3.I-Staplerukuhlukaniswa
I-stapler yokusika eqondile ihlanganisa umzimba wesibambo, ummese wokusunduza, isihlalo somagazini wezinzipho kanye nesihlalo se-anvil, umzimba wesibambo unikezwa inkinobho ecindezelayo yokulawula ummese ophushayo, ikhamera ixhunywe ngokuzungezayo emzimbeni wesibambo, kanye nekhamera. inehhuku.Uhlangothi lwekhamera lunikezwe indlela yokuphepha.Uma indlela yokuphepha isesimweni esikhiyiwe, ingxenye yehhuku ixhunywe kwinkinobho yokusunduza, futhi ikhamera igxilile ngokuhlobene nomzimba wesibambo;lapho indlela yokuphepha isesimweni esingakhiyiwe, ingxenye yehuku ikhulula inkinobho yokuphusha.Uma indlela yokuphepha ikhiyiwe, ikhamera ilungiswa ngokuhlobene nesibambo, futhi inkinobho yokusunduza ayikwazi ukuya phambili, ukuze ummese ophushayo ukwazi ukuvinjelwa ekubeni uphushwe ngaphambi kwesikhathi lapho indawo yensimbi ingalungiswanga kahle.
I-stapler yokusoka ihlanganisa umkhono wesihlalo sezinzipho kanye ne-nail anvil, umkhono wenduku eshelelayo uhlelwe kumkhono wesihlalo sezinzipho, induku eshelelayo ixhunywe esihlalweni sokunamathisela izinzipho, futhi induku eshelelayo ifakwa kumkhono wenduku eshelelayo.Induku eshelelayo inendiza yokuqala emelene nokujikeleza, udonga lwangaphakathi lomkhono wenduku eshelelayo linendiza yesibili emelene nokujikeleza, futhi izindiza ezimbili ezimelene nokujikeleza zihlangana ndawonye.Ingxenye eyodwa yenduku eshelelayo kanye nomkhono wenduku eshelelayo inikezwe ubambo oluqondisayo ngakundlela ye-axial yenduku eshelelayo, futhi enye ingxenye inikezwe igroove eyisiqondiso ngasendleleni ye-axial yenduku eshelelayo, futhi ubambo oluqondisayo ifakwe emseleni oqondisayo.Ngokubambisana kwezimbambo eziqondisayo kanye nemigqa eqondisayo, ukuma phakathi kwenduku eshelelayo kanye nomkhono wesihlalo sezipikili kunembile, okungukuthi, ukuma komkhono wesihlalo sezipikili kanye nesihlalo se-nail anvil kunembile, ukuze ukwakheka kahle okuyisisekelo kungaqinisekiswa.
4 Indlela yokusebenzisa i-stapler
Sebenzisa i-anastomosis yamathumbu ukukhombisa ukusetshenziswa kwe-stapler.Ukuphela okuseduze kwe-anastomosis kufakwe i-suture ye-purse-string, futhi isihlalo esiyisisekelo sifakwe futhi siqiniswe.Induku ephakathi yesihlalo ixhunyiwe, futhi ukujikeleza kuseduze nodonga lwamathumbu amashubhu e-distal and proximal intestinal.Ibanga phakathi kwesihlalo se-stapler kanye nesisekelo lilungiswa ngokuvumelana nobukhulu bodonga lwamathumbu.Ngokuvamile, kukhawulelwe kokuthi ~ noma ukuzungezisa isandla kuqinile (kunenkomba yokuqina esibambeni) ukuvula ukuphepha;
Cindezela ngokuqinile i-wrench ye-anastomotic futhi uzwe "chofoza" umsindo, okusho ukuthi ukusika kanye ne-anastomosis kuqediwe.Ungahoxisi i-stapler okwamanje.Hlola ukuthi i-anastomosis iyagculisa yini nokuthi ezinye izicubu ezifana ne-mesentery zishunyekiwe yini kuyo.Ngemuva kokwelashwa okuhambisanayo, khulula i-stapler.Futhi uyikhiphe ngobumnene ekugcineni ukuze uhlole ukuthi izindandatho zokukhishwa kwamathumbu e-distal kanye ne-proximal aphelele yini.
5 Izinyathelo Zokuqapha
(1) Ngaphambi kokusebenza, hlola ukuthi isikali kanye nesikali esingu-0 ziqondile yini, ukuthi ukuhlangana kuqondile, nokuthi ucezu oluphushayo nesipikili se-tantalum akukho yini.I-gasket yepulasitiki kufanele ifakwe esihlalweni senaliti.
(2) Ingxenye ephukile yeshubhu yamathumbu ezokwenziwa i-anastomosed kufanele ikhululwe ngokuphelele futhi ikhishwe okungenani ama-2 cm.
(3) Ibanga lenaliti ye-purse-string suture akufanele lidlule amasentimitha, futhi umkhawulo kufanele ube ngu-2 kuya ku-3 mm.Izicubu eziningi kakhulu kulula ukuzifaka ku-anastomosis futhi zivimbele i-anastomosis.Qaphela ukuthi ungaphuthelwa i-mucosa.
(4) Lungisa ukuhlukana ngokuhambisana nobukhulu bodonga lwamathumbu, okungcono kube ngu-1 kuya ku-2 cm.
(5) Hlola isisu, umminzo nezinye izicubu eziseduze ngaphambi kokudubula ukuze uvimbele ukucindezelwa kwe-anastomosis.
(6) Ukusika kufanele kusheshe, futhi ukucindezela kokugcina kuzokwenza ama-staples abe yisimo "B", futhi alwele impumelelo eyodwa.
(7) Phuma ku-stapler ngobumnene, futhi uhlole ukuthi izicubu ezisikiwe ziyiringi yini ephelele.
Isikhathi sokuthumela: Feb-16-2022
