Laparoscopy bụ nyocha nyocha ma ọ bụ ịwa ahụ n'ime akụkụ ahụ dị n'ime oghere afọ ma ọ bụ pelvis. Laparoscopy bụ usoro ịwa ahụ nke ọgbara ọhụrụ nke a na-eme ọ bụghị site na oghere ebumpụta ụwa ma ọ bụ nnukwu mbepụ akpụkpọ anụ, kama site na obere (na-emekarị 0.5-1.5 cm), ebe ịwa ahụ na-achọkarị nnukwu mbepụ ma si otú ahụ na-ahapụ nnukwu scars. Maka mgbapu, a na-eji trocar eme ihe, site n'enyemaka nke a na-amapu mgbidi afọ, na-etinyekwa ngwa anya anya (laparoscope) n'ime tube nke nwere dayameta nke 0.2-1.0 cm.
Ngwá ọrụ bụ isi maka laparoscopy bụ laparoscope - tube ígwè nke nwere dayameta nke 5-10 mm (2 mm maka micro laparoscopy) nwere usoro oghere mgbagwoju anya na nduzi ọkụ. Igwefoto ahụ na-ebufe onyonyo site na oghere gaa na anya anya, na ntuziaka ọkụ na-eduzi ọkụ ọkụ sitere na onye na-enye ọkụ n'ime oghere afọ. Ị nwere ike ileba anya ozugbo na oghere laparoscopic - nke a emeela ọtụtụ iri afọ, ma na ọbịbịa nke obere igwefoto endoscopic (ugbu a ha na-atụ 50-150 grams) na-ejikọta na oghere laparoscopic n'ime iri afọ atọ gara aga, ndị ọrụ ụlọ ọrụ niile nwere ike ịhụ ọganihu niile nke ọrụ ahụ na nyochaa. A na-eme nchọpụta nchọpụta na ụfọdụ usoro dị mfe n'okpuru nchịkwa mpaghara, na ọtụtụ usoro laparoscopic na-eme n'okpuru nchịkwa izugbe.
Ọ dịghị ihe dịka "ịwa ahụ laparoscopic". Laparoscopy bụ otu n'ime ụzọ isi nweta akụkụ ahụ ịwa ahụ. N'agbanyeghị usoro mmejuputa ya, ọdịdị nke usoro ịwa ahụ adịghị agbanwe. A na-emepụta okwu ndị a site na iji okwu mgbọrọgwụ "n'obosara" (site na Greek scope-m see), ọkara mbụ nke aha usoro ahụ na-egosi akụkụ ahụ ma ọ bụ oghere a na-emegharị ma ọ bụ nyochaa.
Laparoscopy bụ otu n'ime ụdị endoscopy dị iche iche, endoscopy gụnyere laparoscopy, nyocha thoracoscopic, hysteroscopy, cystoscopy, arthroscopy na ihe ndị ọzọ.
Thoracoscopy - ntinye aka na obi;
Nephroscopy - ntinye aka na ịwa ahụ na akụrụ;
Cystoscopy - ịwa ahụ na eriri afo;
Hysteroscopy - ịwa ahụ na akpanwa;
Gastroscopy - ịwa ahụ na afo.
Ọ bụrụ na agbakwunyere prefix "fibro" na aha ahụ, ọ pụtara na a na-eme usoro ahụ site na iji endoscope na-agbanwe agbanwe, dịka ọmụmaatụ, fiber hysteroscopy bụ nyocha nke akpanwa site na iji endoscope na-agbanwe agbanwe.
Usoro nke ịwa ahụ laparoscopic dịgasị iche iche dabere na ụdị ịwa ahụ na ụlọ ọrụ ahụike. Ndị ọrịa dị njikere ịnata otu nlekọta ahụ dịka ịwa ahụ. Nke mbụ, a na-agba ndị ọrịa nọ na ngalaba ahụ ọgwụ ọgwụ maka enyemaka mgbu ọzọ na ịkwalite nrụpụta ọrụ. A na-akpọ ọrụ ndị a "nchịkwa mbụ". A na-ebuga onye ọrịa ahụ n'ọnụ ụlọ ịwa ahụ na akwa akwa.
A na-etinye catheter rọba dị nro n'ime akwara cubital nke onye ọrịa maka igbanye ọgwụ, ihe ngwọta, ọgwụ anestetiiki na ihe na-ebelata mgbu. A na-etinye ihe mkpuchi rọba ma ọ bụ silicone n'ihu onye ọrịa ma na-enye ngwakọta iku ume site na nkpuchi.
Sekọnd ole na ole ka e mesịrị, onye ọrịa ahụ na-arahụ ụra na onye na-ahụ maka anesthesiologist na-agbanye - ọ na-etinye tube plastik a kpara akpa n'ime ụgbọ elu, na-eku ume ma na-echekwa ụzọ ikuku. N'oge ịwa ahụ, onye ọrịa na-enweta ikuku ikuku ikuku na-achịkwa.
Maka laparoscopy, oghere afọ na-ejupụta na gas - n'ọtụtụ ọnọdụ, a na-eji carbon dioxide mee ihe maka nzube a. A na-agbanye gas iji bulie mgbidi afọ gaa n'ụdị dome n'elu akụkụ ahụ ma nye ezigbo ọhụụ na ịnweta akụkụ ahụ. Ndị na-enyere aka na ndị dọkịta na-awa ahụ na-agwọ afọ onye ọrịa ahụ na ngwọta antiseptik maka mgbanwe enwere ike imeghe ịwa ahụ na, na iwu anesthesiologist, tinye ogologo agịga Veress site na otubo. Emebere ya site na isi mmiri na-eju mmiri iji belata mmebi nke akụkụ ahụ dị n'ime ahụ nwere ike ime n'oge mgbatị afọ. Mgbe nkwenye site n'enyemaka nke ọtụtụ ule na agịga dị n'ezie n'ime oghere abdominal, a na-ejikọta eriri nke insufflator na agịga. Ngwa eletrọnịkị ọkaibe a na-enye ohere ịnye carbon dioxide n'ime oghere ma na-edobe nrụgide dị n'ime ya na 1 mmHg ziri ezi.
Mgbe nrụgide gas dị n'ime oghere ahụ ruru 10-16 mmHg (dabere na nhọrọ dọkịta na-awa ahụ), a na-ewepụ agịga Veress ma tinye trocar mbụ site na otubo - ígwè ma ọ bụ plastik nke etinyere nyocha trihedral ma ọ bụ tapered. Mgbe agbachara mgbidi ahụ, a na-ewepụ stylet ma tinye ya site na cannula (tube) n'ime endoscope na laparoscope. Laparoscope bụ dayameta 10, 5 ma ọ bụ 2 mm (na-eji micro laparoscope) tube ígwè nwere usoro oghere dị mgbagwoju anya na nduzi ọkụ. Site na igwefoto vidiyo pere mpe agbakwunyere na-eru gram 50-100 yana ike halogen ma ọ bụ xenon ọkụ (ndị na-enye ọkụ), ndị otu niile na-arụ ọrụ nwere ike ịhụ ọganihu nke ọrụ ahụ na ihuenyo nyocha.
Mgbe ewebatachara laparoscope, lelee oghere afọ wee tinye 2-4 ọzọ trocars n'okpuru njikwa anya. Isi okwu mmeghe nke trocar na-adabere na akụkụ ahụ a na-arụ ọrụ na ụdị ntinye aka - na cholecystectomy, a na-etinye trocar n'ime elu afọ n'okpuru ebe a na-akwụ ụgwọ, na ịwa ahụ gynecological - na ala ala.
Na ụkpụrụ, ngwá ọrụ nwere ogologo 30-40 cm na dayameta nke 2 ruo 12 mm nwere ike ịrụ ọrụ niile dị ka usoro ịwa ahụ. Njide, ịdọrọ n'akụkụ, ijide akụkụ ahụ na clips, ntọhapụ na ikewapụ akụkụ ahụ site na anụ ahụ gbara ya gburugburu (nkụkọ) site na dissectors, mkpa endoscopic na ngwá ọrụ electrosurgical, site n'enyemaka nke coagulation, nkwụsịtụ nke obere ọbara ọgbụgba. Coagulation - protein n'ogige atụrụ n'okpuru mmetụta nke elu-ugboro alternating ugbu a, ya mere lumen nke arịa ọbara na-emechi. Enwere ike ịkwụsị ọbara na-agbapụta na nnukwu arịa site na igbutu (iji ihe ntanye titanium), ijikọta ihe suture, na iji stapler endoscopic sutu.
Endoscopic staplers na-arụ ọrụ dị oke mkpa na ịwa ahụ endoscopic - nke a nwere ike iyi ihe na-adịghị ahụkebe, ma kama ịwa ahụ, dọkịta na-awa ahụ na-ejide ihe nkedo agịga ruo ogologo oge - Usoro nke ịcha, ịkwanye, na bandeeji na-ewe oge karịa nkesa anụ ahụ. Dọkịta dọkịta na-awa nwere ike kee ihe dị ka eriri nchekwa 60 kwa nkeji, ma ọ bụ otu eriri kwa sekọnd. Ka ọ dị ugbu a, na ịwa ahụ endoscopic, a na-eji ngwá ndị dị gịrịgịrị nke siri ike kee dochie aka onye dọkịta na-awa ahụ. Ya mere, dịka ọmụmaatụ, European Association of Physicians and Surgeons setịpụrụ ụkpụrụ - kee eriri atọ na 40 sekọnd. Ya mere, nke a bụ ihe ọhụrụ mgbanwe mgbanwe nke keere òkè dị oke mkpa n'ịgbasa oghere nke ntinye aka endoscopic, staplers. Dọkịta na-awa nwere ike ịrụ inter enteric anastomoses na otu ngagharị nke aka, sealingly gafere eriri afọ, suture ọbara ọgbụgba arịa, wdg, kama ogologo na mgbe ụfọdụ ọ fọrọ nke nta agaghị ekwe omume ntuziaka endoscopic suturing. Ọ bụrụla nke ọma na teknụzụ iji rụọ ọrụ ịwa ahụ ọ bụla site na usoro ịwa ahụ endoscopic site n'enyemaka nke stapler.