ligasuretm的临床应用PPT学习教案

1、会计学1ligasuretm的临床应用的临床应用Energy Based Tissue and Vessel Fusion 第1页/共43页第2页/共43页第3页/共43页Manufacturers Recommended Range of Vessel Size for Application (mm)0.51.01.52.02.53.03.54.04.55.05.56.06.57.07.58.08.59.09.5 10.0Suture Clips Staples Monopolar ES Bipolar ES Ultrasonic Coag Vessel Sealing *3 sizes

2、of clips and appliersVascular Staples 第4页/共43页Pressure and Energy压力和能量压力和能量To Create a Fusion Zone产生一个融合带产生一个融合带第5页/共43页an advance in a unique electrosurgical technology that combines pressure and energy to create a fusion zone一种先进电外科技术将压力和能量结合从而产生融合带Developed in response to surgeon requests for an

3、additional option to current vessel ligation methods根据外科医生的需求发展的技术，从而提供目前血管结扎手段以外的方法。第6页/共43页第7页/共43页continuous feedback control输送能量脉冲同时进行持续的反馈控制nPulses adapt as the cycle progressesn随循环周期的进行调整能量脉冲nSenses that tissue response is complete and stops the cycle监测组织反馈当闭合完成时停止能量输送第8页/共43页第9页/共43页Coagulati

4、on relies on vessel shrinkage and a proximal thrombus for vessel occlusion.凝血依赖于血管的收缩和近端血栓凝血依赖于血管的收缩和近端血栓堵塞血管堵塞血管Vessel fusion fuses the intimal walls of the vessel, completely obliterating the lumen.脉管闭合技术融合了血管壁的内膜，从脉管闭合技术融合了血管壁的内膜，从而完全封闭管腔。而完全封闭管腔。*Porcine Model第10页/共43页第11页/共43页第12页/共43页H & E

5、 stained longitudinal section of sealed porcinerenal arteryH & E染色的猪肾动脉闭合带的纵切面The seal zone. Note the fused lumen of the vessel walls.闭合带；注意血管壁已被融合在一起，内腔消失。第13页/共43页0%20%40%60%80%100%1.0-1.9mm 2-3.9mm4-7mmUltrasonics超声刀超声刀Bipolar双极双极Vessel Fusion脉管闭合技术脉管闭合技术Vessel sizes第14页/共43页第15页/共43页* Compar

6、ison of Healing Process Following Ligation with Sutures and Bipolar Vessel Sealing PETERSON, STRANAHAN, SCHMALTZ, MIHAICHUK, COSGRIFF Surgical Technology International Sutures at 28 daysLigaSure at 28 days第16页/共43页第17页/共43页第18页/共43页第19页/共43页第20页/共43页第21页/共43页Surgical specialties with experience in v

7、essel fusion technology第22页/共43页第23页/共43页第24页/共43页第25页/共43页uAnatomy解剖解剖uVaginal Hysterectomy经阴道子宫切除术经阴道子宫切除术 uTAH经腹子宫切除术经腹子宫切除术 uLAVH腔镜辅助的经阴道子宫切除术腔镜辅助的经阴道子宫切除术 uSupracervical Hysterectomy子宫颈上子宫切除术子宫颈上子宫切除术第26页/共43页第27页/共43页第28页/共43页Study by: Barbara Levy, MDClinical Assistant Professor of OB/GYN, U

8、of WA Seattle, WASealableNot recommended第29页/共43页Study by: Robert McLellan, MDDepartment of GynecologyLahey Clinic, Burlington, MASealableNot recommended第30页/共43页第31页/共43页第32页/共43页Right Hemicolectomy右半结肠切除术右半结肠切除术第33页/共43页Transverse Colectomy横结肠切除术横结肠切除术第34页/共43页Left Colectomy左半结肠切除术左半结肠切除术第35页/共43页Sigmoid Colectomy乙状结肠切除术乙状结肠切除术第36页/共43页Low Anterior Resection低位前切除低位前切除第37页/共43页nAnal or rectal sarcomasn肛门或直肠肉瘤肛门或直肠肉瘤