Ukuqonda izinqubo ze-Laparotomy ne-Laparoscopy

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I-Laparotomy Versus Laparoscopy

I-laparotomy yinkathi yezokwelapha jikelele yokuhlinzwa okwenziwe esiswini ngokusebenzisa ukukhishwa okujwayelekile kwendabuko, kunokuba indlela encane engavamile. Elinye igama lalo misebenzi ejwayelekile ukuhlinzwa yi-coeliotomy.

I-laparotomy isebenzisa ukuchithwa okugcwele okugcwele futhi inguqulo encane ye-inqubo ibizwa ngokuthi i-laparoscopy futhi isebenzisa ukucubungula okuncane okuncane.

Inqubo yendabuko - i-laparotomy - ivame ukubizwa ngokuthi "evulekile" inqubo, ngoba ukufakwa komzimba kwenza ukuvuleka okuvumela udokotela ohlinzayo ukuba acabange ngezitho, imithwalo yegazi, namathissi emgodini wesisu. I-laparotomy isebenzisa izinsimbi zama-laparoscopic kuhlanganise nekhamera efakwa emibonweni encane kakhulu ukuvumela udokotela ohlinzayo ukuba acabange ngezakhiwo zangaphakathi nezinsimbi zokuhlinza.

Isinqumo sokwenza inqubo ivuleke noma i-laparoscopically ihlala nodokotela ohlinzayo nokuthi yini, uma ilindele, ukuthola ngesikhathi sokuhlinzwa. Uma ukuhlinzwa kwenziwa njengesimo esiphuthumayo, udokotela ohlinzayo angenza i-laparotomy noma i-laparoscopic laparotomy ngoba inikeza umbono omkhulu futhi ungashesha kakhulu kunendlela encane engavamile. Uma imizuzu ibalwa, inqubo yokuvula evulekile ivame ukuhamba ngesivinini esithile esigabeni sokuqala sokuhlinzwa.

Ezimweni eziningi inqubo evulekile igcinelwe izimo lapho isikhathi siyisisekelo, isiguli singazinzile noma lapho inqubo idinga ukugxila okukhulu, njengokuhlinzwa okudinga ukuthi ingxenye enkulu yamathumbu ibonakale futhi ifinyeleleke.

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I-laparotomy ehlolisisayo ne-Laparoscopy ehlolisayo

I-laparotomy yokuhlolisisa yigama elinikezwe ukuhlinzwa okuvulekile kwesisu okusetshenziselwa ukuhlola izitho kanye nezicubu zesisu lapho ukuxilongwa kungakenziwa. Uma umthombo wezinkinga zesisu akusobala, ukuhlolwa okubukwayo kwesiguli esiswini kungasiza.

Esikhathini esidlule, i-laparotomy yokuhlola yayivame ukuqhutshwa "ubuhlungu besisu obungokwemvelo," lapho ukuhlolwa kungaphumelelanga ekunqumeni isizathu sobuhlungu. Kwakwenziwe nangezinye izizathu eziningi, kufaka phakathi ukuhlukumezeka, okusolakala ukuthi umdlavuza noma ezinye izimo ezingahlolwa.

Namuhla, indlela encane engavamile iyasetshenziswa kaningi kunalendlela evulekile. Uma inqubo isenziwa ngamasu amancane ahlaselayo, ibizwa ngokuthi i-laparoscopy yokuhlola

Ukuhlinzwa okuhlolisisayo, ngokuvamile, kuvamile kunalokho okwakudlule esikhathini esedlule ngenxa yokukwazi ukuthola izithombe zomzimba usebenzisa i-Magnetic Resonance Imagine (MRI), i-Computer Tomography (CT Scans) nezinye izinqubo. Singakwazi ukuhlolisisa izinto ngaphandle kokubheka futhi sibone ukuhlinzwa, futhi izinkinga eziningi zingelashwa ngemithi esikhundleni se-scalpel.

Kwezinye izimo, udokotela ohlinzayo angathola imbangela yenkinga yesisu futhi aqede inqubo yokuhlola ngaphandle kokwelapha okunye. Lokhu okutholakele kungabuye kuxoxwe lapho isiguli siphapheme ngokuphelele futhi siqaphele, futhi uhlelo lwezokwelapha ludalwa. Isibonelo, uma owesifazane etholakala enama-cysts ama-ovarian amakhulu ngesikhathi se-laparotomy, udokotela ohlinzayo angase anqume ukuxoxa ngenqubo kanye nezinye izindlela nesiguli ngaphambi kokuba aqhubeke nokwelapha okuhlinzekwa.

Phakathi ne-laparotomy yokuhlola, amasampuli amathisiphinde angathathwa ngenqubo ebizwa nge- biopsy . Lokhu kwenziwa ukusiza ngokuxilongwa kwezinkinga zesisu njengoba izicubu zingabuyekezwa ngaphansi kwe-microscope futhi inkinga ingase ihlolwe ngaleyo ndlela.

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Izizathu Ze-Laparotomy Noma I-Laparoscopy

Izizathu Ze-Laparotomy

I-laparotomy igama elivamile lenqubo yokuhlinzwa eyenziwa esiswini. Igama elithi laparotomy lokuhlola elivame ukusetshenziselwa ukuchaza inqubo esetshenziselwa ukucacisa uhlobo lwesifo. Isibonelo, uma isiguli sithola ubuhlungu besisu kanti umthombo walokho ubuhlungu abucaci, udokotela ohlinzayo uzohlela i-laparotomy yokuhlola.

Izizathu Ezivamile Ze-Laparotomy:

I-intestine Enkulu Nezincane : I-perforation emathunjini, ukuvinjelwa kwamathumbu, umdlavuza,

Isibindi : I-trauma, i-cirrhosis, ukukhuliswa kwesibindi, isidingo sokugcoba.

Uhlelo lwe-Urinary-Izinso, Ureters nesinye Isilonda : Ama-blockages afana namatshe aso, umdlavuza, ukuhlukumezeka

Uhlelo Lokuzala Lomama: Endometriosis, umdlavuza, ukukhulelwa kwe-ectopic, ukuvuvukala

I-Gallbladder : Ngokuvamile kwenziwa ngokusebenzisa indlela encane engavamile, ezimweni ezingavamile kungenzeka isuswe besebenzisa indlela evulekile

Iphutha : I-Trauma, ukukhuliswa kwamaphiko, ukuphuka

Ama -pancreas: Ukuvuvukala ama-pancreas, umdlavuza

Izikhalazo ezijwayelekile zesisu : Izifo ezifana ne- abscess , umdlavuza, ukuhlukumezeka, ukuvuvukala kwezicubu, ukucacisa isigaba senqubo yesifo, ukunamathela ezinkambisweni zangaphambilini

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Ukuhlinzwa Kokuphuthumayo Kwe-Laparotomy

I-laparotomy ingenziwa ngokushesha, okusho ukuthi isiguli sibhekene nesimo esisongela ukuphila futhi i-laparoscopy iyadingeka ukuze inqume ukuthi uhlobo luni inkinga, ukuphatha le nkinga noma kokubili. Inkinga ingase iphume emthonjeni ongaziwa, umonakalo ku-organ noma ngisho nokuphuma kwegazi okungenakulawulwa ngisho noma imbangela yaziwa.

Inqubo evame ukuyenza ngemuva kokulimala okudabukisayo okubangelwa ubuhlungu besisu kukhona ukujula kwe-peritoneal deep (DPL). Yilapho ukucubungula okuncane kuyenziwa esiswini kanti isisu esiswini sesisu siphunduzwa nge-fluid. Uma uketshezi kuphuma emzimbeni enezibalo eziningi zegazi, i-laparotomy ingaboniswa. I-DPL ayitholi ukuthi iyini umthombo wokulimala kodwa ikhombisa ukuphuma kwegazi kukhona. I-laparotomy izoxilonga ukulimala kanti udokotela ohlinzayo angase akwazi ukulungisa le nkinga.

Ukuhlukunyezwa, njengengozi yemoto noma ukulimala okungenayo (ukugwaza noma ukulimala kwesibhamu) kuyimbangela evamile yokulimala kwesisu okufanele kutholakale noma kuphathwe nge-laparotomy. Kulezi zimo kungase kube sobala ukuthi kunesilonda esikhulu esiswini, kodwa izimboni, izitsha kanye nezicubu ezibandakanyekayo kungenzeka ukuthi azicaci. Kulezi zimo, udokotela ohlinzayo angabona ngeso lengqondo ukulimala futhi ahlolisise inkinga, futhi ezimweni eziningi, aphathe le nkinga.

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I-Laparotomy: Izingozi nezinkinga

Ngaphandle kwezingozi ezijwayelekile zokuhlinzwa kanye nezingozi ze-anesthesia , kokubili i-laparoscopy ne-laparotomy zibeka izingozi zabo siqu. Izingozi zihluka ngokusekelwe enkingeni noma izifo ezenza inqubo idingekile, kodwa izingozi eziqondene nenqubo yilezi:

• Ukutheleleka
• I-hernia engenangqondo
• Ukuhlwitha kusuka kusayithi lokuhlinza

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Ngesikhathi se-Laparotomy ne-Laparoscopy Procedures

I-laparotomy noma i-laparoscopy iqala ngokuphathwa kwe-anesthesia jikelele. Lapho i-anesthesia iqeda ukusebenza, isikhumba sesisu sisilungiselela ngesisombululo sokulwa nokuvimbela ukutheleleka endaweni yokuhlinzwa.

Udokotela ohlinzayo uzokwenza ukuchotshozwa. Uma ubuhlungu busesiswini esingaphansi kwesisu ngaphezu kwesithasiselo, ukuhlanganiswa kuyobekwa endaweni leyo.

Uma kulungiswa uhlelo lwe-laparoscopy lwenqubo encane encane, ukucubungula okuncane okungaphansi kwe-inch eside kuzokwenziwa, uma i-laparotomy ihlelwe, kuzothathwa ukukhipha okukhulu.

Uma ukuqubuka okukhulu kuzosetshenziselwa, kungenzeka ukuthi kube ukuhlanganiswa kwe-midline, okuyi-incision ebonakalayo ebeka phakathi kwethambo le-pubic nangaphansi kwe-sternum, nokufakwa kwe-transverse, okubekwe eceleni.

Kwezinye izimo, ukuhlaselwa kungase kube mncane ekuqaleni kokuhlinzwa futhi kwandiswe lapho kudingeka khona ukuqedela izinqubo ngemuva kokuthola ukuxilongwa. Kwesinye isikhathi inqubo encane engavamile ingaba inqubo evulekile uma udokotela ohlinzayo edinga indawo engaphezulu ukuze abone ngeso lengqondo inkinga noma umsebenzi.

Uma sekufakiwe, izitho nezicubu zizohlolwa ngezimpawu zesifo, ukutheleleka noma ukuvuvukala. I-biopsies ingathathwa ngama-tissue ahlukene uma kudingeka. Kwezinye izimo, isigxobo esiswini singase "sihlanzwe," lapho uketshezi oluyinyumba lufakwa khona esiswini, bese luqoqwa ukuze luqhubeke luqhutshwa.

Lapho izitho kanye nezicubu zesisu sezihloliwe, "ukubheka nokubona" ​​ingxenye yenqubo sekuphelile; Nokho, ezimweni eziningi, inqubo yokwengeza izokwenziwa. Isibonelo, i-laparotomiya yenziwa ukuze uthole umthombo wezihlungu zesisu, futhi isithasiselo esibangelwayo siyatholakala, inqubo ye-appendectomy izohlanganiswa ne-laparotomy.

Ukukhishwa kungahle kuvaliwe ngezindlela ezihlukahlukene. Ukucubungula okukhulu kuvaliwe nge-sutures noma okuyisisekelo, izincane ezincane zingavalwa ngezingxenye zokunamathisela okuthiwa i-ster-strips noma iglue yokuhlinza. Lokhu kuhlanganiswa kuhlanganiswa ne-bandage yokuhlinza oyinyumba. I-anesthesia imisiwe futhi imithi inikezwa ukuba ivuse isiguli, esithathiwe endaweni yokutakula.

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Ukuphinda Kusuka Ku-Laparotomy

Ukubuyiselwa kwindlela yokulahla i-laparotomy kuyahluka kakhulu kusuka kwesiguli kuya kwesiguli. Lokhu kubangelwa inani elikhulu lezinkinga ezenza ukuhlinzwa kudingeke. Ngokuvamile, inqubo engaqondakali eyilarotomy futhi akukho inqubo eyengeziwe idinga amaviki amabili kuya kwangu-6 okuphumula ngaphambi kokubuyela emisebenzini evamile. Lokhu kungakhuliswa kakhulu ngezinqubo ezidingekayo ngemuva kokuthola ukuxilongwa.

Iziguli ezine-laparotomi futhi zinezimo ezingathí sina eziyinkimbinkimbi (isiguli esasiyingozi emotweni kanye namathambo aphukile nokugaya kwangaphakathi okudinga i-laparotomy) kungathatha isikhathi eside ukuphulukisa kusukela ekuhlinzekeni. Umzimba usebenza ukuphulukisa ukulimala okuningi ngesikhathi esisodwa, ngakho isikhathi sokuphulukiswa esiphelele sinwetshiwe. Ezinye izinkinga ezenza i-laparotomy iyadingeka zingase ziphuze ukuphulukisa. Isiguli esinesifo somdlavuza singase sibe nokululala okunzima kakhulu njengoba ukwelashwa komdlavuza kungase kutholakale nokuthola. Okufanayo nakakhulu uma unenqubo eyengeziwe yokuhlinzwa ne-laparotomy.

Uma usukhishiwe esibhedlela ukuze ululame ekhaya, kubalulekile ukuthi ukunakekelwa okukhethekile kuthathwe ukuvimbela ukutheleleka futhi uthathe kahle ukunakekelwa . Ukutheleleka kungenye yezinkinga ezivame kakhulu kulokhu kuhlinzeka, ngakho-ke ukwazi indlela yokuthola izimpawu zokutheleleka kubalulekile. Hlela ukuqinisa ukushaywa kwakho lapho uvuka ekuhleleni noma noma yimuphi omunye umsebenzi okhulisa ukucindezelwa kwesisu ukuvimbela ubuhlungu, ukuhlukunyezwa nokunciphisa ingozi ye-hernia engaqondakali.

_Imithombo:

> Ukuhlolwa Kwemimba. Izikhungo zezempilo zikazwelonke. 2006. http://www.nlm.nih.gov/medlineplus/ency/article/002928.htm