Ezinqubo zokususwa kwe-endoscopic, sivame ukuthemba imishini ethuthukisiwe, kodwa sivame ukunganaki izici eziyisisekelo zokunyakaza. Kungani ngisho nalapho isilonda sibonakala sibambeke kahle, siphuma ngokushesha nje lapho siqinisa ugibe? Namuhla, sithola ukuqonda encwadiniIndlela ye-Oho: Amasu Ayisisekelo ku-Endoscopy Yokugaya Ukudla, ake sithole imininingwane emincane kakhulu ekulawulweni kwezingibe okuzogcina kunqume impumelelo noma ukwehluleka.
Odokotela be-endoscopist cishe bonke bake babhekana nalezi zikhathi 'zokucindezela kwegazi okukhulu': Uqondisa ngokucophelela isicupho phezu kwesilonda, usethe izilungiselelo zokujiya kahle, bese unyathela i-pedal—ube usuzwa 'ukukhala', bese isilonda siphuma, noma okubi nakakhulu, sisuswa kancane kancane.
Kulezi zikhathi, ukusabela kokuqala kwabantu abaningi ukusola inhlanhla noma imishini engasebenzi kahle. Kodwa-ke, emehlweni ochwepheshe abanolwazi abaye babuyekeza izinqubo eziningi, lokhu akuvamile ukuba yindaba yenhlanhla. Ngokuvamile kuyibhomu elihlala isikhathi eside elifakwe yimikhuba emibi yokusebenza.
Namuhla, sisebenzisa ifilosofi yobuchwepheshe yodokotela wezifo zamehlo odumile waseJapan uDkt. Ken Oho, ake singene 'ezindaweni ezimbili ezingabonakali' ekusikweni kwe-snare ezinganakwa kalula yizimfundamakhwela kanye namasosha asebekhulile ngokufanayo—i-i-fulcrumkanyeisikhungo.
Uchungechunge Olujwayelekile Lokugebenga – Izinyathelo Ezixhumene, Ngayinye Ibalulekile
Lapho besebenzisa ugibe, abasafufusa abaningi bavame ukushesha baqonde ngqo esilondeni ngokushesha nje lapho bethola ithuluzi. Nakuba ukunyakaza kwabo kushesha, bavame ukugcina bengcolile futhi bengahlelekile.
Ku-"Oho Method," ukulungisa ugibe kulandela ukulandelana okunengqondo okuqinile, okuvame ukuhlukaniswa ngezinyathelo ezine:
Lungisa ugibe:Okokuqala, thola i-fulcrum ukuze uzinzise ithuluzi.
Hlehlisa isikhwama sangaphandle ukuze uvule ugibe bese ulungisa usayizi walo:Lesi sinyathelo sinquma ububanzi bokususwa kwenxeba. Kumelwe kulungiswe ngokunembile ngokuya ngobukhulu besilonda.
Bamba futhi uqinise njengokungathi "wamukela" isilonda ogibeni:Lena inqubo esebenzayo "yokwamukela" isilonda esikuso, kunokulinda nje ukuthi siwele ngaphakathi.
Thuthukisa igobolondo langaphandle ngenkathi uqinisa ukuze uvimbele ukuthi i-snare tip ingasuki:Lesi yisinyathelo esibaluleke kakhulu, futhi lapho odokotela abaningi be-endoscopist bevame ukukhubeka khona. Uma igobolondo langaphandle lingathuthukisiwe, amandla okuqinisa azodonsela i-snare tip emuva, okwenza isilonda singatholakali.
Le nqubo ingase izwakale ilula, kodwa isinyathelo ngasinye sidinga izinga eliphezulu lokuxhumana kwesandla neso.
Gxila Ethiphu Logibe - Ukuthola Lelo "Phuzu Eliqinile"
Kungani i-tip ibaluleke kangaka? Ngoba ku-lumen ethambile neguquguqukayo yamathumbu, i-tip isebenza njenge-"anchor" yethu yokusebenza.
Odokotela abaningi be-endoscopist bajwayele ukusebenzisa ingxenye encane yamathumbu noma uhlangothi oluphambene nokunamathiselwa kwe-mesenteric njenge-fulcrum, kodwa lokhu kuvame ukuholela ekusheleleni.
Imfihlo ye-"Oho Method" ilele kulokhu:besebenzisa inhlonhlo yogibe uqobo njengesisekelo.
Kunezindlela ezimbili ezisebenzayo zalokhu. Wonke umuntu angabheka eduze uMfanekiso 1 (Ukulungisa Ugibe), engiwucaphune encwadini:
Indlela 1 (Isithombe 1a):Vula ngokuphelele ugibe bese umboza isilonda phezulu. Lena yindlela ejwayelekile esetshenziswayo lapho amathumbu eqondile futhi isilonda kulula ukusibamba.
Indlela 2 (Isithombe 1b):Sebenzisa udonga lwamathumbu ohlangothini lomlomo njengesisekelo, bese uvula kancane kancane ugibe.
Indlela 3 (Isithombe 1c):Uma kungekho fulcrum ezinzile ohlangothini lomlomo, ungasebenzisa udonga oluseceleni njenge-fulcrum esikhundleni salokho. Bese, vula kancane i-snare; lokhu kwenza kube lula ukubamba isilonda.
Qaphela:Singaqhubeka nezinyathelo ezilandelayo zokuvula nokuqinisa uma i-snare tip isizinzile futhi iqine kahle endaweni yayo ngaphandle kokushelela. Uma i-tip ingakwazi ukuma, zonke izinyathelo ezilandelayo zizoba yize.
Gxila Enkabeni Yogibe - Gwema Ukukhohlisa "Kokuthatha Izinto Njengezinto Ezivamile"
"Ukuqinisa ngqo ugibe kungabangela ukuthi isilonda sisuke phakathi nendawo."
Kungani? Kukhona into engabonakali kahle emzimbeni lapha.
Uma siqinisa ugibe, lubuyela emuva lungene emgodleni wangaphandle. Phakathi nale nqubo, isisekelo sogibe (isiphetho esixhunywe emgodleni) sisebenzisa amandla okusunduza angaphandle. Lokhu kuholela emphumeleni obalulekile: isilonda sivame ukudonswa kakhulu maphakathi nogibe kunokuba sidonswe phansi.
Uma ungakayilungisi kahle indawo ngaphambi kokuqinisa, ingxenye kuphela yesilonda ingaba ngaphakathi kwesicupho kuyilapho okunye kushiywe ngaphandle. Uma ususebenzise i-electrocautery, ingxenye eveziwe ngeke isuswe, okuholela "ekususweni kwezicucu."
Ngakho-ke, iyini ikhambi?
Ngesikhathi sokuqinisa ugibe, udinga ukuhambisa kancane kancane ugibe lwangaphandle ngasikhathi sinye. Inhloso yokukhipha ugibe ngenkathi uqinisa ukuqinisekisa ukuthi isilonda sihlala siphakathi nendawo yogibe (njengoba kuboniswe kuMfanekiso 2).
Ungawuthathi kalula lo mnyakazo olula 'wokusunduza kancane ngaphambi kokuqinisa'—ukuvumela ukuthi ubone ngokucacile isilonda sifakwe ngokuphelele kusikrini, kunokuthembela nje 'ekuzizweni'.
Iphuzu Eliyinhloko LikaDkt. Ohba – Hlala Ugxile Ngokugcwele Ukuze Uvimbele 'Ukulahlekelwa Yinhloso'
UDkt. Ohba ufingqe umongo oyinhloko wokuphathwa kogibe.
Uma isihloko sesitha singacindezelwanga ngokuqinile ngokumelene nezicubu, isihloko sizodonseka njengoba uqinisa isitha, okwenza isilonda siphume. Ngakolunye uhlangothi, uma isihloko sicindezelwe kakhulu, i-fulcrum izosuka esihlokweni iye esigxotsheni sangaphandle. Ngakho-ke, kubalulekile ukuthi“Isihloko sogibe siba yisiphetho.”
"Ngikholwa ukuthi wonke umuntu ube nesipiliyoni sokucabanga, 'Bengiqiniseka ukuthi yonke inxeba ibingaphakathi kogibe,' bese kuqedwa ngokususwa kancane kancane. Lokhu akuyona nje inhlanhla embi; kunesizathu salokho. Kumelwe sihlale sigxile ngokuphelele ukuqinisekisa ukuthi yonke inxeba ingaphakathi kogibe, futhi sivimbele ukuthi ingaphumi ngesikhathi sokuqina!"
Lesi sitatimende sivumelana ngempela nososayensi abaningi be-endoscopist. Lokho esikubiza ngokuthi “inhlanhla embi” empeleni kuwukunganaki imininingwane yendlela yethu yokusebenza.
Uma ufunda lokhu, ingabe unalo lelo "sikhathi se-aha"? Kuvela ukuthi imininingwane emincane esivame ukuyikhohlwa ngesikhathi sezinqubo isivele ifingqiwe ngokucacile ngabanduleli bethu.
“Uma ufuna ukufunda ngokuhlelekile lolu hlelo lokusebenza lwe-endoscopic ‘olusezingeni lencwadi’ futhi uthole ukuqonda okujulile kokuthi uDkt. Ken Ohba uhlukanisa kanjani yonke imikhuba eyisisekelo kakhulu, ngincoma kakhulu ukuthi ufundeI-Endoscopy Yokugaya Ukudla: Amasu Ayisisekelo Esitayela se-Ohba. Ukwazi izinto eziyisisekelo kuyisihluthulelo sentuthuko eqhubekayo nehlala njalo.
Ugibe Olufanele Luqeda Indlela Yokusebenza
Ukwazi kahle i-fulcrum kanye nesikhungo kuyisisekelo. Kodwa isandla esinekhono sidinga ithuluzi elithembekile. Ikhwalithi ephezuluugibe lokususwa kwe-polypectomykufanele inikeze:
Ukuvula nokuvala okubushelelezi
Akukho ukujima, akukho ukungabaza
Amandla ajikelezayo ahlala njalo
Ukubanjwa okuthembekile ngaphandle kokuklebhula izicubu
Ukuhambisana kwe-electrosurgical
Ukusika nokujiya okubikezelwayo
Ukuzungezisa
Ukuqondiswa okunembile kokwakheka komzimba okunzima
Kwa-ZRHmed, sakha izithiyo ze-polypectomy ezilahlwayo eziklanywe ngalezi zimo zezokwelapha engqondweni. Izithiyo zethu zitholakala ngesimo se-oval, i-hexagonal, kanye ne-crescent, ngezinketho ezijikelezayo nezingenakujikeleziswa, ukusetshenziswa okubandayo nokushisa, kanye nobude bokusebenza obusukela ku-1200mm kuya ku-2300mm. Yonke imikhiqizo iqinisekiswe yi-MDR CE futhi yenziwe ngaphansi kwe-ISO 13485.
Asenzi ama-endoscope. Senza amathuluzi akusiza ukuthi usebenze kangcono.
Isikhathi sokuthunyelwe: Juni-05-2026