T h a m do o b u n g la m ot d o n g tac bat b uo c c h o moi t r u o n g hop. Ti en h a n h th a m do toan o b u n g c h u k h o n g chi t h a m do m ot v un g tieu k h u n g . Q u a y den soi len p hi a tren c h o p he p q u an sat tang c a o c u a o b u n g , da c biet c h u y den gan. Sau do q u a y kfnh soi h u o n g ve phia tieu k h u n g , bat dau t h a m do tieu k h u n g ( hnih 16 x e m 6 phu ban). Luu y sau khi da c h o c du c a c trocart, nen g ia m ap luc o b u n g x u o n g c o n 12 m m Hg va duy tri o ap luc t r ong s uot tien trinh p h i u thuat. Boi vi ap luc o b u n g tu 12 m m Hg tro x u o n g k h o n g c o anh h u o n g gi d en h u y e t d o n g c u a ngudi b enh. T r o n g mo t so t r u o n g h o p da c biet (can de c a m m a u ) c o the’ tang ap luc t rong o b u n g len den 18 m m Hg n h u n g voi didu kien chi tang t r on g vai phut c u n g voi s u theo doi c h a t c h e c u a bac sT gay me. T r o n g q u a trinh noi soi, co the tang luu l uo n g b o m c u a khi C 0 2 len c a o h on ( k h o a n g 5 -6 lit/phut) t rong n h u n g t r u o ng h op C 0 2 bi that t ho at nhi6u n h u doi trocart, d u n g laser, h o joint ...
A p d u n g noi soi de p h i u t huat la mo t t rong nhieu tien bo c u a y ho c t ro n g vai th ap ky v u a qua. N i m v u n g va t ha nh t ha o c ac ky t huat c o ba n la dieu kien tien q u y e t g i u p c h o p h i u t huat noi soi t h a n h c o n g .
TAI LIEU THAM KHAO
1. Bruhat M A , M a g e G, P o ul y J L, M a n h e s H, C an i s M, W a t t i e s A - C o e l i o s c o p i e o p e r a t o i r e - M E D S I / M c G R A W - H I L L , 1989.
2. Blanc B, Boubli L, - E n d o s c o p i e ut er ine - e d i t i o n Pr ade l, 1996.
3. G l o w a c z o w e r E, R a i g a J, W a t t i e z A, C an i s M, Bruhat M A - M i s e e n pl a ce de la c o e l i o c h i r u r g i e .
4. W a t t i e z A, B ot ch or is hvi li R, - Mate rie l et t e c h n i q u e s de ba se de la c o e l i o c h i r u r g i e . 5. M e n c a g l i a L, W a t t i e z A - M a n u a l o f g y n e c o l o g i c a l l a p a r o s c o p i c s u r g e ry , 1998. 6. L a n s a c J, B od y G, M a g n i n G - C h i ru rg i e par voie c o e l i s c o p i q u e . La p r a ti qu e c h i r u g i c a l e en g y n e c o l o g i e - o b s t e t r i q u e , M a s s o n , 1998. 7. Q u e r l e u D - C o e l o s c o p i e d i a g n o s t i q u e et o p e r a t o i r e . T e c h n i q u e s c h i r u r g i c a l e s en g y n e c o l o g i e , M a s s o n 1995, 29.
CAC PHITONG PHAP CAM MAUAP DUNG TRONG PHAU THUAT NOI SOI AP DUNG TRONG PHAU THUAT NOI SOI
N g u y e n t ) U c H i n h
C a m m a u luon luon di lien voi phdu thuat du la pha u t hu at m a b u n g h a y phau thuat noi soi. D a c biet t rong phdu thuat noi soi, c a m m a u la m o t thi rat q u a n trong. Co nhi6u t r u o ng h a p phdu thuat noi soi phai c h u y e n s a n g p h a u t huat m o b u n g vl k h o n g the c a m m a u d u g c . H o n nura t ro n g luc phdu t huat noi soi, neu c a m m a u k h o n g tot se g a y c an t r a rat lan c h o c u o c phdu thuat, thdi gian phdu thuat se rat dai. VI vay c a c phdu thuat vien m d noi soi nen ndm v un g t h e m c a c ky thuat c a m m a u c o the ap d u n g d ug c.
C h u n g toi xin liet ke mo t so p h u o n g p h a p c a m m a u ha y d u g c a p du ng : - C a m m a u b i n g h u ye t t hanh a m, b dng a p luc c ao - D o t dien - Thdt chi - Clip - L a s e r - Sieu a m
T r o n g bai n a y c h u n g toi chi trinh b a y 4 ky t huat dau vi l aser va sieu a m da d u g c trinh ba y t ro n g mo t bai rieng.