I-Trocar Entsha Yokusebenzisa Okukodwa

Ngaphambi kokufaka nokusebenzisa lo mkhiqizo, sicela ufunde incwadi yeziqondiso ngokucophelela

Ibhukwana lemiyalo ye-laparoscopic trocar elahlayo

I. Igama lomkhiqizo, imodeli, imininingwane

Iyunithi ye-laparoscopic trocar elahlayo (mm)

II.Ukusebenza kwe-laparoscopic trocar okulahlwayo

Idivayisi yokubhoboza isetshenziswa njengethuluzi lokuhlinza i-laparoscopic.I-pneumoperitoneum kufanele isungulwe kuqala, bese u-5-12 mm wesikhumba kufanele unqunywe endaweni efanele esiswini.Lungisa i-trocar ngesandla nge-engeli efanele ku-pneumoperitoneum-ephakanyisiwe yesisu.Ngokusikwa kwesikhumba, cindezela phansi phezulu kwedivayisi yokubhoboza ngentende yesandla sakho, bese ufaka idivayisi yokubhoboza esikhunjeni.Lapho idivayisi yokubhoboza ingena emgodini wesisu, ngokushesha khipha ikhoni yokubhoboza ukuze wenze umgudu osebenzayo, bese ufaka i-laparoscope/insimbi ukuze uyibheke kanye Nokusebenza.

III.Ukwakheka kwesakhiwo esiyinhloko se-laparoscopic trocar

Umshini wokubhoboza we-laparoscopic olahlwayo wakhiwe ikakhulukazi ikepisi lokuvala, isembozo sokukhiya nesokulungisa, ivalvu yomjovo womoya, i-cannula, i-puncture cone, i-valve yokuvimbela umoya kanye nekepisi lokuvala elizilungisayo.

Phakathi kwazo: i-cap yokuvala, i-cap yokuvala nokulungisa, i-valve yomjovo wegesi, i-casing, ne-puncture cone yenziwe ngezinto ze-PC, futhi i-valve yokuvimbela umoya kanye ne-self-adjusting sealing cap yenziwe ngezinto ze-silicone.

IV. Ububanzi be-laparoscopic trocar elahlayo yohlelo lokusebenza

Isetshenziselwa ukubhoboza izicubu zodonga lwesisu lomzimba womuntu ngesikhathi se-laparoscopy nokuhlinzwa, kanye nokusungula umgudu wokusebenza wokuhlinzwa kwesisu.

V. Isakhiwo sokubukeka kwe-laparoscopy esilahlwayo

1.Isivalo sokuvala 2. Isivalo sokukhiya nokulungisa 3. Ivalvu yokujova 4. Umkhono

5. Ikhoni yokubhoboza 6. Ivalvu evimba umoya 7. Ikepisi elivalayo elizilungisayo

1.isibalo 1I-P-TC-(5/10/12/15）i-trocar

VI.Alahlwayo Laparoscopic trocar Contraindications

Ayikwazi ukusetshenziswa ezigulini ezisanda kuzalwa, futhi kufanele isetshenziswe ngokuqapha kwabesifazane abakhulelwe.

VII.Ukufakwa kwe-laparoscopic trocar okulahlwayo

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VIII.I-laparoscopic trocar Imiyalelo yokusetshenziswa

1. Ngaphambi kokusebenzisa i-cannula yokubhoboza elahlayo yenkampani yethu, kunconywa ukuthi usungule i-pneumoperitoneum kuqala, bese wenza ukusika kwesikhumba emgodini wesisu omkhulu ngokwanele ukuze kungene i-cannula.Enye indlela yokuqinisekisa ukuthi ukusika isikhumba kukhulu ngokwanele ukucindezela ishubhu le-trocar langaphandle liye phansi odongeni lomzimba, udale umbhalo oyisiyingi, bese usika ngobubanzi obunwetshiwe bombhalo ukuze kungene ukungena kwe-cannula, isb. 5mm ukubhoboza I-casing. idinga ukukhushulwa ububanzi ngo-2mm.Qaphela ukuthi ukusikeka okuncane kungase kubangele ukumelana nesikhumba se-cannula, kukhuphule amandla okungena futhi kunciphise ukulawula kukadokotela icannula ngesikhathi sokufakwa.

2. Lungisa i-cannula yokubhoboza nge-engeli efanele esiswini esiphakanyisiwe ngemva kwe-pneumoperitoneum.Ama-trocars alahlwayo abukhali kune-trocars esetshenziswa kabusha futhi ngakho-ke ngokuvamile adinga amandla amancane ukuze uwafake.Kodwa qaphela: Ukungabi negesi eyanele, ukungasiki isikhumba esikhulu ngokwanele, noma ukusebenzisa amandla amaningi kungandisa ingozi yokulimala kwezitho zangaphakathi.

3. Ngaphambi kokwethula i-cannula yokubhoboza esikhunjeni, faka ikhoni yokubhoboza ku-cannula yokubhoboza.

4. Cindezela phansi phezulu kwe-cannula ebhobozayo ngentende yesandla sakho.Ngesikhathi esifanayo, ukugcina ukucindezela kusibambo kungashintshi, faka i-cannula yokubhoboza elahlayo esikhunjeni.Faka ukucindezela okuqhubekayo okuya phansi ngesikhathi sokungena kwe-cannula.

5. Uma i-cannula isingenile emgodini wesisu, kufanele kuqashelwe ukuthi ungayisebenzisi kabusha i-cannula.Uma udokotela ohlinzayo ecabanga ukuthi i-cannula yokubhoboza itholakala emgodini wesisu, ikhoni yokubhoboza kufanele ikhishwe ngokushesha futhi ifakwe ku-laparoscope ukuze ibukwe.

6. Uma ukubhoboza kungaqediwe, phinda izinyathelo ezi-3-5.

7. Uma ukubhoboza kuyi-10 mm noma ngaphezulu ngemva kokuhlinzwa, i-fascia ejulile kufanele ivalwe ukuze kuncishiswe ingozi ye-incisional hernia ngokuhlinza.

8. Ngemuva kokuthi ukubhoboza kuphumelele, ngaphambi kokusebenzisa ithuluzi le-endoscopic, sebenzisa okokuthambisa kwezokwelapha endaweni yensimbi ye-endoscopic noma indandatho yokuvala yesibhobho ukuze unciphise ukumelana nokwenza umsebenzi ube lula futhi usheshe.

IX.Izindlela ezilahlwayo ze-laparoscopic trocar nokugcinwa kwazo

1. Isitoreji: Gcina ekamelweni elinomswakama olinganiselwe ongekho ngaphezu kuka-80%, elinomoya ohlanzekile, futhi elingenawo amagesi ezonakalisayo.

2. Ezokuthutha: Umkhiqizo opakishiwe ungathuthwa ngamathuluzi avamile.Ngesikhathi sokuthutha, kufanele kuphathwe ngokucophelela futhi ugweme ilanga eliqondile, ukungqubuzana okunamandla, imvula kanye ne-gravity extrusion.

X.Idethi yokuphelelwa yisikhathi ye-laparoscopic trocar

Ngemuva kokuthi lo mkhiqizo ukhishwe inzalo nge-ethylene oxide, isikhathi sokuvala inzalo iminyaka emithathu, futhi usuku lokuphelelwa yisikhathi luboniswa kulebula.

XI.Uhlu lwezesekeli ze-laparoscopy ezilahlwayo

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XII.Izinyathelo nezixwayiso ze-laparoscopic trocar ezilahlwayo

1. Uma usebenzisa lo mkhiqizo, imininingwane yokusebenza kwe-aseptic kufanele ilandelwe ngokuqinile;

2. Sicela uhlole ukupakishwa kwalo mkhiqizo ngokucophelela ngaphambi kokusetshenziswa, uma ukupakishwa kwamabhamuza konakalisiwe, sicela uyeke ukuyisebenzisa;

3. Lo mkhiqizo uvalwa inzalo nge-ethylene oxide, futhi umkhiqizo ovalwe inzalo owokusetshenziswa emtholampilo.Sicela uhlole inkomba yediski ebhokisini lokupakisha lokuvala inzalo lalo mkhiqizo, “okuluhlaza okwesibhakabhaka” kubonisa ukuthi umkhiqizo ufakwe inzalo nge-ethylene oxide futhi ungasetshenziswa ngokuqondile emtholampilo;

4. Lo mkhiqizo owokusetshenziswa kanye kuphela futhi awukwazi ukuvalwa inzalo ngemva kokusetshenziswa;

5. Sicela uhlole ukuthi umkhiqizo ungaphakathi kwesikhathi sokuqinisekisa ngaphambi kokusetshenziswa.Isikhathi sokuqinisekisa ukuvala inzalo iminyaka emithathu.Imikhiqizo engaphezulu kwesikhathi sokuqinisekisa inqatshelwe ngokuphelele ukusetshenziswa;

6. Ukwehluleka ukwakha nokugcina i-pneumoperitoneum efanelekile ngesikhathi sokuhlinzwa kwesisu kungase kunciphise indawo yokusebenza etholakalayo, ngaleyo ndlela kuvimbele ukuhamba phambili kwekhoni yokubhoboza futhi kwandise ingozi yokulimala kwezicubu ze-visceral.

7. Abanolwazi kuphela nabajwayelene namasu e-endoscopic abangenza ukuhlinzwa kwe-endoscopic.Ngaphambi kokuhlinzwa, odokotela kufanele bahlole izincwadi nezincwadi ezifanele ukuze baqonde amasu, izinkinga kanye nezingozi ze-endoscopy.

8. Ikhoni yokubhoboza emise okukodwa ibukhali futhi iphephile, ngakho-ke kudingeka amandla amancane ngesikhathi sokufakwa.Amandla amakhulu angase anciphise ukulawula komsebenzisi phezu kwe-engeli yokufaka nokujula kwekhoni yokubhoboza, okwandisa ingozi yokulimala kwezicubu zangaphakathi.

9. Ukunamathela, ukungahambi kahle kwe-anatomical noma ezinye izithiyo kungase kuvimbele noma kubambezeleke, okuzokwenza ukuthi i-puncture cone ilimaze ukwakheka kwesitho sangaphakathi ngesikhathi sokubhoboza ngokungaboni.Kunconywa ukusebenzisa ukuhlinzwa kwe-laparoscopic evulekile, bese usebenzisa lo mkhiqizo ngemuva kokwengeza ama-sutures ekusetshenzisweni kokungenisa kwe-fascia yesisu.

10. Ngaphambi nangemva kokukhipha i-cannula elahlayo emgodini wesisu, hlola indawo yokuhlinza ukuze uthole ukopha.Ukopha kungalawulwa nge-cautery noma i-hand sutures.Ngokubona kukadokotela, i-laparotomy ingadingeka.

11. Uma usungaphakathi kwesisu, kufanele kuqikelelwe ukuthi ungaphinde ucindezele i-cannula.Uma amandla anele asetshenziswa ekugcineni ukuze kuhanjiswe ikhoni phambili, kuzodala umonakalo ezicutshini zangaphakathi.

12. Uma usebenzisa amathuluzi e-endoscopic kanye nezinsiza ezikhiqizwe abakhiqizi abahlukene ngesikhathi esisodwa ekuhlinzweni kwe-endoscopic, ukuhambisana phakathi kwamathuluzi ahlukene kufanele kubhekwe, futhi ukufakwa kukagesi nokubeka phansi kufanele kuhlolwe.

13. Uma ukusika kwesikhumba okubhoboziwe kungu-10mm noma ngaphezulu, i-fascia ejulile kufanele ivalwe ukuze kuncishiswe amathuba okuba ne-incisional hernia.

14. Ngesikhathi sokuhlinzwa kwe-laparoscopic, isiguli kufanele sibe sesimweni sokulala ikhanda libheke phansi nezinyawo zibheke phezulu.Uma usebenzisa i-cannula yokuqala yokubhoboza, phakamisa udonga lwesisu esingezansi ngesandla esisodwa, sebenzisa i-cannula yokubhoboza ngesinye isandla, usika esikhumbeni senkaba, bese usishutheka esinyeni nge-engeli engama-degree angu-45.

15. Imikhiqizo evalwe amagciwane kufanele igcinwe endaweni epholile, eyomile, ehlanzekile, engenawo amagesi abolayo.

16. Ngemva kokuba ukubhoboza kuphumelele, gcoba okokuthambisa kwezokwelapha endaweni yensimbi ye-endoscopic noma iringi yokuvala yedivayisi yokubhoboza ngaphambi kokusebenzisa ithuluzi le-endoscopic ukunciphisa ukumelana nokwenza umsebenzi ube lula futhi usheshe.

17. Bheka ilebula yedethi yokukhiqiza

18. Incazelo yezithombe, izimpawu nezifinyezo ezisetshenziswa emaphaketheni nasemalebula