I-Meckel diverticulectomy

I-Meckel diverticulectomy ukuhlinzwa ukukhipha isikhwama esingajwayelekile sendwangu yamathumbu amancane (amathumbu). Lesi sikhwama sibizwa ngokuthi yi-Meckel diverticulum.

Uzothola i-anesthesia ejwayelekile ngaphambi kokuhlinzwa. Lokhu kuzokwenza ulale futhi ungakwazi ukuzwa ubuhlungu.

Uma uhlinzwa uvulekile:

• Udokotela wakho ohlinzayo uzokwenza ukusika okukhulu esiswini sakho ukuvula indawo.
• Udokotela wakho ohlinzayo uzobheka amathumbu amancane endaweni lapho isikhwama noma i-diverticulum ikhona.
• Udokotela wakho ohlinzayo uzosusa i-diverticulum odongeni lwamathumbu akho.
• Kwesinye isikhathi, udokotela ohlinzayo angadinga ukukhipha ingxenye encane yamathumbu akho kanye ne-diverticulum. Uma lokhu sekwenziwe, imikhawulo evulekile yamathumbu akho izothungwa noma iboshwe ndawonye. Le nqubo ibizwa ngokuthi i-anastomosis.

Odokotela abahlinzayo nabo bangenza lokhu kuhlinzwa besebenzisa i-laparoscope. I-laparoscope iyinsimbi ebukeka njengesibonakude esincane esinekhamera ekhanyayo nevidiyo. Ifakwa esiswini sakho ngokusebenzisa ukusika okuncane. Ividiyo evela kwikhamera ivela kumonitha egumbini lokusebenza. Lokhu kuvumela udokotela ohlinzayo ukuthi abuke ngaphakathi esiswini sakho ngesikhathi sokuhlinzwa.

Ekuhlinzeni usebenzisa i-laparoscope:

• Kusikwa kathathu kuye kwemihlanu esiswini sakho. Ikhamera namanye amathuluzi amancane azofakwa ngalokhu kusikeka.
• Udokotela wakho ohlinzayo angenza nokusika okungamasentimitha ama-5 kuye kwayi-7.6 ubude ukufaka isandla, uma kudingeka.
• Isisu sakho sizogcwala igesi ukuvumela udokotela ohlinzayo abone indawo futhi enze ukuhlinzwa enendawo eyengeziwe yokusebenza.
• I-diverticulum isebenza njengoba kuchaziwe ngenhla.

Ukwelashwa kuyadingeka ukuvimbela:

• Ukopha
• Ukuvinjelwa kwamathumbu (ukuvinjelwa emathunjini akho)
• Ukutheleleka
• Ukuvuvukala

Uphawu oluvame kakhulu lweMeckel diverticulum ukuphuma kwegazi okungenabuhlungu okuvela engxenyeni. Indle yakho ingaqukatha igazi elisha noma ibukeke imnyama futhi ilindile.

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukungezwani komzimba nemithi noma izinkinga zokuphefumula
• Ukopha, amahlule egazi, noma ukutheleleka

Izingozi zalokhu kuhlinzwa yilezi:

• Ukulimala kwezitho zomzimba eziseduze.
• Ukutheleleka kwamanxeba noma isilonda kuvuleka ngemuva kokuhlinzwa.
• Izicubu ezibandayo ngokusika kokuhlinzwa. Lokhu kubizwa ngokuthi i-hernia engacwengi.
• Amaphethelo emathumbu akho athungiwe noma ahlanganiswe ndawonye (anastomosis) angavuleka. Lokhu kungadala izinkinga ezisongela impilo.
• Indawo lapho kuthungelwe khona amathumbu ndawonye kungadala isibazi futhi kudale ukuvaleka kwamathumbu.
• Ukuvaleka kwamathumbu kungenzeka ngemuva kwesikhathi kusuka ekunamathelweni okubangelwa ukuhlinzwa.

Tshela udokotela wakho ohlinzayo:

• Uma ukhulelwe noma ungakhulelwa
• Imiphi imithi oyiphuzayo, ngisho nemithi, izithasiselo, noma amakhambi owathengile ngaphandle kwencwadi kadokotela

Phakathi nezinsuku ngaphambi kokuhlinzwa kwakho:

• Ungacelwa ukuthi uyeke ukuthatha izinciphisi zegazi. Lokhu kufaka ama-NSAID (i-aspirin, ibuprofen), i-vitamin E, i-warfarin (i-Coumadin), i-dabigatran (i-Pradaxa), i-rivaroxaban powder (i-Xarelto), i-apixaban (i-Eliquis), ne-clopidogrel (i-Plavix).
• Buza udokotela wakho ukuthi yimiphi imishanguzo okufanele usayiphuza ngosuku lokuhlinzwa.
• Uma ubhema, zama ukuyeka. Buza udokotela wakho noma umhlengikazi usizo lokuyeka.

Ngosuku lokuhlinzwa kwakho:

• Landela imiyalo kadokotela wakho mayelana nokuthi uyeka nini ukudla nokuphuza.
• Thatha imithi otshelwe ukuthi uyiphuze ngophuzo oluncane lwamanzi.
• Fika esibhedlela ngesikhathi.

Iningi labantu lihlala esibhedlela usuku olungu-1 kuya kwele-7 kuye ngokuthi ukuhlinzwa kwakukukhulu kangakanani. Ngalesi sikhathi, abahlinzeki bezempilo bazokuqapha ngokucophelela.

Ukwelashwa kungafaka:

• Imithi yezinhlungu
• Tube ngamakhala akho ungene esiswini sakho ukuze ukhiphe isisu sakho futhi unciphise isicanucanu nokuhlanza

Uzonikezwa futhi uketshezi ngomthambo (IV) kuze kube yilapho umhlinzeki wakho ezwa ukuthi usukulungele ukuqala ukuphuza noma ukudla. Lokhu kungenzeka ngokushesha nje ngosuku olulandelayo ngemuva kokuhlinzwa.

Uzodinga ukulandelela nodokotela wakho ohlinzayo esontweni elilodwa noma amabili ngemuva kokuhlinzwa.

Iningi labantu abenze lokhu kuhlinzwa linomphumela omuhle. Kepha imiphumela yanoma yikuphi ukuhlinzwa incike empilweni yakho yonke. Khuluma nodokotela wakho ngomphumela wakho olindelekile.

I-Meckel diverticulectomy; I-Meckel diverticulum - ukuhlinzwa; I-Meckel diverticulum - ukukhanda; Ukopha kwe-GI - I-Meckel diverticulectomy; Ukopha emathunjini - iMeckel diverticulectomy

• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile

• I-diverticulectomy kaMeckel - uchungechunge

UFransman RB, uHarmon JW. Ukuphathwa kwe-diverticulosis yamathumbu amancane. Ku: UCameron AM, uCameron JL, ama-eds. Ukwelashwa Kwamanje. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2020: 143-145.

UHarris JW, i-Evers BM. Amathumbu amancane. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 49.