Technological Advancements uye Clinical Applications yeUltra-High-Definition Surgical Microscopes

 

Kuvhiya maikorosikopuvanoita basa rakakosha zvakanyanya muminda yemazuva ano yekurapa, kunyanya muminda-yakanyanya senge neurosurgery, ophthalmology, otolaryngology, uye kuvhiyiwa kusinganyanyi kupindira, uko kwava midziyo yakakosha. Nekugonesa kwepamusoro,Mamicroscopes anoshandainopa maonero akadzama, zvichiita kuti vavhiyi vaone zvinhu zvisingaoneki nemaziso, zvakadai setsinga dzetsinga, tsinga dzeropa, uye matishu, zvichiita kuti vanachiremba vasakuvadza nyama pavanenge vachivhiyiwa. Kunyanya mune neurosurgery, kukwidziridzwa kwepamusoro kwe microscope kunobvumira kunyatsogadziriswa kwezviputi kana zvirwere zvinorwara, kuve nechokwadi chekugadzirisa mazamu akajeka uye kudzivisa kukuvadzwa kwemitsipa yakaoma, nokudaro kuvandudza hutano hwevarwere mushure mekupora.

Mamicroscopes ekuvhiya echinyakare anowanzo kuve ane masisitimu ekuratidzira ekugadziriswa kwakajairwa, anokwanisa kupa ruzivo rwakakwana rwekuona kutsigira zvinodikanwa zvekuvhiya zvakaoma. Nekudaro, nekukurumidza kukura kwehunyanzvi hwekurapa, kunyanya kubudirira mumunda wekuona tekinoroji, mhando yekufungidzira yemamicroscopes ekuvhiya yave zvishoma nezvishoma chinhu chakakosha mukuvandudza kurongeka kwekuvhiya. Kuenzaniswa nemakorosikopu ekuvhiya echinyakare, mamicroscopes epamusoro-soro anogona kupa mamwe mashoko. Nekuunza masisitimu ekuratidzira uye ekufungidzira ane zvigadziriso zve4K, 8K, kana kunyange zvakakwirira, ultra-high-definition yekuvhiya maikorosikopu inoita kuti vavhiyi vanyatsoona uye kugadzirisa zvironda zvidiki uye zvimiro zveanatomical, zvichiwedzera kurongeka uye kuchengetedzwa kwekuvhiya. Nekuenderera mberi kwekubatanidzwa kwehunyanzvi hwekugadzira mifananidzo, hungwaru hwekugadzira, uye chokwadi chechokwadi, ultra-high-definition microscopes yekuvhiya haingonatsiridze kunaka kwekufungidzira asiwo inopa hungwaru hutsigiro hwekuvhiya, kutyaira nzira dzekuvhiya kune yakakwirira chaiyo uye yakaderera njodzi.

 

Kliniki yekushandisa ye Ultra-yakakwirira-tsanangudzo maikorosikopu

Nekuenderera mberi kwekuvandudza tekinoroji yekufungidzira, ekupedzisira-yepamusoro-tsanangudzo maikorosikopu ari kutamba zvishoma nezvishoma basa rakakosha mumakiriniki maapplication, nekuda kwekugadzirisa kwawo kwakanyanya, kunaka kwekufungidzira kwemhando yepamusoro, uye chaiyo-nguva inosimba yekutarisa kugona.

Ophthalmology

Kuvhiyiwa kwemaziso kunoda kuvhiyiwa chaiko, izvo zvinoisa maitiro ehunyanzvi epamusoroophthalmic kuvhiya maikorosikopu. Semuyenzaniso, mufemtosecond laser corneal incision, maikorosikopu yekuvhiya inogona kupa kukwidziridzwa kwepamusoro kuti utarise kamuri yepamberi, kuchekwa kwepakati pemboni yeziso, uye kutarisa nzvimbo yekuchekwa. Mukuvhiyiwa kwemaziso, kuvhenekera kwakakosha. Iyo maikorosikopu haingopi zvakanakisa zvekuona zvimiro zvine kuderera kwechiedza asi zvakare inoburitsa yakakosha mwenje tsvuku, iyo inobatsira mukuvhiya kwecataract yese. Uyezve, optical coherence tomography (OCT) inoshandiswa zvakanyanya mukuvhiya maziso ekuona pasi pevhu. Inogona kupa mifananidzo yakachinjika, ichikunda kuganhurirwa kwemaikorosikopu pachayo, iyo isingagoni kuona matishu akanaka nekuda kwekutarisa kwemberi. Somuenzaniso, Kapeller et al. yakashandisa 4K-3D kuratidzwa uye piritsi komputa kuti iratidze otomatiki dhiyagiramu yeMicroscope-integrated OCT (miOCT) (4D-miOCT). Zvichienderana nemhinduro yemushandisi, kuongororwa kwehuwandu hwekuita, uye zviyero zvakasiyana-siyana, vakaratidza kugona kwekushandisa 4K-3D kuratidza sechinzvimbo che4D-miOCT pamaikorosikopu chena. Uyezve, mukudzidza kwaLata et al., nekuunganidza zviitiko zvevarwere gumi nevatanhatu vane congenital glaucoma inoperekedzwa neziso renzombe, vakashandisa maikorosikopu ine miOCT basa kuti vaone kuvhiyiwa munguva chaiyo. Nekuongorora data rakakosha senge preoperative parameters, kuvhiyiwa, postoperative complication, yekupedzisira kuona acuity, uye corneal ukobvu, vakapedzisira varatidza kuti miOCT inogona kubatsira vanachiremba kuona zvimiro zvenyama, kugadzirisa maoparesheni, uye kuderedza njodzi yematambudziko panguva yekuvhiyiwa. Nekudaro, kunyangwe OCT zvishoma nezvishoma ichive chishandiso chine simba chekubatsira mukuvhiya kwe vitreoretinal, kunyanya muzviitiko zvakaoma uye kuvhiyiwa kwazvino (senge gene therapy), vamwe vanachiremba vanobvunza kana ichinyatso kuvandudza kushanda kwekiriniki nekuda kwekudhura kwayo uye nguva refu yekudzidza.

Otolaryngology

Otorhinolaryngology kuvhiyiwa imwe nzvimbo yekuvhiya inoshandisa maikorosikopu ekuvhiya. Nekuda kwekuvapo kwemakomba akadzika uye zvimiro zvakatetepa mumeso, kukudza uye kuvhenekera kwakakosha kune zvakabuda pakuvhiya. Kunyangwe endoscopes dzimwe nguva inogona kupa maonero ari nani enzvimbo dzakatetepa dzekuvhiya,ultra-high-definition makorosikopu ekuvhiyakupa maonero akadzama, zvichibvumira kukwidziridzwa kwenzvimbo dzakatetepa dzeanatomical senge cochlea uye sinuses, kubatsira vanachiremba mukurapa mamiriro akaita seotitis media uye nasal polyps. Somuenzaniso, Dundar et al. akaenzanisa migumisiro yemicroscope uye endoscope nzira dzekuvhiyiwa kwe stapes mukurapa otosclerosis, kuunganidza data kubva kuvarwere ve84 vakaonekwa kuti vane otosclerosis avo vakavhiyiwa pakati pe2010 ne2020. Kushandisa kuchinja kwemhepo-bone conduction kusiyana vasati vavhiyiwa uye mushure mekuvhiyiwa sechiratidzo chekuyera, zvigumisiro zvekupedzisira zvakaratidza kuti kunyange zvazvo nzira dzose dziri mbiri dzaive nemigumisiro yakafanana pakuvhiya kwekunzwa uye kudzidzira kwekunzwa kwakave nemigumisiro yenguva pfupi pakudzidza kwekunzwa. curve. Saizvozvo, mune imwe ongororo yakaitwa naAshfaq et al., timu yekutsvagisa yakaita microscope-yakabatsira parotidectomy pavarwere makumi manomwe vane parotid gland tumors pakati pa2020 na2023, vachitarisa pakuongorora basa remamicroscopes mukuzivikanwa kwetsinga dzechiso nedziviriro. Mhedzisiro yacho yakaratidza kuti maikorosikopu aive nezvakanakira zvikuru mukuvandudza kujeka kwemunda wekuvhiya, kunyatso ratidza hunde huru nematavi etsinga yechiso, kuderedza tsinga, uye hemostasis, zvichiita kuti zvive chinhu chakakosha chekusimudzira tsinga dzechiso. Uyezve, sezvo kuvhiyiwa kunowedzera kuoma uye kwakanyatsojeka, kubatanidzwa kweAR uye nzira dzakasiyana-siyana dzekufungidzira dzine maikorosikopu ekuvhiya kunoita kuti vavhiyi vakwanise kuvhiya kunotungamirirwa nemifananidzo.

Neurosurgery

Kushandiswa kweUltra-high-definitionmicroscopes yekuvhiya mune neurosurgeryyachinja kubva pakuona kwechinyakare kuenda kudigitization, augmented reality (AR), uye nerubatsiro rwehungwaru. Somuenzaniso, Draxinger et al. yakashandisa maikorosikopu yakasanganiswa neyakazvigadzira yega MHz-OCT system, ichipa yakakwirira-resolution yemativi matatu-dimensional mifananidzo kuburikidza ne 1.6 MHz scanning frequency, inobudirira kubatsira vanachiremba mukusiyanisa pakati pemamota uye hutano tishu munguva chaiyo uye kuwedzera kurongeka kwekuvhiya. Hafez et al. akaenzanisa kushanda kwechinyakare microscopes uye ultra-high-definition microsurgical imaging system (Exoscope) mukuedza cerebrovascular bypass kuvhiyiwa, kuwana kuti kunyange zvazvo microscope yakanga ine nguva shoma ye suture (P <0.001), Exoscope yakaita zviri nani maererano nekugovera suture (P = 0.001). Pamusoro pezvo, iyo Exoscope yakapa yakanyatsogadzikana yekuvhiya chimiro uye yakagovaniswa chiono, ichipa zvakanakira zvekudzidzisa. Saizvozvowo, Calloni et al. akaenzanisa mashandisirwo eExoscope uye echinyakare maikorosikopu ekuvhiya mukudzidziswa kwevanogara neurosurgery. Vagari gumi nevatanhatu vakaita kudzokorora mabasa ekucherechedzwa kwemaitiro pamhando dze cranial vachishandisa midziyo miviri. Zvigumisiro zvakaratidza kuti kunyange zvazvo pakanga pasina mutsauko mukuru munguva yose yekushanda pakati pezviviri, Exoscope yakaita zviri nani mukuziva zvivakwa zvakadzika uye yakaonekwa seine intuitive uye yakasununguka nevakawanda vatori vechikamu, ine mukana wekuva mukuru mune ramangwana. Sezviri pachena, ultra-high-definition microscopes yekuvhiya, yakagadzirirwa 4K high-definition displays, inogona kupa vose vatori vechikamu mifananidzo yekuvhiya ye 3D iri nani, kufambisa kutaurirana kwekuvhiya, kutumira ruzivo, nekuvandudza kushanda kwekudzidzisa.

Kuvhiya musana

Ultra-yakakwirira-tsanangudzomaikorosikopu ekuvhiyakuita basa rakakosha mumunda wekuvhiya musana. Nekupa yakakwirira-resolution matatu-dimensional imaging, ivo vanogonesa vavhiyi kuti vatarise yakaoma anatomical chimiro chemuzongoza zvakajeka, kusanganisira zvikamu zvisingaoneki zvakaita setsinga, tsinga dzeropa, uye mapfupa emapfupa, nokudaro vachiwedzera kurongeka uye kuchengetedzwa kwekuvhiya. Maererano nekugadzirisa scoliosis, microscopes yekuvhiya inogona kuvandudza kujekesa kwekuona kwekuvhiya uye kukwanisa kugadzirisa zvakanaka, kubatsira vanachiremba kunyatsoona maitiro e-neural uye zvirwere zvinorwara mukati memugero wakamanikana, nokudaro zvakachengeteka uye zvinobudirira kupedza decompression uye kugadzikana maitiro.

Zuva et al. akaenzanisa kushanda uye kuchengeteka kwemicroscope-inobatsira anterior cervical kuvhiyiwa uye kuvhiyiwa kwechinyakare kwakazaruka mukurapa kwe ossification ye posterior longitudinal ligament yecervical spine. Varwere makumi matanhatu vakakamurwa kuva boka rinobatsira microscope (30 kesi) uye boka rekuvhiya rechinyakare (30 kesi). Zvigumisiro zvakaratidza kuti boka rinobatsira microscope raiva nekurasikirwa kweropa kwepamusoro-soro, kugara muchipatara, uye marwadzo ekuvhiyiwa mushure mekuenzaniswa neboka rekuvhiya kwechinyakare, uye chiyero chekugadzirisa chakanga chakaderera muboka rinobatsira microscope. Saizvozvo, mukuvhiya kwepelinha fusion, Singhatanadgige et al. akaenzanisa mashandisirwo emagetsi ekuvhiya maikorosikopu uye magirazi ekusimudzira ekuvhiya mune zvishoma invasive transforaminal lumbar fusion. Chidzidzo chacho chaisanganisira varwere ve100 uye hachina kuratidza kusiyana kwakasiyana pakati pemapoka maviri ekurwadziwa kwepashure, kuvandudzwa kwebasa, kuwedzera kwepelinha, fusion rate, uye zvinetso, asi microscope yakapa nzvimbo iri nani yekuona. Pamusoro pezvo, mamicroscopes akasanganiswa neAR tekinoroji anoshandiswa zvakanyanya mukuvhiya musana. Somuenzaniso, Carl et al. yakagadzira tekinoroji yeAR muvarwere gumi vachishandisa chiratidziro chakaiswa musoro chemicroscope yekuvhiya. Mhedzisiro yacho yakaratidza kuti AR ine mukana mukuru wekushandisa mukuvhiya kwemusana, kunyanya mumamiriro ezvinhu akaoma eanatomical uye dzidzo yekugara.

 

Pfupiso uye Outlook

Kuenzaniswa nemakorosikopu ekuvhiya echinyakare, mamaikorosikopu ekuvhiya epamusoro-soro anopa zvakanakira zvakawanda, zvinosanganisira sarudzo dzekukudza kwakawanda, kupenya kwakagadzikana uye kwakajeka, masisitimu emeso chaiwo, kureba kwekushanda, uye nzvimbo dzakagadzikana dzeergonomic. Uyezve, yavo yepamusoro-resolution yekuona sarudzo, kunyanya kubatanidzwa neakasiyana ekufungidzira modhi uye AR tekinoroji, inotsigira zvinobudirira kuvhiya kunotungamirwa nemifananidzo.

Pasinei nezvakawanda zvakanakira zvekuvhiya maikorosikopu, vachiri kutarisana nematambudziko makuru. Nekuda kwehukuru hwadzo, ultra-high-definition yekuvhiya maikorosikopu inounza mamwe matambudziko ekushanda panguva yekufambisa pakati pemakamuri ekuvhiya uye intraoperative positioning, izvo zvinogona kukanganisa kuenderera uye kushanda zvakanaka kwekuvhiya. Mumakore achangopfuura, dhizaini yekugadzira maikorosikopu yakagadziridzwa zvakanyanya, ine zvitakuri zvadzo zvemaziso uye mabinocular lens barrels anotsigira akasiyana-siyana ekurerekera uye kutenderera kugadziridzwa, zvakanyanya kuwedzera kuchinjika kwekushandisa kwemidziyo uye kuita kuti chiremba anovhiya atarise uye oparesheni munzvimbo yakasarudzika uye yakasununguka. Uyezve, kuenderera mberi kwekuvandudza tekinoroji inopfekeka yekuratidzira kunopa vanachiremba vanovhiya nerutsigiro rwekuona ergonomic panguva yekuvhiyiwa kwemicrosurgical, zvichibatsira kudzikisira kuneta kwekushanda uye kuvandudza kurongeka kwekuvhiya uye kugona kwekuita kwachiremba. Nekudaro, nekuda kwekushaikwa kwechimiro chinotsigira, kugara uchitarisa zvakare kunodiwa, zvichiita kuti kugadzikana kweinopfekwa yekuratidzira tekinoroji yakaderera kune yakajairwa mamicroscopes ekuvhiya. Imwe mhinduro ndeyekushanduka kwechigadziriso chemidziyo yakanangana neminiaturization uye modularization kuti ichinje zvakanyanya kune akasiyana siyana ekuvhiya mamiriro. Nekudaro, kuderedzwa kwevhoriyamu kunowanzo sanganisira chaiyo machining maitiro uye akadhura-akabatanidzwa optical zvikamu, zvichiita kuti mutengo chaiwo wekugadzira wemidziyo udhure.

Rimwe dambudziko remakorosikopu ekuvhiya ane ultra-high-definition kutsva kweganda kunokonzerwa nekupenya kwesimba guru. Kupa maratidziro akajeka ekuona, kunyanya pamberi pevazhinji vanocherekedza kana makamera, chitubu chechiedza chinofanira kubudisa chiedza chakasimba, chinogona kupisa mutumbi wemurwere. Zvave zvichishumwa kuti ophthalmic kuvhiya maikorosikopu anogona zvakare kukonzera phototoxicity kune ocular pamusoro uye kubvarura firimu, zvichiita kuti kuderera ocular cell basa. Naizvozvo, optimize mwenje manejimendi, kugadzirisa saizi yenzvimbo uye kusimba kwechiedza zvinoenderana nekukudza uye kureba kwekushanda, kwakakosha zvakanyanya kune ekuvhiya maikorosikopu. Mune ramangwana, kufungidzira kwemaziso kunogona kuunza panoramic imaging uye matatu-dimensional reconstruction tekinoroji kuti uwedzere nzvimbo yekuona uye kunyatso dzosera matatu-dimensional marongero enzvimbo yekuvhiya. Izvi zvichaita kuti vanachiremba vanzwisise zviri nani mamiriro ezvinhu epanzvimbo yekuvhiya uye kudzivisa kurasikirwa nemashoko anokosha. Nekudaro, panoramic imaging uye matatu-dimensional kuvakazve kunosanganisira chaiyo-nguva kutora, kunyoresa, uye kuvaka patsva kwemifananidzo yakakwira-resolution, ichigadzira huwandu hukuru hwe data. Izvi zvinoisa zvakanyanya kudiwa pakubudirira kwechifananidzo chekugadzirisa algorithms, Hardware computing simba, uye masisitimu ekuchengetedza, kunyanya panguva yekuvhiya uko chaiyo-nguva kuita kwakakosha, zvichiita kuti dambudziko iri rinyanye kusimba.

Nekukurumidza kukura kwehunyanzvi hwakadai sekufungidzira kwekurapa, kungwara kwekugadzira, uye computational optics, ultra-high-definition yekuvhiya maikorosikopu yakaratidza kugona kukuru mukusimudzira kurongeka kwekuvhiya, kuchengetedzwa, uye ruzivo rwekushanda. Mune ramangwana, ultra-high-definition microscopes yekuvhiya inogona kuramba ichikura mumativi mana anotevera: (1) Panyaya yekugadzira michina, miniaturization uye modularization inofanira kuwanikwa pamutengo wakaderera, zvichiita kuti kushandiswa kwekliniki kukuru kugoneke; (2) Gadzira mamwe maitiro ekugadzirisa chiedza chepamusoro kugadzirisa nyaya yekukuvara kwechiedza kunokonzerwa nekuvhiyiwa kwenguva refu; (3) Dhizaina akangwara ebetsero algorithms ari ese ari maviri chaiwo uye akareruka kusangana ne computational kuita zvinodiwa zvemidziyo; (4) Batanidza zvakadzama AR uye marobhoti ekuvhiya masisitimu kuti ape rutsigiro rwepuratifomu yekudyidzana kure, kushanda chaiko, uye otomatiki maitiro. Muchidimbu, ultra-high-definition microscopes yekuvhiya inoshanduka kuita yakakwana yekuvhiya yekubatsira sisitimu inobatanidza kuwedzera kwemufananidzo, kucherechedzwa kwehungwaru, uye inodyidzana mhinduro, zvichibatsira kuvaka dhijitari ecosystem yekuvhiya mune ramangwana.

Ichi chinyorwa chinopa mucherechedzo wekufambira mberi muakajairwa matekinoroji e-ultra-high-definition yekuvhiya maikorosikopu, ine tarisiro pakushandisa kwavo nekusimudzira mukuvhiya. Nekukwidziridzwa kwekugadziriswa, e-ultra-high-definition maikorosikopu ari kuita basa rakakosha muminda yakadai seyeurosurgery, ophthalmology, otolaryngology, uye kuvhiyiwa kwemusana. Kunyanya, kubatanidzwa kweiyo intraoperative precision navigation tekinoroji mukuvhiya kusinganyanyi kupinza kwakasimudza iko kurongeka uye kuchengetedzeka kwemaitiro aya. Tichitarisa kumberi, sezvo hungwaru hwekugadzira uye hunyanzvi hwemarobhoti huchifambira mberi, mamicroscopes epamusoro-soro anozopa rubatsiro rwakanyanya uye nehungwaru hwekuvhiya, kusimudzira kufambira mberi kwekuvhiya kusinganyanyi kupindira uye kubatana kuri kure, nokudaro zvichiwedzera kusimudzira kuchengetedzwa kwekuvhiya uye kugona.