Ngosizo lensimbi ekhethekile (i-laparoscope), emva kokucubungula okuncane emgodini wesisu, kungenzeka ukufeza kokubili ukuhlolwa kwalo kokuhlola ngokuphathelene nomzimba (i-laparoscopy yokuxilonga) kanye nokungenelela okuncane okuhlinzekwa kwegazi (i-laparoscopy yokuhlinzwa noma yokusebenza).
Izinkomba ze-laparoscopy ku-gynecology
Izinkomba eziyinhloko ze-laparoscopy:
- ukungabi namandla kwabesifazane (ukuxilongwa kokuphulwa kobugebengu bama-tubes of fallopian nokuqedwa kwabo, ukuxoshwa kokunamathela);
- izifo ezithathelwanayo ezikhungweni zokubeletha (ukukhulelwa kwe-ectopic, i-appendicitis enzima, i-ovarian apoplexy);
- ukususwa kwama-cysts ovari, ama-tumor we-uterus nama-ovari, ama-polyps, ama-fibroids wesisu;
- i-tubation ye-tublopian tubes ngenkathi inzalo;
- ukususwa kwesibeletho nama-ovari;
- ukuxilongwa nokuphathwa kwe-endometriosis yama-ovari kanye ne-peritoneum;
- ukuxilongwa kanye nokwelashwa kwama-ovaries we-polycystic, ukuhlukunyezwa kokuthuthukiswa kwesisu , ukuvuthwa kwesibeletho;
- ukulungiselela i-IVF.
Kukhona nokuphikisana okuthile kwe-laparoscopy ku-gynecology:
- ukuthambekela kokuphuma kwegazi (nge-hemophilia, i-diathesis engavamile);
- izifo ezithintekayo zesimiso senhliziyo, isimiso sokuphefumula, isibindi nezinso;
- izifo ezithathelwanayo eziyingozi;
- i-peritonitis ye-purulent;
- i-hernia ene-diaphragmatic;
- ukushaqeka noma i-coma;
- izicubu ezimbi emzimbeni wesisu;
- ukukhuluphala ngokweqile;
- isimo ngemuva kokusebenza kwe-cavitary noma inqubo yokunamathela emgodini wesisu.
Ukulungiselela i-laparoscopy ekuguleni kwegazi
Ngaphandle kokuqeqeshwa okuqondile, kunemibuzo eminingi yokuhlolwa nokuhlolwa okumelwe kwenziwe nge-laparoscopy. Lokhu kuhlanganisa ukuhlolwa kwegazi kanye nokuvivinya umchamo, ukuhlolwa kwamathambo amaqanda ezinambuzane, ukuhlola igazi kwegazi (isifo segazi), ukuhlolwa kwe-syphilis, i-HIV, i-hepatitis ye-viral, ukuhlolwa kwegazi ngokujwayelekile ngesifo se-flora, i-ultrasound ye-pelvic, i-ECG, i-fluorography kanye isiphetho sochwepheshe.
Ukulungiselela i-Peredoperatsionnaya kuwukudla ngaphambi kokuba i-laparoscopy inokwelapha, intukuthelo ye-fiber, ingabangeli ukuqhuma. Ebusuku bokuhlinzwa, kwenziwa i-enema yokuhlanza, futhi ngosuku lokuhlinza kunqatshelwe ukuthatha ukudla nokuphuza amanzi, kunqume ukulungiswa.
I-laparoscopy yokusebenza ekuguleni komzimba
Nge-laparoscopy, i-trocar ifakwa ngokusebenzisa ukungena endaweni yesigodi 10 mm (kuyo, i-laparoscope enekhamera yevidiyo efakwe), nasesifundazweni se-pelvic - i-trocar amabili ye-5 mm ngezinsimbi. Faka isikhumba somzimba isikhumba se-carbon dioxide ukuthola kalula izitho. Ngosizo lwezinsimbi zokuhlinza, ukungenelela okudingekayo okuhlinzekwayo kuyadingeka. Ngemuva kwalo, vimbela ukuphuma kwegazi bese usebenza ngamagundane.
I-laparoscopy in gynecology: isikhathi se-postoperative
Ngemuva kokuhlinzwa, usuku lwesiguli kufanele lube ngaphansi kokuqondiswa odokotela ukuvimbela ukuthuthukiswa kwezinkinga ezingenzeka. Ngemuva kwe-laparoscopy, ukuphuma kwegazi okungaphakathi kungakhula, ngesikhathi sokusebenza, izitho zangasese noma imithwalo yegazi kungonakaliswa, umsebenzi wenhliziyo noma amaphaphu ungaphazanyiswa ngokufaka i-carbon dioxide emgodini wesisu. Ezingxenyeni zakamuva, ukuthuthukiswa kwe-emphysema engaphansi kwe-intanethi kungenzeka uma kwenzeka igesi ewela ngaphansi kwesikhumba, i-thrombosis yezimpahla zesisu esiswini.
Izinzuzo ze-laparoscopy
Inzuzo yalokhu kungenelela isilonda esincane esilandelayo, ukulimala okuncane, ukungabikho kwamacembe nobuhlungu esikhathini esibekwe ngemuva, ukulahleka kwegazi okuncane ngokungenelela, isikhathi esifushane sokulandela isikhathi, ithuba lokuxilongwa kanye nokwelapha ngesikhathi esisodwa. Ukungahambi kahle yi-anesthesia ejwayelekile ngesikhathi sokungenelela, futhi ngokuzimisela okungalungile kwezinkomba noma ukuthuthukiswa kwezinkinga, kungenzeka ukuthuthukisa isidingo sokuhumusha ukusebenza kwe-laparoscopic ibe yindawo evamile.