Esophageal mechanical stapling method 1, part of the stomach esophagus anastomosis end to side. Completed half of the esophagus and the stomach removed, the suture margin residual stomach, the anterior wall of residual stomach in the middle cut a small hole cut into the vascular clamp from the stomach cavity, the suture margin of gastric remnant 3 – 4cm at the greater curvature by pore-piercing guide fixed on the center of the esophagus within the stapler from the stoma into the stomach shot, cut out from the anterior wall of the stomach, I steps with a full stomach and esophageal anastomosis end to side. Finally close the anterior wall of the stomach incision.
2, part of the stomach and esophagus side to side anastomosis. Nearly half of the stomach and the stomach removed after the suture, the upper part of esophageal and gastric stump in front of close, will be the arm side to side stapled set of human esophageal lumen, and the other arm by 5cm from the edge of the remnant stomach sutured small incision at the anterior wall of the stomach into the stomach cavity, stomach and esophageal side to side for a match. Withdrawal of stapling the end of the esophagus and stomach interrupted suture incision. Suture closure devices are also available the end of the esophagus and the stomach wall incision, making it a "pyramid" shaped anastomosis.
Esophageal mechanical stapling method 3, the oral stapler anastomosis. Surgeon Xuanyong 25mm diameter smaller to fit through the mouth stapler. Esophagus in the neck below the lcm scheduled for resection of esophageal anastomosis and cancer, esophageal stump suture line of 3-pin traction. A hand surgeon in the field who stapling surgery, its through the mouth into the pharynx. Other hand touch the front-end anastomosis forward, under the guidance of the index finger, down to the bottom of the esophagus lumen, consistent with direct access to the site of the proposed line.
If the neck line of a colonic anastomosis in esophageal, will be free of the colon by retrosternal or chest pulled up to the neck, slotted head set screw ends of human colon and neck, along the center rod to do sewing purse. In the esophageal stump along the center pole to do the same purse suture. Removal of traction lines and tighten the nut end of the stapler, so that closely aligns the esophagus and the intestinal wall, grip the handle to complete the anastomosis.
If a full stomach and esophageal anastomosis end to side, then sew closed after the cardia, the fundus to the neck from the chest to mention, the highest point on the fundus to make a small hole into screw slot head, the stomach along the center pole separately and esophagus purse suture, removal of traction line, tighten the nut, so that closely aligns the esophagus and the stomach wall, grip the handle to complete the match.
4, the cervical esophagus of a side to side anastomosis of the colon. Colon placed on the free side of the cervical esophagus, corresponding to the two organs separately face the leaders of a small port side to side anastomosis, the esophageal anastomosis side of the incision should be located in the middle bit. Side to side to complete the esophagus of a colonic anastomosis, the anastomosis is closed with a suture below the esophageal lumen, below the resected specimens in close line, and then one side of the home side closed the colon small incision stapled.
Esophageal mechanical stapling method 5, a stomach palliative esophageal side to side anastomosis. Have been unresectable esophageal or cardia cancer resection or contraindications applicable. Low left thoracotomy incision through the chest, the free lower esophagus. Expand the leap muscle tear, ligation 3 – 4 short gastric vessels. Put on the bottom of the stomach in the stomach anterior edge of 5-6cm away from the tumor and the tumor at the esophageal wall to make a small incision, complete with side to side stapled esophagogastric anastomosis side to side, and then close the incision into stapler .