Ibikoresho bishya bya Endoskopi | Laparoscopic stapler

Ikoreshwa rya Laparoscopic Linear Cutter Stapler hamwe nibigize

I. Izina ryibicuruzwa, icyitegererezo, ibisobanuro
Izina ryibicuruzwa: Ikoreshwa rya endoscopic umurongo ugabanya stapler nibigize
Icyitegererezo:Ikoreshwa rya endoskopi yumurongo ugabanya stapler: PESS35, PESS45, PESS60, PESM35, PESM45, PESM60, PESL35, PESL45, PESL60, PEPS35, PEPS45, PEPS60, PEPM35, PEPM45, PEPM60, PEPL35, PEPL45, PEPL60;
Ikoreshwa rya endoskopi yumurongo ukata ibice byingenzi: PSGST35M, PSGST35W, PSGST35B, PSGST35D, PSGST35G, PSGST35T, PSGST45M, PSGST45W, PSGST45B, PSGST45D, PSGST45G, PSGST45T, PSGST60M, PSGST60 , PSGST60T, PSGST60D, PSGST60B, PSGST35G , PSGST60D, PSGST60B PPEPR60D, PPEPR60G, PPEPR60T.
II.Imikorere y'ibicuruzwa
Stapler igomba guhagarikwa neza, ibice byasimbuwe bigomba kuba byoroshye, bihamye, kandi bitarimo inzitizi, kandi hagomba kubaho amajwi cyangwa ibindi bisobanuro mugihe ibice biri mukibanza.Ibikoresho byingenzi bigomba gutwarwa mu nteko, kandi ibyingenzi ntibigomba kugaragara hejuru yikarito ya karitsiye nyuma yo kunyeganyezwa.Gufungura no gufunga urwasaya rwa stapler bigomba guhinduka kandi ntihakagombye kubaho.Imiterere ihuriweho hamwe no guhinduranya imiterere ya stapler igomba guhinduka kandi nta mbogamizi.Isano iri hagati yumubiri wibigize nibigomba kuba bikomeye kandi byizewe.Nyuma yuko stapler azunguza umutwe kuruhande ntarengwa, irashobora kurangiza neza kurasa no gusubiramo.Hariho imbaraga zifatika nyuma yimisaya ya stapler ifunze, kandi imbaraga zo gufatana ntizigomba kuba munsi ya 4N.Hariho imbaraga zimwe zo gufunga nyuma yimisaya ya stapler ifunze, kandi imbaraga zo gufunga ntizigomba kuba munsi ya 30N.Ifite imikorere imwe imwe.Stapler igomba kugira stapling nziza no gukata imikorere.Ibice bisimburwa birashobora gukoreshwa mugukata inshuro nyinshi no gutondeka kandi bitarenze inshuro 8.Igice cyo gukata nyuma ya buri kibaho kigomba kuba cyiza kandi kitarimo burrs, kandi uburebure bwimpera ya kure ya buri murongo wikurikiranya bugomba kuba burebure kuruta umurongo wo gutema Uburebure bugomba kuba nibura inshuro 1.5 uburebure bwimisumari, hamwe na staples nyuma ya buri anastomose bigomba kumera nka “B”.Umurongo wibanze nyuma ya anastomose ugomba kugira imbaraga zumurongo wumurongo wingenzi, kandi imbaraga zumurongo wumurongo ntizigomba kuba munsi ya 0.1N / mm.Stapler igomba kugira ibikoresho byerekana ibimenyetso byerekana ibimenyetso byerekana umuriro cyangwa imiterere.
III.Imiterere nyamukuru
Ikoreshwa rya endoskopi yumurongo ukata stapler hamwe nibigize bigizwe numubiri nibigize, aho umubiri ugizwe na anvil, umutwe uhuriweho, inkoni, kuzunguruka, gukanda, guhinduranya icyerekezo, guhinduranya icyerekezo, kurasa idirishya, icyerekezo cyerekana Icyerekezo cyerekana idirishya ryerekana, buto yo kurekura, ikiganza, ikiganza cyo gufunga, icyuma cyo kurasa, icyuma cyo gutema, hamwe nintebe ya karitsiye ya karitsiye, inteko igizwe na karitsiye nyamukuru.
IV.Igipimo cyo gusaba
Irakwiriye kwangwa, guhinduranya no anastomose yibihaha, tissue bronchial, igifu n'amara mugihe cyo kubaga kumugaragaro cyangwa endoskopi.

Reba Ishusho 1, Igishushanyo 2, Imbonerahamwe 1, na Imbonerahamwe ya 2 kubwoko nuburinganire bwibanze bwa endoskopi yumurongo ugabanya ibice hamwe nibice.

V. Kugaragara kw'ibicuruzwa n'imiterere

1 - Intebe irwanya imisumari, 2 - Umutwe uhuriweho, 3 - Inkoni;4 - Kuzunguruka;5 - Guhindura paddle; 6 - Akabuto kayobora icyerekezo;7 - Kurasa idirishya ryerekana;8 - Idirishya ryerekana icyerekezo;9 - Kurekura buto;10 - ikiganza ； 11 - gufunga;12 - icyuma cyo kurasa;13 - gukata icyuma;14 - intebe ya karitsiye

Igishushanyo 1 Umubiri wumurongo ugabanya stapler ya endoskopi ikoreshwa

1-Igikoresho cya bin-2

Igishushanyo 2 Gukata umurongo guteranya inteko ya endoscope

Imbonerahamwe 1 Ibipimo fatizo byumubiri

Imbonerahamwe 1 Ibipimo fatizo byumubiri

Icyitonderwa: Ibigize bifite uburebure bwa 35 birashobora gukoreshwa gusa kumubiri ufite uburebure bwa 35, ibice bifite uburebure bwa 45 bishobora gukoreshwa gusa kumubiri ufite uburebure bwa 45, hamwe nibigize hamwe uburebure bujyanye na 60 bushobora gukoreshwa gusa kuburebure buhuye Umubiri ni 60.

Imbonerahamwe 2 Igice cyibanze cyibice: mm

VI.Kurwanya
1).Indwara ikabije;
2).Birabujijwe rwose gukoresha iki gikoresho ku mwijima cyangwa mu mitsi.Bitewe no kwikuramo ibintu nkibi, gufunga igikoresho bishobora kugira ingaruka mbi;
3).Ntishobora gukoreshwa mubice aho hemostasis idashobora kugaragara;
4).Ibice byijimye ntibishobora gukoreshwa mubice bifite umubyimba uri munsi ya 0,75mm nyuma yo kwikuramo cyangwa kubice bidashobora guhunikwa neza kugeza mubyimbye bya 1.0mm;
5).Ibice byera ntibishobora gukoreshwa mubice bifite umubyimba uri munsi ya 0.8mm nyuma yo kwikuramo cyangwa ingirangingo zidashobora guhagarikwa neza kugeza mubyimbye bya 1,2mm;
6).Ibigize ubururu ntibigomba gukoreshwa kumyenda iri munsi ya 1,3mm yubugari nyuma yo kwikuramo cyangwa idashobora guhagarikwa neza kugeza mubyimbye bya 1.7mm.
7).Ibice bya zahabu ntibishobora gukoreshwa mubice bifite umubyimba uri munsi ya 1,6mm nyuma yo kwikuramo cyangwa ingirangingo zidashobora guhagarikwa neza kugeza mubyimbye bya 2.0mm;
8).Icyatsi kibisi ntigikwiye gukoreshwa kumyenda iri munsi ya 1.8mm yubugari nyuma yo kwikuramo cyangwa idashobora guhagarikwa neza kugeza mubyimbye bya 2.2mm.
9).Ibigize umukara ntibigomba gukoreshwa kumyenda iri munsi ya 2.0mm yubugari nyuma yo kwikuramo cyangwa idashobora guhagarikwa neza kugeza mubyimbye bya 2,4mm.
10).Birabujijwe rwose gukoresha kuri tissue kuri aorta.

VII.Uburyo bwo gukoresha
Staple cartridge amabwiriza yo kwishyiriraho:
1).Kuramo igikoresho na cartridge ya staple mubipaki yabyo munsi ya aseptic;
2).Mbere yo gupakira igikarito nyamukuru, menya neza ko igikoresho kiri kumugaragaro;
3).Reba niba igikarito nyamukuru ifite igifuniko gikingira.Niba igikarito nyamukuru idafite igifuniko kirinda, birabujijwe kuyikoresha;
4).Ongeraho igikarito ya staple hepfo yintebe ya jap staple cartridge, uyinjizemo muburyo bwo kunyerera kugeza igihe karitsiye ya staple ihujwe na bayonet, ikosora karitsiye ya staple mu mwanya wawe hanyuma ukureho igifuniko kirinda.Muri iki gihe, igikoresho cyiteguye gucana;.
5).Mugihe urimo gupakurura igikarito nyamukuru, kanda igikarito nyamukuru werekeza ku cyerekezo cyintebe yimisumari kugirango urekure kuntebe ya karitsiye;
6).Kugirango ushyireho cartridge nshya, subiramo intambwe 1-4 hejuru.

Amabwiriza yo gukorana:
1).Funga ikiganza cyo gufunga, kandi ijwi rya "kanda" ryerekana ko ikiganza cyo gufunga cyafunzwe, kandi ubuso bwihariye bwa karitsiye ya staple iri muburyo bufunze;Icyitonderwa: Ntugafate icyuma cyo kurasa muri iki gihe
2).Iyo winjiye mu cyuho cy'umubiri unyuze muri cannula cyangwa gutemagura trocar, ubuso bwihariye bwigikoresho bugomba kunyura muri cannula mbere yuko ubuso bwihariye bwa karitsiye ya capaple bushobora gufungurwa;
3).Igikoresho cyinjira mu cyuho cyumubiri, kanda buto yo kurekura, fungura ubuso bwihariye bwigikoresho, hanyuma usubize ikiganza cyo gufunga.
4).Hindura knob izenguruka urutoki rwawe rwo kuzunguruka, kandi irashobora guhinduka dogere 360;
5).Hitamo ubuso bukwiye (nk'imiterere y'umubiri, urugingo cyangwa ikindi gikoresho) nk'ubuso bwo guhuza, gukurura paddle yoguhindura inyuma ukoresheje urutoki rwerekana, koresha imbaraga zifatika hamwe nubuso bwo guhuza kugirango uhindure inguni ikwiye, kandi urebe ko staple cartridge iri mumwanya wo kureba.
6).Hindura umwanya wigikoresho kuri tissue kugirango anastomose / gukata;
Icyitonderwa: Menya neza ko urugingo rushyizwe hagati yubuso butagaragara, nta mbogamizi ziri hejuru yimiterere, nka clips, imirongo, insinga ziyobora, nibindi, kandi umwanya urakwiye.Irinde gukata kutuzuye, ibintu byubatswe nabi, na / cyangwa kunanirwa gufungura ubuso bwibikoresho.
7).Igikoresho kimaze guhitamo tissue kugirango anastomose, funga ikiganza kugeza gifunze hanyuma wumve / wumve ijwi "kanda";
8).Igikoresho cyo kurasa.Koresha uburyo bwa "3 + 1 ″ kugirango ukore ibikorwa byuzuye byo gukata no kudoda;“3.Muri icyo gihe, reba neza ko umubare uri ku idirishya ryerekana umuriro ari “1 ″“ Iyi ni inkoni, umubare uziyongera kuri “1 ″ hamwe na buri nkoni, inshuro 3 zose zikurikiranye, nyuma y’igitero cya gatatu, icyuma icyerekezo cyerekana Windows kumpande zombi zumutwe wera uzerekanwa werekeza kumpera yigikoresho, byerekana ko icyuma kiri muburyo bwo Kugaruka, gufata no kurekura icyuma cyo kurasa, idirishya ryerekana ryerekana 0, byerekana ko icyuma yagarutse aho itangiriye;
9).Kanda buto yo kurekura, fungura ubuso butagaragara, hanyuma usubize umuriro wo gufunga;
Icyitonderwa: Kanda buto yo kurekura, niba ubuso butagaragara, banza wemeze niba idirishya ryerekana "0 ″ kandi niba idirishya ryerekana icyerekezo cyerekana icyerekezo cyegereye igikoresho kugirango umenye neza ko icyuma kiri mu ntangiriro umwanya.Bitabaye ibyo, ugomba gusunika hasi icyerekezo cyo guhinduranya icyuma kugirango uhindure icyerekezo cyicyuma, hanyuma ufate neza icyuma cyo kurasa kugeza gihuye nigikoresho cyo gufunga, hanyuma ukande buto yo kurekura;
10).Nyuma yo kurekura tissue, reba ingaruka za anastomose;
11).Funga ikiganza cyo gufunga hanyuma ukuremo igikoresho.

VIII.Uburyo bwo gufata neza ibicuruzwa no kubungabunga

1. Ububiko: Bika mucyumba gifite ubushuhe bugereranije butarenze 80%, bihumeka neza, kandi nta myuka yangiza.
2. Ubwikorezi: Ibicuruzwa bipakiye birashobora gutwarwa nibikoresho bisanzwe.Mugihe cyo gutwara abantu, bigomba kwitabwaho kandi bikirinda urumuri rwizuba, kugongana gukabije, imvura nubushuhe.
IV.Itariki izarangiriraho
Ibicuruzwa bimaze guhagarikwa na okiside ya Ethylene, igihe cyo guhagarika ni imyaka itatu, kandi itariki izarangiriraho irerekanwa kuri label.

X. Urutonde rw'ibice
nta na kimwe

XI, Kwirinda, Kuburira
1. Mugihe ukoresheje iki gicuruzwa, ibikorwa bya aseptic bigomba gukurikizwa rwose;
2. Nyamuneka reba neza ibicuruzwa bipfunyitse neza mbere yo kubikoresha, niba ibipfunyika byangiritse, nyamuneka ureke kubikoresha;
3. Iki gicuruzwa cyahinduwe na okiside ya Ethylene, kandi ibicuruzwa biva mu mahanga ni ibyo gukoreshwa mu mavuriro.Nyamuneka reba icyerekezo cya disiki kumasanduku yo gupakira ibicuruzwa, "ubururu" bivuze ko ibicuruzwa byahinduwe kandi bishobora gukoreshwa mubuvuzi;
4. Iki gicuruzwa gikoreshwa mugikorwa kimwe kandi ntigishobora guhinduka nyuma yo gukoreshwa;
5. Nyamuneka reba niba ibicuruzwa biri mugihe cyemewe mbere yo gukoreshwa.Igihe cyo kuboneza urubyaro ni imyaka itatu.Ibicuruzwa birenze igihe cyemewe birabujijwe rwose;
6. Inteko yo gukata laparoskopi yakozwe nisosiyete yacu igomba gukoreshwa ifatanije nubwoko bujyanye nibisobanuro byerekana ikoreshwa rya laparoskopi yumurongo wo gukata byakozwe na sosiyete yacu.Reba Imbonerahamwe 1 na Imbonerahamwe 2 kugirango ubone ibisobanuro birambuye;
7. Ibikorwa byibasiye byibuze bigomba gukorwa nabantu bahawe amahugurwa ahagije kandi bamenyereye tekinike zidasanzwe.Mbere yo kubaga ikintu icyo ari cyo cyose kibabaza, ibitabo by'ubuvuzi bijyanye na tekinike, ingorane zabyo n'ingaruka zabyo bigomba kubazwa;
8. Ingano yibikoresho byibasirwa cyane nababikora bitandukanye birashobora gutandukana.Niba ibikoresho byo kubaga byibasiye cyane nibikoresho byabyo byakozwe nababikora bitandukanye bikoreshwa mugikorwa kimwe icyarimwe, birakenewe kugenzura niba bihuye mbere yigikorwa;
9. Ubuvuzi bwimirasire mbere yo kubagwa bushobora gutera impinduka.Kurugero, izi mpinduka zirashobora gutera tissue kubyimba birenze ibyateganijwe kubintu byatoranijwe.Ubuvuzi ubwo aribwo bwose bwo kuvura umurwayi mbere yo kubagwa bugomba gusuzumwa neza kandi bushobora gusaba impinduka muburyo bwo kubaga cyangwa uburyo;
10. Nturekure buto kugeza igikoresho cyiteguye kuzimya;
11. Witondere kugenzura umutekano wa karitsiye mbere yo kurasa;
12. Nyuma yo kurasa, menya neza ko ureba hemostasis kumurongo wa anastomotique, urebe niba anastomose yuzuye kandi niba hari ibimeneka;
13. Menya neza ko umubyimba winyuma uri murwego rwagenwe kandi ko tissue yagabanijwe neza muri stapler.Ibibyimba byinshi kuruhande rumwe birashobora gutera anastomose mbi, kandi hashobora kubaho gutemba kwa anastomotique;
14. Mugihe cyimyanya irenze cyangwa yibyibushye, kugerageza guhatira imbarutso bishobora kuvamo suture ituzuye hamwe no guturika kwa anastomotic cyangwa kumeneka.Byongeye, kwangiza ibikoresho cyangwa kunanirwa umuriro bishobora kubaho;
15. Isasu rimwe rigomba kurangira.Ntuzigere ucana igice igice.Kurasa bituzuye bishobora kuvamo ibintu bidakwiye, umurongo waciwe utuzuye, kuva amaraso no kuva muri suture, na / cyangwa bigoye gukuramo igikoresho;
16. Witondere kurasa kugeza ku ndunduro kugirango umenye neza ko ibice byakozwe neza kandi inyama zaciwe neza;
17. Fata icyuma cyo kurasa kugirango ugaragaze icyuma gikata.Ntukande inshuro nyinshi, bizatera kwangirika kurubuga rwa anastomose;
18. Mugihe winjizamo igikoresho, menya neza ko umutekano uri mumwanya ufunze kugirango wirinde gukora utabishaka kwimikorere yumuriro, bikaviramo impanuka kubwimpanuka no kohereza igice kitaragera cyangwa cyuzuye cyoherejwe;
19. Igihe ntarengwa cyo kurasa cyibicuruzwa ni inshuro 8;
20. Gukoresha iki gikoresho hamwe nibikoresho byongera umurongo wa anastomotic bishobora kugabanya umubare wamafuti;
21. Iki gicuruzwa nigikoresho kimwe cyo gukoresha.Igikoresho kimaze gukingurwa, cyaba cyarakoreshejwe cyangwa kidakoreshwa, ntigishobora kongera guhindurwa.Witondere gufunga umutekano mbere yo gukora;
22. Umutekano mubihe bimwe na bimwe bya magnetiki resonance (MR):
· Ibizamini bitari ivuriro byerekana ko ibikoresho byatewe hamwe nicyiciro cyibikoresho bya TA2G bishobora gukoreshwa kuri MR uko bikwiye.Abarwayi barashobora kubisikana neza nyuma yo gushiramo ibintu mubihe bikurikira:
· Urwego rwa magnetique ihagaze ni hagati ya 1.5T-3.0T.
· Umwanya ntarengwa wa magnetiki yumwanya ni 3000 gauss / cm cyangwa munsi.
· Sisitemu nini ya MR ivugwa, isikana iminota 15, igipimo cyo kugereranya umubiri wose (SAR) ni 2 W / kg.
· Mugihe cyo gusikana, kuzamuka kwubushyuhe ntarengwa bwibintu byateganijwe kuba 1.9 ° C nyuma yo kubisikana muminota 15.
Amakuru yubukorikori:
Iyo bipimishije bidasubirwaho ukoresheje amashusho ya echo pulse ikurikirana hamwe na sisitemu ya magnetiki ihagaze 3.0T MR, staples yateje ibihangano hafi mm 5 uvuye aho byatewe.
23. Reba ikirango cyumunsi wo gukora;