Doğal Orifislerden Transluminal Endoskopik Cerrahi ve Hemşirelik

Minimal invaziv cerrahinin son yıllarda gelişmesi ve hasta taleplerinin artması ile doğal orifislerden transluminal endoskopik cerrahi (NOTES), laparoskopik yöntemin ardından en önemli yeniliklerden biri olmuştur. Doğal açıklık cerrahisi olarak da bilinen NOTES, cerrahi girişimin vücudun doğal açıklıklarının (mide, vajina, mesane ve rektum) kullanılarak yapıldığı tekniktir. NOTES yöntemi ile cerrahi girişimin avantajları arasında, daha az kozmetik sorun gelişimi; ameliyat sonrası ağrı şiddetinin, cerrahi alan infeksiyonu ve fıtık oluşum riskinin daha az olması yer almaktadır. Bunun yanı sıra viseral ve vasküler yaralanma, gecikmiş anastomoz, giriş yeri kaçakları, ameliyat sonrası organlarda yapışıklık, disparoni gibi dezavantajları da mevcuttur. Cerrahi uygulamalarında NOTES gibi yeni yaklaşım ve tekniklerin gelişimi, cerrahi ekibinin bir parçası olan hemşirelere de yeni sorumluluklar getirmiştir. Doğal açıklık cerrahisi sonrası hastanede kalış süresinin ve iyileşme sürecinin kısalması ve komplikasyon görülme oranının azalması gibi avantajlarından dolayı hemşirelik bakımına etkilerinin olumlu olarak yansıdığı görülmektedir. Bu bağlamda doğal açıklık cerrahisi daha bilgili, daha deneyimli cerrah ve cerrahi hemşirelerinin gerekliliğini ortaya koymuştur. Ancak literatürde bu konuya ilişkin hemşireler üzerinde yapılmış çalışmaya pek rastlanmamaktadır. Dolayısıyla yeni gelişmekte olan bu yöntemin bilgisayarlı simulasyon ortamlarında pratik yapıldıktan sonra hasta üzerinde çalışılması, hemşirelik üzerine araştırmaların arttırılması ve eğitimin planlanması önerilmektedir.

Anahtar Kelimeler:

Cerrahi Bakım, Doğal Açıklık Cerrahisi, Hemşire, NOTES

Natural Orifice Transluminal Endoscopic Surgery and Nursıng

With the development of minimally invasive surgery and increasing patient demands, Natural orifice transluminal endoscopic surgery (NOTES) has been one of the most important innovations after the laparoscopic method. NOTES, also known as natural clarity surgery, is the technique in which surgical interventions are performed using the natural openings of the body (stomach, vagina, bladder and rectum). The advantages of surgical intervention using the NOTES method include less cosmetic problem, less postoperative pain intensity, less postoperative inflammation, and a lower risk of hernia formation. However, there are disadvantages such as visceral and vascular injury, delayed anastomosis, entrance leakage, postoperative adhesions in organs, and dyspareunia. The development of new approaches and techniques, such as NOTES, brought new responsibilities to nurses who are part of the surgical team. It was found that the advantages of the NOTES method (such as shortening the hospital stay and recovery period and reducing the incidence of complications) reflected positively on nursing care. In this context, the NOTES method has revealed the necessity of more knowledgeable and experienced surgeons and surgical nurses. There are not many studies in the medical literature about the of nurses in this topic. Therefore, it is recommended that this newly developing method should be studied on the patient after practice in computerized simulation environments, researches on nursing should be increased and education should be planned.

Keywords:

Surgıcal Care, Natural Orifice Transluminal Endoscopic Surgery, Nurse, NOTES,

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