Intshayelelo
Kwindawo yonyango yale mihla, ugqirha we-laparoscopic wavela njengendlela yokuguqukayo, etshintsha kakhulu impilo yeenkqubo zotyando. Oku kufumanisa le ndlela yokungahlaseli ihlazo ifumene isithuba esibuhlungu ngenxa yeenzuzo zayo ezininzi ngotyando oluvulekileyo. Ngokwenza inyathelo elincinci esiswini, oogqirha banokuthi bafake i-laparoscope - ityhubhu emfutshane, eguqukayo equlatha ukukhanya kunye nekhamera- kunye nezixhobo ezikhethekileyo zoqhaqho. Oku kubavumela ukuba benze iinkqubo ezintsonkothileyo ngokuphucula ukuchaneka, ukunciphisa umonakalo we-tissi, kunye nokuncitshiswa kwegazi. Izigulana zihlala zifumana indawo yokuhlala amafutshane, amaxesha okubuyela ngokukhawuleza, kunye nepende engaphantsi kwemali, ekhokelela kumgangatho ophuculweyo wobomi ngexesha lenkqubo yokubuyisela kwimeko yesiqhelo. Unyango lwe-laparoscopic lufumene izicelo kuluhlu olubanzi lweendawo zonyango, ukusuka kwi-gynecology kunye notyando ngokubanzi kunye ne-urology kunye ne-coloredy yotyando, ukuba yinxalenye yoqhaqho.
Ukuhambelana nokunyuka kweendlela ze-laparoscopic yiyunithi ye-electrosgucgelical (ESU), eye yaba sisixhobo esingathethekiyo kwigumbi lokusebenza. I-ESS isebenzisa i-curmating ephezulu-frequal yombane ukusika, ukudibanisa, okanye ukuncwina kwezicubu ngexesha lenkqubo yoqhaqho. Iteknoloji yenza ukuba oogqirha baphumeza i-hestinasis (ulawulo lokuphuma) ngokuphumelelayo kwaye wenze ukungabikho kwezicubu ngokuchaneka okukhulu. Ukukwazi ukulawula ngokukhethekileyo amandla ombane anikezelwe kwi-tissue enze i-ESUS i-ESS STAPLE kwi-staples evulekileyo kunye ne-Laparoscopic utyandele, enegalelo kwimpumelelo kunye nokhuseleko lweenkqubo.
Nangona kunjalo, ngaphandle kwezibonelelo ezimangalisayo zohlobo lwe-laparoscopic kunye neeyunithi ze-elektrosical, inkxalabo ebalulekileyo ivele malunga nokusetyenziswa kwe-ESS kwiinkqubo ze-laparoscopic: Isizukulwana segesi esiyingozi. Xa i-frequency yombane yangoku ye-EUS inxibelelana nezicubu, inokubangela i-vaporation, ingenza ukuba i-vaporaction yezinto eziphilayo, ezikhokelela ekuvelisweni komxube ontsonkothileyo weegesi. Ezi geses azikho kuphela ezinokubangela isigulana phantsi kotyando kodwa zikwabeka isisongelo esibalulekileyo kwimpilo nokhuseleko lwabasebenzi bezonyango abakho kwigumbi lokusebenza.
Imingcipheko yezempilo enxulumene nezi gesi eziyingozi ziyahluka kwaye zifikelele kude. Kwixesha elifutshane, ukuvezwa kwezi gesi kunokubangela ukucaphukisa amehlo, impumlo, kunye nephecana lokuphefumla zabaguli kunye nababoneleli bezempilo. Kwisithuba sexesha elide, ukuvezwa okuphindaphindiweyo kunokunyusa umngcipheko wemicimbi enzulu yezempilo, ezinje ngezifo zokuphefumla, kubandakanya umhlaza wemiphunga, kunye nezinye iingxaki zempilo. Njengoko i-laparoscopic utyando iqhubeka ukhula ngokuthandwa kwaye ukusetyenziswa kweeyunithi ze-electrosurucial zihlala zibanzi, ukuqonda imeko yezi zintlekele eziyingozi, iziphumo zabo ezinokubakho, kunye nendlela yokuthoba ingozi ibaluleke kakhulu kuluntu lwezonyango. Eli nqaku lijolise ekuphoseni ngokupheleleyo esi sihloko sibalulekileyo, ukuphalaza isikhanyiso kwisayensi isizukulwana segesi, iimpembelelo zempilo ezinokuqeshwa ukuze kuqinisekiswe indawo ekhuselekileyo yoqhankqalazo.
Iziseko ze-laparoscopic utyando kunye neeyunithi ze-electrosurulical
I-Laparoscopic utyargery: Isimanga esincinci esincinci
Utyando lwe-laparoscopic, okwabizwa ngokuba utyando oluhlaselweyo oluncinci okanye i-sundolerry, imele i-sump ebalulekileyo phambili kwicandelo leendlela zokwenza utyando. Le nkqubo iguqukele kwindlela yokungenelela kwamanyathelo amaninzi enziwa, ehambisa izigulana ukuba izibonelelo zithelekiswa neendlela zokwenza utyando oluvulekileyo.
Inkqubo iqala ngokudalwa kwezithuba ezininzi, ngokungabi ngaphezu kweemilimitha ezimbalwa kwisentimitha ubude, kwisisu esigulayo. Ngolunye lolu thuba, ifakiwe i-laparoscope. Esi sixhobo esinxilisayo sixhotyiswe ngekhamera ePhakamileyo kunye nomthombo onamandla wokukhanya. Ikhamera idlulisela ixesha lokwenyani, imifanekiso ekhulisiweyo yegadi yangaphakathi kwi-idoni, ibonelela ngotyando enovavanyo olucacileyo nolucacileyo malunga nendawo yoqhaqho.
Oogqirha ke bafaka izixhobo ze-LAPAROSCIC ze-laparoscopic kwizithuba ezisele. Ezi zixhobo zenzelwe ukuba zide, zincinci, ziguquguqukayo, zivumela ubuqhetseba obufanelekileyo ngaphakathi komzimba ngelixa kuncipha umonakalo kwizicubu ezijikelezileyo. Ngoncedo lwezixhobo, oogqirha bophandezelo banokwenza uluhlu olubanzi lweenkqubo, kubandakanya ukususwa kwe-gellbladder (cholecystectomy), i-Cholecystectomy), i-Appendectomy, ukulungiswa kwe-hernia, kunye notyando oluninzi lwe-gynecological kunye nondernicological.
Esona sibonelelo sibalulekileyo se-Laparoscopic utyando le-laparoscopic sisimo sokuncitshiswa emzimbeni. Isithuba esincinci sibangela ukulahlekelwa kwegazi elincinci ngexesha ngokuthelekiswa utyando oluvulekileyo, apho i-upoment enkulu yenziwe ukubhengeza indawo yotyando. Oku akususi kuphela isidingo sokutofelwa igazi kodwa kunciphisa umngcipheko wezinto ezinzima ezinxulumene nokopha kakhulu. Ukongeza, izithuba ezincinci zikhokelela kwintlungu engaphantsi yentsebenzo yesigulana. Kuba kukho ukuphazamiseka okuncinci kwimisipha kunye nezicubu, izigulana zihlala zifuna amayeza eentlungu ezincinci kunye namava inkqubo yokubuyisela efanelekileyo.
Ixesha lokubuyisela kwakhona emva kotyando lwe-laparoscopic kukufutshane kakhulu. Izigulana zihlala zihlala izinto eziqhelekileyo kungekudala, rhoqo kwiintsuku ezimbalwa ukuya kwiveki, kuxhomekeka kubunzima benkqubo. Oku kuthelekiswa notyando oluvulekileyo, olunokuthi lufune iiveki zokubuyisela kwakhona kunye nexesha elide lezinto eziguqulweyo. Ukuhlala kwisibhedlele esifutshane sesinye inzuzo, engasiyo nje indleko kuphela zempilo kodwa ivumela abaguli ukuba babuyele kubomi babo bemihla ngemihla.
Utyando lwe-laparoscopic lufumene izicelo ezibanzi kwiingcali ezahlukeneyo zonyango. Kwi-gynecology, isetyenziselwa iinkqubo ezinje nge-hysterectomy (isuswa kwesibeleko), i-Ovarian Cystectomy, kunye nonyango lwe-endometriosis. Ngotyando ngokubanzi, iqeshwe kwi-Galbladder Shutdar, kunye neemeko zokunyanga njengezilonda ze-peptic kunye neentlobo zomhlaza. Iingcali ze-Irologists zisebenzisa iindlela ze-laparoscopic iinkqubo ezinje ngeNephrectomy (ukususwa kwezintso) kunye ne-prostatectomy. Ukusetyenziswa gwenxa kunye nokusebenza kwenkqubo ye-laparoscopic kuye kwenza ukhetho olukhethiweyo kungenelelo oluninzi lokunyathela ngalo lonke ixesha kunokwenzeka.
Iiyunithi ze-electrosugecal: Ukuchaneka kwamandla kuhlelo
Iiyunithi ze-electrosurulical (i-ESUS) zizixhobo zezonyango ezidlala indima ebalulekileyo kwiinkqubo zotyando zale mihla, ngakumbi kwi-Laparoscopic utyando. Ezi zixhobo zisebenzisa imigaqo yombane ukuze yenze imisebenzi eyahlukeneyo ngexesha lotyando, i-tissis yesicubu kunye nokuhla kwe-quabinter.
Umgaqo osisiseko wokuSebenza we-ESU ubandakanya isizukulwana semipu-moya ephezulu. Ezi rurensi ziqhele ukusukela kwi-300 khz ukuya kwi-5 mhz, ngaphezulu kuluhlu lwe-frequency lombane wekhaya (i-50 - 60 hz). Xa i-EU isebenza, i-frequency yangoku ihanjiswa kwindawo yotyando nge-electrode ekhethekileyo, enokubakho kwi-scralpel-njenge-scalpel-njenge-prebecce okanye uhlobo olwahlukileyo lwe-prebe okanye uhlobo olwahlukileyo lwe-prebe okanye uhlobo olwahlukileyo lwe-prebe okanye uhlobo olwenziwe ngesandla okanye uhlobo olwahlukileyo lwe-probe.
Xa isetyenziselwa ukusika izicubu, irejista ephakamileyo i-frequency yangoku ibangela iimolekyuli zamanzi ngaphakathi kwi-tissue ukuze iqhume ngokukhawuleza. Olu tshintsho luvelisa ubushushu, oluvuyisa izicubu kwaye luzisika ngokufanelekileyo. Inzuzo yale ndlela kukuba ibonelela ngokucocekileyo kwaye ichanekile. Ubushushu obuve buye bavela kunye nemithambo yegazi elincinci njengoko izicubu zinqunyulwa, zinciphisa ukopha ngexesha lenkqubo. Oku kuthelekiswa neendlela zokusikeka kwemveli ngokwesiko, ezinokubangela ukopha ngakumbi kwaye kufuna amanyathelo ongezelelweyo okufezekisa i-hestinasis.
Ngenxa yokuhamba, i-EU ihlengahlengiswa ngokuzisa iphethini eyahlukileyo yombane okwangoku. Endaweni yokusika kwizicubu, okwangoku isetyenziselwa ukufudumeza izicubu ukuya kwinqanaba apho iiproteni ngaphakathi kweeseli zeseli. Oku kubangela ukuba izicubu zihlangane, okanye i-clot, icime imithambo yegazi kunye nokuyeka ukopha. U-Essus unokusetwa kumanqanaba ombane ahlukeneyo kunye namatsha, avumele oogqirha ukuba balawule ngokuchanekileyo ubungakanani bobushushu kunye nobunzulu bengubo yezicubu, kuxhomekeka kwiimfuno ezithile zotyando.
I-Laparoscopic utyando, i-Essus ixabiseke ngakumbi. Ukukwazi ukwenza ukungabikho kwesicubo se-tishure kunye nokufezekisa i-heamonasis esebenzayo ngemvumelwano encinci yeenkqubo ze-laparoscopic kubalulekile. Ngaphandle kokusetyenziswa kuka-Essus, kuya kuba ngumceli mngeni ngakumbi ukulawula ukopha kunye nokwenza izicubu ezinqwenelekayo ngaphakathi kwendawo encinci ye-ovis. U-Essus wenza ookhokhoyo ukuze asebenze ngokukuko, ukunciphisa ixesha lonke lotyando. Oku kungekuphela nje izibonelelo zesigulana ngokuhambelana nexesha eliphantsi kwe-anesthesia kodwa linciphise umngcipheko wezinzima ezinxulumene neenkqubo ezinde ezinxulumene notyando olude.
Ngapha koko, ukuchaneka okufunyenwe ngu-Essus kwi-Laparoscopic utyando oluchanekileyo lwe-thessies enesifo xa usinda kwizicubu ezisempilweni. Oku kubaluleke kakhulu kwiinkqubo apho ugcino lomsebenzi oqhelekileyo lubalulekile, njengakolunye utyando lomhlaza. Ukusetyenziswa kukaEssu kwanegalelo elikhulu kwimpumelelo kwaye ukhuselo lwe utyando lwe-laparoscopic, lubenza babe ngumgangatho osemgangathweni kunye nokungafikeleli kwintshukumo yotyando yale mihla. Nangona kunjalo, njengoko sele kukhankanyiwe ngaphambili, ukusetyenziswa kwe-Essus kwi-Laparoscopic ikwazisa ngombandela wesizukulwana segesi esiyingozi, esiya kuphonononga ngokweenkcukacha kula macandelo alandelayo.
IGenesis leGeses Eyingozi
Iziphumo ze-hormal kunye nokuphendula kwemichiza
Xa iyunithi ye-electrosugecal ivuliwe ngexesha lotyando we-laparoscopic, iyolula uthotho olunzima lweziphumo ze-thermal kunye nokuphendula kweekhemikhali ngaphakathi kwezicubu zebhayoloji. I-frequency-frequency yombane edlulayo ngokusebenzisa izicubu ivelisa ubushushu obukhulu. Olu bushushu sisiphumo samandla ombane aguqulwa abe ngamandla e-thermal njengoko okwangoku kudibana nokuxhathisa izicubu. Iqondo lokushisa kwindawo ye-electrode - ukusebenzisana kwezicubu kunokuphakama ngokukhawuleza kumanqanaba aphezulu kakhulu, ihlala igqitha kwi-100 ° C, kwaye kwezinye iimeko, ifikelela kwi-Argrees enamakhulu amaninzi, efikelela kwi-Argrees enamakhulu ali-100, afikelela kwi-Argrees enamakhulu ali-100, afikelela kwi-Argrees enamakhulu ali-100, afikelela ngama-100 afikelela kwi-AMARISHIUS Celsius.
Kula maqondo obushushu aphakamileyo, izicubu zisebenza nzima, ekwabizwa ngokuba yiPyrolysis. Amanzi ngaphakathi kwezicubu ngokukhawuleza akhawuleze akhawuleze, olu luphawu lokuqala olubonakalayo lwempembelelo ye-shirmal. Njengoko amaqondo obushushu eqhubeka enyuka, izinto eziphilayo zezicubu, ezinjengeeproteni, i-lipids, kunye ne-carbohydrate, qala ukuqhekeza. Iiproteni, ezenziwa ngamakhonkco amade e-Amino Acids, qala ukutshintshwa uze ubole iziqwenga ezincinci zemolekyuli. I-lipids, equka i-acids ye-acids kunye ne-glycerol, ikwaye kwahlanjwa ngenkani, ivelisa iintlobo ezahlukeneyo zeemveliso. I-carbohydrate, njenge-Glycogen egcinwe kwiiseli, ezichaphazeleka ngendlela efanayo, iqhekezwe kwiswekile elula kwaye igqitywe ngaphezulu.
Iinkqubo zokungalunganga ze-thermal zihamba kunye nengxokolo yokuphendula kweekhemikhali. Umzekelo, ukohlukana kweeprotein kunokukhokelela ekuqulunweni kwe-nitrogen -qhinga. Xa i-Amino-Intsalela ye-Acid kwiiproteni ishushu, i-nitrogen - i-carbon yeekhabonda icocekile, ikhokelela ekukhulu kwe-ammonia - njengemikhombisi kunye nezinye iimolethi ezinazo iimolekyuli. Ukubola kwee-lipids kunokuvelisa i-acids enamafutha kunye ne-Aldehydes. Le meko yokuphendula yekhemikhali ayisosiphumo sobushushu obuphezulu se-pyrolysis kodwa kukwaphenjelelwa bubukho beoksijini kwicandelo le-subnical kunye nokuqulunqwa kwezicubu eziphathwayo. Indibaniselwano yezi nkqubo ze-thermal kunye neekhemikhali zezona ekugqibeleni zikhokelela kwisizukulwane zeeglasi ezinobungozi ngexesha lotyando we-laparoscopic usebenzisa iyunithi ye-elektrososgue.
I-Gases eqhelekileyo eyenzakalisayo ivelisiwe
1. I-carbon monoxide (CO)
1. I-carbon monoxide yindawo engenabala, engenamanzi, kwaye irhasi enetyhefu enziwa rhoqo ngexesha lokusetyenziswa kweyunithi ye-elektroscopic. Ukusekwa kwe-CO kwenzeka ikakhulu ngenxa yokudibana okungaphelelanga kwento yezinto eziphilayo kwizicubu. Xa iqondo lobushushu le-pyrolysis, i-lipids, kunye ne-carbohydrate yenzeka kwindawo evaliweyo yeoksijini), i-carbon evaliweyo ngaphakathi kwe-assical dioxide (). Endaweni yoko, ngokuyinxalenye kuphela, okukhokelela kwimveliso ye-CO.
1. Imingcipheko yezempilo enxulumene ne-CO ibalulekile. I-CO inezinto ezimbi kakhulu kwi-hemoglobin egazini kuneoksijini. Xa igqithileyo, ibophelela kwi-hemoglobin ukwenza i-carboxloglobin, inciphisa ioksijini - ukuphatha ubungakanani begazi. Nokuba ukuvezwa kwenqanaba eliphantsi lokubonakalisa ukubangela iintloko, isiyezi, isicaphucaphu, kunye nokudinwa. Ukuvezwa kwexesha elide okanye inqanaba eliphezulu kunokukhokelela kwiimpawu ezinzima ngakumbi, kubandakanya ukudideka, ukuphulukana nokwazi, kunye namatyala agqithisileyo, ukufa. Kwigumbi lokusebenza, bobabini isigulana kwaye abasebenzi bezonyango basengozini yokuvezwa kwe-CO ukuba i-ventilation efanelekileyo kunye neenkqubo zokukhupha igesi azikho.
1. Amasuntswana emsi
1. Umsi oveliswe ngexesha lenkqubo ye-electrosurg iqulethe umxube ontsonkothileyo wemigangatho eqinileyo nengamanzi. La masuntswana aqulunqwe ngezinto ezahlukeneyo, kubandakanya iziqwenga ezifudumeleyo ze-tissure, izinto eziphilayo ezinqabileyo, kunye neziqwengana ezinyathelweyo ezivela kwi-thermal ye-therigue. Ubungakanani bala masuntswana bunokuvela kwi-micrometer engaphantsi kwemicrometer ukuya kwii-micrometer ezininzi kububanzi.
1. Xa i-faintrod, la masuntswana emsi anokubangela ukucaphukisa iphecana lokuphefumla. Banokubekwa kwiipaseji zempumlo, i-trachea, kunye nemiphunga, ekhokelela ekwenzeni, ukuthunga, kunye nomqala obuhlungu. Ixesha elingaphezulu, ukuvezwa okuphindaphindiweyo kula masuntswana anokwandisa umngcipheko wokuphuhlisa iingxaki zokuphefumla kakhulu, ezinjenge-bitch engapheliyo kunye nomhlaza wemiphunga. Ukongeza, amasuntswana omsi anokuthwala ezinye izinto eziyingozi, ezifana ne-vis kunye ne-bacteria ezikhoyo kwizicubu, ezinokubangela umngcipheko owosulelekileyo kubasebenzi bezonyango.
1. I-orting ye-orgating ye-orgation (VOCs)
1. Uluhlu olubanzi lweentambo zezinto eziphilayo eziguqukayo zenziwa ngexesha lokusetyenziswa kweyunithi ye-elektrosical. Oku kubandakanya i-Benzene, iFomaldehyde, Acrolein, kunye nee-hydrocarbons ezahlukeneyo. I-Benzene yi-carcinogen eyaziwayo. Ukuvezwa kwexesha elide - i-Benzene i-Benzene inokumonakalisa umongo wethambo, okhokelela ekunciphiseni kweeseli ezibomvu zegazi, iiseli zegazi ezimhlophe, kunye neeplates, imeko ebizwa ngokuba yi-aflatise i-Anemia. Inokonyusa umngcipheko wokuphuhlisa i-leukemia.
I-1. I-formaldehyde yenye ye-VOC esebenzayo. Yinto yokuphumelela - igesi yegesi enokubangela ukucaphukisa kwamehlo, impumlo, kunye nomqala. Ukuboniswa ixesha elide kwi-formaldehyde idityaniswe kumngcipheko onyukayo wokuphuhlisa izifo zokuphefumla, kubandakanya isifuba, kunye neentlobo zomhlaza, ezinje ngomhlaza omhlaza. I-ACRoLEIN, kwelinye icala, kukucaphukisa okungacaphukisayo okunokubangela uxinzelelo olukhulu lokuphefumla nokuba luxinzelelo olusezantsi. Inokonakalisa i-epitiratory epitirage kwaye idityaniswe neengxaki zokuphefumla zexesha elide. Ubukho bale VOCs kwindalo yokusebenza ibeka isoyikiso kwimpilo yeqela lotyando kunye nesigulana, sibalaselisa imfuneko yamanyathelo asebenzayo okunciphisa ubukho obufanelekileyo.
Impembelelo kwiMpilo
Umngcipheko kwizigulana
Ngexesha le-Laparoscopic utyando, izigulana zivezwa ngokuthe ngqo kwiigesi eziyingozi eziveliswe yiyunithi ye-elektrosical. Ukuphefumla kwezi gesi kunokuba neziphumo zexesha elide nezikade zempilo yazo.
Kwixesha elifutshane, ezona mpawu ziqhelekileyo zihlangabezana nezigulana zihambelana nokucaphukisa ukuphefumla. Ubukho bamasuntswana emsi, i-Colating Counts copunds Oku kunokukhokelela ekwenzeni, ukuthunga, kunye nomqala obuhlungu. Ukucaphuka kwephecana lokuphefumla kunokubangela imvakalelo yokuqina esifubeni nasekuphefumleni okufutshane. Ezi mpawu azibangelanga kuphela ukungonwabi ngexesha lotyando kodwa nazo zinokuphazamisa ukuphefumla kwesigulana, eziyinkxalabo enkulu, ngakumbi xa isigulana siphantsi kwe-anesthesia.
Kwixesha elide, eliphindaphindiweyo okanye ukubaluleka kokubonakalayo kwezi gesi eziyingozi kunokukhokelela kwimiba enzulu yezempilo. Enye yezona zinto zixhalabisayo kukubanakho ukonakaliswa kwemiphunga. Ukuphefumla kwamasuntswana emsi kunye neeVOC ezithile, ezinje nge-Benzene kunye ne-forlealdehyde, inokubangela ukonakala kwizicubu ze-luphu. Amasuntswana amancinci anokungena nzulu kwi-alveoli, i-tist encinci ye-subs kwimiphunga apho kwatshintsha khona irhasi. Kanye kwi-alveoli, la masuntswana anokubangela impendulo yokuvuvukala kwimiphunga. Ukuvuvukala okungapheliyo kwimiphunga kunokukhokelela kuphuhliso lweemeko ezinje ngesifo esinganyangekiyo esiphelweni I-Copd ibonakaliswa ngobunzima bokuphefumla, ukukhohlela, kunye nemveliso ye-mucus egqithisileyo, ukunciphisa umgangatho wobomi bomguli.
Ngapha koko, imeko ye-cartinogenic yenye yeegesi, njengo-Bengne, ibeka umngcipheko wexesha elide lomhlaza. Nangona owona mngcipheko womhlaza womhlaza ngenxa ye-Laparoscopic ye-laparoscopic iphantsi, isiphumo esikhawulezayo sokuvezwa kwexesha (ngakumbi kwizigulana ezinokuthi zithathelwe ingqalelo. Ubukho be-Benzene kumsi ohlulekayo bunokonakalisa i-DNA kwiiseli zemiphunga, ezikhokelela kuguquko olunokubangela ukuba umhlaza wemiphunga.
Ingozi kubasebenzi bezempilo
Abasebenzi bezempilo, kubandakanya oogqirha, abongikazi, kunye neengcali ze-anesthesiologist, nazo zisemngciphekweni ngenxa yokuvezwa kwezinto eziqhelekileyo neziphindaphindiweyo kwiigesi ezinobungozi. Imeko yegumbi lokusebenza ihlala ivalelwe, kwaye ukuba i-ventilation efanelekileyo kunye neenkqubo zokukhupha igesi azikho, uxinzelelo lwezi gesi eziyingozi ziyakhawuleza.
Ukuvezwa kwexesha elide-Ukuvezwa kwexesha elide kwiigesi kwigumbi lokusebenza kunyusa umngcipheko wabasebenzi bezempilo abaphuhlisa izifo zokuphefumla. Ukuphefumla okuqhubekayo kwamasuntswana emsi kunye neeVOC kungakhokelela kuphuhliso lwe-Asthma. Uhlobo olucaphukisayo lweegesi lunokubangela ukuba iindlela zomoya zibandezelwe kwaye zicocekile, zikhokelela kwiimpawu ezifana nokuthoba, ukuphefumla, kunye nokuqina kwesifuba. Abasebenzi bezempilo banokube ngumngcipheko ophezulu wokukhulisa ibronis ye-birchitis engapheliyo. Ukuvezwa okuphindaphindiweyo kumsi wetyala kunokubangela i-tubes ye-robchial ukuba ikhutshiwe kwaye icaphukiswe, ivelise imveliso yokukhohlela, i-leucus, kunye nobunzima bokuphefumla.
Umngcipheko womhlaza unexhala olubalulekileyo kubasebenzi bezempilo. Ubukho beegesi ze-carcinogenic njenge-bedzene kunye ne-famildehydes kwimo yegumbi lokusebenza kuthetha ukuba ngokuhamba kwexesha, ukuvezwa kukhulisa kunokunyusa iintlobo ezithile zomhlaza. Ukongeza kumhlaza wemiphunga, abasebenzi bezempilo abanokuba semngciphekweni ophezulu wokufumana imithanga yendlela ephezulu yokuphefumla, ngenxa yomhlaza we-neapharyngel, ngenxa yoqhakamshelwano ngqo lwee-carcinoal kunye nezicubu ze-carcinoal kunye nezicubu ze-carcinoal kunye nezicubu ze-carcinoal.
Ngapha koko, ukuphefumla kwezigadi eziyingozi kunokuba neziphumo zempilo yabasebenzi bezempilo. Ezinye zezinto kumsi ohlulekileyo, ezinjengeentsimbi ezinzima ezinokubakho ekulandeleni izixa ezikhoyo kwizicubu ezibekiwe, zinokufunyanwa kwigazi. Kanye kwigazi, ezi zinto zinokuchaphazela iigadi ezahlukeneyo kunye neenkqubo emzimbeni, onokubakho kwiingxaki ze-neurological, ukonakala kwezintso, kunye neminye imigaqo yezempilo. Impembelelo yexesha elide kwezi zinto zibonisa, kodwa kucacile ukuba umngcipheko wezempilo kubasebenzi bezempilo ubalulekile kwaye ufuna ingqalelo enkulu kunye namanyathelo okhuseleko.
Ukufumanisa nokubeka iliso
Iindlela zokuchonga okwangoku
1. Izinzwa zegesi
1. Izinzwa zegesi zidlala indima ebalulekileyo ekuboneni iigesi eziyingozi eziveliswe ngexesha lotyando we-laparoscopic. Kukho iintlobo ezininzi zenzwa zerhasi esetyenziswayo, nganye inomgaqo wayo owodwa kunye nezibonelelo.
1. Izinzwa zerhasi ye-electrochemical : Ezi zinzwa zisebenza ngokusekwe kumgaqo-siseko wokuphendula kwe-elektroniki. Xa irhasi ekujolise kuyo, njenge-carbon monoxide (co), iza kunxibelelana ne-electros ye-ENGROR, intsingiselo ye-elektroniki yenzeka. Umzekelo, kwinzwa ye-elektroniki e-elektroniki, i-CO i-oxidod kwi-elektrode ye-elektrode, kwaye umbane owenzayo ngoku ulingana noxinzelelo lwe-CO kwindawo ekufutshane. Le yangoku ilinganiswe kwaye iguqulwe ibe ngumqondiso ofundekayo, ivumela isigqibo esichanekileyo soxinzelelo. Izinzwa ze-electrochemical zinobuthathaka kakhulu kwaye zikhetha, zisenza kakuhle - zilungele ukufumana igesi ekhethekileyo eyingozi kwindawo yotyando. Banokubonelela ngedatha yexesha lokwenyani kumanqanaba eegesi, ukunika impendulo kwangoko kwimeko yokugxila eyingozi.
1. Izinzwa zegesi zegesi : Izinzwa ze-infrared zisebenza kumgaqo wokuba iigesi ezahlukileyo zifumana imitha ye-radiacred kwi-wavelengt nganye. Umzekelo, ukufumana i-carbon diokside () kunye nezinye ii-hydrocarbons, i-sensor ikhupha ukukhanya. Xa ukukhanya kudlula kwindawo ezaliswe yigesi kwigumbi lokusebenza, iigesi ekujoliswe kuzo zifumana imitha ye-infrared kwiimpawu zazo zempawu zawo. Inzwa isondela emva koko ilinganisa isixa sokukhanya esikufunukele okanye esidluliselwe, kwaye isekwe kulo mlinganiso, sinokubala uxinzelelo lwegesi. Izinzwa ze-infrared azikho-uqhagamshelo kwaye zinobomi obude. Zikwazinzile kwaye zinokusebenza kwiimeko ezahlukeneyo zokusingqongileyo, zibethengela ukuba zibonakalise ukubekwa esweni okuqhubekayo kweegesi ezinobungozi ngexesha lotyando we-laparoscopic utyandeni.
1. Ukukhutshwa komsi kunye neenkqubo zokubeka esweni
I-1. Iinkqubo zokupheliswa komsi yinxalenye ebalulekileyo yokubeka iliso kwigesi kwigumbi lokusebenza. Ezi nkqubo zenzelwe ukuba zisuse umsi kunye neegesi eziyingozi eziveliswe ngexesha lokusetyenziswa kweYunithi ye-elektrosical.
1. Izixhobo zokukhutshelwa komsi ezisebenzayo : Ezi zixhobo, ezinjengokunyanzelwa komsi ofihlakeleyo, ziqhagamshelwe ngokuthe ngqo kwindawo yotyando. Basebenzisa indlela enamandla yokuzimisela ukuzoba umsi kunye neegesi njengoko ziveliswa. Umzekelo, i-Evacurid yesandla ephangiweyo inokubekwa kufutshane nesixhobo sombane xa sisebenza. Njengoko i-ESU iyavelisa umsi, umtyholwana ngokukhawuleza waphosa ngaphakathi, ukuthintela iigesi ukuba zingasasaze kwindalo yegumbi lokusebenza. Ezinye iinkqubo eziphambili zokukhutshwa komsi ziyadityaniswa nezixhobo ze-laparoscopic ngokwayo, qinisekisa ukuba umsi ususwa kufutshane nomthombo njengoko kunokwenzeka.
1. Izinto zokubeka iliso kwiinkqubo zokukhutshwa komsi : Ukongeza ekukhutshelwa, ezi nkqubo zihlala zakhiwe - kwiinto ezibonakalayo. Oku kunokubandakanya izivalo zegesi ezifanayo nezo zichazwe apha ngasentla. Umzekelo, inkqubo yokukhuphela umsi inokuba ne-consor incasor edityaniswe nendlela yayo. Njengoko le nkqubo iphosa umsi, i-sensor ilinganisa uxinzelelo kwi-consim yomsi ongenayo. Ukuba uxinzelelo lungaphezulu kwinqanaba elikhuselekileyo, i-alamu inokubangelwa, igxile kwiqela lotyando ukuba lithathe amanyathelo afanelekileyo, njengokunyusa amandla okuqinisa okanye ukuhlengahlengisa ubuchule bokuhlinzwa ukunciphisa isizukulwana segesi.
Ukubaluleka kokubeka esweni rhoqo
1. Ukukhusela impilo yesigulana
1.. Ukubeka iliso rhoqo kugxininiso lwegesi eyingozi ngexesha lotyando we-laparoscopic kubalulekile ukukhusela impilo yesigulana. Kuba isigulana siveze ngokuthe ngqo kwiigesi kwicandelo le-sub thergical, nokuba ukuvezwa kwegama elincinci kumanqanaba aphezulu eegesi ezinobungozi kunokuba neempembelelo ezimbi kwangoko. Umzekelo, ukuba uxinzelelo lwe-carbon monoxide (co) kwindawo yotyando ayibekwa esweni kwaye ifikelela kwinqanaba eliyingozi, isigulana sinokufumana ukwehla kweoksijini - ukuphatha ubungakanani begazi. Oku kunokukhokelela kwi-hypoxia, enokubangela ukonakala kumalungu afanelekileyo anjengengqondo, intliziyo, kunye nezintso. Ngokubeka iliso rhoqo igesi, iqela lotyando linokuqinisekisa ukuba isigulana asivelwanga kumanqanaba eegesi eziyingozi ezinokubangela iingxaki zempilo ezibi.
I-1. Ingozi yexesha elide - impilo yexesha elide inokuba incitshisiwe ngokubeka iliso rhoqo. Njengoko bekutshiwo ngaphambili, ukuveza iigesi ezithile njenge-benzene kunye ne-formaldehyde ngokuhamba kwexesha kunokunyusa umngcipheko wokufumana umhlaza. Ngokugcina uguquko lwegesi kwindawo yotyando ngaphakathi kwemida ekhuselekileyo, ukubonakaliswa kwesigulana kwezinto ezincitshisiweyo kwezinto ezincitshisiweyo, ukunciphisa umngcipheko wexesha elide kunye ne-Laparoscopic.
1. Ukuqinisekisa ukhuseleko lwabasebenzi bezempilo
1. Abasebenzi bezempilo kwigumbi lokusebenza basemngciphekweni wokuvezwa okuphindaphindiweyo kwiigesi eziyingozi. Ukubeka iliso rhoqo kuyanceda ukukhusela impilo yabo. Ixesha elingaphezulu, ukubonakaliswa okuqhubekayo kwiigesi kwigumbi lokusebenza kunokukhokelela kuphuhliso lwezifo zokuphefumla ezinje nge-asthma, i-bronitis engapheliyo, kunye nomhlaza wemiphunga. Ngokubeka iliso kugxininiso lwegesi rhoqo, amaziko ezempilo anokuthatha amanyathelo asebenzayo ukuphucula umoya okanye usebenzise iinkqubo zokukhutshwa kwegesi. Umzekelo, ukuba ukubekwa kweliso kubonisa ukuba ukugxininiswa kweenkqubo ze-orlating eziguqukayo (VOCs) zihlala ziphezulu, isibhedlele sinokutyala kwiinkqubo ezinesiphene zomoya okanye ukuphucula isixhobo esikhoyo somsi. Oku kuqinisekisa ukuba abasebenzi bezempilo abakhange baveze amanqanaba ayingozi kwizinto eziyingozi ngexesha lomsebenzi wabo, ukukhusela impilo yabo yexesha elide kunye nentlalo-ntle.
1. Ukuqinisekiswa komgangatho kwintshukumo yoNyango
1.. Ukubeka iliso rhoqo kwegesi eliyingozi yinkalo ebalulekileyo yokuqinisekiswa komgangatho kunyango lwetyala. Ivumela izibhedlele kunye namaqela otyando ukuvavanya ukusebenza kweendlela zabo zokhuseleko. Ukuba idatha yokubeka esweni ibonisa ukuba ukugxininiswa kwegesi kuyaguquguquka ngaphakathi kuluhlu olukhuselekileyo, ibonisa ukuba iinkqubo ezikhoyo ze-ventilations kunye neenkqubo zokukhupha igesi ziyasebenza ngokufanelekileyo. Kwelinye icala, ukuba idatha ityhila ukuba ukugxininisa ukuba kuyasondela okanye ngaphezulu kwemida ekhuselekileyo, ibonisa imfuneko yokuphucula. Oku kunokubandakanya ukuvavanya intsebenzo yeyunithi ye-electrosurge, ukujonga nayiphi na inkqubo yokukhupha igesi, okanye ukuqinisekisa ukuba igumbi lokusebenza liphumelele umoya. Ngokusebenzisa idatha yokubeka iliso ukwenza izigqibo ezinolwazi, amaqela oRhweyo anokuqhubekeka ukuphucula ukhuseleko lwegumbi lokusebenza, ukuphucula umgangatho uphela ngononophelo.
Izicwangciso zokunciphisa
Ulawulo lobunjineli
1. Ukuphucula uyilo lwe-ESU
1. Abavelisi beeyunithi ze-electrosgarical banokudlala indima ebalulekileyo ekunciphiseni isizukulwana segesi eyingozi. Enye indlela kukongeza iindlela zokuhambisa amandla e-ESUs. Umzekelo, ukuphuhlisa i-ESS ngolawulo olufanelekileyo malunga nombane okwangoku kunokunciphisa ukususwa okugqithisileyo. Ngokulawula ngokuchanekileyo inani lamandla anikezelwe kwizicubu, amaqondo obushushu kwizicubu-i-elektrobe zinokulawulwa ngcono. Oku kunciphisa amathuba okuba ngaphezulu kwe-tishu, ethi inciphise ubungakanani bokubola kwe-thermal kunye nokuveliswa kweegesi eziyingozi.
1. Enye inkalo yokuphuculwa koyilo lwe-ESU kukusetyenziswa kwezixhobo ze-electrode. Ezinye izixhobo ezitsha zinokuba nenxaxheba engcono yokuqhubela phambili kunye nokuxhathisa, kuvumela ukuhanjiswa okufanelekileyo kwamandla ombane ngelixa kuncitshiswa ubushushu - ukonakala kwe-tishu. Ukongeza, uphando lunokugxila ekuphuhliseni i-electrodes elenzelwe ngokukodwa ukunciphisa ukumiswa kwezicubu ezixhasayo, njengoko izicubu ezixhasayo zingumthombo ophambili weegesi ezinobungozi kunye neegesi.
1. Ukuphucula iinkqubo zokungena kwendawo yoqhawulo-mveliso
1. Umoya osebenzayo ubalulekile kwigumbi lokusebenza ukuze ususe iigesi eziyingozi eziveliswe ngexesha lotyando we-laparoscopic. Iinkqubo zemveli zemveli zinokuphuculwa ngokwamanqanaba aphezulu. Umzekelo, i-laminar-ukuhamba kwe-ventilation ifakwe. Ezi nkqubo zenza ukuhamba komoya okungaguqukiyo, ukuhambisa umoya ongcolisekileyo uphume kwigumbi lokusebenza ngendlela efanelekileyo. Ngokugcina i-moya engapheliyo kwaye ejolise kuyo i-moya entsha yomoya, iinkqubo zokuhamba kweLaminar zinokuthintela ukuqokelelwa kweegesi eziyingozi kwimeko yoqhaqho.
1. Ukongeza kwi-ventilation jikelele, iinkqubo zokuphelisa ingingqi zinokudityaniswa kwiseti ye-sub. Ezi nkqubo zenzelwe ukuthwala ngqo umsi kunye neegesi emveni, kufutshane nesixhobo se-electrososical. Umzekelo, i-suction isixhobo esisekwenzelwanga esisekwe kwingingqi sinokubekwa kufutshane ne-laparoscope okanye i-eguece. Oku kuqinisekisa ukuba iigesi eziyingozi ziyasuswa ngokukhawuleza njengoko zivelisiwe, ngaphambi kokuba zibe nethuba lokusasazeka kwigumbi elikhulu lokusebenza. Ukulungiswa rhoqo nokubeka iliso kwezi moya kunye neenkqubo zokuphelisa zibalulekile ukuqinisekisa ukusebenza kwabo kakuhle. Iifilitha kwiinkqubo kufuneka zitshintshwe rhoqo ukuze zigcine ukusebenza kwabo ekususeni amasuntswana anobungozi kunye neegesi ezivela emoyeni.
Izixhobo zokukhusela umntu (i-PPE)
1. Ukubaluleka kwePPE yabasebenzi bezempilo
1. Abasebenzi bezempilo kwigumbi lokusebenza kufuneka babonelelwe kwaye baqeqeshelwe ngokufanelekileyo ukusebenzisa izixhobo ezikhuselayo (i-PPE) ukunciphisa ukuvezwa kwabo kwiigesi ezinobungozi. Elinye lawona maqhekeza abaluleke kakhulu kwi-PPE ngumqhubi ophezulu. Abaphengululi-ntsapho, njengamanqanaba e-N95 okanye inqanaba lokuphefumla kobume bemikhosi, benzelwe ukucoca amasuntswana amahle, kubandakanya abo babekho kumsi wengxangxasi. Aba bapheli banokunciphisa ngokufanelekileyo ukuntywila kwamasuntswana emsi, izixhobo zokusebenza eziguqukayo, kunye nezinye izinto eziyingozi kumoya wegumbi lokusebenza.
I-1. Izihlangu zobuso ikwayinxalenye ebalulekileyo yePPE. Babonelela ngomaleko ongezelelweyo wokukhusela amehlo, impumlo, kunye nomlomo wokudibana ngokuthe ngqo nomsi wotyando kunye neebhulukhwe. Oku akuncedisi nje ukuthintela ukuphefumla kweegesi eziyingozi kodwa kukhusela ngokuchasene neearhente zosulelo ezinokubakho ezinokubakho kumsi.
1. Ukusetyenziswa ngokuchanekileyo kwePPE
1. Ukusetyenziswa ngokufanelekileyo kwePPE kubalulekile ekusebenzeni kwayo. Abasebenzi bezempilo kufuneka baqeqeshelwe ukuba bangathini na kwaye badle iidreyini zabo. Ngaphambi kokuba ubeke i-respitor, kubalulekile ukwenza i-fit-jongili. Oku kubandakanya ukugubungela i-respirerator ngezandla zozibini kunye nokuphefumla kunye nokuphelisa ngokunzulu. Ukuba ukuvuza komoya kufumanisa ukuba ujikeleze imiphetho yomphetho, kufuneka ilungiswe okanye itshintshwe ukuqinisekisa itywina elifanelekileyo.
I-1. Izikhuselo zobuso kufuneka zinxibe ngokuchanekileyo ukubonelela ngokupheleleyo. Kuya kufuneka bahlengahlengiswe ukuze balingane kakuhle entlokweni kwaye akufuneki batyelwe ngexesha lo utyando. Ukuba ukwiphepha lento yenzeka, izisombululo ze-FOG-I-FOG zinokusetyenziswa. Ukongeza, i-PPE kufuneka itshintshwe rhoqo. Abaphenyi kufuneka batshintshwe ngokweengcebiso zomenzi, ngakumbi ukuba zimanzi okanye zonakaliswe. Izihlangu zobuso kufuneka zicocwe kwaye zibulala iintsholongwane phakathi kohambo ukuthintela ukuqokelelwa kweendlela ezingcolisekileyo.
Ezona ndlela zilungileyo kwigumbi lokusebenza
1. Ukucoca rhoqo kunye nokugcinwa
1. Ukugcina indawo yegumbi lokusebenza elicocekileyo ibalulekile ekunciphiseni ukuvezwa kwegesi eyingozi. Iindawo eziphezulu kwigumbi lokusebenza kufuneka zicocwe rhoqo ukuze zisuswe nakuphi na intsalela kwezinto eziyingozi ezikhoyo kumsi wetyala. Oku kubandakanya ukucoca iitafile zoqhaqho, izixhobo kunye nemigangatho. Ukucocwa rhoqo kunceda ukuthintela ukunqunyanyiswa kwakhona kwamasuntswana anokuzinza kwiindawo eziphezulu, ukunciphisa ukugxininiswa kwezinto eziyingozi emoyeni.
I-1. Icandelo le-electrosurger ngokwalo kufuneka ligcinwe ngokufanelekileyo. Ukuhanjiswa rhoqo kwe-ESU kunokuqinisekisa ukuba iyasebenza kwintsebenzo efanelekileyo. Oku kubandakanya ukukhangela naluphi na unxibelelwano oluzimeleyo, olunxibileyo - i-eleclicrodes, okanye eminye imiba yoomatshini. I-ESU igcinwe kakuhle inokwenzeka ukuba ivelise ubushushu obugqithisileyo okanye ukungasebenzi kakuhle, okunokuba negalelo ekuvelisweni kweegesi eziyingozi.
1. Uncedo lwendlela yokuhlinqwa
I-1. Oogqirha banokudlala indima ebalulekileyo ekunciphiseni ukuveliswa kwegesi eyenzakalisayo ngokusebenza kweendlela zabo zokuhlinzwa. Umzekelo, ukusebenzisa indawo ephantsi yamandla esebenzayo kwicandelo le-electrosugecal linokunciphisa inani lomonakalo wezicubu kunye nemveliso yegesi elandelayo. Ngokulawula ngenyameko ixesha lokuSebenza le-ESU kunye nexesha lokunxibelelana kunye nezicubu, oogqirha banako ukunciphisa ubungakanani bezinto zokuhombisa.
1. Omnye umsebenzi obalulekileyo kukusebenzisa i-ESU ngokufutshane, ithutyana iqhube kunokuba isebenze ngokuqhubekayo. Oku kuvumela izicubu ukuba zipholile phakathi kuqhuma, zinciphisa ubushushu obupheleleyo onxulumene nezicubu kunye nesizukulwana seegesi eziyingozi. Ukongeza, xa kunokwenzeka, ezinye iindlela zoqhawulo-mveliso ezivelisa umsi kunye negesi, ezinje ngokuhlamba i-ultrasonic, inokuqwalaselwa. Ezi ndlela zinokubonelela ngokusika izicubu ezifanelekileyo kunye nokudibanisa ngelixa kuncitshiswa ukuvelisa imveliso ye-Mveliso-iimveliso, igalelo kwindawo ekhuselekileyo yolawulo lwabaguli kunye nabasebenzi bezempilo.
Uphando kunye nembono yexesha elizayo
Izifundo eziqhubekayo
Okwangoku, zininzi izifundo eziqhubekayo ekusombululeni umba wokuveliswa kwegesi eyingozi ngexesha lotyando we-laparoscopic usebenzisa iiyunithi ze-elektroscopical. Inkalo enye yophando igxile ekuphuhlisweni kwezinto ze-novel ze-electrosgue. Izazinzulu zikhangela ukusetyenziswa kweepollys eziphambili kunye ne-nanomastetials ezineepropathi ezodwa. Umzekelo, ezinye iindawo ze-nanomasmassultine zinokwazi ukuphucula ukusebenza kweenkqubo zokudluliselwa kwamandla ngexesha lokufakelwa kwe-electrosury ngelixa kuncitshiswa isixa sobushushu - ukonakala kwezicubu. Oku kunokukhokelela ekwehliseni ukupapashwa kwezizukulwana zegesi eziyingozi. Kuphononongo lwakutshanje, abaphandi baphanda ngokusetyenziswa kwekhabhoni - i-Natnotube-idityaniswe i-electrodes. Iziphumo zibonise ukuba le electros inokufezekisa ukusika izicubu ezisebenzayo kunye nokuhamba nokuhamba nge-fireen esincinci xa kuthelekiswa nee-elektroni zesiko, ebonisa ukuncitshiswa okunokubakho kwimveliso yegesi eyingozi.
Omnye umgca wophando ujolise ekuphuculeni uyilo lweeyunithi ze-elektrosical ngokwazo. Iinjineli ziyasebenza ekuphuhliseni i-ESS ngeenkqubo zokulawula ngakumbi. Esi sizukulwana sitsha sasiya kuba nakho ukuhlengahlengisa ngokuzenzekelayo igalelo lombane kunye nemveliso yamandla esekwe kuhlobo lwezicubu kunye nomsebenzi otyatyayo. Ngokulungelelanisa ngokuthe ngqo ukuhanjiswa kwamandla, umngcipheko wokugcina amanzi okupholisa izicubu kunye nokuvelisa igesi enobungozi kakhulu kunokuncitshiswa. Umzekelo, ezinye iiprototypes zixhotywe ngenzwazana ezinokukufumanisa ukufunyanwa kwezicubu zexesha lokwenyani. U-ESU emva koko uhlengahlengisa useto lwayo ngokufanelekileyo ukuqinisekisa intsebenzo efanelekileyo kunye nesizukulwana segesi.
Ukongeza, izifundo ziqhutywa ekusebenziseni imithombo yamandla e-elektrosgery. Abanye abaphandi baphonononga ukusetyenziswa kwee-lars okanye amandla e-ultrasonic njengezinye iindlela zokufikelela kwinqanaba eliphezulu-frequency yombane okwangoku. U-Lasers, umzekelo, unokubonelela ngoncedo lwezinto ezichanekileyo ngokusasaza okuncinci kunye nokungafikeleli kwiimveliso ezincinci. Nangona kusekho kumanqanaba ovavanyo, ezi zinye izixhobo ezenziweyo zotyando ezisisiseko zibonisa ukunciphisa ingxaki eyingozi yegesi enxulumene neeyunithi zemveli ze-elektroniki ezinxulumene neeyunithi zemveli ze-elektroniki.
Umbono we-Laparoscopic utyando lwe-Laparoscopic
Ikamva lika-Laparoscopic lo utyando lubambe isithembiso esihle sokunciphisa umngcipheko onxulumene negesi eyingozi. Ngobuchule obuqhubekayo betekhnoloji, sinokulindela ukubona ukuphuculwa okubonakalayo kukhuseleko lwezi nkqubo.
Enye yezona zinto zibalulekileyo kwixesha elizayo zinokuba luphuhliswa kweenkqubo ezihlanganisiweyo zokuhlela. Ezi nkqubo ziya kudibanisa iiyunithi ze-elektrosical ze-electrosgerical eneegesi ezisebenzayo-zokukhupha kunye neenkqubo zokucoca. Umzekelo, iyunithi ye-electrosugecal inokudityaniswa ngqo kwi-time-ye-/ i-Arvator yoMsi-i-Arvator esebenzisa itekhnoloji yokufihlakeleyo, enjengeefilitha ezisekwe kwi-nanoprercle. Ezi filitha ziya kuba nakho ukususa isuntswana neegesi ezincinci kunye neegesi ezivela kwindalo yotyando, iqinisekisa imeko emngciphekweni wesigulana kunye neqela lonyango.
Ngapha koko, ngenkqubela phambili yenkqubela phambili yobukrelekrele (i-AI) kunye nokufunda ngomatshini, iirobhothi zokuhambisa, iirobhothi zinokudlala indima ebalulekileyo kwi-Laparoscopic utyando lwe-laparoscopic. Ezi robhothi zinokucwangciswa ukuba zenze iinkqubo zoqhaqho ngokuchaneka okuphezulu, kusetyenziswa ubuncinci bamandla afunekayo kwi-zunguue ye-tissue. I-Ai-I-Algorithms enamandla anokuphinda zihlalutye iimpawu ze-tissule kwixesha lokwenyani kwaye zilungelelanise indlela yotyando ngokufanelekileyo, zinciphisa kwakhona isizukulwana segesi eyingozi.
Ngokuphathelele kwezonyango, izikhokelo zexesha elizayo kunye neenkqubo zoqeqesho zonyango zinokugxininisa ekunciphiseni ukunciphisa igesi. Oogqirha banokuqeqeshwa ukuze basebenzise ubuchule obutsha boqhawulo-mveliso kunye nezixhobo ezenzelwe ukunciphisa ukuveliswa kweegesi eziyingozi. Iikhosi eziqhubekayo zezonyango zinokugxila kwiziphumo zophando zamva nje kunye neendlela ezilungileyo kule ndawo, ziqinisekisa ukuba ababoneleli bezempilo baphakame-ukuya kuthi ga ngoku zezona ndlela zisebenzayo zokunciphisa umngcipheko wegesi.
Ukuqukumbela, ngelixa umba wesizukulwana segesi onobungozi ngexesha lotyando we-laparoscopic usebenzisa iiYunithi ze-elektroscopical inkxalabo ebalulekileyo, uphando oluqhubekayo kunye nokuhamba kwengqondo ekhoyo kunye nokuhamba kwengqondo. Ngokudibanisa izisombululo zobunjineli bobunjineli, izixhobo eziphambili, kunye neendlela zokuphucula iindlela zokwenza utyando, sinokujonga phambili kwixesha elizayo apho ugqirha we-Laparoscopic unokwenziwa ngomngcipheko omncinci kwimpilo noKhuseleko lwazo zombini ezi zigulana kunye nabasebenzi bezempilo.
Ukuqukumbela
Kwisishwankathelo, ukusetyenziswa kweeyunithi ze-electrosurical ngexesha lotyando we-laparoscopic, ngelixa unika izibonelelo ezibalulekileyo malunga nokuchaneka kokuchaneka kunye ne-heimoris, kunika isizukulwana segesi esiyingozi. Ezi geses, kubandakanya i-carbon monoxide, i-supersungs, kunye ne-orlating yezinto eziphilayo, iyoyikisa enkulu kwimpilo yezigulana kunye nabasebenzi bezempilo.
Iingozi zexesha elifutshane kunye nexesha elide-zezexesha elide ezinxulunyaniswa nezi gesi eziyingozi azinakuthathelwa ingqalelo. Izigulana zinokufumana ukucaphukisa okuphefumlayo kwangoko ngexesha lotyando, kwaye kwixesha elide, kubuso bomngcipheko wokukhulisa izifo zokuphelisa okunganyangekiyo. Abasebenzi bezempilo, ngenxa yokuboniswa kwabo okuphindaphindiweyo kwindalo yegumbi, nasemngciphekweni wokuphuhlisa uluhlu lweengxaki zokuphefumla kunye nenkqubo yezempilo.
Iindlela zokuchonga okwangoku, ezinje ngezinzwa zegesi kunye nokukhutshwa komsi kunye neenkqubo zokubeka esweni, zidlala indima ebalulekileyo ekuboneni ubukho kunye nokugxininiswa kwezi gesi ziyingozi. Ukubeka iliso rhoqo kungenjalo kungekuphela nje ekukhuseleni impilo yabaguli kunye nabasebenzi bezempilo kodwa nokuqinisekisa umgangatho wotyando.
Mitigation strategies, including engineering controls like improving ESU design and enhancing surgical ventilation systems, the use of personal protective equipment by healthcare workers, and the implementation of best practices in the operating room, are all vital in reducing the risks associated with harmful gas exposure.
Uphando oluqhubekayo lubambe isithembiso esikhulu kwikamva le-laparoscopic utyando. Ukuphuhliswa kwezinto zenoveli, ukuphuculwa koyilo lwe-ESU, kunye nokuhlolwa kwemithombo yamandla e-elect ye-electgery kunika ithemba lokusivelisa igesi. Umbono weenkqubo zotyando ezihlanganisiweyo ezihlanganisiweyo kunye nokusetyenziswa kweerobhothi ze-AI-I-robots enikwe amandla anokuphucula ukhuseleko lweenkqubo ze-laparoscopic.
Kubaluleke kakhulu ukuba uluntu lwezonyango, kubandakanya oogqirha, i-anesthesiologshini, abongikazi, kunye nabavelisi besixhobo sonyango, bayazi ukubaluleka kwalo mbandela. Ngokusebenza kunye, ukuphunyezwa amanyathelo afanelekileyo okhuseleko, kunye nokuhlala unolwazi malunga nenkqubela phambili yetekhnoloji, sinokuzabalazela kwixesha elizayo apho ugqirha we-laparoscopic unokwenziwa ngomngcipheko omncinci kwimpilo nokhuseleko lwabo bonke abachaphazelekayo. Ukukhuseleka kwabaguli kunye nabasebenzi bezempilo kwigumbi lokusebenza kufuneka kuhlala kuyinto ephambili, kwaye bajongane nengxaki yokuveliswa kwegesi eyenzakalisayo kwi-laparoscopic utyando le-elektroscopic kusetyenziswa le njongo.
