Ka holomua o ka hoʻohana ʻana o nā exoscopes i nā kaʻina hana neurosurgical

 

ʻO ka hoʻopili ʻana onā microscope ʻoki kinoa ua hoʻonui nui nā neuroendoscopes i ka pono o nā kaʻina hana neurosurgical, Eia nō naʻe, ma muli o kekahi mau ʻano kūlohelohe o nā lako ponoʻī, aia nō iā lākou kekahi mau palena i nā noi lapaʻau. I ka mālamalama o nā hemahema onā microscope hanaa me nā neuroendoscopes, me ka holomua ʻana i ke kiʻi kikohoʻe, ka pilina pūnaewele Wifi, ka ʻenehana pale a me ka ʻenehana optical, ua lilo ka ʻōnaehana exoscope i alahaka ma waena o nā microscopes ʻokiʻoki a me nā neuroendoscopes. Loaʻa i ka exoscope ka maikaʻi o ke kiʻi a me ke kahua ʻike ʻokiʻoki, ke kūlana ergonomic maikaʻi, ka pono o ke aʻo ʻana a me ka hoʻopili ʻana o ka hui ʻokiʻoki ʻoi aku ka maikaʻi, a ua like kona pono noi me nā microscopes strical. I kēia manawa, hōʻike nui ka palapala i nā ʻokoʻa ma waena o nā exoscopes a me nā microscopes ʻokiʻoki i nā ʻano lako hana ʻenehana e like me ka hohonu o ke kahua, ke kahua ʻike, ka lōʻihi o ka focal a me ka hana, nele i kahi hōʻuluʻulu manaʻo a me ka nānā ʻana o ka hoʻohana kikoʻī a me nā hopena ʻokiʻoki o nā exoscopes i ka neurosurgery, No laila, hōʻuluʻulu mākou i nā exoscopes noi i ka neurosurgery i nā makahiki i hala iho nei, kālailai i ko lākou mau pono a me nā palena i ka hana lapaʻau, a hāʻawi i nā kuhikuhi no ka hoʻohana ʻana i nā lāʻau lapaʻau.

Ka Mōʻaukala a me ka Hoʻomohala ʻana o nā exoscopes

Loaʻa i nā microscope ʻoki kino ka mālamalama hohonu maikaʻi loa, ke kahua ʻoki kino kiʻekiʻe, a me nā hopena kiʻi stereoscopic, hiki ke kōkua i nā kauka ʻoki kino e nānā pono i ke ʻano hohonu o nā ʻiʻo neural a me nā vascular o ke kahua ʻoki kino a hoʻomaikaʻi i ka pololei o nā hana microscopic. Eia nō naʻe, ʻo ka hohonu o ke kahua o kamicroscope ʻoki kinohe pāpaʻu a he haiki ke kahua o ka ʻike, ʻoiai ma ka hoʻonui kiʻekiʻe. Pono ke kauka lapaʻau e hoʻoikaika pinepine a hoʻoponopono i ke kihi o ka wahi i manaʻo ʻia, kahi hopena koʻikoʻi i ke ʻano o ke ʻoki ʻana; Ma ka ʻaoʻao ʻē aʻe, pono ke kauka lapaʻau e nānā a hana ma o kahi eyepiece microscope, e koi ana i ke kauka lapaʻau e mālama i kahi kūlana paʻa no ka manawa lōʻihi, hiki ke alakaʻi maʻalahi i ka luhi. I nā makahiki he ʻumi i hala iho nei, ua ulu wikiwiki ke ʻoki kino minimally invasive, a ua hoʻohana nui ʻia nā ʻōnaehana neuroendoscopic i ka neurosurgery ma muli o kā lākou mau kiʻi kiʻekiʻe, nā hopena lapaʻau maikaʻi aʻe, a me ka ʻoluʻolu o ka mea maʻi. Eia nō naʻe, ma muli o ke kahawai haiki o ke ala endoscopic a me ke alo o nā ʻano neurovascular koʻikoʻi kokoke i ke kahawai, me nā ʻano o ke ʻoki cranial e like me ka hiki ʻole ke hoʻonui a hoʻemi paha i ka lua cranial, hoʻohana nui ʻia ka neuroendoscopy no ke ʻoki kumu iwi poʻo a me ke ʻoki ventricular ma o nā ala nasal a me ka waha.

Ma muli o nā hemahema o nā microscope ʻoki kino a me nā neuroendoscopes, me ka holomua i ke kiʻi kikohoʻe, ka pilina pūnaewele WiFi, ka ʻenehana pale, a me ka ʻenehana optical, ua kū mai ka ʻōnaehana aniani waho ma ke ʻano he alahaka ma waena o nā microscope ʻoki kino a me nā neuroendoscopes. E like me ka neuroendoscopy, ʻo ka ʻōnaehana aniani waho maʻamau he aniani ʻike mamao, kahi kumu kukui, kahi kāmela wehewehe kiʻekiʻe, kahi pale hōʻike, a me kahi bracket. ʻO ke ʻano nui e hoʻokaʻawale i nā aniani waho mai ka neuroendoscopy he aniani ʻike mamao me ke anawaena o kahi 10 mm a me ka lōʻihi o kahi 140 mm. Aia kona lens ma kahi kihi 0 ° a i ʻole 90 ° i ke axis lōʻihi o ke kino aniani, me kahi laulā lōʻihi o 250-750 mm a me ka hohonu o ke kahua o 35-100 mm. ʻO ka lōʻihi o ka focal a me ka hohonu hohonu o ke kahua nā pono nui o nā ʻōnaehana aniani waho ma mua o ka neuroendoscopy.

Ua hoʻolaha ka holomua o ka ʻenehana polokalamu a me nā lako i ka hoʻomohala ʻana o nā aniani o waho, ʻoiai ka puka ʻana mai o nā aniani o waho 3D, a me nā aniani waho 3D 4K ultra high definition hou loa. Hoʻohou mau ʻia ka ʻōnaehana aniani o waho i kēlā me kēia makahiki. Ma ke ʻano o ka polokalamu, hiki i ka ʻōnaehana aniani o waho ke nānā i ka wahi ʻoki ma ka hoʻohui ʻana i ke kiʻi tensor diffusion resonance magnetic preoperative, ka hoʻokele intraoperative, a me nā ʻike ʻē aʻe, no laila e kōkua ana i nā kauka e hana i nā ʻoki pololei a palekana. Ma ke ʻano o ka lako, hiki i ke aniani o waho ke hoʻohui i ka 5-aminolevulinic acid a me nā kānana indocyanine no ka angiography, ka lima pneumatic, ka lima hana hiki ke hoʻololi ʻia, ka hoʻopuka multi screen, ka mamao o ka nānā ʻana a me ka hoʻonui nui ʻana, no laila e hoʻokō ai i nā hopena kiʻi maikaʻi aʻe a me ka ʻike hana.

Hoʻohālikelike ma waena o ka exoscope a me nā microscope ʻoki kino

Hoʻohui ka ʻōnaehana aniani waho i nā hiʻohiʻona o waho o ka neuroendoscopy me ke ʻano kiʻi o nā microscope ʻokiʻoki, e hoʻokō ana i nā ikaika a me nā nāwaliwali o kekahi, a hoʻopiha i nā hakahaka ma waena o nā microscope ʻokiʻoki a me ka neuroendoscopy. Loaʻa i nā aniani waho nā ʻano o ka hohonu hohonu o ke kahua a me ke kahua ākea o ka ʻike (ke anawaena kahua ʻokiʻoki o 50-150 mm, ka hohonu o ke kahua o 35-100 mm), e hāʻawi ana i nā kūlana kūpono loa no nā hana ʻokiʻoki hohonu ma lalo o ka hoʻonui kiʻekiʻe; Ma ka ʻaoʻao ʻē aʻe, hiki i ka lōʻihi o ke aniani waho ke hiki i 250-750mm, e hāʻawi ana i kahi mamao hana lōʻihi a me ka hoʻomaʻamaʻa ʻana i nā hana ʻokiʻoki [7]. E pili ana i ka nānā ʻana i nā aniani waho, ua ʻike ʻo Ricciardi et al. ma o ka hoʻohālikelike ʻana ma waena o nā aniani waho a me nā microscope ʻokiʻoki he like ke ʻano kiʻi o nā aniani waho, ka mana optical, a me nā hopena hoʻonui i nā microscope. Hiki i ke aniani waho ke hoʻololi koke mai kahi hiʻohiʻona microscope i kahi hiʻohiʻona macroscopic, akā i ka wā e "haiki ai ke kahawai ʻokiʻoki ma luna a ākea ma lalo" a i ʻole i ālai ʻia e nā ʻano ʻiʻo ʻē aʻe, ua kaupalena pinepine ʻia ke kahua o ka ʻike ma lalo o ka microscope. ʻO ka pōmaikaʻi o ka ʻōnaehana aniani waho, hiki iā ia ke hana i ke ʻoki kino ma ke ʻano ergonomic, e hōʻemi ana i ka manawa e nānā ai i ke kahua ʻoki kino ma o ka eyepiece microscope, a laila e hōʻemi ana i ka luhi o ke kauka i ke ʻoki kino. Hāʻawi ka ʻōnaehana aniani waho i nā kiʻi ʻoki kino 3D like i nā mea komo ʻoki kino āpau i ka wā o ke kaʻina hana ʻoki kino. ʻAe ka microscope i ʻelua mau kānaka e hana ma o ka eyepiece, ʻoiai hiki i ke aniani waho ke kaʻana like i ke kiʻi like i ka manawa maoli, e ʻae ana i nā kauka ʻoki kino he nui e hana i nā hana ʻoki kino i ka manawa like a hoʻomaikaʻi i ka pono o ke ʻoki kino ma ka kaʻana like ʻana i ka ʻike me nā limahana āpau. I ka manawa like, ʻaʻole hoʻopilikia ka ʻōnaehana aniani waho i ke kamaʻilio like ʻana o ka hui ʻoki kino, e ʻae ana i nā limahana ʻoki kino āpau e komo i ke kaʻina hana ʻoki kino.

exoscope i ke ʻoki kino neurosurgery

Ua hōʻike ʻo Gonen et al. i 56 mau hihia o ke ʻoki endoscopic glioma, ʻo 1 wale nō o ia mau hihia i loaʻa nā pilikia (ke kahe ʻana o ke koko ma kahi ʻoki) i ka wā perioperative, me ka nui o ka hanana o 1.8%. Ua hōʻike ʻo Rotermund et al. i 239 mau hihia o ke ʻoki transnasal transsphenoidal no nā adenomas pituitary, a ʻaʻole i hopena ke ʻoki endoscopic i nā pilikia koʻikoʻi; I kēia manawa, ʻaʻohe ʻokoʻa koʻikoʻi i ka manawa ʻoki, nā pilikia, a i ʻole ka laulā resection ma waena o ke ʻoki endoscopic a me ke ʻoki microscopic. Ua hōʻike ʻo Chen et al. ua wehe ʻia he 81 mau hihia o nā tumors ma o ke ʻano sinus retrosigmoid. Ma ke ʻano o ka manawa ʻoki, ke kekelē o ka resection tumor, ka hana neurological postoperative, ka lohe, a me nā mea ʻē aʻe, ua like ke ʻoki endoscopic me ke ʻoki microscopic. Ke hoʻohālikelike nei i nā pono a me nā hemahema o ʻelua mau ʻano hana ʻoki, ua like a ʻoi aku paha ke aniani waho i ka microscope ma ke ʻano o ke kiʻi wikiō, ke kahua ʻike ʻoki, ka hana, ergonomics, a me ke komo ʻana o ka hui ʻoki, ʻoiai ua helu ʻia ka ʻike hohonu he like a ʻoi aku paha i ka microscope.

exoscope ma ke aʻo ʻana i ka Neurosurgery

ʻO kekahi o nā pono nui o nā aniani waho, ʻo ia ka hiki iā lākou ke kaʻana like i nā kiʻi ʻokiʻoki 3D like, e ʻae ana i nā limahana ʻokiʻoki a pau e komo nui i ke kaʻina hana ʻokiʻoki, kamaʻilio a hoʻouna i ka ʻike ʻokiʻoki, hoʻomaʻamaʻa i ke aʻo ʻana a me ke alakaʻi ʻana i nā hana ʻokiʻoki, hoʻonui i ke komo ʻana i ke aʻo ʻana, a hoʻomaikaʻi i ka pono o ke aʻo ʻana. Ua ʻike ʻia ka noiʻi i ka hoʻohālikelike ʻia me nā microscope ʻokiʻoki, ʻoi aku ka pōkole o ke aʻo ʻana o nā aniani waho. I ke aʻo ʻana ma ka hale hana no ka suturing, i ka wā e loaʻa ai i nā haumāna a me nā kauka noho ka hoʻomaʻamaʻa ʻana ma ka endoscope a me ka microscope, ʻike ka hapa nui o nā haumāna he maʻalahi ka hana me ka endoscope. I ke aʻo ʻana i ke ʻokiʻoki malformation craniocervical, ua nānā nā haumāna a pau i nā ʻano anatomical ʻekolu-dimensional ma o nā aniani 3D, e hoʻonui ana i ko lākou ʻike i ke anatomy malformation craniocervical, e hoʻomaikaʻi ana i ko lākou hoihoi no nā hana ʻokiʻoki, a e hoʻopōkole ana i ka manawa hoʻomaʻamaʻa.

Nānā

ʻOiai ua holomua nui ka ʻōnaehana aniani waho i ka hoʻohana ʻana i hoʻohālikelike ʻia me nā microscopes a me nā neuroendoscopes, aia nō hoʻi kona mau palena. ʻO ka hemahema nui o nā aniani ʻike waho 2D mua ʻo ia ka nele o ka ʻike stereoscopic i ka hoʻonui ʻana i nā ʻano hohonu, kahi i hoʻopilikia i nā hana ʻoki a me ka hoʻoholo ʻana o ke kauka. Ua hoʻomaikaʻi ke aniani waho 3D hou i ka pilikia o ka nele o ka ʻike stereoscopic, akā i nā hihia kakaikahi, ʻo ke kau ʻana i nā aniani polarized no ka manawa lōʻihi hiki ke hoʻoulu i ka ʻoluʻolu ʻole e like me ka ʻeha poʻo a me ka nausea no ke kauka, ʻo ia ke kikowaena o ka hoʻomaikaʻi ʻenehana i ka hana aʻe. Eia kekahi, i ke ʻoki cranial endoscopic, i kekahi manawa pono e hoʻololi i kahi microscope i ka wā o ke ʻoki ʻana no ka mea pono kekahi mau puʻupuʻu i ka fluorescence guided visual resection, a i ʻole lawa ʻole ka hohonu o ka hoʻomālamalama ʻana o ke kahua ʻoki. Eia kekahi, i ke ʻoki cranial endoscopic, i kekahi manawa pono e hoʻololi i kahi microscope i ka wā o ke ʻoki ʻana no ka mea pono kekahi mau puʻupuʻu i ka fluorescence guided visual resection, a i ʻole lawa ʻole ka hohonu o ka hoʻomālamalama ʻana o ke kahua ʻoki. Ma muli o ke kumukūʻai kiʻekiʻe o nā lako me nā kānana kūikawā, ʻaʻole i hoʻohana nui ʻia nā endoscopes fluorescence no ka ʻoki ʻana o ka puʻupuʻu. I ka wā o ke ʻoki kino, kū ke kōkua ma ke kūlana ʻē aʻe i ke kauka lapaʻau nui, a i kekahi manawa ʻike i kahi kiʻi hōʻike e wili ana. Me ka hoʻohana ʻana i ʻelua a ʻoi aku paha mau hōʻike 3D, hana ʻia ka ʻike kiʻi ʻoki kino e ka polokalamu a hōʻike ʻia ma ka pale kōkua ma ke ʻano 180 ° i hoʻohuli ʻia, hiki ke hoʻoponopono pono i ka pilikia o ka hoʻohuli ʻana o ke kiʻi a hiki i ke kōkua ke komo i ke kaʻina hana me ka maʻalahi.

I ka hōʻuluʻulu manaʻo, ʻo ka hoʻonui ʻia ʻana o ka hoʻohana ʻana i nā ʻōnaehana endoscopic i loko o ka neurosurgery e hōʻike ana i ka hoʻomaka ʻana o kahi au hou o ka nānā ʻana i loko o ka neurosurgery. Ke hoʻohālikelike ʻia me nā microscopes ʻokiʻoki, ʻoi aku ka maikaʻi o ke kiʻi o nā aniani waho a me ke kahua ʻike ʻokiʻoki, ʻoi aku ka maikaʻi o ke kūlana ergonomic i ka wā o ke ʻoki ʻana, ʻoi aku ka maikaʻi o ke aʻo ʻana, a me ka komo ʻana o ka hui ʻokiʻoki ʻoi aku ka maikaʻi, me nā hopena ʻokiʻoki like. No laila, no ka hapa nui o nā ʻokiʻoki cranial a me ka spinal maʻamau, he koho palekana a maikaʻi hoʻi ka endoscope. Me ka holomua a me ka hoʻomohala ʻana o ka ʻenehana, hiki i nā mea hana ʻike intraoperative ke kōkua i nā hana ʻokiʻoki e hoʻokō i nā pilikia ʻokiʻoki haʻahaʻa a me ka prognosis maikaʻi.