I-Laparoscopic Gynecological Surgery

Xa kukho ukudibanisa okunzulu phakathi kwe-ovarian fallopian tube kunye ne-peritoneum kufuphi nodonga olusecaleni lwe-pelvic okanye i-uterosacral ligament, ukuba umsebenzi awufanelekanga, uya kubangela ukulimala kwe-ureter. Inokubangelwa zizixhobo okanye umonakalo wombane. Inokuthi ibe yi-transection epheleleyo okanye ukulimala kancinci. Iziphumo zihambelana nenqanaba lomonakalo, ixesha lokufumanisa kunye nokuba ngaba unyango lufike ngexesha kwaye lufanelekile. Nje ukuba ukwenzakala okanye ukwenzakala okukrokrisayo kufunyenwe, nceda uqhagamshelane nesebe le-urology ngonyango lwangexesha kunye noluchanekileyo, kungenjalo kuya kubangela iziphumo ezibi. Isitshixo sokuthintela kukuba ngaba oogqirha banokuqonda ngokupheleleyo indawo ye-anatomical ye-ureter kwi-pelvic cavity kunye neendawo ezijongene nokulimala. Ukubambelela kakhulu kwe-pelvic kudla ngokukhokelela ekutyebeni kwe-pelvic peritoneum, kunzima ukwahlula ikhosi ye-ureter engaphantsi kwayo, kwaye kulula ukunqumla i-catheter ye-urinary okanye kubangele ukulimala kombane ngokuhlukana kwe-rash, ligation kunye ne-hemostasis. Ngeli xesha, i-retroperitoneum kufuneka ivulwe kuqala ukufumana i-ureter, kwaye emva koko i-lysis kufuneka yenziwe emva kokubona ulwalathiso olusebenzayo kunye nobudlelwane kunye nesayithi lokubambelela. Enye indlela kukufaka i-catheter ye-ureter ngaphambi kokusebenza, oku luncedo ukuchonga indawo ye-ureter. Uvavanyo lotyando: i-ovarian elula kunye ne-fallopian tube adhesion ibonakala inqabile, kwaye ngokuqhelekileyo kukho ukunamathela kwamanye amalungu e-pelvic. Okanye ngokuchaseneyo, i-ovarian tubal adhesion idla ngokuba yinxalenye ye-pelvic adhesion. Ngoko ke, kulungele ngakumbi ukubiza i-pelvic adhesion lysis. Imigaqo yokusebenza, izinto ezibalulekileyo zokusebenza kunye nezakhono ezilandelwa zezi zimbini ziyafana, kodwa le yokugqibela ibandakanya uluhlu olubanzi. Nangona olu tyando lubandakanya kuphela ukukhululwa kokunamathela, ngokwenene kusisiseko solunye utyando lwe-laparoscopic kunye nolunye ubunzima botyando lwe-laparoscopic. Okokuqala, zonke iindlela ezisetyenziselwa ukukhululwa kwe-adhesion, ezifana ne-clamp, i-traction, i-exposure, ukuhlukana, ukusika, i-electrocautery, i-electrocoagulation kunye ne-suture, isiseko sotyando lwe-laparoscopic. Ukuba awuyazi kakuhle, awukwazi ukuthetha ngezinye iinkqubo. Okwesibini, ukuba i-pelvic adhesion ayisonjululwanga kwaye indawo ye-anatomical yezicubu ezahlukeneyo kunye namalungu ayicacanga, ukunyanzelisa eminye imisebenzi kunokubangela umonakalo omkhulu, oyinto eneneni enkulu yotyando. Ngaphezu koko, i-pelvic adhesions zihlala zizigulana ezingenanzala kunye neentlungu ezingapheliyo ze-pelvic. Ukuba i-adhesions ayisonjululwanga kakuhle okanye i-adhesions enzulu ngakumbi ibangelwa emva kokusebenza, ngokwenene ichasene nenjongo yokuqala yalo msebenzi. Ke ngoko, abaqhubi bayafuneka ukuba basebenzise izakhono ezahlukeneyo zotyando lwe-laparoscopic, baqhelane nobudlelwane be-anatomical yamalungu abalulekileyo e-pelvic kunye nesisu, kwaye bakwazi ukufumana izinto ezingaqhelekanga ngexesha kwaye bajongane nazo ngempumelelo. Ngoko ke, lo msebenzi awufanelekanga kwabaqalayo.