Kuiswa kwegastric band ndiko kudzoreredzwa kwekuvhiya kufutisa (gastroplasty) iyo ine chinangwa chekudzikisa kukura kwedumbu. Iyo inowanzoitwa ne laparoscopy. Kurasikirwa kwehuremu kunotarisirwa kunogona kunge kuri pakati pe40-60% yehuremu hwakawandisa. Kuti kuwedzere mikana yekubudirira, kuiswa kwegastric band kunofanira kusanganiswa nekutevera mushure mekuvhiyiwa neboka rekuvhiya uye kutevedzera mimwe mitemo nemurwere, kunyanya maererano nekudya.

Gastroplasty kuvhiya kufutisa kune chinangwa chekudzikisa kukura kwedumbu. Zvinoita kuti zvikwanisike kuderedza kuwanda kwechikafu chakapinzwa nekukonzera kunzwa kwekutanga satiety iyo inobatsira varwere kugadzirisa madyiro avo sechikamu chekutonga kwakazara uye kwenguva refu kwekufutisa kwavo.

Gastric band

Mhete ye gastroplasty inoiswa yakatenderedza chikamu chepamusoro chedumbu kuganhura kahomwe kadiki. Iri dumbu diki rinozadza nekukurumidza panguva yekudya, zvichikonzera kuguta kwekutanga. Zvadaro, kahomwe kadiki aka kanopinda zvishoma nezvishoma muchikamu chemudumbu chiri pasi pechindori uyezve kugaya kunoitika sezvakangoita. Iyi mhete yakabatanidzwa nechubhu diki kune bhokisi rekutonga rakaiswa pasi peganda. Iyi mhete inogona kusimbiswa kana kusunungurwa nekupinza mvura mukesi, kuburikidza neganda. Kuisa gastric bhendi ndiko chete kuchinjika kuvhiya kufutisa.

Mamwe marudzi egastroplasty

• Iyo gastric bypass inzira inosanganisa kuvakwa kwehomwe diki nechekumusoro kwedumbu izvo zvinokonzeresa kuderera kwegastric kugona, uye pfupi-dunhu rechikamu chedumbu kudzikamisa huwandu hwechikafu chakabatwa nemuviri.
• Sleeve gastrectomy (kana kuti sleeve gastrectomy) inosanganisira kubvisa inenge 2/3 yemudumbu, uye kunyanya chikamu chine masero anobudisa hormone inokurudzira kudya (ghrelin). Dumbu rinoderedzwa kuita chubhu yakatwasuka, uye chikafu chinopfuura nekukurumidza nemuura.

Kugadzirira kuiswa kwegastric band

Kuvhiyiwa kunofanira kutangirwa nekuongorora kwakakwana kunobvumirawo murwere kuti ave nenguva yekufunga asati apfuurira kune chiito chekuvhiya.

Zuva rebvunzo

Murwere anopinda muchipatara zuva rakapfuura (kana kuti mangwanani) ekuvhiya. 

Kupindira

Kuvhiya kunowanzoitwa laparoscopically nerubatsiro rwekamera kuburikidza nediki diki kubva pa5 kusvika 15 mm. Muzviitiko zvisingawanzoitiki, zvinogona kuitwa kuburikidza neklasic incision (laparotomy). Kuvhiya kunoitika pasi peanesthesia, uye inogona kupedza kusvika maawa matatu.

Kufanana nekuvhiya kwese gastroplasty, kuiswa kwegastric band kunogona kutariswa muvanhu:

• Iine body mass index (BMI) yakakura kudarika kana yakaenzana ne40
• NeBMI yakakura kudarika kana yakaenzana ne35 vane matambudziko akakomba ane uremu (chirwere cheshuga, high blood pressure, sleep apnea, heart failure)

Mhedzisiro inotarisirwa

Kuwedzera uremu kunoenderana nenhamba yekuwedzera mapaundi kana ichienzaniswa neinotarirwa uremu hwakakodzera hunoverengerwa pahwaro hweBMI pakati pe23 ne25. Mushure mekugadzirisa gastric band, iyo inotarisirwa kurasikirwa kwehuremu sechikamu che l iye uremu hwakawandisa ndeye 40-60% . Izvi zvinoenderana nekuderera kwehuremu hunosvika makumi maviri kusvika makumi matatu makirogiramu kumunhu wepakati pehurefu (20m30) ane BMI yakaenzana ne1.

Zvinogona kuitika

Kuiswa kwegastric band kunoda kunyatsotariswa neboka rekuvhiya mushure mekuvhiya. Ivhareji yekugara muchipatara inenge mazuva matatu, inobvumira boka rezvokurapa kuti ritore chero dambudziko repashure pekushanda (hutachiona, kubuda ropa, nezvimwewo) Kufutisa kunowedzera ngozi yephlebitis (kuvhara mutsinga) uye pulmonary embolism. Muchiitiko ichi, majekiseni ekutetepa ropa uye compression masokisi anogona kutariswa mushure mekuvhiyiwa.

Gare gare mechanical complications inogonawo kuitika:

• Matambudziko ane chokuita nenyaya yacho: zvirwere, kutama kwemhosva pasi peganda, kurwadziwa panzvimbo yemhosva, kuputika kwechubhu inobatanidza nyaya uye mhete;
• Kutsvedza kwemhete uye kuwedzera kwehomwe pamusoro pering izvo zvinogona kukonzera kurutsa kwakanyanya kana kutadza kudya;
• Esophageal kusagadzikana (reflux, esophagitis);
• Maronda emudumbu anokonzerwa nemhete (kuora kwedumbu, kutama kwemhete).

Mhedzisiro yekupindira

• Murwere anofanirwa kubvunza chiremba wake uye nyanzvi yezvekudya kuti arambe achitevera. Anofanira kuremekedza zano rekudya: idya semi-mvura wobva wasimba, idya zvishoma nezvishoma, usanwe uchidya, cheva zvakaonda zvakanaka.
• Mushure mokudzokera kumba, murwere anofanira kutarisa kuitika kwezvimwe zviratidzo (kupfupika kwekufema, kurwadziwa kwepamuviri, kupisa, kubuda ropa kubva kune anus, kudzokorora kurutsa kana kurwadziwa kwepfudzi) uye kubata chiremba wake kana chimwe chazvo chikaitika. . Kunyangwe kunonoka mushure mekuvhiyiwa, kurutsa kunofanira kuziviswa kuna chiremba wake.
• Sezvinoita chero kuvhiyiwa kufutisa, kubata pamuviri hakukurudzirwe mukati megore rekutanga postoperative.