Minimal Invasive Surgery at University Hospital Sharjah

DEPARTMENT OF GENERAL SURGERY

MINIMALLY INVASIVE SURGERY

For Appointments Call: +971 6 505 8555 Or Visit: www.uhs.ae

Minimally Invasive Surgery What is Minimally Invasive (Laparoscopic) Surgery?

Minimally Invasive Surgery is a type of surgery that uses special tools that are designed to decrease the size of incisions and reduce how much the body’s tissues get damaged. One kind of Minimally Invasive Surgery involves the use of a “Scope,” a viewing device that allows surgeons to look inside the body without opening it up all the way. This article is about the type of surgery that involves scopes.

There are several different types of scopes, but they all work in roughly the same way. They consist of a long, thin tube with a tiny camera and a light on the end. The camera sends pictures of the inside of the body to a TV screen. When doing this type of surgery, the surgeon makes a small incision just big enough for the scope to fit through. He or she also makes 2 or more other incisions that slim tools can fit through. These tools include clamps, scissors, and stitching devices, which the surgeon can control from outside the body. While looking at the picture on the screen, the surgeon uses those tools to do the operation.

What do the latest studies say about minimally invasive surgery?

Minimally invasive surgery has been shown to shorten hospital stays, decrease pain and provide patients with a more rapid recovery as well as cost savings. A recent John Hopkins study showed that 170,000 fewer hospital days, 4,306 fewer postoperative complications and $337M in annual savings would occur if surgeons at hospitals that more often used open surgical procedures increased their rates of minimally invasive procedures to the average of those hospitals that used them the most.

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Minimally Invasive Surgery

What are the different types of minimally invasive scope surgery?

There are lots of different types. Their names are based on the body parts that are involved. The scopes used for the different types of surgery are named that way, too:

Thoracoscopes are used in the chest for “thoracoscopic surgery. This type of surgery can be used to remove pieces of lung or to do certain types of heart surgery.

Laparoscopes are used in the belly for “laparoscopic surgery.” This type of surgery can be used to remove the gallbladder or the uterus, or to do lots of other different procedures.

Hysteroscopes are used in the uterus and vagina for “hysteroscopic surgery. This type of surgery can be used to remove abnormal growths in the uterus, or to do a number of different procedures on the uterus and vagina.

Arthroscopes are used inside joints for “arthroscopic surgery. This type of surgery can be used to repair or replace joints in the knee, shoulder, and hip.

Endoscopes go down your throat and into the esophagus, stomach, bile ducts, or intestines. Most times these scopes are used just to inspect those body parts. Other times, these scopes are used to do a procedure. This might involve getting a small piece of tissue for testing, or opening an area that is too narrow. During surgery, an endoscope can also be inserted directly into one of these body parts to help the surgeon find the problem.

Colonoscopes go up your rectum and into the large intestine, or colon. They are similar to endoscopes.

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Minimally Invasive Surgery What are the beneďŹ ts of minimally invasive surgery?

When compared to traditional surgery, minimally invasive surgery can result in much less pain and swifter recovery while providing an alternative for repairing and preventing a wide range of conditions. Depending on the procedure, patients may leave the hospital the same day, or in a few days, and return to normal activities more quickly than patients recovering from open surgery.

How is minimally invasive surgery different from regular surgery?

In general, this type of surgery makes recovery easier. That's because: It usually involves several small wounds, rather than one big one The inside of the body does not get as exposed to open air as it would

with regular surgery The organs don't get moved around as much 4

Minimally Invasive Surgery Can Patients Always Choose to have Minimally Invasive Surgery?

No. Many procedures can now be done through a minimally invasive approach. But it's not always up to the patient to choose what type of surgery to have. Whether or not a patient can have this type of surgery will depend on: Whether there is a surgeon available who has enough experience

doing the type of surgery the patient needs Why the patient needs surgery. (As an example, patients who need

surgery to remove very large cancers cannot always have minimally invasive procedures.)

What other health problems the patient might have

Even when a patient starts out having minimally invasive surgery, there's no guarantee that the surgery will stay that way. Few times surgeons start out doing minimally invasive surgery and then realize that they need to switch to open surgery. This doesn’t mean the surgeon has done anything wrong; it's just something that happens sometimes after a surgery gets started.

If you go in for minimally invasive surgery, be prepared to wake up and ďŹ nd out that you had open surgery. This could happen for a few different reasons, such as: The surgeon found something unexpected when he or she got started The surgeon couldn’t see well enough or properly treat the organ he

or she was trying to operate on Bleeding occurred that could not be controlled with a minimally invasive approach

The important thing to remember is that if a surgeon switches to regular surgery; it is usually to protect the safety of the patient.

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Minimally Invasive Surgery What are some common minimally invasive procedures?

Minimally invasive surgery is the optimal choice for patients for a signiďŹ cant number of surgical procedures including: Hernia Repair (Bilateral or Recurrent) Colon Resection Appendectomy Gallbladder Removal Bariatric or Weight-Loss Surgery Gastrectomy Splenectomy to Remove the Spleen Adrenalectomy to Remove One or Both Adrenal Glands Anti-Reux Surgery, Sometimes Called Hiatal Hernia Repair, Procedures

to Prevent Heartburn Treatment of Varicocele Some Nephrectomies Gynecological Procedures

Laparoscopic surgery can be performed safely and effectively in pregnant women.

The procedure has been performed as late as 34 weeks of gestation (like appendicitis and cholecystitis), but the optimal time is the second trimester.

Pregnant women are tilted to the left position to minimize uterine compression of the vena cava and the aorta. Other modiďŹ cations are done during surgery in order to adapt to the presence of the enlarged uterus. A skilled laparoscopic surgeon is required to do these procedures.

There is no evidence that open procedures are safer than laparoscopic procedures.

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Minimally Invasive Surgery Use of laparoscopy in children and adolescents is rapidly increasing. Minimally invasive approaches have become the standard of care for many abdominal and pelvic procedures. Laparoscopy offers advantages of fewer major wound-associated complications, less incisional pain, a shorter recovery, and improved cosmesis.

Patients are positioned for surgery in a manner which is safe and allows the surgical team optimal access for patient care. An additional consideration in pediatric laparoscopy is the variable size of the patient. ModiďŹ cations are done during surgery in order to adapt to the size of the child.

The location of incisions in children and adolescents must be chosen carefully to provide adequate operating space, avoid injury, and optimize cosmesis. Experienced in pediatric laparoscopy is required for these procedures.

Complications of pediatric laparoscopy occur in 1 to 2 percent of procedures. The types of complications are similar to those for adult laparoscopy.

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Minimally Invasive Surgery What should every patient know?

Patients should be informed by their physician or surgeon when making any healthcare decisions. If you are a patient considering minimally invasive surgery (MIS), we encourage you to review the Patient Information Brochures to learn if you may be a candidate for less invasive surgery, questions to ask your surgeon or physician, common procedures, how to prepare, what happens during your operation and what is expected after surgery.

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P.O. Box: 72772, Sharjah, UAE Tel: +971 6 505 8555, Fax: +971 6 505 8444 Email: info@uhs.ae, Website: www.uhs.ae /UHSharjah /UHSharjah

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‫ص‪.‬ب‪ ،72772 :‬اﻟﺷﺎرﻗﺔ ‪ ،‬اﻹﻣﺎرات اﻟﻌرﺑﯾﺔ اﻟﻣﺗﺣدة‬ ‫ھﺎﺗف‪ ،+971 6 505 8555 :‬ﻓﺎﻛس‪+971 6 505 8444 :‬‬ ‫ﺑرﯾد إﻟﻛﺗروﻧﻲ‪ ،info@uhs.ae :‬اﻟﻣوﻗﻊ اﻹﻟﻛﺗروﻧﻲ‪www.uhs.ae :‬‬

‫‪/UHSharjah‬‬

‫‪/UHSharjah‬‬

‫‪/UniversityHospitalSharjah‬‬

‫‪/UHSharjah‬‬

‫ﻧﺗﻌﺎﻣل ﻣﻊ ﻣﻌظم ﺷرﻛﺎت اﻟﺗﺄﻣﯾن‬

‫ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر‬ ‫ﯾﺟب ﻋﻠﻲ ﻛل ﻣرﯾض ﻣﻌرﻓﺔ ؟‬ ‫ﯾﺟب إطﻼع اﻟﻣرﯾض ﺑواﺳطﺔ طﺑﯾﺑﮫ اﻟﻣﻌﺎﻟﺞ ﻋﻧد اﺗﺧﺎذ أي ﻗرار ﺑﺷﺄن اﻟﻌﻣﻠﯾﺔ اﻟﻣراد‬ ‫اﺟراؤھﺎ‪.‬‬ ‫إذا ﻛﻧت ﻣن اﻟﻣرﺿﻰ اﻟذﯾن ﯾﻔﻛرون ﻓﻲ ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر ﻓﺈﻧﻧﺎ ﻧﺷﺟﻌك ﻟﻣراﺟﻌﺔ‬ ‫ﻛﺗﯾﺑﺎت اﻟﻣرﺿﻰ ‪ .‬إذا ﻛﻧت ﻣرﺷﺣﺎ ﻷي ﻋﻣﻠﯾﺔ ﺑﺎﻟﻣﻧظﺎر ﯾﺟب ﻋﻠﯾك ﺳؤال طﺑﯾﺑك‬ ‫اﻟﻣﻌﺎﻟﺞ أو اﻟﺟراح ﻋن اﻟﻌﻣﻠﯾﺎت اﻟﺷﺎﺋﻌﺔ – ﻛﯾف ﺗﺟﮭز ﻧﻔﺳك – ﻣﺎ اﻟذي ﯾﺣدث أﺛﻧﺎء‬ ‫اﻟﻌﻣﻠﯾﺔ وﻣﺎھو اﻟﻣﺗوﻗﻊ ﺑﻌد اﻟﺟراﺣﺔ‬

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‫ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر‬ ‫إﺳﺗﺧدام ﻣﻧظﺎر اﻟﺑطن ﻓﻲ اﻷطﻔﺎل واﻟﻣراھﻘﯾن‬ ‫ھﻧــﺎك زﯾــﺎدة ﻓــﻲ اﻋﺗﺑــﺎر أن ﺟراﺣــﺔ اﻟﻣﻧظــﺎر ھــﻲ اﻟطرﯾﻘــﺔ اﻷﺳﺎﺳــﯾﺔ ﻹﺟــراء‬ ‫اﻟﻌﻣﻠﯾﺎت ﺑﺎﻟﺑطن واﻟﺣوض ‪.‬‬ ‫ﻣﻧظﺎر اﻟﺑطن ﻟﮫ ﻓواﺋد ﻋده ‪:‬‬ ‫∠ ﺗﻘﻠﯾل اﻟﻣﺿﺎﻋﻔﺎت اﻟﻣﺗﻌﻠﻘﺔ ﺑﺎﻟﺟروح اﻟﻛﺑﯾرة‪.‬‬ ‫∠ أﻟم أﻗل‪.‬‬ ‫∠ ﻓﺗرة ﺗﻌﺎﻓﻲ أﻗل وﻧﺗﺎﺋﺞ ﺗﺟﻣﯾﻠﯾﺔ أﻓﺿل ‪.‬‬ ‫ ﯾوﺿﻊ اﻟﻣرﯾض ﺑطرﯾﻘﺔ اﻣﻧﺔ ﺗﻣﻛن اﻟﻔرﯾﻖ اﻟﺟراﺣﻲ ﻣن ﺗﻘدﯾم أﻓﺿل اﻟرﻋﺎﯾﺔ‬ ‫ﻟﻠﻣرﯾض‪ .‬ھﻧﺎك اﻋﺗﺑﺎرات ﺧﺎﺻﺔ ﻟﺟراﺣﺔ اﻟﻣﻧظﺎر ﻓﻲ اﻷطﻔﺎل ﺗراﻋﻲ اﻷﺣﺟﺎم‬ ‫اﻟﻣﺧﺗﻠﻔﺔ ﻟﻠﻣرﺿﻰ ‪.‬ﺣﯾث ﯾﻘوم اﻟﺟراح ﺑﺈﺟراء ﺑﻌض اﻟﺗﻌدﯾﻼت أﺛﻧﺎء اﻟﺟراﺣﺔ ﻟﺗﻼﺋم‬ ‫ﺣﺟم اﻟطﻔل ‪.‬‬ ‫ ﺗﺧﺗﺎر أﻣﺎﻛن اﻟﺟروح ﻋﻧد اﻷطﻔﺎل ﺑﻌﻧﺎﯾﺔ ﻹﻋطﺎء اﻟﻣﺳﺎﺣﺔ اﻟﻛﺎﻓﯾﺔ ﻹﺟراء اﻟﻌﻣﻠﯾﺔ‬ ‫– ﺗﻔﺎدي اﻹﺻﺎﺑﺎت –ﺗﺣﺳﯾن اﻟﻧﺎﺣﯾﺔ اﻟﺟﻣﺎﻟﯾﺔ ‪.‬‬ ‫ﺿرورة وﺟود ﺧﺑرة ﻛﺎﻓﯾﺔ ﻷﺟراء ﻋﻣﻠﯾﺎت ﻣﻧظﺎر اﻷطﻔﺎل ‪.‬‬ ‫ ﻣﺿﺎﻋﻔﺎت ﻋﻣﻠﯾﺎت اﻟﻣﻧﺎظﯾر ﻟدى اﻷطﻔﺎل ﺗﻣﺛل ‪ %2 - %1‬ﻣن اﻟﻌﻣﻠﯾﺎت‪ .‬طﺑﯾﻌﺔ‬ ‫اﻟﻣﺿﺎﻋﻔﺎت ﻣﺷﺎﺑﮭﮫ ﻟﻠﺑﺎﻟﻐﯾن ‪.‬‬

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‫ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر‬ ‫ﻣﺎھﻲ أﻛﺛر ﻋﻣﻠﯾﺎت اﻟﻣﻧﺎظﯾر ؟‬

‫اﻟﺟراﺣﺔ طﻔﯾﻔﺔ اﻟﺗوﻏل ھﻲ اﻟﺧﯾﺎر اﻷﻣﺛل ﻟﻠﻣرﺿﻰ ﻟﻌدد ﻛﺑﯾر ﻣن اﻟﻌﻣﻠﯾﺎت اﻟﺟراﺣﯾﺔ‬ ‫ﺑﻣﺎ ﻓﻲ ذﻟك‪:‬‬ ‫ اﺻﻼح اﻟﻔﺗﻖ "ﺑﺎﻟﺟﺎﻧﺑﯾن أو اﻟﻣﺗﻛرر"‬ ‫ اﺳﺗﺋﺻﺎل اﻟﻘوﻟون‬ ‫ إزاﻟﺔ اﻟزاﺋدة اﻟدودﯾﺔ‬ ‫ إزاﻟﺔ اﻟﻣرارة‬ ‫ ﺟراﺣﺔ اﻟﺳﻣﻧﺔ وإﻧﻘﺎص اﻟوزن‬ ‫ إزاﻟﺔ اﻟﻣﻌدة‬ ‫ إزاﻟﺔ اﻟطﺣﺎل‬ ‫ إزاﻟﺔ اﻟﻐدة ﻓوق اﻟﻛﻠوﯾﺔ‬ ‫ إﺻﻼح ﻓﺗﻖ اﻟﺣﺟﺎب اﻟﺣﺎﺟز – اﻟوﻗﺎﯾﺔ ﻣن ﺣرﻗﺔ اﻟﻔؤاد‬ ‫ ﻋﻼج اﻟدواﻟﻲ‬ ‫ ﺑﻌض أﻧواع إزاﻟﺔ اﻟﻛﻠﻰ‬ ‫ اﻟﺟراﺣﺎت اﻟﻧﺳﺎﺋﯾﺔ‬

‫ﺟراﺣﺔ ﻣﻧظﺎر اﻟﺑطن ﯾﻣﻛن إﺟراؤھﺎ ﺑﺻورة ﻓﻌﺎﻟﺔ واﻣﻧﺔ ﻓﻲ اﻟﻧﺳﺎء‬ ‫اﻟﺣواﻣل‬ ‫ ‬

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‫ﯾﻣﻛن اﺟراء اﻟﻌﻣﻠﯾﺔ ﺣﺗﻰ اﻷﺳﺑوع ‪ 34-‬ﻣﺛل ﻋﻣﻠﯾﺔ إزاﻟﺔ اﻟﻣرارة – اﻟزاﺋدة‬ ‫اﻟدودﯾﺔ – اﻟوﻗت اﻷﻣﺛل ھو اﻟﺛﻠث اﻟﺛﺎﻧﻲ ﻣن اﻟﺣﻣل‪.‬‬

‫اﻟﺣﺎﻣل ﺗوﺿﻊ ﻋﻠﻰ اﻟﺟﺎﻧب اﻷﯾﺳر ﻟﺗﻘﻠﯾل اﻟﺿﻐط ﻣن اﻟرﺣم اﻟﻣﺗﺿﺧم ﻋﻠﻰ‬ ‫ﺷرﯾﺎن اﻷﺑﮭر واﻟورﯾد اﻷﺟوف اﻟﺳﻔﻠﻲ ‪ .‬ھﻧﺎك ﺑﻌض اﻟﺗﻌدﯾﻼت اﻟﺗﻲ ﺗﺗم أﺛﻧﺎء‬ ‫اﻟﺟراﺣﺔ ﻟﻣﻼﺋﻣﺔ اﻟرﺣم اﻟﻣﺗﺿﺧم وھذه اﻟﻌﻣﻠﯾﺎت ﺗﺣﺗﺎج ﻟﺟراح ذو ﺧﺑرة‪.‬‬ ‫ﻻﯾوﺟد دﻟﯾل ﻋﻠﻰ أن أﺟراء اﻟﻌﻣﻠﯾﺔ ﺑﺎﻟطرق اﻟﺗﻘﻠﯾدﯾﺔ أﻛﺛرأﻣﺎﻧﺎ ﻣن ﺟراﺣﺔ‬ ‫اﻟﻣﻧظﺎر‪.‬‬ ‫‪6‬‬

‫ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر‬ ‫ھل ﯾﻣﻛن ﻟﻠﻣرﯾض داﺋﻣﺎ إﺧﺗﯾﺎر ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر؟‬ ‫ﻛﻼ‪ .‬ھﻧﺎك اﻟﻌدﯾد ﻣن اﻟﻌﻣﻠﯾﺎت ﯾﻣﻛن إﺟراﺋﮭﺎ ﺑﺎﻟﻣﻧظﺎر وﻟﻛن ﻟﯾس داﺋﻣﺎ ﯾﻛون ﺑﻣﻘدور‬ ‫اﻟﻣرﯾض اﺧﺗﯾﺎر ﺟراﺣﮫ اﻟﻣﻧظﺎر وذﻟك ﯾﻌﺗﻣد ﻋﻠﻰ ‪-:‬‬ ‫ ‬

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‫وﺟود ﺟراح ذو ﺧﺑرة ﻛﺎﻓﯾﺔ ﻹﺟراء اﻟﻌﻣﻠﯾﺔ اﻟﺗﻲ ﯾﺣﺗﺎﺟﮭﺎ اﻟﻣرﯾض‪.‬‬ ‫دواﻋﻲ إﺟراء اﻟﻌﻣﻠﯾﺔ ﻣﺛﻼ إذا اﺣﺗﺎج اﻟﻣرﯾض إزاﻟﺔ ورم ﺳرطﺎن ﻛﺑﯾر اﻟﺣﺟم‬ ‫ﻋﻧدھﺎ ﻻ ﯾﻣﻛن داﺋﻣﺎ اﺧﺗﯾﺎر ﺟراﺣﺔ اﻟﻣﻧظﺎر‪.‬‬ ‫ﺑﻌض اﻟﻣﺷﺎﻛل اﻟﺻﺣﯾﮫ اﻟﺗﻲ ﯾﻌﺎﻧﻲ ﻣﻧﮭﺎ اﻟﻣرﯾض‬

‫ﺣﺗﻰ ﻋﻧدﻣﺎ ﯾﺑدأ اﻟﺟراح إﺟراء اﻟﻌﻣﻠﯾﺔ ﺑﺎﻟﻣﻧظﺎر ﻻﯾوﺟد ﺿﻣﺎن ﺑﺄن اﻟﻌﻣﻠﯾﺔ ﺳوف‬ ‫ﺗﻛﺗﻣل ﺑﺎﻟﻣﻧظﺎر إذ ﻗد ﯾﺿطر اﻟﺟراح‪ ،‬وﻟﻛن ﻓﻲ ﺣﺎﻻت ﻗﻠﯾﻠﺔ‪ ،‬ﺗﺣوﯾل اﻟﻌﻣﻠﯾﺔ ﻋن‬ ‫طرﯾﻖ اﻟﻔﺗﺢ وھذا ﻻﯾﻌﻧﻲ أن اﻟﺟراح ﻗد ارﺗﻛب ﺧطﺄ‪ .‬إﻧﮫ ﻓﻘط ﯾﺣدث أﺣﯾﺎﻧﺎ ﺑﻌد ﺑدأ‬ ‫اﻟﻌﻣﻠﯾﺔ‬ ‫وھذا ﯾﺣدث ﻷﺳﺑﺎب ﻣﺧﺗﻠﻔﮫ ﻣﺛل‪:‬‬ ‫ ‬

‫إذا وﺟد اﻟﺟراح أﺷﯾﺎء ﻏﯾر ﻣﺗوﻗﻌﺔ أﺛﻧﺎء ﺑداﯾﺔ اﻟﻌﻣﻠﯾﮫ‪.‬‬

‫ إذا ﻟم ﯾﺗﻣﻛن اﻟﺟراح ﻣن اﻟرؤﯾﺔ ﺑﺻورة ﻛﺎﻓﯾﯾﺔ أو ﻣﻌﺎﻟﺟﺔ اﻟﺟزء اﻟﻣراد إﺟراء‬ ‫اﻟﻌﻣﻠﯾﺔ ﻋﻠﯾﮫ‬ ‫ ‬

‫إذا ﻧزف اﻟﻣرﯾض وﻟم ﯾﺗﻣﻛن اﻟﺟراح ﻣن اﯾﻘﺎﻓﮫ ﺑﺎﻟﻣﻧظﺎر‬

‫ﻣن اﻟﻣﮭم ﺗذﻛر أﻧﮫ ﻓﻲ ﺣﺎﻟﺔ ﻗﺎم اﻟﺟراح ﺑﺎﻟﺗﺣوﯾل ﻟﻠطرﯾﻘﺔ اﻟﻣﻌﺗﺎدة ﻓﺈن ذﻟك ﺑداﻋﻲ‬ ‫اﻟﺳﻼﻣﺔ وﺣﻣﺎﯾﺔ اﻟﻣرﯾض‪.‬‬

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‫ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر‬ ‫ﻣﺎھﻲ ﻓواﺋد ﺟراﺣﺔ اﻟﻣﻧظﺎر ؟‬ ‫ﺑﺎﻟﻣﻘﺎرﻧﺔ ﻣﻊ اﻟطرق اﻟﻣﻌﺗﺎدة‪ ،‬ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر ﺗﺳﺑب أﻗل أﻟﻣﺎ ﺑﻛﺛﯾر ‪.‬واﻷﺳرع ﻓﻲ‬ ‫اﻟﺗﻌﺎﻓﻲ وھده ﺗﺷﻣل ﻧطﺎق واﺳﻊ ﻣن اﻟﺣﺎﻻت‪ .‬وﻋﻠﻰ ﺣﺳب ﻧوع اﻟﻌﻣﻠﯾﺔ ‪,‬ﻗد ﯾﺧرج‬ ‫اﻟﻣرﯾض ﻣن اﻟﻣﺳﺗﺷﻔﻰ ﻓﻲ ﻧﻔس اﻟﯾوم أو ﺑﻌد أﯾﺎم ﻗﻠﯾﻠﺔ وﯾﻌود ﻟﻣﻣﺎرﺳﺔ ﻧﺷﺎطﮫ اﻟﻣﻌﺗﺎد‬ ‫ﺑﺻورة أﺳرع ﻣﻘﺎرﻧﺔ ﺑﺎﻟﻌﻣﻠﯾﺎت اﻟﻣﻌﺗﺎدة ﻋن طرﯾﻖ اﻟﻔﺗﺢ ‪.‬‬

‫ﻛﯾف ﺗﺧﺗﻠف اﻟﺟراﺣﺔ طﻔﯾﻔﺔ اﻟﺗوﻏل ﻋن اﻟﺟراﺣﺔ اﻟﻌﺎدﯾﺔ؟‬ ‫ﻋﻣوﻣﺎ ھذا اﻟﻧوع ﻣن اﻟﺟراﺣﺎت ﯾﺟﻌل اﻟﺗﻌﺎﻓﻲ ﺑﺻورة أﺳﮭل وذﻟك ﻟﻸﺳﺑﺎب اﻟﺗﺎﻟﯾﺔ ‪:‬‬ ‫ ‬

‫ﺗﺗم اﻟﻌﻣﻠﯾﺔ ﺑواﺳطﺔ ﺷﻖ أو ﺷﻘوق ﺻﻐﯾرة‪.‬‬

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‫ﻻﯾﺗﻌرض داﺧل اﻟﺟﺳم ﻟﻠﮭواء اﻟﻣﻔﺗوح ﻣﻘﺎرﻧﺔ ﺑﺎﻟطرق اﻟﻣﻌﺗﺎدة‪.‬‬

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‫ﻻﯾﺗم ﺗﺣرﯾك اﻷﻋﺿﺎء اﻟداﺧﻠﯾﺔ ﺑﺻورة ﻛﺑﯾرة‪.‬‬ ‫‪4‬‬

‫ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر‬

‫ﻣﺎھﻲ أﻧواع ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر ؟‬ ‫ھﻧﺎك أﻧواع ﻛﺛﯾرة وﻣﺧﺗﻠﻔﺔ‪ .‬وﺗﻌﺗﻣد ﺗﺳﻣﯾﺗﮭﺎ ﻋﻠﻰ اﻟﺟزء اﻟﻣﺳﺗﮭدف ﻣن اﻟﺟﺳم وﺗﺳﻣﯾﺔ‬ ‫اﻟﻣﻧظﺎر اﻟﻣﺳﺗﺧدم ﻓﻲ اﻟﻌﻣﻠﯾﺎت ﺗﺗم ﺑﻧﻔس اﻟطرﯾﻘﺔ‪.‬‬ ‫ ‬

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‫ﻣﻧظﺎر اﻟﺻدر‪ :‬ﯾﺳﺗﺧدم ﻹﺟراء اﻟﻌﻣﻠﯾﺎت ﺑﺎﻟﺻدر وﻗد ﯾﺳﺗﺧدم ﻹزاﻟﺔ ﺟزء ﻣن‬ ‫اﻟرﺋﺔ وإﺟراء أﻧواع ﻣﺣددة ﻣن ﺟراﺣﺔ اﻟﻘﻠب‬ ‫ﻣﻧظﺎر اﻟﺑطن‪ :‬ﯾﺳﺗﺧدم ﻓﻲ ﺟراﺣﺎت اﻟﺑطن ﻣﺛل ازاﻟﺔ اﻟﻣراره ازاﻟﺔ اﻟزاﺋده‬ ‫اﻟدودﯾﮫ‪ ،‬ازاﻟﺔ اﻟرﺣم وﻏﯾرھﺎ ﻣن اﻟﻌﻣﻠﯾﺎت ﻛﻣﺎ ان ﻟﮫ اﺳﺗﺧداﻣﺎت اﺧرى ﻋدﯾده‬ ‫ﻣﻧظﺎر اﻟرﺣم‪ :‬ﯾﺳﺗﺧدم ﻟﻌﻣﻠﯾﺎت اﻟرﺣم واﻟﻣﮭﺑل ﻛﺎزاﻟﺔ اورام اﻟرﺣم وﻏﯾرھﺎ ﻣن‬ ‫اﻟﻌﻣﻠﯾﺎت‬ ‫ﻣﻧظﺎر اﻟﻣﻔﺻل‪ :‬ﯾﺳﺗﺧدم داﺧل اﻟﻣﻔﺎﺻل ﻹﺟراء اﻟﻌﻣﻠﯾﺎت وھذا اﻟﻧوع ﯾﺳﺗﺧدم‬ ‫ﻹﺻﻼح أو اﺳﺗﺑدال اﻟﻣﻔﺎﺻل ﻓﻲ اﻟرﻛﺑﺔ واﻟﻛﺗف واﻟورك ‪.‬‬ ‫ﻣﻧظﺎر اﻟﻣﻌدة ‪ :‬ھو إدﺧﺎل اﻟﻣﻧظﺎر ﻋﺑر اﻟﻔم ﻟﻠوﺻول ﻟﻠﻣرئ ‪ -‬اﻟﻣﻌدة –اﻟﻘﻧﺎة‬ ‫اﻟﻣرارﯾﺔ أو اﻷﻣﻌﺎء‪.‬ھذا اﻟﻧوع ﻣن اﻟﻣﻧﺎظﯾر ﯾﺳﺗﺧدم ﻏﺎﻟﺑﺎ ﻟرؤﯾﺔ ھذه اﻷﺟزاء ﻣن‬ ‫اﻟﺟﺳم وأﺣﯾﺎﻧﺎ ﺗﺳﺗﺧدم ﻷﺧذ اﻟﻌﯾﻧﺎت ﻣن اﻟﺟﺳم أو ﺗوﺳﯾﻊ ﺑﻌض اﻷﺟزاء اﻟﺿﯾﻘﺔ‬ ‫‪.‬أﺛﻧﺎء اﻟﺟراﺣﺔ ﯾﻘوم اﻟﺟراح ﺑﺈدﺧﺎل اﻟﻣﻧظﺎر ﻣﺑﺎﺷرة ﻟﻠﺟزء اﻟﻣطﻠوب ﻟﺗﺣدﯾد‬ ‫اﻟﻣﺷﺎﻛل ‪.‬‬ ‫ﻣﻧظﺎر اﻟﻘوﻟون ‪ :‬ﯾدﺧل ﻋﺑر اﻟﻣﺳﺗﻘﯾم ﺣﺗﻰ ﯾﺻل ﻟﻸﻣﻌﺎء اﻟﻐﻠﯾظﺔ ‪.‬‬ ‫‪3‬‬

‫ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر‬ ‫ﻣﺎ ھﻲ ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر؟‬ ‫ھﻲ ﻧوع ﻣن اﻟﺟراﺣﺎت اﻟﺗﻲ ﺗﺳﺗﺧدم ﻓﯾﮭﺎ أدوات ﻣﺻﻣﻣﺔ ﺧﺻﯾﺻﺎ ﻟﺗﺻﻐﯾر ﺣﺟم‬ ‫اﻟﺟروح وﺗﻘﻠﯾل اﻷﺿرار ﻋﻠﻰ أﻧﺳﺟﺔ اﻟﺟﺳم ‪ .‬ﯾﺳﺗﺧدم اﻟﻣﻧظﺎر ﻟﻠﺳﻣﺎح ﻟﻠﺟراح‬ ‫ﺑﻣﻌﺎﯾﻧﺔ داﺧل اﻟﺟﺳم دون اﻟﺣﺎﺟﺔ ﻟﻔﺗﺢ ﻛل اﻟﻣﻧطﻘﺔ اﻟﻣراد ﻣﻌﺎﯾﻧﺗﮭﺎ‪.‬‬ ‫ھﻧﺎك ﻋدة أﻧواع ﻣن اﻟﻣﻧﺎظﯾر ﻟﻛﻧﮭﺎ ﺗﻘرﯾﺑﺎ ﺗﻌﻣل ﺑﻧﻔس اﻟطرﯾﻘﺔ إذ ﺗﺗﺄﻟف ﻣن‬ ‫أﻧﺑوب رﻓﯾﻊ طوﯾل ﯾﻧﺗﮭﻲ ﺑﻛﺎﻣﯾرا ﺻﻐﯾرة وﻣﺻدر ﻟﻠﺿوء‪ .‬ﺗﻘوم اﻟﻛﺎﻣﯾرا ﺑﺈرﺳﺎل‬ ‫اﻟﺻور ﻣن داﺧل اﻟﺟﺳم إﻟﻰ ﺷﺎﺷﺔ ﺗﻠﻔزﯾوﻧﯾﺔ‪.‬‬ ‫ﻋﻧد إﺟراء ھذا اﻟﻧوع ﻣن اﻟﺟراﺣﺎت ﯾﻘوم اﻟﺟراح ﺑﻌﻣل ﺷﻖ ﺻﻐﯾر ﯾﺗﺳﻊ ﻟﻠﻣﻧظﺎر‬ ‫ﺛم ﯾﻘوم ﺑﻌﻣل ﺷﻘﯾن أو أﻛﺛر ﻟﻠﺳﻣﺎح ﻟﻸدوات اﻟرﻓﯾﻌﺔ اﻷﺧرى ﺑﺎﻟﻣرور ﻋﺑرھﺎ‪.‬‬ ‫ھذه اﻷدوات ﺗﺷﻣل اﻟﻣﻘﺻﺎت‪ ،‬أدوات اﻟﻠﻘط‪ ،‬وأﺟﮭزة اﻟﺗﻘطﯾب واﻟّﺗﻲ ﯾﺗﺣﻛم ﺑﮭﺎ‬ ‫اﻟﺟراح ﻣن ﺧﺎرج اﻟﺟﺳم ‪.‬‬

‫ﻣﺎذا ﻗﺎﻟت أﺣدث اﻟدراﺳﺎت ﻋن ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر؟‬

‫ﻟﻘد أظﮭرت ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر ﻗﺻر ﻓﺗرة اﻹﻗﺎﻣﺔ ﺑﺎﻟﻣﺳﺗﺷﻔﯾﺎت‪ ،‬ﺗﻘﻠﯾل اﻷﻟم‪ ،‬ﺳرﻋﺔ أﻛﺑر‬ ‫ﻟﻠﻣﻌﺎﻓﺎة‪ ،‬و ﺗﻘﻠﯾل اﻟﺗﻛﺎﻟﯾف‪ .‬أظﮭرت دراﺳﺔ ﺣدﯾﺛﺔ ﻟﺟون ھوﻛﯾﻧز أن ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر‬ ‫أدت إﻟﻰ ‪ 170,000‬أﻗل أﯾﺎم إﻗﺎﻣﺔ ﺑﺎﻟﻣﺳﺗﺷﻔﻰ و ‪ 4,306‬أﻗل ﻣﺿﺎﻋﻔﺎت ﺑﻌد‬ ‫اﻟﺟراﺣﺔ و ‪ 337‬ﻣﻠﯾون دوﻻر ﺗوﻓﯾر ﺳﻧوﯾﺎ – ﻓﻲ ﺣﺎل ﻗﺎم اﻟﺟراﺣﯾن ﺑزﯾﺎدة ﻋﻣﻠﯾﺎت‬ ‫اﻟﻣﻧﺎظﯾر ﻓﻲ اﻟﻣﺳﺗﺷﻔﯾﺎت‪.‬‬ ‫‪2‬‬

‫ﻗﺳم اﻟﺟراﺣﺔ اﻟﻌﺎﻣﺔ‬

‫ﺟراﺣﺔ اﻟﻣﻧﺎظﯾر‬

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