Laparoscopi ni uburyo bwo kwisuzumisha cyangwa kubaga ku ngingo z'imbere zo mu nda cyangwa mu nda. Laparoscopi nuburyo bugezweho bwo kubaga aho kubagwa bidakozwe binyuze mu gufungura bisanzwe cyangwa gukomeretsa uruhu runini, ahubwo binyuze mu bice bito (ubusanzwe cm 0,5-1,5), mu gihe kubaga bisanzwe bisaba gukomeretsa binini bityo bigasiga inkovu nini. Kugirango utobore, hakoreshwa trocar, hifashishijwe urukuta rw'inda rwacumiswe, kandi igikoresho cyoroshye cya optique (laparoscope) cyinjizwa mu muyoboro ufite diameter ya cm 0.2-1.0.
Igikoresho nyamukuru cya laparoskopi ni laparoskopi - umuyoboro wicyuma ufite diameter ya mm 5-10 (mm 2 kuri micro laparoscopi) hamwe na sisitemu igoye kandi ikayobora urumuri. Lens yohereza ishusho kuva mumurongo kugeza ku jisho, kandi umuyobozi wumucyo ayobora urumuri ruva kumurika rukinjira mu cyuho cyinda. Urashobora kureba mu buryo butaziguye lens ya laparoscopique - ibi byakozwe mu myaka ibarirwa muri za mirongo, ariko hamwe no kuza kwa kamera ntoya ya endoskopi (ubu ipima garama 50-150) ifatanye na lens ya laparoscopique mu myaka mirongo itatu ishize, abakozi bose bo mu cyumba cyo gukoreramo barashobora kubona aho ibikorwa byose bigeze kuri monite. Gusuzuma hamwe nuburyo bworoshye bukorwa munsi ya anesthesi yaho, kandi inzira nyinshi za laparoskopique zikorwa muri anesthesia rusange.
Ntakintu nka "kubaga laparoskopi". Laparoscopi ni bumwe mu buryo bwo kugera ku ngingo zo kubaga. Hatitawe kuburyo bwo gushyira mubikorwa, imiterere yuburyo bwo kubaga ntabwo ihinduka. Aya magambo yashizweho akoresheje ijambo umuzi "urugero" (uhereye ku kigereki-ndabona), igice cya mbere cyizina ryuburyo bwerekana urugingo cyangwa umwobo bikoreshwa cyangwa bisuzumwa.
Laparoscopi ni bumwe mu bwoko bwa endoskopi, kandi endoskopi ikubiyemo laparoskopi, isuzuma rya thoracoscopique, hysteroscopi, cystoskopi, arthroscopi n'ibindi.
Thoracoscopy - kwitabira igituza;
Nephroscopy - gutabara no kubaga impyiko;
Cystoscopi - kubaga uruhago;
Hysteroscopy - kubaga kwa nyababyeyi;
Gastroscopy - kubaga igifu.
Niba imbanzirizamushinga “fibro” yongewe ku izina, bivuze ko inzira ikorwa hifashishijwe endoskopi yoroheje, urugero, fibre hysteroscopi ni isuzuma rya nyababyeyi ukoresheje endoskopi yoroheje.
Tekinike yo kubaga laparoskopi iratandukanye gato bitewe n'ubwoko bwo kubaga n'ikigo nderabuzima. Abarwayi biteguye kwitabwaho kimwe no kubagwa bisanzwe. Ubwa mbere, abarwayi bo muri salle batewe imiti kugirango barusheho kugabanya ububabare no kongera umusaruro. Ibi bikorwa byitwa "preoperative administration". Umurwayi ajyanwa mucyumba cyo kubaga ku kabati.
Catheter yoroheje yinjizwa mumitsi yumurwayi kugirango yinjizwemo imiti, ibisubizo, anesthetike, hamwe nububabare. Maskeri ya reberi cyangwa silicone ifatanye mumaso yumurwayi kandi imvange ihumeka itangwa binyuze muri mask.
Nyuma yamasegonda, umurwayi arasinzira hanyuma anesthesiologue intubates - ashyiramo umuyoboro wa pulasitike usobekeranye mumuyaga, urabyimba kandi urinda umwuka. Mugihe cyo kubagwa, umurwayi yakira umwuka uhumeka uhumeka.
Kuri laparoskopi, umwobo wo munda wuzuyemo gaze - akenshi, dioxyde de carbone ikoreshwa kubwiyi ntego. Gazi yatewe kugirango izamure urukuta rw'inda rumeze nk'ikizenga hejuru y'ingingo kandi gitange neza kandi kigere ku ngingo. Abafasha n'abaganga bavuraga inda yose y’umurwayi bakoresheje imiti igabanya ubukana kugira ngo hashobore kubaho uburyo bwo kubagwa ku mugaragaro, kandi babitegetswe na anesthesiologue, bashyiramo urushinge rurerure rwa Veress binyuze mu nsi. Yakozwe hamwe nisoko yuzuye isoko kugirango igabanye kwangirika kwingingo zimbere mugihe cyo gutobora inda. Nyuma yo kwemeza hifashishijwe ibizamini byinshi ko urushinge rwose ruri mu cyuho cyinda, hose ya insufflator ifatanye nurushinge. Ubu buryo bwa elegitoroniki buhanitse butanga gutanga karuboni ya dioxyde de cavide kandi igahita ikomeza umuvuduko wacyo hamwe na mmHg 1.
Nyuma yumuvuduko wa gaze mumwobo ugera kuri mm 10-16 mmHg (ukurikije guhitamo kwa muganga), urushinge rwa Veress rurakurwaho hanyuma trocar ya mbere yinjizwa mu nsi - umuyoboro wicyuma cyangwa plastike winjizamo iperereza ryitwa trihedrale cyangwa kaseti. Nyuma yo gutobora urukuta, stylet irakurwaho hanyuma yinjizwa muri cannula (tube) muri endoscope na laparoscope. Laparoscope ni mm 10, 5 cyangwa 2 mm ya diametre (ukoresheje micro laparoscope) icyuma gifite sisitemu igoye kandi ikayobora urumuri. Hamwe na kamera ya videwo ntoya ifite uburemere bwa garama 50-100 hamwe na halogen ikomeye cyangwa xenon yumucyo (illuminator), itsinda ryose rikora rirashobora kureba aho ibikorwa bigeze kuri ecran ya monitor.
Nyuma yo kumenyekanisha laparoscope, genzura umwobo wo munda hanyuma ushyiremo izindi trocars 2-4 munsi yo kugenzura. Ingingo yo kumenyekanisha trocar iterwa ningingo ikorerwa hamwe nubwoko bwokwitabira - muri cholecystectomy, trocar yinjizwa munda yo hejuru munsi yigitereko gihenze, mububiko bwabagore - munda yo hepfo.
Ihame, ibikoresho bifite uburebure bwa cm 30-40 na diameter ya mm 2 kugeza 12 mm birashobora gukora ibikorwa byose nkubuhanga busanzwe bwo kubaga. Kugumana, gushimuta kuruhande, gufata urugingo hamwe na clips, kurekura no gutandukanya urugingo nuduce dukikije (gutandukana) hakoreshejwe disikete, imikasi ya endoskopi nibikoresho bya elegitoroniki, hifashishijwe coagulation, guhagarika ugereranije no kuva amaraso mato mato. Coagulation - poroteyine zigabanuka bitewe numuyoboro mwinshi uhinduranya, bityo lumen yumuvuduko wamaraso ugafunga. Amaraso ava mumato manini arashobora guhagarikwa mugukata (ukoresheje clips ya titanium), guhambira hamwe nibikoresho bya suture, no kudoda hamwe na stapler ya endoskopi.
Endoscopic staplers igira uruhare runini mugubaga endoskopi - ibi birasa nkibidasanzwe, ariko aho kuba scalpel umuganga ubaga afashe urushinge igihe kirekire - Inzira yo kudoda, kudoda, no guhambira bifata igihe kinini kuruta gutandukanya ibice. Umuganga ubaga ubuhanga ashobora guhambira ipfundo ryumutekano 60 kumunota, cyangwa ipfundo rimwe kumasegonda. Hagati aho, mu kubaga endoskopi, amaboko yo kubaga asimbuzwa ibikoresho byoroheje bigoye guhambira. Kurugero, Ishyirahamwe ryiburayi ryabaganga nabaganga bashizeho urwego - guhambira ipfundo gatatu mumasegonda 40. Ibi rero byari udushya twa revolution yagize uruhare runini mugukwirakwiza intera ya endoskopique, staplers. Abaganga babaga barashobora gukora anastomose ya enteric hamwe nigikorwa kimwe cyikiganza, bakanyuza mu mara, imiyoboro y'amaraso ya suture, nibindi, aho kubikora birebire kandi rimwe na rimwe ntibishoboka intoki za endoskopi. Byashobokaga muburyo bwa tekinike gukora igikorwa icyo ari cyo cyose cyo kubaga hakoreshejwe uburyo bwo kubaga endoskopique hifashishijwe stapler.