{"id":3812,"date":"2022-06-13T12:55:26","date_gmt":"2022-06-13T12:55:26","guid":{"rendered":"https:\/\/onehospital.mk\/?p=3812"},"modified":"2022-09-12T12:29:28","modified_gmt":"2022-09-12T12:29:28","slug":"surgery-with-modern-technology-in-the-21st-century-which-operations-are-performed-most-often-dr-petre-kodovski-specialist-in-general-surgery","status":"publish","type":"post","link":"https:\/\/onehospital.mk\/sq\/surgery-with-modern-technology-in-the-21st-century-which-operations-are-performed-most-often-dr-petre-kodovski-specialist-in-general-surgery\/","title":{"rendered":"Kirurgjia me teknologji moderne n\u00eb shekullin 21, cilat operacione kryhen m\u00eb shpesh? \u2013 Dr. Peter Kodovski (Specialist i Kirurgjis\u00eb s\u00eb P\u00ebrgjithshme)"},"content":{"rendered":"

Kirurgjia \u00ebsht\u00eb nj\u00eb deg\u00eb e mjek\u00ebsis\u00eb klinike q\u00eb merret me trajtimin e s\u00ebmundjeve dhe d\u00ebmtimeve n\u00eb nj\u00eb m\u00ebnyr\u00eb operative, m\u00eb sakt\u00eb, me dor\u00ebn e kirurgut ose duke p\u00ebrdorur instrumente.<\/strong><\/p>\n

Emri \"kirurgji\" vjen nga fjala greke \"Chirurgia\", q\u00eb do t\u00eb thot\u00eb dor\u00eb dhe pun\u00eb, e cila fjal\u00eb p\u00ebr fjal\u00eb shpjegon nevoj\u00ebn p\u00ebr nj\u00eb dor\u00eb kirurgjikale t\u00eb sakt\u00eb, t\u00eb aft\u00eb dhe me p\u00ebrvoj\u00eb p\u00ebr nj\u00eb operacion t\u00eb suksessh\u00ebm.<\/p>\n

N\u00eb m\u00ebnyr\u00eb q\u00eb kirurgu t\u00eb kryej\u00eb pun\u00ebn e tij me sukses dhe sakt\u00ebsi, \u00ebsht\u00eb e nevojshme t\u00eb ket\u00eb nj\u00eb edukim t\u00eb gjer\u00eb mjek\u00ebsor, si dhe njohuri t\u00eb teknik\u00ebs dhe teknologjis\u00eb.<\/p>\n

Cilat operacione kryhen m\u00eb shpesh?<\/strong><\/p>\n

\u2013 Kirurgjia e Kalkuloz\u00ebs Biliare<\/strong><\/p>\n

Gur\u00ebt e t\u00ebmthit n\u00eb fshik\u00ebz e t\u00ebmthit ndodhin duke grumbulluar p\u00ebrmbajtjen e tij, kolesterolin dhe bilirubin. Ato variojn\u00eb n\u00eb madh\u00ebsi nga shum\u00eb t\u00eb vogla (1-2 mm) deri n\u00eb form\u00eb r\u00ebre, deri n\u00eb shum\u00eb t\u00eb m\u00ebdha q\u00eb mbushin t\u00ebr\u00eb fshik\u00ebz\u00ebn e t\u00ebmthit dhe kan\u00eb form\u00ebn e saj. Shpesh pacienti ka nj\u00eb p\u00ebrzierje t\u00eb t\u00eb gjitha madh\u00ebsive.<\/p>\n

Guralec\u00ebt n\u00eb h. qeset jan\u00eb t\u00eb pranishme n\u00eb 20-30% t\u00eb popullsis\u00eb dhe jan\u00eb m\u00eb t\u00eb zakonshme tek femrat, raporti \u00ebsht\u00eb 4: 1. N\u00eb disa raste, gur\u00ebt e vegj\u00ebl japin p\u00ebrshtypjen e t\u00ebmthit dhe nuk formojn\u00eb kurr\u00eb gur\u00eb. Simptomat jan\u00eb: dhimbje n\u00ebn harkun e djatht\u00eb brinjor dhe lug\u00ebn dhe mund t\u00eb p\u00ebrhapet n\u00eb shpatull\u00ebn e djatht\u00eb, t\u00eb p\u00ebrzier dhe t\u00eb vjella. N\u00eb disa raste, n\u00eb rastin e gur\u00ebve t\u00eb vegj\u00ebl, nj\u00eb gur mund t\u00eb hyj\u00eb n\u00eb kanalin kryesor biliar, duke penguar rrjedh\u00ebn biliare, me \u00e7'rast simptoma e par\u00eb e pacientit \u00ebsht\u00eb zverdhja e l\u00ebkur\u00ebs dhe mukozave t\u00eb dukshme, e ndjekur nga ethe dhe fe\u00e7e t\u00eb bardha. N\u00eb k\u00ebt\u00eb rast, \u00ebsht\u00eb nj\u00eb nd\u00ebrlikim i s\u00ebmundjes. Metoda standarde p\u00ebr v\u00ebrtetimin e gur\u00ebve biliare \u00ebsht\u00eb ECHO abdominale. N\u00eb disa raste, kur kirurgu vler\u00ebson, \u00ebsht\u00eb e nevojshme t\u00eb b\u00ebhen teste diagnostikuese m\u00eb komplekse - ERCP dhe MRCP. Grumbullimi i t\u00ebmthit, p\u00ebr fat t\u00eb keq, \u00ebsht\u00eb ekskluzivisht nj\u00eb s\u00ebmundje kirurgjikale (mund t\u00eb trajtohet vet\u00ebm me kirurgji). Metoda standarde e trajtimit kirurgjik kudo n\u00eb bot\u00eb \u00ebsht\u00eb metoda laparoskopike, e njohur gjer\u00ebsisht si \"kirurgjia me kat\u00ebr vrima\". Lloji i anestezis\u00eb \u00ebsht\u00eb gjithmon\u00eb i p\u00ebrgjithsh\u00ebm. Me k\u00ebt\u00eb operacion, pacienti nuk ka nj\u00eb prerje si m\u00eb par\u00eb, duke p\u00ebrjashtuar k\u00ebshtu mund\u00ebsin\u00eb e hernies ventrale n\u00eb vendin e operacionit, koh\u00ebzgjatja e operacionit shkurtohet, nevoja p\u00ebr antibiotik\u00eb dhe ila\u00e7e kund\u00ebr dhimbjeve \u00ebsht\u00eb m\u00eb e vog\u00ebl dhe sasia e barnave. n\u00eb anestezi zvog\u00eblohet, dhimbja pas operacionit zvog\u00eblohet n\u00eb m\u00ebnyr\u00eb drastike, pacienti mobilizohet me shpejt\u00ebsi dhe kalon me shpejt\u00ebsi n\u00eb marrjen e l\u00ebngjeve dhe ushqimit p\u00ebrmes goj\u00ebs. Rehabilitimi i pacientit \u00ebsht\u00eb shum\u00eb m\u00eb i shpejt\u00eb, aft\u00ebsia p\u00ebr t\u00eb punuar \u00ebsht\u00eb e mundur pas nj\u00eb jave. Nj\u00ebkoh\u00ebsisht me metod\u00ebn laparoskopike mund\u00ebsohet ekzaminimi i organeve t\u00eb tjera n\u00eb bark dhe mund\u00ebsisht trajtimi i tyre kirurgjik, d.m.th. \"Dy operacione n\u00eb nj\u00eb\".<\/p>\n

– Kirurgjia e hernies <\/strong>i pjes\u00ebs s\u00eb p\u00ebrparme t\u00eb barkut ose i njohur gjer\u00ebsisht si hernie ose brunch, shfaqet si kombinim i rritjes s\u00eb presionit intra-abdominal (kur ngrihen sende t\u00eb r\u00ebnda, kapsll\u00ebku, kollitja dhe teshtitja e zgjatur, tumoret, d\u00ebshtimi i zemr\u00ebs, etj.) dhe hapja ose dob\u00ebsia e muskulatur\u00ebs ose fascia ku presioni i shtuar i shtyn organet dhe indet p\u00ebrmes pik\u00ebs s\u00eb dob\u00ebt t\u00eb murit.<\/p>\n

Dob\u00ebsia e muskujve mund t\u00eb jet\u00eb e lindur, por zakonisht ndodh n\u00eb nj\u00eb koh\u00eb t\u00eb m\u00ebvonshme n\u00eb jet\u00eb. N\u00eb var\u00ebsi t\u00eb vendit t\u00eb shfaqjes dallojm\u00eb: Hernia Ingenuale, Hemorale, K\u00ebrthizore, Epigastrike dhe tejet e rrall\u00eb Spiegel. Grupi special p\u00ebrfshin qepjet ventrale ose incisale, t\u00eb cilat ndodhin n\u00eb vendin e nj\u00eb operacioni t\u00eb m\u00ebparsh\u00ebm abdominal.<\/p>\n

Hernia nuk njeh kufi moshe, ajo prek si burrat ashtu edhe grat\u00eb. Ajo manifestohet si nj\u00eb \u00ebnjtje pa dhimbje ose pak e ndjeshme e l\u00ebkur\u00ebs s\u00eb stomakut, e cila zakonisht ndodh pas ushtrimit fizik dhe zhduket kur pacienti \u00ebsht\u00eb shtrir\u00eb.<\/p>\n

N\u00eb m\u00ebnyr\u00eb evolucionare, me kalimin e koh\u00ebs, hernia rritet n\u00eb madh\u00ebsi. Jasht\u00ebzakonisht n\u00eb f\u00ebmij\u00ebri mund t\u00eb ndodh\u00eb q\u00eb me zhvillimin e murit muskulor t\u00eb forcohen natyrsh\u00ebm ato pika t\u00eb dob\u00ebta. Prandaj, tek f\u00ebmij\u00ebt mund t\u00eb pritet trajtim kirurgjik.<\/p>\n

\"\"<\/p>\n

\u00c7far\u00eb \u00ebsht\u00eb operacioni i hapur?<\/strong><\/p>\n

Kjo \u00ebsht\u00eb procedura kryesore tradicionale. K\u00ebtu, mjeku b\u00ebn nj\u00eb prerje t\u00eb madhe p\u00ebr t\u00eb z\u00ebvend\u00ebsuar ose riparuar indin ose nj\u00eb organ n\u00eb trup. Kirurgu do t\u00eb p\u00ebrdor\u00eb nj\u00eb bisturi p\u00ebr t\u00eb b\u00ebr\u00eb nj\u00eb prerje deri n\u00eb dhjet\u00eb in\u00e7 p\u00ebr t\u00eb lejuar hyrjen n\u00eb organ.<\/p>\n

\u00c7far\u00eb \u00ebsht\u00eb kirurgjia laparoskopike?<\/strong><\/p>\n

I njohur gjithashtu si kirurgjia e vrim\u00ebs s\u00eb \u00e7el\u00ebsit, kirurgjia me fasho, laparoskopia diagnostike dhe kirurgjia minimale invazive, laparoskopia \u00ebsht\u00eb nj\u00eb operacion i vog\u00ebl i nisur me prerje. \u00cbsht\u00eb m\u00eb pak e dhimbshme se operacionet e tjera dhe zakonisht p\u00ebrdoret p\u00ebr t\u00eb diagnostikuar dhe trajtuar organet n\u00eb rajonin e legenit ose t\u00eb barkut.<\/p>\n

\"\"<\/p>\n

Dallimi midis kirurgjis\u00eb s\u00eb hapur dhe kirurgjis\u00eb laparoskopike <\/strong>!?<\/strong><\/p>\n

Dallimi kryesor midis kirurgjis\u00eb s\u00eb hapur dhe kirurgjis\u00eb laparoskopike \u00ebsht\u00eb madh\u00ebsia e prerjes. Kirurgjia e hapur \u00ebsht\u00eb nj\u00eb procedur\u00eb tradicionale n\u00eb t\u00eb cil\u00ebn b\u00ebhet nj\u00eb prerje e vetme, disa in\u00e7 e gjat\u00eb, n\u00ebse jo m\u00eb shum\u00eb, p\u00ebr t\u00eb hyr\u00eb n\u00eb bark.<\/p>\n

N\u00eb t\u00eb kund\u00ebrt, Kirurgjia laparoskopike \u00ebsht\u00eb nj\u00eb operacion minimal invaziv <\/strong>q\u00eb p\u00ebrdor disa prerje prej nj\u00eb \u00e7erek ose m\u00eb pak. K\u00ebtu, kirurgu p\u00ebrdor nj\u00eb mjet t\u00eb ve\u00e7ant\u00eb laparoskopi p\u00ebr t\u00eb ndihmuar n\u00eb kryerjen e procedurave duke p\u00ebrdorur prerje shum\u00eb t\u00eb vogla. Laparoskopia p\u00ebrdor teknika m\u00eb t\u00eb avancuara n\u00eb krahasim me kirurgjin\u00eb e hapur. Prandaj, shum\u00eb njer\u00ebz preferojn\u00eb laparoskopin\u00eb sesa kirurgjin\u00eb e hapur.<\/p>\n

P\u00ebrve\u00e7 k\u00ebsaj, individit i duhet m\u00eb shum\u00eb koh\u00eb p\u00ebr t'u rikuperuar nga operacioni i hapur sesa nga laparoskopia. Sipas raporteve, qasja laparoskopike n\u00eb p\u00ebrgjith\u00ebsi shkakton m\u00eb pak humbje gjaku dhe m\u00eb pak trauma dhe siguron sh\u00ebrim m\u00eb t\u00eb shpejt\u00eb me shtrimin n\u00eb spital t\u00eb reduktuar n\u00eb krahasim me kirurgjin\u00eb e hapur.<\/p>\n

Megjithat\u00eb, laparoskopia k\u00ebrkon anestezi t\u00eb p\u00ebrgjithshme dhe kushton m\u00eb shum\u00eb se operacioni i hapur. Ka edhe kufizime t\u00eb caktuara p\u00ebr njer\u00ebzit me s\u00ebmundje t\u00eb tilla si s\u00ebmundje t\u00eb zemr\u00ebs, obezitet etj., nd\u00ebrkoh\u00eb q\u00eb operacioni i hapur kushton m\u00eb pak dhe mund t\u00eb kryhet n\u00ebn anestezi lokale nd\u00ebrsa pacienti \u00ebsht\u00eb zgjuar. Megjithat\u00eb, mund t\u00eb shkaktoj\u00eb q\u00ebndrime m\u00eb t\u00eb gjata n\u00eb spital, plag\u00eb m\u00eb t\u00eb m\u00ebdha, m\u00eb shum\u00eb dhimbje dhe nj\u00eb rrezik m\u00eb t\u00eb lart\u00eb t\u00eb komplikimeve t\u00eb tilla si infeksioni dhe gjakderdhja.<\/p>\n

Me rritjen e nd\u00ebrgjegj\u00ebsimit publik dhe p\u00ebrparimet n\u00eb rritje n\u00eb kirurgjin\u00eb minimalisht t\u00eb aksesueshme, nj\u00eb nga pyetjet m\u00eb t\u00eb shpeshta nga njer\u00ebzit \u00ebsht\u00eb n\u00ebse ata duhet t\u00eb shkojn\u00eb p\u00ebr kirurgji t\u00eb hapur apo laparoskopike. N\u00eb shumic\u00ebn e rasteve, nj\u00eb qasje minimalisht invazive mund t\u00eb mos jet\u00eb e realizueshme dhe operacioni i hapur mund t\u00eb ket\u00eb nj\u00eb rezultat m\u00eb t\u00eb mir\u00eb.<\/p>\n

Megjithat\u00eb, ndonj\u00ebher\u00eb e kund\u00ebrta mund t\u00eb jet\u00eb e v\u00ebrtet\u00eb. N\u00eb dit\u00ebt e sotme, shum\u00eb kirurg\u00eb preferojn\u00eb kirurgjin\u00eb laparoskopike sepse \u00ebsht\u00eb m\u00eb e shpejt\u00eb dhe m\u00eb e avancuar. Sidoqoft\u00eb, gjithmon\u00eb duhet t\u00eb konsultoheni me mjekun tuaj p\u00ebr t\u00eb ditur p\u00ebrfitimet dhe rreziqet e \u00e7do operacioni p\u00ebrpara se t\u00eb b\u00ebni zgjedhjen tuaj.<\/p>\n

Kirurgjia \u00ebsht\u00eb nj\u00eb ngjarje e r\u00ebnd\u00ebsishme e jet\u00ebs q\u00eb do t\u00eb ndryshoj\u00eb t\u00eb ardhmen tuaj p\u00ebr mir\u00eb. Megjithat\u00eb, ka disa \u00e7mime q\u00eb duhen paguar p\u00ebr k\u00ebt\u00eb. Si kirurgjia e hapur ashtu edhe ajo laparoskopike kan\u00eb t\u00eb mirat dhe t\u00eb k\u00ebqijat e tyre. Prandaj, kur vendosni se p\u00ebr \u00e7far\u00eb operacioni d\u00ebshironi t\u00eb shkoni, mbani parasysh koston dhe periudh\u00ebn e rikuperimit.<\/p>\n

\"\" \"\"<\/p>","protected":false},"excerpt":{"rendered":"

Surgery is a branch of clinical medicine that deals with the treatment of diseases and injuries in an operative manner. The name “surgery” comes from the Greek word “Chirurgia”, which means hand and work, which literally explains the need for a precise, skillful, and experienced surgical hand for a successful operation. 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