Q1:Can the Coupler be
used in the mammary gland department?
A1:Yes,
breast surgery can use Coupler microvascular anastomat for the repair and
reconstruction of postoperative defects such as breast cancer, chest wall and
abdominal wall tumors.
Q2:Is the stapler
omnipotent?
A2:In
recent years, the treatment and reconstruction of breast cancer has attracted
great attention and attention, and the training courses of rapid microsurgery
technology have mushroomed. Many doctors who did not carry out free skin flap
surgery and did not have the microsurgery technology before went out for
training for a week and returned to open the surgery, which is extremely risky.
Q3:In breast surgery
operation anastomat in which flap has been applied?
A3:TRAM
free transplantation (DIEP) of TRAM skin flap pedicled with inferior vena cava,
gluteus musculocutaneous flap, latissimus dorsi musculocutaneous flap and
femoral anterolateral flap were used to repair chest and abdomen defects.
Q4:Which areas of blood
vessels are often sutured by stapler?
A4:It
mainly consists of internal thoracic vessels, thoracic dorsal vessels, axillary
arterial branches.
Q5:The potential of
stapler in breast cancer repair and reconstruction
A5:The
amount of tissue needed to repair the defect of the breast is relatively large,
and the flap is characterized by large area and thickness; Experienced doctors
will prepare two sets of blood vessels, and usually choose the suture between
the superior blood vessels 1 moxibustion 2 stasis and the subject area (another
set of blood vessels is available for emergency use) or both sets of blood
vessels to guarantee the blood flow of the flap. If the imaging examination of
poor blood flow status is conducted, internal or external pressure enhancement
may be adopted to improve the blood flow status. The conventional method is 2
arteries and 4 veins, and the general stapler application of 2 veins is not
problematic.
Q6:The specification of
stapler commonly used in breast surgery
A6:Stapler
1.5, 2.0, 2.5 are widely used in these three specifications.
Q7:The stapler fits
poorly in the armpit?
A7:If
the subject area is to suture the axillary arteriovenous, the anastomotic site
is relatively deep, and the visual field is not good. It is recommended that
the master knife and assistant stand on the same side (both are adjusted to an
optimal position).
Q8:What other concerns
do we need when using staplers?
A8:Vascular shape,
the length of vascular pedicle, the selection of superior blood vessels and
regional vessels, etc.
For example, the
average length of the peritoneal vein pedicles of DIEP skin flap was 10.3, and
the intrathoracic vessels were selected in the affected area. If the affected
side vessels could not be used, the anastomosis of the vessels in the
contralateral thoracic or thoracic dorsal blood vessels would be improved. If
the intrathoracic venous vessel is too thin to cause the mismatch, we may also
consider the lower limb saphenous vein and the thoracic dorsal vein bridge, or
the upper limb cephalic vein reversal displacement and the flap venous
anastomat (special case is not recommended).
Q9:Is the stapler
approved by a breast clinician?
A9:Fully recognize
product advantages,
Postoperative
complications of breast cancer included 1, hematoma and subcutaneous effusion
2, axillary vein injury and phlebitis 3, skin flap edge necrosis 4, intercostal
arm and thoracic long nerve injury, 5, upper limb limitation 6, radiation ulcer
7, and chronic lymphedema of the affected limb. Stapler can support and protect
the anastomat port, avoid the collapse of stapler port to form thrombosis,
reduce damage of blood vessels with rapid and high-quality anastomosis, reduce
operation time and risk probability, greatly improve the success rate of skin
flap, and win the favor of breast surgeons
Q10:Extension and application
of stapling device in breast surgery
A10:When using the
stapler for breast cancer free flap surgery, it is important to understand the
level of microsurgical technique of the main operator and one his/her assistant,
and whether such surgery has been carried out successfully independently,
otherwise the stapler cannot be recommended blindly.
Please add other
suggestions if you have.
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