ʻO Meckel diverticulectomy

ʻO Meckel diverticulectomy kahi ʻoki e wehe i kahi ʻeke kūpono ʻole o ka pale o ka ʻōpū liʻiliʻi (ʻōpū). Kapa ʻia kēia ʻeke he divertikulum Meckel.

E loaʻa iā ʻoe ka anesthesia laulaha ma mua o ke kahakaha ʻana. E hiamoe kēia a ʻaʻole hiki iā ʻoe ke ʻeha.

Inā he ʻoki ākea kāu:

• E ʻokiʻoki kāu kauka lāʻau iā ʻoe i kahi ʻoki nui i kou ʻōpū e wehe i kahi.
• E nānā kāu kauka lāʻau i ka ʻōpū liʻiliʻi ma kahi e waiho ai ka ʻeke a i ʻole divertikulum.
• E hoʻoneʻe kāu mea lapaʻau i ka diverticulum mai ka paia o kou ʻōpū.
• I kekahi manawa, pono paha i ke kaukipō ke wehe i kahi ʻāpana o kou ʻōpū me ka divertikulum. Inā hana ʻia kēia, e humuhumu a hoʻopaʻa ʻia i nā hope hāmama o kou ʻōpū. Kapa ʻia kēia kaʻina hana he anastomosis.

Hiki i nā kauka hana ke hana i kēia ʻoki me ka hoʻohana ʻana i ka laparoscope. ʻO ka laparoscope kahi mea hana e like me ke teleskopa liʻiliʻi me kahi kukui a me ka pahu paʻi wikiō. Hoʻokomo ʻia i loko o kou ʻōpū ma o kahi ʻoki liʻiliʻi. Hōʻike ʻia ke wikiō mai ka pahu paʻi kiʻi ma kahi monitor ma ka lumi lumi. ʻAe kēia i ke kaukipō e ʻike i loko o kou ʻōpū i ka wā o ke kaha.

I ke kahakaha ʻana i ka hoʻohana ʻana i ka laparoscope:

• ʻEkolu a ʻelima mau ʻoki liʻiliʻi e hana ʻia i kou ʻōpū. E hoʻokomo ʻia ka pahu paʻi kiʻi a me nā pono hana ʻē aʻe ma o kēia mau ʻoki.
• Hiki paha i kāu kaukipoki ke ʻokiʻoki he 2 a 3 ʻīniha (5 a 7.6 cm) ka lōʻihi e kau i ka lima, inā pono.
• E hoʻopiha ʻia kou ʻōpū i ka ʻaila e hiki ai i ka mea lōkō ke ʻike i ka wahi a hana i ke ʻoki me kahi lumi hou e hana ai.
• Hana ʻia ka diverticulum e like me ka mea i hōʻike ʻia ma luna.

Pono ka mālama ʻana e pale ai:

• Kahena
• Hoʻopili i ka ʻōpū (kahi paʻa i kou ʻōpū)
• Maʻi kīnā
• Hoʻonā

ʻO ka ʻōuli maʻamau o ka Meckel diverticulum ka hoʻokahe ʻole ʻia o ke kahe mai ka pololei. Loaʻa i kāu pahu i ke koko hou a nānā ʻeleʻele a lohi paha.

Nā pilikia no ka anesthesia a me ke kahakaha ʻana ma:

• Nā hopena āpau i nā lāʻau a i ʻole nā ​​pilikia hanu
• Kahe ʻana o ke kahe, ke koko koko, a i ʻole ka maʻi

ʻO nā pilikia no kēia ʻoki kino penei:

• Poino i nā mea pili kokoke i ke kino.
• Wahi nā maʻi maʻi a i ʻole ka ʻeha ma hope o ke kaha ʻana.
• Hoʻopaʻa i ke kino ma o ka ʻokiʻoki. Kapa ʻia kēia he hernia incisional.
• Hiki ke hāmama nā kihi o kou ʻōpū i humuhumu a hoʻopaʻa ʻia (anastomosis). ʻO kēia paha ke kumu o nā pilikia hoʻoweliweli i ke ola.
• ʻO kahi e humuhumu pū ʻia nā ʻōpū hiki ke wili a hana i ka blockage o ka ʻōpū.
• Hiki ke pale i ka ʻōpū ma hope mai nā adhesions i hoʻokumu ʻia e ke ʻoki.

E haʻi i kāu kauka.

• Inā ʻoe a hāpai paha
• He aha nā lāʻau āu e lawe nei, ʻo nā lāʻau, nā mea hoʻopiha, a i ʻole nā ​​mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau

I nā lā ma mua o kou ʻoki kino:

• E noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i nā mea lahilahi. Hoʻopili kēia i nā NSAIDs (aspirin, ibuprofen), vitamina E, warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), a me clopidogrel (Plavix).
• E nīnau i kāu kauka i nā lāʻau e pono ai ʻoe e lawe i ka lā o ke ʻoki.
• Inā puhi ʻoe, hoʻāʻo e kū. E noi i kāu kauka a kahu hānai paha no ke kōkua ʻana e haʻalele.

I ka lā o kou ʻoki kino:

• E hāhai i nā ʻōlelo aʻoaʻo a kāu kauka e pili ana i ka manawa e hōʻoki ai i ka ʻai ʻana a me ka inu ʻana.
• E lawe i nā lāʻau i haʻi ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E hōʻea i ka haukapila i ka manawa.

Noho ka hapa nui o ka poʻe i ka haukapila no 1 a 7 mau lā e pili ana i ka nui o ka ʻoki ʻana. I kēia manawa, e nānā pono nā mea mālama ola iā ʻoe.

Hiki ke hoʻopili ʻia i ka mālama ʻana:

• Nā lāʻau ʻeha
• Tube ma o kou ihu i loko o kou ʻōpū e ninini i kou ʻōpū a hoʻomaha i ka nausea a me ka luaʻi

E hāʻawi ʻia ʻoe i nā wai ma o kahi aa koko (IV) a hiki i ka manaʻo o kāu mea lawelawe ua mākaukau ʻoe e hoʻomaka e inu a ʻai paha. Hiki i kēia ke like me ka lā ma hope o ke kaha ʻana.

Pono ʻoe e hāhai me kāu kauka lāʻau i hoʻokahi pule a ʻelua paha ma hope o ke kahakaha ʻana.

ʻO ka hapa nui o ka poʻe i loaʻa i kēia ʻoki kino he hopena maikaʻi. Akā ʻo nā hopena o kēlā me kēia ʻoki ʻana pili i kou olakino holoʻokoʻa. E kamaʻilio me kāu kauka e pili ana i kāu hopena i manaʻo ʻia.

Meckel diverticulectomy; Meckel divertikulum - ʻoki kino; Meckel divertikulum - hoʻoponopono; Kahe ʻana o GI - Meckel diverticulectomy; ʻO ke kahe o Gastrointestinal - Meckel diverticulectomy

• Mālama ʻeha ʻeha - wehe

• Meckel's diverticulectomy - moʻo

ʻO Fransman RB, Harmon JW. Ka mālama ʻana i ka diverticulosis o ka ʻōpū liʻiliʻi. I: Cameron AM, Cameron JL, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 13th ed. Piladelapia, PA: Elsevier; 2020: 143-145.

Harris JW, Evers BM. ʻŌpū liʻiliʻi. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 49.