Operation on the junction of esophagus and cardia

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食管下端曲张静脉结扎术
time:2021-10-27   click :1199

1. Ligation of lower esophageal varices, also known as modified combined devascularization, is suitable for portal hypertension and bleeding of lower esophageal varices. First, the omentum of the large and small curvature of the gastric fundus was dissociated, the free length was generally 6 ~ 7 cm, and the blood vessels were ligated one by one. A circle of ligation line was sutured 3cm above the cardia through the superficial muscle layer.
2. Cut a small opening in the anterior wall of the stomach to stop bleeding by electrocoagulation, pull it open with a retractor, and insert the Huaxia disposable tubular stapler into the gastric cavity until the lower end of the esophagus.
3. Separate the nail holder from the body, and then ligate the whole layer of esophageal wall on the central rod.
4. Adjust the distance between the nail butting seat and the head of Huaxia stapler to make it close together and prepare for firing anastomosis.
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Fig. 1-2-1 purse string suture was performed at the lower end of the esophagus after disconnection of the lower esophageal and left gastric vessels
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Fig. 1-2-2 inserting Huaxia disposable tubular stapler from gastric incision
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Figure 1-2-3 open the stapler and prepare to tie the purse string to the central rod
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Fig. 1-2-4 closing nail holder and body
5. Fire the stapler, cut off the lower end of the esophagus, complete the end-to-end anastomosis, and exit the stapler. After firing, open the Huaxia stapler and exit.
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Figure 1-2-5 after firing, open the Cathay stapler and exit
6. Use allis forceps to lift the anterior gastric wall incision tissue, and the anterior gastric wall incision is closed with Huaxia disposable linear suture device. Remove excess tissue along the stapler, loosen and remove the stapler. The gastric wall incision was closed with Huaxia disposable linear suture.
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Fig. 1-2-6 closing the gastric wall incision with Huaxia disposable linear suture device

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