engine?
Cousin, what are you talking about! Mi Wenlin wanted to cry.
After a while, the expressions of the seniors were still okay and they had no intention of ridiculing Mi Siran.
"That's a bit of an idea." Dr. Yao, a PhD in Engineering, commented on the answer "engine". "This answer is a bit of a side-step."
So what is it?
It is a push-type.
Misran sighed: Just a little bit.
Xie Wanying smiled and asked the junior sister who could answer the question: "What is the biggest problem of the push type? Do you know?"
"Is it not suitable if the blood vessels are too small?" Mi Siran said.
...
...
This junior sister is smart. Lin Hao and Pan Shihua nodded.
The push-type anastomosis involves inserting one blood vessel into another blood vessel, which requires a pusher as the axis to drive the blood vessel into the anastomosis. If the diameter of the blood vessel is too small, the pusher and other supporting devices are difficult to make, and the doctor will find it difficult to operate a tool that is too thin, so it is better to sew it by hand.
The diameter of the mainstream blood vessels that the S stapler can handle is four to five millimeters. If the blood vessels are as thin as a few tenths of a millimeter, they cannot be used at all. This is the case with the so-called most advanced S stapler, let alone other staplers. Therefore, the S stapler is usually used at the proximal end of the coronary artery, near the aortic root, where the blood vessels are the thickest.
The difficulty lies in the distal vascular anastomosis. For patients with single-vessel lesions, the distal vessels are usually closer to the aorta and thicker, so they can be anastomosed with an S stapler. Patients with multiple lesions are in a more complicated situation. Some of them may have vessels that exceed the lower limit of the diameter that the S stapler can handle, and the operating angle during laparoscopy is tricky, so doctors cannot use it.
This is exactly the case with this patient. CT angiography shows that the diameter of the patient's heart blood vessels is not optimistic.
Are there staplers for even smaller blood vessels? Yes, they are non-push type in the future, and the idea is to develop into a method similar to the traditional manual suturing method used by surgeons. The two ends of the blood vessels are inserted into the stapler and multiple curved needles with threads are released at both ends. When the stapler is withdrawn, multiple sutures are passed through the two ends of the blood vessels at the same time. At this time, the doctor tightens the sutures to align the blood vessel surfaces and then ties a surgical knot.
At present, there is no relevant image of this stapler in Dr. Yao's computer database. Xie Wanying dared to risk exposing her rebirth and drew it for Dr. Yao to see. I don't know if there are any related research institutions secretly studying it. This question needs to be asked by the engineering doctor.
Zuo Jinmao poked his head out and saw what she had drawn and said, "Hey, isn't this his toy?"
Does Dr. Yao have it? Could it be that this device was developed by Dr. Yao?
"Take it out and show it to her." Zuo Jinmao urged his companion.
Yao Zhiyuan went to get his schoolbag.
Not surprisingly, the bag of the engineering doctoral student once again attracted everyone's attention. The bag of the engineering student was full of hard science fiction, with a tool box taking up a large space. Stylish plaid shirts and game cards were indispensable for the playful genius. There were no books, because geniuses don't like to memorize books.
Yao Zhiyuan lowered his head and searched through his schoolbag. There were too many small items and it took some eyesight.
Others nearby continued the discussion: If there is no suitable stapler, can the doctor use a surgical robot to sew manually?
It stands to reason that if things had come to that point, the doctor would have tried everything he could and if that didn't work, he would have resorted to thoracotomy.
Therefore, when the stapler does not work, in order to ensure the success rate of manual suturing, doctors need to help patients plan a feasible coronary artery pathway map for surgery.
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