I-Laparoscopic kanye ne-Bariatric Surgery

Isibhedlela esihamba phambili se-Bariatric and Laproscopic surgery e-Hyderabad, India

Ukukhuluphala ngokweqile kungabangela izifo eziningana ezisongela ukuphila kubantu. Abantu abahlushwa ukukhuluphala ngokweqile abane-BMI engaphezu kuka-40 nezimo ezisongela ukuphila kungase kudingeke badlule ezinqubweni ezithile zezokwelapha ukuze banciphise ingozi yezifo zabo.

I-Bariatric Surgery ingenye yezinqubo ezinjalo ezisetshenziselwa iziguli ezihlushwa ukukhuluphala kakhulu kanye nezinkinga eziningi ze-metabolic. Inhlanganisela yalokhu kokubili ingase ibeke ukuphila engozini. Ngakho-ke, ukuhlinzwa kwe-gastric bypass kanye nokunye ukuhlinzwa kokunciphisa umzimba (okubizwa ngokuthi ukuhlinzwa kwe-bariatric) kuvame ukutuswa kulezi ziguli. Kodwa-ke, kubalulekile ukukhumbula ukuthi ukuhlinzwa kwe-bariatric akuyona inqubo yezimonyo. Ngokuphambene nalokhu, kuyinqubo esindisa ukuphila enconywa kuphela ezigulini eziyidinga kakhulu. Lokhu kufaka phakathi labo abangakwazi ukuthuthukisa isimo sabo ngokusebenzisa izinguquko zokudla nokuzivocavoca. Ngaphezu kwalokho, ukuhlinzwa kuqukethe izinqubo ezinkulu ezingase zibe yingozi yemiphumela engemihle kanye nezici eziyingozi njenganoma yikuphi ukuhlinzwa okukhulu.

Ubani odinga ukuhlinzwa?

Ukuhlinzwa kuhloswe ukunciphisa isisindo seziguli ezikhuluphele kakhulu ezine-BMI engama-40 noma ngaphezulu ezisengozini yezimo ezisongela ukuphila njengomfutho wegazi ophakeme, i-cholesterol ephezulu, i-apnea yokulala, izifo zenhliziyo, unhlangothi, Uhlobo lwe-2 yesifo sikashukela, i-NAFLD (i-Nonalcoholic fatty disease) noma i-NASH (i-nonalcoholic steatohepatitis).

Abantu abane-BMI engu-35-40 nabo bangase banikezwe lokhu kuhlinzwa uma benezinkinga ezinzima ezihlobene nesisindo. Kodwa-ke, kufanele kukhunjulwe ukuthi ukuhlinzwa kudinga ukuthi iziguli zihlangabezane neziqondiso ezithile futhi akuwona wonke umuntu okhuluphele ongakhetha ukuhlinzwa kwe-Bariatric. Ngisho nangemva kwenqubo, iziguli kudingeka zenze izinguquko ezinkulu endleleni yokuphila futhi zilandele njalo ukuze ziqaphe isimo sempilo yazo.

Izinhlobo Zokuhlinzwa Kwe-Bariatric

• I-Gastric Bypass: Lena enye yezindlela ezivame ukushiwo zokuhlinzwa kwe-Bariatric. Indlela lokhu kuhlinzwa okusebenza ngayo ekwehliseni isisindo seziguli iwukwenza isikhwama esincane esisuka esiswini bese sixhuma isikhwama esisanda kwakhiwa ngqo emathunjini amancane. Ukudla okugwinywe ngumuntu bese kungena esikhwameni esincane kusuka lapho kuqondiswe khona emathunjini amancane. Ngale ndlela kuphela inani elilinganiselwe lokudla elingena emzimbeni wabo.
• Ukuhlinzwa Kwesisindo: Lolu olunye uhlobo lokuhlinzwa kwe-Bariatric lapho inhloso kuwukukhawulela ukudla kwesiguli. Lokhu kwenziwa ngokuvimbela isisu ukuthi singanwebeki size sigcwale. Phakathi nalokhu kuhlinzwa, udokotela ohlinzayo angasebenzisa amasu amathathu alandelayo:

  • Ibhande lesisu eliguquguqukayo le-laparoscopic

  • I-gastroplasty enebhande eliqondile

  • I-sleeve se-sleeve

  • I-Biliopancreatic diversion nge-duodenal switch (BPD/DS) 

Lolu olunye lwezinhlobo ezingavamile zokuhlinzwa kokunciphisa umzimba. Lokhu kwenziwa ngezinyathelo ezimbili, eyokuqala okuyi-sleeve gastrectomy. Esinyathelweni sesibili, ingxenye yamathumbu idlula bese ingxenye yayo yokugcina ixhunywe ku-duodenum eduze kwesisu. Inhloso yokuhlinzwa akukhona nje ukunciphisa inani lokudla umuntu elikudlayo kodwa futhi ukunciphisa ukumuncwa kwezakhi ezinjengamaprotheni namafutha.

Izici zengozi

Njengoba sekushiwo, ukuhlinzwa kwe-bariatric yigama elibhekisela ekuhlinzeni okuningana okuhloswe ngayo ukunciphisa isisindo somuntu. Njenganoma yikuphi okunye ukuhlinzwa, ukuhlinzwa kwe-bariatric kungase kudale izingozi ezithile zempilo. Lezi zinkinga zingase zibe ezesikhathi esifushane nezesikhathi eside. Amagciwane, ukopha kakhulu, amahlule egazi, ukuvinjelwa kwamathumbu, ukulahla imfucuza, izinkinga zokuphefumula, njll. yizici ezivamile zengozi ezihlobene nokuhlinzwa kwe-Bariatric.

Izinzuzo Zokuhlinzwa Kwe-Laparoscopic kanye Ne-Bariatric

Ukuhlinzwa kwe-laparoscopic, ikakhulukazi kumongo wokuhlinzwa kwe-bariatric (ukuhlinzwa kwesisindo), kunikeza izinzuzo eziningana uma kuqhathaniswa nezindlela zokuhlinza ezivulekile zendabuko. Nazi izinzuzo zokuhlinzwa kwe-laparoscopic kanye ne-bariatric:

Izinzuzo Zokuhlinzwa Kwe-Laparoscopic:

• I-Invasive Kancane: Ukuhlinzwa kwe-laparoscopic kuhilela ukwenza izimbotshana ezincane lapho kufakwa khona amathuluzi akhethekile nekhamera (i-laparoscope). Le ndlela yokuhlasela kancane ibangela ukuhlukumezeka kwezicubu ezincane, ubuhlungu obunciphile ngemva kokuhlinzwa, nokululama ngokushesha uma kuqhathaniswa nokuhlinzwa okuvulekile.
• Izimbobo Ezincane: Izinqubo ze-Laparoscopic zidinga ukucutshungulwa okuncane, okuholela ekubeni nezibazi ezincane kanye nemiphumela yezimonyo ethuthukisiwe. Iziguli zivame ukuzwa ukungakhululeki futhi zinezibazi ezincane, ezingabonakali uma kuqhathaniswa nokuhlinzwa okuvulekile.
• Ukululama Ngokushesha: Ngenxa yokuncipha kokuhlukumezeka kwezicubu nokusikwa okuncane, iziguli ezihlinzwa nge-laparoscopic ngokuvamile zithola ukuhlala esibhedlela okufushane kanye nezikhathi zokululama ngokushesha. Bangabuyela emisebenzini evamile, okuhlanganisa umsebenzi nokuzivocavoca, ngokushesha kunokuhlinzwa okuvulekile.
• Ingozi Encishisiwe Yezinkinga: Ukuhlinzwa kwe-laparoscopic kuhlotshaniswa nengozi ephansi yezinkinga ezifana nokutheleleka kwesilonda, i-hernias, nezinkinga zokusika uma kuqhathaniswa nokuhlinzwa okuvulekile. Indlela yokuhlasela kancane iholela ekulahlekelweni kwegazi elincane, amazinga aphansi okutheleleka, kanye nokuncipha kwengozi yezinkinga zangemva kokuhlinzwa.
• Ukubuka Okungcono Kakhulu: Izinqubo ze-Laparoscopic zinikeza odokotela abahlinzayo umbono okhulisiwe, onencazelo ephezulu yendawo yokuhlinza usebenzisa ikhamera efakwe ngenye yezicucu ezincane. Lokhu kuboniswa okuthuthukisiwe kuvumela ukunemba okukhulu, ukunemba, nokulawula phakathi nokuhlinzwa.
• Uhlu Olubanzi Lwezicelo: Ukuhlinzwa kwe-laparoscopic kungasetshenziswa ukwelapha izimo eziningi ezihlukahlukene kuzo zonke izici zezokwelapha ezihlukene, okuhlanganisa ukuhlinzwa kwe-bariatric, ukuhlinzwa kwamathumbu, ukuhlinzwa kwezifo zabesifazane, ukuhlinzwa komchamo, nokuhlinzwa okuvamile.

Izinzuzo Zokuhlinzwa Kwe-Bariatric:

• Ukunciphisa Isisindo Okuphumelelayo: Ukuhlinzwa kwe-Bariatric, okufana ne-gastric bypass, i-sleeve gastrectomy, kanye ne-gastric banding, kuphumelela kakhulu ekukhuthazeni ukwehla kwesisindo okubalulekile nokuqhubekayo ezigulini ezinokukhuluphala. Kungasiza abantu ukuthi bathole ukuncipha okukhulu kwesisindo futhi bathuthukise izimo zempilo ezihlobene nokukhuluphala njengesifo sikashukela sohlobo 2, umfutho wegazi ophakeme, kanye nesifo sokuphelelwa umoya.
• Ukuxazululwa Kwezimo Zezempilo Ezihlobene Nokukhuluphala: Ukuhlinzwa kwe-Bariatric kungaholela ekuxazululeni noma ekuthuthukisweni kwezimo zezempilo ezihlobene nokukhuluphala ngokweqile, okuhlanganisa uhlobo lwe-2 yesifo sikashukela, umfutho wegazi ophezulu, i-cholesterol ephezulu, i-apnea evimbela ukulala, nobuhlungu obuhlangene. Iziguli eziningi zithola ukuxolelwa kwalezi zimo ngemva kokuhlinzwa kwesisindo.
• Ikhwalithi Yempilo Ethuthukisiwe: Ukuhlinzwa kwe-Bariatric akusizi nje ukunciphisa umzimba kuphela kodwa futhi kuthuthukisa ikhwalithi yokuphila yonke. Iziguli zivame ukubika izithuthukisi ekusebenzeni komzimba, ukuhamba, ukuzethemba, isithombe somzimba, nokuphila kahle kwengqondo ngemva kokuhlinzwa kwesisindo.
• Ukugcinwa Kwesisindo Sesikhathi eside: Ukuhlinzwa kwe-Bariatric kunikeza impumelelo yesikhathi eside ekunciphiseni isisindo kanye nokugcinwa kwesisindo ezigulini eziningi. Kusiza abantu ukuba basebenzise imikhuba yendlela yokuphila enempilo, okuhlanganisa izinguquko zokudla kanye nokuzivocavoca okuvamile, okufaka isandla ekwehleni kwesisindo esiqhubekayo kanye nemiphumela yezempilo engcono ngokuhamba kwesikhathi.
• Ukwehliswa Kwezinto Eziyingozi Zenhliziyo: Ukuhlinzwa kwe-Bariatric kungaholela ekwehleni okukhulu kwezici eziyingozi zenhliziyo ezifana nomfutho wegazi ophakeme, amazinga aphezulu e-cholesterol, kanye nokumelana ne-insulin. Lokhu kunganciphisa ingozi yesifo senhliziyo, unhlangothi, nezinye izinkinga zenhliziyo nemithambo yegazi ezihlobene nokukhuluphala.

Ukwelashwa okunikezwa yi-CARE Hospitals

I-Institute of Laparoscopic & Bariatric Surgery e-Hyderabad inikeza odokotela abakhethekile kanye nokwelashwa kusetshenziswa izinqubo ezihlasela kancane. Lokhu kubandakanya okulandelayo:

• Ukuhlinzwa Kwesisindo: Lolu hlobo lokuhlinzwa lwenziwa ngezinqubo ezintathu ezilandelayo:

  • Ibhande lesisu eliguquguqukayo le-laparoscopic: Kule nqubo, udokotela ohlinzayo ubeka ibhande leSilastic elisesiswini ngaphansi kwepayipi lokudla. Lena enye yezinqubo ezincane kakhulu zokuhlinzwa kwe-bariatric ngoba esikhundleni sokusikeka okukhulu kwesisu, udokotela ohlinzayo wenza izimbotshana ezincane bese efaka ithuluzi le-laparoscopic elifakwe ikhamera ngaphakathi emzimbeni. Ukusebenzisa leli thuluzi ibhande libekwe.

  • I-Vertical Banded Gastroplasty:  Kule nqubo, ingxenye engaphezulu yesisu igxiliwe ngokubheka phezulu futhi isikhwama esincane senziwa engxenyeni engenhla yesisu eduze kwepayipi lokudla.

  • I-Sleeve Gastrectomy: Kulolu hlobo lokuhlinzwa kwe-bariatric, ingxenye enkulu engaba ngu-80% ikhishwa esiswini. Ngakho-ke, isisu sincishiswa cishe ku-15% womthamo waso wokuqala. Kulolu hlobo lwenqubo yokulahlekelwa isisindo, isisu sigcina sifana neshubhu noma umkhono.

• I-Gastric Bypass: Lona uhlobo oluvame kakhulu lokuhlinzwa kwe-bariatric. Izibhedlela ze-CARE zinikeza izinsiza ezisezingeni eliphezulu kanye nodokotela abangochwepheshe abanolwazi lweminyaka eminingi benza lolu hlobo lokuhlinzwa.

Izibhedlela ze-CARE zingasiza kanjani?

Izibhedlela ze-CARE zihlinzeka ngezinsiza zesimanje kanye odokotela abangochwepheshe bokuhlinzwa kwe-bariatric kanye ne-laparoscopic eHyderabad. Sigxila Ekuhlinzweni Kokufinyelela Okuncane okuvumela odokotela abahlinzayo ukuthi benze izinqubo eziyinkimbinkimbi besebenzisa izimbobo ezincane esikhundleni sezinqubo zokuhlinzwa ezivulekile ezihlaselayo. Cishe i-70% yokuhlinzwa okwenziwa ezibhedlela ze-CARE isebenzisa inqubo ye-MAS. Ngenxa yalokho, iziguli zizwa ubuhlungu obuncane bokusebenza futhi zithola ukululama ngokushesha. Izibhedlela ze-CARE ziphinde ziqinisekise ukuthi iziguli zihlolwa kabanzi ngaphambi kokuba zikhethe ukuhlinzwa. Ngaphezu kwalokho, ukunakekelwa okubanzi kunikezwa ngesikhathi sokulandelela inqubo. Ukuhlinzwa kwe-Bariatric kudinga ikhwalithi enhle nokunakekelwa kwangemva kwesikhathi okubanzi ukuze kugwenywe noma yiziphi izinkinga. Sinochwepheshe abenza ngokucophelela konke ukulandelela okudingekayo futhi bahlole iziguli zabo.