Isixhobo esibini sokulungelelanisa isantya sendlela yokwetyisastapleribandakanya umzimba we-stapler, iqhosha lomzimba eliqhagamshelwe ngokujikelezayo nomzimba we-stapler, kunye nesikrufu esidityaniswe neqhosha lomzimba.Isikrufu sifakwe kumqolo ongaphakathi womzimba we-stapler, umphambili wesikrufu udityaniswe nentonga esembindini kumqolo ongaphakathi womzimba we-stapler, kwaye isikrufu sinecandelo elidityanisiweyo lomsonto wokuqala kunye necandelo lesibini lomsonto, I-pitch. yecandelo lomsonto wokuqala mkhulu kunelo lecandelo lomsonto wesibini.Inokunciphisa ngokukhawuleza umgama phakathi komgqomo wezikhonkwane kunye nesiseko sezikhonkwane, kwaye emva koko isilayidi icandelo lomsonto wesibini ngokunxulumene nomzimba weqhosha, ukuze isantya esishukumayo sesikrufu sicothe xa iqhosha lijikwa, elilungele ukusebenza. kwendlela yokugaya ukutya.
Iqhosha lokulungelelanisa le-digestive tract stapler libandakanya i-knob body, edityaniswa ngokujikelezayo kunye nomzimba we-stapler, kunye nomzimba we-knob udityaniswe ngesikrufu;Umzimba we-knob ubonelelwa ngamaqhuqhuva eradial akhuliswa ngokwemitha, kwaye kukho ubuncinci amaqhuqhuva amabini.I-radial bulge yenza i-knob imile njengebhabhathane.Xa uyisebenzisa, ukuba uvumela iminwe yakho ityhale i-radial bulge, unokufumana ngokuthe ngqo i-torque ukwenza i-knob ijikeleze, enokuthi icinezele izicubu zomntu kubukhulu obumiselwe kwangaphambili, kwaye akukho phantse ukungqubana phakathi kweminwe yakho kunye neradial. i-bulge, ekhusela ngokufanelekileyo umonakalo weeglavu ze-latex ezigqithwe ngumqhubi.
I-stapling nail ye-digestive tract stapler iqulethe isithsaba sesikhonkwane kunye nomlenze wesikhonkwane omalunga no-U.Umlenze wesikhonkwane unendawo egobayo.Inxalenye ephezulu yecandelo lokugoba yindawo ephezulu yomlenze wesikhonkwane, kwaye inxalenye engezantsi yecandelo lokugoba liphantsi komlenze wesikhonkwane.Inxalenye engezantsi yomlenze wesikhonkwane igobela ngaphakathi kwindawo yokugoba ngokumalunga nendawo ephezulu yomlenze wesikhonkwane.Ubude bomlenze wesikhonkwane somlenze we-nail ngu-4.84 mm -4.92 mm.Ukuphakama komlenze wesikhonkwane we-anastomotic unokubunjwa ngokuqhelekileyo.Emva kokuqulunqa, umlenze wesikhonkwane ugoba kwindawo yokugoba, okuphucula amathuba okubunjwa okusemgangathweni.
I-stapler yokusika ehambelanayo ibandakanya umzimba wokubamba, imela yokutyhala, isihlalo somgqomo wezikhonkwane kunye nesitulo sokubethelela iinzipho.Umzimba wokubamba unikezwe iqhosha lokutyhala lokulawula imela yokutyhala, umzimba wokubamba udityaniswe ngokujikelezayo kunye nekhamera, kwaye ikhamera ibonelelwa ngenxalenye yekhonkco.Icala lekhamera libonelelwe ngendlela yokhuseleko.Xa umatshini wokukhusela ukwimeko evaliweyo, ikhonkco ibanjwe kwiqhosha lokutyhala, kwaye ikhamera igxininiswe ngokumalunga nomzimba wokubamba;Xa indlela yokhuseleko ikwimeko engatshixwanga, inxalenye yehuku ikhupha iqhosha lokutyhala.Xa indlela yokhuseleko itshixiwe, ikhamera igxininiswe ngokumalunga nomzimba wokubamba, kwaye iqhosha lokutyhala alikwazi ukuqhubela phambili, ukuze kuthintelwe imela yokutyhala ekutyhaleni kwangoko xa indawo yesixhobo ingalungiswanga.
I-stapler yokusika i-circular iquka umkhono wesihlalo se-nail kunye nesihlalo sokuqhawula isikhonkwane, apho i-sleeve ye-sliding rod ihlelwe, apho intonga ye-sliding idibaniswe, kwaye i-sliding stick ifakwe kwi-sleeve ye-sliding stick.Intonga ye-sliding ibonelelwe ngenqwelomoya yokumisa ukujikeleza kokuqala, kwaye udonga lwangaphakathi lomkhono wentonga yokuslayida lubonelelwa ngenqwelomoya yesibini yokumisa ukujikeleza, kwaye iinqwelomoya ezimbini zokumisa ukujikeleza zihambelana.Enye inxalenye yebar yesilayidi kunye nomkhono webar yesilayidi ibonelelwe ngembambo yesikhokelo ecaleni kwe-axial direction yebar yesilayidi, kwaye enye inxalenye ibonelelwe ngegroove yesikhokelo ecaleni kwe-axial yebar yesilayidi, kunye nombambo wesikhokelo. ifakwe kwi-groove yesikhokelo.Ngentsebenziswano yembambo yesikhokelo kunye negroove yesikhokelo, indawo yokuma phakathi kwentonga etyibilikayo kunye nomkhono wesihlalo sezikhonkwane ichanekile, oko kukuthi, indawo phakathi komkhono wesitulo sesikhonkwane kunye nesihlalo sezikhonkwane ichanekile, ukuze kuqinisekiswe ukubumba okuchanekileyo. yesikhonkwane sokuthunga.
Indlela yokusebenza ye-stapler
Indlela yokusetyenziswa kwe-stapler ichazwa yi-intestinal anastomosis.Amathumbu asondeleyo e-anastomosis axutywe ngesikhwama, abekwe kwisihlalo sezikhonkwane kwaye aqiniswe.I-stapler ifakwe ukusuka ekupheleni okude, ihlatywe ngaphandle kwesixhobo sokubhoboza esisembindini se-stapler, idityaniswe nentonga esembindini ye-stapler esondelelene nesitulo sezikhonkwane, ijikeleziswa kufutshane nodonga lwamathumbu olukude kunye nolusondeleyo, kunye nomgama phakathi kwe-stapler. ngokuchasene nesihlalo sezikhonkwane kunye nesiseko sihlengahlengiswa ngokobunzima bodonga lwamathumbu, Ngokuqhelekileyo, yi-1.5 ~ 2.5cm okanye ukujikeleza kwesandla kuqinile (kukho isalathisi sokuqina kwisibambo) ukuvula i-fuse;
Cinezela ukuvalwa kwe-anastomosis wrench ngokuqinileyo, kwaye ukuva isandi esithi "cofa" kuthetha ukuba i-anastomosis yokusika igqityiwe.Musa ukuphuma kwi-stapler okwethutyana.Khangela ukuba i-anastomosis iyanelisa kwaye ingaba kukho ezinye izihlunu ezifana ne-mesentery efakwe kuyo.Emva konyango oluhambelanayo, khulula i-stapler kwaye uyikhuphe ngobunono kwi-distal end ukuze ukhangele ukuba i-distal kunye ne-proximal resection resection ring igqityiwe.
Izilumkiso ze-stapler
(1) Phambi kokuba usebenze, khangela ukuba isikali silungelelaniswe nesikali esingu-0, ukuba indibano ichanekile, nokuba iqhekeza lokutyhala kunye nesikhonkwane se-tantalum zilahlekile.Iiwasha zeplastiki ziya kufakwa kwisibambi senaliti.
(2) Isiphelo esaphukileyo samathumbu ukuze sihlanjululwe kufuneka sikhululeke ngokupheleleyo kwaye sihluthwe ubuncinane kwi-2 cm.
(3) Umgama wenaliti ye-suture ye-purse string suture ayikho ngaphezu kwe-0.5cm, kwaye umda yi-2 ~ 3mm.Izicubu ezininzi zilula ukuba zifakwe kwi-anastomosis, ethintela i-anastomosis.Qaphela ukuba ungashiyi i-mucosa.
(4) Lungisa isithuba ngokobunzima bodonga lwamathumbu, kunye ne-1 ~ 2 cm ngokufanelekileyo.
(5) Qwalasela isisu, ummizo kunye nezinye izihlunu ezimeleneyo phambi kokuba udubule ukuthintela ukuba zingaxinaniswa kwi-anastomosis.
(6) Ukusika kuya kukhawuleza, kwaye uxinzelelo lokugqibela luya kusetyenziswa ukwenza isikhonkwane se-seam sibe yimilo "B", ukwenzela ukuba sizame ukuphumelela ngexesha elinye.Ukuba ucinga ukuba ayichanekanga, ungayisika kwakhona.
(7) Phuma kakuhle kwi-stapler, kwaye ukhangele ukuba izicubu ezisikiweyo ziyiringi epheleleyo.
Ixesha lokuposa: Jul-06-2022
