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Q&A

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Q1:Can the Coupler be used in the mammary gland department?
A1:Yes, breast surgery can use Coupler microvascular anastomat for the repair and reconstruction of postoperative defects such as breast cancer, chest wall and abdominal wall tumors.
Q2:Is the stapler omnipotent?
A2:In recent years, the treatment and reconstruction of breast cancer has attracted great attention and attention, and the training courses of rapid microsurgery technology have mushroomed. Many doctors who did not carry out free skin flap surgery and did not have the microsurgery technology before went out for training for a week and returned to open the surgery, which is extremely risky.
Q3:In breast surgery operation anastomat in which flap has been applied?
A3:TRAM free transplantation (DIEP) of TRAM skin flap pedicled with inferior vena cava, gluteus musculocutaneous flap, latissimus dorsi musculocutaneous flap and femoral anterolateral flap were used to repair chest and abdomen defects.
Q4:Which areas of blood vessels are often sutured by stapler?
A4:It mainly consists of internal thoracic vessels, thoracic dorsal vessels, axillary arterial branches.
Q5:The potential of stapler in breast cancer repair and reconstruction
A5:The amount of tissue needed to repair the defect of the breast is relatively large, and the flap is characterized by large area and thickness; Experienced doctors will prepare two sets of blood vessels, and usually choose the suture between the superior blood vessels 1 moxibustion 2 stasis and the subject area (another set of blood vessels is available for emergency use) or both sets of blood vessels to guarantee the blood flow of the flap. If the imaging examination of poor blood flow status is conducted, internal or external pressure enhancement may be adopted to improve the blood flow status. The conventional method is 2 arteries and 4 veins, and the general stapler application of 2 veins is not problematic.
Q6:The specification of stapler commonly used in breast surgery
A6:Stapler 1.5, 2.0, 2.5 are widely used in these three specifications.
Q7:The stapler fits poorly in the armpit?
A7:If the subject area is to suture the axillary arteriovenous, the anastomotic site is relatively deep, and the visual field is not good. It is recommended that the master knife and assistant stand on the same side (both are adjusted to an optimal position).
Q8:What other concerns do we need when using staplers?
A8:Vascular shape, the length of vascular pedicle, the selection of superior blood vessels and regional vessels, etc.
For example, the average length of the peritoneal vein pedicles of DIEP skin flap was 10.3, and the intrathoracic vessels were selected in the affected area. If the affected side vessels could not be used, the anastomosis of the vessels in the contralateral thoracic or thoracic dorsal blood vessels would be improved. If the intrathoracic venous vessel is too thin to cause the mismatch, we may also consider the lower limb saphenous vein and the thoracic dorsal vein bridge, or the upper limb cephalic vein reversal displacement and the flap venous anastomat (special case is not recommended).
Q9:Is the stapler approved by a breast clinician?
A9:Fully recognize product advantages,

Postoperative complications of breast cancer included 1, hematoma and subcutaneous effusion 2, axillary vein injury and phlebitis 3, skin flap edge necrosis 4, intercostal arm and thoracic long nerve injury, 5, upper limb limitation 6, radiation ulcer 7, and chronic lymphedema of the affected limb. Stapler can support and protect the anastomat port, avoid the collapse of stapler port to form thrombosis, reduce damage of blood vessels with rapid and high-quality anastomosis, reduce operation time and risk probability, greatly improve the success rate of skin flap, and win the favor of breast surgeons
Q10:Extension and application of stapling device in breast surgery
A10:When using the stapler for breast cancer free flap surgery, it is important to understand the level of microsurgical technique of the main operator and one his/her assistant, and whether such surgery has been carried out successfully independently, otherwise the stapler cannot be recommended blindly.

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