Kutaya kwa Laparoscopic Linear Cutter Stapler ndi Zida Gawo 3

Kutaya kwa Laparoscopic Linear Cutter Stapler ndi Zida Gawo 3
(Chonde werengani buku la malangizo mosamala musanayike ndikugwiritsa ntchito mankhwalawa)

VI.Laaparoscopic Linear Cutting Stapler Contraindications:

1. Kutupa koopsa kwa mucosal;

2. Ndizoletsedwa kugwiritsa ntchito chipangizochi pachiwindi kapena ndulu.Chifukwa cha kupanikizika kwa minofu yotereyi, kutsekedwa kwa chipangizocho kungakhale ndi zotsatira zowononga;

3. Sangagwiritsidwe ntchito m'madera omwe hemostasis sangathe kuwonedwa;

4. Zigawo za imvi sizingagwiritsidwe ntchito pamagulu omwe ali ndi makulidwe osakwana 0.75mm pambuyo pa kupanikizana kapena minyewa yomwe singathe kupanikizidwa bwino mpaka makulidwe a 1.0mm;

5. Zigawo zoyera sizingagwiritsidwe ntchito pamagulu omwe ali ndi makulidwe osakwana 0.8mm pambuyo pa kupanikizana kapena minyewa yomwe siingapangidwe bwino mpaka makulidwe a 1.2mm;

6. Chigawo cha buluu sichiyenera kugwiritsidwa ntchito pa minofu yomwe imakhala yocheperapo 1.3mm pambuyo pa kupanikizana kapena yomwe siingapangidwe bwino mpaka 1.7mm.

7. Zigawo za golidi sizingagwiritsidwe ntchito pamagulu omwe ali ndi makulidwe osakwana 1.6mm pambuyo pa kupanikizana kapena minyewa yomwe siingathe kupanikizidwa bwino ndi makulidwe a 2.0mm;

8. Chigawo chobiriwira sichiyenera kugwiritsidwa ntchito pa minofu yomwe ili yocheperapo 1.8mm yochuluka pambuyo pa kupanikizana kapena yomwe siingakhoze kupanikizidwa bwino ndi makulidwe a 2.2mm.

9. Chigawo chakuda sichiyenera kugwiritsidwa ntchito pa minofu yomwe ili yocheperapo 2.0mm pambuyo pa kupanikizana kapena yomwe siingakhoze kupanikizidwa bwino ndi makulidwe a 2.4mm.

10. Ndizoletsedwa kugwiritsa ntchito minofu pa aorta.

VII.Laaparoscopic Linear Cutting Stapler Malangizo:

Malangizo oyika makatiriji oyambira:

1. Chotsani chida ndi makatiriji oyambira m'matumba awo pansi pa opaleshoni ya aseptic;

2. Musananyamule katiriji yokhazikika, onetsetsani kuti chidacho chili poyera;

3. Yang'anani ngati katiriji yayikulu ili ndi chophimba choteteza.Ngati cartridge yaikulu ilibe chivundikiro chotetezera, ndiyoletsedwa kuigwiritsa ntchito;

4. Gwirizanitsani cartridge yamtengo wapatali pansi pa mpando wa cartridge wa nsagwada, ikani m'njira yotsetsereka mpaka katiriji yokhazikika igwirizane ndi bayonet, konzani katiriji yokhazikika ndikuchotsa chophimba choteteza.Panthawiyi, chidacho chakonzeka kuwotcha;(Zindikirani: Katiriji yokhazikika isanayikidwe, chonde musachotse chivundikiro choteteza katiriji.)

5. Mukatsitsa katiriji yoyambira, kanikizani katiriji kolowera komwe kuli mpando wa misomali kuti mutulutse pampando waukulu wa cartridge;

6. Kuti muyike katiriji yatsopano, bwerezani masitepe 1-4 pamwambapa.

Malangizo a Intraoperative:

1. Tsekani chogwirira chotseka, ndipo phokoso la "kudina" limasonyeza kuti chogwirira chotseka chatsekedwa, ndipo occlusal pamwamba pa cartridge ya staple ili mu chikhalidwe chotsekedwa;Zindikirani: Musagwire chogwirira chowombera panthawiyi

2. Mukalowa m'mimba mwa thupi kudzera mu cannula kapena incision ya trocar, occlusal pamwamba pa chidacho chiyenera kudutsa mu cannula pamaso pa occlusal pamwamba pa cartridge ya staple;

3. Chidacho chimalowa mkati mwa thupi, kanikizani batani lotulutsa, tsegulani pa occlusal pamwamba pa chipangizocho, ndikukhazikitsanso chogwirira chotseka.

4. Tembenuzirani chikhomo chozungulira ndi chala chanu kuti chizungulire, ndipo chikhoza kusinthidwa madigiri 360;

5. Sankhani malo oyenera (monga mawonekedwe a thupi, chiwalo kapena chida china) monga malo olumikizirana, kokerani chowongolera kumbuyo ndi chala cholozera, gwiritsani ntchito mphamvu yolumikizirana ndi malo olumikizirana kuti musinthe mbali yoyenera yopindika, ndi onetsetsani kuti cartridge yokhazikika ili mkati mwa masomphenya.

6. Sinthani malo a chida kuti minofu ikhale anastomosed / kudula;

Zindikirani: Onetsetsani kuti minofuyo imayikidwa mopanda phokoso pakati pa malo occlusal, palibe zopinga mu malo occlusal, monga ma clip, mabulaketi, mawaya owongolera, ndi zina zotero, ndipo malowa ndi oyenera.Pewani mabala osakwanira, ma staples omwe sanapangidwe bwino, ndi/kapena kulephera kutsegula malo ozungulira a chida.

7. Chidacho chikasankha minofu kuti ikhale anastomosed, kutseka chogwiriracho mpaka kutsekedwa ndikumva / kumva "kudina" phokoso;

8. Chida chowombera.Gwiritsani ntchito njira ya "3+1" kuti mupange ntchito yodulira ndi kusefera;"3": Gwirani chogwirira chowombera mokwanira ndikusuntha kosalala, ndikuchimasula mpaka chigwirizane ndi chotsekera.Pa nthawi yomweyo, onani kuti chiwerengero pa zenera chizindikiro chowombera ndi "1" "Ichi ndi sitiroko, chiwerengero chidzawonjezeka ndi" 1 "ndi sitiroko iliyonse, okwana 3 zikwapu zotsatizana, pambuyo sitiroko yachitatu, tsamba. mawindo owongolera mbali zonse za chogwirira choyera chokhazikika chidzaloza kumapeto kwa chidacho, kuwonetsa kuti mpeni uli munjira yobwerera, gwirani ndikumasula chogwiriziranso, zenera la chizindikiro lidzawonetsa 0, zomwe zikuwonetsa kuti mpeniwo uli munjira yobwerera. wabwerera pomwe adayambira;

9. Dinani batani lotulutsa, tsegulani malo occlusal, ndikukhazikitsanso chogwirira chowombera cha chogwirira chotseka;

Zindikirani: Dinani batani lotulutsa, ngati malo occlusal sakutseguka, choyamba tsimikizirani ngati zenera la chizindikiro likuwonetsa "0" komanso ngati zenera lolozera chala likulozera mbali yakutsogolo ya chida kuti muwonetsetse kuti mpeni uli poyambira. udindo.Kupanda kutero, muyenera kukankhira pansi batani losinthira tsambalo kuti mutembenuzire komwe tsambalo, ndikugwiritsitsa chogwiriracho mpaka chigwirizane ndi chotsekera, ndiyeno dinani batani lotulutsa;

10. Mukamasula minofu, fufuzani zotsatira za anastomosis;

11. Tsekani chogwirira chotseka ndikutulutsa chidacho.