Sabon Endoscopic stapler | Laparoscopic stapler

Laparoscopic Linear Cutter Stapler da Abubuwan da za a iya zubarwa

I. Sunan samfur, samfuri, ƙayyadaddun bayanai
Sunan samfur: Za'a iya zubar da endoscopic madaidaiciyar yankan stapler da aka gyara
Bayanin samfuri:endoscopic linzamin kwamfuta yankan stapler: PESS35, PESS45, PESS60, PESM35, PESM45, PESM60, PESL35, PESL45, PESL60, PEPS35, PEPS45, PEPS60, PEPM35, PEPM45, PEPM60, PEPL435, PL0;
Abubuwan da za a iya zubar da endoscopic linzamin kayan masarufi: PSGST35M, PSGST35W, PSGST35B, PSGST35D, PSGST35G, PSGST35T, PSGST45M, PSGST45W. B, PSGST60T, PSGST60D, PSGST60B, PSGST35G , PSGST60D, PSGST60B PPEPR60D, PPEPR60G, PPEPR60T.
II.Ayyukan samfur
Ya kamata a sanya ma'aunin ma'auni daidai, abubuwan da za su maye gurbin ya kamata su kasance masu dacewa, tsayayye, kuma ba tare da toshewa ba, kuma ya kamata a sami sauti ko wasu faɗakarwa lokacin da abubuwan ke cikin wurin.Ya kamata a ɗora nauyin ma'auni a cikin taro, kuma kada a fallasa ma'auni a saman ma'auni na ma'auni bayan an girgiza su.Budewa da rufe jaws na stapler ya kamata su kasance masu sassauƙa kuma kada a sami cunkoso.Tsarin haɗin gwiwa da tsarin juyawa na stapler ya kamata ya zama mai sassauƙa kuma ba shi da shinge.Haɗin kai tsakanin stapler jiki da abubuwan haɗin gwiwa yakamata ya kasance mai ƙarfi kuma abin dogaro.Bayan stapler ya juya kansa zuwa matsakaicin kusurwa, zai iya samun nasarar kammala harbe-harbe da sake saitawa.Akwai wani ƙaƙƙarfan ƙarfi bayan an rufe jaws na stapler, kuma ƙarfin matsawa bai kamata ya zama ƙasa da 4N ba.Akwai wani ƙarfin rufewa bayan an rufe jaws na stapler, kuma ƙarfin rufewa bai kamata ya zama ƙasa da 30N ba.Yana da takamaiman aikin hannu ɗaya.Ya kamata stapler ya kasance yana da kyau mai kyau da kuma yanke aiki.Za'a iya amfani da abubuwan da za'a iya maye gurbinsu don yankan da yawa da stapling kuma ba ƙasa da sau 8 ba.Yanke gefen bayan kowane ƙusa ya kamata ya zama mai tsabta kuma ba tare da burrs ba, kuma tsawon ƙarshen ƙarshen kowane layi na layi ya kamata ya fi tsayi fiye da layin yankan Tsawon ya kamata ya zama akalla sau 1.5 na tsawon ƙusa, da kuma matakan bayan kowane anastomosis. ya kamata a tsara su kamar "B".Matsakaicin layin bayan anastomosis yakamata ya kasance yana da ƙayyadaddun ƙarfin suture na layi, kuma ƙarfin suturen layi bai kamata ya zama ƙasa da 0.1N/mm ba.Dole ne ma'auni ya kamata ya sami na'urar nuna ra'ayi na tsarin harbe-harbe wanda zai iya nuna tsarin harbe-harbe ko matsayi.
III.Babban tsari
Za a iya zubar da endoscopic mikakke stapler da aka gyara sun hada da jiki da kuma aka gyara, a cikin abin da jiki ya ƙunshi magara, hadin gwiwa shugaban, sanda, Rotary ƙulli, daidaitawa filafili, ruwa shugabanci sauyawa button, harbe-harbe nuna taga, ruwa shugabanci Kunshi wani nuna alama taga, maballin saki, abin hannu, abin rufewa, harbin harbi, wuka yankan, da wurin zama na harsashi, taron yana kunshe da katridge mai tsayi da madaidaitan.
IV.Iyakar aikace-aikace
Ya dace da resection, transection da anastomosis na huhu, bronchial nama, ciki da kuma hanji a bude ko endoscopic tiyata.

Dubi Hoto na 1, Hoto 2, Tebur 1, da Tebura 2 don nau'ikan da ma'auni na asali na endoscopic linear yankan staplers da yanke sassa.

V. Siffar samfur da tsarin

1- Wurin zama na hana farce, 2-Haɗin gwiwa, 3—Rodi;4- Kumburi na juyawa;5-Paddle na daidaitawa;6-Maɓallin sauya hanyar ruwa;7-Taga mai nuna harbi;8-Tagar nunin jagorar ruwa;9-Maɓallin saki;10-hannu;11-hannun rufewa;12-hannun harbi;13-yankan wuka;14- kujerar harsashin farce

Hoto 1 Jikin madaidaicin yankan stapler don zubar da ciki

1-Staple bin 2-matsala

Hoto 2 Matsakaicin yankan madaidaiciyar layi don endoscope mai yuwuwa

Tebura 1 Ma'auni na asali na jiki

Tebura 1 Ma'auni na asali na jiki

Lura: Abubuwan da ke da tsayin tsayin 35 za a iya amfani da su kawai don jiki mai tsayin tsayin 35, abubuwan da ke da tsayin tsayin 45 za a iya amfani da su kawai ga jiki tare da tsawon madaidaicin 45, da kuma abubuwan da ke tare da Za'a iya amfani da tsayin da ya dace da 60 kawai don tsayin da ya dace Jikin 60 ne.

Tebura 2 Asalin girman naúrar abubuwan haɗin gwiwa: mm

VI.Contraindications
1).Mucosal edema mai tsanani;
2).An haramta sosai don amfani da wannan na'urar akan hanta ko nama.Saboda abubuwan da suka dace na irin waɗannan kyallen takarda, rufewar na'urar na iya samun sakamako mai lalacewa;
3).Ba za a iya amfani da shi a cikin sassan da ba za a iya ganin hemostasis ba;
4).Ba za a iya amfani da sassan launin toka ba don kyallen takarda tare da kauri na ƙasa da 0.75mm bayan matsawa ko don kyallen takarda waɗanda ba za a iya matsawa da kyau zuwa kauri na 1.0mm ba;
5).Ba za a iya amfani da fararen fata ba don kyallen takarda tare da kauri na ƙasa da 0.8mm bayan matsawa ko kyallen takarda waɗanda ba za a iya matsawa da kyau zuwa kauri na 1.2mm ba;
6).Bai kamata a yi amfani da ɓangaren shuɗi ba don nama wanda bai wuce 1.3mm kauri ba bayan matsawa ko kuma wanda ba za a iya matsawa da kyau zuwa kauri na 1.7mm ba.
7).Ba za a iya amfani da abubuwan haɗin gwal don kyallen takarda tare da kauri na ƙasa da 1.6mm bayan matsawa ko kyallen takarda waɗanda ba za a iya matsawa da kyau zuwa kauri na 2.0mm;
8).Kada a yi amfani da ɓangaren kore don nama wanda bai wuce 1.8mm kauri ba bayan matsawa ko kuma wanda ba za a iya matsawa da kyau zuwa kauri na 2.2mm ba.
9).Bai kamata a yi amfani da ɓangaren baƙar fata ba don nama wanda bai wuce 2.0mm kauri ba bayan matsawa ko kuma wanda ba za a iya matsawa da kyau zuwa kauri na 2.4mm ba.
10).An haramta sosai don amfani da nama akan aorta.

VII.Yadda ake amfani da shi
Umarnin shigarwa na harsashi mai mahimmanci:
1).Fitar da kayan aiki da ma'auni daga cikin fakitin su a ƙarƙashin aikin aseptic;
2).Kafin loda ma'auni mai mahimmanci, tabbatar da cewa kayan aikin yana cikin yanayin budewa;
3).Bincika ko babban harsashi yana da murfin kariya.Idan harsashi mai mahimmanci ba shi da murfin kariya, an hana amfani da shi;
4).Haɗa madaidaicin katako zuwa kasan wurin zama na katako na muƙamuƙi, saka shi a cikin hanyar zazzagewa har sai an daidaita harsashi tare da bayoneti, gyara katako mai mahimmanci a wurin kuma cire murfin kariya.A wannan lokacin, kayan aiki yana shirye don yin wuta;(Lura: Kafin a shigar da harsashi mai mahimmanci a wurin, don Allah kar a cire murfin kariyar ma'auni.)
5).Lokacin zazzage babban harsashi, tura madaidaicin harsashi zuwa alkiblar kujerar ƙusa don sakin shi daga wurin zama na harsashi;
6).Don shigar da sabon katako mai mahimmanci, maimaita matakai 1-4 a sama.

Umarnin ciki:
1).Rufe makullin rufewa, kuma sautin "danna" yana nuna cewa an kulle hannun rufewa, kuma wurin ɓoye na katako mai mahimmanci yana cikin yanayin rufewa;Lura: Kar a riƙe hannun harbi a wannan lokacin
2).Lokacin shiga cikin rami na jiki ta hanyar cannula ko incision na trocar, murfin kayan aiki dole ne ya wuce ta cikin cannula kafin a iya buɗe murfin murfin katako mai mahimmanci;
3).Kayan aiki yana shiga cikin rami na jiki, danna maɓallin saki, buɗe murfin kayan aiki, sannan sake saita hannun rufewa.
4).Juya kullin jujjuya tare da yatsan hannun ku don juyawa, kuma ana iya daidaita shi 360 digiri;
5).Zaɓi saman da ya dace (kamar tsarin jiki, gaɓa ko wani kayan aiki) azaman saman lamba, ja filin daidaitawa baya tare da yatsan maƙarƙashiya, yi amfani da ƙarfin amsawa tare da farfajiyar lamba don daidaita kusurwar lanƙwasa da ta dace, kuma tabbatar da hakan. babban harsashi yana cikin filin hangen nesa.
6).Daidaita matsayi na kayan aiki zuwa nama don anastomosed / yanke;
Lura: Tabbatar cewa an sanya nama a tsaka-tsakin tsaka-tsakin tsaka-tsakin, babu wani shinge a cikin wuraren da aka rufe, irin su shirye-shiryen bidiyo, shinge, wayoyi masu jagora, da dai sauransu, kuma matsayi ya dace.Ka guje wa yanke da bai cika ba, ƙayyadaddun kayan aiki mara kyau, da/ko gazawar buɗe wuraren rufewar kayan aikin.
7).Bayan na'urar ta zaɓi ƙwayar da za a yi amfani da ita, rufe hannun har sai an kulle shi kuma ji/ji sautin "danna";
8).Na'urar harbi.Yi amfani da yanayin "3+1" don samar da cikakken aikin yankewa da sutura;“3″: kama hannun harbe-harbe cikakke tare da motsi masu santsi, sannan a sake shi har sai ya dace da rikewar rufewa.A lokaci guda, lura cewa lambar akan taga mai nuna harbi shine "1" "Wannan bugun jini ne, lambar za ta karu da "1" tare da kowane bugun jini, jimlar bugun jini 3 a jere, bayan bugun na uku, ruwan wukake. Window mai nuni a bangarorin biyu na farin kafaffen rike zai nuna zuwa kusa da ƙarshen kayan aiki, yana nuna cewa wuƙa tana cikin yanayin Komawa, riƙe da sake sakin hannun harbin, taga mai nuna alama zai nuna 0, yana nuna cewa wukar tana cikin yanayin Komawa. ya koma matsayinsa na farawa;
9).Latsa maɓallin saki, buɗe farfajiyar ɓoye, kuma sake saita hannun harbi na hannun rufewa;
Lura: Danna maɓallin sakin, idan farfajiyar ɓoye ba ta buɗe ba, da farko tabbatar ko taga mai nuna alama yana nuna "0" kuma ko taga mai nuna alamar ruwa yana nuni zuwa gefen kusa na kayan aiki don tabbatar da cewa wuƙa tana cikin farko. matsayi.In ba haka ba, kuna buƙatar danna maɓallin juyawa na ruwan wuka don juyar da alkiblar ruwan, kuma ku riƙe rikewar harba har sai ya dace da hannun rufewa, sannan danna maɓallin sakin;
10).Bayan sakin nama, duba tasirin anastomosis;
11).Rufe hannun rufewa kuma fitar da kayan aiki.

VIII.Hanyoyin kulawa da samfura

1. Adana: Ajiye a cikin ɗaki tare da ɗanɗano mai zafi wanda bai wuce 80% ba, yana da iska mai kyau, kuma babu iskar gas mai lalata.
2. Sufuri: Za'a iya ɗaukar samfurin da aka haɗa tare da kayan aiki na yau da kullum.A lokacin sufuri, ya kamata a kula da shi da kulawa kuma a guje wa hasken rana kai tsaye, tashin hankali, ruwan sama da extrusion mai nauyi.
IV.Ranar karewa
Bayan da samfurin ya haifuwa ta hanyar ethylene oxide, lokacin haifuwa shine shekaru uku, kuma an nuna ranar karewa akan lakabin.

X. Jerin sassan
babu

XI, Gargaɗi, Gargaɗi
1. Lokacin amfani da wannan samfurin, aseptic bayani dalla-dalla ya kamata a bi sosai;
2. Da fatan za a duba marufi na wannan samfurin a hankali kafin amfani, idan marufin blister ya lalace, da fatan za a daina amfani da shi;
3. Wannan samfurin yana haifuwa ta hanyar ethylene oxide, kuma samfurin haifuwa don amfanin asibiti ne.Da fatan za a duba alamar faifai akan akwatin marufi na wannan samfurin, “blue” yana nufin cewa samfurin an haifuwa kuma ana iya amfani dashi kai tsaye a asibiti;
4. Ana amfani da wannan samfurin don aiki ɗaya kuma ba za a iya haifuwa ba bayan amfani;
5. Da fatan za a bincika ko samfurin yana cikin lokacin inganci kafin amfani.Lokacin ingancin haifuwa shine shekaru uku.An haramta samfuran da suka wuce lokacin inganci;
6. Dole ne a yi amfani da taron yankan laparoscopic da kamfaninmu ya samar tare da nau'in nau'i mai dacewa da ƙayyadaddun ƙayyadaddun laparoscopic linear cutting stapler wanda kamfaninmu ya samar.Dubi Table 1 da Table 2 don cikakkun bayanai;
7. Ya kamata mutanen da suka sami isassun horo kuma sun saba da dabarun cin zarafi kaɗan su yi.Kafin yin wani ɗan ƙaramin tiyata, ya kamata a tuntuɓi wallafe-wallafen likitanci da suka shafi fasaha, rikice-rikicensa da haɗarinsa;
8. Girman ƙananan kayan aiki masu haɗari daga masana'antun daban-daban na iya bambanta.Idan an yi amfani da ƙananan kayan aikin tiyata da na'urorin haɗi waɗanda masana'antun daban-daban suka samar a cikin aiki ɗaya a lokaci guda, ya zama dole a bincika ko sun dace kafin aikin;
9. Maganin radiation kafin tiyata na iya haifar da canje-canjen nama.Misali, waɗannan canje-canjen na iya haifar da kaurin nama fiye da abin da aka kayyade don zaɓaɓɓen madaidaicin.Duk wani magani na majiyyaci kafin a yi masa tiyata ya kamata a yi la'akari da shi a hankali kuma yana iya buƙatar canje-canje a cikin fasahar tiyata ko kusanci;
10. Kada ku saki maɓallin har sai kayan aiki ya shirya don yin wuta;
11. Tabbatar tabbatar da amincin harsashi mai mahimmanci kafin harbi;
12. Bayan harbe-harbe, tabbatar da duba hemostasis a layin anastomotic, duba ko anastomosis ya cika kuma ko akwai wani leka;
13. Tabbatar cewa kauri na nama yana cikin kewayon ƙayyadaddun kuma an rarraba nama daidai a cikin stapler.Nama mai yawa a gefe ɗaya na iya haifar da anastomosis mara kyau, kuma anastomotic leakage na iya faruwa;
14. A cikin yanayin wuce haddi ko nama mai kauri, ƙoƙari na tilasta abin da zai iya haifar da suturar da ba ta cika ba da yiwuwar fashewar anastomotic ko zubar da ciki.Bugu da ƙari, lalacewar kayan aiki ko gazawar wuta na iya faruwa;
15. Dole ne a kammala harbi daya.Kada a taɓa kunna wani ɓangare na kayan aikin.Harba da ba ta cika ba na iya haifar da gyare-gyaren da ba daidai ba, layin yanke da bai cika ba, zubar jini da zubewa daga suturar, da/ko wahalar cire kayan aikin;
16. Tabbatar da wuta har zuwa ƙarshe don tabbatar da cewa an kafa ma'auni daidai kuma an yanke nama daidai;
17. Matse hannun harbi don fallasa abin yankan.Kada a danna hannun akai-akai, wanda zai haifar da lalacewa ga wurin anastomosis;
18. Lokacin shigar da na'urar, tabbatar da cewa amincin yana cikin rufaffiyar wuri don guje wa kunna lever ɗin harbi ba tare da gangan ba, wanda ke haifar da fallasa mai haɗari na ruwan wukake da ɓarna da wuri ko cikakken ƙaddamar da ma'auni;
19. Matsakaicin lokutan harbe-harbe na wannan samfurin shine sau 8;
20. Yin amfani da wannan na'urar tare da kayan ƙarfafa layin anastomotic na iya rage yawan harbe-harbe;
21. Wannan samfurin na'urar amfani ne guda ɗaya.Da zarar an buɗe na'urar, ko da an yi amfani da ita ko a'a, ba za a iya sake bafar ta ba.Tabbatar da kulle kullewar tsaro kafin a yi aiki;
22. Amintacce ƙarƙashin wasu sharuɗɗa na ƙarfin maganadisu na nukiliya (MR):
Gwaje-gwajen da ba na asibiti ba sun nuna cewa za a iya amfani da matakan da za a iya dasa su tare da darajar kayan TA2G don MR.Ana iya bincika marasa lafiya cikin aminci nan da nan bayan an shigar da su a cikin yanayi masu zuwa:
Kewayon filin maganadisu a tsaye yana tsakanin 1.5T-3.0T kawai.
Matsakaicin girman filin maganadisu shine 3000 gauss/cm ko ƙasa.
Tsarin MR mafi girma da aka ruwaito, dubawa na mintuna 15, duk matsakaicin matsakaicin rabo na jiki (SAR) shine 2 W/kg.
A karkashin yanayin dubawa, ana sa ran matsakaicin hauhawar zafin jiki na ma'aunin zafi da sanyio zai zama 1.9°C bayan dubawa na mintuna 15.
Bayanan fasaha:
Lokacin da aka gwada ba tare da asibiti ba ta amfani da hoto mai juzu'in bugun bugun jini na gradient da tsarin magnetic filin 3.0T MR, ma'auni sun haifar da kayan tarihi kusan mm 5 daga wurin da aka dasa.
23. Dubi alamar don kwanan watan samarwa;