Nyob rau hauv niaj hnub minimally invasive phais, laparoscopy tau dhau los ua tus qauv kub rau kev kho ntau yam kab mob plab. Kev pib ntawm cov txheej txheem no feem ntau pib nrog qhov zoo li yooj yim tab sis tseem ceeb ntsuas: lubVeress koob. Raws li "thawj lub rooj vag" rau kev tsim pneumoperitoneum thiab tsim kom muaj qhov chaw ua haujlwm, kev tsim thiab kev siv ntawm Veress koob ncaj qha cuam tshuam rau kev nyab xeeb thiab kev ua haujlwm ntawm kev phais.

I. Core Safety Mechanism: Caij nplooj ntoos hlav-Loaded Blunt Inner Stylet

Qhov tseem ceeb tshaj plaws ntawm Veress koob yog nws cov qauv dual: lub ntsej muag ntse sab nrauv thiab lub ntsej muag puab sab hauv nruab nrog lub caij nplooj ntoo hlav. Thaum lub koob taub hau nkag mus rau cov fascial fascial resistant txheej ntawm lub plab phab ntsa, qhov tsis kam ua rau blunt stylet retract, nthuav tawm cov ntse beveled taub rau txiav. Thaum lub taub nkag mus rau hauv qhov dawb peritoneal kab noj hniav thiab tsis kam ploj mus, lub caij nplooj ntoos hlav tam sim ntawd xa cov blunt stylet, projecting nws dhau ntawm sab nrauv cannula. Qhov no zoo tiv thaiv plab hnyuv, omentum, thiab hlab ntsha los ntawm laceration. Qhov no"xov-thiab- tiv thaiv"Cov txheej txheem yog qhov laj thawj tseem ceeb vim li cas Veress rab koob tseem yog cov cuab yeej nyiam rau kev nkag mus rau laparoscopic.

II. Cov kev txiav txim siab tseem ceeb hauv chaw kho mob: Kev Xaiv Chaw Nkag Nkag thiab Cov Kev Ntsuas Qhov Tseem Ceeb

Txawm hais tias nws cov yam ntxwv kev nyab xeeb, cov txheej txheem tsis raug tseem tuaj yeem ua rau muaj teeb meem loj. Yog li ntawd, standardized insertion txheej txheem yog qhov tseem ceeb. Feem ntau, lub umbilicus raug xaiv los ua thawj qhov chaw nkag vim nws cov phab ntsa tsawg tsawg thiab tsis muaj cov hlab ntsha loj. Rau cov neeg mob uas muaj keeb kwm ntawm kev phais plab, lwm qhov chaw xws li thaj tsam sab laug subcostal lossis sab laug sab sauv (Palmer's point) yuav tsum raug txiav txim siab kom tsis txhob ua rau quav quav.

Thaum muab tso, tus kws phais siv lub dab teg ruaj khov, ua tib zoo pomob qho tib si "pops": thawj los ntawm lub qhov quav ntawm lub qhov quav, qhov thib ob los ntawm peritoneum. Ua raws li qhov no, kev pom zoo ntawm kev tso intraperitoneal yog qhov yuav tsum tau ua ua ntej txuas lub insufflator. Qhov no yog tiav los ntawm covdai poob testlos yogkev kuaj ntshav siab. Insufflation siab yuav tsum tau khaws cia nyob rau hauv qhov ntau npaum li cas (feem ntau12-15 mmHg) txhawm rau xyuas kom pom kev pom zoo txaus thaum txo qis cov teebmeem kev mob plawv.

III. Technical Evolution thiab yav tom ntej Trends

Nrog rau kev tshwm sim ntawm kev phais neeg hlau thiab ib leeg -incision laparoscopy (SILS), Veress koob txuas ntxiv mus. Piv txwv suav nrogOptical Veress koob​ nrog kev sib xyaw ua ke, tso cai rau cov kws phais kom pom cov ntaub so ntswg hauv lub sijhawm tiag tiag - lub sijhawm thaum tso.Smart Veress koob​ incorporating pressure sensors can provide real -lub sij hawm tawm tswv yim ntawm cov ntaub so ntswg tsis kam, pab txiav txim qhov kev loj hlob ntawm qhov puncture. Tsis tas li ntawd,ntxiv -Ntev Veress koob(txog 150 hli) tau siv ntau dua rau cov neeg mob rog kom ntseeg tau qhov tob tob tob.

Xaus

Txawm hais tias me me, cov txheej txheem kev nyab xeeb thiab daim ntawv thov txheej txheem ntawm Veress koob yog qhov kev tiv thaiv tseem ceeb rau kev phais laparoscopic ua tiav. Kev nkag siab tob txog nws cov qauv kev ua haujlwm thiab cov ntsiab lus ntawm kev ua haujlwm yog ib qho yuav tsum tau kawm rau txhua tus kws phais mob me me.