II. CAC TAI BIEN, BIEN CHUTNG
5. Sur dung laser trong phau thuat noi so
L a s e r la m o t p h u o n g tien phau t huat co hieu n a n g rat c a o va rat c h i n h x ac ddi vdi c a c p h i u t huat vien c d k inh n g h i e m . N g u g c lai, no trd ne n rat n g u y hi£m neu p h i u t huat vien c h u a cd kinh n g h i e m p h i u t huat noi soi. Su tiep xuc k h o n g nhin t ha y co the gay ra thiing ruot d xa. K h o n g nen sir d u n g laser t rong noi soi neu k h o n g d u g c d a o tao p h i u t huat noi soi m ot c a c h c i n than va c h u a q u e n sir d u n g laser t rong m d b u n g k inh die’n. D e dd p h o n g tai bien nay, n g u d i ta sir d u n g tay d a o laser " b ac k s t o p " , b o m n u d e m uo i s in h ly va o c un g do Douglas, tdn trong c ac c h on g chi dinh, dac biet la c ac vung g i n ruot.
Ill- KET LUAN
P h i u t hua t noi soi c d rat n hi eu uu d i e m va d a c d rat n h i e u tien bo t ro n g n h u n g n a m g a n day. T u y n hi e n, p h i u t huat noi soi c u n g c d c a c tai b i e n va c a c bi en c h u n g n g u y h ie m c d the g a y tu vong. D e lam g i a m c a c tai b ie n , c a n phai n h a n m a n h rang:
- C a c p h i u t hu at vien noi soi c an d u g c d a o tao cdn than. - C a n n d m vurng c a c c h o n g chi dinh.
- T d n t r o n g c a c q u y t i c an to an c u a p h i u t huat noi soi de t r a n h c a c tai bi en c u a c h o c k im b o m hoi, c h o c trocart, t ra n h tai bien tdn t h u o n g r u ot va m a c h m a u .
- C am m a u ky khi phdu thuat.
- K i e m tra cdn th an toa n bo c a c bo pha n d u g c boc t ach de t r a n h bo sot c a c t6n t h u o n g t h u n g ruot, b an g q u a n g , nieu q ua n.
Ki nh n g h i e m c h o thay, viec ton t rong c a c q u y tdc ve an to an va c a c c h o n g chi dinh c ua c ac ky thuat c o the tranh dugc cai tai bien c u a phau thuat noi soi.
TAI LIEU THAM KHAO
1. M - A Bruhat, G . M a g e , J - L . P o u l y , H . M a n h e s , M . C a n i s , A. W a t t i e z . C o e l i o s c o p i e o pe ra toi re . M e d s i / M c G r a w - Hill Paris 1989. 133 - 152. 2. C . C h a p r o n , G . M a g e , M . Ca r is , J - L P o u l y , A . W a t t i e z , S.Bassil, D . Q u e r l e u , M - A Bruhat- C o m p l i c a t i o n s c h i r u r g i c a l e s de la c o e l i o s c o p i e o p e r a t o i r e en g y n e c o l o g i e . L a C h i r u g i e A b d o m i n o - p e l v i e n n e pa r c o e l i o s c o p i e . Spr inger - v e r lu a Paris 1992, 81 - 86. 3. L u c a M e n c a g l i a Paris, A . W a t t i e z — C o m p l i c a t i o n s o f l a p a r o s c o p y . M a n u a l o f g y n e c o l o g i c a l l a pa r o s c o p i c s ur ge r y. E n d o pre ss, T u t t l i n g e n 1998. 74 - 79.