nekuputsa kwekwanisiro yekuvhara. Mamiriro akadaro akazara nekubuda ropa, izvo zvisingagamuchirwi.

Mune vakwegura, mamiriro ose ezvinhu, izvo zvinopesana neparparcopiic intervention intervention, inowanzonyorwa. Mumamiriro ezvinhu akadaro, varwere vanotanga kushandiswa vachishandisa nzira yekutambira-mini, iyo inenge isingawanikwi.