3.Staplergulu
Chomera chodulira chozungulira chimaphatikizapo chigwiriro, mpeni wokankhira, mpando wa magazini ya misomali ndi mpando wa anvil, thupi lachigwiriro limaperekedwa ndi batani lopondereza kuti liwongolere mpeni wokankhira, kamera imalumikizidwa mozungulira ndi chogwirizira, ndi kamera. ali ndi mbedza.Mbali ya kamera imaperekedwa ndi njira yotetezera.Pamene makina otetezera ali mu malo otsekedwa, gawo la mbedza limakokedwa pa batani, ndipo kamera imakhazikika pokhudzana ndi thupi;pamene makina otetezera ali osatsegulidwa, gawo la mbedza limatulutsa batani la kukankhira.Njira yachitetezo ikatsekedwa, kamerayo imakhazikika pokhudzana ndi chogwirizira, ndipo batani la kukankhira silingapitirire patsogolo, kotero kuti mpeni wokankhira ukhoza kupewedwa kukankhidwiratu nthawi isanakwane pamene malo a chidacho sichinasinthidwe bwino.
Mdulidwe wa mdulidwe umaphatikizapo dzanja la mpando wa misomali ndi chotchinga cha msomali, ndodo yotsetsereka imakonzedwa mu dzanja la mpando wa msomali, ndodo yotsetsereka imagwirizanitsidwa ndi mpando wokhomerera msomali, ndipo ndodo yotsetsereka imalowetsedwa mu dzanja la ndodo.Ndodo yotsetsereka imakhala ndi ndege yoyamba yotsutsana ndi kuzungulira, khoma lamkati la manja otsetsereka liri ndi ndege yachiwiri yotsutsana ndi kuzungulira, ndipo ndege ziwiri zotsutsana ndi kuzungulira zimagwirizana.Gawo limodzi la ndodo yotsetsereka ndi manja otsetsereka limaperekedwa ndi nthiti yolondolera motsatira njira ya axial ya ndodo yotsetsereka, ndipo mbali inayo imaperekedwa ndi njira yolowera mbali ya axial ya ndodo yotsetsereka, ndipo nthiti yolondolera ndi kulowetsedwa mu nkhokwe yotsogolera.Kupyolera mu mgwirizano wa nthiti zolondolera ndi ma groove otsogolera, kuika pakati pa ndodo yotsetsereka ndi manja a mpando wa msomali ndikolondola, ndiko kuti, kuika kwa mkono wa mpando wa msomali ndi mpando wa msomali ndi wolondola, kotero kuti mapangidwe olondola a chokhazikika chikhoza kutsimikiziridwa.
4 Momwe mungagwiritsire ntchito stapler
Gwiritsani ntchito intestinal anastomosis kusonyeza kugwiritsa ntchito stapler.Mapeto oyandikira a anastomosis amapangidwa ndi suture ya chikwama, ndipo mpando wokhazikika umalowetsedwa ndikumangika.Ndodo yapakati ya mpando imalumikizidwa, ndipo kuzungulira kuli pafupi ndi khoma la matumbo a distal ndi proximal intestinal tubes.Mtunda pakati pa mpando wa stapler ndi maziko amasinthidwa malinga ndi makulidwe a khoma la m'mimba.Nthawi zambiri, zimangokhala ~ kapena kuzungulira kwa dzanja kumakhala kolimba (pali chizindikiro cholimba pa chogwirira) kuti mutsegule chitetezo;
Finyani mwamphamvu anastomotic wrench ndikumva "kudina", zomwe zikutanthauza kuti kudula ndi anastomosis kwatha.Osachotsa stapler panthawiyi.Onani ngati anastomosis ndi yokhutiritsa komanso ngati minofu ina monga mesentery imalowetsedwamo.Pambuyo lolingana mankhwala, kumasula stapler.Ndipo pang'onopang'ono mutulutse kuchokera kumapeto kuti muwone ngati mphete za distal ndi proximal matumbo resection zatha.
5 Stapler Precautions
(1) Musanagwiritse ntchito, fufuzani ngati sikelo ndi 0 sikelo zikugwirizana, ngati msonkhano uli wolondola, komanso ngati chidutswa chokankhira ndi msomali wa tantalum zikusowa.Gasket ya pulasitiki iyenera kuikidwa pampando wa singano.
(2) Mapeto osweka a m'mimba chubu kuti anastomosed ayenera kumasulidwa kwathunthu ndi anavula osachepera 2 cm.
(3) Mtunda wa singano wa suture wa thumba lachikwama suyenera kupitirira masentimita, ndipo m'mphepete mwake uyenera kukhala 2 mpaka 3 mm.Minofu yambiri ndiyosavuta kuyika mu anastomosis ndikulepheretsa anastomosis.Samalani kuti musaphonye mucosa.
(4) Sinthani masinthidwe molingana ndi makulidwe a khoma lamatumbo, makamaka 1 mpaka 2 cm.
(5) Yang'anani m'mimba, mmero ndi minyewa ina yoyandikana nayo musanawombe kuti mupewe kutsekeka kwa anastomosis.
(6) Kudula kuyenera kukhala kofulumira, ndipo kukakamiza komaliza kumapangitsa kuti zotsalirazo zikhale mawonekedwe a "B", ndikuyesetsa kuchita bwino.
(7) Tulukani pa stapler pang'onopang'ono, ndipo onani ngati minofu yodulidwayo ndi mphete yathunthu.
Nthawi yotumiza: Feb-16-2022
