ʻO ka Laparoscopy kahi hana diagnostic a ʻokiʻoki paha ma nā ʻōpū o loko o ka ʻōpū a i ʻole ke pelvis. ʻO ka Laparoscopy kahi hana ʻokiʻoki hou i hana ʻia ʻaʻole ma o ka wehe maoli ʻana a i ʻole nā ʻoki ʻili nui, akā ma o nā puncture liʻiliʻi (maʻamau 0.5-1.5 cm), ʻoiai ʻo ke ʻoki maʻamau e koi i nā ʻoki nui a no laila e waiho i nā ʻōpala nui. No ka puncture, hoʻohana ʻia kahi trocar, me ke kōkua ʻana o ka pā o ka ʻōpū, a hoʻokomo ʻia kahi mea optical optical (laparoscope) i loko o kahi paipu me ke anawaena o 0.2-1.0 cm.
ʻO ka mea hana nui no ka laparoscopy ka laparoscope - he paipu metala me ke anawaena o 5-10 mm (2 mm no ka micro laparoscopy) me kahi ʻōnaehana lens paʻakikī a me ke alakaʻi māmā. Hoʻouna ka lens i ke kiʻi mai ka lens i ka maka, a alakaʻi ke alakaʻi kukui i ke kukui kukui mai ka mea hoʻomālamalama i loko o ka ʻōpū o ka ʻōpū. Hiki iā ʻoe ke nānā pono i ka lens laparoscopic - ua hana ʻia kēia no nā makahiki he mau makahiki, akā me ka hiki ʻana mai o nā kiʻi kiʻi endoscopic liʻiliʻi (i kēia manawa ke kaupaona nei lākou he 50-150 grams) i hoʻopili ʻia i ka lens laparoscopic i nā makahiki he ʻekolu i hala, hiki i nā limahana hana āpau ke ʻike i ka holomua o ka hana ma ka nānā. Hana ʻia ka ʻike a me kekahi mau kaʻina hana maʻalahi ma lalo o ka anesthesia kūloko, a ʻo ka hapa nui o nā kaʻina hana laparoscopic e hana ʻia ma lalo o ka anesthesia āpau.
ʻAʻohe mea e like me "laparoscopic surgery". ʻO ka Laparoscopy kekahi o nā ala e hiki ai ke komo i nā kino o ke kino. Ma waho o keʻano o ka hoʻokōʻana,ʻaʻole e loli keʻano o ke kaʻina hana. Hoʻokumu ʻia kēia mau huaʻōlelo me ka hoʻohana ʻana i ka huaʻōlelo "scope" (mai ka Greek scope-ʻike wau), ʻo ka hapa mua o ka inoa o ke ʻano e hōʻike ana i ke kino a i ʻole ka lua e hoʻoponopono ʻia a nānā ʻia.
ʻO ka Laparoscopy kekahi o nā ʻano o ka endoscopy, a ʻo ka endoscopy e pili ana i ka laparoscopy, thoracoscopic examination, hysteroscopy, cystoscopy, arthroscopy a pēlā aku.
Thoracoscopy - hana ma ka umauma;
Nephroscopy - ka hana ʻana a me ke ʻoki ʻana i nā puʻupaʻa;
Cystoscopy - ka ʻoki ʻana ma ka ʻōpū;
Hysteroscopy - ke kaʻina hana ma ka ʻōpū;
Gastroscopy - ʻoki ʻana ma ka ʻōpū.
Inā hoʻohui ʻia ka prefix "fibro" i ka inoa, ʻo ia ka mea e hana ʻia ke kaʻina hana me ka hoʻohana ʻana i kahi endoscope maʻalahi, no ka laʻana, ʻo ka fiber hysteroscopy kahi nānā ʻana i ka ʻōpū me ka hoʻohana ʻana i ka endoscope flexible.
ʻOkoʻa iki ke ʻano o ka ʻoki laparoscopic ma muli o ke ʻano o ke ʻoki a me ke keʻena lapaʻau. Ua mākaukau nā poʻe maʻi e loaʻa ka mālama like e like me ke ʻoki maʻamau. ʻO ka mea mua, ua hoʻokomo ʻia nā mea maʻi i loko o ke keʻena me nā lāʻau lapaʻau no ka hoʻomaha hou ʻana i ka ʻeha a me ka hoʻonui ʻana i ka pono. Ua kapa ʻia kēia mau hana ʻo "preoperative administration". Lawe ʻia ka mea maʻi i ke keʻena hana ma luna o kahi kauā.
Hoʻokomo ʻia kahi catheter plastik palupalu i loko o ka cubital vein o ka mea maʻi no ka hoʻokomo ʻana i nā lāʻau lapaʻau, nā hoʻonā, anesthetics, a me nā mea hōʻeha ʻeha. Hoʻopili ʻia kahi mask rubber a silicone paha i ka maka o ka mea maʻi a hāʻawi ʻia ka hui hanu ma o ka mask.
Ma hope o kekona, hiamoe ka mea maʻi a hoʻokomo ka anesthesiologist - hoʻokomo ʻo ia i kahi paipu plastik i hoʻopaʻa ʻia i ke alaloa, hoʻoulu a hoʻopaʻa i ke ala ea. I ka wā o ke kaʻa ʻana, loaʻa i ka mea maʻi ka hoʻokuʻu ʻana i ka māmā artificial.
No ka laparoscopy, hoʻopiha ʻia ka ʻōpū o ka ʻōpū i ke kinoea - i ka hapanui o nā hihia, hoʻohana ʻia ka carbon dioxide no kēia kumu. Hoʻokomo ʻia ke kinoea e hoʻokiʻekiʻe i ka paia o ka ʻōpū i kahi ʻano dome ma luna o nā ʻōpū a hāʻawi i ka ʻike maikaʻi a me ke komo ʻana i nā kino. Ua mālama nā mea kōkua a me nā kauka lapaʻau i ka ʻōpū holoʻokoʻa o ka mea maʻi me nā hopena antiseptic no ka hiki ke hoʻololi i ka wehe ʻana a, ma ke kauoha a ka anesthesiologist, hoʻokomo i kahi nila Veress lōʻihi ma o ka piko. Hoʻolālā ʻia me kahi kumu i hoʻopiha ʻia i ka pūnāwai e hōʻemi i ka pōʻino i nā kino o loko i lalo i ka wā o ka ʻōpū o ka ʻōpū. Ma hope o ka hōʻoia ʻana me ke kōkua o kekahi mau hoʻāʻo ʻana aia maoli ka nila i loko o ka ʻōpū o ka ʻōpū, ua hoʻopili ʻia ka hose o ka insufflator i ka nila. Hāʻawi kēia mea uila maʻalahi i ka hāʻawi ʻana i ka carbon dioxide i loko o ka lua a mālama pono i ke kaomi i loko me ka pololei o 1 mmHg.
Ma hope o ka piʻi ʻana o ke kaomi kinoea i loko o ka lua i ka 10-16 mmHg (ma muli o ke koho ʻana o ke kauka lapaʻau), wehe ʻia ka nila Veress a hoʻokomo ʻia ka trocar mua ma ka piko - he mea metala a i ʻole ka ʻiʻo i hoʻokomo ʻia i loko o kahi trihedral a i ʻole tapered probe. Ma hope o ke kuʻi ʻana i ka paia, wehe ʻia ka stylet a hoʻokomo ʻia ma o ka cannula (tube) i loko o ka endoscope a me ka laparoscope. ʻO ka laparoscope he 10, 5 a i ʻole 2 mm ke anawaena (me ka micro laparoscope) paipu metala me kahi ʻōnaehana lens paʻakikī a me ke alakaʻi māmā. Me nā kiʻi wikiō liʻiliʻi i hoʻopili ʻia me 50-100 grams a me nā kumu kukui halogen a i ʻole xenon (iluminators), hiki i ka hui hana holoʻokoʻa ke nānā i ka holomua o ka hana ma ka pale nānā.
Ma hope o ka hoʻokomo ʻana i ka laparoscope, e nānā i ka ʻōpū o ka ʻōpū a hoʻokomo i 2-4 trocars hou aʻe ma lalo o ka mana ʻike. ʻO ke kiko o ka hoʻokomo trocar e pili ana i ke kino e hana ʻia ana a me ke ʻano o ka wawao - i ka cholecystectomy, hoʻokomo ʻia ka trocar i ka ʻōpū o luna ma lalo o ke kumu kūʻai, i ka ʻoki gynecological - i ka ʻōpū o lalo.
Ma ke kumu, hiki i nā mea kani me ka lōʻihi o 30-40 cm a me ke anawaena o 2 a 12 mm hiki ke hana i nā hana like a pau e like me nā ʻenehana hana maʻamau. ʻO ka hoʻopaʻa ʻana i ka ʻaoʻao, ka hopu ʻana i ke kino me nā clips, ka hoʻokuʻu ʻana a me ka hoʻokaʻawale ʻana o ke kino mai nā ʻiʻo a puni (dissection) ma o ka dissectors, nā ʻoki endoscopic a me nā mea hana electrosurgical, me ke kōkua o ka coagulation, ka hoʻopau pili ʻana o ke kahe ʻana o nā moku liʻiliʻi. Coagulation - wili nā protein ma lalo o ka mana o ke alapine kiʻekiʻe, no laila e pani ka lumen o ke kīʻaha koko. Hiki ke hooki i ke koko mai na moku nui ma ke oki ana (me ka hoohana ana i na paopao titanium), ka hoopili ana me na mea humuhumu, a me ka humuhumu me ka endoscopic stapler.
He koʻikoʻi koʻikoʻi nā stapler endoscopic i ke kaʻina endoscopic - he mea ʻokoʻa paha kēia, akā ma kahi o ka scalpel ka paʻa ʻana o ka lāʻau lapaʻau i kahi paʻa nila no ka lōʻihi loa - ʻoi aku ka lōʻihi o ke kaʻina hana o ke humuhumu ʻana, humuhumu, a me ke kāʻei. Hiki i ke kauka lapaʻau akamai ke hoʻopaʻa i 60 mau puʻupuʻu palekana i ka minuke, a i ʻole hoʻokahi puʻupuʻu i kekona. I kēia manawa, i ka hana endoscopic, ua hoʻololi ʻia nā lima o ke kaukō e nā mea hana lohi i ʻoi aku ka paʻakikī o ka nakinaki ʻana. No laila, no ka laʻana, ua hoʻonohonoho ka European Association of Physicians and Surgeons i kahi maʻamau - hoʻopaʻa i kahi ʻekolu i loko o 40 kekona. No laila, he hana hou kēia i hana nui i ka hoʻonui ʻana i ke ʻano o nā hana endoscopic, nā stapler. Hiki i nā kauka lapaʻau ke hana i nā anastomoses inter enteric me ka neʻe hoʻokahi o ka lima, e hoʻopaʻa paʻa i ka ʻōpū, nā moku kahe koko, a me nā mea ʻē aʻe, ma kahi o ka lōʻihi a i kekahi manawa aneane hiki ʻole ke hoʻopaʻa lima endoscopic suturing. Ua lilo i mea ʻenehana hiki ke hana i kekahi hana ʻokiʻoki ma ke ʻano o ka ʻokiʻoki endoscopic me ke kōkua o kahi stapler.