Sažetak
UVOD: Ginekologija je grana medicine koja proučava bolesti i liječenje ženskog reproduktivnog sistema (maternice, jajnika i vagine), a odgovorna je i za sveukupno zdravlje žene. Prevod sa latinskog znači “nauka o ženama”, za razliku od andrologija, koja se bavi zdravstvenim problemima specifičnim za muški reproduktivni sistem. Važnu ulogu u razvoju ove grane ima medicinske prevencije i edukacije žena.
CILJ RADA: Objasniti proces endoskopije i njegove primjene u ginekološkim operacijama,
korištenje instrumenata – optičkih instrumenata (endoskopa) i održavanje (dezinfekcija, sterilizacija), te ulogu instrumentarke u procesu izvođenja ginekoloških endoskopskih operacija.
MATERIJALI I METODE: da bi se postigao ovaj cilj, korišteni su deskriptivni i statistički podaci iz državnog zavoda za statistiku-Skopje i privatne bolnice Remedika u Skopje.
REZULTATI: U prvoj Privatnoj bolnici Remedika u Skopju, metode endoskopije se rade od samog početka, od 2005g . U prvoj godini je urađeno 60 endoskopskih procedura i njihov broj svake godine raste da bi se došlo do broja u 2015 godini od 480 endoskopskih intervencija .
DISKUSIJA: endoskopska metoda u Makedoniji je počela da se radi 1995.godine i to na Klinici za ginekologiju Skopje. U prvoj godini je urađeno 170 endoskopskih procedura, dok u Prvoj Privatnoj bolnici Remedika Skopje endoskopije se rade od samog početka osnivanja od 2005 g. do danas. U prvoj godini je urađeno 60 endoskopskih procedura i njihov broj svake godine raste da bi se došlo do broja u 2015. godini od 480 endoskopskih intervencija. U operacionim salama u Remedici rade 12 instrumentarki i svi su vrsno obučeni pri instrumentiranju kod ovih intervencija.
ZAKLJUČAK: endoskopija je jednostavan postupak koji omogućava doktoru da pogleda unutrašnjost ljudskog tijela pomoću instrumenta koji se naziva endoskop. Endoskopija se neprestano razvija i kontiruirano napreduje u zadnjih godina, aktuelna je i robotska endoskopija. Kako bi instrumentake pratile ovaj proces napretka moraju neprestano da se educiraju kako putem stručnih časopisa tako, i posjećivanjem elitnih centara koji imaju iskustvo kod ovih procedura.
KLJUČNE RIJEČI: endoskopija, laparaskopija, histereskopija, optički instrumenti
Summary
ROLE NURSE GYNECOLOGICAL ENDOSCOPIC OPERATIONS
INTRODUCTION: Gynaecology is the branch of medicine that studies the disease and the treatment of the treatment of the female reproductive system (uterus, ovaries and vagina), and is responsible for the overall health of women. Translated from the Latin meaning “the science of women”, as opposed to andrology, which deals with health issues specific to the male reproductive system.An important role in the development of this industry has medical prevention and education of women.
AIM: To explain the process of endoscopy and its application in gynecological operations, instruments – optical instruments (endoscopes) and maintenance (disinfection, sterilization) and instumenting role in gynecological endoscopic surgery.
MATERIALS AND METHODS: In order to achieve this goal, used the descriptive and statistical data from the State Statistics Institute-Skopje and private hospitals Remedika in Skopje.
RESULTS: In the first private hospital in Skopje Remedika endoscopy method to work from the very beginning of 2005g. In the first year was done 60 endoscopic procedures and their number increases every year in order to come to the number in 2015 of 480 endoscopic interventions.
DISCUSSION: The endoscopic method in Macedonia started to work 1995Year and to the Department of Obstetrics Skopje in the first year is set by 170 endoscopic procedures while at the First Private Hospital Remedika Skopje endoscopy is done from the very beginning of 2005g. till today. U first year was done 60 endoscopic procedures and their number increases every year in order to come to the number in 2015 of 480 endoscopic interventions In operating rooms in Remedica work nurse 12 And all were finely dressed in instrumentation for these interventions.
CONCLUSION:Endoscopy is a simple procedure that allows the doctor to look inside the human body using an instrument called an endoscope. Endoscopy is constantly evolving and continuously improves the rear current year is robotic endoscopy so that nurse followed the progress of this process must constantly educate both through trade journals both elite and visiting centers that have experience in these procedures.
KEY WORDS: endoscopy, laparoscopy, histereskopija, optical instruments.
Introduction
Gynecology is a branch of medicine that studies the disease and the treatment of treatment of the female reproductive system (uterus, ovaries and vagina), and is responsible for the overall health of women. Translated from the Latin meaning “the science of women”, as opposed to andrology, which deals with health issues specific to the male reproductive system.An important role in the development of this industry has medical prevention and education of women.Diagnostics in gynecology is aimed at early detection and monitoring of certain diseases and changes. Standard diagnostic methods are: gynecological examination, ultrasound, vaginal and cervical smear, Pap test and colposcopy.Almost all modern gynecologists and obstetricians. In many areas, the specialties of gynecology and obstetrics overlap.
Examples of diseases to be treated gynecologists:
• pre-cancer and cancer of the reproductive organs, including the ovaries, fallopian tubes, uterus, cervix, vagina and vulva:
• urinary incontinence
• amenorrhea (absence of menstruation)
• dysmenorrhea (painful menstruation)
• infertility
• Menorrhagia (heavy menstrual periods); frequent indication for hysterectomy
• pelvic organ prolapse
• vaginal infections (vaginitis), cervix and uterus (including fungal, bacterial, viral and protozoal)
• Other vaginal diseases
Endoscopy means watching inside and typically refers to looking inside the body for medical reasons using an endoscope, the instrument used to examine the interior of a hollow organ or body cavity. Unlike most other medical devices for recording, the endoscope is inserted directly into the body.Endoscopy is a simple procedure that allows the doctor to look inside the human body using an instrument called an endoscope. This type of operation is called “keyhole surgery”, and usually leaves a few small scars on the outside.
Objective
Explain the process of endoscopy and its application in gynecological operations. Explain tools – optical instruments (endoscopes) and maintenance (disinfection, sterilization).Explain the importance of the role nurse in gynecological endoscopic surgery.
Materials and methods
To achieve this goal, I used the descriptive statistics from the National Statistics Institute-Skopje and Skopje Remedika, private hospital. Displayed systematized and made the calls, and the obtained information drawn conclusions.
Results
In the first private hospital in Skopje Remedika endoscopy method to work from the very beginning of 2005g. In the first year was done 60 endoscopic procedures and their number increases every year in order to come to the number in 2015 of 480 endoscopic interventions.
Figure 1. endoscopic interventions in PZU.Remedika 2005-2015
Discussion
Endoscopic gynecology began to work 1995god. in Macedonia and to the Department of Obstetrics Skopje in the first year is set by 170 endoscopic procedures while at the First Private Hospital Remedika Skopje endoscopy is done from the very beginning of 2005g. In the first year was done 60 endoscopic procedures and their number increases every year in order to come to the number in 2015 of 480 endoscopic interventions. Number endoscopic interventions is increasing for several reasons – the number of doctors who work endoscopy from year to year more and more increases . At the beginning of the endoscopy worked only one gynecologist and now eight gynecologist doing endoscopy, Also the increasingly patients through various sources like the media, Internet … learn the advantages associated with endoscopic interventions but I insist that they are operated in this way, what matters is what is proving that the advantages associated with endoscopy as a small number of complications, reduced the number of hospital days, quick revitalization and return to daily activities, better visibility as camera system increases operational field on which it runs are all key to more and more work endoscopic surgery. It should emphasize that in some hospitals in Europe unless there is some contraindications for endoscopy, virtually all operations performed in this way.
Role nurse-instrumentlist at all endoscopic intervention is not only participating in the operation, but it is necessary to know the whole apparatus, because the image is transferred to the monitor and the operator should have a clear picture throughout the entire operation. Also the instruments in these actions are very specific with a small lumen made of several parts and practical success of the operation depends largely on maintaining instruments .It must be noted that ligashur greatly facilitate this intervention and it should be noted that this type of intervention can be reported with robot technology. Unfortunately, in our country there is still no robot, because the camera itself is too expensive, but this is the future, especially in invasive laparoscopic gynecology.
Figure 2. endoscopic robot
In the operating rooms in Remedica work 12 nurse-instumenting And all were finely dressed in instrumentation for these interventions
Figure 3. endoscopic operating room
Conclusion
Endoscopy is a simple procedure that allows the doctor to look inside the human body using an instrument called an endoscope.Hysteroscopy and laparoscopy are minimally invasive operations that are used to monitor or diagnose diseases or to perform the operation.
Nurse has an important role in gynecological endoscopic surgery and must be mentally and physically ready to prepare materials, operating room and to assist with operational endeavor
Instrumentlist for specific instruments used in these operating procedures must be great to know the procedures around the dismantling and cleaning of instruments and how their disinfection and sterilization.Endoscopy used optical instruments and cold bright. Also the cautery and Ligasure which are extremely expensive so instumenting role is enormous and about the persistence of all these instruments if properly used and maintained can be used for a long time, and thus to reduce price of all endoscopic procedures.Endoscopy is constantly evolving and constantly in progres, he rear current year is robotic endoscopy so that instrumentake followed this process progress must continually educate both through trade journals both elite and visiting centers that have experience in these procedures.
References
- Prof. Dr Gligor Dimitrov, As. Dr Andrijana STERJOVSKI – Aleksovska, Authorized lectures in gynecology, 2013
- Mladenoviḱ D. et al., Obstetrics and Gynecology, Institute for Textbooks, Belgrade, 2008
- Ristiku Lj., Practical Gynecology, Freemental, Belgrade, 2006
- Berek and Novak, Gynecology, Tabernacle, 2011
- Breathers and Krisman, clinical gynecologic oncology, Tabernacle, 2011
- Cullen, Ultrasound in ginekologijata and akušerstvoto, Tabernacle, 2011
- Hoffman, Williams Gynecology 2nd ed., McGraw Hill, 2012
- Johns Hopkins Manual of Gynecology and Obstetrics, Ars Lamina (Alamin)
- Goldman and Ausiello, Cecil Medicine 23rd edition, Women’s Health, Tabernacle