Kuyika kwa gastric band ndi ntchito yosinthika ya opaleshoni ya kunenepa kwambiri (gastroplasty) yomwe cholinga chake ndi kuchepetsa kukula kwa m'mimba. Kawirikawiri amachitidwa ndi laparoscopy. Kutaya kulemera komwe kumayembekezereka kungakhale mu 40-60% ya kulemera kwakukulu. Kuonjezera mwayi wopambana, kuyika kwa gulu la m'mimba kuyenera kugwirizanitsidwa ndi kutsata pambuyo pa opaleshoni ndi gulu la opaleshoni ndikutsatira malamulo ena a wodwalayo, makamaka ponena za zakudya.

Gastroplasty ndi opaleshoni ya kunenepa kwambiri yomwe cholinga chake ndi kuchepetsa kukula kwa m'mimba. Zimapangitsa kuchepetsa kuchuluka kwa chakudya chomwe chimalowetsedwa mwa kuyambitsa kumva kukhuta koyambirira komwe kumathandiza odwala kusintha madyedwe awo monga gawo la chisamaliro chokwanira komanso chanthawi yayitali cha kunenepa kwawo.

Gulu la m'mimba

Mphete ya gastroplasty imayikidwa kuzungulira kumtunda kwa m'mimba kuti muchepetse kathumba kakang'ono. Kachifuko kakang'ono kameneka kamadzaza msanga panthawi yodyetsa, zomwe zimayambitsa kukhuta koyambirira. Kenaka, kathumba kakang'ono kameneka kamalowa pang'onopang'ono m'chigawo cha m'mimba chomwe chili pansi pa mpheteyo ndiyeno chimbudzi chimachitika bwino. Mphete iyi imalumikizidwa ndi kachubu kakang'ono kubokosi lowongolera lomwe limayikidwa pansi pa khungu. Mphete iyi imatha kumangidwa kapena kumasulidwa polowetsa madzi mumphikawo, kudzera pakhungu. Kuyika chotchinga chapamimba ndi njira yokhayo yomwe ingasinthire kunenepa kwambiri.

Mitundu ina ya gastroplasty

• Chapamimba chodutsa ndi njira yomwe imaphatikiza kupanga kathumba kakang'ono kumtunda kwa m'mimba komwe kumapangitsa kuchepa kwakukulu kwa chapamimba, komanso kufupikitsa kwa gawo la matumbo kuti achepetse kuchuluka kwa zakudya zomwe thupi limatengera.
• The sleeve gastrectomy (kapena sleeve gastrectomy) imakhala ndi kuchotsa pafupifupi 2/3 ya m'mimba, makamaka gawo lomwe lili ndi ma cell omwe amatulutsa timadzi timene timatulutsa chilakolako chofuna kudya (ghrelin). Mimba imachepetsedwa kukhala chubu choyima, ndipo chakudya chimadutsa mofulumira m'matumbo.

Kukonzekera kuyika chapamimba gulu

Opaleshoniyo iyenera kutsatiridwa ndi kufufuza kwathunthu komwe kumapangitsanso wodwalayo kukhala ndi nthawi yoganizira asanayambe kuchita opaleshoni.

Tsiku la mayeso

Wodwala amalowa m'chipatala dzulo (kapena m'mawa) la opaleshoniyo. 

Kuchitapo kanthu

Opaleshoni nthawi zambiri imachitika laparoscopically mothandizidwa ndi kamera kudzera m'magawo ang'onoang'ono kuyambira 5 mpaka 15 mm. Nthawi zambiri, imatha kuchitidwa pogwiritsa ntchito njira yapakatikati (laparotomy). Opaleshoniyo imachitika pansi pa anesthesia wamba, ndipo imatha mpaka maola atatu.

Monga maopaleshoni onse a gastroplasty, kuyika kwa gastric band kumatha kuganiziridwa mwa anthu:

• Ndi body mass index (BMI) yoposa kapena yofanana ndi 40
• Ndi BMI yoposa kapena yofanana ndi 35 omwe ali ndi vuto lalikulu la thanzi (shuga, kuthamanga kwa magazi, kupuma movutikira, kulephera kwa mtima)

Zotsatira zoyembekezeredwa

Kulemera kwakukulu kumafanana ndi chiwerengero cha mapaundi owonjezera poyerekeza ndi kulemera koyembekezeka koyenera kuwerengedwera pamaziko a BMI pakati pa 23 ndi 25. Pambuyo popanga gulu la m'mimba, kulemera kwake kumayembekezeredwa monga peresenti ya l iye kulemera kwakukulu ndi 40-60% . Izi zikufanana ndi kuonda kwa pafupifupi 20 mpaka 30 kg kwa munthu wamtali wapakati (1m70) wokhala ndi BMI yofanana ndi 40.

Zovuta zotheka

Kuyika kwa gulu la m'mimba kumafuna kuyang'anitsitsa mosamala ndi gulu la opaleshoni pambuyo pa opaleshoni. Nthawi zambiri m'chipatala amakhala pafupi ndi masiku a 3, amalola gulu lachipatala kuti liziyang'anira zovuta zilizonse zomwe zimachitika pambuyo pa opaleshoni (matenda, kutaya magazi, etc.) Kunenepa kwambiri kumawonjezera chiopsezo cha phlebitis (kutsekeka m'mitsempha) ndi pulmonary embolism. Pamenepa, jekeseni wochepetsera magazi ndi kupaka masitonkeni amatha kuganiziridwa pambuyo pa opaleshoni.

Pambuyo pake zovuta zamakina zitha kuchitikanso:

• Mavuto okhudzana ndi mlanduwo: matenda, kusamuka kwa mlanduwo pansi pa khungu, kupweteka komwe kuli mlandu, kuphulika kwa chubu cholumikiza mlanduwo ndi mphete;
• Kutsetsereka kwa mphete ndi kufutukuka kwa thumba pamwamba pa mphete zomwe zingayambitse kusanza kwakukulu kapena kulephera kudya;
• matenda am'mitsempha (reflux, esophagitis);
• Zilonda zam'mimba zomwe zimayambitsidwa ndi mphete (kukokoloka kwa m'mimba, kusamuka kwa mphete).

Zotsatira za kulowererapo

• Wodwalayo ayenera kukaonana ndi dokotala wake wa opaleshoni ndi katswiri wa zakudya kuti amutsatire kwa nthawi yayitali. Ayenera kulemekeza malangizo a zakudya: kudya theka-zamadzimadzi kenako olimba, kudya pang'onopang'ono, osamwa pamene akudya, kutafuna zolimba bwino.
• Pambuyo pobwerera kunyumba, wodwalayo ayenera kuyang'anitsitsa zochitika za zizindikiro zina (kupuma pang'ono, kupweteka kwa m'mimba, kutentha thupi, kutuluka magazi kuchokera ku anus, kusanza mobwerezabwereza kapena kupweteka kwa mapewa) ndikuwonana ndi dokotala wake wa opaleshoni ngati chimodzi mwa izo chikuchitika. . Ngakhale mochedwa opareshoni, kusanza mobwerezabwereza kuyenera kuuzidwa kwa dokotala wake.
• Mofanana ndi opaleshoni iliyonse ya kunenepa kwambiri, mimba sichivomerezeka m'chaka choyamba cha postoperative.