Ukushintsha Amathrendi Okuhlinzwa Kwe-Bariatric

Ukuhlinzwa bariatric empeleni igama eliyiqoqo elinikezwe i-Gastric Bypass Surgery nokunye ukuhlinzwa kokuncipha kwesisindo okuhlobene. Ukuhlinzwa kwe-Bariatric kuvame ukusetshenziselwa iziguli ezikhuluphele kakhulu ukunciphisa isisindo sazo. Izinhlobo zokuhlinzwa kwe-Bariatric zifaka i-Biliopancreatic diversion with duodenal switch (BPD/DS), Gastric Bypass (Roux-en-Y), kanye ne-Sleeve gastrectomy.

Iziguli ezikhuluphele kakhulu zisengozini yezimo eziningana zezokwelapha, kuhlanganise nesifo sikashukela, i-cholesterol ephezulu, umfutho wegazi, izifo zenhliziyo, njll. Uma ukudla kanye nendlela yokuphila kushintsha kuphela akukwazi ukusiza lezi ziguli, khona-ke ukuhlinzwa kwe-bariatric kwenziwa esimweni esinjalo.

Ukuhlinzwa kokuqala kwe-bariatric kwenziwa ngendlela ye-Gastric Bypass ngo-1954. Odokotela nethimba baxhumanisa ithumbu elingenhla nelingaphansi kwaphumela ekudluleni inani elikhulu lama-calories. Le nqubo ngokwayo kamuva yashintshwa ngokungeza i-Jejunocolic Shunt ngo-1963, lapho ithumbu elincane elingaphezulu lalixhunywe ku-Colon. Lokhu kwakwaziwa ngokuthi iJejuno-ileal Bypass. Kwakuyinqubo engcono kodwa kwaholela ebunzimeni obuthile kamuva. Kusukela lapha kuqhubeke, I-Bariatric Surgery iye yaba nezinguquko eziningana phakathi neminyaka.

Ngo-1967, i-mini bypass yasungulwa lapho isisu sagxiliswa khona, futhi ithumbu elincane ladlula. Lokhu kwakubizwa ngokuthi i-Intestinal Bypass futhi yayisebenza kahle ekwehliseni isisindo. Kodwa-ke, kuholele emiphumeleni engathandeki efana ne-anemia, ukuvuza kwe-anastomotic, nokunye ukuntuleka komsoco. 

Kusukela ngeminyaka yawo-1990, izinqubo zokuhlinza kwesisindo esizaziyo namuhla zathuthukiswa. Isibonelo, ibhande lesisu lathuthukiswa, elalandelwa ngokushesha ukushintshwa kwe-Duodenal. I-Gastric Bypass (Roux-en-Y) yasungulwa ngo-1996 nguDkt. Scopinaro kanye no Gianetta. Le nqubo ibihloselwe ukwehlisa izinkinga ezibangelwa yi-Intestinal Bypass.

Ukubheka okushintsha njalo Izitayela zakamuva zokuhlinzwa kwe-bariatric phakathi neminyaka, kungashiwo ukuthi ukuhlinzwa kuye kwathuthuka kakhulu ukuze kuthuthukiswe imiphumela nokunciphisa izinkinga.

Izigaba ze-Bariatric Surgery Evolution

Abacwaningi be-Bariatric & Metabolic Institute bahlukanise lezi zindlela ezishintshayo zokuhlinzwa kwe-Bariatric zibe yizigaba ezintathu ezilandelayo,

1. Isigaba Sokuphayona:

Lesi sigaba, ngawo-1900, njengoba kuchazwe ngaphambili, yilapho ukwehla kwesisindo kanye nezinqubo ze-Gastric Bypass zathuthukiswa. Lesi sigaba sathuthukiswa ngokusekelwe ekuqapheliseni ukuthi ukudlula noma ukukhipha ingxenye yamathumbu kungaholela ekwehleni kwesisindo. Njengoba ukuhlinzwa kwenziwa futhi kuthuthukiswa izinkinga, amasu amasha athuthukiswa ngokuhamba kwesikhathi ukuze kuncishiswe lezi zinkinga. Lesi kwakuyisigaba lapho kwenziwa i-Jejuno-ileal Bypass. Kodwa-ke, ukutholwa okubaluleke kakhulu kwalesi sikhathi kwakuyi-bypass yesisu kanye ne-gastric band. Lezi zinqubo zaqale zenziwa ekuhlinzweni okuvulekile futhi, ngokuhamba kwesikhathi, ngisho nange-laparoscopically.

2. Isigaba se-Laparoscopic:

Kulesi sigaba, cishe ngo-1994, i-Laparoscopic Adjustable Gastric Banding (LAGB) yathuthukiswa. Ukuduma kwe-Bariatric Surgery kukhuphuke kwafinyelela phezulu eminyakeni embalwa eyalandela njengoba kwenziwa intuthuko ezinqubweni ze-laparoscopic zamathumbu. Lesi kwakuyisigaba lapho emazweni amaningi, izikhungo ezikhethekile ze-Excellences zithuthukiswa lapho odokotela emtholampilo izibhedlela ezingcono kakhulu zokuhlinza i-bariatric eNdiya baqeqeshwe ngokukhethekile ukwenza inqubo ye-laparoscopic bariatric. 

Nokho, lokhu kuthandwa okukhulayo kwashintsha ngokushesha, futhi izitayela zaqala ukwehla. Isizathu esiyinhloko salokhu kuguqulwa kwamathrendi kwakuyizimo eziningi zokusebenza kabusha kanye nezinkinga zesikhathi eside ezihlobene nenqubo ye-LABG. Ukuze kuxazululwe le nkinga, inqubo entsha ebizwa ngokuthi i-Laparoscopic Sleeve Gastrectomy (LSG) yasungulwa. Le nqubo ibe yimpumelelo, futhi izinkinga ezimbalwa ezihlobene ne-LAGB zaxazululwa yi-LSG. 

Kodwa-ke, izitayela nge-LSG nazo zashintsha ngemva kweminyaka embalwa njengoba ukuthuthukiswa kwezinkinga ezimbalwa kanye nesifo se-Gastroesophageal reflux GERD kwabikwa ezigulini ze-LSG.

3. Isigaba Se-Metabolic:

Isigaba sakamuva kakhulu esenzeke kule minyaka eyishumi edlule kumathrendi ahlobene Nokuhlinzwa Kwesifo Sezinzwa sihlonzwe abacwaningi njengesigaba se-metabolic. Kulesi sigaba, imithelela ye-metabolic kanye nezindlela Zokuhlinzwa Kwe-Bariatric zihlonziwe. Kwahlonzwa ukuthi indlela yokuqala yokwenza eyaholela ekwehleni kwesisindo ngokuvinjelwa kanye ne-malabsorption kamuva yaba izinguquko zePhysiological. Lesi sigaba manje sibhekene nezinguquko ze-metabolic ezenzeka emzimbeni ngokushesha ngemva kokuhlinzwa kwe-bariatric. Ucwaningo olukhulu kanye nezifundo ziyenziwa emkhakheni ukuze kuqondwe imithelela ye-metabolic ye-Bariatric Surgery.

Ngokuhamba kweminyaka, ukuhlinzwa kokunciphisa umzimba kuye kwazuza ukuthandwa phakathi koquqaba. Manje, abanye abantu baze babafunele ngenxa yezizathu zobuhle ngisho noma bengakhuluphali. Kodwa-ke, kufanele kuqashelwe ukuthi ukuhlinzwa kwe-Bariatric ezinkulungwaneni zabantu kuyinqubo ebalulekile yokuthuthukisa izinga lempilo yabo futhi baphile ngendlela enempilo. 

Ngakho-ke i-Bariatric Surgery ingasindisa izimpilo. Kodwa kungase kube neminye imithelela ngokomzimba. Ngokuthuthuka kwezobuchwepheshe kanye nocwaningo kulo mkhakha, kungase kufaneleke ukuthemba ukuthi esikhathini esizayo, kungase kuthuthukiswe Izinqubo Ze-Bariatric ezengeziwe ezingase zibhekane nemiphumela engemihle ebangelwa izinqubo zamanje ngendlela engcono.