Gabatarwa zuwa Matsalolin Tiyatarwa

Game da Linear Cutter Stapler

Likitan fiɗa ɗan ƙasar Hungary Hümér Hültl, “uban ɗinki na tiyata ne ya fara yin wannan dabarar”.Hultl's prototype stapler a 1908 yana auna nauyin kilo 8 (3.6 kg) kuma ya ɗauki sa'o'i biyu don haɗuwa da kaya. An tsaftace fasaha a cikin Tarayyar Soviet a cikin 1950s, wanda ya ba da damar yin amfani da na'urorin suturing na farko da aka sake amfani da su don yin amfani da su don haifar da hanji da jijiyoyi anastomoses. .Ravitch ya kawo samfurin stapler bayan halartar taron tiyata a cikin USSR kuma ya gabatar da shi ga ɗan kasuwa Leon C. Hirsch, wanda ya kafa Surgical America a 1964 don kera sutures ɗin tiyata a ƙarƙashin na'urarsa ta Auto Suture. Har zuwa ƙarshen 1970s, USSC sun fi girma. mamaye kasuwa, amma a cikin 1977 Johnson & Johnson's Ethicon iri ya shiga kasuwa, kuma a yau ana amfani da samfuran duka biyu tare da masu fafatawa daga Gabas mai Nisa.USSC ta sami Tyco Healthcare a cikin 1998 kuma ta canza sunanta zuwa Covidien a ranar 29 ga Yuni, 2007. An yi nazari sosai kan aminci da patency na inji (anastomotic) hanji anastomosis.A irin waɗannan karatun, anastomoses ɗin da aka yi da sutured yawanci suna kama da kamanni ko ƙasa da ƙasa don yayyowa. Wannan na iya zama sakamakon ci gaban da aka samu a fasahar suture na baya-bayan nan da kuma ƙarin ayyukan tiyata masu haɗari.Tabbas, suturar roba na zamani sun fi tsinkaya kuma ba su iya kamuwa da kamuwa da cuta fiye da kayan da aka yi amfani da su kafin shekarun 1990-gut, siliki, da lilin. Wani mahimmin fasalin na intestinal staplers shine cewa gefuna na stapler yana aiki a matsayin hemostat, matsawa. gefen raunin da kuma rufe tashar jini a lokacin aikin stapling.Binciken da aka yi kwanan nan ya nuna cewa ta yin amfani da fasaha na suturing na yanzu, babu wani bambanci mai mahimmanci a sakamakon tsakanin suturing na hannu da kuma anastomosis na inji (ciki har da shirye-shiryen bidiyo), amma anastomosis na inji ana yi shi da sauri. leaks ya zama ruwan dare bayan tiyata.A halin yanzu ana bincika madadin dabaru don rufe ƙwayar huhu.

Nau'i da Aikace-aikace

Na farko na kasuwanci stapler aka yi da bakin karfe tare da titanium staples cushe a cikin refillable staple cartridges.Tsapler na zamani tiyata ko dai za a iya zubar da su, yi da filastik, ko kuma sake amfani da, Bakin karfe.Dukansu nau'ikan yawanci ana ɗora su tare da harsashin da za a iya zubarwa. Layukan da aka yi amfani da su na iya zama madaidaiciya, mai lankwasa ko zagaye. Ana amfani da staplers madauwari don anastomosis na ƙarshe zuwa ƙarshen bayan hanji ko kuma, mafi rikicewa, tiyata na esophagogastric. Ana iya amfani da waɗannan kayan aikin a buɗe ko laparoscopic. hanyoyin, tare da kayan aiki daban-daban da aka yi amfani da su don kowane aikace-aikacen. Laparoscopic staplers sun fi tsayi, ƙananan, kuma za a iya bayyana su don ba da damar shiga daga iyakacin adadin tashar jiragen ruwa. kusa da raunuka na ciki da na fata.Akan yi amfani da ɗigon fata tare da abin da za a iya zubarwa kuma a cire su tare da na'urar cirewa na musamman. Ana kuma amfani da Staplers a cikin hanyar gastroplasty band a tsaye (wanda aka fi sani da "gastric stapling").Ko da yake ana amfani da na'urorin anastomotic na ƙarshen-zuwa-ƙarshen madauwari don tsarin narkewa, ba a taɓa kwatanta ma'aunin madauwari don anastomosis na jijiyoyin jini da daidaitaccen anastomosis na hannu ba duk da tsattsauran binciken Yi babban bambanci da dabarun suture (Carrel).Baya ga hanyoyi daban-daban na haɗa jirgin ruwa (versioned) zuwa kututturen narkewa (inverted), babban dalili na iya zama cewa, musamman ga ƙananan jiragen ruwa, aikin hannu da daidaito da ake buƙata don matsayi kawai kututturen jirgin ruwa da sarrafa kowane na'ura ba zai iya ba. zama ƙasa da ƙasa Yana aiwatar da ɗinkin da ake buƙata don daidaitaccen ɗinkin hannu, don haka babu amfani sosai a yin amfani da kowane kayan aiki. Duk da haka, dashen gabobin na iya zama banda inda waɗannan matakai biyu, na'urar sakawa a kututturen jijiyoyin bugun jini da kunna na'urar, ana iya yin su ta daban-daban. sau ta ƙungiyoyin tiyata daban-daban a ƙarƙashin yanayi mai aminci ba tare da lokacin da ake buƙata ya shafi adana gabobin Donor ba, watau a ƙarƙashin yanayin sanyi na ischemic na sashin mai ba da gudummawa da tebur na baya bayan an raba sassan jikin mai karɓa.Maƙasudin ƙarshe shine rage haɗarin lokacin ischemic dumi mai haɗari. na sashin mai ba da gudummawa, wanda za'a iya ƙunshe a cikin mintuna ko ƙasa da haka, ta hanyar haɗa ƙarshen na'urar tare da sarrafa stapler. Yayin da mafi yawan kayan aikin tiyata an yi su ne da titanium, bakin karfe an fi amfani da shi don wasu gyare-gyaren fata da shirye-shiryen bidiyo.Titanium yana da ƙasa da amsawa tare da tsarin rigakafi kuma, saboda ƙarfe ne wanda ba na ƙarfe ba, baya tsoma baki sosai tare da na'urorin MRI, ko da yake wasu kayan aikin hoto na iya faruwa. roba absorbable sutures.

Cire spikes fata

Lokacin da aka yi amfani da matakan fata don rufe raunukan fata, ya zama dole a cire kayan aiki bayan lokacin warkarwa mai dacewa, yawanci kwanaki 5 zuwa 10, ya danganta da wurin da raunin ya faru da sauran dalilai. na takalmi ko faranti kunkuntar da sirara da za a saka a karkashin karuwar fata. Bangaren da ke motsi wata karamar ruwa ce wadda idan aka matsa matsi da hannu, sai ta tura takalmi ta hanyar ramin takalman, ta nakasa matattarar zuwa "M". " siffa don sauƙin cirewa.A cikin gaggawa, ana iya cire ma'auni tare da nau'i-nau'i na arterial.