强生Science of stapling.ppt

* Ethicon Endo-Surgery has developed this understanding through careful consideration of surgical principles, experience and clinical and scientific evidence. Click * * We couple that knowledge with our design and manufacturing processes Click * * At the outset, I mentioned how tissue compression generates appropriate staple formation that leads to a desired outcome. Click * * At this point, I welcome your questions and comments. When Q A session completes, advance to last slide. * 合理的器械设计 DESIGN MANUFACTURE 组织压力 确保… 正确的缝钉成形 带来… 止血佳 / 密闭无漏 完整的缝合线 最佳的组织处理 Q A * * * * Dr. William Halsted emphasized safety in surgery and stressed the importance of meticulous hemostasis and careful tissue handling. These anastomotic principles, also known as Halsteds Principles, are a set of interrelated principles – all related to tissue handling, tissue exposure and hemostasis. No tissue tension Leak proof anastomosis Good hemostasis Adequate blood supply Adequate lumen * The Origins of The Surgical Stapler: 1800’s: Dr. Henroz - Belgium (among others). Began experimenting with new surgical devices to improve operative performance and, by extension, patient outcomes. Primarily developed for bowel surgery. 1909: First instrument was invented by Humer Hültl - Hungary. It was inspired by Dr. Hültl’s concern about risk of contamination from gastric and intestinal contents. He had three primary goals: Shorten the duration of the operation Close the tissue in the simplest, most reliable way Allow for resection of soft tissue in a clean manner to prevent contamination Recognized need for tissue compression Featured: B-shaped staples Two staggered staple lines 1921: Aladár von Petz produced a simpler device considered the forerunner of modern open mechanical staplers. It was lighter, easy-to-use, but left out the staggered staple line. However, demonstrated importance of compression, and alignment of anvil and cartridge (ie. horse collar at the distal end). 1934: Dr. H. Friedr