Introduction to Medical Consumables——he aha ka trocar？

ʻO ka pahi kaua, me nā ʻaoʻao ʻoi ʻoi ma nā ʻaoʻao ʻelua, he ʻaoʻao pololei a me ka piko kiko. Ke hoʻohana ʻia, hiki ke make i nā hahau i mua a i hope, a hiki i ka piko ke komo maʻalahi i ka pale kaua. He mea kaua weliweli loa ia.

I kēia lā naʻe, e kūkākūkā mākou i ka trocar, kahi lāʻau lapaʻau a me ka ʻokiʻoki, hiki ke hoʻohālikelike ʻia me ka pahi kaua. I ka hōʻoki ʻana i ka lāʻau lapaʻau liʻiliʻi loa, ke ʻike ʻia kahi maʻi maʻi i loko o ke kino e pono ai ke hoʻoneʻe ʻia, ʻo ka mea hana mua i hoʻohana ʻia ʻo ka trocar. Ua like ke ʻano o ka trocar me ke ʻano o ka pahi kaua a, ʻeleu a hiki ke komo hohonu i loko o ka ʻili. Hoʻolālā ʻia kahi trocar e komo i loko o ka paia o ka ʻōpū a hana i kahi ala no nā mea hana ʻoki ʻē aʻe e komo i loko o ka lua kino; ʻo ia ke ʻano o ka mea hana ʻokiʻoki liʻiliʻi.

 

 

Nā ʻano a me nā ʻokoʻa o Trocars

Ma ka laulā, ʻo ke kumu nui o kahi trocar laparoscopic e hoʻokumu i kahi ala i loko o ka ʻōpū o ka ʻōpū.  

Ma muli o ke ʻano o ka trocar core, hiki ke hoʻokaʻawale ʻia lākou i ʻekolu ʻano:

1. ʻoki trocars

2. nā trocars ʻike

3.dilating trocars.  

ʻO nā hōʻailona no nā trocars ʻike e hoʻokumu i kahi ala hana i ka lua kino. Hoʻohana ʻia nā trocars ʻoki i ka hui pū ʻana me nā endoscopes e ʻoki i nā ʻiʻo o ke kino a hoʻokumu i kahi kahawai ʻōpū o ka ʻōpū i ka wā o ke kaʻina endoscopic. Hoʻohana ʻia nā trocars dilating ma mua o ka hana laparoscopic e puncture i ka ʻili a me ka fascia a me ka hoʻokomo ʻana i nā mea hana pre-surgical, e hoʻokipa i nā ʻano puncture ʻokoʻa, e like me ka pani ʻana (Veress needle method, direct method), inser.

Hoʻokaʻawale ʻia nā trocars Laparoscopic e pili ana i kā lākou hoʻohana ʻana i nā mea hana hiki ke hoʻohana hou ʻia, kēlā me kēia me nā kikoʻī like ʻole. Hiki ke 80mm, 110mm, a i ʻole 150mm ka lōʻihi o ka cannula trocar, a ʻo ke anawaena o ke kahawai trocar core hiki ke 5mm, 8mm, 10mm, 12mm, a i ʻole 15mm. Hoʻokaʻawale ʻia lākou e kā lākou ʻano hoʻopaʻa ʻana: seal ring sealing a me gas sealing.

 

 

Ka Moolelo o Trocars

 

I ke kenekulia 19, ua hoʻomohala ke kauka Pelekania ʻo Reginald S. Southey (1835 – 1899) i ka "Southey tube" ma hope o ka nānā ʻana i ka hoʻoheheʻe ʻana o ka wai mai nā blisters i nā maʻi me ka edema ākea. Ua hoʻolālā ʻia kēia mea hou e hoʻokahe i ka wai subcutaneous nui mai ke kino. Ma o ka hoʻomaʻamaʻa mau ʻana a me ka hoʻomaʻemaʻe ʻana, ua hoʻohui ʻo Southey i kahi cannula a hoʻolālā i nā puka he nui, kahi i alakaʻi ai i ke ʻano mua o ka trocar.

I ka makahiki 1938, ua hana ke kauka lapaau Hungarian Janos Veress i kahi nila me kahi obturator blunt i hoʻopiha ʻia i ka pūnāwai e hoʻihoʻi koke i ke komo ʻana ma ka paia o ka ʻōpū. ʻO kēia mea hana, i kapa ʻia ʻo Veress needle, i hoʻolālā ʻia e pale aku i ka hōʻeha ʻana i nā ʻōpū o loko ke komo i ka ʻōpū o ka ʻōpū no ka insufflation.

I ka puka ʻana mai o nā ʻano hana ʻē aʻe no ka mālama ʻana i ka edema, ua hāʻule mālie ka trocar i kēia pōʻaiapili. Ua hoʻololi ʻia i loko o ka trocar hou i hoʻohana ʻia i ke ʻoki laparoscopic.

I kēia lā, me ka holomua ʻana o ka ʻenehana lapaʻau a me ka ʻenehana, hana mau a hoʻomaikaʻi ʻia nā mea hana laparoscopic a me nā mea hana. He kuleana koʻikoʻi ka trocar a ua lilo ia i mea hoʻohana pono i ka hana laparoscopic.

 

Noi o Trocars

Ma muli o ka maikaʻi o ka hana laparoscopic, e like me ka ʻeha liʻiliʻi, ka emi ʻana o ka ʻeha, ka haʻahaʻa o ka maʻi, ka wikiwiki o ka hoʻōla ʻana o ka ʻōpū, a me nā ʻōpala liʻiliʻi ma hope o ka hana, ʻo ka manaʻo o ka hōʻoki liʻiliʻi invasive, i hōʻike ʻia e nā ʻenehana laparoscopic, ua ʻike nui ʻia a mahalo ʻia e nā limahana lapaʻau a me nā maʻi. I kēia lā, hiki ke hoʻohana ʻia i nā ʻano hana ʻokiʻoki.

621964

621964

Myomectomy (ka wehe ʻana i nā fibroids ʻōpū)

ʻOvarian cystectomy

ʻoki ʻoki ʻoki ʻoki ʻana

ʻokiʻoki ʻana i ka pahu Fallopian

ʻAi ʻole

Hoʻomaʻemaʻe pelvic

ʻO ka ʻoki ʻana i ka Hepatobiliary:

Cholecystectomy (ka wehe ʻana i ka ʻōpū o ka ʻōpū)

ʻImi maʻamau a me ka unuhi pōhaku

ʻOki ʻana o ke ake

ʻO ka hoʻoheheʻe ʻana o ka ate a me ka hoʻokahe wai

Ka hoʻokahe ʻana o ke akepaʻa

Ka hoʻohuli ʻana i ka biliary-enteric

Urology:

Nephrectomy (wehe ʻia ka ʻōpū)

Adrenalectomy

Ureterolithotomy (unuhi pohaku ureteral)

ʻO ka ʻoki ʻana i ka ʻōpū:

Ka nui a i ʻole ka ʻāpana gastrectomy (ka wehe ʻana i ka ʻōpū)

Appendectomy (wehe ʻia ka appendix)

Hoʻoponopono ʻana i ka maʻi ʻeha

Adhesiolysis (hoʻokuʻu ʻia ʻana o ka ʻōpū)

ʻO ka ʻoki ʻana i ka maʻi ʻaʻai

ʻO ka ʻoki ʻoki ʻana:

Lobectomy (ka wehe ʻana i ka ʻōpū māmā)

ʻoki ʻana i ka maʻi maʻi ʻaʻai

 

 

 

ʻO nā mea nui o Trocars

ʻO ka trocar me ʻekolu ʻāpana:

ʻO ka cannula. ʻO kēia ka lāʻau i hoʻokomoʻia i loko o ka mea maʻi e hāʻawi i ke komo i ka'ōpū o ka'ōpū.

ʻO ke sila. Loaʻa kēia ma ka piko o ka cannula a hōʻoia ʻaʻole e pakele ka ea mai ka ʻōpū o ka ʻōpū me ka ʻae ʻana i nā mea pono e hele ai. Inā ʻaʻole mālama pono ʻia ke ea i ka wā o ka laparoscopy, hiki i kēia ke keʻakeʻa i ka ʻike ʻana o ke kauka ’ i ka wahi e hana ʻia nei.

ʻO ka mea hoʻopio. ʻO kēia ka hana e hiki ai i ka cannula ke komo mua i loko o ka ʻōpū.

1-Paʻa:；2-Gas Valve；3-Valve Sealing Cap；4- Cannula；5- Obturator