Kufambira mberi kwekushandiswa kwe exoscopes mune neurosurgical maitiro

 

Kushandiswa kwemaikorosikopu ekuvhiyauye neuroendoscopes yakawedzera kushanda kweneurosurgical maitiro, Zvakadaro, nekuda kwehumwe hunhu hwemichina pachayo, vane zvimwe zvipingaidzo mukushandiswa kwekiriniki. ln chiedza chekushomeka kwekushanda maikorosikopuuye neuroendoscopes, pamwe chete nekufambira mberi kwekufungidzira kwedhijitari, Wifi network yekubatanidza, tekinoroji yekrini uye tekinoroji yemaziso, iyo exoscope system yave sebhiriji pakati pekuvhiya maikorosikopu uye neuroendoscopes. Iyo exoscope ine yepamusoro yemufananidzo quaity uye yekuvhiya yekuona nzvimbo, zviri nani ergonomic posture, kudzidzisa kushanda pamwe nekunyatsoshanda kwechikwata chekuvhiya kubatanidzwa, uye kushanda kwayo kwekushandisa kwakafanana neiyo strical maikorosikopu. Parizvino, zvinyorwa zvinonyanya kutaura kusawirirana pakati peexoscopes uye ma microscopes ekuvhiya mune technicaequipment maficha akadai kudzika kwemunda, nzvimbo yekuona, kureba uye kushanda, kushaya pfupiso uye kuongororwa kweiyo chaiyo applcation uye yekuvhiya mhedzisiro ye exoscopes mune neurosurgery, nekudaro, isu tinopfupisa mashandisiro avakaita mumakore achangoburwa, neurosurgery uye kupfupika kwavo. zvipimo mukuita kwekiriniki, uye kupa mareferensi ekushandiswa kwecinical.

Iyo Nhoroondo uye Kukudziridzwa kwe exoscopes

Maikorosikopu ekuvhiya ane kupenya kwakadzikama kwakanakisa, nzvimbo yekuvhiya yakakwira-resolution, uye stereoscopic imaging effects, izvo zvinogona kubatsira vanachiremba vanovhiya kuti vaone yakadzika neural uye vascular tissue structure yemunda wekuvhiya zvakajeka uye kuvandudza kururamisa kwemaitiro emicroscopic. Zvisinei, kudzika kwemunda wekuvhiya maikorosikopuhaina kudzika uye nzvimbo yekuona yakamanikana, kunyanya pakukwidziridzwa kwepamusoro. Chiremba anovhiya anoda kudzokorodza kutarisa uye kugadzirisa kona yenzvimbo inotarirwa, iyo ine simba rakakura pane rhythm yekuvhiya; Kune rumwe rutivi, chiremba anovhiya anofanira kutarisa uye kushanda kuburikidza ne microscope eyepiece, inoda kuti chiremba anovhiya arambe akamira kwenguva yakareba, izvo zvinogona kutungamirira kuneta nyore nyore. Mumakumi mashoma emakore apfuura, kuvhiyiwa kusinganyanyi kukuvadza kwakakurumidza kugadzirwa, uye neuroendoscopic masisitimu akashandiswa zvakanyanya muurosurgery nekuda kwemifananidzo yavo yepamusoro, mhedzisiro yekiriniki iri nani, uye kugutsikana kwemurwere kwakanyanya. Nekudaro, nekuda kweiyo nhete chiteshi cheiyo endoscopic nzira uye kuvapo kweakakosha neurovascular zvimiro padyo negwara, pamwe nehunhu hwekuvhiyiwa kwecranial sekutadza kuwedzera kana kutetepa mhango, neuroendoscopy inonyanya kushandiswa pakuvhiya dehenya uye kuvhiyiwa kweventricular kuburikidza nemhino nemuromo.

Tichifunga nezvekukanganisa kwemakorosikopu ekuvhiya uye neuroendoscopes, pamwe nekufambira mberi mukufungidzira kwedhijitari, WiFi network yekubatanidza, tekinoroji yekirini, uye tekinoroji yemaziso, iyo yekunze girazi system yabuda sebhiriji pakati pekuvhiya maikorosikopu uye neuroendoscopes. Zvakafanana neuroendoscopy, iyo yekunze girazi system kazhinji ine girazi rinoona kure, mwenje sosi, yakakwirira-tsanangudzo kamera, skrini yekuratidzira, uye bracket. Chimiro chikuru chinosiyanisa magirazi ekunze kubva neuroendoscopy girazi rekuona kure rine dhayamita ingangoita 10 mm uye kureba ingangoita 140 mm. Lens yaro iri pa 0 ° kana 90 ° angle kusvika kureba axis yemuviri wegirazi, ine focal kureba renji 250-750 mm uye kudzika kwemunda kwe35-100 mm. Iyo yakareba yakatarisa kureba uye kudzika kwakadzika kwemunda ndiwo akakosha mabhenefiti ekunze egirazi masisitimu pamusoro neuroendoscopy.

Kufambira mberi kwesoftware uye tekinoroji yehardware yakasimudzira kuvandudzwa kwezvionioni zvekunze, kunyanya kubuda kwe3D ekunze magirazi, pamwe neazvino 3D 4K yekupedzisira tsanangudzo yekunze magirazi. Iyo yekunze girazi system inogara ichivandudzwa gore rega rega. Panyaya yesoftware, iyo yekunze girazi system inogona kuona nzvimbo yekuvhiya nekubatanidza preoperative magnetic resonance diffusion tensor imaging, intraoperative navigation, uye rumwe ruzivo, zvichibatsira vanachiremba kuita mavhiya chaiwo uye akachengeteka. Nezve hardware, girazi rekunze rinogona kubatanidza 5-aminolevulinic acid uye indocyanine filters for angiography, pneumatic arm, inogadziriswa kushandiswa kwekubata, multi screen output, yakareba kutarisa kure uye kukura kukuru, nokudaro kuwana migumisiro yemifananidzo iri nani uye ruzivo rwekushanda.

Kuenzanisa pakati peexoscope uye microscopes yekuvhiya

Iyo yekunze yegirazi sisitimu inosanganisa ekunze maficha euroendoscopy nemhando yemufananidzo wemakorosikopu ekuvhiya, achizadzisa masimba emumwe neutera, uye kuzadza maburi pakati pemakorosikopu ekuvhiya uye neuroendoscopy. Magirazi ekunze ane hunhu hwekudzika kwakadzika kwemunda uye nzvimbo yakafara yekuona (yekuvhiya dhayamita ye50-150 mm, kudzika kwemunda we35-100 mm), ichipa zvakanyanya nyore mamiriro ekuvhiya kwakadzika pasi pekukudza kukuru; Kune rimwe divi, kureba kwegirazi rekunze kunogona kusvika 250-750mm, ichipa chinhambwe chekushanda chakareba uye kufambisa kuvhiya [7]. Nezvekuonekwa kwemagirazi ekunze, Ricciardi et al. inowanikwa kuburikidza nekuenzanisa pakati pezvionioni zvekunze uye maikorosikopu ekuvhiya kuti magirazi ekunze ane mufananidzo wemhando, simba rekuona, uye magnification maitiro kune maikorosikopu. Girazi rekunze rinogonawo kukurumidza kushandura kubva kune microscopic maonero kune macroscopic maonero, asi apo nzira yekuvhiya "yakatetepa kumusoro uye yakafara pasi" kana kuti yakavharwa nemamwe masikirwo emasikirwo, nzvimbo yekuona pasi pe microscope inowanzogumira. Kubatsira kwekunze kwegirazi system ndeyekuti inogona kuita kuvhiyiwa mune imwe ergonomic posture, ichideredza nguva inopedzerwa yekuona nzvimbo yekuvhiya kuburikidza nemaikorosikopu eyepiece, nekudaro kuderedza kuneta kwekuvhiya kwechiremba. Iyo yekunze girazi sisitimu inopa yakafanana mhando 3D yekuvhiya mifananidzo kune vese vatori vechikamu pakuvhiya panguva yekuvhiya. Iyo microscope inobvumira kusvika kune vanhu vaviri kuti vashande kuburikidza nemaziso, nepo girazi rekunze rinogona kugovera mufananidzo wakafanana munguva chaiyo, zvichibvumira vanachiremba vakawanda kuti vaite mavhiya panguva imwe chete uye kuvandudza kushanda kwekuvhiya kuburikidza nekugovana ruzivo nevashandi vose. Panguva imwecheteyo, iyo yekunze girazi system haikanganisi kutaurirana kwechikwata chekuvhiya, zvichibvumira vese vashandi vekuvhiya kuti vatore chikamu mukuvhiya.

exoscope mukuvhiya neurosurgery

Gonen et al. yakashuma 56 zviitiko zve glioma endoscopic kuvhiyiwa, iyo chete 1 nyaya yakanga ine matambudziko (kubuda ropa munzvimbo yekuvhiya) munguva yeperioperative nguva, ine chiitiko che 1.8 chete%. Rotermund et al. yakashuma 239 zviitiko zve transnasal transsphenoidal kuvhiyiwa kwepituitary adenomas, uye endoscopic kuvhiyiwa hakuna kukonzera matambudziko akakomba; Zvichakadaro, pakanga pasina mutsauko wakakosha munguva yekuvhiya, matambudziko, kana resection renji pakati pekuvhiya endoscopic uye kuvhiyiwa kwemicroscopic. Chen et al. yakashuma kuti 81 nyaya dzemamota dzakavhiyiwa dzakabviswa kuburikidza neiyo retrosigmoid sinus nzira. Panyaya yekuvhiya nguva, dhigirii rekubvisa bundu, postoperative neurological function, kunzwa, nezvimwewo, endoscopic kuvhiyiwa kwakafanana nekuvhiyiwa kwemicroscopic. Kuenzanisa zvakanakira nekuipa kwemaitiro maviri ekuvhiya, girazi rekunze rakafanana kana rakakwirira kune microscope maererano nemhando yemufananidzo wevhidhiyo, nzvimbo yekuvhiya yekuona, kuvhiyiwa, ergonomics, uye kubatanidzwa kwechikwata chekuvhiya, nepo kudzika kwekuona kunonzi kwakafanana kana kwakaderera kune microscope.

exoscope muNeurosurgery Kudzidzisa

Chimwe chezvakanakira magirazi ekunze ndechekuti vanobvumira vese vashandi vekuvhiya kuti vagovane mhando imwechete yemifananidzo yekuvhiya ye3D, vachibvumira vese vanovhiya kuti vatore chikamu zvakanyanya mukuvhiya, kutaurirana uye kutumira ruzivo rwekuvhiya, kufambisa kudzidzisa uye kutungamira kwekuvhiya, kuwedzera kutora chikamu chekudzidzisa, uye kuvandudza kushanda kwekudzidzisa. Tsvagiridzo yakawana kuti kana ichienzaniswa nemaikorosikopu ekuvhiya, curve yekudzidza yemagirazi ekunze ipfupi. Murabhoritari yekudzidzira suturing, apo vadzidzi nevarapi vanogara vachiwana kudzidziswa pane ese endoscope uye maikorosikopu, vadzidzi vazhinji vanoona zviri nyore kushanda ne endoscope. Mukudzidzisa kwekuvhiya kwecraniocervical malformation, vadzidzi vese vakacherekedza matatu-dimensional anatomical zvimiro kuburikidza ne3D magirazi, vachiwedzera kunzwisisa kwavo kwecraniocervical malformation anatomy, kuvandudza kwavo kufarira kwekuvhiya, uye kupfupisa nguva yekudzidziswa.

Outlook

Kunyangwe iyo yekunze girazi system yakaita kufambira mberi kwakanyanya mukushandisa kana ichienzaniswa nemamicroscopes uye neuroendoscopes, ine zvakare yainogumira. Chinhu chikuru chekudzokera shure kwekutanga kwe2D kunze kwekuona magirazi kwaive kushaikwa kwechiratidzo chestereoscopic mukukudza zvimiro zvakadzika, izvo zvakakanganisa kuvhiya uye kutonga kwachiremba. Iyo itsva 3D yekunze girazi yakavandudza dambudziko rekushaikwa kwechiratidzo che stereoscopic, asi muzviitiko zvisingawanzo, kupfeka magirazi epolarized kwenguva yakareba kunogona kukonzera kusagadzikana senge musoro uye kusvotwa kwechiremba anovhiya, iyo inotarisisa yekuvandudza kwehunyanzvi mudanho rinotevera. Uye zvakare, mukuvhiya kwe endoscopic cranial, dzimwe nguva zvinodikanwa kuchinja kune maikorosikopu panguva yekuvhiya nekuti mamwe mabundu anoda fluorescence inotungamirwa yekuona resection, kana kudzika kwekuvhenekesa kwemunda wekuvhiya hakuna kukwana. Uye zvakare, mukuvhiya kwe endoscopic cranial, dzimwe nguva zvinodikanwa kuchinja kune maikorosikopu panguva yekuvhiya nekuti mamwe mabundu anoda fluorescence inotungamirwa yekuona resection, kana kudzika kwekuvhenekesa kwemunda wekuvhiya hakuna kukwana. Nekuda kwemutengo wakakwira wemidziyo ine akakosha mafirita, fluorescence endoscopes haisati yave kushandiswa zvakanyanya pakubvisa bundu. Panguva yekuvhiyiwa, mubatsiri anomira panzvimbo yakatarisana nemukuru wechiremba, uye dzimwe nguva anoona mufananidzo unotenderera unotenderera. Uchishandisa maviri kana anopfuura 3D kuratidza, iyo yekuvhiya mufananidzo ruzivo inogadziriswa nesoftware uye inoratidzwa pachiratidziro chemubatsiri mune yakapepetwa 180 ° fomu, iyo inogona kunyatsogadzirisa dambudziko rekutenderera kwemufananidzo uye kuita kuti mubatsiri atore chikamu mukuvhiya zviri nyore.

Muchidimbu, kuwedzera kwekushandiswa kwe endoscopic system mu neurosurgery inomiririra kutanga kwenguva itsva yekuona intraoperative yekuona neurosurgery. Kuenzaniswa nema microscopes ekuvhiya, magirazi ekunze ane chimiro chemufananidzo uye nzvimbo yekuvhiya yekuona, zviri nani ergonomic posture panguva yekuvhiyiwa, kudzidzisa zviri nani kubudirira, uye kunyatsoshanda kwechikwata chekuvhiya, nemigumisiro yakafanana yekuvhiya. Naizvozvo, kune akajairika cranial uye musana uye musana, endoscope isarudzo yakachengeteka uye inoshanda nyowani. Nekufambira mberi uye kusimudzira tekinoroji, mamwe maturusi ekuona emukati anogona kubatsira mukuvhiya kuti uwane kuderera kwekuvhiya matambudziko uye zviri nani kufungidzira.