Ci gaban aikace-aikacen exoscopes a cikin hanyoyin neurosurgical

 

Aikace-aikace namicroscopes na tiyatakuma neuroendoscopes sun inganta ingantaccen hanyoyin aikin neurosurgical, duk da haka, saboda wasu halaye na kayan aikin da kansu, suna da wasu ƙuntatawa a aikace-aikacen asibiti. ln haske na kasawarmicroscopes masu aikida kuma neuroendoscopes, tare da ci gaba a cikin hoton dijital, haɗin yanar gizo na Wifi, fasahar allo da fasahar gani, tsarin exoscope ya kasance a matsayin gada tsakanin microscopes na tiyata da neuroendoscopes. Exoscope yana da mafi girman girman hoto da filin gani na tiyata, mafi kyawun yanayin ergonomic, ingancin koyarwa da ingantaccen haɗin gwiwar ƙungiyar tiyata, kuma tasirin sa na aikace-aikacen yana kama da na strical microscopes. A halin yanzu, wallafe-wallafen sun fi ba da rahoton bambance-bambance tsakanin exoscopes da microscopes na tiyata a cikin abubuwan fasaha kamar zurfin filin, filin gani, tsayin daka da aiki, rashin taƙaitawa da bincike na takamaiman aikace-aikacen da sakamakon tiyata na exoscopes a cikin neurosurgery, Saboda haka, mun taƙaita ƙayyadaddun aikace-aikacen exoscopes a cikin shekarun baya-bayan nan da kuma nazarin ayyukan su na neurosurge. nassoshi don cinical amfani.

Tarihi da Ci gaban Exoscopes

Na'urar microscopes na tiyata suna da haske mai zurfi mai zurfi, babban yanayin aikin tiyata mai mahimmanci, da kuma tasirin hoto na stereoscopic, wanda zai iya taimakawa likitocin su lura da zurfin tsarin jijiyoyi da jijiyoyin jini na filin tiyata a fili da kuma inganta daidaiton ayyukan microscopic. Duk da haka, zurfin filin namicroscope na tiyataba shi da zurfi kuma filin kallo yana da kunkuntar, musamman a babban girma. Likitan tiyata yana buƙatar mayar da hankali akai-akai da daidaita kusurwar yankin da aka yi niyya, wanda ke da tasiri mai mahimmanci a kan ƙwanƙwasa; A daya bangaren kuma, likitan fida yana bukatar ya lura kuma ya yi aiki ta hanyar na’urar ido ta na’ura mai ma’ana (microscope), yana bukatar likitan da ya kula da tsayuwar daka na dogon lokaci, wanda zai iya haifar da gajiya cikin sauki. A cikin 'yan shekarun da suka gabata, ƙananan ƙwayar tiyata ta haɓaka da sauri, kuma an yi amfani da tsarin neuroendoscopic a cikin neurosurgery saboda hotuna masu kyau, mafi kyawun sakamako na asibiti, da kuma gamsuwar haƙuri. Duk da haka, saboda kunkuntar tashar hanyar endoscopic da kuma kasancewar mahimman tsarin neurovascular a kusa da tashar, tare da halaye na tiyata na cranial kamar rashin iyawa don fadadawa ko raguwa da kogin cranial, neuroendoscopy an fi amfani dashi don aikin tiyata na kwanyar kwanyar da kuma tiyata ta ventricular ta hanyar hanci da na baka.

Idan aka yi la’akari da gazawar na’urorin aikin tiyata da na’urori masu kwakwalwa, haɗe tare da ci gaba a cikin hoto na dijital, haɗin yanar gizo na WiFi, fasahar allo, da fasahar gani, tsarin madubi na waje ya fito a matsayin gada tsakanin microscopes na tiyata da neuroendoscopes. Hakazalika da neuroendoscopy, tsarin madubi na waje yakan ƙunshi madubi mai hangen nesa, tushen haske, kyamara mai mahimmanci, allon nuni, da sashi. Babban tsarin da ke bambanta madubai na waje daga neuroendoscopy shine madubi mai hangen nesa mai tsayin kusan 10 mm kuma tsawon kusan 140 mm. Lens ɗinsa yana a kusurwar 0 ° ko 90 ° zuwa tsayin kusurwar jikin madubi, tare da tsayin tsayin tsayin 250-750 mm da zurfin filin 35-100 mm. Tsawon tsayi mai tsayi da zurfin zurfin filin shine mahimman fa'idodin tsarin madubi na waje akan neuroendoscopy.

Ci gaban software da fasahar kayan masarufi ya haɓaka haɓakar madubai na waje, musamman fitowar madubin na waje na 3D, da kuma sabbin madubin 3D 4K ultra high definition na waje. Ana sabunta tsarin madubi na waje kowace shekara. Dangane da software, tsarin madubi na waje zai iya hango wurin tiyata ta hanyar haɗawa da ɗaukar hoto na faɗakarwar maganadisu kafin fara aiki, kewayawa ta ciki, da sauran bayanai, ta haka ne ke taimaka wa likitoci yin aikin tiyata daidai da aminci. Dangane da kayan aiki, madubi na waje zai iya haɗa 5-aminolevulinic acid da indocyanine filters don angiography, hannu na pneumatic, daidaitacce mai aiki, fitowar allo da yawa, nesa mai nisa da haɓaka girma, don haka samun mafi kyawun tasirin hoto da ƙwarewar aiki.

Kwatanta tsakanin exoscope da microscopes na tiyata

Tsarin madubi na waje yana haɗa fasalin waje na neuroendoscopy tare da ingancin hoto na ƙananan ƙwayoyin cuta, suna daidaita ƙarfin juna da raunin juna, da kuma cike giɓi tsakanin microscopes na tiyata da neuroendoscopy. Madubai na waje suna da halaye na zurfin filin filin da faffadan ra'ayi (diamita na filin tiyata na 50-150 mm, zurfin filin 35-100 mm), yana ba da yanayi mai matukar dacewa don ayyukan tiyata mai zurfi a ƙarƙashin babban girma; A gefe guda, tsayin tsayin madubi na waje zai iya kaiwa 250-750mm, yana ba da nisa mai tsayi da sauƙaƙe ayyukan tiyata [7]. Game da hangen nesa na madubin waje, Ricciardi et al. wanda aka samo ta hanyar kwatanta tsakanin madubai na waje da na'urorin aikin tiyata cewa madubin waje suna da kwatankwacin ingancin hoto, ikon gani, da tasirin haɓakawa zuwa na'urori masu ƙima. Madubin na waje kuma zai iya saurin canzawa daga hangen nesa zuwa hangen nesa, amma lokacin da tashar tiyata ta kasance "kunkuntar a sama da fadi a kasa" ko kuma wasu sifofi na nama suka toshe su, filin kallon karkashin na'urar yana yawanci iyakance. Amfanin tsarin madubi na waje shi ne cewa zai iya yin tiyata a cikin yanayin da ya fi ergonomic, yana rage lokacin da aka kashe don kallon filin tiyata ta hanyar na'urar ido na microscope, ta haka ne ya rage gajiyar tiyatar likita. Tsarin madubi na waje yana ba da hotunan aikin tiyata na 3D iri ɗaya ga duk mahalarta aikin tiyata yayin aikin tiyata. Na’urar hangen nesa tana ba da damar har zuwa mutane biyu su yi aiki ta hanyar na’urar gani, yayin da madubi na waje zai iya raba hoto iri ɗaya a ainihin lokacin, yana ba da damar likitocin fiɗa da yawa su yi aikin tiyata a lokaci ɗaya da haɓaka ingantaccen aikin tiyata ta hanyar raba bayanai tare da duk ma’aikata. A lokaci guda kuma, tsarin madubi na waje ba ya tsoma baki tare da sadarwar juna na ƙungiyar tiyata, yana barin duk ma'aikatan tiyata su shiga cikin aikin tiyata.

exoscope a cikin aikin tiyata na neurosurgery

Gonen et al. ya ba da rahoton lokuta 56 na aikin tiyata na glioma endoscopic, wanda kawai shari'ar 1 kawai ke da rikitarwa (zubar da jini a yankin tiyata) yayin lokacin aikin tiyata, tare da adadin abin da ya faru na kawai 1.8%. Rotermund et al. ya ruwaito lokuta 239 na tiyata transsphenoidal transnasal don pituitary adenomas, kuma aikin tiyata na endoscopic bai haifar da matsala mai tsanani ba; A halin yanzu, babu wani bambanci mai mahimmanci a lokacin tiyata, rikitarwa, ko kewayon resection tsakanin aikin tiyata na endoscopic da tiyata na microscopic. Chen et al. an ruwaito cewa an cire lokuta 81 na ciwace-ciwace ta hanyar tiyata ta hanyar retrosigmoid sinus. Dangane da lokacin tiyata, digiri na resection na ƙari, aikin jijiya na baya-bayan nan, ji, da dai sauransu, aikin tiyata na endoscopic ya kasance kama da tiyata na microscopic. Idan aka kwatanta fa'ida da rashin amfani da dabarun tiyata guda biyu, madubi na waje yana kama da na'urar hangen nesa ta fuskar ingancin hoton bidiyo, filin aikin tiyata, aiki, ergonomics, da halartar ƙungiyar tiyata, yayin da zurfin hasashe ana ƙididdige shi azaman kama ko ƙasa da na'urar gani.

exoscope a cikin Koyarwar Neurosurgery

Ɗaya daga cikin manyan fa'idodin madubin waje shine cewa suna ba da damar duk ma'aikatan tiyata su raba hotuna iri ɗaya na 3D masu inganci, ba da damar duk ma'aikatan tiyata su shiga cikin aikin tiyata, sadarwa da watsa bayanan tiyata, sauƙaƙe koyarwa da jagorar ayyukan tiyata, haɓaka aikin koyarwa, da haɓaka tasirin koyarwa. Bincike ya gano cewa idan aka kwatanta da na'urorin duban fiɗa, yanayin koyan madubin waje ya fi guntu. A cikin horon dakin gwaje-gwaje don sutura, lokacin da ɗalibai da likitocin mazaunin suka sami horo akan duka endoscope da microscope, yawancin ɗalibai suna samun sauƙin aiki tare da endoscope. A cikin koyar da aikin tiyata na ƙwayar cuta na craniocervical, duk ɗalibai sun lura da sifofin jikin mutum uku ta hanyar gilashin 3D, haɓaka fahimtar su game da ƙwayar cuta ta craniocervical, inganta sha'awar ayyukan tiyata, da rage lokacin horo.

Outlook

Kodayake tsarin madubi na waje ya sami babban ci gaba a aikace-aikacen idan aka kwatanta da microscopes da neuroendoscopes, kuma yana da iyakokinsa. Babban koma baya na farkon madubin kallon waje na 2D shine rashin hangen nesa na stereoscopic a cikin haɓaka zurfin sifofi, wanda ya shafi ayyukan tiyata da hukumcin likitan fiɗa. Sabon madubi na waje na 3D ya inganta matsalar rashin hangen nesa na stereoscopic, amma a lokuta da yawa, saka gilashin polarized na dogon lokaci zai iya haifar da rashin jin daɗi kamar ciwon kai da tashin zuciya ga likitan tiyata, wanda shine mayar da hankali ga inganta fasaha a mataki na gaba. Bugu da ƙari, a cikin aikin tiyata na endoscopic cranial, wani lokaci ya zama dole don canzawa zuwa na'urar microscope yayin aikin saboda wasu ciwace-ciwacen daji suna buƙatar gyaran fuska na gani mai haske, ko zurfin hasken filin tiyata bai isa ba. Bugu da ƙari, a cikin aikin tiyata na endoscopic cranial, wani lokaci ya zama dole don canzawa zuwa na'urar microscope yayin aikin saboda wasu ciwace-ciwacen daji suna buƙatar gyaran fuska na gani mai haske, ko zurfin hasken filin tiyata bai isa ba. Saboda tsadar kayan aiki tare da masu tacewa na musamman, har yanzu ba a yi amfani da endoscopes mai haske ba a ko'ina don gyaran ƙwayar cuta. A lokacin tiyata, mataimaki ya tsaya a sabanin matsayi na babban likitan tiyata, kuma wani lokacin yana ganin hoton nuni. Yin amfani da nunin 3D biyu ko fiye, bayanan hoton tiyata ana sarrafa su ta hanyar software kuma ana nuna su akan allon mataimaka a cikin sigar 180 ° mai jujjuya, wanda zai iya magance matsalar jujjuya hoto yadda yakamata kuma ya ba da damar mataimaki ya shiga cikin aikin tiyata cikin dacewa.

A taƙaice, ƙara yawan amfani da tsarin endoscopic a cikin neurosurgery yana wakiltar farkon sabon zamani na hangen nesa na ciki a cikin neurosurgery. Idan aka kwatanta da na'urorin aikin tiyata, madubai na waje suna da mafi kyawun hoto da filin kallo, mafi kyawun matsayi na ergonomic yayin tiyata, ingantaccen koyarwar koyarwa, da ingantaccen haɗin gwiwar ƙungiyar tiyata, tare da sakamakon tiyata iri ɗaya. Saboda haka, don yawancin aikin tiyata na cranial da na kashin baya, endoscope sabon zaɓi ne mai aminci da inganci. Tare da ci gaba da haɓaka fasaha, ƙarin kayan aikin gani na ciki na iya taimakawa a cikin ayyukan tiyata don cimma ƙananan matsalolin tiyata da ingantacciyar hasashen.