Isingeniso Sezinto Ezisetshenziswayo Zezokwelapha——iyini i-trocar?

Inkemba, enemiphetho ebukhali nhlangothi zombili, inenkemba eqondile kanye nethiphu elicijile. Uma isetshenziswa, ingaba yingozi kukho kokubili ukushaya okuya phambili nokuhlehlayo, futhi ichopho lingangena kalula ezimbathweni zempi. Kuyisikhali esiyingozi kakhulu.

Namuhla, nokho, sizoxoxa nge-trocar, ukusetshenziswa kwezokwelapha nokuhlinza, okungaqhathaniswa nenkemba. Ekuhlinzweni kwezokwelapha okungangeneleli kancane, lapho kutholwa isimo sezokwelapha ngaphakathi emzimbeni esidinga ukususwa ngokuhlinzwa, ithuluzi lokuqala elisetshenziswayo yi-trocar. Ukuma kwe-trocar kufana nenkemba futhi, ishesha futhi ikwazi ukungena ekujuleni kwesikhumba. I-trocar iklanyelwe ukungena odongeni lwesisu futhi idale umzila wezinye izinsimbi zokuhlinza ukuze zingene emgodini womzimba; iwuhlobo lwensimbi yokuhlinza engenele kancane.

 

 

Izinhlobo Nomehluko Wama-Trocars

Ngokuvamile, inhloso eyinhloko ye-laparoscopic trocar iwukusungula umzila emgodini wesisu.  

Ngokusekelwe ohlotsheni lwe-trocar core, zingahlukaniswa ngezinhlobo ezintathu:

1.ukusika ama-trocars

2.ama-trocars abukwayo

3.dilating trocars.  

Izinkomba zama-trocars abukwayo wukusungula umgudu wokwenziwa wokungena emgodini womzimba. Ama-trocars okusika asetshenziswa ngokuhambisana nama-endoscopes ukubhoboza izicubu zomzimba futhi asungule isiteshi somgodi wesisu ngesikhathi sokuhlinzwa kwe-endoscopic.I-Dilating trocars isetshenziswa ngaphambi kokuhlinzwa kwe-laparoscopic ukubhoboza isikhumba kanye ne-fascia kanye nokufaka imishini yangaphambi kokuhlinzwa, ukuhlalisa izindlela zokubhoboza ezihlukene, njengendlela yokuvala (i-Veress direct), i-dilating direct.

I-Laparoscopic trocars ihlukaniswa ngokusekelwe ekusetshenzisweni kwayo kumathuluzi alahlwayo futhi asebenziseka kabusha, ngalinye linezici ezihlukahlukene. Ubude be-trocar cannula bungaba ngu-80mm, 110mm, noma 150mm, futhi ububanzi besiteshi esiyinhloko se-trocar bungaba ngu-5mm, 8mm, 10mm, 12mm, noma 15mm. Aphinde ahlukaniswe ngezindlela zawo zokuvala: ukuvala indandatho yophawu nokuvala igesi.

 

 

Umlando wamaTrocars

 

Ngekhulu le-19, udokotela waseBrithani u-Reginald S. Southey (1835 – 1899) wasungula "i-Southey tube" ngemva kokubona ukuphuma koketshezi kumabhamuza ezigulini ezine-edema evamile. Lokhu kuqanjwa kwaklanyelwe ukukhipha uketshezi oluningi olungaphansi kwesikhumba emzimbeni. Ngokuzijwayeza okuqhubekayo nokucwengwa, u-Southey wengeze i-cannula futhi waklama ukuvuleka okuningi, okuholele kuhlobo lokuqala lwe-trocar.

Ngo-1938, udokotela ohlinzayo waseHungary u-Janos Veress wasungula inaliti ene-blunt obturator elayishwe entwasahlobo ehosha ngokuzenzakalelayo lapho ingena ngodonga lwesisu. Le divayisi, eyaziwa ngokuthi inaliti ye-Veress, yayiklanyelwe ukugwema ukulimala ezithweni zangaphakathi lapho ingena emgodini wesisu ukuze iphefumule.

Njengoba ezinye izindlela zokwelapha i-edema zavela, i-trocar kancane kancane yaphela ukusetshenziswa kulo mongo. Iguquke yaba yi-trocar yesimanje esetshenziswa ekuhlinzeni i-laparoscopic.

Namuhla, ngentuthuko eqhubekayo kubuchwepheshe bezokwelapha nezimboni, amathuluzi we-laparoscopic namadivayisi asungulwa futhi athuthukiswa ngokuqhubekayo. I-trocar idlala indima ebaluleke kakhulu futhi isiyinto ebalulekile esetshenziswayo ekuhlinzeni kwe-laparoscopic.

 

Ukusetshenziswa kwe-Trocars

Ngenxa yezinzuzo zokuhlinzwa kwe-laparoscopic, njengokuhlukumezeka okuncane, ubuhlungu obuncishisiwe, amazinga okutheleleka aphansi, ukululama ngokushesha kwamathumbu, kanye nezibazi ezincane zangemva kokuhlinzwa, umqondo wokuhlinzwa okungenasidingo, omelelwa amasu we-laparoscopic, uya ngokuya uqashelwa futhi uhlonishwa yibo bobabili ochwepheshe bezokwelapha neziguli. Namuhla, ingasetshenziswa ezinhlotsheni eziningi zezinqubo zokuhlinzwa.

Izifo Zabesifazane:

I-Hysterectomy

I-Myomectomy (ukususwa kwe-uterine fibroids)

I-Ovarian cystectomy

Ukuhlinzwa kokukhulelwa kwe-Ectopic

Ukuhlinzwa kweshubhu le-Fallopian

Ukungazali

Ukuvunyelwa kwe-Pelvic

Ukuhlinzwa Kwe-Hepatobiliary:

Cholecystectomy (ukususwa kwenyongo)

Ukuhlolwa kwe-bile duct evamile kanye nokukhipha amatshe

Ukukhishwa kwesibindi

I-cyst fenestration yesibindi kanye nokukhipha amanzi

Ukukhipha ithumba lesibindi

I-Biliary-enteric diversion

I-Urology:

I-Nephrectomy (ukususwa kwezinso)

I-Adrenalectomy (ukususwa kwezindlala ze-adrenal)

Ureterolithotomy (ukukhishwa kwetshe le-ureteral)

Ukuhlinzwa Kwesisu:

I-gastrectomy ephelele noma ingxenye (ukususwa kwesisu)

I-Appendectomy (ukususwa kwe-appendix)

Ukulungisa isilonda esinezimbobo

I-Adhesiolysis (ukukhululwa kokunamathela emathunjini)

Ukukhishwa kwe-Colourectal tumor

Ukuhlinzwa Kwethoracic:

I-Lobectomy (ukususwa kwe-lung lobe)

Ukukhishwa komdlavuza we-Esophageal

 

 

 

Izingxenye eziyinhloko ze-Trocars

I-trocar ehlanganisa izingxenye ezintathu:

I-cannula. Lona umphini ofakwa esigulini ukuze unikeze ukufinyelela emgodini wesisu.

Uphawu. Lokhu kutholakala phezulu kwe-cannula futhi kuqinisekisa ukuthi akukho moya ophumayo emgodini wesisu kuyilapho kuvumela noma yiziphi izinto ezidingekayo ukuthi zidlule. Uma umfutho womoya unganakekelwa kahle ngesikhathi se-laparoscopy, lokhu kungakhinyabeza umbono kadokotela ohlinzayo ’ wendawo ehlinzwayo.

I-obturator. Lena indlela eyenza i-cannula ikwazi ukungena okokuqala esiswini.

1-Handle:; 2-Gas Valve;3-Valve Ukuvala Cap;4- Cannula;5- Obturator