Ni iki cyitwa kubaga mu gituza bifashishije amashusho (VATS)? Intego, Uburyo & Gukira

Kubaga mu gituza bifashishije amashusho, cyangwa VATS, ni uburyo bwo kubaga butagira ingaruka nyinshi butuma abaganga babaga mu gituza bakoresheje ibikomere bito n'icyuma gito gifata amashusho. Bitekereze nk'ububaga bwo mu gituza no mu gatuza. Mu mwanya wo gukora urwungano runini, umuganga ubaga akora ibikomere bito bitari bike akoresha ibikoresho byihariye biyoborwa n'amashusho y'igihe nyacyo kugira ngo akore uburyo mu buryo bwizewe kandi butunganye.

Ni iki cyitwa kubaga mu gituza bifashishije amashusho (VATS)?

VATS ni uburyo bwo kubaga bwa none buha umuganga ubaga umucyo mu gituza atagombye gukora ibikomere binini. Mugihe cyo kubaga, agati gato gashyirwamo gafite icyuma gifata amashusho cyitwa thoracoscope gashyirwa mu gikomere gito hagati y'imbaragasa zawe. Icyo cyuma gifata amashusho cyohereza amashusho ya live kuri moniteri, gituma ikipe yawe y'abaganga ibona neza icyo barimo gukora.

Ubu buryo bwahinduye kubaga mu gituza kuko butera ibikomere bike ku mubiri wawe ugereranije no kubaga gakondo. Uburyo bwa VATS bwinshi busaba ibikomere bito 2-4 gusa, buri kimwe gifite santimetero imwe cyangwa ebyiri z'uburebure. Umuganga ubaga ashobora gukora imirimo myinshi yo kubaga akoresheje utwo twobo duto twari gusaba gufungura igituza cyawe cyose.

Ubu buryo bufite akamaro cyane cyane mu kubaga amabuye, ariko bunakoreshwa mu buryo bujyanye n'umuhogo wawe, umutima, n'umurongo ukikije amabuye yawe. Ubushishozi n'ubwinjiriro buke bituma ari amahitamo meza ku barwayi benshi bakeneye kubagwa mu gituza.

Kuki kubaga mu gituza bifashishije amashusho bikorwa?

VATS ishobora kuvura indwara nyinshi zifata amabuye yawe, igituza, n'ibindi bikorwa byegereye. Muganga wawe ashobora kugusaba ubu buryo igihe ukeneye kubagwa ariko ugashaka kugabanya igihe cyo gukira n'ibikomere byo kubaga. Ubu buryo bufite akamaro cyane cyane mu gukora isuzuma no kuvura.

Ibi nibyo bintu bisanzwe bituma muganga wawe ashobora kugusaba VATS:

• Gukuraho kanseri y'ibihaha, harimo lobectomy (gukuraho igice cy'ibihaha) cyangwa wedge resection (gukuraho agace gato)
• Biopsy y'utubumbe cyangwa ibibyimba bishobora kuba bifite ubukana kugirango hamenyekane niba ari kanseri
• Ubuvuzi bw'ibihaha byaguye (pneumothorax) binyuze mu gukuraho blebs cyangwa gufunga imiyoboro y'umwuka
• Gukuraho amazi cyangwa amaraso avuye mu bihaha byawe (pleural effusion cyangwa hemothorax)
• Ubuvuzi bwa emphysema ikaze binyuze mu kubaga kugirango ibihaha bigabanuke
• Gukuraho ibibyimba cyangwa ibikomere mu gatuza kawe
• Gusana imyobo iri mu muhogo wawe cyangwa diaphragm

Umuvuzi wawe azatekereza kandi VATS kubera ibibazo bitavugwa cyane nko gukuraho igice cyanduye, kuvura indwara zimwe na zimwe z'umutima, cyangwa gukemura ibibazo byo mu gatuza kawe. Ubushobozi bwiyi tekiniki busobanura ko akenshi ishobora gusimbura uburyo bwinshi bwo kubaga bukoreshwa mugihe cyo kugera ku ntego zimwe zo kuvura.

Ni iki gikorerwa muri VATS?

Kubaga kwa VATS bibera mu cyumba cyo kubagiramo munsi ya anesthesia rusange, bivuze ko uzaba uryamye rwose mugihe cyose cyo kubaga. Uburyo bwose bukunze gufata amasaha 1-4, bitewe n'uburyo bwo kubaga kwawe. Itsinda ryawe ry'abaganga bazagukurikiranira hafi mugihe cyose cyo kubaga.

Ibi nibyo bibaho mugihe cyo kubaga kwawe kwa VATS:

1. Uzagabwa imiti izagutera ubujura maze ushyirwe ku ruhande kugira ngo umuganga abone uko akora isuzuma neza mu gituza cyawe
2. Umuganga wawe azakora ibishashi bito 2-4 hagati y'urubavu rwawe, akenshi ku ruhande rw'igituza cyawe
3. Torakosikopi (camera ntoya) ishyirwa mu gishashi kimwe kugira ngo itange ishusho isobanutse neza imbere mu gituza cyawe
4. Ibikoresho byihariye byo kubaga bishyirwa mu tundi tundi dushashi duto
5. Umuganga wawe akora igikorwa gisabwa areba amashusho abaho
6. Iyo kubaga kurangije, umuyoboro muto ushobora gushyirwamo kugira ngo uvane amazi cyangwa umwuka
7. Ibishashi bifungwa n'imishumi cyangwa uruvange rw'ubuvuzi

Mugihe cyo kubaga, rimwe mu muhaha wawe urahagarara by'agateganyo kugira ngo umuganga wawe abone uko akora isuzuma neza. Ibi ni ibisanzwe kandi birizewe. Itsinda ryawe ry'abaganga bazagufasha guhumeka mugihe cyo kubaga bakoresheje umuyoboro wihariye wo guhumeka.

Uburyo bwa VATS butuma umuganga wawe akuraho urugingo, agasubiza ibyangiritse, cyangwa agafata ibizamini bitabangamiye cyane urugingo ruzima ruzengurutse. Ubu buryo bwitondewe ni kimwe mu mpamvu z'ingenzi zituma koroherwa na VATS akenshi byihuta kandi bidasharira cyane kurusha kubaga gakondo.

Ni gute wakwitegura igikorwa cyawe cya VATS?

Kwitegura kubagwa kwa VATS bikubiyemo intambwe z'ingenzi kugira ngo wizere umutekano wawe n'umusaruro mwiza ushoboka. Itsinda ryawe ry'ubuvuzi rizagufasha mu ntambwe zose zo kwitegura kandi risubize ibibazo byose ushobora kugira. Kwitegura kwinshi bitangira hafi icyumweru mbere y'itariki yo kubagwa kwawe.

Kwitegura kwawe mbere yo kubagwa birashoboka ko bizakubiyemo izi ntambwe z'ingenzi:

• Ibizamini byose by'amaraso, imirasire ya X yo mu gituza, ndetse bishobora no gukoresha CT scan kugira ngo bifashe umuganga wawe gutegura uburyo bwo kubaga
• Reka kunywa itabi byibuze mu byumweru 2 mbere yo kubagwa, kuko ibi bituma ukira neza kandi bigabanya ingorane
• Suzuma imiti yose ukoresha n'umuganga wawe uhagarike imiti ituma amaraso atinda gupfa niba ubisabwe
• Tegura umuntu uzakujyana mu rugo kandi agumane nawe mu masaha 24 ya mbere nyuma yo kubagwa
• Kurikiza amabwiriza yo kwiyiriza, ubusanzwe ntukarya cyangwa ngo unywe ikintu icyo aricyo cyose nyuma ya saa sita z'ijoro mbere yo kubagwa
• Kora imyitozo yo guhumeka cyane n'uburyo bwo gukorora uzakenera nyuma yo kubagwa
• Tegura ahantu uzakoreramo imyitozo yo gukira mu rugo hamwe n'imikoresho yoroshye kandi yegeranye

Muganga wawe ashobora kandi kugusaba ibizamini byo gupima imikorere y'ibihaha kugira ngo barebe uko ibihaha byawe bikora neza mbere yo kubagwa. Niba ufite izindi ndwara nka diyabete cyangwa indwara y'umutima, itsinda ryawe ry'abaganga rizakorana kugira ngo barebe ko ibi byose bigenzurwa neza mbere yo kubagwa.

Bisanzwe rwose kumva ufite impungenge mbere yo kubagwa. Ntuzatinye kubaza ikipe yawe y'ubuzima icyo aricyo cyose kikureba. Bashobora gutanga izindi mfashanyigisho cyangwa gusubiza ibibazo byihariye ku byo witegura mu gihe cyo gukira.

Ni gute usoma ibisubizo byawe bya VATS?

Gusobanukirwa ibisubizo byawe bya VATS biterwa n'impamvu wagiye kubagwa. Niba warakoze biopsy, ibisubizo byawe bya pathology ubusanzwe bizaboneka mu minsi mike kugeza ku cyumweru nyuma yo kubagwa. Umuganga wawe azasobanura ibi byavuye muri ibyo bizamini n'icyo bisobanura ku buzima bwawe no kuvurwa mu gihe kizaza.

Kubijyanye n'uburyo bwo gupima VATS, ibisubizo byawe bishobora kuba birimo amakuru yerekeye ibizamini by'imitsi, isesengura ry'amazi, cyangwa ibyo umuganga wawe yabonye mu gihe cyo kubagwa. Muganga wawe azategura gahunda yo gusuzuma ibisubizo byose mu buryo burambuye kandi asubize ibibazo byose ufite.

Niba warabazwe VATS (kubagwa kugira ngo uvure indwara), "ibisubizo" byawe bizapimwa n'uko uburyo bwakoreshejwe bwakemuye ikibazo cyawe. Ibi bishobora kuba harimo guhumeka neza, ibimenyetso byakemutse, cyangwa gukuraho neza igice cyanduye. Iterambere ryawe ryo gukira n'ibizamini byo gukurikiranwa bizafasha kumenya intsinzi yo kubagwa kwawe.

Itsinda ryabakugize bazanaguha raporo irambuye y'icyakozwe mugihe cyo kubagwa kwawe. Iyi nyandiko iba igice cy'amateka yawe y'ubuvuzi buriho kandi ishobora gusangirwa nabandi baganga bitabiriye ubuvuzi bwawe.

Ni ubuhe buryo bwiza bwo gukira nyuma ya VATS?

Gukira neza kwa VATS bikubiyemo gukurikiza amabwiriza y'ikipe yawe y'ubuzima mugihe wumva ibimenyetso byumubiri wawe. Abantu benshi barwara cyane kandi bakira vuba ugereranije no kubagwa mu gituza gakondo, ariko buri wese akira ku gipimo cye. Gukira kwawe mubisanzwe bigenda mu byiciro byinshi biteganyijwe.

Dore uko gukira neza kwa VATS kugaragara:

• Kugenda hakiri kare mumasaha 24, gutangira kwicara no kugenda bigufi
• Imyitozo yo guhumeka cyane no gukorora kugirango birinde umusonga wo mu muhogo kandi ugumane ibihaha byawe
• Kugenda gahoro gahoro mu bikorwa muminsi 2-4, wirinda kuzamura ibintu biremereye mbere na mbere
• Gucunga ububabare ukoresheje imiti yategetswe nkuko byategetswe na muganga wawe
• Kwitaho neza igikomere kugirango wirinde indwara kandi uteze imbere gukira
• Kwitabira gahunda zose zo gukurikiranwa kugirango ukurikirane iterambere ryawe
• Kugaruka mubikorwa bisanzwe buhoro buhoro, mubisanzwe muminsi 4-6

Abantu benshi bashobora gusubira kumurimo muminsi 1-2 niba akazi kabo kadakubiyemo imirimo ikomeye. Ariko, ugomba kwirinda kuzamura ikintu cyose kiremereye kurenza ibiro 10 muminsi mike ya mbere. Urwego rwawe rw'imbaraga ruzagenda ruzamuka buhoro buhoro, kandi abarwayi benshi bumva basubiye mubuzima bwabo busanzwe muminsi 4-6.

Ni ngombwa kwitondera ibimenyetso by’ingorane mu gihe cyo gukira, nk'uko kurushaho kuribwa, umuriro, guhumeka bigoranye, cyangwa impinduka ku nshinge z'aho babaze. Nubwo ingorane zitaba kenshi kuri VATS, kumenya no kuvura hakiri kare ibibazo byose bituma haboneka ibisubizo byiza.

Ni ibihe bintu byongera ibyago byo kugira ingorane za VATS?

Nubwo VATS muri rusange ifite umutekano kurusha kubagwa bisanzwe, ibintu bimwe na bimwe bishobora kongera ibyago byo kugira ingorane. Kumva ibyo bintu byongera ibyago bifasha ikipe yawe ibaga gufata ingamba zikwiye kandi bigufasha gufata ibyemezo bifitiye akamaro ku kwitabwaho kwawe. Ingorane nyinshi ntizikunda kubaho kandi zirashobora gucungwa iyo zibayeho.

Ibintu byinshi bishobora kongera ibyago byo kugira ingorane za VATS:

• Ubukure bwo hejuru (imyaka irenga 70), nubwo imyaka yonyine itagutera kutemererwa kubagwa
• Amateka yo kunywa itabi cyangwa kunywa itabi ubu, bigira ingaruka ku mikorere y'ibihaha no gukira
• Indwara zikomeye z'ibihaha nk'indwara ya COPD cyangwa pulmonary fibrosis
• Indwara z'umutima cyangwa izindi ndwara zikomeye
• Kubagwa mu gituza mbere cyangwa imirasire ivura kanseri itera inkovu
• Ubunini burenze urugero, bushobora gutuma uburyo bukora bugorana cyane
• Indwara zo gupfuka kw'amaraso cyangwa gukoresha imiti igabanya amaraso

Umuvuzi uzabaga azasuzuma neza ibyo bintu byose mbere yo gusaba VATS. Mu bihe bimwe na bimwe, imyiteguro y'inyongera cyangwa guhindura uburyo busanzwe bishobora gufasha kugabanya ibyago. Kugira ibintu byongera ibyago ntibisobanura ko udashobora kugira VATS, ariko bisobanura ko ikipe yawe izafata ingamba zidasanzwe.

N'iyo ibintu byongera ibyago bihari, VATS akenshi iguma kuba uburyo bwiza kuko ntibishyira umubiri wawe mu gushyushya kurusha kubagwa bisanzwe. Ikipe yawe y'ubuvuzi izakorana nawe kugira ngo iteze imbere ubuzima bwawe mbere yo kubagwa kandi itange ubugenzuzi bukwiye mu gihe cyo gukira kwawe.

Ni byiza kugira VATS cyangwa kubagwa bisanzwe?

VATS ikunze gukoreshwa kurusha kubaga bifunguye igihe bishoboka mu buryo bw'ikoranabuhanga kuko bitanga inyungu zigaragara ku barwayi benshi. Ariko, guhitamo neza biterwa n'uburwayi bwawe bwihariye, imiterere y'umubiri wawe, n'ubuzima bwawe muri rusange. Muganga wawe azagusaba uburyo buguha amahirwe meza yo gukira neza hamwe n'ibibazo bike.

VATS isanzwe itanga izi nyungu kurusha kubaga bifunguye: ibikomere bito bikira vuba, kubabara guke mugihe cyo gukira, igihe gito cyo kumara mu bitaro (akenshi iminsi 1-3 ugereranije n'iminsi 5-7), kugabanya ibyago byo kwandura, gutakaza amaraso make mugihe cyo kubaga, no gusubira vuba mu bikorwa bisanzwe. Ibisubizo byiza byo kumurika biragaragara cyane, hamwe n'ibikomere bito aho kuba igikomere kinini cyo mu gituza.

Ariko, kubaga bifunguye bishobora kuba ngombwa mubibazo bimwe na bimwe. Ibi birimo ibibyimba binini cyane, imitsi myinshi yaturutse mu kubaga kwabanje, impinduka zimwe na zimwe z'imiterere y'umubiri, cyangwa mugihe muganga akeneye uburyo bworoshye bwo gukora imirimo igoye. Rimwe na rimwe, uburyo bwa VATS bugomba guhindurwa bukaba kubaga bifunguye mugihe cyo kubaga niba hari ibibazo bitunguranye bivutse.

Muganga wawe azaganira nawe kuri izo mpamvu zombi akagusobanurira impamvu basaba uburyo runaka kubera uko ubuzima bwawe bumeze. Intego ni ukugera ku musaruro mwiza w'ubuvuzi mugihe ugabanya ibyago n'igihe cyo gukira. Wizere ubuhanga bw'ikipe yawe yo kubaga kandi ntugatinye kubaza ibibazo kubyerekeye icyo basaba.

Ni izihe ngaruka zishobora guterwa na VATS?

Ibibazo biva muri VATS ntibisanzwe, bibaho munsi ya 10% by'imirimo ikorwa. Iyo ibibazo bibayeho, akenshi biba bito kandi byoroshye kuvura. Ikipe yawe yo kubaga yiteguye neza guhangana n'ikibazo icyo aricyo cyose gishobora kuvuka, kandi ibibazo byinshi bishobora gukemurwa nta ngaruka zirambye.

Ibibazo bisanzwe ushobora guhura nabyo birimo:

• Umuvuduko w’umwuka uva mu bihaha byawe ushobora gutuma umuyoboro wo mu gituza cyawe uguma mu gihe kirekire
• Urubavu ku nshinge cyangwa guhura n’imitsi bigenda bikira uko igihe kigenda
• Ukuva amaraso guto cyangwa kwegeranya amazi hafi y’ibihaha byawe
• Umutima utangira gutera nabi by’agateganyo bitewe no kurakara mu gihe cyo kubagwa
• Udukoko mu nshinge, bikira neza iyo uvuzwe n’imiti yica udukoko
• Uburwayi bwo mu bihaha, cyane cyane niba utakora imyitozo yo guhumeka

Ingorane zitavugwa kenshi ariko zikomeye zirimo kuva amaraso menshi bishobora gusaba ko wongererwa amaraso, kwangirika kw’ibice byegereye nk’imitsi y’amaraso cyangwa imitsi, ibibumbe by’amaraso mu maguru yawe cyangwa mu bihaha, cyangwa ibibazo bikomeye by’umutima. Itsinda ry’abaganga bakubaga bakurikirana hafi kugira ngo bamenye kandi bavure ingorane zose hakiri kare.

Inkuru nziza ni uko ingorane zikomeye zitavugwa kenshi kuri VATS, kandi urugero rw’ingorane muri rusange ruri hasi ugereranyije no kubagwa gakondo. Itsinda ry’abaganga bazaganira nawe ku ngaruka zikugiraho kandi bakubwire ibimenyetso byo kwitondera mu gihe urimo gukira.

Ni ryari nkwiriye kubona umuganga nyuma ya VATS?

Ugomba guhita uvugana n’itsinda ry’abaganga niba ubonye ibimenyetso byo kwitondera mu gihe urimo gukira. N’ubwo ibimenyetso byinshi nyuma yo kubagwa bisanzwe mu gukira, ibimenyetso bimwe bisaba ubufasha bwihuse bw’abaganga. Ntuzuyaze guhamagara umuganga wawe niba ufite icyo uhangayikishijweho mu gihe urimo gukira.

Vugana n’umuganga wawe ako kanya niba ubonye kimwe muri ibi bimenyetso:

• Urubavu rukabije cyangwa rugenda rurushaho kudakira n’imiti igabanya ububabare yagutanzwe
• Guhema guhagarara mu buryo butunguranye cyangwa kugorwa no guhumeka
• Urubavu rurenze 101°F (38.3°C) cyangwa guhinda umururumba
• Ukwiyongera kw’itukura, kubyimba, cyangwa kuvamo amazi ku nshinge zawe
• Gukorora amaraso cyangwa ibintu bifite amaraso
• Ibimenyetso by’ibibumbe by’amaraso nk’ukubyimba kw’amaguru, gushyuha, cyangwa urubavu
• Isesemi idahorera cyangwa kuruka bikubuza kunywa amazi

Ugomba kandi kuvugana n’ikipe yawe y’ubuvuzi ku bindi bibazo bitihutirwa nk’ububabare burambye bubuza gusinzira, ibibazo bijyanye n’imiti yawe, cyangwa impungenge ku iterambere ryo gukira kwawe. Bariho kugira ngo bagushyigikire mu gihe cyo gukira kwawe.

Ibyo guhura na muganga buri gihe ni ngombwa kabone n’iyo wumva umeze neza. Uru ruzinduko rutuma muganga wawe ashobora gukurikirana uko ukira, akavana imitsi niba bibaye ngombwa, kandi akareba niba ugenda neza nk'uko byitezwe. Ntukirengagize izo gahunda n’iyo wumva umeze neza.

Ibibazo bikunze kubazwa kuri VATS

Ese kubagwa kwa VATS ni byiza mu kuvura kanseri y’ibihaha?

Yego, VATS ni uburyo bwiza ku barwayi benshi ba kanseri y’ibihaha, cyane cyane abafite indwara yo mu ntangiriro. Ubushakashatsi bwerekana ko VATS ishobora kugira akamaro nk’uko kubagwa bisanzwe mu gukuraho kanseri y’ibihaha mugihe ituma umuntu akira vuba kandi akagira ububabare buke. Muganga wawe w’inzobere mu by’indwara z’umubiri n’umuganga ubaga bazemeza niba VATS ikwiriye hashingiwe ku bunini, aho iherereye, n’icyiciro cya kanseri yawe.

Ku kanseri y’ibihaha yo mu ntangiriro, VATS lobectomy (gukuraho uruhande rw’ibihaha) yabaye uburyo busanzwe bukoreshwa mu bitaro byinshi. Ubu buryo butuma umuntu abagwa atari uko akomeretse cyane butuma kanseri ikurwaho yose mugihe hakoreshwa igice gito cy’ibihaha bifite ubuzima. Urwego rwo kubaho igihe kirekire rurasa n’urwo kubagwa bisanzwe.

Ese uburyo bwa VATS butera ibibazo bihoraho byo guhumeka?

VATS mubisanzwe ntibitera ibibazo bihoraho byo guhumeka ku barwayi benshi. Mubyukuri, abantu benshi bagira imikorere myiza yo guhumeka nyuma y’uburyo bwa VATS bukuraho igice cy’ibihaha kirwaye cyangwa kivura indwara nko gupfuka kw’ibihaha. Igice cy’ibihaha cyawe gifite ubuzima mubisanzwe gihanganira neza igice cyose cyakuweho.

Abandi barwayi bashobora kubona impinduka ntoya mu mikorere yabo yo gukora imyitozo ngororamubiri mu ntangiriro, ariko ibi mubisanzwe biragenda neza uko umubiri wawe wimenyereza. Niba wari ufite imikorere mibi y’ibihaha mbere yo kubagwa kubera indwara, VATS ishobora rwose guteza imbere guhumeka kwawe mu gukuraho ahantu hari ibibazo by’igice cy’ibihaha.

Nzamara igihe kingana iki mu bitaro nyuma ya VATS?

Abantu benshi barwaye VATS bamara iminsi 1-3 mu bitaro, ibyo bikaba bigabanya cyane ugereranyije n'iminsi 5-7 isanzwe isabwa nyuma yo kubagwa mu gituza. Igihe nyacyo giterwa n'uburyo uburwayi bwawe bukomeye ndetse n'uburyo wihuta gukira. Uburwayi bworoshye bushobora gutuma utaha mu rugo umunsi ukurikira.

Urugozi rwawe rwo mu gituza ruzavanwaho mu minsi 1-2 igihe igihaha cyawe cyongeye kwaguka neza kandi nta mwuka mwinshi ugaragara. Iyo urwo rugozi ruvanyweho kandi wumva umeze neza mu kwihanganira ububabare, ugenda neza, kandi urya neza, birashoboka ko uzaba witeguye gutaha.

Ese VATS ishobora gukorwa ku bihaha byombi mu gihe kimwe cyo kubaga?

Rimwe na rimwe VATS ishobora gukorwa ku bihaha byombi mu gihe kimwe, ariko ibi biterwa n'ibintu byinshi birimo ubuzima bwawe muri rusange, imikorere y'ibihaha, ndetse n'uburwayi bwihariye burimo kuvurwa. VATS ku mpande zombi (zombi) ikunze gukorwa ku burwayi bumwe na bumwe nk'ubwirinzi bwa pneumothorax idasanzwe.

Umuvuzi wawe azasuzuma neza niba inzira imwe cyangwa inzira zikurikirana z'impande zombi ari zo ziteganye umutekano kurusha izindi ku buzima bwawe. Rimwe na rimwe biraba byiza kuvura uruhande rumwe mbere, ukemerera gukira, hanyuma ukavura urundi ruhande niba bibaye ngombwa. Iyi myanzuro ifatirwa ku miterere yawe yihariye.

Ese nzaba mfite ibikomere bigaragara nyuma yo kubagwa kwa VATS?

VATS isiga ibikomere bito cyane, bitagaragara cyane ugereranyije no kubagwa bisanzwe. Ubusanzwe uzagira ibikomere bito 2-4, buri kimwe kigera kuri santimetero imwe cyangwa ebyiri z'uburebure, ku ruhande rw'igituza cyawe. Ibi bigabanuka cyane uko igihe gihita kandi akenshi ntibigaragara nyuma y'umwaka.

Ibikomere bishyirwa ahantu hateguwe neza hagati y'imvune zawe kandi akenshi bihiswa n'imiterere isanzwe y'igituza cyawe. Abarwayi benshi babisanga byemewe cyane mu buryo bwo kwisanisha ugereranyije n'igikomere kinini cyo kubagwa bisanzwe, gishobora kuba gifite uburebure bwa santimetero 15-20.