Intshayelelo kwiiStaples zoTyando

Malunga Linear Cutter Stapler

Ubuchwephesha buhlaziywe ngugqirha wotyando waseHungary uHümér Hültl, "uyise wotyando lwe-suturing".Iprototype stapler ye-Hultl ngo-1908 yayinobunzima obuziikhilogram eziyi-8 (3.6 kg) kwaye yathatha iiyure ezimbini ukuze idityaniswe kwaye ilayishe.Ubuchule bucocwe eSoviet Union ngeminyaka yoo-1950, nto leyo eyayivumela ukuba kusetyenziswe izixhobo zokuqala zokurhweba ezisetyenziselwa ukwenza amathumbu kunye ne-vascular anastomoses. .I-Ravitch izisa isampuli ye-stapler emva kokuya kwinkomfa yotyando kwi-USSR kwaye iyazisa usomashishini uLeon C. Hirsch, owaseka i-Surgery America kwi-1964 ukuvelisa i-sutures yokuhlinzwa phantsi kwesixhobo sakhe se-Auto Suture brand.Kuze kube sekupheleni kwe-1970, i-USSC ubukhulu becala. imarike, kodwa ngo-1977 uphawu lukaJohnson & Johnson lwe-Ethicon lwangena emarikeni, kwaye namhlanje zombini ezi mpawu zisetyenziswa ngokubanzi kunye nabakhuphisana nabo abavela kwiMpuma Ekude.I-USSC yafunyanwa nguTyco Healthcare ngo-1998 kwaye yatshintsha igama layo kwi-Covidien ngoJuni 29, 2007. Ukhuseleko kunye ne-patency ye-mechanical (anastomotic) ye-bowel anastomosis ifundwe ngokubanzi.Kuphononongo olulolu hlobo, ii-anastomos ezifakwe i-sutured zikholisa ukuthelekiseka okanye zithande ukuvuza.Ewe, iisutu zokwenziwa zale mihla zicingeleka ngakumbi kwaye zichaphazeleka kancinci kusulelo kunezixhobo ezisetyenziswayo ngaphambi kweminyaka yoo-1990s—ithumbu, isilika, nelinen. Olona phawu lubalulekileyo lwezithinteli zamathumbu kukuba imiphetho yestapler isebenza njengehemostat, icinezela. imiphetho yesilonda kunye nokuvala umthambo wegazi ngexesha lenkqubo ye-stapling.Uphononongo lwakutsha nje lubonise ukuba ukusebenzisa iindlela zangoku ze-suturing, akukho mahluko ubalulekileyo kwiziphumo phakathi kwe-suturing manual kunye ne-anastomosis yomatshini (kubandakanywa neziqeshana), kodwa i-anastomosis yomatshini yenziwa ngokukhawuleza kakhulu.Kwizigulane ezinezicubu zemiphunga zitywinwe nge-staplers ye-pneumonectomy, umoya. ukuvuza kuqhelekile emva kotyando.Iindlela ezizezinye zokuvala izihlunu zemiphunga ziyaphandwa.

Iintlobo kunye nezicelo

I-stapler yokuqala yorhwebo yenziwe ngentsimbi engatyiwayo kunye ne-titanium staples epakishwe kwii-cartridges ze-stapleable refillable.Izixhaso zotyando zanamhlanje zisenokulahlwa, zenziwe ngeplastiki, okanye ziphinde zisetyenziswe, zenziwe ngentsimbi engenasici.Zombini ezi ntlobo zivame ukulayishwa ngeekhatriji ezilahlayo.Imigca ye-staple ingaba ngokuthe tye, igobile okanye ijikeleze.I-staplers ye-circular isetyenziselwa ukuphelisa i-anastomosis emva kokutshatyalaliswa kwamathumbu okanye, ngokugqithiseleyo, ukuhlinzwa kwe-esophagogastric.Ezi zixhobo zingasetyenziselwa kwi-open or laparoscopic. iinkqubo, kunye nezixhobo ezahlukeneyo ezisetyenziselwa isicelo ngasinye.I-laparoscopic staplers zinde, zincinci, kwaye zinokuchazwa ukuze zivumele ukufikelela kwinani eliqingqiweyo leechwephesha zetrocar.Ezinye i-staplers ziqulethe imela enokusika kunye ne-staple kwi-operation.Staplers enye isetyenziselwa vala amanxeba angaphakathi kunye nolusu.Izithintelo zesikhumba zidla ngokusetyenziswa kunye ne-stapler elahlayo kwaye isuswe kunye ne-stapler ekhethekileyo.Nangona izixhobo ze-anastomotic ezijikelezayo zokuphela kwendlela yokugaya zisetyenziswa ngokubanzi, i-staplers ejikelezayo ye-vascular anastomosis ayizange ifaniswe ne-anastomosis yezandla eziqhelekileyo nangona izifundo ezinzulu Yenza umehluko omkhulu kunye (Carrel) ubuchule be-suture.Ngaphandle kwendlela eyahlukileyo yokudibanisa isitya (i-eversioned) kwi-digestive (inverted) isiphunzi, esona sizathu siphambili sinokuthi, ngakumbi kwiinqanawa ezincinci, umsebenzi wezandla kunye nokuchaneka okufunekayo ukubeka kuphela isiphunzi somkhumbi kwaye uqhube nasiphi na isixhobo asikwazi. Yiba nganeno ngokuphawulekayo Wenza umthungo ofunekayo wokuthunga ngesandla okusemgangathweni, ngoko ke akukho kusetyenziswa kungako ekusebenziseni nasiphi na isixhobo.Noko ke, uqhaqho-fakelo lwelungu lunokuba ngumqobo apho ezi zigaba zibini, ukuma kwesixhobo kwi-vascular stump kunye nokusebenza kwesixhobo, kunokwenziwa ngeendlela ezahlukeneyo. amaxesha ngamaqela ahlukeneyo otyando phantsi kweemeko ezikhuselekileyo ngaphandle kwexesha elifunekayo elichaphazela ukugcinwa kwelungu loMnikeli, oko kukuthi, phantsi kweemeko ezibandayo ze-ischemic zelungu lomnikeli kunye netafile engasemva emva kokutshatyalaliswa kwelungu lendalo lommkeli. Injongo yokugqiba kukunciphisa isigaba esiyingozi se-ischemic yelungu lomnikeli, enokuthi iqulethwe kwimizuzu okanye ngaphantsi, ngokulula ngokuncamathisela ekupheleni isixhobo kunye nokuxhaphaza stapler.Ngelixa uninzi stapler zotyando zenziwe titanium, intsimbi stainless isetyenziswa ngokuqhelekileyo kwezinye izinto ezisisiseko isikhumba kunye clips.Titanium ayisebenzi kakhulu kunye ne-immune system kwaye, ngenxa yokuba isinyithi esingenayo i-ferrous, ayiphazamisi kakhulu i-MRI scanners, nangona ezinye izinto ze-imaging zingenzeka. i-synthetic absorbable sutures.

Ukususwa kwee-spikes zesikhumba

Xa izitena zesikhumba zisetyenziselwa ukutywina amanxeba esikhumba, kuyimfuneko ukususa i-staples emva kwexesha elifanelekileyo lokuphilisa, ngokuqhelekileyo iintsuku ezi-5 ukuya kwezi-10, kuxhomekeke kwindawo yenxeba kunye nezinye izinto. Isihlangu okanye ipleyiti emxinwa kwaye ibhityile ngokwaneleyo ukuba ifakwe phantsi kwe-spike yesikhumba. Inxalenye eshukumayo yincakuba encinci ethi, xa kufakwa uxinzelelo lwesandla, ityhale i-staple ezantsi nge-slot kwisihlangu, iguqula i-staple ibe "M " imilo yokususwa lula.Kwimeko engxamisekileyo, i-staples inokususwa kunye ne-arterial forceps.I-Skin staple removers zenziwe ngeendlela ezahlukeneyo kunye neefom, ezinye ziyalahlwa kwaye ezinye ziphinda zisetyenziswe.