Akwụkwọ ntuziaka laparoscopic trocar enwere ike ịtụfu

Tupu itinye na iji ngwaahịa a, biko jiri nlezianya gụọ ntuziaka ntuziaka

Akwụkwọ ntuziaka laparoscopic trocar enwere ike ịtụfu

I. Aha ngwaahịa, ụdị, nkọwapụta

Otu trocar laparoscopic enwere ike ịtụfu (mm)

II.Arụmọrụ trocar laparoscopic enwere ike ịtụfu

A na-eji ngwaọrụ mgbapu dị ka ngwa ịwa ahụ laparoscopic.Ekwesịrị ịmalite ịmalite pneumoperitoneum, mgbe ahụ, a ga-eme mbepụ akpụkpọ anụ 5-12 mm n'ọnọdụ kwesịrị ekwesị n'ime afọ.Jiri aka dozie trocar n'akụkụ kwesịrị ekwesị n'elu pneumoperitoneum dị elu nke afọ.Site na mbepụ akpụkpọ ahụ, jiri ọbụ aka gị pịa n'elu ngwaọrụ mgbapu, ma tinye ihe ntanye n'ime mbepụ akpụkpọ ahụ.Mgbe ngwaọrụ mgbapu na-abanye n'ime oghere afọ, wepụ ngwa ngwa cone ahụ ka ọ bụrụ ọwa na-arụ ọrụ, wee tinye laparoscope / ngwa maka nlele na ọrụ.

III.Ngwakọta ihe owuwu laparoscopic trocar nke enwere ike iwepu

Ngwa ntupu laparoscopic nke a na-atụfukarị bụ okpu mkpuchi, mkpuchi mkpuchi na idozi, valvụ injection ikuku, cannula, cone puncture, valve mgbochi ikuku na okpu mkpuchi na-edozi onwe ya.

N'ime ha: mkpuchi mkpuchi, mkpuchi na mkpuchi mkpuchi, valvụ injection gas, casing, na cone puncture bụ nke ihe PC, na valvụ na-egbochi ikuku na mkpuchi mkpuchi na-edozi onwe ya bụ ihe silicone.

IV.Ntufu laparoscopic trocar akporo ngwa

A na-eji ya igbapu anụ ahụ abdominal nke ahụ mmadụ n'oge laparoscopy na ịwa ahụ, na iji guzobe ọwa na-arụ ọrụ maka ịwa ahụ afọ.

V. Ntụfu laparoscopic trocar ọdịdị Ọdịdị

1.Sealing okpu 2. Mkpọchi na idozi okpu 3. valve injection 4. Sleeve

5. Ịkpọpu cone 6. valvụ na-egbochi ikuku 7. Okpu mkpuchi na-edozi onwe ya

1.nọmba 1P-TC-(5/10/12/15)trocar

VI.Ntụfu laparoscopic trocar Contraindications

Enweghị ike iji ya na ndị ọrịa ọhụrụ, ma ekwesịrị iji nlezianya mee ihe na ụmụ nwanyị dị ime.

VII.Nrụnye laparoscopic trocar enwere ike ịtụfu

onweghi

VIII.Ntuziaka laparoscopic trocar enwere ike iwepu ntuziaka maka ojiji

1. Tupu iji ụlọ ọrụ anyị nwere ike ikpofu cannula, a na-atụ aro ka ịmepụta pneumoperitoneum mbụ, wee mee ka akpụkpọ anụ dị n'ime oghere afọ nke buru ibu iji nabata cannula.Otu ụzọ ị ga-esi hụ na mbepụ akpụkpọ ahụ buru ibu zuru oke bụ ịpịa tube dị n'èzí na mgbidi ahụ, na-emepụta akara okirikiri, wee jiri dayameta gbasaa nke ọma nke akara akara iji nweta ntinye cannula, dịka 5mm puncture The casing. kwesịrị ịbawanye na dayameta site na 2mm.Rịba ama na mbepụ ntakiri nwere ike ịkpata nguzogide anụ ahụ nke cannula, na-abawanye ike ịbanye na ibelata njikwa dọkịta na-awa ahụ n'oge ntinye.

2. Dozie cannula ntụpọ n'akụkụ kwesịrị ekwesị n'elu afọ dị elu mgbe pneumoperitoneum gasịrị.Ụgbọ ala ndị a na-atụfu n'ike dị nkọ karịa trocars enwere ike iji ya mee ihe, yabụ na-achọkarị obere ike itinye.Ma kpachara anya: Enweghị gas zuru oke, emeghị oke akpụkpọ ahụ zuru oke, ma ọ bụ iji ike dị ukwuu mee ihe nwere ike ime ka ohere nke imerụ akụkụ ahụ dị n'ime ahụ dịkwuo elu.

3. Tupu iwebata puncture cannula site na mbepụ akpụkpọ ahụ, tinye cone puncture n'ime cannula puncture.

4. Jiri ọbụ aka gị pịa elu n'elu cannula na-apupu.N'otu oge ahụ, na-edobe nrụgide na aka ahụ mgbe niile, tinye cannula nke a na-atụfu ya n'ime mbepụ akpụkpọ ahụ.Tinye nrụgide ala na-aga n'ihu n'oge ntinye cannula.

5. Ozugbo cannula abanyela n'ime oghere afọ, a ghaghị ịkpachara anya ka ị ghara itinyeghachi cannula ahụ.Ọ bụrụ na dọkịta na-awa ahụ na-eche na puncture cannula dị n'ime oghere afọ, a ga-ewepụ cone ahụ ozugbo ma tinye ya na laparoscope maka nlele.

6. Ọ bụrụ na agwụchaghị ntụpọ ahụ, megharịa nzọụkwụ 3-5.

7. Ọ bụrụ na nkwụsịtụ ahụ dị 10 mm ma ọ bụ karịa mgbe ọ rụchara ọrụ, a ga-emechi fascia miri emi iji belata ihe ize ndụ nke incisional hernia site na suturing.

8. Mgbe mgbatị ahụ na-aga nke ọma, tupu ị na-eji ngwá ọrụ endoscopic, tinye mmanu ahụike n'elu ngwá ọrụ endoscopic ma ọ bụ mgbanaka akara nke puncturer iji belata nguzogide ma mee ka ọrụ ahụ dịkwuo mfe na ngwa ngwa.

IX.Nkwadebe laparoscopic trocar na-edozi na usoro nhazi

1. Nchekwa: Chekwaa n'ime ụlọ nwere iru mmiri na-erughị 80%, ikuku na-ekpo ọkụ nke ọma, na enweghị gas na-emebi emebi.

2. Ụgbọ njem: Enwere ike ibuga ngwaahịa ngwugwu na ngwá ọrụ nkịtị.N'oge njem, ekwesịrị iji nlezianya na-edozi ya ma zere ìhè anyanwụ kpọmkwem, nkukota ihe ike, mmiri ozuzo na ike ndọda.

X.Ụbọchị ngafe laparoscopic trocar a na-atụfu

Mgbe emechara ngwaahịa a site na ethylene oxide, oge sterilization bụ afọ atọ, ma ụbọchị njedebe ga-egosi na label.

XI.Ndepụta ngwa ngwa laparoscopic enwere ike ịtụfu

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XII.Akpachara anya na ịdọ aka ná ntị laparoscopic trocar

1. Mgbe ị na-eji ngwaahịa a, nkọwa ọrụ aseptic kwesịrị ịgbaso nke ọma;

2. Biko lelee nkwakọ ngwaahịa a nke ọma tupu ejiri ya, ma ọ bụrụ na ngwugwu nke ọnya mebiri emebi, biko kwụsị iji ya;

3. A na-eme ka ngwaahịa a bụrụ nke ethylene oxide, na ngwaahịa igba ogwu bụ maka ojiji ụlọ ọgwụ.Biko lelee akara ngosi diski dị n'igbe nkwakọ ngwaahịa sterilization nke ngwaahịa a, "acha anụnụ anụnụ" na-egosi na ethylene oxide agbazela ngwaahịa ahụ na enwere ike iji ya mee ihe ozugbo;

4. Ngwaahịa a bụ maka otu oge na enweghị ike igba ogwu mgbe ejiri ya;

5. Biko lelee ma ngwaahịa a dị n'ime oge nkwado tupu ejiri ya.Oge nkwado sterilization bụ afọ atọ.Ngwaahịa gafere oge nkwado ka amachibidoro iji;

6. Ịdịghị ịmepụta na ịnọgide na-enwe pneumoperitoneum kwesịrị ekwesị n'oge ịwa ahụ afọ nwere ike ibelata ohere ọrụ dịnụ, si otú ahụ na-egbochi ọganihu nke cone puncture ma na-abawanye ohere nke mmerụ anụ ahụ visceral.

7. Naanị ahụmahụ na maara nke ọma na usoro endoscopic nwere ike ime ịwa ahụ endoscopic.Tupu ịwa ahụ, ndị dọkịta kwesịrị ịgakwuru akwụkwọ na akwụkwọ ndị dị mkpa iji ghọta usoro, nsogbu na ihe ize ndụ nke endoscopy.

8. Otu cone na-agbapụta otu ụdị dị nkọ ma dị nchebe, ya mere a na-achọ obere ike n'oge ntinye.Oke ike nwere ike ibelata njikwa onye ọrụ na akụkụ ntinye na omimi nke cone mkpọmkpọ, na-abawanye ohere nke imerụ anụ ahụ dị n'ime ahụ.

9. Adhesions, ihe na-adịghị mma nke anatomical ma ọ bụ ihe mgbochi ndị ọzọ nwere ike igbochi ma ọ bụ gbuo oge, nke ga-eme ka cone puncture mebie nhazi akụkụ ahụ dị n'ime n'oge nkwụsị anya.A na-atụ aro ka iji ịwa ahụ laparoscopic mepere emepe, wee jiri ngwaahịa a mgbe agbakwunyere sutures na ojiji mbubata abdominal fascia.

10. Tupu na mgbe ewepụsịrị cannula nke a na-ewepụ site na oghere afọ, lelee ebe ịwa ahụ maka hemostasis.Enwere ike ịchịkwa ọbara ọgbụgba site na cautery ma ọ bụ suture aka.N'uche dọkịta, enwere ike ịchọ laparotomy.

11. N'otu oge n'ime oghere afọ, a ghaghị ịkpachara anya ka ị ghara ịmaliteghachi cannula.Ọ bụrụ na etinyere ike zuru oke na njedebe ihu iji mee ka cone gaa n'ihu, ọ ga-emebi anụ ahụ dị n'ime.

12. Mgbe ị na-eji ngwá ọrụ endoscopic na ngwa ndị na-emepụta ihe dị iche iche na-emepụta n'otu oge na ịwa ahụ endoscopic, a ga-enyocha ndakọrịta n'etiti ngwá ọrụ dị iche iche, a ga-enyochakwa mkpuchi eletriki na ala ala.

13. Ọ bụrụ na ọkpụkpụ akpụkpọ anụ ahụ gbawara agbawa bụ 10mm ma ọ bụ karịa, a ga-emechi fascia miri emi iji belata ohere nke incisional hernia.

14. N'oge ịwa ahụ laparoscopic, onye ọrịa kwesịrị ịnọ n'ọnọdụ dị elu na isi ala na ụkwụ elu.Mgbe ị na-eji cannula nke mbụ, jiri otu aka bulite mgbidi afọ ala, jiri aka nke ọzọ mee ihe nkwụsịtụ ahụ, mee nsị n'akpụkpọ ahụ n'akpa nwa, ma tinye ya n'akụkụ eriri afo na ogo 45.

15. Ekwesịrị ịchekwa ngwaahịa sterilized na ebe dị jụụ, kpọrọ nkụ, dị ọcha, ikuku ikuku na-enweghị ikuku na-emebi emebi.

16. Mgbe mgbatị ahụ na-aga nke ọma, tinye mmanụ ọgwụ ọgwụ n'elu ngwá ọrụ endoscopic ma ọ bụ mgbanaka akara nke ngwaọrụ nkwụsị tupu iji ngwá ọrụ endoscopic belata nkwụsị ma mee ka ọrụ ahụ dịkwuo mfe na ngwa ngwa.

17. Lee akara maka ụbọchị mmepụta

18. Nkọwa nke eserese, akara na mkpirisi eji na nkwakọ ngwaahịa na akara