I-laparoscopy yamanyikwe ngaphambili yenziwa ngenhloso yokuthola ukuxilonga - ukunquma isigaba se-oncology yesitho noma ukuhlinzwa kwe-palliative ngehlobo lomdlavuza ongasebenzi.
Eminyakeni eyishumi edlule, ukusetshenziswa kwendlela kukhule kakhulu. I-Laparoscopy yenzelwe i-pancreatic necrosis, ukudonswa kwama-cysts e-pancreatic "yamanga", ukususwa kwe-tumor formations ye-pancreas.
Izinzuzo zokusebenzisa amandla wezokwelapha zibandakanya ukwehla kobukhulu bezinhlungu ngesikhathi sokuvuselela, ukwehla kwamathumbu esibelethweni. Futhi, isikhathi esifushane sokuhlala esimeni sokuma, ukululama ngokushesha kwesiguli.
Inqubo ye-laparoscopic inikezela isithombe esihle kakhulu se-anatomical, esibaluleke kakhulu ekusebenzeni kokuhlinzwa kwe-pancreatic ngenxa yobuningi bemithambo yegazi emikhulu endaweni yokungenela nendawo indawo yamanyikwe esifundeni se-retroperitoneal.
Izinzuzo kanye nezinkomba ze-pancreatic laparoscopy
I-Laparoscopy iyindlela entsha yokungenelela kokuhlinzwa nezinqubo zokuxilonga. Ucwaningo olunjalo lusiza ukwehlukanisa ama-pathologies ahlukahlukene, ikakhulukazi maqondana nezinkinga ezibangelwa ukwephulwa kokusebenza kwamanyikwe.
Inqubo ilula kakhulu i-cholangiography nokusetshenziswa kwezinto ezingafani, i-radiography, ne-biopsy. Le ndlela ikuvumela ukuthi uthole imbangela ngqo yalesi sifo, esiza ezimweni eziphuthumayo ukuze uqale ngokushesha ukwelashwa.
Izinzuzo zifaka ukungabikho kwesikhala odongeni lwesibeletho olungaphandle, ukunemba okuphezulu kokuxilongwa, ukukhohlisa kobuhlungu kanye nokulahlekelwa kwegazi okuncane. Futhi, isikhathi esifushane sokuvuselela kabusha, ubungozi obuncane bezinkinga zangemva kokusebenza.
Imisipha yesisu ingahanjiswa amahora angama-24 ngemuva kokungenelela. Ukungeniswa esibhedlela kwesiguli kwenziwa ngezinsuku ezi-4 kuphela, ngemuva kokuthi isiguli sikhishwe ekhaya. I-Laparoscopy njengendlela yokuhlinzwa ingenziwa kumacala alandelayo:
- Ukufa kwezicubu ze-pancreatic ngemuva kokuhlaselwa ngamandla kwe-pancreatitis;
- Isidingo sokubona ngamehlo ukuguqulwa kwesitho sangaphakathi ngokuvuvukala kwamanyikwe;
- Ukuba khona kwama-cysts kanye nezinhlobo ezahlukahlukene zokwakheka okuvela kwifomu elingapheli le-pancreatitis.
Inqubo yeLaparoscopic yenziwa njengendlela yokucwaninga. Ukukhonjwa yi-jaundice (kusiza ukusungula i-etiology ngqo), ukukhula kwesibindi kwe-etiology engaziwa, ama-ascites - uma kungenakwenzeka ukuthola imbangela yokuthuthuka ngezinye izindlela. Kungcono ukwenza nge-cholecystitis ukuze ungafaki ubukhona bamaseli womdlavuza, kanye nokuthola izifo ezithinta umchamo.
I-laparoscopy ye-pancreatitis isiza ukuthola ukuthi lesi sifo sikusiphi isigaba, isilinganiso somonakalo emzimbeni wesitho sangaphakathi.
Ukulungiselela okusebenzayo
Ngaphambi kokuthi sitshele ukuthi kulungiselelwa ini, sizokhuluma ngemibango. Akunakwenzeka ukwenza ubuqili ngokumelene nesizinda se-tumor neoplasms, uma kungenzeka ukuthi ngaphambili kwakukhona ukumisa isimo sabo esibuhlungu. I-contraindication yesibili ukungabi nalwazi kukadokotela ekwenzeni izindlela zokuhlinzwa ezivulekile kuma-pancreas noma izinqubo eziyinkimbinkimbi ze-laparoscopic.
Ukungenelela kuyenziwa ngokuya kudokotela ohambelayo. Futhi, ukukhohlisa okunjalo kunikezwa yizikhungo zezokwelapha ezizimele. Intengo iyinhlanganisela yezinto eziningi, kufaka nenqubomgomo yamanani emtholampilo. Izindleko eziphansi ngama-ruble angama-35,000.
Ngaphambi kokuhlinzwa, kwenziwa i-elebhu nokuhlonza izinsimbi. Nikeza ukuhlolwa kwegazi okujwayelekile, ukuhlolwa kwe-biochemical, i-computer tomography, i-MRI, i-angiography, i-biopsy.
Njengoba sesithole imiphumela yalolu cwaningo, kuhlanganiswa uhlelo lokusebenza. Ukulungiselela ngaphambi nje kwenqubo:
- Ukubona ngeso lesakhiwo se-anatomical sesitho sokugaya ukudla.
- Ukuhlolwa kwegazi kwe-biochemical ukukhipha ukuxhomekeka kwesimila kuma-hormone.
- Ukuhlolwa kwe-CT kusiza ekuboneni indawo efanelekile yokungena kwama-pancreas ngesikhathi sokuhlinzwa.
- Ukuhlolwa kwabahlola umdlavuza. Umcimbi ukhonjiswa kuzo zonke izinhlobo zamathumba e-pancreatic.
Imvamisa, i-laparoscopy iveza ama-neoplasms amabi ayethathwa njengengakacaci ngaphambi kokuhlinzwa. Kulesi simo, ezinye izindlela zibhekelelwa: izifo ezihambisanayo, ukuba khona / ukungabikho kwamaseli emgqeni we-resection, kanye nokuthi kungaba khona ukwelashwa okusebenzayo.
Umbuzo nawo uyaxazululwa ukuthi ngabe kuyadingeka yini ukwenza omunye umsebenzi, kodwa vele ngokusho kwemigomo yezokwelapha yezinqubo ze-oncological.
Izici ze-laparoscopy
Ukwenza i-laparoscopy yokuxilonga, i-anesthesia iyenziwa. Ukuze lokhu kwenzeke, ukulethwa kusengaphambili kwenziwa, isiguli sihanjiswa egumbini lokusebenzela kwi-gurney. Ngemuva kokubeka etafuleni elisebenzayo, khetha isikhundla esifanele. Ngemuva kwalokho isiguli sinikezwa i-anesthesia, kufakwa ishubhu ku-trachea, bese kuba ne-endotracheal anesthesia.
Ukuvimbela ubunzima obunjalo njenge-thrombophlebitis, imishini ekhethekile yokubandakanyeka ngezikhathi ezithile ifakwa emilenzeni ngalinye eliphansi lesiguli. Udonga olungaphambili lwesisu luphethwe ngesixazululo se-antiseptic, indawo okuhlinzayo imbozwe ngezicubu ezingcolile.
Kwenziwe into encane ukufaka izinsimbi zezokwelapha. Ngemuva kokucashunwa kwe-tumor neoplasm, i-tis necrosis, izinto ezisetshenziswayo zisuswa ngokucophelela futhi sutures isetshenziswa ekwakhekeni. Ngemuva kwalokho kufakwa i-trocar - ithuluzi lokuhlinza elidingekayo ukubhoboza umgodi wesisu, uma kunesidingo sokukhipha uketshezi kanye namagesi.
I-laparoscopic distal pancreatectomy yenziwa kusetshenziswa izindlela ezintathu:
- Ngokugcotshwa kwethafa endaweni eyodwa;
- Ngokugcinwa kophondo nemithambo yegazi kuyo;
- Ukuwela emikhunjini ye-splenic, noma kunjalo, ngaphandle kokususa i-spleen.
Ngenqubo yokungenelela kokuhlinzwa, udokotela uzama ukulondolozela ubonda, ngoba lesi sitho sangaphakathi sidlala indima ekhethekile ekulweni namagciwane we-pathogenic, wona nawo onomthelela omuhle ekulweni komuntu isikhathi eside. Lolu lwazi aluqinisekisiwe ngokuphelele, ngakho-ke, abanye odokotela bayawukhipha umhluzi, ikakhulukazi lapho kunzima ukugcina imithambo yegazi ngesikhathi sokukhohlisa kwe-laparoscopic. Le nqubo ilula futhi ishesha ngoba awudingi ukuchitha isikhathi uhlanganisa imithambo yegazi.
Ngokushesha emva kokungenelela, isiguli sibuyiselwa endaweni yokunakekela kakhulu, lapho-ke kungukuqala kwesimo esizinzile. Kungekudala, isiguli sizodluliselwa ekuhlinzwa esiswini noma emnyangweni jikelele, lapho sithola khona ukwelashwa nokondleka.
Ngemuva kokukhipha, isiguli sinconywa ukubonwa kwe-prophylactic, vakashela uchwepheshe wezokwelapha okungenani kanye ezinyangeni eziyisithupha ukwenza ukuhlolwa kwe-ultrasound. Qiniseka ukuthi unquma umuthi, ukudla okudlayo (landela ukudla okungu-5 nge-pancreatitis okungenani unyaka), indlela yokuphila enempilo.
Indlela eyenziwa ngayo i-pancreatic laparoscopy iboniswa kuvidiyo kule ndatshana.
