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Rak jajčnikov je najpogostejši vzrok smrti pri ženskah, ki zbolijo za ginekološkimi raki. Za večino obolelih z napredovalim rakom je bolezen usodna. Razlog za to je slaba prepoznavnost bolezni v zgodnjih stadijih, ko je zdravljenje učinkovito.

Uvod: Sterilizacija ženske je pogosto uporabljen način kontracepcije. Najpogosteje je izvedena laparoskopsko. Ženske se pogosto srečujejo z zdravstvenimi težavami po laparoskopski sterilizaciji in za reševanje le-teh uporabljajo več strategij. Namen: Namen diplomskega dela je proučiti dejavnike in zaplete, ki se pojavijo po laparoskopski sterilizaciji in vplivajo na kakovost življenja žensk, ter podati usmeritve za soočanje z omenjenimi dejavniki v vsakdanjem življenju žensk. Metode dela: Za iskanje literature smo uporabili različne domače in tuje podatkovne baze, kot so COBIB.si, CINAHL, Medline, SpringerLink in Google učenjak. Iskanje literature je potekalo s pomočjo naslednjih ključnih besed v slovenskem in angleškem jeziku: »laparoskopska sterilizacija/laparoscopic sterilization«, »laparoskopska sterilizacija IN zapleti/laparoscopic sterilization AND complications«, »laparoskopska sterilizacija IN življenje žensk/laparoscopic sterilization AND women's lives«, »laparoskopska sterilizacija IN posledice/laparoscopic sterilization AND consequences«. Za vključitev literature v analizo smo upoštevali naslednja merila: prosto dostopne raziskave, ki so objavljene v celoti, jezik članka in letnik objave. V končno analizo je bilo uvrščenih 16 člankov. Za vsebinsko analizo, smo uporabili tehniko odprtega kodiranja besedila. Rezultati: Članki, ki smo jih analizirali, so večinoma na drugem in šestem hierarhičnem nivoju, zato je naš pregled literature srednje močno raziskovalno zasnovan. Identificiranih je bilo 42 kod. Kode smo razvrstili v tri glavne kategorije: zapleti, ki se najpogosteje pojavijo po laparoskopski sterilizaciji, vpliv laparoskopske sterilizacije na zdravje žensk in vpliv laparoskopske sterilizacije na kakovost življenja žensk. Razprava in zaključek: Ugotovili smo, da se po laparoskopski sterilizaciji kakovost življenja bistveno zmanjšuje pri ženskah z nižjo stopnjo izobrazbe kot pri ženskah z višjo stopnjo izobrazbe. To poudarja pomen podrobnega posvetovanja pred sterilizacijo. Prihodnje raziskave, osredotočene na pojav zapletov po laparoskopski sterilizaciji, bi morale biti zasnovane z longitudinalno raziskovalno strategijo, tako da bi spremljali pacientke daljše časovno obdobje. Potrebna je na pacientko osredotočena zdravstvena nega od predoperativnega svetovanja do upravljanja pooperativnih zapletov, da bi se dosegli dobri rezultati laparoskopske sterilizacije in posledično dobra kakovost življenja žensk po njej. Introduction: Sterilization of a woman is a commonly used method of contraception. It is most often performed laparoscopic. Women often face health problems after laparoscopic sterilization and use several strategies to address them. Purpose: The purpose of this thesis is to study the factors and complications that occur after laparoscopic sterilization and affect the quality of life of women, and to provide guidelines for dealing with these factors in the daily lives of women. Methods: We used various domestic and foreign databases, such as COBIB.si, CINAHL, Medline, SpringerLink and Google Scholar, to search for literature. The literature was searched using the following keywords in Slovene and English: "laparoscopic sterilization / laparoscopic sterilization", "laparoscopic sterilization AND complications", "laparoscopic sterilization AND women's lives", "laparoscopic sterilization AND consequences ". The following criteria were used to include the literature in the analysis: freely available research published in full, the language of the article, and the year of publication. 16 articles were included in the final analysis. For content analysis, we used the open text encoding technique. Results: The articles we analyzed are mostly at the second and sixth hierarchical levels, so our literature review is moderately research-based. 42 codes were identified. The codes were classified into three main categories: complications that most commonly occur after laparoscopic sterilization, the impact of laparoscopic sterilization on women’s health, and the impact of laparoscopic sterilization on women's quality of life. Discussion and conclusion: We found that after laparoscopic sterilization, the quality of life decreases significantly in women with a lower level of education than in women with a higher one. This underlines the importance of detailed consultation before sterilization. Future research focusing on the occurrence of complications after laparoscopic sterilization should be designed with a longitudinal research strategy to monitor patients over a longer period. Patient-focused nursing care from preoperative counseling to postoperative management is needed to achieve good laparoscopic sterilization results and consequently a good quality of life for women after it.

Izhodišče: Opioidni analgetiki in analgetiki z drugim mehanizmov delovanja imajo sinergistični učinek. Z njimi lahko zmanjšamo porabo opioidnih analgetikov. Znano je, da deksmedetomidin in lidokain zmanjšata porabo opioidov, vendar vpliv deksmedetomidina na porabo opioidnih analgetikov pri laparoskopskih črevesnih resekcijah še ni bil raziskan. S to raziskavo smo želeli ugotoviti, če uporaba dodanega deksmedetomidina ali lidokaina zmanjša porabo opioidov med in po operaciji. Metode: Med raziskavo smo opazovali: (i) porabo fentanila, (ii) porabo piritramida prvi in drugi dan po operaciji in (iii) spremembo zaznavne sposobnosti glede na vrednosti pred operacijo in nastanek nevropatske bolečine dva meseca po operaciji. 59 bolnikov smo naključno razdelili v tri skupine. Bolnike v kontrolni skupini (CG) smo anestezirali z neprekinjeno infuzijo propofola in odmerki fentanila. Dekmedetomidinski skupini (DG) smo dodali neprekinjeno intravenozno infuzijo dekmedetomidina (0.5 µg/kg/h), lidokainski (LG) pa infuzijo lidokaina (1.5 mg/kg/h). Rezultati: Med skupinami nismo opazili razlik v porabi fentanila. Prvi dan po operaciji smo opazili značilno nižjo porabo piritramida v LG v primerjavi s CG (p=0.019) in drugi dan po operaciji v LG v primerjavi z DG (p=0.003). Skupna poraba piritramida je bila značnilno nižja v LG v primerjavi s CG (p=0.003). Nismo našli razlik v spremembi spoznavne sposobnosti po operaciji glede na vrednosti preoperativno in v nastanku nevropatske bolečine dva meseca po operaciji. Zaključki: Lidokain in deksmedetomidin sta zmanjšala porabo propofola med operacijo, vendar nista zmanjšala porabe fentanila. Lidokain je zmanjšal porabo piritramida po operaciji. &#8195 Background: Combination of opioid analgesics and analgesics with different mechanism of action has synergistic analgesic effect and therefore the consumption of opioid analgesics could be decreased. It is known that dexmedetomidine and lidocaine have both opioid sparing effects, but the influence of dexmedetomidine in laparoscopic intestine resections has not been observed yet. In this study we investigated if additional dexmedetomidine or lidocaine can reduce opioid consumption. Methods: Within the study we observed: (i) fentanyl consumption, (ii) consumption of piritramide on the first and the second postoperative day, and (iii) cognitive function before and after the operation and neuropathic pain two months after the operation. 59 participants were randomly allocated into three groups. The anaesthesia type in the control group (CG) was continuous propofol infusion and fentanyl boluses. Continuous intravenous infusion of dexmedetomidine (0.5 µg/kg/h) and lidocaine (1.5 mg/kg/h) was added to dexmedetomidine (DG) and lidocaine group (LG), respectively. Results: There was no reduction in fentanyl consumption among the groups. We noted significantly lower consumption of piritramide in LG compared with CG on the first postoperative day (p=0.019), and in LG compared with DG on the second postoperative day (p=0.003). There were no differences in changes in cognitive function before and after the surgery and appearance of neuropathic pain two months after the surgery. Conclusions: Lidocaine and dexmedetomidine reduced intraoperative propofol consumption but failed to decrease fentanyl demand. Lidocaine reduced piritramide consumption postoperatively.

Diplomska naloga je bila prilagoditev robotske roke UR5 za kirurške aplikacije. Za ta namen so bile uporabljene EndoWrist klešče, ki se uporabljajo pri laparoskopskih robotskih operacijah za manipulacijo s tkivom. Ker se EndoWrist klešče uporabljajo v da Vinci kirurškemu sistemu, je bilo potrebno narediti krmilje in ohišje za montažu laparoskopsih klešč na robotsko roko. Cilj je dokazati možnost prilagoditve robota UR5 kot kirurškega, seveda pa pričakovana natančnost UR5 robota in da Vinci sistema nista enaka. Ohišje je bilo modelirano v programskem okolju SolidWorks in natisnjeno s 3D tiskalnikom. Za elektronske komponente ki so omogočile napajanje servomotorjev in mikrokrmilnika, je vezje bilo narejeno v Altium Designer. Program za mikrokrmilnik je bil napisan v Code Composer Studio. Rezultat je uspešno krmiljenje laparoskopskih klešč preko robota UR5. The thesis was to adapt the robotic arm UR5 for surgical applications. For this purpose the EndoWrist forceps that are used for robot controlled laparoscopic surgery for tissue manipulation were used. Because EndoWrist forceps are used in the da Vinci surgical system, the control for servo motors and the housing for mounting laparoscopic forceps on a robotic arm was necessary. The objective is to demonstrate the possibility of adjusting the robot UR5 as surgical. Of course, the expected accuracy of the UR5 robot and the da Vinci system are not the same. Housing was modelled in software SolidWorks, and printed with a 3D printer. For electronic components which have enabled the power supply for servo motors and microcontroller, the circuit was made in Altium Designer. The code for microcontroller was written in Code Composer Studio. The result is a successful control of a laparoscopic forceps via the UR5 robot.