Kupita patsogolo kwa kugwiritsa ntchito ma exoscopes mu njira za neurosurgical

 

Kugwiritsa ntchito kwamicroscopes opaleshonindi neuroendoscopes zathandizira kwambiri mphamvu ya opaleshoni ya mitsempha, Komabe, chifukwa cha mawonekedwe a zida zomwezo, zimakhala ndi zovuta zina pazachipatala. ln kuwala kwa zofooka zamicroscope ntchitondi ma neuroendoscopes, kuphatikiza ndi kupita patsogolo kwa kujambula kwa digito, kulumikizana kwa netiweki ya Wifi, ukadaulo wowonekera ndiukadaulo waukadaulo, dongosolo la exoscope lakhala ngati mlatho pakati pa ma microscopes opangira opaleshoni ndi ma neuroendoscopes. Exoscope ili ndi mawonekedwe apamwamba kwambiri komanso mawonekedwe opangira opaleshoni, kaimidwe kabwino ka ergonomic, kuphunzitsa kogwira mtima komanso kuchita bwino kwa gulu la opaleshoni, ndipo magwiridwe ake amafanana ndi ma microscopes. Pakalipano, mabukuwa amafotokoza kusiyana pakati pa ma exoscopes ndi ma microscopes opangira opaleshoni muzinthu zamakono monga kuya kwa munda, malo owonera, kutalika kwa ntchito ndi ntchito, kusowa chidule ndi kusanthula kwapadera ndi zotsatira za opaleshoni ya exoscopes mu neurosurgery, Choncho, timafotokozera mwachidule ubwino wa neurosurgery m'zaka zaposachedwa. zoperewera muzochitika zachipatala, ndikupereka maumboni ogwiritsira ntchito cinical.

Mbiri ndi Kukula kwa exoscopes

Ma microscopes opangira opaleshoni amakhala ndi kuwunikira kozama kwambiri, mawonekedwe apamwamba kwambiri opangira opaleshoni, komanso zotsatira za kujambula kwa stereoscopic, zomwe zingathandize maopaleshoni kuti aziwona mawonekedwe akuya amisempha ndi mitsempha yamalo opangira opaleshoni ndikuwongolera kulondola kwa maopaleshoni ang'onoang'ono. Komabe, kuya kwa munda wamicroscope opaleshonindi ozama ndipo gawo lowonera ndi lopapatiza, makamaka pakukulitsa kwakukulu. Dokotala wochita opaleshoni amafunika kuyang'anitsitsa mobwerezabwereza ndikusintha mbali ya malo omwe akuwongolera, omwe amakhudza kwambiri ndondomeko ya opaleshoni; Kumbali inayi, dokotalayo ayenera kuyang'anitsitsa ndi kugwiritsira ntchito diso la microscope, zomwe zimafuna kuti dokotalayo akhalebe ndi mawonekedwe okhazikika kwa nthawi yaitali, zomwe zingayambitse kutopa mosavuta. M'zaka makumi angapo zapitazi, opaleshoni yochepetsetsa pang'onopang'ono yakula mofulumira, ndipo machitidwe a neuroendoscopic akhala akugwiritsidwa ntchito kwambiri mu neurosurgery chifukwa cha zithunzi zawo zapamwamba, zotsatira zabwino zachipatala, komanso kukhutira kwakukulu kwa odwala. Komabe, chifukwa cha njira yopapatiza ya njira ya endoscopic komanso kupezeka kwa zinthu zofunika kwambiri za neurovascular pafupi ndi njirayo, kuphatikiza ndi mawonekedwe a opaleshoni ya cranial monga kulephera kukulitsa kapena kufooketsa fupa la cranial, neuroendoscopy imagwiritsidwa ntchito makamaka pakuchita opaleshoni yachigaza komanso opaleshoni yam'mimba kudzera m'mphuno ndi mkamwa.

Chifukwa cha zofooka za ma microscopes opangira opaleshoni ndi ma neuroendoscopes, kuphatikizapo kupita patsogolo kwa kujambula kwa digito, kugwirizanitsa kwa intaneti ya WiFi, teknoloji yowonetsera, ndi luso lamakono la kuwala, mawonekedwe a galasi akunja atulukira ngati mlatho pakati pa ma microscopes opangira opaleshoni ndi neuroendoscopes. Mofanana ndi neuroendoscopy, makina agalasi akunja nthawi zambiri amakhala ndi galasi loyang'ana patali, gwero lowunikira, kamera yodziwika bwino, chophimba chowonetsera, ndi bulaketi. Kapangidwe kake kamene kamasiyanitsa magalasi akunja kuchokera ku neuroendoscopy ndi galasi loyang'ana patali ndi mainchesi pafupifupi 10 mm ndi kutalika pafupifupi 140 mm. Magalasi ake ali pa ngodya ya 0 ° kapena 90 ° kumtunda wautali wa galasi, wokhala ndi kutalika kwa 250-750 mm ndi kuya kwa 35-100 mm. Kutalika kwapang'onopang'ono komanso kuzama kwa gawo ndiubwino wofunikira wamagalasi akunja pa neuroendoscopy.

Kupita patsogolo kwa mapulogalamu ndi luso la hardware kwalimbikitsa chitukuko cha magalasi akunja, makamaka kutuluka kwa magalasi akunja a 3D, komanso magalasi atsopano a 3D 4K ultra high definition akunja. Dongosolo lagalasi lakunja limasinthidwa pafupipafupi chaka chilichonse. Pankhani ya mapulogalamu, makina a galasi akunja amatha kuwona malo opangira opaleshoniyo pophatikiza maginito opangira maginito a resonance tensor imaging, intraoperative navigation, ndi zina zambiri, potero kuthandiza madokotala kuchita maopaleshoni olondola komanso otetezeka. Pankhani ya hardware, galasi lakunja likhoza kugwirizanitsa 5-aminolevulinic acid ndi zosefera za indocyanine za angiography, mkono wa pneumatic, chogwiritsira ntchito chosinthika, zowonetsera zowonetsera zambiri, kuyang'ana mtunda wautali ndi kukulitsa kwakukulu, potero kukwaniritsa zotsatira zabwino za chithunzi ndi zochitika zogwirira ntchito.

Kuyerekeza pakati pa exoscope ndi maikulosikopu opangira opaleshoni

Dongosolo lagalasi lakunja limaphatikiza mawonekedwe akunja a neuroendoscopy ndi mawonekedwe azithunzi za maikulosikopu opangira opaleshoni, kuthandizira mphamvu ndi zofooka za mnzake, ndikudzaza mipata pakati pa maikulosikopu opangira opaleshoni ndi neuroendoscopy. Magalasi akunja ali ndi mawonekedwe akuya akuya komanso malo owoneka bwino (ochita opaleshoni m'mimba mwake 50-150 mm, kuya kwa 35-100 mm), kupereka zinthu zabwino kwambiri zopangira maopaleshoni akuya pansi pakukula kwakukulu; Kumbali inayi, kutalika kwa galasi lakunja kumatha kufika 250-750mm, kupereka mtunda wautali wogwira ntchito ndikuthandizira maopaleshoni [7]. Pankhani yowonera magalasi akunja, Ricciardi et al. zopezeka poyerekezera magalasi akunja ndi ma microscopes opangira opaleshoni kuti magalasi akunja ali ndi mawonekedwe ofanana ndi mawonekedwe, mphamvu ya kuwala, ndi kukulitsa kwa ma microscope. Galasi lakunja limathanso kusintha mwachangu kuchokera ku mawonekedwe ang'onoang'ono kupita ku mawonekedwe a macroscopic, koma njira yopangira opaleshoniyo "yopapatiza pamwamba ndi yotakata pansi" kapena kutsekeredwa ndi zida zina za minofu, gawo lowonera pansi pa microscope nthawi zambiri limakhala lochepa. Ubwino wa dongosolo galasi kunja ndi kuti akhoza kuchita opaleshoni mu ergonomic lakhalira, kuchepetsa nthawi kuona malo opaleshoni kudzera microscope eyepiece, potero kuchepetsa kutopa kwa dokotala opaleshoni. Magalasi akunja akunja amapereka zithunzi zofanana za opaleshoni ya 3D kwa onse ochita opaleshoni panthawi ya opaleshoni. Ma microscope amalola kuti anthu awiri azigwira ntchito pogwiritsa ntchito diso, pamene galasi lakunja lingathe kugawana chithunzi chomwecho mu nthawi yeniyeni, kulola madokotala ambiri opaleshoni kuti achite opaleshoni nthawi imodzi ndikuwongolera bwino opaleshoni pogawana zambiri ndi ogwira ntchito onse. Panthawi imodzimodziyo, dongosolo la galasi lakunja silimasokoneza kuyankhulana kwa gulu la opaleshoni, kulola ogwira ntchito onse opaleshoni kutenga nawo mbali pa opaleshoni.

exoscope mu opaleshoni ya neurosurgery

Gonen et al. adanenanso za 56 za opaleshoni ya glioma endoscopic, yomwe 1 yokha inali ndi zovuta (kutulutsa magazi m'dera la opaleshoni) panthawi ya opaleshoni, ndi chiwerengero cha 1.8% yokha. Rotermund et al. lipoti 239 milandu transnasal transsphenoidal opaleshoni kwa pituitary adenomas, ndi endoscopic opaleshoni sizinabweretse mavuto aakulu; Panthawiyi, panalibe kusiyana kwakukulu pa nthawi ya opaleshoni, zovuta, kapena kuchotsedwa pakati pa opaleshoni ya endoscopic ndi opaleshoni ya microscopic. Chen et al. inanena kuti 81 milandu zotupa anali opaleshoni kuchotsedwa mwa njira retrosigmoid nkusani. Pankhani ya nthawi ya opaleshoni, mlingo wa chotupa chotupa, postoperative minyewa, kumva, ndi zina zotero, opaleshoni ya endoscopic inali yofanana ndi opaleshoni ya microscopic. Poyerekeza ubwino ndi kuipa kwa njira ziwiri za opaleshoni, galasi lakunja ndi lofanana kapena lapamwamba kuposa microscope ponena za khalidwe lachithunzi cha kanema, malo opangira opaleshoni, opaleshoni, ergonomics, ndi kutenga nawo mbali kwa gulu la opaleshoni, pamene malingaliro akuzama amawerengedwa ngati ofanana kapena otsika kwa microscope.

Exoscope mu Maphunziro a Neurosurgery

Chimodzi mwazabwino zazikulu za magalasi akunja ndikuti amalola onse ogwira ntchito opaleshoni kugawana zithunzi zofananira za opaleshoni ya 3D, kulola ogwira ntchito onse ochita opaleshoni kuti atenge nawo mbali pakuchita opaleshoni, kulankhulana ndi kufalitsa zambiri za opaleshoni, kutsogolera kuphunzitsa ndi kuwongolera ma opaleshoni, kuonjezera kutenga nawo mbali pophunzitsa, komanso kupititsa patsogolo luso la kuphunzitsa. Kafukufuku wapeza kuti poyerekeza ndi ma microscopes opangira opaleshoni, njira yophunzirira ya magalasi akunja ndi yayifupi. M'maphunziro a labotale opangira suturing, ophunzira ndi madotolo okhalamo akalandira maphunziro pa endoscope ndi maikulosikopu, ophunzira ambiri amapeza kukhala kosavuta kugwira ntchito ndi endoscope. Pophunzitsa za opaleshoni ya craniocervical malformation, ophunzira onse adawona mawonekedwe amitundu itatu kudzera m'magalasi a 3D, kupititsa patsogolo kumvetsetsa kwawo kwa craniocervical malformation anatomy, kukulitsa chidwi chawo pa maopaleshoni, ndikufupikitsa nthawi yophunzirira.

Outlook

Ngakhale makina agalasi akunja apita patsogolo kwambiri pakugwiritsa ntchito poyerekeza ndi ma microscopes ndi neuroendoscopes, ilinso ndi malire ake. Choyipa chachikulu cha magalasi owonera akunja a 2D chinali kusowa kwa masomphenya a stereoscopic pakukulitsa zozama, zomwe zidakhudza maopaleshoni opangira opaleshoni komanso kuweruza kwa maopaleshoni. Galasi yatsopano yakunja ya 3D yasintha vuto la kusowa kwa masomphenya a stereoscopic, koma nthawi zina, kuvala magalasi opangidwa ndi polarized kwa nthawi yayitali kungayambitse kupweteka monga mutu ndi nseru kwa dokotala wa opaleshoni, yomwe ndi cholinga cha kusintha kwaukadaulo mu sitepe yotsatira. Komanso, mu endoscopic cranial opaleshoni, nthawi zina zofunika kusintha kwa maikulosikopu pa opareshoni chifukwa zotupa zina amafuna fluorescence motsogozedwa zithunzi resection, kapena kuya kwa opaleshoni munda kuunikira sikokwanira. Komanso, mu endoscopic cranial opaleshoni, nthawi zina zofunika kusintha kwa maikulosikopu pa opareshoni chifukwa zotupa zina amafuna fluorescence motsogozedwa zithunzi resection, kapena kuya kwa opaleshoni munda kuunikira sikokwanira. Chifukwa cha kukwera mtengo kwa zida zokhala ndi zosefera zapadera, ma fluorescence endoscopes sanagwiritsidwebe ntchito kwambiri pochotsa chotupa. Panthawi ya opaleshoni, wothandizira amaima mosiyana ndi dokotala wamkulu wa opaleshoni, ndipo nthawi zina amawona chithunzi chozungulira. Pogwiritsa ntchito mawonetsero awiri kapena angapo a 3D, chidziwitso cha chithunzi cha opaleshoni chimakonzedwa ndi mapulogalamu ndikuwonetsedwa pawindo lothandizira mu mawonekedwe a 180 °, omwe amatha kuthetsa vuto la kusinthasintha kwa zithunzi ndikupangitsa wothandizira kutenga nawo mbali pa opaleshoniyo mosavuta.

Mwachidule, kuchulukirachulukira kwa ma endoscopic system mu neurosurgery kumayimira chiyambi cha nthawi yatsopano yowonera ma intraoperative mu neurosurgery. Poyerekeza ndi ma microscopes opangira opaleshoni, magalasi akunja ali ndi maonekedwe abwino a fano ndi malo opangira opaleshoni, mawonekedwe abwino a ergonomic panthawi ya opaleshoni, kuphunzitsa bwino, komanso kutenga nawo mbali kwa gulu la opaleshoni, ndi zotsatira zofanana za opaleshoni. Chifukwa chake, pakuchita maopaleshoni ambiri amsana ndi msana, endoscope ndi njira yatsopano yotetezeka komanso yothandiza. Ndi kupita patsogolo ndi chitukuko cha teknoloji, zida zowonjezereka zowonetsera ma intraoperative zingathandize pochita opaleshoni kuti akwaniritse zovuta zochepetsera opaleshoni komanso kufotokozera bwino.