Procurement of domestic knee arthroscopy and imported knee arthroscopy difference in what

Knee arthroscopy can check and diagnose intra-articular diseases, applicable to knee injuries, non-infectious arthritis, knee arthroscopy is currently considered to be a better means of treatment for knee joint lesions. In contrast to traditional knee surgery, which is characterized by high trauma, high bleeding, slow postoperative recovery, and large surgical scars at the joints, knee arthroscopy has the advantages of low trauma, low bleeding, precise efficacy, fast recovery, fewer complications, and small surgical scars, and so on. Knee arthroscopy is now introduced as follows. 1 Preoperative preparation 1.1 Patient preparation Visiting the patient 1 day before surgery, understanding the patient's medical history and all kinds of preoperative treatments, examination reports, etc., understanding the patient's physical condition, according to the patient's cognitive level and taking appropriate psychological care measures for their anxiety, and introducing the surgical steps and time to the patient, explaining the importance of the anesthesia position, and the importance of the operation, so that the patient can see the operation process through the TV monitor, eliminating their uneasiness and anxiety. We also introduce the steps and time of the operation to the patients, explain the importance of cooperating with the anesthesia position and the fact that the patients can see the operation process clearly through the TV monitor during the operation, so as to eliminate their uneasiness and cooperate with the operation with a good attitude. 1.2 Preparation of operating rooms for minimally invasive surgery, the operating room should be strictly sterilized and disinfected, and in principle, the surgery should be arranged in a clean operating room as much as possible. The air purification machine should be used to continuously purify the air during the operation, so that the indoor temperature can be maintained at 22℃～25℃, the relative humidity at 50%～60%, and the light should not be too bright so as not to influence the clarity of images, and the air purification machine should be regularly inspected and repaired, and the flow of people should be reduced to reduce the chance of contamination and prevent the infection of the surgical incision, and improve the efficiency of the operation. The air purification machine should be inspected and maintained regularly to reduce personnel movement so as to minimize the chance of contamination and prevent infection of the surgical incision and increase the cure rate. 1.3 Instrument preparation According to the different texture of the instruments, choose the appropriate sterilization method, in principle, should take the autoclave sterilization method as far as possible. For example, endoscopes, mirror sheaths, tube hearts, cold light source cables, camera cables, shaving knife handles, shaving knife grinders, hoses, etc., should be fumigated and sterilized with 2% formaldehyde, while arthroscopic routine instrument packages, probes, meniscus strippers, basket forceps (left, middle and right curved), sets of needles, spatulas, intake tubes needles, medullary clamps, etc., should be sterilized by autoclaving. Routinely prepare disposable irrigators, suction tubes, suction heads, guide tubes, surgical membranes, elastic bandages, cotton wool, lower extremity tourniquets, hemostats, suction devices and so on. 1.4 Preparation of irrigation solution: Compound Ringer's solution or saline is usually used. 2 Surgical coordination 2.1 Anesthesia methods Generally, epidural block anesthesia or lumbar anesthesia are used. 2.2 Surgical Position The operator is located on the affected side to facilitate the change of joint position and the flexion, extension and rotation of the knee joint. Both upper limbs are abducted, intravenous fluids are established, and blood pressure and oxygen saturation are monitored to facilitate anesthesia observation and ensure safe and smooth surgery. 2.3 Steps of cooperation (1) Put a pneumatic tourniquet on the root of the thigh of the affected limb, routinely disinfect the towel, put a disposable foot cover on the affected limb, and put a disposable sterile C-arm cover on the top layer of the table to ensure that the operating table is not contaminated by wetness. (2) Correctly connect and adjust the arthroscopic camera system and perfusion system, endoscope, camera, camera converter connector, monitor cold light source, optical fiber bundle and other fiber optic cables, as well as the perfusion channel and other devices, according to the surgical instruments required for the sequential and orderly placement of the instruments on the instrument table. (3) Choose the appropriate access according to the needs of the surgical site. There are 3 patellar approaches: ① anteromedial approach: a small incision is made 1cm above the medial capsule and 1cm next to the patellar tendon, and the puncture needle is inserted into the joint cavity. ②Extra-superior approach: a small incision is made at 2.5cm above the quadriceps tendon, above the patellar tendon, and above the superior angle of the quadriceps tendon, a lancet is inserted, and the infusion bottle is connected to the irrigation bottle. (iii) Anterolateral approach: a small incision is made 1cm above the lateral joint line, 1cm above the patellar tendon, and an arthroscopic trocar is inserted. Insert the lens sheath, place the arthroscope, open the irrigation system to flush the joint cavity and make the field clear. (4) Under the arthroscope, another incision is made according to the need of surgery, and the suprapatellar bursa, patellofemoral joint, intercondylar fossa, medial interspace, lateral interspace, lateral saphenous fossa and medial saphenous fossa of the limb are examined in the order of moving the limb and the adhesion is loosened and the biopsy is done according to the need of the surgery, and the surgical method is determined according to the result of the microscopic examination, and the corresponding instruments are selected. 3 Precautions (1) Knee arthroscopy is performed in the joint, and intra-articular infection will seriously affect the joint function, so it should be controlled from all aspects, and the indications for surgery and the patient's own condition should be strictly controlled. If there is local inflammation or infection foci, systemic infectious diseases, or other susceptibility factors, they should be controlled before surgery. (2) According to the patient's condition, a drainage tube should be placed to prevent postoperative joint effusion and short-term joint swelling. (3) Preoperative soaked surgical scissors and fumigated arthroscopic instruments should be rinsed with saline before use. (4) The itinerant nurse should closely observe the changes of the condition and add the perfusion fluid in time to prevent air from entering into the joint capsule and affecting the effect of surgical vision, and to ensure the patient's comfort and reduce the pain as much as possible during the operation. (5) In order to ensure that the operation can be carried out smoothly, the maintenance of arthroscopic instruments should be strengthened and cleaned well. (6) Fiber optic cable to avoid bending, the inner diameter should be >10cm, open the cold light source should be weak to strong. (Edited by Sea Eagle) The author's unit: 521000 Chaozhou, Guangdong Province, the PLA No. 188 Hospital operating room with Baidu search knee arthroscopy web page will have more you want to answer

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