Imisebenzi ye-ESD ayifuni ukwenziwa ngokungenamkhethe okanye ngokungenamkhethe.
Iindlela ezahlukeneyo zisetyenziselwa iindawo ezahlukeneyo. Amalungu aphambili ngummizo, isisu, kunye ne-colorectum. Isisu sahlulwe saba yi-antrum, indawo ye-prepyloric, i-angle yesisu, i-gastric fundus, kunye nokugoba okukhulu komzimba wesisu. I-colorectum yohlulwe kwikholoni kunye ne-rectum. Phakathi kwabo, i-ESD ye-antrum i-curvature izilonda ezinkulu yinxalenye yenqanaba lokungena, ngelixa i-ESD ye-gastric angle, i-cardia, kunye nezilonda zekholoni zasekunene kunzima kakhulu.
Umgaqo jikelele kukuqwalasela i-gravity factor ephantsi kwaye uqale ngenxalenye enzima kwaye inxalenye elula. Qala i-incision kunye nokuhlutha ukusuka kwindawo ephantsi yomxhuzulane. Ngexesha lokuhluthwa, ukuhluthwa kufuneka kwakhona kuqale kwindawo enzima kakhulu. Ummizo we-ESD unokwenziwa ngokusikwa kohlobo lokutyhala. Isalathiso sokusika kunye nokuhluthwa kwezilonda zesisu kufuneka zenziwe kwangaphambili. Izilonda kwi-angle yesisu, i-curvature encinci ye-gastric body, kunye nommandla we-prepyloric unokuvezwa ngokutsalwa. Itekhnoloji yetonela kunye nendlela yepokotho zombini ziyinxalenye yesicwangciso se-ESD. Ubuchwephesha obuvela kwi-ESD bubandakanya i-ESTD, i-EFTR, i-ESE, i-POEM, njl. Ezi teknoloji nazo zibuchwephesha obuvela ngokwemvelo emva kokuba izakhono ze-ESD ziphumelele. Ngoko i-ESD sisiseko.
2. Iinkcukacha zokusebenza kwe-ESD
Iinkcukacha zokusebenza kwe-ESD zinkcukacha phantsi kwesikhokelo sesicwangciso esikhulu.
Iinkcukacha zokuSebenza
Iinkcukacha zokusebenza ziquka ukumakisha, ukutofa, ukuxobula, njl.
Kukho amaqhinga amabini: enye yimela elawulekayo echola phantsi kombono othe ngqo (sebenzisa imela engaboniyo ukukha kancinci kangangoko kunokwenzeka), kwaye enye kukulawulwa kwemida kunye nemibutho emincinci.
Ukuleyibhile kunye nokutofa
Ukumakishwa kwe-Electrocoagulation kusetyenziselwa ukumakisha. Ngokuqhelekileyo, umda wezilonda (2-5 mm ngaphandle) usetyenziswa njengophawu. Ukumakishwa kunokwenziwa kwinqanaba ngenqaku okanye ukusuka kumakhulu ukuya kuncinci. Ekugqibeleni, ikhefu phakathi kwamanqaku amabini okumakisha kufuneka libe phakathi kwe-5 mm, kwaye kufuneka ibonakale xa i-endoscope isondele kwintsimi yombono.
Kwinqaku elilandelayo eliphawulweyo. Isitofu sisekelwe kwimikhwa yobuqu. Emva kokutofa kwi-submucosal layer, inaliti kufuneka ihoxiswe kancinane kwaye iphinde ifakwe kwakhona ukuze kuqinisekiswe ukuba isilonda siphakanyiswe kubude obaneleyo bokusikeka okulandelayo kunye nokucoca.
Sika
Ukusika, ezinye iindawo zisikwa ukusuka kude ukuya kufutshane okanye kufutshane ukuya kude (ukutyhala ukusika), ngokwemikhwa yomntu kunye namacandelo athile, kuyafuneka kwakhona ukusika ukusuka kwinqanaba eliphantsi lomxhuzulane kuqala. Ukusika kubandakanya ukusika okuncinci kwangaphambili kunye nokusika kwangaphambili. Ukusikwa kwangaphambili kufuneka "chaneke" kwaye "kwanele". Ubunzulu bokusika kufuneka bube ngokwaneleyo ngaphambi kokuba kuqhutywe umsebenzi wokucoca okulandelayo. Njengokuthatha imela kunye nokuseka ifestile yengelosi. Kanye xa wangena kwifestile yengelosi,
I-ESD ithetha ukufumana indlela esebenzayo. Kodwa eneneni, ayizizo zonke ii-ESD ezinokungena kwifestile yeNgelosi. Uninzi lwezilonda ezincinci kunye nezilonda ezikhethekileyo ze-ESD ngokusisiseko azikwazi ukungena kwi-Angel's Window. Ngeli xesha, ikakhulu kuxhomekeke ekusebenzeni kwemela esulungekileyo.
Khulula: Khulula indawo ekunzima ukuyiphatha kuqala. Xa uhlambulula inxalenye ye-submucosal, kufuneka yenziwe ukusuka kumacala omabini ukuya kwiziko, ukwenza "isitshixo" esine-V. Ubunzulu be-peripheral pre-cut cut kufuneka bube ngokwaneleyo, ngaphandle koko kulula ukukhupha ngaphaya komda. Okukhona izicubu ezishiyekileyo zingaphantsi, kokukhona inkulu iqondo lenkululeko. Kuyimfuneko ukulawula imela ukusika izicubu ngokuthe ngqo, ngakumbi izicubu zokugqibela. Ukuba ulawulo alulunganga, kulula ukusika kakhulu okanye kuncinci kakhulu.
Indlela yokubamba isipili
Kukho iindlela ezimbini zokubamba umda we-ESD, zombini ezilawula umzimba wobubanzi, amaqhosha, kunye nezixhobo ezingaphakathi nangaphandle. Kukho iindlela ezimbini: "ulwalathiso lwesandla sasekhohlo + izixhobo" kunye "nezandla ezibini kwizandla ezine". Umgaqo obalulekileyo wokubamba ububanzi kukugcina intsimi yokusebenza izinzile kwaye iyalawuleka. Okwangoku, indlela yezandla ezimbini ukuya kwezine inozinzo olungcono lokulawula umda kwaye isetyenziswa ngokubanzi. Kuphela xa i-scope izinzile inokuthi i-exposure operation ye-tissue ezincinci + ii-flaps ziphathwe ngcono.
Kuphela ngesibuko esilungileyo sokubamba indlela imela inokulawulwa ngcono. Ubuchwephesha bokukha imela bunokulawula ngcono ulwalathiso, injongo kukuhlala kude nomqolo wezihlunu kunye nokusika izicubu ekujoliswe kuzo. Xa usenza i-ESD submucosal incision, kuyimfuneko ukusika kufuphi ne-muscle layer, ubunzulu be-tissue incision yanele, kwaye kulula ukuyeka ukopha. Eyona nto ibalulekileyo kukuqinisekisa ukuba ukusika akunzulu kakhulu okanye kudlule, kwaye ubuchule bokuchola imela bubuchule obuphambili ngeli xesha.
Ukulawula umbono
Ulawulo lomkhombandlela lukwabonakaliswe ekuvezweni nasekulawuleni ummandla wokujonga. Ukongeza kokujikeleza i-knob kunye nomzimba we-lens, ii-caps ezicacileyo kunye nezixhobo zikwasetyenziselwa ukuveza intsimi yembono okanye izicubu ezijoliswe kuyo, ngakumbi amandla amancinci asetyenziselwa ukuveza kunye nokunyusa izicubu ezincinci, nto leyo i-deformation encinci ye-tissue.
Lawula umgama wentsimi yombono. Kuphela xa intsimi yombono igcinwe kumgama ofanelekileyo inokuqhutywa kwaye ilawulwe. Ukuba ikude kakhulu okanye isondele kakhulu, kuya kuba nzima ukulawula imela ngokuzinzileyo. Iintshukumo ezifihlakeleyo zinokubonakala ngathi akukho ntshukumo, kodwa izicubu sele zinamandla okuguqula izinto. Yiyo loo nto i-ESD kufuneka isebenzise umgama ofanelekileyo kunye noguquko olufanelekileyo.
Ezi nkcukacha zingentla, ukubamba iilensi, kunye necandelo lolawulo lokujonga zezona ziqulatho ziphambili ze-ESD "ulawulo lwelensi".
Thina, i-Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ngumenzi e-China okhethekileyo kwizinto ezityiwayo ze-endoscopic, ezifana ne-biopsy forceps, i-hemoclip, i-polyp snare, inaliti ye-sclerotherapy, i-catheter yokutshiza, iibrashi ze-cytology, i-guidewire, i-baskette yokubuyiswa kwamatye, i-drainteral yokufikelela kwi-nasal the biliterary. ukufunxa njl ezisetyenziswa ngokubanzi kwi-EMR, ESD, ERCP. Iimveliso zethu ziqinisekisiwe nge-CE, kwaye izityalo zethu ziqinisekisiwe nge-ISO. Impahla yethu ithunyelwe eYurophu, kuMntla Melika, kuMbindi Mpuma kunye nenxalenye yeAsia, kwaye ifumana ngokubanzi umthengi wokuqatshelwa kunye nendumiso!
Ixesha lokuposa: Jul-14-2025