Isisekelo sokuhlinzayizinto eziyisisekelo ezikhethekile ezisetshenziswa ekuhlinzeni ukuze kushintshwe izinsimbi zokuvala izilonda zesikhumba noma ukuxhuma noma ukuhlehlisa ingxenye yamathumbu noma amaphaphu.Ukusetshenziswa kwezinhlamvu eziyisisekelo ku-sutures kunciphisa ukusabela kokuvuvukala kwendawo, ububanzi benxeba, kanye nesikhathi sokuvala.Intuthuko yakamuva, evela ku 1990s, ukusetshenziswa kweziqeshana esikhundleni sezinto eziyisisekelo kwezinye izinhlelo zokusebenza;lokhu akudingi ukungena okuyisisekelo.
Ukusetshenziswa kwe-Linear Cutter Stapler
Imiyalo yokusetshenziswa
I-stapler yokusika umugqa elahlayo ibeka imigqa emibili enyakazayo yemigqa emibili ye-titanium staples, futhi isike futhi ihlukanise izicubu ngesikhathi esisodwa phakathi kwemigqa emibili yemigqa emibili. ichotshozwe ukuvalwa kwensimbi.
Mayelana ne-Linear Cutter Stapler
Le nqubo yasungulwa udokotela ohlinzayo waseHungary u-Hümér Hültl, "uyise wokuhlinza i-suturing".I-prototype stapler ka-Hultl ngo-1908 yayinesisindo esingamakhilogremu angu-8 (3.6 kg) futhi yathatha amahora amabili ukuze ihlanganiswe futhi ilayishe.Isu lacwengisiswa eSoviet Union ngeminyaka yawo-1950, okwavumela imishini yokuqala yokuthunga ekhiqizwe kabusha ethengiswayo ukuthi isetshenziselwe ukwakha amathumbu nama-anastomoses emithambo. .U-Ravitch uletha isampula ye-stapler ngemva kokuhambela ingqungquthela yokuhlinzwa e-USSR futhi wethula kusomabhizinisi u-Leon C. Hirsch, owasungula i-Surgery America ngo-1964 ukuze enze ama-sutures okuhlinza ngaphansi kwedivayisi yakhe ye-Auto Suture brand.Kuze kube sekupheleni kwawo-1970, i-USSC ikakhulukazi yayigcwele imakethe, kodwa ngo-1977 uhlobo lwe-Ethicon kaJohnson & Johnson lwangena emakethe, futhi namuhla yomibili le mikhiqizo isetshenziswa kabanzi kanye nezimbangi ezivela eMpumalanga Ekude.I-USSC yatholwa yi-Tyco Healthcare ngo-1998 futhi yashintsha igama layo laba i-Covidien ngoJuni 29, 2007. Ukuphepha kanye ne-patency ye-mechanical (anastomotic) bowel anastomosis ifundwe kabanzi.Kulolu cwaningo, ama-anastomos ane-sutured ngokuvamile ayaqhathaniseka noma athambekele kancane ekuvuzeni. Lokhu kungase kube umphumela wenqubekelaphambili yakamuva kubuchwepheshe be-suture kanye nezinqubo zokuhlinza eziqaphela kakhulu ingozi.Kunjalo, ama-synthetic sutures esimanje abonakala kakhudlwana futhi angenwa kalula yizifo kunezinto eziyisisekelo ze-suture ezasetshenziswa ngaphambi kweminyaka yawo-1990—amathumbu, usilika, nelineni.Isici esiyinhloko sezinto eziyisisekelo zamathumbu ukuthi imiphetho ye-stapler isebenza njenge-hemostat, ecindezelayo. emaphethelweni enxeba nokuvala umthambo wegazi ngesikhathi sokugxilwa.Ucwaningo lwakamuva lubonise ukuthi ukusebenzisa amasu amanje okuthunga, awukho umehluko omkhulu emiphumeleni phakathi kwe-suturing manual kanye ne-anastomosis yemishini (kuhlanganise neziqeshana), kodwa i-anastomosis yomshini yenziwa ngokushesha kakhulu. ukuvuza kuvamile ngemva kokuhlinzwa.Ezinye izindlela zokuvala izicubu zamaphaphu ziyaphenywa okwamanje.
Izinhlobo Nezicelo
I-stapler yokuqala yezohwebo yayenziwe ngensimbi engagqwali enezisekelo ze-titanium ezipakishwe kuma-staple cartridges agaywa kabusha.Izinsimbi zokuhlinza zesimanje ziyakwazi ukulahlwa, zenziwe ngepulasitiki, noma zingasetshenziswa kabusha, zenziwe ngensimbi engagqwali.Zombili izinhlobo zivame ukulayishwa ngama-cartridges alahlwayo.Imigqa eyisisekelo ingaba iqondile, igobile noma iyindilinga.Ama-staplers ayindilinga asetshenziselwa i-anastomosis ekupheleni kuya ekupheleni ngemva kokukhishwa kwamathumbu noma, ngokuphikisana kakhulu, ukuhlinzwa kwe-esophagogastric.Lawa mathuluzi angasetshenziswa endaweni evulekile noma ye-laparoscopic. izinqubo, ngamathuluzi ahlukene asetshenziselwa isicelo ngasinye.Ama-stapler e-Laparoscopic made, azacile, futhi angachazwa ukuze avumele ukufinyelela kusuka enanini elilinganiselwe lamachweba we-trocar.Ezinye izinto eziyisisekelo ziqukethe ummese ongasika futhi ugxile ekusebenzeni okukodwa.Ama-Staplers asetshenziselwa vala amanxeba angaphakathi nesikhumba.Izinsalela zesikhumba ngokuvamile zisetshenziswa nge-stapler elahlayo futhi zisuswe ngesicoci esikhethekile sokususa.Ama-Staplers nawo asetshenziswa kunqubo ye-gastroplasty yebhande elimile (eyaziwa ngokuthi "i-gastric stapling").Nakuba amadivaysi e-anastomotic e-end-to-end end-to-end ye-anastomotic ye-digestive tract asetshenziswa kabanzi, i-staplers eyindilinga ye-vascular anastomosis ayikaze iqhathaniswe ne-anastomosis yezandla ezijwayelekile naphezu kocwaningo olunzulu Yenza umehluko omkhulu ngamasu (Carrel) suture.Ngaphandle kwendlela ehlukene yokuxhuma isitsha (esiguquliwe) esigxotsheni sokugaya (inverted), isizathu esiyinhloko esingaba ukuthi, ikakhulukazi imikhumbi emincane, umsebenzi wezandla kanye nokunemba okudingekayo ukubeka kuphela isiphunzi somkhumbi futhi usebenzise noma iyiphi idivayisi ayikwazi. ibe ngaphansi kakhulu Yenza ukuthunga okudingekayo ekuthungeni kwesandla okujwayelekile, ngakho-ke akukho ukusetshenziswa okuningi ekusebenziseni noma iyiphi into.Kodwa-ke, ukufakelwa isitho somzimba kungase kube okuhlukile lapho lezi zigaba ezimbili, ukuma kwedivayisi kusiphunzi semithambo kanye nokusebenza kwedivayisi, kungenziwa ngezindlela ezahlukene. izikhathi ngamathimba ahlukahlukene okuhlinza ngaphansi kwezimo eziphephile ngaphandle kwesikhathi esidingekayo esithinta ukulondolozwa kwesitho somnikeli, okungukuthi ngaphansi kwezimo ezibandayo ze-ischemic zesitho somnikeli kanye netafula elingemuva ngemva kokukhishwa kabusha kwesitho semvelo somamukeli.Umgomo wokuphothula ukunciphisa isigaba se-ischemic esiyingozi esishisayo. yesitho somnikeli, esingaqukethwe ngemizuzu noma ngaphansi, ngokumane unamathisele isiphetho sedivayisi bese usebenzisa i-stapler. Nakuba izisekelo eziningi zokuhlinzwa zenziwe nge-titanium, insimbi engagqwali isetshenziswa kakhulu kwezinye izinto eziyisisekelo neziqeshana zesikhumba.I-Titanium ayisebenzi kahle emasosheni omzimba futhi, ngenxa yokuthi iyinsimbi engeyona insimbi, ayiphazamisi kakhulu izikena ze-MRI, nakuba ezinye izinto zobuciko bezithombe zingase zenzeke.Izisekelo ze-Synthetic absorbable (bioabsorbable) ezisekelwe ku-polyglycolic acid seziyatholakala, njengoba ziningi. ama-synthetic absorbable sutures.
Ukususwa kwama-spikes esikhumba
Uma izisekelo zesikhumba zisetshenziselwa ukuvala amanxeba esikhumba, kuyadingeka ukususa okuyisisekelo ngemva kwesikhathi esifanele sokuphulukiswa, ngokuvamile izinsuku ezingu-5 kuya kweziyi-10, kuye ngokuthi inxeba likuphi kanye nezinye izici. yesicathulo noma ipuleti elincane futhi lincane ngokwanele ukuba lifakwe ngaphansi kwe-spike yesikhumba. Ingxenye enyakazayo iyinsingo encane okuthi, lapho kufakwa ukucindezela kwesandla, iphushe okuyisisekelo phansi ngembobo esicathulweni, iguqule okuyisisekelo kube "M. " shape ukuze kube lula ukususa.Esimeni esiphuthumayo, ama-staples angasuswa nge-arterial forceps.Izisusa eziyisisekelo zesikhumba zenziwa ngezindlela ezihlukene, ezinye ziyalahlwa kanti ezinye zingasetshenziswa kabusha.
Isikhathi sokuthumela: Nov-18-2022
