Children with arterial arterial veins are prone to bronchitis, pneumonia, physical retness, malnutrition. Thoracic laparoscopic surgery clamping the arterial tube is a safe and effective method to treat arterial arterial veins.
1. What problems does arterial arterial veins cause the child?
During the development of the fetus, an arterial tube exists for the communication of the aorta and pulmonary artery.
After the baby is born, the arterial tube will have to close. However, in some children, this arterial tube still exists causing left-right ventilation causing overload of the lungs, left and left venerley leading to increased pulmonary artery pressure, respiratory symptoms such as fatigue, shortness of breath, pulmonary artery dilation, left atrial dilation, left vena catheity, decreased systoural blood pressure.
In these cases, the patient will be operated on to close the arterial tube and prevent and treat complications.
2. Thoracic laparoscopic surgery clamps arterial tubes
- The patient is diagnosed with arterial arterial veins and is accompanied by one or more symptoms: large tubes (over 4mm), shortness of breath, pneumonia, slow growth, structural changes of the heart chambers, heart valves, endocarditis.
- The diameter of the arterial tube does not exceed the diameter of the clip (8-9mm).
Contrainttrained relative to those cases.
- Increased fixed lung pressure
- Heart failure, severe renal liver failure
- Complex congenital heart disease
- Progressive bacterial infections
- Thoracic malformation, thickening of the left pleura due to injury or pathology.
- Position: The patient lying on his right side must have a slightly bumpy 20-30 degrees above the table. Let young children lie horizontally and older children lie vertically of the table. The surgeon stands on the patient's leg and the surgeon stands on the left side of the surgeon, the screen is placed on the patient's head.
- 1 lung ventilation anesthesia
- Order 4 Trocar
- Inflatable pressure 6-8mmHg, flow 1 liter/min.
- Wiping on the lungs into the arterial tube area.
- Open the bronchi according to the front bank of the aortic from the bottom of the tube to the place where the artery is located under the blow.
- Pull the bronchial flap and nerve X and the rope upside down, surgery to clearly see the nerves turned backwards.
- Exposing the arterial veins, dissecting the upper and lower slits between the aortic and the arterial veins; dissect the back of the arterial tube until the surgical needle is inserted through the back of the arterial tube to the angle between the artery tube and the aortic above the tube.
- Next, thread 1 segment of only vicryl 2.0 pulled across the back down the lower slot of the arterial tube with the aortic; lift the thread up to pull the arterial tube forward.
- Then, insert the clip pliers into the chest, pass through the arterial tube and clip the arterial tube with 1 or 2 clips
- Withdraw 3 Trocart for tools, stitch up skin incisions
- Squeezing the ball that inflates the lungs
- Trocart withdrawal for otoscope, suture of skin incision
2.4 Post-surgical monitoring
- Monitor pulse, blood pressure, breathing rate.
- When the patient returns to the resuscitation room: Scan the lungs.
- Monitor signs of blood spills, pleural effusion.
- Incision Tracking
- Cardiac ultrasound examination before discharged from hospital
- After 6 months, ultrasound 1 evaluation of cardiac rehabilitation after surgery
2.5. Handling accidents
Pneumothorax-spill: medical treatment, pleural or re-operation depending on the degree.
- Collapsed lungs: Bronchoscopy sucks sputum, dissects again.
- Heart failure: Treatment of cardiac arrest, resuscitation.
- Infection: Dressing, implantation of microorganisms then treatment according to antibiotics.
- Tubular survival: Medical treatment or re-surgery.
- Neurological damage: Medical treatment.
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