Ndiani chiremba mukuru wevanachiremba? Ngatitaurei nezvazvo zviri nyore!

Ungave wakanzwa nezve 'General Surgeon'. Kana kuti pamwe wakasangana nemumwe wemhuri yako kana shamwari. Ndiani chaizvo chiremba mukuru wevanachiremba? Anoita basa rei? Vakasiyana sei nevamwe vanachiremba? Ngatitaurei nezveizvi zvese nemutauro uri nyore weSinhala waunogona kunzwisisa.

Ndiani chaizvo chiremba mukuru wezvirwere zvepfungwa?

Zvichitaurwa zviri nyore, chiremba mukuru wezvirwere zvese chiremba pamwe chete nechiremba wezvirwere zvese. Izvi zvinoreva kuti anogona kuongorora zvirwere, kuzvirapa, uye kana zvichidikanwa, kuita oparesheni. Chinhu chakakosha ndechekuti vanhu ava havangogumiri pachikamu chimwe chete chemuviri. Kungofanana nachiremba wemhuri yedu, asi vanogonawo kuita oparesheni.

Semuenzaniso, vamwe vanachiremba vanoongorora moyo ('Cardiologist') kana uropi ('Neurology'). Asi chiremba mukuru anoshanda munzvimbo yakakura zvikuru. Semuenzaniso, vanogona kurapa nhengo dzemudumbu ('nhengo dzemudumbu'), bundu mune dzimwe nhengo dzemuviri wako, kana kukuvara kwakawanda kubva mutsaona panguva imwe chete. Ndivo vanoita basa guru mukutarisira murwere asati avhiyiwa ('preoperative'), panguva yekuvhiyiwa ('operative'), uye mushure mekuvhiyiwa ('postoperative'). Kazhinji ndivo vanoshanda pamwe chete nevamwe vanachiremba nevanamukoti.

Kuvhiya kwakajairika ndeimwe yemabasa gumi nemana ekuvhiya anozivikanwa neAmerican College of Surgeons.

Chii chinorapwa nachiremba mukuru wezvekuvhiya?

Ndakambotaura kare kuti chiremba mukuru wezvirwere zvakafanana ne "chiremba wemhuri anogonawo kuvhiya." Saka vanorapa zvirwere zvakasiyana-siyana. Uye, kurapwa ikoko kunosanganisira kuvhiya kwakasiyana-siyana. Zvisinei, kana chiremba mukuru wezvirwere achifunga kuti haana chivimbo chakazara mukurapa chirwere chakati, achakutumira kuna nyanzvi. Ndiwo mutoro wavo zvakare.

Ndezvipi zvirwere zvinowanzorapwa?

Heano mamwe ematambudziko anowanzo rapa chiremba mukuru:

• Kukuvara kwekukuvara: Fungidzira vachirapa kukuvara kwakakomba kunokonzerwa netsaona kana kudonha pavanenge vachifamba mumugwagwa.
• Zvisina kumira zvakanaka mumuviri: Izvi zvinogona kunge zviri zvirema zvekuzvarwa nazvo kana kuti mapundu anokura pazera rehupenyu.
• Kenza yemazamu: Kenza yemazamu, iyo inogona kuitika kuvarume nevakadzi, inorapwa nekuvhiyiwa.
• Zvirwere zvemudumbu wepamusoro:Izvi zvinoreva zvirwere zvine chekuita negurokuro, dumbu, uye ura hudiki. Semuenzaniso, kana zvinhu zvakaita segastritis zvikawedzera kuipa, ungangoda kuvhiyiwa ne endoscopy kana kutovhiyiwa.
• Nzira yenyongo: Izvi zvinosanganisira gallbladder, ducts yenyongo, pancreas, nechiropa. Matombo enyongo anowanzo bviswa nekuvhiyiwa nachiremba mukuru.
• Matambudziko eEndocrine: Semuenzaniso, kuvhiyiwa kunoitwa kurapa bundu mugland rethyroid kana adrenal glands.
• Matambudziko etsinga dzeropa: Anopindirawo mune mamwe matambudziko etsinga dzeropa.
• Kurwara kwakanyanya uye chirwere chisingarapiki: Dzimwe nguva vanovhiyiwa zvinodiwa nevarwere vari mumakamuri ekuchengetwa kwakanyanya, kana mune zvimwe zvinhu zvinoitwa kuderedza marwadzo evarwere pakupera kwehupenyu hwavo.

Unova sei Surgeon General?

Kuva chiremba wepfungwa hakusi nyore. Kutanga, vanofanira kuva chiremba. Izvi zvinoreva kuti vanofanira kudzidza kwemakore mana kuchikoro chekurapa vowana "dhigirii rezvepfungwa". Ndipo pavanotanga kudzidziswa kuva chiremba wepfungwa.

Kuti vaite izvi, vanofanirwa kupedza chirongwa chekugara kwenguva refu chemakore mashanu kana kupfuura . Kudzidziswa uku kunoitwa zvishoma nezvishoma. Kureva kuti, mushure mekupedza gore rimwe chete zvinovapa mukana wekupinda mugore rinotevera.

Kunyangwe mushure mekupedza kudzidziswa uku, vachiri kufanira kupasa bvunzo mbiri dzebhodhi kuti vave chiremba mukuru ane certification.

1. Yekutanga ibvunzo yekukodzera . Iyi ibvunzo yakanyorwa ine mibvunzo ine mhinduro dzakawanda.

2. Kana wapasa bvunzo iyi chete ndipo paunozokwanisa kunyora bvunzo ye "certification" . Iyi bvunzo yemuromo.

Munhu anozozivikanwa se "Certified General Surgeon" mushure mekupasa bvunzo idzi mbiri chete. Saka fungidzira kuti izvi zvinoda kuzvipira kwakadini uye kushanda nesimba!

Chii chinodzidzwa nachiremba mukuru wezvekuvhiya?

Chiremba wezvekuvhiya anodzidza zvakadzama nezvezvikamu zvipfumbamwe zvikuru zvekuvhiya panguva yekudzidziswa kwake. Izvi ndeizvi:

• Nzira yekugaya: Izvi zvinoreva chikamu chega chega chegadziriro yedu yekugaya.
• Nhengo dzemudumbu nedzemuchiuno: Nhengo dziri mukati medumbu, dzakadai sechiropa, itsvo, nepancreas.
• Mazamu, ganda nenyama dzakapfava: Vanodzidzawo nezvezvinhu zviri pamusoro pemuviri.
• Musoro nemutsipa:Vanorapawo mamwe mamiriro ezvinhu anoitika munzvimbo idzi.
• Sisitimu yemwoyo: Ruzivo rwekutanga nezvemoyo netsinga dzeropa.
• Sisitimu yeEndocrine: Sisitimu yemagland anogadzira mahormone.
• Kuvhiyiwa kwekenza: Izvi zvinoreva kurapwa kwegomarara kuburikidza nekuvhiyiwa.
• Kukuvara: Izvi zvinosanganisira kukuvara kwetsandanyama nemapfupa, kukuvara kwemusoro, uye kukuvara kwemaoko.
• Kuvhiyiwa kwevarwere vane chirwere chakakomba uye kwekukurumidzira: Zvinhu zvakaita sekuvhiyiwa kunoponesa hupenyu zvinofanirwa kuitwa nekukasika.

Panguva yekudzidziswa kwavo, vanofanirwa kupedza makore mana nehafu kubva mumakore mashanu vachishanda nevarwere. Uye makore matatu zvichikwira vachishanda munzvimbo pfumbamwe huru dzambotaurwa. Havagone kudzidziswa kwemwedzi inopfuura gumi nemiviri muchirongwa chimwe chete chekuvhiya kana kupfuura mwedzi mitanhatu muchirongwa chekurapa chisina kuvhiya. Izvi zvinoreva kuti kudzidziswa kwavo kunofanira kunge kwakafara zvikuru.

Chii chinoitwa nachiremba mukuru wezvekurapa?

Kana chiremba mukuru achipedza kudzidziswa kwake oenda kubasa, maoparesheni nekurapwa kwaanoita nguva dzose zvinogona kusiyana zvichienderana nechipatara chaanoshanda, kungave kuri muguta guru kana kuti munzvimbo iri kure.

Fungidzira, muchipatara chikuru, chine zvishandiso zvakanaka, panogona kunge paine nyanzvi dzekuvhiya dzinoita mamwe maoparesheni chaiwo. Semuenzaniso, chiremba wemwoyo anogona kuita maoparesheni emwoyo, uye chiremba wetsinga anogona kuita maoparesheni etsinga. Zvisinei, muchipatara chisina nyanzvi dzakawanda, chiremba mukuru anogona kuita mabasa mazhinji aya. Saka, basa ravo rakakosha zvikuru.

Ndeapi mavhiyiro anowanzoitwa?

Heano mamwe marudzi ekuvhiyiwa kwaunogona kutarisira kuti chiremba mukuru aite nguva dzose:

• Kuvhiya kwekudzivirira kudzoreredza ropa (Nissen fundoplication): Kuvhiya kwekudzivirira acid yemudumbu kuti isaenderere muhuro nekuda kwezvirwere zvakaita segastritis.
• Kubviswa kweAppendix (Appendix removal / Appendectomy): Kana hutachiona (appendicitis) hukaitika muchikamu chidiki chemuviri chinonzi appendix, hunobviswa nekuvhiyiwa.
• Kuvhiya kweBariatric (kuderedza uremu): Kuvhiya kubatsira vanhu vakafuta zvakanyanya kuderedza uremu.
• Kuvhiyiwa kwezamu: Kuvhiyiwa kwebundu rezamu, rakadai sekenza yemazamu.
• Kuvhiyiwa kwekuongorora (Laparotomy kana Laparoscopy): Kana chirwere chikasazivikanwa, mukati memuviri munovhurwa kana kuti kamera inoiswa kuti ionekwe mukati.
• Kubviswa kwenyongo (Cholecystectomy): Kubviswa kwenyongo kana paine matambudziko akadai sematombo enyongo.
• Kuvhiyiwa kwekugadzirisa hernia:Kugadzirisa hernia (kubuda kwezvikamu zveura nepanzvimbo isina kusimba mumadziro edumbu).
• Kubviswa kweprostate (Prostatectomy): Kuvhiyiwa kunoitwa kuvarume kurapa zvirwere zvakaita sekenza yeprostate.
• Kubviswa kwetsvina (Spleenectomy): Tsvina inogona kudiwa kubviswa nekuda kwezvirwere zveropa netsaona.
• Kubviswa kwechibereko (Hysterectomy): Kuvhiyiwa kunoitwa kurapa mamwe mamiriro ane chekuita nechibereko muvakadzi.

Ndedzipi nzira dzekuvhiya?

Mazuva ano, vanachiremba vanovhiya varwere vakadzidziswa kushanda netekinoroji yemazuva ano ('tekinoroji-inobatsira nzira dzekuvhiya'). Izvi zvinoreva kuti pachinzvimbo chekushandisa mavanga makuru nenzira yekare, vanoshandisa mavanga madiki uye mavhiyirwo anobatsirwa nekamera. Nzira idzi dzinokonzera kusagadzikana kumurwere uye dzinogonawo kumubatsira kuti apore nekukurumidza.

Pane nzira nhatu chete:

1. Endoscopy

2. Kuvhiyiwa kweLaparoscopic

3. Kuvhiyiwa kwerobhoti

Chii chinonzi Endoscopy?

Iyi inzira inoshamisa zvikuru. Endoscopy inzira inobvumira chiremba wekuvhiya kuti aite maoparesheni madiki mumuviri wako asingacheki ganda rako kana nyama. Fungidzira, vanoshandisa zvishandiso zvirefu, zvitete. Izvi zvinopfuudzwa nemuchubhu refu, rinochinjika rinonzi endoscope. Kumucheto kwechubhu iyi kune kamera diki yevhidhiyo.

Iyi 'endoscope' inopfuudzwa nepahuro pako ('endoscopy yepamusoro') kana mudumbu ('colonoscopy'). Mifananidzo inoonekwa kubva pakamera inoratidzwa pa 'screen'. Chiremba anoshandisa zvishandiso zvidiki izvi kuita oparesheni iyi achitarisa screen.

Zvichitaurwa zviri nyore, uku kuongororwa kana kuvhiyiwa kudiki kunosanganisira kuisa kamera mudumbu pasina kucheka zvakanyanya.

Zvinhu zvinonyanya kuitwa kuburikidza ne endoscopy ndeizvi:

• Kubviswa kwema polyps madiki kana bundu (polypectomy).
• Kutora sampuli dzenyama kuti dziongororwe (biopsy).
• Kucheka nekusunungura tsandanyama dzakasimba (`myotomy`).

Chii chinonzi laparoscopic surgery?

Kuvhiyiwa kweLaparoscopic inzira yekuvhiyiwa isinganyanyi kupindira mumuviri . Mukuita izvi, chiremba anosvika nhengo dzedumbu rako kuburikidza nekucheka kudiki kwe "keyhole", kusingasviki hafu yeinji muhukuru .

Chubhu ine kamera inonzi laparoscope (rudzi rwe endoscope) inopinzwa kuburikidza nerimwe remaburi uye mukati munotariswa. Mifananidzo kubva pakamera inoonekwa pachiratidziro. Zvishandiso zvekuvhiya zvakareba, zvitete zvinopinzwa kuburikidza nemamwe maburi uye kuvhiyiwa kunoitwa uchitarisa pachiratidziro. Nzira iyi inobvumira murwere kuti apore nekukurumidza uye inosiya mavanga mashoma.

Kuvhiyiwa kunonyanya kuitwa navanachiremba vezvekurapa vanovhiya kwakajairika ndekwekuti:

• Appendectomy kuvhiyiwa kwe appendicitis.
• Kuvhiyiwa kwematombo emunduru (Cholecystectomy).
• Kuvhiyiwa kwegastric bypass kuvhiyiwa kwekuderedza uremu.

Chii chinonzi kuvhiyiwa kwemarobhoti?

Kuvhiya kweRobotic inzira yepamusoro yekuvhiya kwe laparoscopic. Inoshandisa laparoscope nemidziyo mirefu, mitete inopinda nepamaburi madiki emakiyi. Musiyano ndewekuti michina iyi inoshandiswa nemaoko erobhoti.

Asi izvi hazvirevi kuti robhoti rinoita oparesheni iri roga. Chiremba anovhiya ruoko rwerobhoti kubva pakombiyuta iri mukamuri rekuvhiyira. Izvi zvinobvumira kuvhiyiwa kwakanyatsojeka uye kwakanyatsonaka. Vanachiremba vanogona kudzidza nezvekuvhiyiwa kwerobhoti panguva yekudzidziswa kwavo nguva dzose, kana kuti vanogona kuita mamwe kudzidziswa (fellowship).

Musiyano uripo pakati pechiremba mukuru wezvekurapa nechiremba wemazuva ese ndeupi?

Uyu mubvunzo unobvunzwa nevanhu vazhinji. Muvhiyi wese chiremba. Asi havasi chiremba wese chiremba. Vanachiremba vanhu vari vanachiremba uye vanowana mamwe kudzidziswa uye chitupa chekuita kuvhiya. Muchidimbu, kuvhiya inzira inoitwa mukati memuviri wemunhu, senge nhengo, nyama, nemapfupa, kurapa kukuvara kana zvirwere.

Chiremba Mukuru (kana kuti Chiremba Mukuru - PCP) chiremba anoshanda nekurapa kwakajairika, kwete nyanzvi. Kazhinji havavhiyi.

Kune rumwe rutivi, chiremba mukuru wezvekuvhiya chiremba akasarudza kuve nyanzvi mukuvhiya. Havangogumiri pabasa rimwe chete rekuvhiya, asi vanoshanda mumunda wakakura we "kuvhiya kwakajairika."

Zvinotora nguva yakareba sei kuti uve Surgeon General?

Chimbofungai, munyika yakaita seAmerica, zvinotora makore mana kuti uwane dhigirii reBachelor's. Zvinotora mamwe makore mana kuti uwane dhigirii reMedical. Zvinotora makore mashanu kuti uwane surgery residency. Izvozvo makore gumi nematatu! Zvinotora nguva kuti upase bvunzo dzebhodhi dzandambotaura. Saka, unofanira kudzidza kwemakore gumi nematatu kuti uve chiremba mukuru. Hazvisi kuzvipira kukuru here?

Musiyano uripo pakati peChiremba Mukuru neChiremba weVana ndeupi?

Iyi ipfungwa inokoshawo. Chiremba wevana wese chiremba mukuru. Asi havasi chiremba mukuru wese chiremba mukuru.

Muchidimbu, chiremba wevana munhu akadzidzira basa rekurapa vana uye akazowana mamwe kudzidziswa kwakakosha ekurapa vana. Zvakafanana nachiremba wevana, asi chiremba uyu anogonawo kuvhiya.

Chiremba wezvekurapa akafanana nachiremba wemazuva ose ane simba rakawedzerwa. Simba iroro kugona kurapa zvirwere zvakasiyana-siyana muimba yekuvhiyira.

Zvinoda kudzidziswa kwakawanda, ruzivo, uye hunyanzvi kuti uve munhu akadai. Asi ibasa rinogutsa zvikuru. Nekuti hapana mazuva maviri akafanana. Nguva dzose pane matambudziko matsva, zviitiko zvitsva.

Pakupedzisira, zvinhu zvekurangarira (Mharidzo Yekuenda Kumba)

Zvakanaka, saka ndinofunga kuti wava nepfungwa yakanaka nezvechiremba mukuru wezvekuvhiya.

• Chiremba mukuru wezvekuvhiya chiremba ane hunyanzvi akadzidziswa kuita maoparesheni akasiyana-siyana. Haangogumiri pachikamu chimwe chete chemuviri.
• Dzinorapa zvinhu zvakawanda, zvakaita sematambudziko emudumbu, tsaona, bundu remazamu, uye hernias.
• Vanotarisira murwere vasati vavhiyiwa, panguva yekuvhiyiwa, uye mushure mekuvhiyiwa.
• Vanogona kuita oparesheni vachishandisa nzira itsva dzakadai se 'Endoscopy' ne 'Laparoscopy', vachishandisa macheko mashoma.
• Kuva chiremba wezvekurapa kunoda dzidzo yakakura nekudzidziswa.
• Kana muchida kuvhiyiwa, chiremba wenyu anogona kukutumirai kuna chiremba mukuru. Musazvidya mwoyo, varipo kuti vakubatsirei.

Kana muine mimwe mibvunzo, taurai nachiremba wenyu. Rambai muine hutano hwakanaka!

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