Kev phais staplesyog cov staples tshwj xeeb uas siv rau hauv kev phais los hloov cov sutures los kaw cov qhov txhab ntawm daim tawv nqaij los yog txuas los yog resect ib feem ntawm txoj hnyuv los yog lub ntsws.Kev siv cov staples ntawm sutures txo cov inflammatory teb, qhov txhab dav, thiab kaw lub sij hawm. 1990s, yog siv cov clips es tsis txhob staples nyob rau hauv ib co kev siv;qhov no tsis xav tau staple nkag.
Kev siv ntawm Linear Cutter Stapler
Cov lus qhia rau kev siv
Disposable linear cutting stapler tso ob kab staggered ntawm ob-kab titanium staples, thiab txiav thiab faib cov ntaub so ntswg ib txhij ntawm ob kab ntawm ob kab.Kev siv cov kab txiav tawm yuav tsum tsis txhob siv rau ntawm cov ntaub so ntswg xws li daim siab lossis tus po, uas yuav yog crushed los ntawm ntsuas kaw.
Hais txog Linear Cutter Stapler
Cov txheej txheem yog pioneered los ntawm Hungarian kws phais Hümér Hültl, "leej txiv ntawm kev phais suturing".Hultl tus qauv stapler hauv xyoo 1908 hnyav 8 phaus (3.6 kg) thiab siv sijhawm ob teev los sib sau ua ke thiab thauj khoom.Cov txheej txheem tau ua kom zoo nyob rau hauv Soviet Union xyoo 1950, tso cai rau thawj cov khoom lag luam tsim rov siv dua suturing siv los tsim lub plab thiab vascular anastomoses. .Ravitch nqa ib qho piv txwv ntawm cov stapler tom qab mus koom lub rooj sib tham phais hauv USSR thiab qhia nws rau tus neeg ua lag luam Leon C. Hirsch, uas tau tsim Surgical America hauv 1964 los tsim cov phais phais hauv qab nws Auto Suture hom khoom siv.Txog thaum xyoo 1970s, USSC loj heev. ua lag luam ua lag luam, tab sis xyoo 1977 Johnson & Johnson's Ethicon hom tau nkag mus rau hauv kev ua lag luam, thiab niaj hnub no ob lub npe tau siv dav nrog cov neeg sib tw los ntawm Far East.USSC tau txais los ntawm Tyco Healthcare hauv 1998 thiab hloov nws lub npe rau Covidien thaum Lub Rau Hli 29, 2007.Qhov kev nyab xeeb thiab patency ntawm cov neeg kho tshuab (anastomotic) plab hnyuv anastomosis tau kawm ntau heev.Hauv cov kev tshawb fawb zoo li no, sutured anastomoses feem ntau yog sib piv los yog tsawg dua tuaj yeem ua rau to.Qhov no yuav yog qhov tshwm sim los ntawm kev nce qib hauv kev siv tshuab suture thiab nce kev pheej hmoo ntawm kev phais mob.Tau kawg, niaj hnub hluavtaws sutures yog qhov kev kwv yees ntau dua thiab tsis tshua muaj kev kis kab mob ntau dua li cov ntaub ntawv staple suture siv ua ntej xyoo 1990 - plab, txhob lo lo ntxhuav, thiab linen.Ib qho tseem ceeb ntawm txoj hnyuv staplers yog tias cov npoo ntawm stapler ua raws li hemostat, compressing. cov npoo ntawm qhov txhab thiab kaw cov hlab ntsha thaum lub sijhawm stapling.Cov kev tshawb fawb tsis ntev los no tau pom tias siv cov txheej txheem suturing tam sim no, tsis muaj qhov sib txawv ntawm cov txiaj ntsig ntawm phau ntawv suturing thiab mechanical anastomosis (xws li clips), tab sis cov neeg kho tshuab anastomosis tau ua sai dua.Cov neeg mob uas lub ntsws cov ntaub so ntswg tau kaw nrog staplers rau pneumonectomy, huab cua. Cov dej xau yog tshwm sim tom qab kev phais.Lwm cov txheej txheem rau kev kaw cov ntaub so ntswg ntsws tam sim no raug tshawb xyuas.
Hom thiab Daim Ntawv Thov
Thawj qhov kev lag luam stapler yog ua los ntawm stainless hlau nrog titanium staples packed nyob rau hauv refillable staple cartridges.Modern phais staplers yog pov tseg, ua los ntawm yas, los yog reusable, ua los ntawm stainless hlau.Ob hom no feem ntau yog ntim nrog cov khoom siv pov tseg.Staple kab tuaj yeem ncaj, nkhaus los yog puag ncig.Circular staplers yog siv rau qhov kawg-rau-kawg anastomosis tom qab plab hnyuv resection los yog, ntau controversially, esophagogastric phais.Cov cuab yeej no yuav siv tau nyob rau hauv qhib los yog laparoscopic. Cov txheej txheem, nrog cov cuab yeej sib txawv siv rau txhua daim ntawv thov.Laparoscopic staplers ntev dua, thinner, thiab tuaj yeem ua kom pom tseeb kom tso cai nkag tau los ntawm cov chaw nres nkoj trocar tsawg. Qee cov staplers muaj riam uas tuaj yeem txiav thiab staple hauv ib qho kev ua haujlwm.Staplers siv los kaw cov qhov txhab sab hauv thiab ntawm daim tawv nqaij.Staples ntawm daim tawv nqaij feem ntau yog siv nrog ib lub stapler pov tseg thiab tshem tawm nrog ib tug tshwj xeeb staple remover.Staplers kuj yog siv nyob rau hauv txoj kev ntsug band gastroplasty (feem ntau hu ua "gastric stapling").Txawm hais tias lub voj voog kawg-rau-kawg anastomotic cov cuab yeej siv rau lub plab zom mov tau dav siv, lub voj voog staplers rau vascular anastomosis yeej tsis tau muab piv rau tus qauv tes anastomosis txawm tias kev tshawb fawb hnyav ua qhov sib txawv loj nrog (Carrel) suture cov tswv yim.Sib nrug los ntawm txoj kev sib txawv ntawm kev sib txuas ntawm lub nkoj (eversioned) mus rau lub plab zom mov (inverted) stump, lub ntsiab hauv qab yog vim li cas, tshwj xeeb tshaj yog rau cov hlab ntsha me, phau ntawv ua haujlwm thiab qhov tseeb yuav tsum tau muab tso rau hauv lub nkoj nkaus xwb thiab tswj txhua yam khoom siv tsis tuaj yeem. tsis tshua muaj kev ua haujlwm stitching xav tau rau tus qauv tes stitching, yog li tsis muaj kev siv ntau hauv kev siv cov khoom siv.Txawm li cas los xij, kev hloov pauv hauv nruab nrog cev yuav yog qhov tshwj xeeb uas ob theem no, ntaus ntawv tso rau ntawm lub vascular stump thiab ntaus ntawv actuation, tuaj yeem ua tau ntawm qhov sib txawv. Lub sij hawm los ntawm cov pab pawg phais sib txawv nyob rau hauv kev nyab xeeb yam tsis muaj lub sij hawm yuav tsum tau cuam tshuam rau tus neeg pub khoom noj preservation, piv txwv li nyob rau hauv txias ischemic tej yam kev mob ntawm tus neeg pub khoom nruab nrog cev thiab lub posterior lub rooj tom qab resection ntawm tus neeg tau txais lub natural organ.Lub hom phiaj ntawm kev ua tiav yog kom txo qis qhov txaus ntshai sov ischemic theem. ntawm tus neeg pub khoom nruab nrog cev, uas tuaj yeem ntim tau hauv feeb lossis tsawg dua, tsuas yog txuas qhov kawg ntawm lub cuab yeej thiab tswj cov stapler.While feem ntau cov staples yog ua los ntawm titanium, stainless hlau feem ntau yog siv rau qee cov tawv nqaij staples thiab clips.Titanium. Nws tsis tshua muaj kev cuam tshuam nrog lub cev tiv thaiv kab mob thiab, vim tias nws yog cov hlau tsis muaj hlau, tsis cuam tshuam nrog MRI scanners, txawm hais tias qee cov duab kos tuaj yeem tshwm sim.Synthetic absorbable (bioabsorbable) staples raws li polyglycolic acid tam sim no muaj, raws li muaj ntau yam. hluavtaws absorbable sutures.
Tshem tawm ntawm daim tawv nqaij spikes
Thaum daim tawv nqaij staples siv los kaw cov qhov txhab ntawm daim tawv nqaij, nws yog ib qho tsim nyog yuav tsum tshem tawm cov staples tom qab lub sijhawm kho kom zoo, feem ntau yog 5 mus rau 10 hnub, nyob ntawm qhov chaw ntawm lub qhov txhab thiab lwm yam. ntawm ib lub khau los yog phaj nqaim thiab nyias txaus kom muab tso rau hauv qab ntawm daim tawv nqaij spike.Qhov txav yog ib qho me me uas, thaum siv tes tuav, thawb lub staple los ntawm ib qho hauv cov khau, deforming lub staple rau hauv "M " shape kom yooj yim tshem tawm.Thaum muaj xwm txheej ceev, cov staples tuaj yeem raug tshem tawm nrog ib khub ntawm arterial forceps.Skin staple removers yog tsim nyob rau hauv ntau yam duab thiab cov ntaub ntawv, ib txhia yog pov tseg thiab ib co yog reusable.
Lub sij hawm xa tuaj: Nov-18-2022
