FAQ Ntawm Trocar Siv Thiab Kev Sib Koom Tes Hauv Chav Ua Haujlwm: Txhim Kho Kev Ua Haujlwm Los Ntawm Pab Pawg Kho Mob

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Kev siv ntawmkoob trocarKev txhawj xeeb tsis yog tsuas yog tus kws phais tus txheej txheem xwb tab sis kuj tseem muaj kev koom tes ntawm cov kws kho mob / cov kws tu neeg mob, kev npaj cov cuab yeej, thiab kev tuav xwm txheej ceev. Cov lus nug uas nquag nug kho mob tau muab tso ua ke hauv qab no:

Q1: Yuav ua li cas los txiav txim qhov loj ntawm daim tawv nqaij?

Nyob rau hauv txoj cai, txoj kab uas hla incision ≈ sab nraud ntawm lub cannula. Rau ib tug 5 hli trocar, ua ib tug 5 hli transverse incision (raws li daim tawv nqaij kab); rau 10 hli trocar, 10-12 mm; rau 12 hli trocar, me ntsis loj los ntawm 2 hli los pab txhawb kev ntxig. Kev phais me me dhau los ua rau muaj kev tiv thaiv ntau dhau, tsis nco qab ua rau tus kws phais mob siv zog ntau dua thiab ua rau muaj kev pheej hmoo raug mob ntxiv; loj heev ua rau huab cua xau, yuav tsum tau sutures kom ruaj ntseg cannula.

Q2: Koj puas tuaj yeem ncaj qha qhov muag tsis pom - tsoo lub trocar yam tsis tau tsim pneumoperitoneum?

Tsis pom zoo raws li niaj hnub (tshwj tsis yog rau txoj kev qhib Hasson). Yog tsis muaj pneumoperitoneum, lub plab phab ntsa sab hauv yog nyob ze rau lub posterior peritoneum thiab cov hlab ntsha loj, ua rau qhov muag tsis pom kev raug mob heev. Kev zam tsuas yog ua rau thaum muaj xwm txheej ceev (xws li, nro pneumothorax yuav tsum tau decompression tam sim ntawd nrog ib qho tshwj xeeb loj trocar). Laparoscopy niaj hnub yuav tsum xub tsim pneumoperitoneum nrog Veress koob lossis siv Hasson qhib txoj kev.

Q3: Yuav ua li cas yog tias lub trocar dheev xau huab cua los yog dislodges thaum phais?

Cov pa roj subcutaneous me me khiav tawm -paub tseeb seb lub cannula puas tau screwed nyob rau hauv qhov chaw los yog ruaj ntseg nrog phuam clamps/sutures; mob hnyav heev - ncua kev ua haujlwm, rov- ntxig rau tib qhov loj me lossis me me trocar nyob rau hauv kev saib xyuas laparoscopic, thiab xyuas qhov chaw nres nkoj qub kom los ntshav. Yog tias lub valve xau, hloov nrog lub trocar seem.

Q4: Kev ceev faj rau cov neeg mob rog rog / emaciated?

Kev rog → xaiv ncua (Ntau dua lossis sib npaug ntawm 120 mm) trocars, ntxig vertically, nqa lub plab phab ntsa kom txaus, ib ntus teem insufflation siab ntawm 14-15 mmHg los pab cais cov kab mob plab plab; Emaciated → them nyiaj tshwj xeeb rau kev nqa lub plab kom tsis txhob muaj qhov tob tob, nruj me ntsis ua qhov tob- txwv txoj kev tiv thaiv ntiv tes, thiab pib teeb tsa pneumoperitoneum siab ntawm 8-10 mmHg, maj mam nce.

Q5: Tus kws saib xyuas mob daim ntawv teev kev npaj ua ntej?

① Xyuas kom tseeb tias cov trocar specifications (inch × ntev) phim cov phiaj xwm phais; ② Paub meej tias cov khoom ntim khoom pov tseg tsis zoo thiab tsis tas sij hawm / rov siv tau cov khoom yog kom tsis muaj menyuam thiab tsis pub dhau lub sijhawm; ③ Npaj reducers, thaub qab trocars, silk sutures rau fixation, insufflation tubing, thiab connectors; ④ Thaum hla lub trocar thaum lub sij hawm phais, tshaj tawm cov qauv thiab pab hauv kev sib txuas cov tubing insufflation; ⑤ Kev sau tom qab kev phais yuav tsum ua raws li kev rov ua dua lossis kev kho mob pov tseg 分流.

Q6: Kev ceev faj rau menyuam yaus?

Xaiv cov menyuam yaus- tej yam luv luv (30–60 mm) ntawm 3 mm lossis 5 mm trocars, ua me me incisions, qis insufflation siab (8–10 mmHg), thiab nruj me ntsis txwv qhov tob thoob plaws hauv kev tiv thaiv kev nkag mus tob heev thiab raug mob tom qab cov qauv.

Tus kws kho mob zoo- kev koom tes hauv kws saib xyuas neeg mob- ua kom raug raws qhov sib piv cov ntsiab lus, kev ruaj ntseg raws sij hawm los tiv thaiv kev tawg, muaj kev hloov pauv zoo ib yam, thiab kev tsim qauv tom qab- siv tuav- tuaj yeem ua kom zoo dua qhov ua tau zoo thiab kev nyab xeeb ntawm trocar koob siv rau qib siab tshaj plaws, sawv cev rau ib qho tseem ceeb ntawm kev tswj hwm kev lag luam niaj hnub no.