Intangiriro kuri Surgical Staples

Ibyerekeranye n'umurongo wo gukata

Ubu buhanga bwatangijwe n’umuganga ubaga wo muri Hongiriya, Hümér Hültl, "se w’ubudozi bwo kubaga".Hultl's prototype stapler mu 1908 yapimaga ibiro 8 (3.6 kg) hanyuma ifata amasaha abiri yo guteranya no kwikorera. Ubu buhanga bwatunganijwe muri Leta Zunze Ubumwe z'Abasoviyeti mu myaka ya za 1950, bituma ibikoresho bya mbere byacururizwaga mu bucuruzi byifashishwa mu gukora amara na anastomose. .Ravitch azana icyitegererezo cya stapler nyuma yo kwitabira inama yo kubaga muri SSSR akayimenyekanisha kuri rwiyemezamirimo Leon C. Hirsch, washinze Surgical America mu 1964 kugira ngo akore udutoki two kubaga munsi y’ibikoresho bye biranga Auto Suture. Kugeza mu mpera za za 70, USSC ahanini yiganjemo isoko, ariko mu 1977 ikirango cya Ethicon Johnson & Johnson cyinjiye ku isoko, kandi uyumunsi ibyo bicuruzwa byombi bikoreshwa cyane hamwe nabanywanyi baturutse muburasirazuba bwa kure.USSC yaguzwe na Tyco Healthcare mu 1998 ihindura izina yitwa Covidien ku ya 29 Kamena 2007. Umutekano n’ububasha by’imitsi (anastomotic) amara anastomose byakozweho ubushakashatsi bwimbitse.Muri ubwo bushakashatsi, anastomose idoze isanzwe igereranywa cyangwa idakunze kumeneka.Ibyo bishobora kuba ibisubizo byiterambere ryateye imbere muburyo bwa tekinoloji ya suture hamwe nuburyo bwo kubaga bwangiza ibyago.Birumvikana ko ibishushanyo bya kijyambere bigezweho birashobora guhanurwa kandi ntibishobora kwandura kurusha ibikoresho bya suture byifashishijwe mbere ya za 90 - amara, ubudodo, nigitambara. Ikintu cyingenzi kiranga amara ni uko impande za stapler zikora nka hemostat, kwikuramo igikomere no gufunga imitsi yamaraso mugihe cyo gufata ingamba.Ubushakashatsi buherutse gukorwa bwerekanye ko ukoresheje tekinoroji yo kudoda iriho, nta tandukaniro rinini rigaragara mubisubizo hagati yo kudoda intoki na anastomose ya mashini (harimo na clips), ariko anastomose yumukanishi ikorwa vuba cyane.Mu barwayi bafite ibihaha byamahaha bifunze hamwe na staple pneumonectomy, umwuka kumeneka birasanzwe nyuma yo kubagwa.Ubu buryo bukoreshwa ubundi buryo bwo gufunga ibihaha.

Ubwoko na Porogaramu

Ikibanza cyambere cyubucuruzi cyakozwe mubyuma bidafite ingese hamwe nibikoresho bya titanium bipakiye muri karitsiye yuzuye yuzuye. Ibikoresho byo kubaga bigezweho birashobora gutabwa, bikozwe muri plastiki, cyangwa bikoreshwa, bikozwe mubyuma bitagira umwanda.Ubwoko bwombi busanzwe bwuzuye amakarito ashobora gutabwa. Imirongo yingenzi irashobora kuba igororotse, igoramye cyangwa izengurutse. Umuzenguruko wizunguruka ukoreshwa muburyo bwa nyuma bwa anastomose nyuma yo kuvura amara cyangwa, cyane cyane, kubaga esophagogastricique.Ibi bikoresho birashobora gukoreshwa mugufungura cyangwa laparoskopi. inzira, hamwe nibikoresho bitandukanye bikoreshwa kuri buri progaramu. Laparoscopic staplers ni ndende, yoroheje, kandi irashobora kuvugwa kugirango yemererwe kugera ku mubare muto w’ibyambu bya trocar.Bamwe mubantu bafite icyuma gishobora gukata no gutondekanya mugikorwa kimwe. gufunga ibikomere by'imbere ndetse n'uruhu. Ibikoresho by'uruhu mubisanzwe bikoreshwa hamwe na stapler ikoreshwa hanyuma bigakurwaho hamwe no kuvanaho staple kabuhariwe. Staplers nayo ikoreshwa muburyo bwa vertical band gastroplasty (bakunze kwita "gastric stapling").Nubwo ibikoresho bya anastomotic bizenguruka kumpera yigitereko bikoreshwa cyane, stapler izenguruka kumitsi ya anastomose ntabwo yigeze igereranwa na anastomose yintoki nubwo ubushakashatsi bwimbitse Kora itandukaniro rinini hamwe nubuhanga bwo kudoda (Carrel).Usibye uburyo butandukanye bwo guhuza icyombo (eversioned) nigifu cyigifu (inverted), impamvu nyamukuru ishobora kuba nuko, cyane cyane kubikoresho bito, imirimo yintoki nibisobanuro bisabwa kugirango ushireho gusa icyombo kandi ukoreshe igikoresho icyo aricyo cyose ntigishobora kuba bike cyane Gukora ubudodo bukenewe mugushushanya intoki zisanzwe, kubwibyo rero ntihakoreshwa cyane mugukoresha ibikoresho ibyo aribyo byose.Nyamara, guhinduranya ingingo bishobora kuba bidasanzwe aho ibi byiciro byombi, ibikoresho bihagaze kumitsi y'amaraso no gukora ibikoresho, bishobora gukorwa muburyo butandukanye inshuro zitsinda ryamatsinda atandukanye yo kubaga mubihe byumutekano nta gihe gikenewe kigira ingaruka ku kubungabunga urugingo rwabaterankunga, ni ukuvuga mubihe bikonje bikonje byurwego rwabaterankunga hamwe nameza yinyuma nyuma yo kwanga urugingo karemano rwakiriwe.Intego yo kurangiza ni ukugabanya icyiciro gishyushye giteye ischemic icyiciro y'urugingo rw'abaterankunga, rushobora kuba rurimo iminota cyangwa munsi, gusa muguhuza impera yigikoresho no gukoresha stapler.Mu gihe ibikoresho byinshi byo kubaga bikozwe muri titanium, ibyuma bitagira umwanda bikoreshwa cyane mubice bimwe na bimwe byuruhu na clips.Titanium ntigikora cyane hamwe na sisitemu yubudahangarwa kandi, kubera ko ari icyuma kitagira ferrous, ntabwo kibangamira cyane scaneri ya MRI, nubwo hari ibihangano byerekana amashusho bishobora kubaho. Ibikoresho bya sintetike byinjira (bioabsorbable) bishingiye kuri acide polyglycolike ubu birahari, nkuko benshi babibona sintetike ikurura suture.

Gukuraho ibibyimba byuruhu

Iyo ibikoreshwa byuruhu bikoreshwa mugushiraho ibikomere byuruhu, birakenewe gukuramo ibice nyuma yigihe gikwiye cyo gukira, mubisanzwe iminsi 5 kugeza 10, ukurikije aho igikomere giherereye nibindi bintu. y'inkweto cyangwa isahani ifunganye kandi yoroheje bihagije kugirango yinjizwe munsi y'uruhu rw'uruhu. Igice cyimuka ni icyuma gito, iyo ushyizwemo igitutu cy'intoki, usunika igicapo hasi unyuze mu mwanya winkweto, ugahindura igikoresho muri "M "imiterere yo gukuraho byoroshye.Mugihe cyihutirwa, staples zirashobora gukurwaho hamwe nimbaraga za arterial.Ibikoresho bivanaho uruhu bikozwe muburyo butandukanye, bimwe birashobora gutabwa kandi bimwe birashobora gukoreshwa.