Inkqubela phambili yokusetyenziswa kwee-exoscopes kwiinkqubo zotyando lwe-neurosurgical

 

Ukusetyenziswa kweiimayikroskopu zotyandokunye nee-neuroendoscopes ziphucule kakhulu ukusebenza kakuhle kweenkqubo zotyando lwe-neurosurgical. Nangona kunjalo, ngenxa yeempawu ezithile zezixhobo ngokwazo, zigcina imida ethile ekusetyenzisweni kwezonyango. Ngenxa yokusilela kweiimakroskopu ezisebenzayokunye nee-neuroendoscopes, kunye nokuqhubela phambili kwimifanekiso yedijithali, uqhagamshelo lwenethiwekhi yeWifi, iteknoloji yesikrini kunye netekhnoloji ye-optical, inkqubo ye-exoscope iye yaba yibhulorho phakathi kwee-microscopes zotyando kunye nee-neuroendoscopes. I-exoscope inomgangatho ophezulu womfanekiso kunye nentsimi yokubona yotyando, ukuma okungcono kwe-ergonomic, ukusebenza kakuhle kokufundisa kunye nokubandakanyeka kweqela lotyando olusebenzayo, kwaye ukusebenza kwayo kufana noko kwe-strical microscopes. Okwangoku, uncwadi luchaza ikakhulu ukungafani phakathi kwee-exoscopes kunye nee-microscopes zotyando kwiinkalo zezixhobo zobugcisa ezifana nobunzulu bentsimi, intsimi yokubona, ubude be-focal kunye nokusebenza, kungekho sishwankathelo kunye nohlalutyo lwesicelo esithile kunye neziphumo zotyando ze-exoscopes kwi-neurosurgery. Ngenxa yoko, sishwankathela ii-exoscopes zokusetyenziswa kwi-neurosurgery kwiminyaka yakutshanje, sihlalutya izibonelelo kunye nemida yazo kwizenzo zonyango, kwaye sinikezela ngeereferensi zokusetyenziswa kwe-cinical.

Imbali kunye noPhuhliso lwee-exoscopes

Iimayikroskopu zotyando zinokukhanya okunzulu okugqwesileyo, umbono wotyando olunesisombululo esiphezulu, kunye nemiphumo yemifanekiso ye-stereoscopic, enokunceda oogqirha botyando ukuba bajonge ulwakhiwo olujulileyo lwezicubu zemithambo-luvo kunye nemithambo-luvo yentsimi yotyando ngokucacileyo kwaye baphucule ukuchaneka kotyando lwe-microscope. Nangona kunjalo, ubunzulu bommandla wentsimiimakroskopu yotyandoayinzulu kwaye intsimi yokujonga incinci, ingakumbi xa ikhuliswa kakhulu. Ugqirha kufuneka agxile ngokuphindaphindiweyo aze alungise i-engile yendawo ekujoliswe kuyo, nto leyo enefuthe elikhulu kwisigqi sotyando; Kwelinye icala, ugqirha kufuneka ajonge aze asebenze nge-eyepiece ye-microscope, nto leyo efuna ukuba ugqirha agcine ukuma okuzinzileyo ixesha elide, nto leyo enokukhokelela ekudinweni ngokulula. Kwiminyaka embalwa edlulileyo, utyando olungenamsebenzi luye lwaphuhliswa ngokukhawuleza, kwaye iinkqubo ze-neuroendoscopic ziye zasetyenziswa kakhulu kutyando lwe-neurosurgery ngenxa yemifanekiso yazo esemgangathweni ophezulu, iziphumo zeklinikhi ezingcono, kunye nolwaneliseko oluphezulu lwesigulana. Nangona kunjalo, ngenxa yomjelo omxinwa wendlela ye-endoscopic kunye nokuba khona kwezakhiwo ezibalulekileyo ze-neurovascular kufutshane nomjelo, kunye neempawu zotyando lwe-cranial ezifana nokungakwazi ukwandisa okanye ukunciphisa umngxuma we-cranial, i-neuroendoscopy isetyenziselwa kakhulu utyando lwesiseko se-skull kunye notyando lwe-ventricular ngeendlela zempumlo kunye nezomlomo.

Ngenxa yeziphene zeemakroskopu zotyando kunye nee-neuroendoscopes, kunye nokuqhubela phambili kwimifanekiso yedijithali, uqhagamshelo lwenethiwekhi yeWiFi, iteknoloji yesikrini, kunye netekhnoloji ye-optical, inkqubo yesipili sangaphandle iye yavela njengebhulorho phakathi kweemakroskopu zotyando kunye nee-neuroendoscopes. Njenge-neuroendoscopy, inkqubo yesipili sangaphandle idla ngokuba nesipili esibona kude, umthombo wokukhanya, ikhamera ecacileyo, isikrini sokubonisa, kunye nebracket. Ulwakhiwo oluphambili olwahlula izipili zangaphandle kwi-neuroendoscopy sisipili esibona kude esinobubanzi obuyi-10 mm kunye nobude obuyi-140 mm. Ilensi yayo ikwi-engile ye-0 ° okanye ye-90 ° ukuya kwi-axis ende yomzimba wesipili, enobubanzi obuyi-250-750 mm kunye nobunzulu bentsimi obuyi-35-100 mm. Ubude obude obujolisiweyo kunye nobunzulu bentsimi zezona zibonelelo ziphambili zeenkqubo zesipili sangaphandle kune-neuroendoscopy.

Ukuqhubela phambili kwesoftware kunye netekhnoloji yehardware kukhuthaze uphuhliso lwezibuko zangaphandle, ngakumbi ukuvela kwezibuko zangaphandle ze-3D, kunye nezibuko zangaphandle ze-3D 4K ezikumgangatho ophezulu kakhulu. Inkqubo yesibuko sangaphandle ihlaziywa rhoqo minyaka le. Ngokwesoftware, inkqubo yesibuko sangaphandle inokuyibona indawo yotyando ngokuhlanganisa i-preoperative magnetic resonance diffusion tensor imaging, i-intraoperative navigation, kunye nolunye ulwazi, ngaloo ndlela inceda oogqirha benze utyando oluchanekileyo nolukhuselekileyo. Ngokwehardware, isibuko sangaphandle sinokudibanisa ii-5-aminolevulinic acid kunye nee-indocyanine filters ze-angiography, i-pneumatic arm, i-adjustable operating handle, i-multi screen output, i-long focusing distance kunye ne-magnification enkulu, ngaloo ndlela ifezekisa iziphumo ezingcono zomfanekiso kunye namava okusebenza.

Uthelekiso phakathi kwe-exoscope kunye ne-microscopes yotyando

Inkqubo yesipili sangaphandle idibanisa iimpawu zangaphandle ze-neuroendoscopy nomgangatho womfanekiso wee-microscopes zotyando, zihambelana namandla kunye nobuthathaka bomnye nomnye, kwaye zizalise izikhewu phakathi kwee-microscopes zotyando kunye ne-neuroendoscopy. Izipili zangaphandle zineempawu zobunzulu obunzulu bentsimi kunye nentsimi ebanzi yombono (ububanzi bentsimi yotyando obuyi-50-150 mm, ubunzulu bentsimi obuyi-35-100 mm), zibonelela ngeemeko ezilula kakhulu zotyando olunzulu phantsi kokwandiswa okuphezulu; Kwelinye icala, ubude be-focal yesipili sangaphandle bunokufikelela kwi-250-750mm, bubonelela ngomgama omde wokusebenza kwaye buququzelele utyando [7]. Ngokuphathelele ukubonakala kwezipili zangaphandle, uRicciardi et al. bafumanise ngokuthelekisa phakathi kwezipili zangaphandle kunye nee-microscopes zotyando ukuba izipili zangaphandle zinomgangatho womfanekiso ofanayo, amandla okukhanya, kunye nemiphumo yokukhulisa ukuya kwii-microscopes. Isipili sangaphandle sinokutshintsha ngokukhawuleza ukusuka kwimbono ye-microscopic ukuya kwimbono ye-macroscopic, kodwa xa umjelo wotyando "unciphile phezulu kwaye ubanzi ezantsi" okanye uthintelwe zezinye izakhiwo zezicubu, intsimi yombono phantsi kwe-microscope idla ngokulinganiselwa. Inzuzo yenkqubo yesipili yangaphandle kukuba inokwenza utyando ngendlela elungeleleneyo, inciphise ixesha elichithwa ujonge intsimi yotyando nge-eyepiece ye-microscope, ngaloo ndlela inciphisa ukudinwa kotyando lukagqirha. Inkqubo yesipili yangaphandle ibonelela ngemifanekiso yotyando ye-3D esemgangathweni ofanayo kubo bonke abathathi-nxaxheba botyando ngexesha lenkqubo yotyando. I-microscope ivumela abantu ababini ukuba basebenze nge-eyepiece, ngelixa isipili sangaphandle sinokwabelana ngomfanekiso ofanayo ngexesha langempela, sivumela oogqirha abaninzi ukuba benze utyando ngaxeshanye kwaye siphucule ukusebenza kakuhle kotyando ngokwabelana ngolwazi nabo bonke abasebenzi. Kwangaxeshanye, inkqubo yesipili sangaphandle ayiphazamisi unxibelelwano oludibeneyo lweqela lotyando, ivumela bonke abasebenzi botyando ukuba bathathe inxaxheba kwinkqubo yotyando.

i-exoscope kutyando lwe-neurosurgery

UGonen nabanye baxele amatyala angama-56 otyando lwe-glioma endoscopic, apho ityala elinye kuphela elalineengxaki (ukopha kwindawo yotyando) ngexesha lotyando, kunye nesantya sokuvela kwe-1.8% kuphela. URotermund nabanye baxele amatyala angama-239 otyando lwe-transphenoidal transnasal kwi-pituitary adenomas, kwaye utyando lwe-endoscopic aluzange lubangele iingxaki ezinkulu; Okwangoku, bekungekho mahluko mkhulu kwixesha lotyando, iingxaki, okanye uluhlu lokususwa phakathi kotyando lwe-endoscopic kunye notyando lwe-microscopic. UChen nabanye baxele ukuba amatyala angama-81 eethumba asuswe ngotyando ngendlela ye-retrosigmoid sinus. Ngokuphathelele ixesha lotyando, ubungakanani bokususwa kwethumba, umsebenzi we-neurological emva kotyando, ukuva, njl.njl., utyando lwe-endoscopic lwalufana notyando lwe-microscopic. Ukuthelekisa iingenelo kunye nokungalungi kweendlela ezimbini zotyando, isibuko sangaphandle sifana okanye singcono kune-microscope ngokubhekiselele kumgangatho womfanekiso wevidiyo, umbono wotyando, utyando, i-ergonomics, kunye nokubandakanyeka kweqela lotyando, ngelixa ukuqonda ubunzulu kulinganiswa njengokufana okanye okungaphantsi kune-microscope.

i-exoscope kwi-Neurosurgery Teaching

Enye yezona nzuzo ziphambili zezipili zangaphandle kukuba zivumela bonke abasebenzi botyando ukuba babelane ngemifanekiso yotyando ye-3D esemgangathweni ofanayo, nto leyo evumela bonke abasebenzi botyando ukuba bathathe inxaxheba ngakumbi kwinkqubo yotyando, banxibelelane kwaye badlulisele ulwazi lotyando, benze lula ukufundisa nokukhokela imisebenzi yotyando, bandise ukubandakanyeka kokufundisa, kwaye baphucule ukusebenza kakuhle kokufundisa. Uphando lufumanise ukuba xa kuthelekiswa neemicroscopes zotyando, igophe lokufunda lezipili zangaphandle lifutshane kakhulu. Kuqeqesho lwelabhoratri lokuthunga, xa abafundi kunye noogqirha abahlala apho befumana uqeqesho kwi-endoscope kunye ne-microscope, uninzi lwabafundi lufumana kulula ukusebenza nge-endoscope. Ekufundiseni utyando lwe-craniocervical malformation, bonke abafundi bajonga izakhiwo ze-anatomical ezinemilinganiselo emithathu ngeeglasi ze-3D, bephucula ukuqonda kwabo i-anatomy ye-craniocervical malformation, bephucula umdla wabo kwimisebenzi yotyando, kwaye benciphisa ixesha loqeqesho.

Imbonakalo

Nangona inkqubo yesipili sangaphandle yenze inkqubela phambili enkulu ekusebenziseni xa kuthelekiswa neemakroskopu kunye nee-neuroendoscopes, nayo inemida yayo. Eyona ngxaki inkulu yezipili zokuqala ze-2D zangaphandle yayikukungabikho kombono we-stereoscopic ekukhuliseni izakhiwo ezinzulu, nto leyo eyachaphazela utyando kunye nokugweba ugqirha. Isipili sangaphandle esitsha se-3D siphucule ingxaki yokungabikho kombono we-stereoscopic, kodwa kwiimeko ezingaqhelekanga, ukunxiba iiglasi ezi-polarized ixesha elide kunokubangela ukungakhululeki okufana nentloko ebuhlungu kunye nesicaphucaphu kugqirha wotyando, nto leyo eyona nto iphambili ekuphuculweni kobuchwepheshe kwinqanaba elilandelayo. Ukongeza, kutyando lwe-endoscopic cranial, ngamanye amaxesha kuyimfuneko ukutshintshela kwimakroskopu ngexesha lotyando kuba ezinye izibilini zifuna i-fluorescence guided visual resection, okanye ubunzulu bokukhanya kwentsimi yotyando alwanelanga. Ukongeza, kutyando lwe-endoscopic cranial, ngamanye amaxesha kuyimfuneko ukutshintshela kwimakroskopu ngexesha lotyando kuba ezinye izibilini zifuna i-fluorescence guided visual resection, okanye ubunzulu bokukhanya kwentsimi yotyando alwanelanga. Ngenxa yeendleko eziphezulu zezixhobo ezinezihluzo ezikhethekileyo, ii-fluorescence endoscopes azikasetyenziswa kakhulu ekususweni kwe-tumor resection. Ngexesha lotyando, umncedisi umi kwindawo eyahlukileyo kugqirha oyintloko, kwaye ngamanye amaxesha ubona umfanekiso ojikelezayo. Ngokusebenzisa iziboniso ezimbini okanye ezingaphezulu ze-3D, ulwazi lomfanekiso wotyando lucutshungulwa yisoftware kwaye luboniswe kwisikrini somncedisi kwimo eguqulweyo ye-180 °, enokusombulula ngempumelelo ingxaki yokujikeleza komfanekiso kwaye yenze umncedisi akwazi ukuthatha inxaxheba kwinkqubo yotyando ngokulula ngakumbi.

Ngamafutshane, ukusetyenziswa okwandayo kweenkqubo ze-endoscopic kutyando lwe-neurospection kubonisa ukuqala kwexesha elitsha lokubona izinto ngaphakathi kotyando kutyando lwe-neurospection. Xa kuthelekiswa nee-microscopes zotyando, izibuko zangaphandle zinomgangatho ongcono womfanekiso kunye nembono yotyando, ukuma okungcono kwe-ergonomic ngexesha lotyando, ukusebenza ngcono kokufundisa, kunye nokubandakanyeka kweqela lotyando olusebenzayo, kunye neziphumo ezifanayo zotyando. Ke ngoko, kuninzi lotyando oluqhelekileyo lwe-cranial kunye nolwe-spinal, i-endoscope lukhetho olutsha olukhuselekileyo nolusebenzayo. Ngokuphucuka nophuhliso lwetekhnoloji, izixhobo ezininzi zokubona izinto ngaphakathi kotyando zinokunceda kwiinkqubo zotyando ukufezekisa iingxaki eziphantsi zotyando kunye nokuqikelela okungcono.