Ina whakaaro tātou ki te pokanga, ko te nuinga o tātou e whakaaro ana ki ngā mea whakamataku pērā i te motu nui, te noho hōhipera mō ētahi rā, me te mamae roa, tika? Engari ināianei, kua tino whanake te pūtaiao hauora. I tēnei rā, ka kōrero tātou mō tētahi pokanga whakamiharo e mahia ana me te kore e motu nui, engari mā roto i tētahi kōhao iti noa iho. Koinei te mea e kiia nei e tātou ko te Pokanga Whakaekenga iti, ko te MIS rānei e kiia nei e ngā tākuta.
He aha te Pokanga Whakaiti i te Urunga (MIS)?
He ariā tino māmā noa iho tēnei. Whakaarohia mēnā he tikanga noa tāu pokanga, me tapahi te tākuta i tētahi tapahi nui, he maha inihi pea te roa, kia tae atu ai ki te wāhi e mahia ana te pokanga. Engari ki te MIS, ka iti noa iho ngā tapahi ka mahia e ngā taote pokanga i roto i tō kiri me ō kiko. Ko te tikanga, kaua e tapahi kotahi te tapahi nui, ka mahia e rātou tētahi, neke atu rānei , he tapahi rite ki te rahi o te kōhao kī .
Mā roto i ēnei kōhao iti, ka whakauruhia he ngongo angiangi me te kāmera e piri ana (e kiia ana tēnei he endoscope) me ngā taputapu pokanga roa, angiangi kua hangaia mō te tinana. Nā te mea ka whakaaturia ngā whakaahua mai i te kāmera ki runga i te mata nui (aroturuki), ka taea e te tākuta te kite mārama i roto i te tinana, ā, ka tino tika te mahi i te pokanga. Mā tēnei ka whakaitihia tō mamae, ō raruraru, me te wā whakaora.
He aha ngā tikanga matua mō te mahi i ēnei pokanga?
He maha ngā momo tikanga kei roto i te hangarau MIS. Ka tīpakohia ēnei tikanga i runga i te momo pokanga me te wāhanga tinana e rongoatia ana.
1. Pokanga Kōhao Kī
Koinei te tikanga tino rongonui. E ai ki te kōrero i runga ake nei, ka mahia te pokanga mā te hanga i ētahi tapahi iti, ka whakaurua he kāmera (he 'endoscope') mā roto i tētahi, ā, ka whakaurua ngā taputapu pokanga mā roto i ētahi atu.
- I roto i ngā pokanga puku, ka kiia tēnei kāmera he laparoscope . Ka kiia aua pokanga he pokanga laparoscopic .
- He kāmera te thoracoscope e whakamahia ana mō ngā pokanga e pā ana ki te kōhao o te uma.
- Ka whakamahia he arthroscope hei tirotiro i roto i ngā hononga pēnei i te turi me te pakihiwi.
2. Pokanga Robotic
Ko tētahi atu wāhanga matatau o te hangarau MIS tēnei. I konei, hei utu mō te whakahaere ā-ringa i ngā taputapu, ka noho te taote pokanga ki te papatohu rorohiko, ka whakahaere i ngā ringa karetao . Ka whakauruhia ēnei ringa karetao mā roto i ngā tapahi iti. Mā tēnei tikanga ka taea ngā pokanga tino ngawari, iti hoki, me te tino tika. Ko te 'Pūnaha Pokanga Da Vinci' rongonui tētahi o aua pūnaha karetao.
3. Pokanga Endovascular
He tikanga tino rerekē tēnei. Ko te mahi i konei ko te hanga i tētahi kōhao iti rawa ki te ngira, ka whakauru i tētahi ngongo angiangi (catheter) mā roto i taua ngongo ki roto i tētahi oko toto. Kātahi ka tukuna ngā taputapu e tika ana mā roto i taua ngongo, ā, ka mahia ngā pokanga pēnei i te whakatakoto i tētahi stent ki roto i te ngākau, pēnei i te "stent", me te "angioplasty". I ētahi wā, kāore e hiahiatia he tapahi i konei.
4. Pokanga Kōhao Taiao
I tēnei tikanga, kāore he tapahi e mahia ana i roto i tō tinana. Engari, ka whakauruhia he endoscope mā roto i ngā pūaha tūturu o te tinana, pērā i te waha me te ihu, ā, ka mahia ngā pokanga pērā i te tango i ngā pukupuku i roto i te puku me te korokoro.
He aha ngā pokanga e tino whakamahia ana mā te whakamahi i te tikanga MIS?
I ēnei rā, he maha ngā pokanga e mahia ana mā te whakamahi i tēnei tikanga MIS. Mā te ripanga i raro nei koe e āwhina ki te mārama ki tēnei.
| Momo pokanga | Ngā tauira |
|---|---|
| Puku (Laparoscopic) | Te tango i te pūkahukahu `(cholecystectomy)`, te tango i te apendiks `(appendectomy)`, te whakatika hernia `(hernia repair)`. |
| Urological | Te tango i ngā whatukuhu `(nephrectomy)`, te tango i te prostate `(prostateectomy)`. |
| Tuaiwi | Te whakakotahitanga o te tuaiwi, te tango i ngā pukupuku tuaiwi. |
| E pā ana ki te ngākau | Te whakatikatika i te takirere o te ngākau (te whakatikatika i te takirere mitral), te kati i ngā kōhao i te ngākau (te whakatikatika i te koha o te septal atrial). |
| Te tirotiro i te uaua o te hononga o te waewae | Te whakatika i ngā whara o te pakihiwi, te turi, te hope rānei. |
| Te whakahekenga taumaha (Bariatric) | Ngā pokanga ringaringa puku me ngā pokanga karo puku. |
Mā wai tēnei pokanga e pai ai? Ka taea e te katoa te mahi?
I ngā wā maha, he haumaru ake tēnei tikanga MIS i te pokanga tuwhera tuku iho. Inaa, i ētahi wā, ahakoa te hunga kāore e taea te aro ki tētahi motu nui, ki ētahi atu mate hauora rānei, ka taea te pokanga mā te whakamahi i tēnei tikanga.
Heoi, kāore i te rite tonu tēnei mō te katoa. Mā tō taote pokanga e whakatau mēnā he tika tēnei tikanga māu i muri i te tirotiro mārire i tō āhua hauora.
Hei tauira:
- Kāore e taea te whakamahi i tēnei tikanga i ngā wā e hiahiatia ana te pokanga wawe, pērā i te tangata kua whakaurua ki te ETU (Emergency Treatment Unit) i muri i tētahi aituā, nā te mea me whai whakarite.
- I te wā o te pokanga laparoscopic, ka pupuhihia te hau waro hauhā ki roto i te puku hei āwhina i te tiro i ngā whekau. He mea morearea pea tēnei mō te hunga whai mate manawa, mate pūkahukahu rānei .
Nō reira, ki te hiahia koe ki te pokanga, he mea pai kia kōrero koe ki tō tākuta mō tēnei tikanga, kia rapu tohutohu ai hoki.
He aha ngā painga me ngā ngoikoretanga o ēnei pokanga?
Pērā i tētahi atu tikanga, he painga, he ngoikoretanga hoki ōna.
Ngā Painga
- He iti rawa te kino (ngā whara) ki te tinana.
- He iti noa te toto e puta i te wā o te pokanga.
- He iti ake te mōrearea o ngā raruraru i tērā i te pokanga tuwhera.
- Nā te iti rawa o ngā tapahi, he iti rawa ngā koha i muri i te whakaoranga, kāore rānei e kitea.
- He poto ake ngā rā e noho ana koe i te hōhipera. Ka taea e koe te hoki ki te kāinga i taua rā anō i muri i ētahi pokanga.
- He poto rawa te wā whakaora. Ahakoa he maha ngā marama e ora ai te motu nui, ka ora ēnei motu iti i roto i ētahi wiki.
- Nā te iti o te mamae, kāore hoki e hiahiatia he rongoā whakamamae.
Ngā ngoikoretanga
- E hiahiatia ana he taote pokanga kua whakangungua motuhake me ngā taputapu motuhake, utu nui hoki mō tēnei.
- Kāore pea tēnei ratonga e wātea ana i ngā hōhipera katoa .
- Tērā pea ka roa ake te pokanga i te pokanga tuku iho.
- E ai ki te kōrero i runga ake nei, kāore i te pai mō ngā āhuatanga ohorere.
- Mō ētahi tāngata (ina koa ko te hunga he mate manawa/pūkahukahu), tera pea ētahi mōrearea mō te whakamahi i te hau mō te pokanga.
Karere Tangohia ki te Kāinga
- Ko te Pokanga Whakaekenga Iti (MIS) he tikanga pokanga hou e whakamahi ana i ngā tapahi iti, pērā i ngā kōhao kī, hei utu mō ngā tapahi nunui.
- Ko ngā painga matua ko te iti o te mamae, te tere o te ora, te iti o te wā e noho ana i te hōhipera, me te iti o ngā koha.
- He maha ngā tikanga MIS e whakamahia whānuitia ana i ēnei rā, pērā i te laparoscopy me te pokanga karetao.
- Kāore tēnei tikanga e pai mō ngā tūroro katoa, mō ngā āhuatanga katoa rānei.
- Mena me pokanga koe, he mea tino nui kia kōrero koe ki tō tākuta mō te tika o te tikanga MIS mōu me ōna painga me ōna huakore, ā, kia mārama ai te whakatau.
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