Ukuhlinzwa kokudlula esiswini

Ukudlula esiswini ukuhlinzwa okusiza ukwehlisa isisindo ngokushintsha ukuthi isisu sakho namathumbu akho amancane akuphatha kanjani ukudla okudlayo.

Ngemuva kokuhlinzwa, isisu sakho sizoba sincane. Uzozizwa ugcwele ngokudla okuncane.

Ukudla okudlayo ngeke kusangena kwezinye izingxenye zesisu sakho namathumbu amancane amunca ukudla. Ngenxa yalokhu, umzimba wakho ngeke uthole wonke ama-calories ekudleni okudlayo.

Uzoba ne-anesthesia ejwayelekile ngaphambi kwalokhu kuhlinzwa. Uzobe ulele futhi ungenazinhlungu.

Kukhona izinyathelo ezimbili ngesikhathi sokuhlinzwa kokudlula esiswini:

• Isinyathelo sokuqala senza isisu sakho sibe sincane. Udokotela wakho ohlinzayo usebenzisa ukudla okuyisisekelo ukuze ahlukanise isisu sakho sibe yingxenye encane engenhla nesigaba esikhulu esingezansi. Ingxenye ephezulu yesisu sakho (ebizwa ngokuthi isikhwama) yilapho ukudla okudlayo kuzoya khona. Isikhwama sicishe silingane ne-walnut. Iphatha cishe i-ounce elilodwa (i-oz) noma ama-28 amagremu (g) ​​wokudla. Ngenxa yalokhu uzodla kancane bese wehlisa isisindo.
• Isinyathelo sesibili ukudlula. Udokotela wakho ohlinzayo uxhuma ingxenye encane yamathumbu akho amancane (ijejunum) emgodini omncane esikhwameni sakho. Ukudla okudlayo manje kuzohamba kusuka esikhwameni kungene kule mbobo entsha nakumathumbu akho amancane. Njengomphumela, umzimba wakho uzomunca amakhalori ambalwa.

Ukudlula esiswini kungenziwa ngezindlela ezimbili. Ngokuhlinzwa okuvulekile, udokotela wakho ohlinzayo wenza ukusika okukhulu kokuhlinzwa ukuvula isisu sakho. Ukudlula kwenziwa ngokusebenza esiswini sakho, emathunjini amancane, nakwezinye izitho.

Enye indlela yokwenza lokhu kuhlinzeka ukusebenzisa ikhamera encane, ebizwa nge-laparoscope. Le khamera ibekwe esiswini sakho. Ukuhlinzwa kubizwa ngokuthi yi-laparoscopy. Ububanzi buvumela udokotela ohlinzayo ukuthi abone ngaphakathi kwesisu sakho.

Kulokhu kuhlinzwa:

• Udokotela ohlinzayo usika okuncane okuyi-4 kuye kwayi-6 esiswini sakho.
• Ububanzi namathuluzi adingekayo ukwenza ukuhlinzwa afakwa ngalokhu kusikeka.
• Ikhamera ixhunywe kumonitha wevidiyo osegumbini lokusebenza. Lokhu kuvumela udokotela ohlinzayo ukuthi abuke ngaphakathi esiswini sakho ngenkathi enza ukuhlinzwa.

Izinzuzo ze-laparoscopy ngokuhlinzwa okuvulekile zifaka:

• Ukuhlala esibhedlela isikhashana nokwelashwa ngokushesha
• Ubuhlungu obuncane
• Izibazi ezincane kanye nengozi ephansi yokuthola i-hernia noma ukutheleleka

Lokhu kuhlinzwa kuthatha amahora amabili kuya kwangu-4.

Ukuhlinzwa kwesisindo kungaba yindlela ongakhetha kuyo uma ukhuluphele kakhulu futhi ungakwazanga ukwehlisa isisindo ngokudla nangokuzivocavoca umzimba.

Odokotela bavame ukusebenzisa inkomba yomzimba (BMI) nezimo zempilo ezinjengesifo sikashukela sohlobo 2 (isifo sikashukela esaqala ebudaleni) nomfutho wegazi ophakeme ukuthola ukuthi yibaphi abantu okungenzeka bahlomule ngokuhlinzwa okwehlisa isisindo.

Ukuhlinzwa ngokudlula esiswini akuyona indlela esheshayo yokulungisa ukukhuluphala. Izoshintsha kakhulu indlela ophila ngayo. Ngemuva kwalokhu kuhlinzwa, kufanele udle ukudla okunempilo, ulawule osayizi bezingxenye zalokho okudlayo, nokuzivocavoca umzimba. Uma ungalandeli lezi zinyathelo, ungaba nezinkinga kusuka ekuhlinzweni nasekunciphiseni kwesisindo esibi.

Qiniseka ukuthi uxoxa ngezinzuzo nezingozi nodokotela wakho ohlinzayo.

Le nqubo inganconywa uma une:

• I-BMI engama-40 noma ngaphezulu. Umuntu one-BMI engama-40 noma ngaphezulu okungenani amakhilogremu ayi-100 (amakhilogremu angama-45) ngaphezu kwesisindo sakhe esinconyiwe. I-BMI ejwayelekile iphakathi kuka-18.5 no-25.
• I-BMI engama-35 noma ngaphezulu nesimo esibi sezempilo esingathuthuka ngokulahleka kwesisindo. Ezinye zalezi zimo ukuvimbela ukuphefumula kokulala, uhlobo lwesibili sikashukela, nesifo senhliziyo.

Ukudlula esiswini ukuhlinzwa okukhulu futhi kunezingozi eziningi. Ezinye zalezi zingozi zibucayi kakhulu. Kufanele uxoxe ngalezi zingozi nodokotela wakho ohlinzayo.

Izingozi zokuthola i-anesthesia nokuhlinzwa ngokujwayelekile zifaka:

• Ukungezwani komzimba nemithi
• Izinkinga zokuphefumula
• Ukopha, amahlule egazi, ukutheleleka
• Izinkinga zenhliziyo

Izingozi zokudlula esiswini zifaka:

• I-gastritis (ulwelwesi oluvuvukele ulwelwesi), isilungulela, noma izilonda zesisu
• Ukulimala esiswini, emathunjini, noma kwezinye izitho ngesikhathi sokuhlinzwa
• Kuvuza kulayini lapho izingxenye zesisu ziboshwe ndawonye
• Ukungondleki kahle
• Ukuqhuma ngaphakathi esiswini sakho okungaholela ekuvinjelweni emathunjini akho ngokuzayo
• Ukuhlanza ekudleni ngaphezu kwesikhwama sakho sesisu kungabamba

Udokotela wakho ohlinzayo uzokucela ukuthi uhlolwe futhi uvakashelwe nabanye abahlinzeki bokunakekelwa kwezempilo ngaphambi kokuba wenze lokhu kuhlinzwa. Ezinye zazo yilezi:

• Ukuhlolwa okuphelele ngokomzimba.
• Ukuhlolwa kwegazi, i-ultrasound ye-gallbladder yakho, nokunye ukuhlolwa ukuze uqiniseke ukuthi uphilile ngokwanele ukuze uhlinzwe.
• Ukuhambela nodokotela wakho ukuze uqiniseke ukuthi ezinye izinkinga zezokwelapha ongahle ube nazo, njengesifo sikashukela, umfutho wegazi ophakeme, nezinkinga zenhliziyo noma zamaphaphu ziyalawulwa.
• Ukwelulekwa ngokudla okunempilo.
• Amakilasi okuzokusiza ufunde ukuthi kwenzekani ngesikhathi sokuhlinzwa, ukuthi yini okufanele uyilindele ngemuva kwalokho, nokuthi yiziphi izingcuphe noma izinkinga ezingase zivele ngemuva kwalokho.
• Ungahle ufune ukuvakashela umeluleki ukuze uqiniseke ukuthi ukulungele ngokomzwelo lokhu kuhlinzwa. Kufanele ukwazi ukwenza izinguquko ezinkulu empilweni yakho ngemuva kokuhlinzwa.

Uma ubhema, kufanele uyeke amasonto ambalwa ngaphambi kokuhlinzwa futhi ungaphinde uqale ukubhema ngemuva kokuhlinzwa. Ukubhema kubambezela ukululama futhi kwenyuse nobungozi bezinkinga. Tshela udokotela wakho noma umhlengikazi uma udinga usizo lokuyeka.

Tshela udokotela wakho ohlinzayo noma umhlengikazi:

• Uma ukhulelwe noma kungenzeka ukhulelwe
• Imiphi imithi, amavithamini, amakhambi, nezinye izithako ozithathayo, ngisho naleyo oyithenge ngaphandle kadokotela

Phakathi nesonto ngaphambi kokuhlinzwa kwakho:

• Ungacelwa ukuthi uyeke ukuthatha imithi eyenza kube nzima ngegazi lakho ukuminyana. Lokhu kufaka phakathi i-aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), nezinye.
• Buza udokotela wakho ukuthi yimiphi imithi okufanele uyithathe ngosuku lokuhlinzwa kwakho.
• Lungisa ikhaya lakho emva kokuhlinzwa.

Ngosuku lokuhlinzwa:

• Landela imiyalo yokuthi ungakuyeka nini ukudla nokuphuza.
• Thatha imithi udokotela wakho akutshele ukuthi uyiphuze ngesiphuzo esincane samanzi.
• Fika esibhedlela ngesikhathi.

Iningi labantu lihlala esibhedlela izinsuku ezi-1 kuya kwezi-4 ngemuva kokuhlinzwa.

Esibhedlela:

• Uzocelwa ukuthi uhlale eceleni kombhede uhambe kancane ngosuku olufanayo lapho uhlinzwa khona.
• Ungaba nepayipi (ithubhu) elingena ngamakhala akho lingene esiswini usuku olulodwa noma olungu-2. Le tube isiza ukukhipha uketshezi oluvela emathunjini akho.
• Ungaba ne-catheter esinyeni sakho ukususa umchamo.
• Ngeke ukwazi ukudla izinsuku zokuqala ezi-1 kuya kwezi-3. Ngemuva kwalokho, ungaba neziphuzo bese ukudla okumsulwa noma okuthambile.
• Ungaba neshubhu exhunywe engxenyeni enkulu yesisu sakho eyeqiwe. I-catheter izophuma eceleni kwakho futhi izokhipha uketshezi.
• Uzogqoka amasokisi akhethekile emilenzeni yakho ukusiza ukuvimbela amahlule egazi.
• Uzothola isibhamu somuthi ukuvimbela amahlule egazi.
• Uzothola umuthi wezinhlungu. Uzophuza amaphilisi ezinhlungu noma uthole umuthi wezinhlungu nge-IV, ipayipi elingena emthanjeni wakho.

Uzokwazi ukuya ekhaya lapho:

• Ungadla oketshezi noma okumsulwa ngaphandle kokuphalaza.
• Ungazungeza ngaphandle kobuhlungu obuningi.
• Awudingi umuthi wezinhlungu nge-IV noma onikezwe ngokudutshulwa.

Qiniseka ukuthi ulandela imiyalo yokuthi ungazinakekela kanjani ekhaya.

Iningi labantu lilahla cishe amakhilogremu ayi-10 kuye kwangama-20 (4.5 kuya ku-9 kilograms) ngenyanga ngonyaka wokuqala ngemuva kokuhlinzwa. Ukwehla kwesisindo kuzokwehla ngokuhamba kwesikhathi. Ngokunamathela ohlelweni lwakho lokudla nokuvivinya umzimba kusukela ekuqaleni, ulahlekelwa isisindo esithe xaxa.

Ungalahlekelwa uhhafu owodwa noma ngaphezulu wesisindo sakho esengeziwe eminyakeni emibili yokuqala. Uzokwehlisa isisindo ngokushesha ngemuva kokuhlinzwa uma usawukudla oketshezi noma okumsulwa.

Ukulahlekelwa isisindo esanele ngemuva kokuhlinzwa kungathuthukisa izimo eziningi zezokwelapha, kufaka phakathi:

• Isifuba Somoya
• Isifo se-reflux se-gastroesophageal (GERD)
• Umfutho wegazi ophezulu
• I-cholesterol ephezulu
• I-apnea yokulala evimbela
• Thayipha 2 sikashukela

Ukukala okuncane kufanele futhi kukwenze kube lula kakhulu kuwe ukuhambahamba nokwenza imisebenzi yakho yansuku zonke.

Ukwehlisa isisindo nokugwema izinkinga ezivela kule nqubo, uzodinga ukulandela ukuzivocavoca kanye nemihlahlandlela yokudla oyinikezwe ngudokotela nodokotela wakho wokudla.

Ukuhlinzwa kwe-Bariatric - ukudlula esiswini; Ukudlula esiswini kweRoux-en-Y; Ukudlula esiswini - iRoux-en-Y; Ukuhlinzwa kwesisindo - ukudlula esiswini; Ukuhlinzwa ngokweqile - ukudlula esiswini

• Ngemuva kokuhlinzwa kwesisindo - yini ongayibuza udokotela wakho
• Ukuphepha kwamakamelo abantu abadala
• Ngaphambi kokuhlinzwa kwesisindo - yini okufanele ubuze udokotela wakho
• Ukuhlinzwa kokudlula esiswini - ukukhipha
• I-laparoscopic gastric banding - ukukhipha
• Ukuvimbela ukuwa
• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile
• Lapho unesicanucanu nokuhlanza
• Ukudla kwakho ngemuva kokuhlinzwa kokudlula esiswini

• Ukuhlinzwa kwesisu kweRoux-en-Y yokwehlisa isisindo
• Ukubhinca esiswini okungaguquguquki
• Kuqondile banded gastroplasty
• Ukuphambukiswa kwe-Biliopancreatic (BPD)
• Ukuphambukiswa kwe-Biliopancreatic nge switch duodenal
• Ukulahla isifo

I-Buchwald H. Laparoscopic Roux-en-Y isisu esedlula. Ku: Buchwald H, ed. I-Atlas ye-Buchwald yeMetabolic & Bariatric Njira Zokuhlinza kanye nenqubos. IPhiladelphia, PA: Elsevier Saunders; 2012: isahluko 6.

I-Buchwald H. Open Roux-en-Y yokudlula esiswini. Ku: Buchwald H, ed. I-Atlas yeBuchwald Yezinqubo Nezinqubo Zokuhlinza ze-Metabolic & Bariatric. IPhiladelphia, PA: Elsevier Saunders; 2012: isahluko 5.

URichards WO. Ukukhuluphala ngokweqile. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; I-2017: isahluko 47.

USullivan S, Edmundowicz SA, uMorton JM. Ukwelashwa kokuhlinzwa kanye ne-endoscopic yokukhuluphala. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 8.