Hysterectomy laparoscopic mokhoa: poso tshebedisano nako, liphello ulasan pelanggan. Tlosa fibroids uterine laparoscopically: ulasan pelanggan

Hona joale, re ntshetswa pele theknoloji e popontshwa le hore lumella bakeng sa mefuta e fapaneng ya ho kenella gynecological le mathata a fokolang haholo le ka tsela e itseng e tlaase ea ho sithabela. Laparoscopic hysterectomy ke - e mong oa bona.

Laparoscopy ka mokhoa o mocha

Laparoscopic opereishene e bile ho pota bakeng sa lilemo tse fetang 20. Nakong ena e thehilweng ka boeona e ka mokhoa minimally itaolang le e atlehang le mathata a fokolang haholo poso tshebedisano.

dithekeniki Laparoscopic ka mafu a basali atile haholo. Nakong e fetileng, mokhoa o joalo o ile a etsa gynecological opereishene meqolo e nyenyane. Empa lilemong tsa morao tjena ka litleliniking fetisisa le lipetlele, ho se ho atile. E mong oa tshebetso tsena ke ho tlosa fibroids uterine laparoscopically. Reviews of bakuli bontša hore ho na le tsosoloso e potlakileng ea bokgoni ba ho sebetsa, kotsi la mathata le adhesions tsa tšenyo tse nyenyane le ho fokolang hore ba letlalo ha e senya ponahalo ea basali.

Bakeng sa tshebetso e hloka basebetsi ba tšoanelehang ba nang le phihlelo. Ho kenella ha e kenngoe tabeng ena, mathata a fokolang haholo. Maemong a mang, e le motsoako oa laparoscopic le ho buoa tloaelehileng feela lokela ho boloka bophelo ba mokuli. setsebi sena se tla khetha mokhoa o nepahetseng ho tšoara bakuli ba tsona ba ka ho e mong le e sebetsana le nyeoe le batho ka bomong.

lipetlele tse ngata le phethe tlosa fibroids uterine laparoscopically. Moscow, hoo e ka bang mong le e mong lefapha gynecological e hlometse ka thepa ea hlokahala le na le litsebi tsa ho phetha mellwane ena. Ho tsoa ho se ho buuoa tsohle gynecological 50-60% ba e tshwerweng ke laparoscopy.

Melemo e ka sehloohong ea mokhoa:

• isa tekanyong e tlaase ea ho sithabela;

• o potlakang hlaphoheloa mosebetsi wa litho tse tsohle;

• Phokotso ea bohloko poso tshebedisano;

• fokolang haholo adhesions ;

• nako khutšoanyane bookelong;

• lula o tlhokomelong ea letsatsi;

• phokotso ya ka dipehelo tsa bokooa;

• bonyane ba hernias postoperative;

• nako bonyane bakeng sa tsosoloso ea;

• ho boloka meriana.

Mpe linako laparoscopy

tsena likarolong tsohle tse ntle tsela ea ho buoa le folisa basali koahela go tlhoka mesola tsohle tse sa tlholeho ka ho buuoa leha e le efe laparoscopic:

• mechine le koetliso ea litsebi ba tšoanelehang hloka ditshenyehelo bohlokoa;

• ngaka lokela rua dithekeniki laparoscopic le ho buoa tsa moetlo;

• mathata a ka tlōla mesebetsi ya makala a amanang le ente ea khase ka cavity mpeng, empa khalemelo le ho lokisa ho thibela mathata ana ka qojoa;

• U se ke ua busa tsoa le monyetla oa ho tshenyo phetha molao ho makala a sa tšoaneng, lisele le dibopeho.

Kopo ka mafu a basali

Ikatisetsa gynecological laparoscopy ho atile. , Ho phaella ho fumanoe maemong a sa tsitsang ba mpa a hlobaetsang le, fumana lisosa tsa ho kgaolela basadi thari, laparoscopic Tsamaiso e sebelisoa ka maemo a joalo ka:

1. Ectopic bokhachane.

2. Lekhalo tsa tube, le.

3. Buoa sterilization.

4. Endometriosis.

5. The sekgomaretsi lefu.

6. mafu Various ba cysts popelo, sklerokistoz, popelo apoplexy.

7. ya mikemike ya sebopeho popelo (hysterectomy laparoscopic mokhoa fokotsa kotsi ya mathata postoperative).

8. dithulaganyo hyperplastic, ha amenable ho phekolo mekhoa e tloaetsoeng.

Tsoa gynecologists sebediswang ka mehla laparoscopic hysterectomy esita le lihlahala tse kotsi. Ke mang ea pele dithekeniki tse ngata bakeng sa tshebetso ena, ho itšetlehile ka boholo ba popelo le, boemo ba lona le ho kenya letsoho mosebetsing oa ho ba litho tsa ka hare ea boahelani. Ho pharaletseng sebediswa fibroids tshebetso ena ha localizations fapaneng.

fibroids uterine

Uterine fibroids - nang kotsi ke lefu leo ho lona le tlas'a tšusumetso ea li-hormone le hlaha keketseho ea dinama tse nyenyane tse fibrous le sebopeho sa mafito. Ho hlokomela e ata phahameng ea lefu lena le - ka bang 25% ea mathata a tsohle gynecological. fibroids uterine ea ama 'mele oohle oa basali. Myomectomy e nkoa e le "khauta tekanyetso" kalafo bakeng sa lefu lena.

Hysterectomy laparoscopically. mefuta

Ha re khetha mokhoa oa ho buoa kalafo ea fibroids e elwa hloko lintho tse ngata: lefelo le boholo ba nodes, tshebetso, kapa ho lahleheloa ke litho tsa ka hare le haufi, boemo kakaretso ea mosali. Ho itšetlehile ka uterine le diso appendages na le mefuta e 'maloa ea ho buuoa ka litho tsa ho hlahisa bana.

Ikatisetsa sebedisa:

- palo yohle hysterectomy ha tlosoa le 'mele le popelo; subtotal - the popelo e tlosoa 'mele. Ha hammoho le popelo khaoloe e le phala - gistertubektomiya, 'me ha liphaephe le Yachnik, tshebetsong joalo e bitsoa gistertubovarioektomiya. Ho etsa liopereishene tse khōlō tse kang pangisterektomii - hlakola genitalia tsohle ka hare hammoho le nodes lisele tsa mmele kapa litsoelesa potolohileng lisele tsa ka hara botshehadi 'me karolo e' ngoe resorted dithulaganyo oncological.

- Ha nyenyane tsa diyuniti le ho boloka bana basali phetha opereishene ablative. E 'ngoe ea tsona ke ho tloswa subserous uterine fibroids laparoscopically. Le hanyenyane uterine lethopa etsoa nodes enucleation, i.e. husking dinama tse nyenyane tse fibrous le e ileng ea latela ho pholosa lekala. Mora tshebetso tsena, mosali e mong a ka ima ka mor'a nako e itseng 'me a beleha.

Contraindications

Ho na le contraindications bakeng sa ho buuoa ho tlosa fibroids popelo laparoscopically. Reviews Gynecologists bontša hore maemong a mangata ke buuoe ka ho phethahatsoa tsohle, ntle le bakeng sa basali ba neng ba le bothata ba ho pelo le methapo e matla, ho hloleha ho hema, ho ba le hernia, mathata a amanang le tsamaiso ea mali coagulation kapa marasmus

A lekanyelitsoeng contraindications - boemo ba motho ba ka ho e buuoa ke khoneha, empa ho hlahisa mathata a mang. Ba:

• haholo bitsoa subcutaneous mafura;

• mafu untreated tšoaetsanoang;

• adhesions;

• effusion kapa ho ba teng ha ea mokelikeli ka cavity ka mpeng ea litha e le nngwe e fetang 1.

Empa gynecologists morao-rao, ho ba le mokhoa o laparoscopic, ka mor'a ho hlahloba mafu a joalo balletsweng tsela ea kalafo, sanitize foci ea tšoaetso le ho phetha ho buoa. Ka nako e tšoanang boima ba "melemo" le "tlhoka mesola" pele u qeta tshebetso laparoscopic.

Ho lokisetsa bakeng sa ho buuoa

Reviews of basali ba undergone hysterectomy laparoscopically, eo tsejoa hore bakuli ba khotsofalla feela ho lokisetsa: tshebetso The nka metsotso e 40, 'me ba lokisetsa ho - libeke tse 2 le ho feta.

Ka tshebetso mosali o lokela ho tla ka mor'a liteko 'me sephetho fumana ho tla nehelanoa:

• liteko mali (palo yohle, skeletal, mofuta mali le RH Ntlha e, bakeng sa lefu la sebete, mokaola le hoama HIV, boikemisetso ba tsoekere);

• liteko moroto - kakaretso le boikemisetso ba tsoekere e;

• smears;

• electrocardiogram;

• x-ray;

• tsa ultrasound;

• colposcopy;

• hlahloba ditsebi: ngaka e thusang batho, haeba ho hlokeha, cardiologist le ba bang.

Pele ho sebetsa bakeng sa bakuli ba fibroids uterine hloka e ka thoko tekotshupo curettage ea popelo le ho fumana diphetho histological. Sena ke ho hlokahala hore ho rarolla tseko ea chelete ho buuoa le ho felisa le ho thibela ntshetsopele ya bokgoni ho eketsehileng dithulaganyo kankere.

All hlahlojoa - mokgwa wa ho hlokahala, 'me feela ka mor'a dinyakisiso feletseng ea ngaka e buoang e tla ba khona ho phetha tlosa popelo ea laparoscopically.

Letsatsi pele ho buuoa ka buelloa ho se je, o lokela ho kuta moriri dikahlolo.

Pele ho buuoa ka, mosali eo o tletseng ho tsoa ka tumello foromo thethebatso, 'me ka thoko bakeng sa ho buuoa. Haeba ho hlokahala, ho fana ka ho lokisetsa tsa bongaka kapa psychoprophylactic bakeng sa ho buuoa.

opereishene Technology

opereishene ho tlosa popelo laparoscopically phethile ha myomas boholo bo ho fihlela ho libeke tse 16 tsa boimana, tse rarahaneng ka ho tsoa mali, tšoauoa ka kgolo ya ka potlako kapa kotsing ea ho phetoho tse kotsi. Le hoja ba bang profesionalce ea nang le phihlelo ka ho feletseng tlosa popelo, boholo ba eo e ka bang 20 libeke tse. Empa hangata ho feta, ba fuoa lilemo la mosali eo, o atlehe ho tloswa ha fibroids uterine laparoscopically siea karolo e itseng e nyenyane ea ho popelo ho ilela khoeli.

Sebelisa tse tharo kapa tse 'nè puncture leboteng ka mpeng (a - haufi le mokhubung le tse ling tse peli - nngwe le e nngwe lehlakoreng) le trocars tsamaisoa. sesebediswa sena fana le khamera bakeng sa tlhokomelo leseli kapa ka supercharger tlhomamiso carbon dioxide e kapa nitrous oxide e le lisebelisoa.

Ka mor'a ho tlosa tlhahlobo e phethile fibroids laparoscopically uterine. Bakeng sa ligament ena e excised, likepe ligated dissected tloha popelo le leboteng ka hara botshehadi e tlosoa ka hara botshehadi ka incisions ka vaults ena. tshebetso ena e bitsoang laparoscopically thuswa bosaling myomectomy. Qeta suturing incisions ka hara botshehadi e. Ka tshebetso e mong a ka hlakola nodes multiple ntle botjha kenella.

Mora odalyayut mali kapa mokelikeli, bokeletseng ka nako ya tshebetso ya, tlhahlobo e etsoang hape 'mele le marako a ea cavity mpeng. Ka hloko hlahloba hore na hantle tlamisitsoe le ligated lijana, ebang propotevanie mali kapa mokelikeli lymphatic. Felisa khase le hore re bontše lisebelisoa. Ebe esengelaki batonga ngai yango le hlaha ka letlalo le subcutaneous dinama tse nyenyane tse ka sebaka sa trocar, letlalo e sutured sutures setlolo.

The nako ya tshebetso e ka ba ho tloha metsotso e 15 ho dihora tse 1.5 ho itšetlehile ka bophahamo ba modumo ea kenella qeta ho buoa.

Analgesia ka tshebetso kang tlosoe popelo laparoscopically: ulasan pelanggan

Seo thethebatso molemo? Potso ena e lokela ho rarolloa hammoho le ngaka e buoang e anesthesiologist, fuoa boemo kakaretso oa mamello, e le litsupa tsa lithuto tsa laboratori le hakanngoa bophahamo ba modumo ea tshebetso. Maemong a mangata, ho kopantswe thethebatso endotracheal. Reviews of basali re e hantle mameletse, ho se hlooho. Female mor'a mor'a metsotso 15-20 ka mor'a opereishene e kang ho tlosa ea popelo laparoscopically.

Nako postoperative le thethebatso tšoanetseng isang litholoana tse molemo ka mor'a ho kenella ka: bohloko ha itšoenye, ho na le feela tse nyenyane boemong bo sa thabiseng, eo e ntse e feta ka matsatsi a 2. Ka linako tse ling ho ka ba ho nyekeloa ke pelo, empa hore lintho li emisa "metoclopramide". Ka letsatsi la pele u ka noa metsi feela. Mantsiboea, o ka se a ntse a tsoha 'me a tsoha. Ka letsatsi la bobeli o ka ja, e leng ha e halefisa le mantle a, tse kang motoho, a ja sopho, lihlahisoa tsa lebese. The ntsa e phethahatsoa ka letsatsi la bobeli ka mor'a ho kenella, 'me ha a siee kula koaloa ka mor'a matsatsi a 30. Ka mor'a hore mosali eo a ka ka tsela e sireletsehileng ea mosebetsing, empa le thibelo tsa mosebetsi o boima 'meleng bakeng sa khoeli. Sutures ba tlosoa ka postoperative letsatsi 5.

Ka mor'a ho buuoa, mathata khoneha, e leng ka seoelo: ena mo ntša kotsi trocar litho tse ka hare, ho tsoa mali ho tswa ho tlas'a lijana ligated, subcutaneous emphysema. All ena ka tsa thibeloa haeba ka tieo khomarela thepa tshebetsong le ho phetha ya thuno ya cavity mpeng ka hloko.

litla

Re lokela ho hlokomela hore ka mor'a hore buuoa joalo ka hysterectomy mokhoa laparoscopic, liphello le tšekamelo ea ho fumana. Hlaphoheloa le hlaha ka mor'a libeke tse 2 ea phekolo. matsatsi a 30 ka mor'a opereishene mosali eo a ka tsoela pele ka khoebo ea bona ka tsela e tloaelehileng. Recommended khoneha ho ikoetlisa. Empa khoeli hamorao, ho ke ke sa rateheng ho laela mesifa mpeng, phahamisa litšepe ka letsatsi.

Mehleng ea pele e ka ba le tse sa reng letho le mahlaba sa eeng moriting ka mpa wa. Ena ke ntho e tloaelehileng 'me ba lokela ho feta matsatsi a 1-2. Sebopeho sa adhesions ke khoneha, empa ho ea ka lipalo-palo ena e hlaha seoelo haholo le feela predisposition liphatsa tsa lefutso tsa phelang kapa tlas'a bontša endometriosis.

tjhajoloha hanyenyane pampitšaneng genital. Ena ke ntho e tloaelehileng ha mae a bomme a bolokoa. Ba tsoela pele ho hlahisa li-hormone hore bakela itsoara joang ka sena.

Maemo a ho dithulaganyo hlabang ka mor'a ho buuoa laparoscopic ke seoelo, hobane lithibela-mafu e khetheloa ho hang-hang ka mor'a ho kenella 'me a tsoela pele ka matsatsi a 5. Ka nako e tšoanang e lokisa metsi le electrolyte hlophisoa mali.

Tsosolositsoeng tsoalo mamello hoo e ka bang hang-hang, empa maemong a mang ho na le ho eketseha ha libido. Mosali e mong a ka phela bophelo bo thobalano ka mor'a khoeli 1 mor'a ho buuoa. Ha 'mele o e bolokwa, u ka ima ka hare ho likhoeli tse tšeletseng ka mor'a ho kenella ka.

Ke hokae moo nka etsa opereishene?

lipetlele tse ngata ka fana hysterectomy laparoscopically. Ka Moscow lipetlele motseng oo ba a hlomelloa le thepa le be le ditsebi tsa ba tsebang mokhoa ona tla u fa ditshebeletso tsena. Theko kgwebisano e lumellana le ngaka e-ba teng.

phuputso e entsoeng ka etsoang ofising kapa a ea bolulo ea pele ho sepetlele. Ho khanna tshebetso joalo khoneha ngodiso palo. Litsenyehelo tsa ho ba hysterectomy laparoscopic ke ba ka bang 45 ho 70 tse sekete.