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Uporaba Trendelenburgovega položaja v robotski kirurgiji : diplomsko delo
ID Glogovec, Neža (Avtor), ID Pajnič, Manca (Mentor) Več o mentorju... Povezava se odpre v novem oknu, ID Arnautovič, Sanja (Komentor)

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Izvleček
Uvod: Robotska kirurgija je namenjena izvajanju visoko tveganih in zapletenih kirurških operativnih posegov. Trendelenburgov položaj je položaj, pri katerem pacient leži v previsni legi z glavo navzdol in nogama navzgor. Tveganja za pacienta med robotskim operativnim posegom v tem položaju so: nevrološke, oftalmološke in otološke, kardiovaskularne, pulmološke, gastrointestinalne in renalne komplikacije ter razne poškodbe. Operacijska medicinska sestra je vključena v pripravo pacienta na robotski operativni poseg in sodeluje pri preprečevanju intraoperativnih komplikacij. Namen: Namen diplomskega dela je predstaviti uporabo Trendelenburgovega položaja v robotski kirurgiji. Zastavljena cilja sta: predstaviti vlogo medicinske sestre med robotskim operativnim posegom in predstaviti tveganja za pacienta, ki je dolgo časa nameščen v Trendelenburgov položaj. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo dela, pregledali domačo in tujo literaturo ter jo vsebinsko analizirali. Literaturo smo iskali in zbirali v bibliografskih podatkovnih bazah, kot so MEDLINE, CINAHL, PubMed in na spletni strani AORN (The Association of periOperative Registered Nurses), ter s pomočjo COBBISS-a in Google Učenjaka. Izločili smo članke, ki so bili vsebinsko neustrezni, na primer tiste, ki so govorili o klasični ali laparoskopski kirurgiji in tiste, ki so govorili o robotski kirurgiji v položaju, ki ne bo Trendelenburgov. Razprava in zaključek: Medicinska sestra, ki pripravlja pacienta na robotski operativni poseg v Trendelenburgovem položaju, mora oceniti stanje kože, prepoznati tveganja za nastanek poškodbe zaradi pritiska, pristriči morebitne dlake na operativnem mestu, pacienta namestiti v ustrezen položaj, namestiti trakove in pripomočke, ki preprečujejo, da bi pacient drsel po operacijski mizi. Podaljšano ležanje v Trendelenburgovem položaju lahko privede do cerebralnega edema, poškodb živcev zgornjih in spodnjih okončin, povišanega očesnega pritiska ter do poškodb tkiva. Medicinska sestra mora znati pacienta za robotski operativni poseg namestiti v ustrezno lego, podložiti področja, kjer obstaja nevarnost za nastanek poškodbe zaradi pritiska, in poskrbeti, da so rjuhe in blazine pod pacientom poravnane. Pri operativnem posegu se za varno nameščanje pacienta v položaj uporabljajo ramenska opornica, oporniki, vakuumska vreča, razni trakovi in blazinice iz gela ter podloge in pene za preprečevanje nastanka poškodbe zaradi pritiska.

Jezik:Slovenski jezik
Ključne besede:robot, operativni poseg, nameščanje pacienta, tveganja, vloga medicinske sestre
Vrsta gradiva:Diplomsko delo/naloga
Organizacija:ZF - Zdravstvena fakulteta
Leto izida:2018
PID:20.500.12556/RUL-105731 Povezava se odpre v novem oknu
COBISS.SI-ID:5551211 Povezava se odpre v novem oknu
Datum objave v RUL:08.12.2018
Število ogledov:3780
Število prenosov:602
Metapodatki:XML DC-XML DC-RDF
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Sekundarni jezik

Jezik:Angleški jezik
Naslov:Use of Trendelenburg position in robotic surgery : diploma work
Izvleček:
Introduction: Robotic surgery is intended for performing high-risk and complicated surgical cases. Trendelenburg position is position, in which the patient lays in overhanging position, with his head down and legs up. Laying in Trendelenburg position can cause several complications, such as: neurological, ophthtalmological and otological, cardiovascular, pulmological, gastrointestinal and renal complications and different injuries. Operating room nurse is included in patient preparation for robotic surgical procedure and plays a big role in preventing intraoperative complications. Purpose: Purpose of this diploma work is introducing the use of Trendelenburg position in robotic surgery. Goals we set are: introducing nurse role during robotic surgical procedure of patient laying in Trendelenburg position and introducing risks for the patient laying in Trendelenburg position for long period of time. Methods: In this diploma work we used descriptive method of work, we reviewed home and foreign literature, and we analysed it. We searched and collected literature from databases like MEDLINE, CINAHL, PubMed and AORN journal, and with help of COBBISS and Google Scholar. We excluded articles, that were inadequate by the content, like the ones, that talked about classic and laparoscopic surgery, and the ones, that talked about robotic surgery in different positions, that were not Trendelenburg position. Discussion and conclusion: The nurse, that is preparing the patient for robotic surgery in Trendelenburg position has to evaluate patient's skin condition and recognize potential risks for bed sores development. She has to cut patient's hair on operative field, position patient in the right position for the surgical procedure and position accessories, that prevent patient sliding from operative table. Prolonged time in Trendelenburg position can lead to cerebral edema, upper and lower extremity nerves injuries, increased eye pressure and tissue injuries. Nurse has to master safe patient positioning and preventing pressure injury by padding places with higher risk of pressure. She has to make sure, that sheets and pillows under patient are smooth and straight. During surgical procedure, shoulder braces, vacuum bag, pads, braces and tapes are used for safe positioning of the patient. Gel pads, foams and pillows are used for preventing pressure injury.

Ključne besede:robot, surgery, patient positioning, risks, nurse role

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