Ci gaban aikace-aikacen exoscopes a cikin hanyoyin tiyata na neurosurgical

 

Aikace-aikacenna'urorin hangen nesa na tiyatada kuma na'urorin binciken neuroendoscopes sun inganta ingancin hanyoyin tiyatar jijiyoyi, Duk da haka, saboda wasu halaye na kayan aikin da kansu, suna da wasu ƙuntatawa a aikace-aikacen asibiti. Dangane da ƙarancinna'urorin microscope masu aikida kuma neuroendoscopes, tare da ci gaban da aka samu a fannin daukar hoto na dijital, haɗin hanyar sadarwa ta Wifi, fasahar allo da fasahar gani, tsarin exoscope ya zama kamar gada tsakanin na'urorin hangen nesa na tiyata da na'urorin hangen nesa na neuroendoscopes. Exoscope yana da inganci mai kyau a hoto da kuma filin gani na tiyata, ingantaccen yanayin ergonomic, ingancin koyarwa da kuma haɗin gwiwar ƙungiyar tiyata mafi inganci, kuma ingancin aikace-aikacensa yayi kama da na na'urorin hangen nesa na strical. A halin yanzu, wallafe-wallafen galibi suna ba da rahoton bambance-bambance tsakanin na'urorin hangen nesa na exoscopes da na'urorin hangen nesa na tiyata a fannoni na kayan aikin fasaha kamar zurfin filin, filin gani, tsawon hankali da aiki, rashin taƙaitaccen bayani da bincike kan takamaiman sakamakon aikace-aikacen da tiyata na exoscopes a cikin tiyatar jijiyoyi. Saboda haka, muna taƙaita na'urorin hangen nesa na aikace-aikace a cikin tiyatar jijiyoyi a cikin 'yan shekarun nan, muna nazarin fa'idodi da iyakokinsu a cikin aikin asibiti, kuma muna ba da nassoshi don amfani da cinical.

Tarihi da Ci gaban exoscopes

Na'urorin hangen nesa na tiyata suna da kyakkyawan haske mai zurfi, filin hangen nesa na tiyata mai ƙuduri mai girma, da tasirin hoton stereoscopic, wanda zai iya taimaka wa likitocin tiyata su lura da tsarin jijiyoyin jini da jijiyoyin jini na zurfin filin tiyata a sarari da kuma inganta daidaiton ayyukan ƙananan ƙwayoyin cuta. Duk da haka, zurfin filinna'urar hangen nesa ta tiyataBa shi da zurfi kuma filin gani yana da faɗi, musamman a babban girma. Likitan tiyata yana buƙatar mayar da hankali akai-akai da daidaita kusurwar yankin da aka nufa, wanda ke da tasiri mai mahimmanci akan yanayin tiyata; A gefe guda kuma, likitan tiyata yana buƙatar lura da aiki ta hanyar na'urar hangen nesa ta microscope, yana buƙatar likitan tiyata ya kiyaye tsayayyen matsayi na dogon lokaci, wanda zai iya haifar da gajiya cikin sauƙi. A cikin 'yan shekarun da suka gabata, tiyata mai ƙarancin mamayewa ta bunƙasa cikin sauri, kuma an yi amfani da tsarin neuroendoscopic sosai a cikin tiyatar jijiyoyi saboda hotuna masu inganci, ingantattun sakamakon asibiti, da gamsuwar marasa lafiya mafi girma. Duk da haka, saboda kunkuntar hanyar hanyar endoscopic da kasancewar mahimman tsarin jijiyoyin jini kusa da tashar, tare da halayen tiyatar jijiyoyi kamar rashin iya faɗaɗa ko rage ramin jijiyoyi, ana amfani da neuroendoscopy galibi don tiyatar tushen kwanyar da tiyatar ventricular ta hanyar hanyoyin hanci da baki.

Ganin gazawar na'urorin hangen nesa na tiyata da na'urorin hangen nesa na neuroendoscopes, tare da ci gaba a fannin daukar hoto na dijital, haɗin hanyar sadarwa ta WiFi, fasahar allo, da fasahar gani, tsarin madubin waje ya fito a matsayin gada tsakanin na'urorin hangen nesa na tiyata da na'urorin hangen nesa na neuroendoscopes. Kamar neuroendoscopy, tsarin madubin waje yawanci ya ƙunshi madubin hangen nesa na nesa, tushen haske, kyamara mai girma, allon nuni, da kuma maƙalli. Babban tsarin da ke bambanta madubin waje daga neuroendoscopy shine madubin hangen nesa na nesa wanda diamitarsa ​​​​ta kai kusan mm 10 kuma tsawonsa ya kai kusan mm 140. Ruwan tabarau yana kusurwar 0 ° ko 90 ° zuwa ga dogon axis na jikin madubin, tare da kewayon tsawon hankali na 250-750 mm da zurfin filin 35-100 mm. Tsawon tsayin hankali da zurfin filin su ne manyan fa'idodin tsarin madubin waje fiye da neuroendoscopy.

Ci gaban fasahar software da hardware ya haɓaka ci gaban madubin waje, musamman fitowar madubin waje na 3D, da kuma sabbin madubin waje na 3D 4K masu matuƙar inganci. Ana sabunta tsarin madubin waje kowace shekara. Dangane da software, tsarin madubin waje zai iya hango yankin tiyata ta hanyar haɗa hoton tensor na maganadisu kafin tiyata, kewayawa a cikin tiyata, da sauran bayanai, ta haka ne ke taimaka wa likitoci yin tiyatar da ta dace kuma mai aminci. Dangane da kayan aiki, madubin waje zai iya haɗa matatun 5-aminolevulinic acid da indocyanine don angiography, pneumatic arm, madannin aiki mai daidaitawa, fitowar allo da yawa, tsawon nisan mai da hankali da kuma girman girma, ta haka ne ake samun ingantaccen tasirin hoto da ƙwarewar aiki.

Kwatanta tsakanin exoscope da na'urorin hangen nesa na tiyata

Tsarin madubin waje yana haɗa siffofin waje na neuroendoscopy tare da ingancin hoton na'urorin hangen nesa na tiyata, yana ƙara wa juna ƙarfi da raunin juna, da kuma cike gibin da ke tsakanin na'urorin hangen nesa na tiyata da na'urorin hangen nesa na neuroendoscopy. Madubin waje suna da halaye na zurfin filin da faɗin filin gani (diamita na filin tiyata na 50-150 mm, zurfin filin 35-100 mm), yana samar da yanayi mai matuƙar dacewa don ayyukan tiyata masu zurfi a ƙarƙashin babban girma; A gefe guda kuma, tsawon madubin waje na iya kaiwa 250-750mm, yana samar da tsawon nisa na aiki da kuma sauƙaƙe ayyukan tiyata [7]. Dangane da hangen nesa na madubin waje da na'urorin hangen nesa na tiyata, Ricciardi et al. sun gano ta hanyar kwatantawa tsakanin madubin waje da na'urorin hangen nesa na tiyata cewa maduban waje suna da ingancin hoto iri ɗaya, ƙarfin gani, da tasirin girma zuwa na'urorin hangen nesa. Madubin waje kuma yana iya canzawa da sauri daga hangen nesa na microscopic zuwa hangen nesa na macroscopic, amma lokacin da hanyar tiyata ta kasance "kunkuntar a sama da faɗi a ƙasa" ko kuma ta toshe ta wasu tsarin nama, filin gani a ƙarƙashin na'urar hangen nesa yawanci yana da iyaka. Amfanin tsarin madubin waje shine yana iya yin tiyata a cikin yanayi mai kyau, yana rage lokacin da ake kashewa wajen kallon filin tiyata ta hanyar na'urar hangen nesa ta microscope, ta haka yana rage gajiyar tiyatar likita. Tsarin madubin waje yana ba da hotuna iri ɗaya na 3D ga duk waɗanda suka shiga aikin tiyatar. Na'urar hangen nesa tana ba da damar har zuwa mutane biyu su yi aiki ta na'urar hangen nesa, yayin da madubin waje zai iya raba hoto iri ɗaya a ainihin lokaci, yana ba da damar likitoci da yawa su yi ayyukan tiyata a lokaci guda kuma yana inganta ingancin tiyata ta hanyar raba bayanai da dukkan ma'aikata. A lokaci guda, tsarin madubin waje ba ya tsoma baki ga sadarwa tsakanin ƙungiyar tiyatar, yana ba da damar duk ma'aikatan tiyata su shiga cikin aikin tiyatar.

exoscope a cikin tiyatar neurosurgery

Gonen da abokan aikinsa sun bayar da rahoton shari'o'i 56 na tiyatar endoscopic ta glioma, wanda mutum 1 ne kawai ya samu matsaloli (zubar da jini a yankin tiyata) a lokacin tiyatar, tare da adadin faruwar lamarin da ya kai 1.8%. Rotermund da abokan aikinsa sun bayar da rahoton shari'o'i 239 na tiyatar transsphenoidal ta hanyar transhasal transfenoidal don pituitary adenomas, kuma tiyatar endoscopic ba ta haifar da matsaloli masu tsanani ba; A halin yanzu, babu wani bambanci mai mahimmanci a lokacin tiyata, rikitarwa, ko kewayon cirewa tsakanin tiyatar endoscopic da tiyatar microscopic. Chen da abokan aikinsa sun bayar da rahoton cewa an cire shari'o'i 81 na ciwace-ciwacen ta hanyar tiyata ta hanyar hanyar sinus ta retrosigmoid. Dangane da lokacin tiyata, matakin cirewa daga ciwon daji, aikin ji bayan tiyata, ji, da sauransu, tiyatar endoscopic ta yi kama da tiyatar microscopic. Idan aka kwatanta fa'idodi da rashin amfanin dabarun tiyata guda biyu, madubin waje yana kama ko ya fi microscope kyau dangane da ingancin hoton bidiyo, filin gani, aiki, ergonomics, da kuma halartar ƙungiyar tiyata, yayin da ake kimanta fahimtar zurfin a matsayin kama ko ƙasa da microscope.

exoscope a cikin Koyarwar Neurosurgery

Ɗaya daga cikin manyan fa'idodin madubai na waje shine yana bawa dukkan ma'aikatan tiyata damar raba hotuna iri ɗaya na tiyata na 3D, wanda hakan ke bawa dukkan ma'aikatan tiyata damar shiga cikin aikin tiyata, isar da bayanai da aika su, sauƙaƙe koyarwa da jagoranci kan ayyukan tiyata, ƙara yawan halartar koyarwa, da kuma inganta ingancin koyarwa. Bincike ya gano cewa idan aka kwatanta da na'urorin hangen nesa na tiyata, lanƙwasa koyo na madubai na waje ya fi guntu. A cikin horon dakin gwaje-gwaje don dinki, lokacin da ɗalibai da likitocin mazauna wurin suka sami horo kan endoscope da na'urar hangen nesa, yawancin ɗalibai suna ganin ya fi sauƙi a yi amfani da endoscope. A cikin koyar da tiyatar tiyatar craniocervical malformation, duk ɗalibai sun lura da tsarin jiki mai girma uku ta hanyar gilashin 3D, suna haɓaka fahimtarsu game da tsarin narkar da kwakwalwa, suna inganta sha'awarsu ga ayyukan tiyata, da kuma rage lokacin horo.

Hasashen Yanayi

Duk da cewa tsarin madubin waje ya sami ci gaba sosai a aikace idan aka kwatanta da na'urorin hangen nesa da na neuroendoscopes, yana da iyakokinsa. Babban koma-baya na farkon madubin hangen nesa na waje na 2D shine rashin hangen nesa na stereoscopic wajen girman gine-gine masu zurfi, wanda ya shafi ayyukan tiyata da hukuncin likitan tiyata. Sabuwar madubin waje na 3D ya inganta matsalar rashin hangen nesa na stereoscopic, amma a lokuta da ba kasafai ba, sanya gilashin da aka yi wa polarized na dogon lokaci na iya haifar da rashin jin daɗi kamar ciwon kai da tashin zuciya ga likitan tiyata, wanda shine babban abin da ake mayar da hankali a kai na inganta fasaha a mataki na gaba. Bugu da ƙari, a cikin tiyatar endoscopic kwanyar, wani lokacin yana da mahimmanci a canza zuwa na'urar hangen nesa yayin aikin saboda wasu ciwace-ciwacen suna buƙatar cirewar gani mai haske, ko kuma zurfin hasken filin tiyata bai isa ba. Bugu da ƙari, a cikin tiyatar endoscopic kwanyar, wani lokacin yana da mahimmanci a canza zuwa na'urar hangen nesa yayin aikin saboda wasu ciwace-ciwacen suna buƙatar cirewar gani mai haske, ko kuma zurfin hasken filin tiyata bai isa ba. Saboda tsadar kayan aiki tare da matattara na musamman, ba a yi amfani da endoscopes na fluorescence sosai don cirewar ƙari ba tukuna. A lokacin tiyata, mataimakiyar tana tsaye a akasin matsayin babban likitan tiyata, kuma wani lokacin tana ganin hoton da ke juyawa. Ta amfani da nunin 3D guda biyu ko fiye, ana sarrafa bayanan hoton tiyata ta hanyar software kuma ana nuna su akan allon mataimakin a cikin siffar 180 °, wanda zai iya magance matsalar juyawar hoto yadda ya kamata kuma ya ba mataimakin damar shiga cikin aikin tiyata cikin sauƙi.

A taƙaice, yawan amfani da tsarin endoscopic a cikin tiyatar jijiyoyi yana wakiltar farkon sabon zamani na gani a cikin tiyatar jijiyoyi. Idan aka kwatanta da na'urorin hangen nesa na tiyata, madubai na waje suna da ingancin hoto da filin gani na tiyata, kyakkyawan yanayin ergonomic yayin tiyata, ingantaccen tasiri na koyarwa, da kuma haɗin gwiwar ƙungiyar tiyata mafi inganci, tare da sakamako iri ɗaya na tiyata. Saboda haka, ga yawancin tiyatar jijiyoyi da ƙashin baya, endoscope sabon zaɓi ne mai aminci kuma mai tasiri. Tare da ci gaba da haɓaka fasaha, ƙarin kayan aikin gani a cikin tiyata na iya taimakawa a cikin ayyukan tiyata don cimma ƙananan rikitarwa na tiyata da ingantaccen hangen nesa.