Laparoskopik Xolesistektomiya nədir?

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Op. Dr. Kamran Beydullayev, MRCS İngiltərə, Ümumi və Transplant Cərrah, 0504063853

Kamran Beydullayev
Kamran Beydullayev
laparoskopik xolesistektomiya

Laparoskopik xolesistektomiya nədir?

Öd kisəsinin laparoskopik üsulla çıxarılmasına laparoskopik xolesistektomiya deyilir.  Laparoskopik üsul dedikdə minimal invaziv cərrahi üsul nəzərdə tutulur ki, bu əməliyyat zamanı video kameranın köməyindən və nazik alətlərdən istifadə edilir.

Laparoskopik cərrahi əməliyyat zamanı qarının divarında kiçik (0.5-1sm) kəsiklər aparılır və bu ölçülü diametrdə olan port adlanan boruşəkilli plastik ya metal instrumentlər bu kəsiklərdən qarın boşluğuna yerləşdirilir. Video kamera və nazik laparoskopik instrumentlər bu portlardan qarın boşluğuna yeridilir. Kamera qarın daxili orqanların görüntüsünü televizor monitoruna ötürür. Cərrah bu orqanları açıq cərrahi əməliyyatda olduğu kimi böyük cərrahi kəsikdən birbaşa deyil, monitorda görür. Video kamera cərrahın gözlərini əvəz edir və cərrah alınan görüntünün və digər instrumentlərin köməyi ilə əməliyyatı yerinə yetirir.

 

 

 

Minimal invaziv cərrahi əməliyyatın üstünlükləri əməliyyatdan sonra ağrıların az olması, sürətli bərpaolma vaxtı, xəstəxanada qalma müddətinin qısalması, tam aktivliyə daha erkən dönmə və daha kiçik ölçülü çapıq toxumasının olmasıdır. Əməliyyatdan sonra qarındaxili bitişmələrin də olması daha az olur.

öd kisəsi əməliyyatı – laparoskopik xolesistektomiya

Laparoskopik xolesistektomiya nə qədər təhlükəlidir?

Çox təhlükəsiz əməliyyat hesab edilir. Ümimi ağırlaşma olmaq ehtimalı 2%-in altındadır.

 

Laparoskopik xolesistektomiya necə həyata keçirilir?

  • Ümumi anesteziya altında aparılır
  • Göbək nahiyəsində 1sm ölçüdə kəsik aparılır, port və videokamera yerləşdirilir. Daha bir dənə 1sm-lik kəsik epiqastral nahiyədə edilir, digər iki 0.5sm kəsiklər isə sağ qabırğa altında edilir və bunlardan da instrumentləri daxil etmək üçün istifadə edilir.
  • Video kameranın görüntüsü ilə və instrumentlərin köməyi ilə öd kisəsi axarı və arteriyası bağlanıb kəsilir, kisə qaraciyərdən soyulub ayrılır.
  • Kisə 1sm lik portların birindən çıxarılır.
laparoskopik xolesistektomiya – öd kisəsi əməliyyatı

Bəzi hallarda əməliyyatı laparoskopik davam etmək olmur. Buna səbəb adətən qarın boşluğunda olan bitişmələr, öd kisəsi və öd yolları anatomiyasının aydın olmaması və əməliyyat zamanı qanaxma ola bilər. Əməliyyatın açıq üsula keçilməsinin əsas səbəbi xəstənin təhlükəsizliyini təmin etməkdir. Əməliyyatın açıq üsula keçməsinə təsir edən faktorlar adətən artıq çəkili xəstələr, xəstənin əvvəllər əməliyyat keçirməsi, əməliyyat daxili qanaxma olur.

Hansı ağırlaşmalar ola bilər?

Əməliyyat adətən ağırlaşmasız keçir. Amma 2% ehtimalla müxtəlif əməliyyatətrafı ağırlaşmaların olması riski var. Bunlara qanaxma, infeksiya, öd qaçağı və sairə aiddir. Əməliyyat zamanı öd kisəsi ətrafı orqanların zədələnməsi ehtimalı var. Bəzən xəstənin təkrar əməliyyata ehtiyacı olur.

öd kisəsi əməliyyatı
laparoskopik xolesistektomiya
öd kisəsi əməliyyatı
laparoskopik xolesistektomiya

 

 

 

 

 

 

Əməliyyatdan sonra xəstə xəstəxanada nə qədər qalır?

Xəstə qida qəbul etməyə başlayan kimi xəstəxanadan evə yazıla bilər. Bu adətən əməliyyatın səhərisi gün olur. Bəzi xəstələr hətta əməliyyat axşamı da evə gedirlər. Açıq əməliyyatda isə bu rəqəm 5 gündür.

laparoskopik xolesistektomiya

 

 

 

 

 

 

 

 

 

Bunlar da maraqlı ola bilər.

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