Hysterectomy indlela laparoscopy: ithuba post-operative, nokubuyekezwa imiphumo. Ukususwa fibroids zesibeleko laparoscopically: ncomo

Okwangoku, sisungule iiteknoloji ezintsha evumela iintlobo yokungenelela yamanina kunye iingxaki oluncinane kwaye iqondo elisezantsi trauma. hysterectomy laparoscopy ngu - omnye wabo.

Laparoscopy njengoko indlela entsha

utyando laparoscopy sele iminyaka engaphezu kwama-20. Ngeli xesha iye yasekwa ngokwalo njengendlela kancinane ezonakalisayo kunye ngempumelelo kunye iingxaki oluncinane post-operative.

ubuchule laparoscopy e zuza yafumana ithandwa kakhulu. Ngaphambili, indlela onjalo wenza imiqulu ezincinane utyando yamanina. Kodwa kwiminyaka yakutshanje kwiiklinikhi nezibhedlele ezininzi, iye yaba zizinto eziqhelekileyo. Enye yezi imisebenzi kukususa fibroids zesibeleko laparoscopically. Izimvo ezigulane zibonisa ukuba kukho ukubuyiselwa okukhawulezayo zokusebenza amandla, ubungozi ingxaki kunye azikhuli umonakalo ezincinane elincinane nolusu ayihambelani ezonakalisa imbonakalo yabafazi.

Kuba msebenzi ufuna abasebenzi abaqeqeshiweyo nabanamava. Ungenelelo likhona kulo mzekelo, iingxaki ezincinci. Kwezinye iimeko, indibanisela laparoscopy kunye notyando eqhelekileyo kufuneka nje ukusindisa ubomi yesigulane. Le specialist aya kuyinyula indlela echanekileyo ukunyanga izigulana zazo kwimeko nganye nganye.

izibhedlele abaninzi ukuphumeza ukususwa fibroids zesibeleko laparoscopically. E Moscow, phantse zonke isebe yamanina lixhotyiswe ngezixhobo eziyimfuneko kwaye neengcali zokuyenza lo nokwenza izinto. Eminikelweni yonke utyando yamanina 50-60% agcinwe laparoscopy.

Eyona engundoqo eziluncedo le ndlela:

• degree aphantsi trauma;

• umsebenzi recovery ekhawulezayo onke amalungu;

• Ukuncitshiswa intlungu post-operative;

• sakugcina azikhuli ;

• ixesha elifutshane esibhedlele;

• bahlalise care ngemini;

• ukuncitshiswa ngokwemiqathango yokukhubazeka;

• ubuncinane hernias postoperative;

• elona xesha lincinane ukuze kulungiswe;

• ukugcina amayeza.

mathuba Negative laparoscopy

Yonke le miba eyakhayo ngexesha kutyando ephilisa abafazi lalugubungela lonke ezingalunganga ukuba ikhona na utyando laparoscopy:

• oomatshini kunye noqeqesho ziingcali zifuna iinkcitho ezibalulekileyo;

• Ingcibi kufuneka babe ubuchule laparoscopy kunye notyando zemveli;

• Iingxaki sele notyeshelo nemisebenzi yamalungu ezinxulumene isitofu berhasi kwi kwisisu, kodwa ukulungiswa kwaye ulungise nokuthintela ezi iingxaki zinokuphetshwa;

• Musa kulawula naziphi na umonakalo ukuba amasebe awohlukeneyo, ancedisana nezakhiwo.

Isicelo e G

In yamanina practice laparoscopy isagquba. Ukongeza uxilongo kwiimeko abaqiniseki esisu ludlule, amisele ezibangela nenzalo, inkqubo laparoscopy isetyenziswa kwiimeko ezifana:

1. pregnancy.

2. Isikhewu tube.

3. inzalo Steel.

4. Endometriosis.

5. Esi sifo ngcina.

6. Izifo ngeentlobo cysts ovarian, sklerokistoz, apoplexy ovarian.

7. ukubunjwa ebubonisayo isibeleko (hysterectomy ubuchule laparoscopy kunciphisa ingozi kubunzima postoperative).

8. Iinkqubo hyperplastic, hayi efanele kuthomalaliso endala.

Kutshanje gynecologists iqhele ukusetyenziswa hysterectomy laparoscopy nkqu ngamathumba amabi. Ngubani liqulunqe iindlela ezininzi kulo msebenzi, ngokuxhomekeka kubungakanani isibeleko, ubume balo kunye ukubandakanyeka kwinkqubo amalungu angabamelwane. Luphawu kusetyenziswa fibroids lo msebenzi kwi kwendawo ezahlukeneyo.

fibroids wesizalo

fibroids wesizalo - isifo elihle apho phantsi kweempembelelo hormone kwenzeka ukwanda yethishyu ezinezikhondo ekumisweni amaqhina. It waphawula kukhokelele kwiqondo eliphezulu lobukho isifo - malunga ne-25% yazo zonke iingxaki yamanina. fibroids wesizalo unefuthe umzimba yonke yabafazi. Myomectomy ithathwa unyango "umgangatho igolide" ngenxa yesi sifo.

Hysterectomy laparoscopically. iintlobo

Xa ukhetha indlela of unyango lwe fibroids kuthathelwa ingqalelo izinto ezininzi: indawo nobungakanani ezalathelwe uphuhliso, ukusebenza, okanye ukulahleka amalungu ezikufutshane, imeko jikelele yomfazi. Kuxhomekeka zesibeleko izitshanguba ezihlobene iindidi eziliqela ukuhlinza amalungu okuzala.

Xa yokwenza isebenzisa:

- iyonke hysterectomy xa esusiwe umzimba kunye wesibeleko; losuku - isibeleko isusiwe umzimba. Ukuba kunye isibeleko umbhobho inqunyulwe - gistertubektomiya, kwaye ukuba imibhobho kunye Yachnik, ukusebenza kuthiwa gistertubovarioektomiya. Ukuze imisebenzi ezinkulu ezifana pangisterektomii - ukucima zonke esini zangaphakathi kunye ezalathelwe uphuhliso nkovu okanye amadlala nezihlunu iinkqubo ikuku yaye ngokuyinxenye abhenele oncological eziyingqongileyo.

- Xa imali encinane kweeyunithi kunye nokulondoloza nabantwana abafazi enze uqhaqho ablative. Enye yezi ukususwa subserous fibroids zesibeleko laparoscopically. Nge wesizalo sisilonda esidumbileyoesingaphakathi ezalathelwe kancinane enucleation kuthwalelwa, ngamanye husking izicwili ezinezikhondo ezalandela ugcino omzimba. Emveni kwezi imisebenzi, umntu obhinqileyo unakho ukufumana ukukhulelwa emva kwexesha elithile ze azale.

Izimo

Kukho Izimo kutyando ukususa fibroids isibeleko laparoscopically. Ukuphonononga Gynecologists lubonisa ukuba kwiimeko ezininzi le msebenzi wenziwe zonke, ngaphandle kwabo bafazi abaphethwe sentliziyo kakhulu, ukusilela yokuphefumla, abe Ithemba, iingxaki kunye nenkqubo coagulation igazi okanye marasmus

Izimo Relative - yimeko apho umsebenzi kunokwenzeka, kodwa siveza neengxaki ezithile. Zezi:

• kukubi kakhulu amafutha ongama;

• Izifo ezosulelayo wedobo;

• azikhuli;

• effusion okanye ubukho ulwelo kwi kwisisu of ilitha ngaphezulu kwe-1.

Kodwa gynecologists mihla, ukuba inkqubo laparoscopy, emva kokuphonononga esi ezinjalo izifo ikhondo unyango emiselweyo, ukuphilisa nakujoliso olutsha usulelo kwaye enze uqhaqho. Ngelo xesha linye uyawulinganisela "kwizazi" kunye "bendlela" ngaphambi kokuba tirhisa operation laparoscopy.

Ukulungiselela utyando

Izimvo abafazi abaye unenzondelelo hysterectomy laparoscopically, kuyaziwa ukuba izigulane abanganelisekanga kwamalungiselelo kuphela: Olu tyando ithatha imizuzu engama-40, nokulungiselela - kwiiveki ezi-2 nangaphezulu.

Kwi ukusebenza lo mfazi uzayo emva iimvavanyo kunye neziphumo ezifunyenweyo ziya kusiwa:

• Iimvavanyo kwegazi (ewonke, kwemichiza, uhlobo lwegazi kunye RH factor, kwesibindi, ngegcushuwa kunye ekunqandeni HIV, ukumiselwa glucose);

• Iimvavanyo umchamo - jikelele kunye nokuzimisela iswekile;

• smear;

• electrocardiogram;

• x-reyi;

• ultrasound;

• Colposcopy;

• Ukuhlolwa leengcaphephe: a therapist, ukuba kuyimfuneko, omnye cardiologist kunye nabanye.

Phambi kokuba operation izigulana fibroids zesibeleko kufuna curettage eyahlukileyo sokuxilonga wesibeleko kunye nokufumana iziphumo histological. Oku kuyimfuneko ukuze kulungiswe umba isixa kotyando kunye nokuphelisa nokuthintela olunye uphuhliso lweenkqubo zomhlaza.

Zonke iimviwo - yinkqubo efunekayo, yaye kuphela emva kokuba uphando epheleleyo ugqirha uza kukwazi ukuphumeza ukususwa isibeleko laparoscopically.

Kusuku ngaphambi kokuba utyando akunconywa ukutya, kufuneka achebe iinwele zikawonke wonke.

Ngaphambi kokuba ahlinzwe, Wawuzalisa umfazi ifomu imvume zomzimba, bangegqithi, kube ngenxa msebenzi. Ukuba kuyimfuneko, ukunika ukulungiselela unyango okanye psychoprophylactic ukuba uqhaqho.

operation Technology

Umsebenzi ukususa isibeleko laparoscopically eyenziwa xa myomas Isanti ukuya kwiiveki ezili-16 zokukhulelwa, ezo nzima nokopha, esibonakala ukwanda okanye umngcipheko yotshintsho amabi. Nangona ezinye iingcali ezinamava kususwe ngokupheleleyo isibeleko, ubukhulu apho malunga ne-20 iiveki. Kodwa ke kaninzi, ngenxa yobudala yomfazi, wenziwe ukususwa fibroids zesibeleko laparoscopically eshiya inxalenye encinane wesibeleko ukuba sexesheni.

Sebenzisa okuhlatywa ezintathu okanye ezine udonga esiswini (a - kufuphi inkaba kunye nezinye ezimbini - on kwicala ngalinye) kunye trocars alawulwa. Esi sixhobo banikwa ikhamera esweni ukukhanya okanye ufakelo supercharger carbon dioxide okanye oxide kunye nezixhobo.

Emva ukususwa uhlolo wenza fibroids laparoscopically wesizalo. Ngokuba lo lungu na excised, izitya ligated dissected ukusuka wesibeleko kunye nodonga ikuku luthe lwancothulwa ngokusebenzisa lobufazi esebenzisa basike nasemagumbini. Olu sebenziso kuthiwa laparoscopically bencediswa myomectomy lobufazi. Chitha suturing basike lobufazi. Xa umsebenzi omnye Ungasusa iindawo ezininzi ngaphandle kwakhona angenelele.

Emva igazi odalyayut okanye ulwelo, okongezeleke ngokusebenza, uhlolo lwenziwe kwakhona izidumbu kunye neendonga kwisisu. bayitshekishe ngocoselelo nokuba novelwano ngalondoda wayibopha kakuhle kwaye ligated nempahla, nokuba igazi propotevanie okanye fluid emithanjeni. Kuphelisa izixhobo zegesi kunye nokubonisa. Ke izitishi kwenzeka kakhulu eluswini kunye inyama ongama kwisiza trocar, isikhumba sutured sutures izithambiso.

Ubude operation ingase ukusuka imizuzu eli-15 ukuya iiyure 1.5 kuxhomekeka kumthamo yokungenelela ngotyando wachitha.

Analgesia kwimisebenzi efana ukususwa isibeleko laparoscopically: ncomo

Yiyiphi zomzimba ingcono? Lo mbuzo kufuneka isonjululwe kunye ugqirha i anesthesiologist, banikwa imeko jikelele kwisigulana, izalathi si zokunikwa izifundo laboratory, umthamo uqikelelo imisebenzi. Kwiimeko ezininzi, edityanisiweyo Ukubulawa endotracheal. Izimvo abafazi bathi ukuba ukunyamezeleka kakuhle, kungekho ebuhlungu. wake Female emva kwemizuzu 15-20 emva utyando ezifana nokususwa isibeleko laparoscopically.

Ithuba postoperative kunye zomzimba olufanelekileyo kukhokelela nemiphumo emihle emva kokuba ungenelelo: iintlungu akuthethi ungazihluphi, kukho ukungaphatheki minor kuphela, nto leyo udlula iintsuku-2. Ngamanye amaxesha kuba isicaphucaphu, kodwa ukuba ebekwe "metoclopramide". Ngosuku lokuqala uyakwazi usele amanzi kuphela. Ngokuhlwa, uyakwazi sele uvuke avuke. Ngosuku lwesibini udle, engaquki ukubacaphukisa kwamathumbu, ezifana isidudu, isuphu, iimveliso zobisi. Isicatshulwa lwenziwa ngosuku lwesibini emva kokuba ungenelelo, yaye ikhefu lokugula ivaliwe emva kweentsuku ezingama-30. Emva koko lo mfazi ngokukhuselekileyo ukuya emsebenzini, kodwa kunye nomqathango kanzima enzima inyanga. Sutures zisuswa ngosuku postoperative 5.

Emva kotyando, iingxaki kunokwenzeka, eyile zinqabile: nale nkxwaleko trocar enyama yangaphakathi, ukopha phantsi iimpahla ligated, emphysema ongama. Konke oku ingathintelwa ukuba balandele ngqo umsebenzi izixhobo ze enze uphicotho-zincwadi kwisisu ngenyameko.

imiphumela

Kufuneka kuqatshelwe ukuba emva msebenzi njenge ndlela laparoscopy hysterectomy, imiphumo bakholisa ukufumana. Indawo yoBuyiselo-kwenzeka emva kweeveki ezi-2 yesiqhelo. iintsuku ezingama-30 emva kokuba umsebenzi lo mfazi yimicimbi yaso njengesiqhelo. Kucetyiswa umthambo kunokwenzeka. Kodwa inyanga kamva, kuba kokungafunekiyo ukulayisha izihlunu esiswini, phakamisa amatye ilanga.

Ngemihla yakudala bangafumana iintlungu ekhathazayo engephi esiswini. Oku kuqhelekile yaye kufuneka kwathi ngemihla 1-2. Ukwenziwa azikhuli kunokwenzeka, kodwa ngokutsho manani oku kwenzeka kunqabile kakhulu kwaye kuphela yofuzo yento ephilayo okanye ngaphantsi endometriosis kubonakaliswa.

Amanzi kancinane ukusuka phecana zangasese. Oku kuqhelekile ukuba amaqanda zombini. Baqhubekeka ukuvelisa hormone ezibangela lo yabo.

Amatyala yeenkqubo ukudumba emva kotyando laparoscopy zinqabile, ngokuba olwa onyulwe ngoko nangoko emva kokuba ungenelelo kunye nokuqhubeka iintsuku ezi-5. Ngelo xesha linye lulungiswe amanzi kunye electrolyte nokwakheka igazi.

Ukubuyiselwa isigulane nenzalo phantse nangoko, kodwa kwezinye iimeko kukho ukwanda yobuntu. Umntu obhinqileyo unakho ukuphila ubomi ngokwesondo emva kwenyanga 1 emva kotyando. Ukuba umzimba igcinwe, ungafumana ukukhulelwa kwiinyanga ezintandathu emva kolo ngenelelo.

na ukuluthwala phi lo msebenzi?

izibhedlele ezininzi ukunikela hysterectomy laparoscopically. Ezibhedlele isixeko Moscow ukuba baxhotyiswa izixhobo kufuneka iingcali ukuba le ndlela iza kuqhuba ezi nkonzo. Ixabiso ukuthenga livumile kunye nogqirha khona.

Le saveyi kungenziwa kwi-ofisi okanye kwindawo yokuhlala pre-esibhedlele. Ukuba baqhube imisebenzi enjalo kunokwenzeka quota yobhaliso. Iindleko hysterectomy laparoscopy imalunga 45 ukuya kuma-70 amawaka.