Umkhono oqondile we-gastrectomy

I-vertical sleeve gastrectomy ukuhlinzwa ukusiza ekunciphiseni isisindo. Udokotela ohlinzayo ususa ingxenye enkulu yesisu sakho.

Isisu esisha, esincane silingana nobhanana. Kukhawulela inani lokudla ongakudla ngokwenza uzizwe ugcwele ngemuva kokudla ukudla okuncane.

Uzothola i-anesthesia ejwayelekile ngaphambi kwalokhu kuhlinzwa. Lo muthi okwenza uhlale ulele futhi ungabi nezinhlungu.

Ukuhlinzwa kuvame ukwenziwa kusetshenziswa ikhamera encane efakwa esiswini sakho. Lolu hlobo lokuhlinzwa lubizwa ngokuthi yi-laparoscopy. Ikhamera ibizwa nge-laparoscope. Ivumela udokotela wakho ohlinzayo ukuthi abone ngaphakathi esiswini sakho.

Kulokhu kuhlinzwa:

• Udokotela wakho ohlinzayo usika (ukusikeka okuncane) okumbili 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.
• Igesi engenabungozi ifakwa esiswini ukuyinweba. Lokhu kunikeza igumbi labahlinzayo ukusebenza.
• Udokotela wakho ohlinzayo ususa iningi lesisu sakho.
• Izingxenye ezisele zesisu sakho zihlanganisiwe kusetshenziswa ukudla okuyisisekelo kokuhlinzwa. Lokhu kudala ithubhu ende emile noma isisu esimise okwebhanana.
• Ukuhlinzwa akubandakanyi ukusika noma ukushintsha imisipha ye-sphincter evumela ukudla ukungena noma ukuphuma esiswini.
• Ububanzi namanye amathuluzi ayasuswa. Ukusikeka kuthungiwe kuvaliwe.

Ukuhlinzwa kuthatha imizuzu engama-60 kuya kwengu-90.

Ukuhlinzwa kwesisindo kungakhuphula ingozi yakho yamatshe enyongo. Udokotela wakho ohlinzayo angancoma ukuthi ube ne-cholecystectomy. Lokhu ukuhlinzwa ukukhipha i-gallbladder. Kungenziwa ngaphambi kokuhlinzwa kwesisindo noma ngasikhathi sinye.

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

I-sleeve eqondile yomkhono akuyona indlela esheshayo yokukhuluphala. 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.

Le nqubo inganconywa uma une:

• Inkomba yomzimba (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.

I-vertical sleeve gastrectomy ivame ukwenziwa kubantu abasindayo kakhulu ukuthi bangaba nezinye izinhlobo zokuhlinza zokwehlisa isisindo ngokuphepha. Abanye abantu bangagcina sebedinga ukuhlinzwa okwehlisa isisindo kwesibili.

Le nqubo ayikwazi ukuhlehliswa uma seyenziwe.

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

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

Izingozi zemikhono emi mpo yilena:

• I-gastritis (ulwelwesi oluvuvukele ulwelwesi), isilungulela, noma izilonda zesisu
• Ukulimala esiswini, emathunjini, noma kwezinye izitho ngesikhathi sokuhlinzwa
• Kuvuza kulayini lapho izingxenye zesisu ziboshwe ndawonye
• Ukudla okunomsoco, yize kuncane kakhulu kunokuhlinzwa okwedlula esiswini
• 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 bakho bezokunakekelwa kwempilo ngaphambi kokuba uhlinzwe. 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 kwenyusa ubungozi bezinkinga. Cela umhlinzeki wakho akusize uyeke.

Tshela udokotela wakho ohlinzayo:

• 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 yokwehlisa igazi. Lokhu kufaka phakathi i-aspirin, ibuprofen (Advil, Motrin), uvithamini E, i-warfarin (i-Coumadin, i-Jantoven), nezinye.
• Buza udokotela wakho ukuthi yimiphi imishanguzo okufanele usayiphuza ngosuku lokuhlinzwa kwakho.

Ngosuku lokuhlinzwa kwakho:

• Landela imiyalo yokuthi ungakuyeka nini ukudla nokuphuza.
• Thatha izidakamizwa udokotela wakho akutshele ukuthi uziphuze ngophuzo oluncane lwamanzi.
• Fika esibhedlela ngesikhathi.

Cishe ungaya ekhaya ezinsukwini ezimbili ngemuva kokuhlinzwa kwakho. Kufanele ukwazi ukuphuza iziphuzo ezicacile ngosuku ngemuva kokuhlinzwa, bese udla ukudla okumsulwa ngesikhathi oya ekhaya.

Uma uya ekhaya, mhlawumbe uzonikezwa amaphilisi ezinhlungu noma uketshezi kanye nomuthi obizwa nge-proton pump inhibitor.

Uma udla ngemuva kokuhlinzwa lokhu, isikhwama esincane sizogcwala ngokushesha. Uzozizwa usuthi ngemuva kokudla inani elincane kakhulu lokudla.

Udokotela ohlinzayo, umhlengikazi, noma ingcweti yokudla uzokuncomela ukudla. Ukudla kufanele kube kuncane ukugwema ukwelula isisu esisele.

Ukwehla kwesisindo kokugcina kungenzeka kungabi kukhulu njengokudlula esiswini. Lokhu kungakwanela abantu abaningi. Khuluma nodokotela wakho ohlinzayo ngokuthi iyiphi inqubo ekufanele kakhulu.

Isisindo ngokuvamile sizophuma kancane kunokuhamba ngokudlula esiswini. Kufanele uqhubeke nokwehlisa isisindo seminyaka engafinyelela kwemibili kuya kwemithathu.

Ukulahlekelwa isisindo esanele ngemuva kokuhlinzwa kungathuthukisa izimo eziningi zezokwelapha ongahle ube nazo. Izimo ezingathuthuka yisifuba somoya, uhlobo 2 sikashukela, isifo sokuqaqamba kwamalunga, umfutho wegazi ophakeme, ukuvimbela ukuphefumula kokulala, i-cholesterol ephezulu nesifo se-gastroesophageal (GERD).

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

Lokhu kuhlinzwa kukodwa akusona isisombululo sokwehlisa isisindo. Kungakuqeqesha ukuthi udle kancane, kepha kusamele wenze umsebenzi omningi. Ukwehlisa isisindo nokugwema izinkinga ezivela kule nqubo, uzodinga ukulandela ukuzivocavoca kanye nemihlahlandlela yokudla okunikezwa udokotela wakho ohlinzayo nodokotela wokudla.

I-Gastrectomy - umkhono; I-Gastrectomy - ukugoba okukhulu; I-Gastrectomy - i-parietal; Ukunciphisa isisu; I-gastroplasty eqondile

• Inqubo yemikhono yesisu

I-American Society for Metabolic and Bariatric Surgery iwebhusayithi.Izinqubo zokuhlinzwa ze-Bariatric. asmbs.org/patients/bariatric-surgery-procedures#sleeve. Kufinyelelwe ngo-Ephreli 3, 2019.

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.

I-Thompson CC, uMorton JM. Ukwelashwa kokuhlinzwa kanye ne-endoscopic yokukhuluphala. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. ISleisenger neFordtran's Gastrointestinal and Liver Disease: IPathophysiology / Diagnosis / Management. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 8.