Kunyatsonzwisisa Laparotomy neRaparoscopy Process

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Laparotomy uye Laparoscopy

Laparotomy ndiyo izwi rezvehutano rezvekuvhiyiwa kunoitwa mudumbu uchishandisa chidimbu chemaitiro akazara, kwete kuvhiringidza zvishoma. Imwe zita rekuvhiya uku kwakajairika ndeyekudzivirira.

A laparotomy inoshandisa yakazara incision uye iyo minimally invasive version yeyo nzira inonzi laparoscopy uye inoshandisa zvinyorwa zviduku zvishoma.

Nzira yemitambo - laparotomy - inowanzonzi "yakazaruka" nzira, nokuti incision inogadzira mukova unobvumira chiremba chiremba kufungidzira nhengo, mutezi weropa, uye mishonga mumakumbo emimba. Ichaparotomy inoshandisa ma-laparoscopic zvishandisi kusanganisira kamera yakaiswa mune zviduku zvishoma kuti zvibvumire chiremba chiremba kufungidzira zvivako zvepakati uye zvigadzirwa zvokuvhiya.

Chisarudzo chekuita nzira yacho yakazaruka kana saroscopiyo inogara nechiremba uye chii, kana chimwe chinhu, anotarisira kuwana panguva yekuvhiyiwa. Kana chirwere ichi chiri kuitwa senjodzi, chirwere ichi chinogona kuita laparotomy neparparoscopic laparotomy nokuti inopa maonero makuru uye inogona kunge yakakurumidza kupinda nzira inenge isingaiti. Apo maminitsi akaverengwa, nzira yakasununguka nzira inowanzowedzera zvakanyanya muchikamu chekutanga chekuvhiya.

Muzviitiko zvakawanda maitiro akazaruka akachengeterwa mamiriro ezvinhu apo nguva ndeyeiyo, murwere haana kugadzikana kana apo chirongwa chinoda kuvharwa kukuru, kwakadai sekuvhiyiwa kunoda kuti chikamu chikuru chemukati chioneke uye chinogoneka.

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Laparotomy Inotsvakurudza neRaparoscopy Inotsvakurudza

Kuongorora kwekudzivirira kwemuviri ndiro zita rakapiwa chirwere chemuviri chakazaruka chinoshandiswa kuongorora nhengo nezviviri zvemuviri kana chirwere chisina kuitwa. Kana iyo yakabva dambudziko remuviri isiri pachena, kuonekwa kwechidziro chemuviri kunogona kubatsira.

Munguva yakapfuura, laparotomy yekuongorora yakawanzoitwa nokuda kwe "kurwadziwa kwepamuviri kusingazivikanwe kwakabva," apo kuedza kwakange kusina kubudirira pakusarudza chikonzero chekutambudzika. Yakaitwawo kune zvimwe zvikonzero zvizhinji, kusanganisira kushungurudzika, kunyungurudzwa kenza kana zvimwe zviitiko izvo kuedza kusingagoni kuongorora.

Nhasi, nzira isingasviki inoshandiswa inoshandiswa kakawanda kudarika nzira iyi yakazaruka. Apo nzira yacho inogadzirwa nemagadzirirwo emadzimai asina simba, inonzi inosarudzwa neparoscopy

Kuvhiyiwa kunotsvakurudza, kazhinji, hakusi kudarika kudarika kwaiitwa munguva yakapfuura nekuda kwekuwedzerwa kukwanisa kuwana mifananidzo yemuviri uchishandisa Magnetic Resonance Imagine (MRI), Computer Tomography (CT Scans) nezvimwe nzira. Tinogona kugara tichiona zvinhu tisingafaniri kutarisa uye kuona maitiro, uye zvinetso zvakawanda zvinogona kurapwa nemishonga kwete pane scalpel.

Mune zvimwe zviitiko, chiremba anovhiya angawana chikonzero chechinetso chemuviri uye anopedzisa nzira yekuongorora pasina kuwedzera kurapwa. Zvitsva zvinogona kuongororwa apo murwere anenge akangwarira uye akangwarira, uye chirongwa chekurapa chakagadzirwa. Semuenzaniso, kana mukadzi akawanikwa aine mazamu akaoma mavhisi panguva yekurapa, chiremba anokwanisa kusarudza kukurukura nzira yacho uye zvimwe zvinoshandiswa nemurwere asati apfuurira mberi nekurapwa kwekuvhiya.

Munguva yekuongorora kweparotori, zvidzidzo zvemuviri zvinogonawo kutorwa mumutambo unonzi biopsy . Izvo zvinoitwa kubatsira kubatwa kwematambudziko emuviri sezvo zvigunwe zvinogona kuongororwa pasi microscope uye nyaya inogona kuongororwa nenzira iyoyo.

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Zvikonzero Zvokureruka Kwepabonde kana Kadhipafasi

Zvikonzero zveRaparotomy

A laparotomy ndiro zita guru rekuvhiya kunoitwa pamimba. Izwi rokuti exploratory laparotomy rinowanzoshandiswa kurondedzera nzira inoshandiswa kugadzirisa mararamiro erwere. Somuenzaniso, kana murwere ari kurwadziwa mumimba uye iyo inotangira kurwadziwa kwacho haisi pachena, chiremba anovhiya acharonga sarotomy.

Zvikonzero Zvijairika Zvepaparotomy:

Utumbo Hwakakura uye Huduku : Kuora kwemukati, kubviswa kwemukati, kenza,

Chiropa : Trauma, cirrhosis, kuwedzera kwechiropa, kudikanwa kwekunhuwa.

Urinary System-Tsvete, Ureters uye Chirafu : Zviputi zvakadai seminyo yemabwe, kenza, tsvina

Chirwere chekuberekwa chikadzi: Endometriosis, kenza, ectopic pregnancy, kuvimba

Gallbladder : Kazhinji yakashandisa kushandiswa kwemuviri kusinganzwisisiki, mumamiriro asingawanzo inogona kubviswa uchishandisa nzira yakasununguka

Nyoka : Trauma, kuwedzera kwepleen, kuputika

Pancreas : Kukuvadzwa kwepancreas, kenza

Zvipupuriro zvemuviri zvepamuviri : Zvirwere zvakadai sekusuruvara , kenza, kushungurudzika, kuputika kwemasumbu, kutarisa danho rehutano hwehutano, kubatisisa kubva kumatambo apfuura

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Emergency Laparotomy Surgery

A laparotomy inogona kuitwa nokukurumidza, zvinoreva kuti murwere ari kutarisana nehupenyu hunotyisa uye laparoscopy inodiwa kuti aone kuti chii chinetso chacho, kurapa dambudziko racho kana kuti zvose. Dambudziko ringangodaro richibuda kubva kune imwe nzvimbo isingazivikanwi, kukanganisa kwomuviri kana kubuda ropa iro risingagoni kudzorwa kunyange zvazvo chikonzero chacho chiri kuzivikanwa.

Nzira iyo inowanzoitwa mushure mekukuvadzwa kunorwadza kunokonzera kurwadziwa kwepamuviri kwakadzama peritoneal washing (DPL). Ikoko ndiko kushandiswa kuduku kunoitwa mudumbu uye mimba yemimba inoputirwa nemvura. Kana iyo yakasviba ichibuda mumuviri ine huwandu hweropa, chirwere chinonzi laparotomy chingaratidzwa. IDPL haina kuongorora kuti chii chinokonzera kukuvara asi inoratidza kuti kubuda ropa kuripo. Ichaparotomy ichacherechedza kukuvadzwa uye chiremba anovhiya anogona kugadzirisa dambudziko zvakare.

Dambudziko redu, rakadai sepasipi yemotokari kana kukuvadza kunoputika (kubvambura kana kuputika gumbo) ndicho chikonzero chinowanzokonzera kukuvara kwemimba kunofanira kuongororwa kana kurapwa neparparotomy. Muzviitiko izvi zvinogona kuve pachena kuti kune chiremera chikuru chemuviri, zvisinei, nhengo, midziyo uye mishonga yakabatanidzwa inogona kunge isina kujeka. Mune zviitiko izvi, chiremba anovhiya anogona kuona zvose kukuvara nekuona kuti chinetso chacho, uye mumatambudziko akawanda, shandisa dambudziko racho zvakare.

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Laparotomy: Ngozi uye Matambudziko

Mukuwedzera kune njodzi dzakawanda dzekuvhiya uye njodzi dzeanesthesia , zvose laparoscopy uye laparotomy dzinoisa panjodzi dzavo pachavo. Njodzi dzinopesana zvichienderana nechinetso chakakosha kana chirwere chinoita kuti chirongwa ichi chidikanwe, asi njodzi dzakananga kune nzira ndeizvi:

• Kurwara
• Incisional hernia
• Kubvisa kubva panzvimbo yekuvhiya

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Panguva yeLaparotomy neLaparoscopy Process

A laparotomy kana laparoscopy inotanga nehutungamiri hwehuwandu anesthesia. Kamwe iyo anesthesia inoshanda, ganda remuviri rinogadzirwa ne antibacterial solution yekudzivirira utachiona panzvimbo yekuvhiya.

Chiremba anovhiya achaita kuti kuve nekugadzirwa. Kana kurwadziwa kuri muzasi kwebonde kwakadzika pamusoro pezvinyorwa, kuiswa kwacho kuchaiswa munzvimbo iyoyo.

Kana pane zvishoma zvishoma zvinoparadzirwa zvinokonzerwa neparoscopy zvakarongeka, zvinyorwa zvisingaverengeki kupfuura masendimita mashoma zvichaitwa, kana chirongwa cheparapotoma chiri kurongwa, chimwe chinhu chinokonzerwa nechisimba chichaitwa.

Kana iyo yakakura inoshandiswa ichishandiswa, inogona kunge iine midline incision, iyo inonzi incision vertical inowanikwa pakati pepisic bone uye pasi pe sternum, uye kuvhara kwepakati, iyo inowanikwa nechepamusoro.

Mune zvimwe zviitiko, kukanganisa kunogona kuva kuduku pakutanga kwekuvhiyiwa uye zvino kuwedzerwa sezvinodikanwa kupedzisa maitiro mushure mekuongororwa kunoitwa. Mune zvimwe zviitiko nzira inowanikwa isina kuvhiringidza inogona kuva nzira yakazaruka kana chiremba anovhiya achida nzvimbo yakawanda kuti aone mupfungwa kana basa.

Kana imwe nguva iyo yakagadzirwa, nhengo nematukisi zvichaongororwa zviratidzo zvezvirwere, utachiona kana kuputika. Nyuchi dzinogona kutorwa nemasikisi akasiyana-siyana sezvaunoda. Mune zvimwe zviitiko, chirwere chemuviri chinogona "kushambidzwa," iyo isina kuchena inowanikwa mumimba, uye inounganidzwa kuti iwedzere kudzidza.

Kana imwe nguva nhengo nezviviri zvemuviri zvave zvichiongororwa, "kutarisa nekuona" chikamu chemuitiro wacho wapfuura; zvisinei, muzviitiko zvizhinji, kumwe kuwedzera kuchaitwa. Semuenzaniso, laparotomy inowanikwa kuti inzwisise kurwadziwa kwepamuviri, uye chidimbu chinoputika chinowanikwa, chirongwa che appendectomy chichazobatanidzwa nechaparotomy.

Iyo incision ingavharwa nenzira dzakasiyana-siyana. Kukurukurwa kwakakura kunowanzovharwa ne sutures kana kuti staples, zviduku zvingangovharwa nemapande ekubatanidza anonzi steri-strips kana glue yekuvhiya. Iyo incision inobva yakafukidzwa neshanduro isina kuvhara yakashandiswa. Anesthesia inomiswa uye mishonga inopiwa kupa munhu murwere, uyo anobva atorwa kunzvimbo yekudzorera.

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Kuwana Kubva Pakuparara

Kubudirira kubva kune-laparotomy nzira inowanzosiyana kubva kune murwere kusvika kune murwere. Izvi zvinokonzerwa nehuwandu hwehutano hunoita kuti chirwere chinodikanwa. Kazhinji kutaura, nzira isina kuoma iyo iparparotomy uye hapana imwe nzira inotora inoda 2 kusvika 6 masvondo ekupora nguva asati adzokera kumabasa ezvisikwa. Izvi zvinogona kuwedzerwa zvakanyanya nemaitiro anodikanwa mushure mekuongororwa kunoitwa.

Varwere vane laparotomi uye vane zvirwere zvakakomba (murwere akanga ari pangozi yemotokari nemapfupa akavhuniwa uye kubuda mukati kunoda kuti laparotomy) inotora nguva yakareba kurapa kubva pakuvhiyiwa. Mutumbi uri kushanda kuporesa kukuvadza kwakasiyana kamwechete, saka nguva yekuporesa nguva yakawedzerwa. Zvimwe zvinetso zvinoita kuti laparotomy inokosha inogonawo kunonoka kuporesa. Murwere ane kenza angave akaoma zvakajeka sezvo kurapwa kwekenza kunogona kuitika nekudzoka. Izvozvowo ndezvechokwadi kana uine chirongwa chinowedzera chokuvhiya nechaparotomy.

Kana uchinge wabviswa kuchipatara kuti uwanezve kumba, zvinokosha kuti kutarisirwa kwakatorwa kunotorwa kudzivirira utachiona uye kutarisira kwakakodzera kwekudzivirira . Utachiona ndechimwe chezvinetso zvakajairika zvekuvhiya uku, saka kuziva kuti kuziva zviratidzo zvehutachiona hunokosha. Ronga kurongedza kusanganisa kwako paunenge uchikwira kubva pakagara kana chero mimwe miitiro inowedzera mimba yekudzivirira kuti utadzire kurwadziwa, dehiscence uye kuderedza dambudziko rekunyengera kwekusaziva.

_Sources:

> Mimba yekuongorora. National Institutes of Health. 2006. http://www.nlm.nih.gov/medlineplus/ency/article/002928.htm