3. Stapler classification
The linear cutting stapler includes a handle body, a push knife, a nail magazine seat and an anvil seat, the handle body is provided with a push button for controlling the push knife, a cam is rotatably connected to the handle body, and the cam has a hook. The side of the cam is provided with a safety mechanism. When the safety mechanism is in a locked state, the hook portion is hooked on the push button, and the cam is fixed relative to the handle body; when the safety mechanism is in an unlocked state, the hook portion releases the push button. When the safety mechanism is locked, the cam is fixed relative to the handle body, and the push button cannot move forward, so that the push knife can be prevented from being pushed prematurely when the position of the instrument is not adjusted properly.
The circumcision stapler includes a nail seat sleeve and a nail anvil, a sliding rod sleeve is arranged in the nail seat sleeve, a sliding rod is connected to the nail anbutment seat, and the sliding rod is inserted into the sliding rod sleeve. The sliding rod has a first anti-rotation plane, the inner wall of the sliding rod sleeve has a second anti-rotation plane, and the two anti-rotation planes fit together. One part of the sliding rod and the sliding rod sleeve is provided with a guiding rib along the axial direction of the sliding rod, and the other part is provided with a guiding groove along the axial direction of the sliding rod, and the guiding rib is inserted into the guiding groove. Through the cooperation of the guide ribs and the guide grooves, the positioning between the sliding rod and the nail seat sleeve is accurate, that is, the positioning of the nail seat sleeve and the nail anvil seat is accurate, so that the correct formation of the staple can be ensured.
4 How to operate the stapler
Use intestinal anastomosis to illustrate the use of the stapler. The proximal end of the anastomosis is sutured with a purse-string suture, and the staple seat is inserted and tightened. The center rod of the seat is connected, and the rotation is close to the intestinal wall of the distal and proximal intestinal tubes. The distance between the stapler seat and the base is adjusted according to the thickness of the intestinal wall. Generally, it is limited to ~ or the hand rotation is tight (there is a tightness indicator on the handle) to open the safety;
Firmly squeeze the anastomotic wrench and hear the "click" sound, which means that the cutting and anastomosis is completed. Do not withdraw the stapler for the time being. Check whether the anastomosis is satisfactory and whether other tissues such as mesentery are embedded in it. After corresponding treatment, loosen the stapler. And gently pull it out from the distal end to check whether the distal and proximal bowel resection rings are complete.
5 Stapler Precautions
(1) Before operation, check whether the scale and 0 scale are aligned, whether the assembly is correct, and whether the push piece and the tantalum nail are missing. A plastic gasket should be installed in the needle seat.
(2) The broken end of the intestinal tube to be anastomosed should be fully freed and stripped at least 2 cm.
(3) The needle distance of purse-string suture should not exceed centimeters, and the margin should be 2 to 3 mm. Too much tissue is easy to embed into the anastomosis and hinder the anastomosis. Be careful not to miss the mucosa.
(4) Adjust the spacing according to the thickness of the intestinal wall, preferably 1 to 2 cm.
(5) Check the stomach, esophagus and other adjacent tissues before firing to prevent the anastomosis from being clamped.
(6) The cutting should be fast, and the final pressure will make the staples into a "B" shape, and strive for one success.
(7) Exit the stapler gently, and check whether the cut tissue is a complete ring.
Post time: Feb-16-2022
