Kwiinkqubo zokususwa kwe-endoscopic, sihlala sibeka ithemba lethu kwizixhobo eziphambili, kodwa sihlala singazinaki izinto ezisisiseko. Kutheni naxa isilonda sibonakala sibambekile, siyaphuma xa siqinisa umgibe? Namhlanje, sifumana ulwazi oluvela kwincwadi.Indlela ye-Oho: Iindlela ezisisiseko kwi-Endoscopy yoKutya, makhe sityhile iinkcukacha ezincinci kakhulu ekulawuleni imigibe ezigqiba impumelelo okanye ukungaphumeleli.
Iingcali ze-Endoscopies kusenokwenzeka ukuba zonke ziye zahlangabezana nala maxesha 'okunyuka koxinzelelo lwegazi': Ulawula ngononophelo isithintelo phezu kwesilonda, ubeke useto lokujiya ngokugqibeleleyo, uze unyathele i-pedal—uze uve 'ukukhala', kwaye isilonda siyaphuma, okanye okubi ngakumbi, sisuswe kancinci.
Kule mizuzu, impendulo yokuqala yabantu abaninzi kukutyhola amashwa okanye izixhobo ezingasebenzi kakuhle. Nangona kunjalo, emehlweni eengcali ezinamava eziye zaphonononga iinkqubo ezininzi, oku akwenzeki kube yinto yethamsanqa. Kudla ngokuba yibhombu yexesha elide etyalwe yimikhwa emibi yokusebenza.
Namhlanje, sithatha ifilosofi yobuchwephesha yengcali ye-endoscopist yaseJapan edumileyo uGqr. Ken Oho, masingene 'kwiindawo ezimbini ezingabonakaliyo' ekususweni kwe-snare ezijongwa lula ngabo baqalayo kunye namajoni asele ekhulile ngokufanayo—ii-fulcrumkwaye iiziko.
Ulandelelwano Oluqhelekileyo Lwemigibe – Amanyathelo Adibeneyo, Ngalinye Libalulekile
Xa besebenzisa umgibe, abantu abaninzi abasaqalayo badla ngokungxama ukuya kwindawo enesilonda ngokukhawuleza nje xa befumana isixhobo. Nangona iintshukumo zabo zikhawuleza, zihlala zingcolile kwaye zingalungelelananga.
Kwi-"Oho Method," ukulungisa umgibe kulandela ulandelelwano oluqinileyo, ngokubanzi lwahlulwe ngamanyathelo amane:
Lungisa umgibe:Okokuqala, chonga i-fulcrum ukuze uzinzise isixhobo.
Hlehlisa isingxobo sangaphandle ukuze uvule umgibe kwaye ulungise ubungakanani bawo:Eli nyathelo limisela ububanzi bokususwa kwenxeba. Kufuneka lilungiswe ngokuchanekileyo ngokobukhulu besilonda.
Bamba uze uqinise ngokungathi "uyamkela" isilonda emgibeni:Le yinkqubo esebenzayo "yokwamkela" isilonda esikuso, endaweni yokulinda nje ukuba siwele ngaphakathi.
Qhuba ishedi engaphandle ngelixa uqinisa ukuthintela ukuba incam yesibatha ingasuki:Eli lelona nyathelo libalulekileyo, kwaye apho uninzi lweengcali ze-endoscopist zihlala zikhubeka khona. Ukuba i-sheath yangaphandle ayiqhubeki, amandla okuqinisa aya kutsala incam ye-snare ngasemva, nto leyo ebangela ukuba isilonda singabikho.
Le nkqubo isenokuvakala ilula, kodwa inyathelo ngalinye lifuna ulungelelwaniso oluphezulu lwesandla neliso.
Gxila kwiNgcebiso yoMgibe – Ukufumana loo “Nqanaba Lizinzileyo”
Kutheni incam ibaluleke kangaka? Kuba kwi-lumen ethambileyo neguquguqukayo yamathumbu, incam isebenza njenge-"ankile" yethu yokusebenza.
Iingcali ezininzi ze-endoscopist ziqhele ukusebenzisa icandelo elincinci lamathumbu okanye icala elichasene ne-mesenteric attachment njenge-fulcrum, kodwa oku kudla ngokukhokelela ekutyibilikeni.
Imfihlo ye-"Oho Method" ilele koku:kusetyenziswa incam yomgibe njengesiseko.
Kukho iindlela ezimbini ezisebenzayo zoku. Wonke umntu angajonga ngokusondeleyo uMfanekiso 1 (Ukulungisa Umgibe), endiwucaphule kwincwadi:
Indlela 1 (Umfanekiso 1a):Vula ngokupheleleyo umgibe uze uvale isilonda phezulu. Le yindlela eqhelekileyo esetyenziswayo xa amathumbu athe tye kwaye isilonda kulula ukusibamba.
Indlela 2 (Umfanekiso 1b):Sebenzisa udonga lwamathumbu kwicala lomlomo njengesiseko, uze uvule kancinci umgibe.
Indlela 3 (Umfanekiso 1c):Ukuba akukho fulcrum ezinzileyo kwicala lomlomo, ungasebenzisa udonga olusecaleni njenge fulcrum endaweni yoko. Emva koko, vula i-snare kancinci; oku kwenza kube lula ukubamba isilonda.
Phawula:Singaqhubeka namanyathelo okuvula nokuqinisa alandelayo kuphela xa incam yesibatha izinzile kwaye iqinile endaweni yayo ngaphandle kokutyibilika. Ukuba incam ayikwazi ukuma, zonke iindlela ezilandelayo aziyi kuba namsebenzi.
Gxila kwiNtsingiselo yoMgibe – Kuphephe Ukukhohlisa “Ukuthatha Izinto Njengezinto Eziqhelekileyo”
"Ukuqinisa ngokuthe ngqo umgibe kunokubangela ukuba isilonda siphambuke embindini."
Ngoba? Kukho into ethile ebonakalayo engabonakaliyo apha.
Xa siqinisa i-snare, ibuyela umva kwi-snare engaphandle. Ngeli xesha le nkqubo, isiseko se-snare (isiphelo esiqhagamshelwe kwi-snare) sisebenzisa amandla okutyhala angaphandle. Oku kukhokelela kwisiphumo esibalulekileyo: isilonda sidla ngokutsalwa ngakumbi embindini we-snare endaweni yokutsalwa kwisiseko sayo.
Ukuba awukayilungisi kakuhle indawo ohlala kuyo ngaphambi kokuba uyiqinise, yinxalenye yesilonda kuphela enokuba ngaphakathi kwi-snare ngelixa enye ishiywe ngaphandle. Wakuba uqalise i-electrocautery, inxalenye eveziweyo ayizukunqunyulwa, nto leyo ebangela ukuba "kususwe iinxalenye ezithile."
Ngoko ke, yintoni isisombululo?
Ngexesha kanye lokuqinisa i-snare, kufuneka ngaxeshanye uqhubele phambili i-snare yangaphandle kancinci kancinci. Injongo yokutyhala i-snare ngaphandle ngelixa uqinisa kukuqinisekisa ukuba isilonda sihlala sisembindini we-snare (njengoko kubonisiwe kuMfanekiso 2).
Musa ukuyithatha lula le ntshukumo ilula 'yokutyhala kancinci ngaphambi kokuba uyiqinise'—ikuvumela ukuba ubone ngokucacileyo isilonda sigqunywe ngokupheleleyo kwisikrini, endaweni yokuthembela nje 'kwimvakalelo'.
Ingongoma ephambili kaGqr. Ohba – Hlala Ugxile Ngokupheleleyo Ukuze Uthintele 'Ukungaphoswa Yinjongo'
UGqr. Ohba ushwankathele eyona nto iphambili yokulawula imigibe.
Ukuba incam ye-snare ayicinezelwanga ngokwaneleyo kwithishu, incam iya kutsaleka njengoko uqinisa i-snare, nto leyo ebangela ukuba isilonda siphume. Ngokwahlukileyo koko, ukuba incam icinezelwe kakhulu, i-fulcrum iya kusuka kwincam iye kwi-sheath yangaphandle. Ke ngoko, kubalulekile ukuba“incam yomgibe iba yinxalenye ebalulekileyo.”
"Ndikholelwa ukuba wonke umntu ukhe wacinga, 'Ndiqinisekile ukuba yonke into ebuhlungu ingaphakathi kwe-snare,' kodwa ekugqibeleni banqunyulwa kancinci. Oku akusilo nje ithamsanqa elibi; kukho isizathu salo. Kufuneka sihlale sigxile ngokupheleleyo ukuqinisekisa ukuba yonke into ebuhlungu ingaphakathi kwe-snare, kwaye siyithintele ukuba ingaphumi ngexesha lokuqina!"
Le ngxelo ihambelana ngokwenene neengcali ezininzi ze-endoscopist. Oko sikubiza ngokuba “lishwa elibi” kukungalungi nje kwiinkcukacha zendlela yethu yokusebenza.
Xa ufunda oku, ngaba unayo loo "mzuzu we-aha"? Kuyavela ukuba iinkcukacha ezincinci esihlala sizityeshela ngexesha leenkqubo sele zishwankathelwe ngokucacileyo ngabangaphambili bethu.
“Ukuba ufuna ukufunda ngokucwangcisiweyo le nkqubo yokusebenza kwe-endoscopic ‘yenqanaba lencwadi’ kwaye ufumane ukuqonda okunzulu kwendlela uGqr. Ken Ohba ahlula ngayo yonke intshukumo esisiseko kakhulu, ndicebisa kakhulu ukuba uyifundeI-Endoscopy yoKugaya: Iindlela eziSiseko zeSitayile se-Ohba. Ukuzazi kakuhle iziseko yeyona nto iphambili ukuze uqhubeke usenza izinto ngendlela ezinzileyo nehlala ixesha elide.
Umgibe Ofanelekileyo Wenza Ubuchule Buphelele
Ukwazi kakuhle i-fulcrum kunye ne-center sisiseko. Kodwa isandla esinobuchule sikwadinga isixhobo esithembekileyo. Umgangatho ophezuluumgibe wokususwa kwe-polypectomykufuneka inikezele:
Ukuvula nokuvala okutyibilikayo
Akukho kuxinana, akukho kuthandabuza
Amandla e-radial ahlala ehleli
Ukubanjwa okuthembekileyo ngaphandle kokukrazula izicubu
Ukuhambelana kwe-electrosurgical
Ukusikwa nokujiya okuqikelelweyo
Ukujikeleza
Ukuqhelaniswa ngokuchanekileyo kwi-anatomy enzima
Kwa-ZRHmed, senza ii-polypectomy snares ezilahlwayo ezenzelwe ezi zinto zibalulekileyo engqondweni. Ii-snares zethu zifumaneka kwiimilo ezi-oval, hexagonal, kunye ne-crescent, kunye neendlela ezijikelezayo nezingenakujikeleziswa, ukusetyenziswa okubandayo nokushisa, kunye nobude bokusebenza ukusuka kwi-1200mm ukuya kwi-2300mm. Zonke iimveliso ziqinisekiswe yi-MDR CE kwaye zenziwe phantsi kwe-ISO 13485.
Asenzi ii-endoscopes. Senza izixhobo ezikunceda usebenze ngcono.
Ixesha lokuthumela: Juni-05-2026