消化管縫合器並びに吻合器の研究

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Since the 12 th century, many suturing devices have been developed in Europe. After 1958,Mine, Androsov and Ravitch have contributed to the development of new stapling surgery with auto suture devices in cancer of the esophagus, stomach, and rectum etc., respectively. In 1972,author developed a new model auto suture with curved shaft and exchangeable round scarpel as deviced PKS-25.The purpose of present study is to clarify the significance of those suturing devices in the past in relation to the development of medical standard at each individual era. Historical background were divided into four stages. 1. groping stage (12-19 th century), 2.development stage (19-20 th century), 3. practical B-shaped stapler application stage (20 th century), 4. disporsable stage (1980-).Evaluation of recent stapling surgery are placed on; 1. production of surplus operative time due to auto sutures was redistributed to further lymph nodes dissection in malignant diseases.2. "Double stapling technique" is neary established in contaminated operation like rectal surgery.3. previous bleeding at anastomotic site as a complication of stapling surgery is now excluded since percentage incidence of bleeding was only 0.17% among 1. 772 cases by author's survey in 1984.4. inversion anastomosis was approved to be as safty method of choice against eversion or layer to layer method since percentage indidece of both anastomotic leakage and stenosis in 1992 were reduced to 6.0% and 3.9% among 3. 634 stapled cases from comparable 7.5% and 4.5% amonog 2. 036 stapled cases in 1984,respectivery.These results suggest that the development of absorbable circular staple is highly expected to satisfy both preventing anastomotic leakage and inconsistent anastomotic stenosis.
日本医療機器学会の論文
1993-07-01

消化管縫合器並びに吻合器の研究

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