Kufambira mberi kwekushandiswa kwe exoscopes mukuvhiyiwa kwetsinga

 

Kushandiswa kwemaikorosikopu ekuvhiyauye neuroendoscopes zvakawedzera kushanda kwenzira dzekuvhiya dzetsinga. Kunyange zvakadaro, nekuda kwehunhu hwemidziyo yacho pachayo, ine zvimwe zvinonetsa pakushandisa mukurapa. Nekuda kwekushomeka kwemaikorosikopu ari kushandauye neuroendoscopes, pamwe chete nekufambira mberi mukufungidzira kwedhijitari, kubatana kweWifi network, tekinoroji yechidzitiro uye tekinoroji yemaziso, sisitimu ye exoscope yavepo sebhiriji pakati pemamaikorosikopu ekuvhiya nemaneuroendoscopes. Exoscope ine kunaka kwemufananidzo kwepamusoro uye nzvimbo yekuona yekuvhiya, chimiro chiri nani che ergonomic, kushanda zvakanaka kwekudzidzisa pamwe nekubatanidzwa kwechikwata chekuvhiya kunoshanda zvakanyanya, uye kushanda kwayo kwakafanana nekwemamaikorosikopu e strical. Parizvino, zvinyorwa zvinonyanya kutaura nezvekusiyana kuripo pakati peexoscopes nemamaikorosikopu ekuvhiya muzvinhu zvehunyanzvi zvakaita sekudzika kwemunda, nzvimbo yekuona, kureba kwenzvimbo uye mashandiro, pasina pfupiso uye kuongororwa kwekushandiswa kwakananga uye mhedzisiro yekuvhiya kwema exoscopes mukuvhiya kwetsinga. Saka, tinopfupikisa ma exoscopes ekushandiswa mukuvhiya kwetsinga mumakore achangopfuura, tinoongorora zvakanakira uye zvisingakwanisike mukurapa, uye tinopa mareferensi ekushandiswa kwecinical.

Nhoroondo neKubudirira kweExoscopes

Mamaikorosikopu ekuvhiya ane chiedza chakadzika kwazvo, nzvimbo yekuona yekuvhiya ine resolution yepamusoro, uye mhedzisiro yemifananidzo ye stereoscopic, izvo zvinogona kubatsira vanachiremba kuona chimiro chetsinga dzetsinga netsinga dzeropa dzenzvimbo yekuvhiya zvakajeka uye kuvandudza kururama kwekuvhiya kwe microscopic. Zvisinei, kudzika kwenzvimbo yemaikorosikopu yekuvhiyaNzvimbo yacho haina kudzika uye nzvimbo yacho yakamanikana, kunyanya pakukura kwakanyanya. Chiremba anofanira kuramba achitarisa uye achigadzirisa kona yenzvimbo yaanoda kuvhiyiwa, izvo zvine simba guru pakuita kwekuvhiyiwa; Kune rumwe rutivi, chiremba anofanira kutarisa nekushandisa eyepiece ye microscope, zvichida kuti chiremba arambe akagadzikana kwenguva yakareba, izvo zvinogona kukonzera kuneta. Mumakumi emakore apfuura, kuvhiyiwa kusinganyanyi kupindira kwakakurumidza kukura, uye masisitimu e neuroendoscopic ave achishandiswa zvakanyanya mukuvhiyiwa kwetsinga nekuda kwemifananidzo yavo yepamusoro, mhedzisiro iri nani yekiriniki, uye kugutsikana kwakanyanya kwemurwere. Zvisinei, nekuda kwenzira yakamanikana ye endoscopic uye kuvapo kwezvimiro zvakakosha zvetsinga pedyo nechiteshi, pamwe chete nehunhu hwekuvhiyiwa kwetsinga dzakadai sekusakwanisa kuwedzera kana kudzikamisa cranial cavity, neuroendoscopy inonyanya kushandiswa pakuvhiyiwa kwedehenya uye kuvhiyiwa kweventricular kuburikidza nenzira dzemhino nemuromo.

Zvichienderana nekushaikwa kwema microscope ekuvhiya uye neuroendoscopes, pamwe chete nekufambira mberi mukufungidzira kwedhijitari, kubatana kweWiFi network, tekinoroji yechidzitiro, uye tekinoroji yemaziso, sisitimu yegirazi rekunze yave iri bhiriji pakati pema microscope ekuvhiya uye neuroendoscopes. Kufanana ne neuroendoscopy, sisitimu yegirazi rekunze inowanzo kuve negirazi rekuona zviri kure, sosi yechiedza, kamera ine tsananguro yepamusoro, skrini yekuratidzira, uye bracket. Chimiro chikuru chinosiyanisa magirazi ekunze ne neuroendoscopy igirazi rekuona zviri kure rine dhayamita yeinenge 10 mm uye kureba kweinenge 140 mm. Lenzi yaro iri pakona ye0 ° kana 90 ° kune axis refu yemuviri wegirazi, ine urefu hwe250-750 mm uye kudzika kwemunda we35-100 mm. Kureba kwefocal uye kudzika kwakadzika kwemunda ndizvo zvakanakira masisitimu egirazi rekunze kupfuura neuroendoscopy.

Kufambira mberi kwetekinoroji yesoftware nehardware kwakakurudzira kugadzirwa kwemagirazi ekunze, kunyanya kubuda kwemagirazi ekunze e3D, pamwe nemagirazi ekunze e3D 4K azvino uno. Sisitimu yegirazi rekunze inogara ichivandudzwa gore rega rega. Panyaya yesoftware, sisitimu yegirazi rekunze inogona kuona nzvimbo yekuvhiyiwa nekubatanidza preoperative magnetic resonance diffusion tensor imaging, intraoperative navigation, nedzimwe ruzivo, nokudaro zvichibatsira vanachiremba kuita maoparesheni akanyatsojeka uye akachengeteka. Panyaya yehardware, girazi rekunze rinogona kubatanidza 5-aminolevulinic acid uye indocyanine filters ye angiography, pneumatic arm, adjustable operating handle, multi screen output, long focusing distance uye larger magnification, nokudaro zvichiita kuti mifananidzo ive nani uye ruzivo rwekushanda.

Kuenzanisa pakati pe exoscope nema microscope ekuvhiya

Sisitimu yegirazi rekunze inosanganisa zvinhu zvekunze zve neuroendoscopy nehunhu hwemufananidzo wemamaikorosikopu ekuvhiya, zvichizadzisa simba neutera hweumwe neumwe, uye zvichizadza mipata iri pakati pemaikorosikopu ekuvhiya ne neuroendoscopy. Magirazi ekunze ane hunhu hwekudzika kwakadzika kwemunda uye nzvimbo yakafara yekuona (dhayamita yemunda wekuvhiya ye50-150 mm, kudzika kwemunda we35-100 mm), zvichipa mamiriro ari nyore kwazvo ekuvhiya kwakadzika pasi pekukwidziridzwa kwakanyanya; Kune rumwe rutivi, kureba kwegirazi rekunze kunogona kusvika 250-750mm, zvichipa daro refu rekushanda uye zvichiita kuti kuvhiyiwa kuve nyore [7]. Nezvekuona magirazi ekunze, Ricciardi et al. vakawana kuburikidza nekuenzanisa magirazi ekunze nemamaikorosikopu ekuvhiya kuti magirazi ekunze ane hunhu hwemufananidzo hwakafanana, simba rekuona, uye mhedzisiro yekuwedzera kuenda kumamaikorosikopu. Girazi rekunze rinogonawo kuchinja nekukurumidza kubva pakuona kwemakrosikopu kuenda pakuona kwemakrosikopu, asi kana nzira yekuvhiya "yakamanikana kumusoro uye yakafara pasi" kana kuti yakavharirwa nezvimwe zvimiro zvenyama, nzvimbo yekuona iri pasi pemaikorosikopu inowanzo shomeka. Chinhu chakanaka chegadziriro yegirazi rekunze ndechekuti inogona kuita kuvhiya nenzira iri nyore, ichideredza nguva inopedzwa ichiona nzvimbo yekuvhiya kuburikidza negirazi remaziso remaikorosikopu, nokudaro ichideredza kuneta kwachiremba pakuvhiya. Sisitimu yegirazi rekunze inopa mifananidzo yekuvhiya ye3D yakafanana kune vese vanovhiya panguva yekuvhiya. Maikorosikopu inobvumira vanhu vanosvika vaviri kushanda negirazi remaziso, nepo girazi rekunze richigona kugovera mufananidzo mumwe chete panguva chaiyo, zvichibvumira vanachiremba vakawanda kuita maoparesheni ekuvhiya panguva imwe chete uye kuvandudza kushanda zvakanaka kwekuvhiya nekugovana ruzivo nevashandi vese. Panguva imwe chete, sisitimu yegirazi rekunze haikanganisi kutaurirana kwechikwata chekuvhiya, zvichibvumira vashandi vese vekuvhiya kutora chikamu mukuvhiya.

exoscope mukuvhiyiwa kweneurosurgery

Gonen nevamwe vake vakataura nezvezviitiko makumi mashanu nematanhatu zvekuvhiyiwa kweglioma endoscopic, uko mumwe chete wavo aive nematambudziko (kubuda ropa munzvimbo yekuvhiyiwa) panguva yekuvhiyiwa, nehuwandu hwekuwanikwa kwe1.8% chete. Rotermund nevamwe vake vakataura nezvezviitiko mazana maviri nemakumi matatu nemapfumbamwe zvekuvhiyiwa kwetransphenoidal transnasal yepituitary adenomas, uye kuvhiyiwa kwe endoscopic hakuna kukonzera matambudziko akakomba; Panguva iyi, pakanga pasina musiyano wakakosha munguva yekuvhiyiwa, matambudziko, kana kubviswa kwemasero pakati pekuvhiyiwa kwe endoscopic nekuvhiyiwa kwe microscopic. Chen nevamwe vake vakataura kuti zviitiko makumi masere nerimwe zvemamota zvakabviswa nekuvhiyiwa kuburikidza ne retrosigmoid sinus approach. Panyaya yenguva yekuvhiyiwa, huwandu hwebundu rekuvhiyiwa, mashandiro etsinga mushure mekuvhiyiwa, kunzwa, nezvimwewo, kuvhiyiwa kwe endoscopic kwakafanana nekuvhiyiwa kwe microscopic. Tichienzanisa zvakanakira nekuipa kwemaitiro maviri ekuvhiya, girazi rekunze rakafanana kana kuti rakakwirira pane microscope maererano nemhando yemufananidzo wevhidhiyo, nzvimbo yekuvhiya, kuvhiyiwa, ergonomics, uye kutora chikamu kwechikwata chekuvhiya, nepo kunzwisisa kwakadzama kuchionekwa sekufanana kana kuderera kune microscope.

exoscope muKudzidzisa nezveNeurosurgery

Chimwe chezvakanakira zvikuru zvemagirazi ekunze ndechekuti anobvumira vashandi vese vekuvhiya kuti vagovane mifananidzo yakafanana ye3D yekuvhiya, zvichibvumira vashandi vese vekuvhiya kuti vatore chikamu chakafanana mukuvhiya, kutaurirana nekutumira ruzivo rwekuvhiya, kuita kuti kudzidzisa nekutungamira maoparesheni ekuvhiya kuve nyore, kuwedzera kudzidzisa, uye kuvandudza kushanda kwekudzidzisa. Tsvagiridzo yakawana kuti kana tichienzanisa nemamaikorosikopu ekuvhiya, curve yekudzidza yemagirazi ekunze ipfupi. Mukudzidziswa kwerabhoritari kwekusunga, apo vadzidzi nevanachiremba vanogara vachidzidziswa pa endoscope ne microscope, vadzidzi vazhinji vanoona zviri nyore kushandisa endoscope. Mukudzidzisa kuvhiya kwecraniocervical malformation, vadzidzi vese vakaona maumbirwo emuviri ane mativi matatu kuburikidza nemagirazi e3D, zvichiwedzera kunzwisisa kwavo anatomy yecraniocervical malformation, zvichivandudza kufarira kwavo maoparesheni ekuvhiya, uye kupfupisa nguva yekudzidzira.

Maonero

Kunyangwe sisitimu yegirazi rekunze yafambira mberi zvikuru mukushandiswa kwayo zvichienzaniswa nemamaikorosikopu nemaneuroendoscopes, inewo miganhu yayo. Dambudziko guru remagirazi ekutanga e2D external view glasses kwaive kushaikwa kwekuona kwe stereoscopic mukuwedzera zvivakwa zvakadzika, izvo zvakakanganisa kuvhiyiwa uye kutonga kwechiremba. Girazi idzva re3D external girazi rakagadzirisa dambudziko rekushaya kuona kwe stereoscopic, asi mune zvisingawanzoitiki, kupfeka magirazi ane polarized kwenguva yakareba kunogona kukonzera kusagadzikana senge musoro uye kuda kurutsa kuna chiremba, inova ndiyo pfungwa yekuvandudza tekinoroji padanho rinotevera. Pamusoro pezvo, mukuvhiyiwa kwe endoscopic cranial, dzimwe nguva zvinodikanwa kuchinjira kumakrosikopu panguva yekuvhiyiwa nekuti mamwe mabundu anoda fluorescence guided visual resection, kana kudzika kwe surgical field lighting hakuna kukwana. Pamusoro pezvo, mukuvhiyiwa kwe endoscopic cranial, dzimwe nguva zvinodikanwa kuchinjira kumakrosikopu panguva yekuvhiyiwa nekuti mamwe mabundu anoda fluorescence guided visual resection, kana kudzika kwe surgical field lighting hakuna kukwana. Nekuda kwemutengo wakakwira wemidziyo ine mafirita akakosha, fluorescence endoscopes haisati yashandiswa zvakanyanya pakubvisa bundu. Panguva yekuvhiyiwa, mubatsiri anomira panzvimbo yakatarisana nachiremba mukuru wekuvhiya, uye dzimwe nguva anoona mufananidzo unotenderera. Uchishandisa zviratidziro zviviri kana kupfuura zve3D, ruzivo rwemufananidzo wekuvhiya runogadziriswa nesoftware uye rwunoratidzwa pachiratidziro chemubatsiri muchimiro chakapindurwa 180 °, izvo zvinogona kugadzirisa dambudziko rekutenderera kwemufananidzo zvinobudirira uye zvinoita kuti mubatsiri akwanise kutora chikamu mukuvhiya zviri nyore.

Muchidimbu, kushandiswa kuri kuwedzera kwema endoscopic systems mukuvhiya kwetsinga kunomiririra kutanga kwenguva itsva yekuona mukati mekuvhiya muuropi. Zvichienzaniswa nema microscope ekuvhiya, magirazi ekunze ane mufananidzo uri nani uye maonero ekuvhiya ari nani, chimiro chiri nani panguva yekuvhiya, kushanda zvakanaka kwekudzidzisa, uye kutora chikamu kwechikwata chekuvhiya kunoshanda, uye mhedzisiro yakafanana yekuvhiya. Naizvozvo, kune akawanda ma surgeries e cranial ne spinal, endoscope isarudzo itsva yakachengeteka uye inoshanda. Nekufambira mberi nekuvandudzwa kwetekinoroji, maturusi akawanda ekuona mukati mekuvhiya anogona kubatsira mukuvhiya kuti pave nematambudziko mashoma ekuvhiya uye fungidziro iri nani.