Utyando lokudlula esibelekweni

Ukudlula kwisisu kukuhlinzwa okukunceda ukuba unciphise umzimba ngokutshintsha indlela isisu sakho kunye namathumbu amancinci akuphatha ngayo ukutya okutyayo.

Emva kotyando, isisu sakho siya kuba sincinci. Uya kuziva uzele kukutya okuncinci.

Ukutya okutyayo akusayi kuphinda kungene kwezinye iindawo zesisu sakho kunye namathumbu amancinci afunxa ukutya. Ngenxa yoku, umzimba wakho awuzukufumana zonke iikhalori kukutya okutyayo.

Uya kuba ne-anesthesia ngokubanzi ngaphambi kolu tyando. Uya kuba ulele kwaye ungenazintlungu.

Kukho amanyathelo amabini ngexesha lotyando lokudlula esiswini:

• Isinyathelo sokuqala senza isisu sakho sincinci. Ugqirha wakho osebenzisa iziqhekeza ukwahlula isisu sakho sibe licandelo elincinci elingaphantsi kunye necandelo elikhulu lasezantsi. Icandelo eliphezulu lesisu sakho (elibizwa ngokuba yingxowa) kulapho ukutya okutyayo kuya kuya khona. Isingxobo silingana nobukhulu be-walnut. Igcina kuphela i-ounce enye (i-oz) okanye i-28 gram (g) yokutya. Ngenxa yoku uya kutya kancinci kwaye unciphise umzimba.
• Inyathelo lesibini kukudlula. Ugqirha wakho uqhagamshela indawo encinci yamathumbu akho amancinci (ijejunum) kumngxunya omncinci kwisingxobo sakho. Ukutya okutyayo ngoku kuya kuhamba ukusuka engxoweni kungene kolu luvulo lutsha nakwisisu sakho esincinci. Ngenxa yoko, umzimba wakho uya kuthabatha iikhalori ezimbalwa.

Ukudlula kwisisu kunokwenziwa ngeendlela ezimbini. Ngoqhaqho oluvulekileyo, ugqirha wakho wotyando usika utyando olukhulu ukuvula isisu sakho. Ukudlula kwenziwa ngokusebenza esiswini sakho, amathumbu amancinci, kunye namanye amalungu.

Enye indlela yokwenza olu tyando kukusebenzisa ikhamera encinci, ebizwa ngokuba yi-laparoscope. Le khamera ibekwe esiswini sakho. Olu tyando lubizwa ngokuba yi-laparoscopy. Ubungakanani buvumela ugqirha ukuba abone ngaphakathi kwesisu sakho.

Kolu tyando:

• Ugqirha wenza i-4 ukuya kwi-6 yokusika okuncinci esiswini sakho.
• Ubungakanani kunye nezixhobo ezifunekayo zokwenza utyando zifakelwa ngokusikwa.
• Ikhamera iqhagamshelwe kwisibekeli sevidiyo kwigumbi lokusebenza. Oku kuvumela ugqirha ukuba abone ngaphakathi esiswini sakho ngelixa esenza utyando.

Izibonelelo ze-laparoscopy ngaphezulu kotyando oluvulekileyo zibandakanya:

• Ukuhlala esibhedlele okufutshane kunye nokuchacha ngokukhawuleza
• Intlungu encinci
• Izibazi ezincinci kunye nomngcipheko omncinci wokufumana i-hernia okanye usulelo

Olu tyando luthatha malunga neeyure ezi-2 ukuya kwezi-4.

Utyando lokunciphisa ukutyeba kunokuba yinto onokukhetha kuyo ukuba utyebe kakhulu kwaye khange ukwazi ukunciphisa umzimba ngokutya nangokwenza umthambo.

Oogqirha bahlala besebenzisa isalathiso sobunzima bomzimba (i-BMI) kunye neemeko zempilo ezinje ngohlobo lweswekile 2 (isifo seswekile esiqale ebudaleni) kunye noxinzelelo lwegazi oluphezulu ukumisela ukuba ngabaphi abantu abanokuthi baxhamle kutyando lokunciphisa umzimba.

Utyando lokudlula ngendlela yesisu ayilungisi ngokukhawuleza ukukhuluphala. Iya kuyitshintsha kakhulu indlela ophila ngayo. Emva kolu tyando, kuya kufuneka utye ukutya okusempilweni, ulawule ubukhulu bezinto ozityayo, kunye nokuzilolonga. Ukuba awulandeli la manyathelo, unokuba neengxaki kuqhaqho kunye nokwehla kobunzima emzimbeni.

Qiniseka ukuba uxoxa ngezibonelelo kunye nomngcipheko kugqirha wakho.

Le nkqubo inokucetyiswa ukuba unayo:

• I-BMI engama-40 okanye ngaphezulu. Umntu one-BMI engama-40 okanye nangaphezulu ubuncinci ziikhilogram ezili-100 (ubunzima beekhilogram ezingama-45) ngaphezulu kobunzima bakhe obucetyiswayo. I-BMI eqhelekileyo iphakathi kwe-18.5 ukuya kuma-25.
• I-BMI engama-35 okanye nangaphezulu kunye nemeko yezonyango enokubuphucula ubunzima bomzimba. Ezinye zeemeko kukuphazamiseka kokuphefumla xa ulele, udidi lwesibini lweswekile, kunye nesifo sentliziyo.

Ukudlula kwisisu kukuhlinzwa okukhulu kwaye kuneengozi ezininzi. Eminye yale mngcipheko imbi kakhulu. Kuya kufuneka uxoxe ngale ngozi kunye nogqirha wakho.

Umngcipheko wokuba ne-anesthesia kunye notyando ngokubanzi kubandakanya:

• Ukunyanga kwamayeza kunyango
• Iingxaki zokuphefumla
• Ukopha, amahlwili egazi, usulelo
• Iingxaki zentliziyo

Umngcipheko wokudlula esiswini kubandakanya:

• I-Gastritis (ukutsha kwesisu), isilungulela, okanye izilonda zesisu
• Ukwenzakala kwisisu, amathumbu, okanye amanye amalungu ngexesha lotyando
• Ukuvuza kumgca apho iinxalenye zesisu zidityaniswe kunye
• Ukungondleki
• Ukuqhekeka ngaphakathi kwesisu sakho kunokukhokelela ekuvaleni kwisisu sakho kwixa elizayo
• Ukuphalaza kukutya ngaphezulu kwesingxobo sakho esiswini

Ugqirha wakho uzakukucela ukuba wenze iimvavanyo kwaye undwendwele nabanye ababoneleli ngezempilo ngaphambi kokuba wenze olu tyando. Ezinye zazo zezi:

• Uvavanyo olupheleleyo lomzimba.
• Uvavanyo lwegazi, i-ultrasound ye-gallbladder yakho, kunye nolunye uvavanyo ukuze uqiniseke ukuba uphilile ngokwaneleyo ukuba unokuhlinzwa.
• Ukutyelelwa ngugqirha wakho uqiniseke ukuba ezinye iingxaki zonyango onokuba nazo, ezinjengesifo seswekile, uxinzelelo lwegazi kunye neengxaki zentliziyo okanye zemiphunga ziphantsi kolawulo.
• Iingcebiso ngezondlo.
• Iiklasi zokukunceda ufunde okwenzekayo ngexesha lotyando, into omele uyilindele emva koko, kwaye yeyiphi ingozi okanye iingxaki ezinokuthi zenzeke emva koko.
• Unokufuna ukutyelela nomcebisi ukuze uqiniseke ukuba ukulungele ngokwasemphefumlweni kolu tyando. Kuya kufuneka ukwazi ukwenza utshintsho olukhulu kubomi bakho emva kotyando.

Ukuba uyatshaya, kuya kufuneka uyeke iiveki ezininzi ngaphambi kotyando kwaye ungaphindi uqale ukutshaya emva kotyando. Ukutshaya kunciphisa ukubuyela umva kwaye kwandisa umngcipheko weengxaki. Tshela ugqirha wakho okanye umongikazi ukuba ufuna uncedo lokuyeka.

Xelela ugqirha wakho okanye ugqirha:

• Ukuba ukhulelwe okanye unokukhulelwa
• Ngawaphi amayeza, iivithamini, imifuno kunye nezinye izongezo ozithathayo, kwanezo uzithengileyo ngaphandle kommiselo

Ngexesha leveki ngaphambi kotyando lwakho:

• Unokucelwa ukuba uyeke ukuthatha amayeza enza ukuba kube nzima kwigazi lakho ukuba lijiye. Oku kubandakanya i-aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), kunye nezinye.
• Buza ugqirha wakho ukuba ngawaphi amayeza ekufuneka uwathathe ngemini yotyando lwakho.
• Lungisa ikhaya lakho emva kotyando.

Ngomhla wotyando:

• Landela imiyalelo malunga nokuba uyeke nini ukutya nokusela.
• Thatha amayeza ugqirha wakho akuxelele ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Fika esibhedlele ngexesha.

Uninzi lwabantu luhlala esibhedlele kangangeentsuku ezi-1 ukuya kwezi-4 emva kotyando.

Esibhedlele:

• Uya kucelwa ukuba uhlale ecaleni kwebhedi kwaye uhambe kancinci ngalo mini utyando.
• Unokuba unayo (ityhubhu) i-catheter ehamba ngempumlo yakho kwisisu sakho kangangeentsuku ezi-1 okanye ezi-2. Le tyhubhu inceda ukukhupha ulwelo emathunjini akho.
• Unokuba ne-catheter kwi-bladder yakho ukususa umchamo.
• Ngekhe utye kwintsuku ezi-1 ukuya kwezi-3 zokuqala. Emva koko, unokuba nolwelo kwaye emva koko ucoce okanye ukutya okuthambileyo.
• Unokuba unayo ityhubhu exhunywe kwinxalenye enkulu yesisu esigqithileyo. I-catheter iya kuphuma ecaleni lakho kwaye iya kukhupha amanzi.
• Uya kunxiba isitokhwe esikhethekileyo kwimilenze yakho ukunceda ukuthintela amahlwili egazi ekubeni abumbe.
• Uya kufumana amayeza ngokuthintela amahlwili egazi.
• Uya kufumana iyeza lentlungu. Uya kuthatha iipilisi zentlungu okanye ufumane amayeza eentlungu nge-IV, ipayinti eya emthanjeni wakho.

Uya kuba nakho ukugoduka xa:

• Ungatya ukutya okungamanzi okanye okucocekileyo ngaphandle kokugabha.
• Ungahamba hamba ngaphandle kweentlungu ezininzi.
• Awudingi iyeza leentlungu nge-IV okanye unikezwe ngokudutyulwa.

Qiniseka ukuba ulandela imiyalelo yendlela onokuzikhathalela ngayo ekhaya.

Uninzi lwabantu luphulukana ne-10 ukuya kwi-20 yeepawundi (i-4.5 ukuya kwi-9 yeekhilogram) ngenyanga kunyaka wokuqala emva kotyando. Ukunciphisa umzimba kuya kuncipha ngokuhamba kwexesha. Ngokuncamathela kwindlela otya ngayo nakwinkqubo yokuzilolonga kwasekuqaleni, ulahlekelwa bubunzima obuninzi.

Ungaphulukana nesiqingatha okanye ngaphezulu kobunzima bakho obongezelelweyo kwiminyaka emibini yokuqala. Uya kuphulukana nobunzima ngokukhawuleza emva kotyando ukuba usahleli ulwelo okanye ukutya okucocekileyo.

Ukuphulukana nobunzima obaneleyo emva kotyando kunokuphucula iimeko ezininzi zonyango, kubandakanya:

• Isifo sombefu
• Isifo se-reflux sesifo se-Gastroesophageal (GERD)
• Igazi elonyukayo
• Cholesterol ephezulu
• Ukuphefumla kokulala okuthintelayo
• Uhlobo lwe-2 yeswekile

Ukulinganisa kancinci kufuneka kukwenze kube lula kakhulu kuwe ukuba ujikeleze kwaye wenze imisebenzi yakho yemihla ngemihla.

Ukwehla kobunzima kwaye uphephe iingxaki ezivela kwinkqubo, kuya kufuneka ulandele imithambo kunye nezikhokelo zokutya ozinikwe ngugqirha kunye nonozakuzaku.

Utyando lweBariatric - ukudlula esiswini; I-Roux-en-Y yokuhamba kwesisu; Ukudlula esiswini-Roux-en-Y; Utyando-ukwehlisa utyando - ukudlula esiswini; Utyando lokutyeba-ukudlula esiswini

• Emva kotyando lokwehla kobunzima-yintoni oza kuyibuza ugqirha wakho
• Ukhuseleko kwigumbi lokuhlambela kubantu abadala
• Phambi kotyando lokwehla kobunzima-yintoni oza kuyibuza ugqirha wakho
• Utyando lokudlula kwisisu-ukukhupha
• I-Laparoscopic gastric banding - ukukhutshwa
• Ukuthintela ukuwa
• Unonophelo lwenxeba lotyando - luvulekile
• Xa unesicaphucaphu nokugabha
• Ukutya kwakho emva koqhaqho olwenziwa sisisu

• Roux-en-Y isisu esenziwe ngotyando ukunciphisa umzimba
• Ukulungelelanisa i-gastric banding
• Nkqo ibhanti gastroplasty
• Ukuphambukiswa kweBiliopancreatic (BPD)
• Ukuphambukiswa kwe-Biliopancreatic nge-duodenal switch
• Ukulahla isifo

I-Buchwald H. Laparoscopic Roux-en-Y yokudlula kwesisu. Ku: Buchwald H, ed. I-Atlas ye-Buchwald yeeMetabolic kunye neBariatric zoPhando kunye neNkqubos. IPhiladelphia, PA: Elsevier Saunders; 2012: isahluko 6.

I-Buchwald H. Vula iRoux-en-Y yokuhamba kwesisu. Ku: Buchwald H, ed. I-Atlas ye-Buchwald ye-Metabolic & Bariatric Techniques kunye neNkqubo. IPhiladelphia, PA: Elsevier Saunders; 2012: isahluko 5.

URichards WO. Ukutyeba okungathethekiyo. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 47.

USullivan S, uEdmundowicz SA, uMorton JM. Unyango kunye nonyango lwe-endoscopic lokutyeba kakhulu. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Gastrointestinal and Liver Disease. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 8.