Siyakwamukela ngemfudumalo kubhulogi yezempilo yokugaya ukudla. Kulokhu sizoxoxa ngokulungiswa kwe-hernia ye-laparoscopic, okwaziwa nangokuthi ukuhlinzwa kwe-hernia ye-laparoscopic. Kuyindlela engavamile kakhulu eye yathandwa kakhulu eminyakeni edlule yokulungisa i-hernia ye-inguinal.
Ngokungena emgodini wesisu ngokusika okuncane, iziguli zingase zizwe ubuhlungu obuncane ngemva kokuhlinzwa futhi zilulame ngokushesha uma kuqhathaniswa nokuhlinzwa okuvulekile okuvamile.
Kulesi sihloko, sizoxoxa ngezinzuzo zokuhlinzwa kwe-laparoscopic, ukusetshenziswa kwayo, kanye namasu ahilelekile kule nqubo. Uma ucabangela ukuhlinzwa kwe-laparoscopic kwe-hernia ephindaphindayo noma icala eliyinkimbinkimbi, nakhu konke okudingeka ukwazi, okubhalwe "ngabantu, ngabantu . "
I-Laparoscopic Hernia.
Ukulungiswa kwe-hernia nge-laparoscopic kuyindlela yokuhlinzwa engadingi ukungenelela okuningi esetshenziselwa ukulungisa ama-hernia ezindaweni ezahlukene zodonga lwesisu. Le ndlela inikeza izinzuzo eziningana, okuhlanganisa ukululama okusheshayo kanye nobuhlungu obuncane ngemva kokuhlinzwa uma kuqhathaniswa nokuhlinzwa okuvulekile kwendabuko.
Ngokusika okuncane, odokotela abahlinzayo bangakwazi ukuthola nokulungisa i-hernia, okuholela ekunciphiseni amanxeba nokuhlala isikhathi esifushane esibhedlela. Lokhu kuthuthuka kokuhlinzwa kuthuthukise kakhulu ikhwalithi yokuphila kweziguli eziningi.
Kuyini ukuhlinzwa kwe-laparoscopic hernia?
Uma kukhulunywa ngokubhekana ne-hernia, isimo sezokwelapha esivamile kodwa esingaba sibi kakhulu , indlela yokuhlinzwa idlala indima ebalulekile ekwelashweni okuphelele.
Endabeni yokulungiswa kwe-hernia ye-laparoscopic , eyaziwa nangokuthi ukuhlinzwa kwe-hernia ye-laparoscopic, le ndlela engavamile kakhulu ihilela ukusetshenziswa kwe-laparoscope, ithuluzi elifana ne-tube elihlonyiswe ngekhamera encane. Lokhu kuvumela udokotela ohlinzayo ukuthi asebenze ngokunemba okukhulu, esebenzisa ukuchezuka okuncane ukuze afinyelele emgodini wesisu.
Ngokungafani nokuhlinzwa okuvulekile kwendabuko, okudinga ukusikwa okukhulu kanye nokubonakala ngqo kwendawo yokuhlinzwa, ukuhlinzwa kwe-laparoscopic hernia kunikeza enye indlela engangenisi kakhulu, okuvame ukuholela ekululameni okusheshayo kanye nokungakhululeki okuncane ngemva kokuhlinzwa kwesiguli.
Esinye sezici ezibalulekile zokuhlinzwa kwe-laparoscopic hernia ukusebenzisa i-mesh ukuqinisa izicubu ezibuthakathaka noma ezonakele ezivumele ukukhula kwe-hernia. Le mesh ibekwa ngemuva kwesici se-hernia, ihlinzeka ngokusekelwa endaweni ethintekile futhi inciphise ingozi ye-hernia ephindaphindayo.
Ngokusebenzisa ukuhlinzwa okungangenisi kakhulu, ukufakwa kwe-mesh kwenziwa lula ngokusikwa okuncane, okufaka isandla enkambisweni yokululama engcono kakhulu kwesiguli.
Isinqumo sokukhetha ukuhlinzwa kwe-laparoscopic hernia sivame ukuthonywa yizinzuzo eziningi ezinikezayo kunokuhlinzwa okuvulekile kwendabuko, okwenza kube ukukhetha okuthandwayo kweziguli eziningi kanye nodokotela abahlinzayo ngokufanayo.
Izinzuzo zokuhlinzwa kwe-laparoscopic uma kuqhathaniswa nokuhlinzwa okuvulekile
Uma kuqhathaniswa ukuhlinzwa kwe-laparoscopic hernia nokuhlinzwa okuvulekile, kuba sobala ukuthi indlela engangenisi kakhulu inezinzuzo eziningana ezikhangayo. Enye yezinzuzo eziphawuleka kakhulu ukuncipha okukhulu kobuhlungu kanye nokungakhululeki okubonwa yiziguli ngemva kokuhlinzwa.
Ngokusebenzisa izimbobo ezincane namathuluzi akhethekile, esikhundleni sokumbozwa okukodwa okukhulu, ukulimala kwemisipha yesisu kuyancishiswa, okuholela ekululameni okusheshayo nokukhululekile.
Ngaphezu kwalokho, ingozi yokuthola izinkinga ezifana nokutheleleka kanye nokwakheka kwezibazi ezinkulu nezibonakalayo iphansi kakhulu ekuhlinzweni kwe-laparoscopic, okufaka isandla emphumeleni omuhle wokuhlinzwa kanye nokwaneliseka kwesiguli sonke.
Ukululama okusheshayo kungenye impawu yokuhlinzwa kwe-hernia ye-inguinal ye-laparoscopic, okuvumela iziguli ukuthi zibuyele emisebenzini yazo evamile, okuhlanganisa nomsebenzi nokuzivocavoca, ngesikhathi esifushane.
Ukuphazamiseka okuncane empilweni yansuku zonke kanye nethuba lokushintsha okubushelelezi kusukela enkambisweni yokuhlinzwa kuyizizathu eziphoqayo zokukhetha ukuhlinzwa kwe-laparoscopic ekwelapheni ama-hernia.
Ngakho-ke, ukubonakala okuthuthukisiwe kwendawo yokuhlinzwa okuhlinzekwa yindlela ye-laparoscopic, kanye nokusetshenziswa kobuchwepheshe obuthuthukisiwe bokuthwebula izithombe, kuvumela udokotela ohlinzayo ukuthi ahambe endaweni ethintekile ngokunemba okukhulu, ekugcineni enegalelo ekulungisweni ngempumelelo kwe-hernia ngaphandle komthelela omkhulu emzimbeni wesiguli.
Ukufinyelela esiswini nge-laparoscopic
Indlela esetshenziswa ekuhlinzeni i-laparoscopic hernia inikeza ithimba lokuhlinzwa ukufinyelela esiswini ngokusika okuncane, isici esihlukile esihlukanisa nokuhlinzwa okuvulekile kwendabuko.
Ukusetshenziswa kwe-laparoscope, ithuluzi elincane elifakwe ikhamera, kuvumela ukubona ngeso lengqondo izakhiwo zangaphakathi ngesikhathi sangempela, njengendawo ye-inguinal lapho i-hernia ikhona khona.
Lokhu kuthwebula izithombe okunencazelo ephezulu kanye nokwandiswa okukhulu okunikezwa yi-laparoscope kunegalelo emvelweni oqondile noqondile wokungenelela kokuhlinzwa, okuvumela udokotela ohlinzayo ukuthi ahlole ukwakheka okuyinkimbinkimbi kwesisu ngokunemba okungenakuqhathaniswa kanye nobungcweti.
Ngaphezu kwalokho, ukusikwa okuncane okusetshenziswa endleleni ye-laparoscopic kunomthelela omncane emzimbeni wesiguli, ikakhulukazi ezicutshini eziphilile ezizungezile kanye nemisipha yesisu.
Ngokunciphisa ukulimala kulezi zindawo, ingozi yezinkinga, njengobuhlungu bangemva kokuhlinzwa, ukwakheka kwezibazi ezinkulu, kanye nesikhathi eside sokululama, incishiswa kakhulu.
Le ndlela imele ushintsho olujwayelekile emkhakheni wokuhlinzwa kwe-hernia, inikeza indlela ehlanjululwe kahle futhi engadingi ukungenelela ekwelapheni i-hernias nezinye izimo ezihlobene nayo, futhi igcizelela indima ebalulekile yentuthuko yezobuchwepheshe kanye nokuhlinzwa ekuthuthukiseni imiphumela yokunakekelwa kweziguli kanye nokwelashwa.
Ngaphezu kwalokho, ukuncishiswa kokuphathwa kwezitho zangaphakathi nezicubu kusiza ukunciphisa ingozi yezinkinga zangaphakathi kanye nezangemva kokuhlinzwa, okuqinisa kakhulu isikhundla sokuhlinzwa kwe-laparoscopic njengendlela engcono kakhulu kubantu abalungiswa i-hernia.
Ubuhlungu obuncane ngemva kokuhlinzwa kanye nokululama okusheshayo
Ukuncipha okukhulu kobuhlungu ngemva kokuhlinzwa kanye nesikhathi sokululama esisheshayo yizici eziphoqelelayo ezihlukanisa ukuhlinzwa kwe-laparoscopic hernia njengendlela evumayo kakhulu kubantu ababhekene nethuba lokungenelela kokuhlinzwa.
Ukusetshenziswa kwezinsika ezincane kanye namathuluzi akhethekile endleleni ye-laparoscopic kunciphisa ukulimala kwemisipha yesisu kanye nezicubu ezizungezile, okuholela ezingeni eliphansi kakhulu lokungakhululeki ngemva kokuhlinzwa kwesiguli.
Lokhu, nakho, kunegalelo enqubweni yokululama esheshayo nephumelelayo, okuvumela abantu ukuthi baqale kabusha imisebenzi yabo yansuku zonke kanye nezibopho zobungcweti kusenesikhathi uma kuqhathaniswa nokuhlinzwa okuvulekile kwendabuko.
Ngaphezu kwalokho, amathuba aphansi okuthola izinkinga, njengokutheleleka endaweni yokuhlinzwa kanye nokwakheka kwezibazi ezinkulu nezibonakalayo, kuyinzuzo enkulu yendlela ye-laparoscopic.
Ukunemba okukhulu kanye nokubona ngeso elibukhali okunikezwa ukusetshenziswa kwe-laparoscope kanye nezinsimbi zokuhlinza ezikhethekile kunegalelo ekwenzeni inqubo ngokucophelela ngomthelela omncane emzimbeni wesiguli, ngaleyo ndlela kukhuthaze isikhathi sokululama esingcono nesilula.
Ngokubeka phambili induduzo yesiguli, ukuphepha, kanye nenhlalakahle iyonke, ukwamukelwa kokuhlinzwa kwe-laparoscopic hernia kubonisa indlela eqhubekayo, egxile esigulini yokwelapha i-hernias kanye nezimo ezihlobene nayo.
Kunini lapho kuboniswa khona ukuhlinzwa kwe-laparoscopic kuma-hernia?
Ukuhlinzwa kwe-hernia nge-laparoscopic kunconywa ezinhlobonhlobo ze-hernias zodonga lwesisu, kufaka phakathi i-inguinal, umbilical, kanye ne-recurrent hernias . Ukuguquguquka nokusebenza kahle kwendlela ye-laparoscopic kwenza kube yindlela yokuqala yokuhlinzwa kubantu abaningi ababhekene nezinselele ze-hernia.
Uma kwenzeka ama-hernia e-inguinal, amelela uhlobo oluvame kakhulu lwe-hernia, inqubo ye-laparoscopic inikeza indlela enenzuzo kakhulu yokulungisa, ebonakala ngengozi ephansi yobuhlungu bangemva kokuhlinzwa, isikhathi sokululama ngokushesha kanye nengozi ephansi yezinkinga.
Lezi zinzuzo ezikhangayo zigcizelela ukubaluleka kokucabangela ukuhlinzwa kwe-laparoscopic njengendlela yokwelapha eyinhloko kubantu abane-hernias ye-inguinal, ekugcineni okunegalelo enkambisweni yokululama ewusizo futhi esheshayo.
Ngaphezu kwalokho, isincomo sokuhlinzwa kwe-laparoscopic hernia ngokwesimo se-hernias ye-inguinal ephindaphindayo neyinkimbinkimbi sigcizelela ukuguquguquka nokusebenza kahle kwale ndlela yokuhlinzwa ethuthukisiwe.
Kungakhathaliseki ukuthi i-hernia ephindaphindayo noma ukuzulazula ezinkingeni zecala eliyinkimbinkimbi, njenge-hernia enengozi enkulu yokuboshwa noma ukuklinywa, inqubo ye-laparoscopic inika amandla ithimba lokuhlinzwa ukuthi lingenelele ngokunemba nangekhono, linciphise izinselele ezingaba khona kanye nobunzima obukhona kulezi zimo.
Lokhu, nakho, kugcizelela indima ebalulekile yokuhlinzwa kwe-laparoscopic hhayi nje kuphela ekulungisweni okuyinhloko kwama-hernia, kodwa futhi nasekuphatheni amacala aphindaphindayo nayinkimbinkimbi, ekugcineni kuthuthukisa umphumela wokuhlinzwa kanye nokuhlangenwe nakho kwesiguli ngemva kokuhlinzwa.
Ukulungiswa kwe-laparoscopic kwama-hernias e-inguinal aphindaphindayo
Ukubhekana nezinto ezicatshangelwayo kanye nezinselele ezibangelwa ama-hernias aphindaphindayo e-inguinal kudinga indlela yokuhlinzwa ebeka phambili ukunemba, ukusebenza kahle, kanye nomthelela oncishisiwe emzimbeni wesiguli.
Kulesi simo, ukulungiswa kwe-laparoscopic kwama-hernias e-inguinal aphindaphindayo kuvela njengendlela yokwelapha ephumelela kakhulu futhi ephumelela kakhulu, ebonakala ngengozi encishisiwe kakhulu yezinkinga zangemuva kokuhlinzwa, isikhathi sokululama ngokushesha, kanye nomphumela omuhle wokuhlinzwa ngokuvamile.
Ikhono lokuhamba endaweni ye-hernia ephindaphindayo ngokunemba okukhulu nokuqinisa indawo ethintekile nge-mesh, konke ngokusebenzisa ukusikwa okuncane kanye nezinsimbi zokuhlinzwa ezithuthukisiwe, kugcizelela indima ebalulekile yendlela ye-laparoscopic ekulungisweni okuphumelelayo kwe-hernia ye-inguinal ephindaphindayo, ekugcineni okuzuzisa isiguli ngenqubo yokululama esheshayo nenhle.
Ngokunciphisa kakhulu ukulimala kwemisipha yesisu kanye nezicubu ezizungezile, ukulungiswa kwe-laparoscopic kwama-hernias e-inguinal aphindaphindayo kuwubufakazi bentuthuko enkulu kwezobuchwepheshe bokuhlinzwa, okugcizelela umthelela wokuguqula ukuhlinzwa okungangenisi kakhulu ekwelapheni ama-hernias ayinkimbinkimbi naphindaphindayo.
Ingozi ephansi yezinkinga, ukululama okusheshayo, kanye nethuba lokuhlangenwe nakho okuhle ngemva kokuhlinzwa kwenza indlela ye-laparoscopic ibe yindlela ekhethwayo kubantu ababhekene nezinselele ze-hernia ye-inguinal ephindaphindayo, ehambisana nomgomo oyinhloko wokuthuthukisa ukunakekelwa kweziguli, imiphumela yokwelashwa, kanye nekhwalithi yokuphila iyonke.
Indlela ye-preperitoneal
Ekulungiseni i-hernia ye-inguinal ye-laparoscopic, ukusetshenziswa kwendlela yokuhlinzwa ngaphambi kokubeletha kuyinto ebalulekile, inqubo yokuhlinzwa eyinkimbinkimbi futhi ehlelwe ngokucophelela esekela impumelelo kanye nokusebenza kahle kwenqubo iyonke.
Ngokufinyelela isikhala sangaphambi kwesisu ngokusebenzisa ukusikwa okuncane nokusebenzisa amathuluzi okuhlinzwa athuthukisiwe, ithimba lokuhlinzwa lingakwazi ukuhamba ngendlela eyinkimbinkimbi yesifunda se-inguinal ngokunemba okungenakuqhathaniswa kanye nobungcweti, ekugcineni lifinyelele ukulungiswa okuphelele nokuhlala isikhathi eside kwe-hernia.
Ukubekwa kwengxenye ye-mesh endaweni yangaphambi kokubeletha , okusizwa yindlela yokwelapha i-laparoscopic engangenisi kakhulu, kusiza ukuqinisa indawo ebuthaka, ukunciphisa ingozi ye-hernia ephindaphindayo, nokubeka isisekelo sesikhathi sokululama esisheshayo nesifanele isiguli.
Ngaphezu kwalokho, indlela yokulungiselela i-peritoneal imelela ushintsho olujwayelekile ekwelashweni kokuhlinzwa kwe-inguinal hernias, okubeka ukulungiswa kwe-laparoscopic njengendlela esezingeni eliphezulu nethuthuke kakhulu ebeka phambili izimiso zokunemba, ukusebenza kahle, kanye nokunakekelwa okugxile esigulini.
Le ndlela ayigcini nje ngokuhlinzeka ngokulungiswa okuphelele nokuhlala isikhathi eside kwe-hernia, kodwa futhi imelela umoya wokuhlinzwa okungangenisi kakhulu, okubonakala ngomthelela ophansi emzimbeni wesiguli, isikhathi sokululama okusheshayo, kanye nokuhlangenwe nakho kokwelashwa okuhle kakhulu.
Ukusetshenziswa okunesu nokuphumelelayo kwendlela yokulungiselela ukuhlinzwa kwesisu kumongo wokulungiswa kwe-hernia ye-inguinal ye-laparoscopic kugcizelela indima ebalulekile yamasu okuhlinzwa athuthukile ekuthuthukiseni ukunakekelwa kwesiguli kanye nemiphumela yokwelashwa, ekugcineni okumelela uphawu lokunakekelwa kokuhlinzwa okuqhubekayo, okugxile esigulini.
Ukusetshenziswa kwe-mesh ukulungisa i-hernia
Isihluthulelo sempumelelo yokulungiswa kwe-hernia ye-inguinal nge-laparoscopic ukusetshenziswa okunembile nokunembe kwe-mesh , into ekhethekile yokuhlinzwa esebenza njengesisekelo sokungenelela kokuhlinzwa okuphelele.
Ngokufaka i-mesh esikhaleni sangaphambi kwe-peritoneal ngokusebenzisa ukusikwa okuncane, ithimba lokuhlinzwa lingenza ukulungiswa okuphelele nokuhlala njalo kwe-hernia, kuncishiswe amathuba okuba ne-hernia ephindaphindayo futhi kuqiniswe indawo ethintekile ngesakhiwo esisekelayo.
Lokhu kusetshenziswa okunesu kwengxenye ye-mesh yokuhlinzwa, okusizwa yindlela encane yokungenelela kwendlela ye-laparoscopic, kusekela impumelelo kanye nokusebenza kahle kokulungiswa kokuhlinzwa, ekugcineni kubeka isiguli esigabeni sokululama esingcono nesisheshayo.
Ngaphezu kwalokho, ukuncishiswa kokuphathwa kanye nokulimala kwezicubu ezizungezile kanye nezakhiwo zangaphakathi, okusizwa ukusikwa okuncane kanye nesici esithuthukisiwe sendlela ye-laparoscopic, kunegalelo enkambisweni yokululama evumayo nelula yesiguli.
Ngokubeka phambili izimiso zokunemba, ukusebenza kahle, kanye nokunakekelwa okugxile esigulini, ukubekwa kwe-mesh esikhaleni sangaphambi kwesisu kumelela isici esiqondile nesiguqulayo sokulungiswa kwe-hernia ye-inguinal ye-laparoscopic , ekugcineni kugcizelela indima ebalulekile yamasu okuhlinza athuthukile kanye nezinto zokwakha ekwenzeni ngcono ukunakekelwa kwesiguli, imiphumela yokwelashwa, kanye nekhwalithi yokuphila iyonke.
Ukuhlinzwa Okungangeni Kakhulu Kwe-Inguinal Hernias
Ukuhlinzwa okungenazo izithiyo eziningi, okuboniswa yindlela ye-laparoscopic ethuthukisiwe nehlelwe ngokucophelela, kuyindlela eguqulayo nephumelela kakhulu yokulungisa i-hernia ye-inguinal.
Ngenxa yokusikwa kwayo okuncane, amathuluzi okuhlinzwa athuthukile, kanye nendlela ephumelelayo neyisu yokulungisa, inqubo ye-laparoscopic inciphisa umthelela emzimbeni wesiguli, inciphise amathuba ezinkinga zangemva kokuhlinzwa, futhi ibeka isiguli esigabeni sokululama esisheshayo nesingcono.
Isiphetho
Lapho sekuqediwe ukubekwa phambili, ukulungiswa kwe-laparoscopic hernia kuziveza njengendlela ephumelelayo nengangenisi kakhulu yokwelapha i-hernia, okunikeza izinzuzo eziningi kusukela ekululameni okusheshayo kuya ekwehleni kwezinkinga zangemva kokuhlinzwa.
Njengoba ubuchwepheshe buthuthuka, kubalulekile ukuthi abathandi bezempilo kanye nomphakathi jikelele bahlale benolwazi ngezinketho ezitholakalayo kanye nezindlela ezingcono kakhulu zempilo yabo.
Uma ucabanga ukuthi lolu lwazi lungaba usizo kwabanye, sikukhuthaza ukuthi wabelane ngalesi sihloko ezinkundleni zokuxhumana. Sisonke, singakhulisa ulwazi mayelana nempilo yokugaya ukudla okuvimbelayo futhi sithuthukise ikhwalithi yokuphila kulabo abasizungezile!
UDkt. Jorge Delgado, Udokotela Ohlinzayo. I-Laparoscopic Hernia.
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