Help the stomach with his hands raised, but not forced traction and pressure pinch, but also should not use the clamp to stop bleeding stomach, so as not to damage the stomach blood supply which may result in tissue necrosis, perforation.
Commonly used separation of esophageal and cardiac surgery a. Separation of the omentum stomach. Gastroepiploic artery in the bow side of the separation vessel gastrocolic ligament. Cut between two clamps and gastroepiploic branch of the left retinal artery, and one by one, or suture ligation. Then, continue up the stomach and spleen isolated ligament, cut short gastric artery ligation of the branch. Stomach and spleen and sometimes short ligament, separation or tear blood vessels to avoid splenic injury, splenic injury or spleen in case, you should try to repair bleeding, if any, can be difficult to splenectomy. Separation, do not damage the stomach greater curvature of the vascular arcades, because no other blood supply to the fundus.
Resection of esophageal and cardiac commonly isolated stomach b. small retinal separation. Then, with his right hand that has been separated from the greater curvature of the stomach wall into his stomach, in the left gastric artery distal to the ligament of liver stomach avascular zone of a blunt puncture holes, from holes along the lesser curvature of the stomach above the arch vessels with a hemostat clamp, cut, ligation of the stomach liver ligament. Small omentum is very thin in other parts of the general, and no major blood vessels, the finger separation. Separation can be put on a little stomach, small bend to the stomach, pancreas touch between the upper edge of the left gastric artery. Perivascular lymph nodes removed as possible, but it should be taken not to damage celiac artery. Finally, while the stomach and lower esophageal filed in batches clamping, cutting and ligation of the breast attached to the cardiac muscle and fold of peritoneal and other organizations.
Commonly used separation of esophageal and cardiac surgery cut off the left gastric artery c. stomach. Treatment needs to be fully revealed the left gastric artery and careful operation to prevent accidents. Flip on the stomach help to put your hands in the pancreas exposed on the edge of the root of the left gastric artery. Appropriate separation, as far as placement of three pairs of proximal joint reliable hemostat. In section 2, 3 clamp off between the blood vessels in the vascular clamp proximal to retain two to prevent clamp slippage. 1 clamp in the following ligation with silk thread and the opening of the clamp; again in line with the first two ligation done suture clamp and opened between the 2 clamp, to ensure reliable hemostasis. Left side of the stomach are ligated clamp after 3 Qudiao, stitches should not be too close to the stomach, so Zhazhu ascending branch of left gastric artery. Cut off the left gastric artery, and gastric cardia has been basically free, since according to the height of anastomosis, the greater curvature of the stomach, small bend to the satisfaction of separation (from the gastric antrum should generally be divided), but must retain the right gastric artery and the right gastroepiploic artery.
- clamping esophagus to stomach irreversible