ʻO ka holomua o ka noi ʻana o nā exoscopes i nā kaʻina neurosurgical

 

ʻO ka noi omicroscopes hanaa ua hoʻonui nui nā neuroendoscopes i ka maikaʻi o nā kaʻina hana neurosurgical, akā naʻe, ma muli o kekahi mau hiʻohiʻona o ka lako ponoʻī, ua paʻa lākou i kekahi mau koi i nā noi lapaʻau. Ma ke ano o na hemahema omicroscopes hanaa me nā neuroendoscopes, i hui pū ʻia me ka holomua o ka kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi kiʻi, Wifi network connectivity, ʻenehana pale a me ka ʻenehana optical, ua lilo ka ʻōnaehana exoscope i alahaka ma waena o nā microscopes a me nā neuroendoscopes. Loaʻa i ka exoscope ke kiʻi kiʻi maikaʻi a me ke kahua ʻike ʻokiʻoki, ʻoi aku ka maikaʻi o ka ergonomic posture, ka maikaʻi o ke aʻo ʻana a me ka ʻoi aku ka maikaʻi o ka hui ʻana i ka hui, a ʻo kāna noi eficacy ua like ia me nā microscopes strical. I kēia manawa, hōʻike nui ka palapala i nā ʻokoʻa ma waena o nā exoscopes a me nā microscopes surgical i nā ʻenehana ʻenehana e like me ka hohonu o ke kahua, ke kahua ʻike, ka lōʻihi a me ka hana, nele i ka hōʻuluʻulu a me ka nānā ʻana o ka applcation kikoʻī a me nā hopena surgical o exoscopes i ka neurosurgery, No laila, hōʻuluʻulu mākou i ka noiʻi exoscopes i nā makahiki i hala. hāʻawi i nā kuhikuhi no ka hoʻohana kino.

ʻO ka mōʻaukala a me ka hoʻomohala ʻana o nā exoscopes

Loaʻa i nā microscopes ʻokiʻoki i ka hoʻomālamalama hohonu maikaʻi loa, ke kahua o ka ʻokiʻoki kiʻekiʻe, a me nā hopena stereoscopic imaging, hiki ke kōkua i nā kauka lapaʻau e nānā i ke ʻano o ka neural hohonu a me ka ʻiʻo vascular o ke kahua ʻoki a hoʻomaikaʻi i ka pololei o nā hana microscopic. Eia naʻe, ka hohonu o ke kahua o kamicroscope ʻokiʻokihe pāpaʻu a he haiki ke kahua o ka ʻike, ʻoi aku ma ka hoʻonui kiʻekiʻe. Pono ke kauka lapaʻau e noʻonoʻo pinepine a hoʻoponopono i ke kihi o ka wahi i hoʻopaʻa ʻia, he hopena koʻikoʻi i ke kani ʻana; Ma kekahiʻaoʻao, pono e nānā a hana ka mea lapaʻau ma o ka microscope eyepiece, e koi ana i ke kauka e mālama i kahi kūlana paʻa no ka manawa lōʻihi, hiki ke maʻalahi i ka luhi. I nā makahiki i hala iho nei, ua hoʻomohala wikiwiki ʻia ke kāʻei liʻiliʻi 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 poʻe maʻi. Eia nō naʻe, ma muli o ke ala liʻiliʻi o ke ala endoscopic a me ka loaʻa ʻana o nā hale neurovascular koʻikoʻi kokoke i ke kahawai, i hui pū ʻia me nā hiʻohiʻona o ka ʻoki ʻana i ka cranial e like me ka hiki ʻole ke hoʻonui a hōʻemi paha i ka lua cranial, hoʻohana nui ʻia ka neuroendoscopy no ka ʻoki ʻana i ke poʻo poʻo a me ka ʻoki ventricular ma o ka nasal a me ka waha.

Hāʻawi ʻia i nā hemahema o nā microscopes a me nā neuroendoscopes, i hui pū ʻia me nā holomua i ka kiʻi kiʻi kiʻi, ka hoʻopili pūnaewele WiFi, ka ʻenehana pale, a me ka ʻenehana optical, ua puka mai ka ʻōnaehana aniani waho ma ke ʻano he alahaka ma waena o nā microscopes surgical a me neuroendoscopes. E like me ka neuroendoscopy, ʻo ka ʻōnaehana aniani o waho ka mea maʻamau i kahi aniani ʻike mamao, kahi kumu kukui, kahi kāmela wehewehe kiʻekiʻe, kahi pale hōʻike, a me kahi bracket. ʻO ka hana nui e hoʻokaʻawale i nā aniani o waho mai ka neuroendoscopy he aniani ʻike mamao me ke anawaena o kahi o 10 mm a me kahi lōʻihi o 140 mm. Aia kona lens ma kahi kihi 0 ° a i ʻole 90 ° i ka axis lōʻihi o ke kino aniani, me ka lōʻihi o ke kiko o 250-750 mm a me ka hohonu o ke kahua o 35-100 mm. ʻO ka lōʻihi lōʻihi a me ka hohonu hohonu o ke kahua ka mea nui o nā ʻōnaehana aniani o waho ma mua o ka neuroendoscopy.

ʻO ka holomua o ka lako polokalamu a me ka ʻenehana ʻenehana ua hoʻoikaika i ka hoʻomohala ʻana i nā aniani o waho, ʻoi aku ka maikaʻi o ka puka ʻana mai o nā aniani 3D o waho, a me nā aniani hōʻike kiʻekiʻe kiʻekiʻe 3D 4K. Hoʻonui mau ʻia ka ʻōnaehana aniani o waho i kēlā me kēia makahiki. Ma ke ʻano o ka lako polokalamu, hiki i ka ʻōnaehana aniani o waho ke nānā aku i ka wahi ʻokiʻoki ma o ka hoʻohui ʻana i ka preoperative magnetic resonance diffusion tensor imaging, intraoperative navigation, a me nā ʻike ʻē aʻe, e kōkua ai i nā kauka e hana 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 nui o ka pale, ka lōʻihi o ka nānā ʻana a me ka hoʻonui nui ʻana, a laila e loaʻa ai nā hopena kiʻi maikaʻi a me ka ʻike hana.

Hoʻohālikelike ma waena o ka exoscope a me nā microscopes hana

Hoʻohui ka ʻōnaehana aniani o waho i nā hiʻohiʻona o waho o ka neuroendoscopy me ka maikaʻi o ke kiʻi o nā microscopes ʻokiʻoki, e hoʻokō ana i nā ikaika a me nā nāwaliwali o kekahi, a hoʻopiha i nā āpau ma waena o nā microscopes surgical a me neuroendoscopy. Loaʻa i nā aniani o waho nā hiʻohiʻona o ka hohonu hohonu o ke kahua a me ka ākea ākea o ka nānā ʻana (ke anawaena o ke 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 o waho ke hiki i 250-750mm, e hāʻawi ana i kahi lōʻihi o ka hana a me ka hoʻomaʻamaʻa ʻana i nā hana ʻoki. E pili ana i ka nānā ʻana i nā aniani o waho, Ricciardi et al. ʻike ʻia ma o ka hoʻohālikelike ʻana ma waena o nā aniani o waho a me nā microscopes ʻokiʻoki i nā aniani o waho e like me ka maikaʻi o ke kiʻi, ka mana optical, a me nā hopena hoʻonui i nā microscopes. Hiki ke hoʻololi koke ke aniani o waho mai kahi hiʻohiʻona microscopic i kahi hiʻohiʻona macroscopic, akā i ka wā e "ʻokiʻoki ai ke kahawai ʻokiʻoki ma luna a ākea i lalo" a i ʻole ke keʻakeʻa ʻia e nā hale kikoʻī ʻē aʻe, ua kaupalena ʻia ke kahua o ka ʻike ma lalo o ka microscope. ʻO ka pōmaikaʻi o ka ʻōnaehana aniani o waho, hiki iā ia ke hana i ke kaʻina hana i kahi kūlana ergonomic ʻoi aku ka maikaʻi, e hōʻemi ana i ka manawa e nānā ai i ke kahua ʻokiʻoki ma o ka microscope eyepiece, a laila e hōʻemi i ka luhi o ke kauka. Hāʻawi ka ʻōnaehana aniani o waho i nā kiʻi ʻoki 3D maikaʻi like i nā poʻe komo ʻoki āpau i ka wā o ke kaʻina hana. ʻO ka microscope hiki i nā kānaka ʻelua ke hana ma o ka maka, ʻoiai hiki i ke aniani o waho ke kaʻana like i ke kiʻi like i ka manawa maoli, e ʻae ana i nā kauka lapaʻau he nui e hana i nā hana ʻokiʻoki i ka manawa like a hoʻomaikaʻi i ka maikaʻi o ke kaʻina hana ma o ka hāʻawi ʻana i ka ʻike me nā limahana āpau. I ka manawa like, ʻaʻole keʻakeʻa ka ʻōnaehana aniani o waho i ka kamaʻilio like ʻana o ka hui ʻokiʻoki, e ʻae ana i nā limahana hana āpau e komo i ke kaʻina hana.

exoscope i ka hana neurosurgery

ʻO Gonen et al. hōʻike 56 hihia o glioma endoscopic oki, o ka 1 wale nō hihia i complications (ke koko i loko o ka surgical wahi) i loko o ka perioperative manawa, me ka incidence ka helu o 1.8% wale nō. ʻO Rotermund et al. hōʻike 239 mau hihia o ka transnasal transsphenoids oki no ka pituitary adenomas, a me ka endoscopic hana ole i hopena i koʻikoʻi complications; I kēia manawa, ʻaʻohe ʻokoʻa koʻikoʻi i ka manawa o ke kaʻina hana, nā pilikia, a i ʻole ka wehe ʻana i waena o ke kaʻina endoscopic a me ke ʻoki microscopic. ʻO Chen et al. Ua hōʻike ʻia he 81 mau maʻi maʻi koko i wehe ʻia ma o ka retrosigmoid sinus approach. Ma ke ʻano o ka manawa o ke kaʻina hana, ka degere o ka wehe ʻana i ka tumo, ka hana neurological postoperative, ka lohe ʻana, a me nā mea ʻē aʻe, ua like ke kaʻina endoscopic me ke ʻoki microscopic. I ka hoʻohālikelike ʻana i nā pono a me nā pōʻino ʻole o nā ʻenehana hana ʻelua, ua like ka aniani o waho a ʻoi aku paha i ka microscope ma ke ʻano o ka maikaʻi o ke kiʻi wikiō, ke kahua o ka nānā ʻana, ka hana, ergonomics, a me ke komo pū ʻana o ka hui, ʻoiai ua helu ʻia ka ʻike hohonu e like a i ʻole ka haʻahaʻa i ka microscope.

exoscope i ke aʻo neurosurgery

ʻO kekahi o nā pōmaikaʻi nui o nā aniani o waho, ʻo ia ka ʻae ʻana i nā limahana hana āpau e kaʻana like i nā kiʻi 3D ʻokiʻoki like ʻole, e ʻae ana i nā limahana hana āpau e komo hou i ke kaʻina hana, kamaʻilio a hoʻouna i ka ʻike ʻoki, hoʻomaʻamaʻa i ke aʻo ʻana a me ke alakaʻi ʻana i nā hana ʻoki, hoʻonui i ke komo ʻana o ke aʻo ʻana, a hoʻomaikaʻi i ka maikaʻi o ke aʻo ʻana. Ua ʻike ʻia ka noiʻi ʻana i ka hoʻohālikelike ʻia me nā microscopes ʻokiʻoki, ʻoi aku ka pōkole o ke aʻo ʻana o nā aniani o waho. Ma ka hoʻomaʻamaʻa hoʻokolohua no ka humuhumu ʻana, ke aʻo ʻia nā haumāna a me nā kauka noho ma ka endoscope a me ka microscope, ʻoi aku ka maʻalahi o nā haumāna i ka hana me ka endoscope. Ma ke aʻo ʻana o ka craniocervical malformation oki, ʻike nā haumāna āpau i ʻekolu-dimensional anatomical structures ma o nā aniani 3D, hoʻonui i ko lākou ʻike no ka craniocervical malformation anatomy, hoʻomaikaʻi i ko lākou hoihoi no nā hana ʻokiʻoki, a hoʻopōkole i ka wā hoʻomaʻamaʻa.

Outlook

ʻOiai ua holomua nui ka ʻōnaehana aniani o waho i ka noi i hoʻohālikelike ʻia i nā microscopes a me nā neuroendoscopes, aia nō kona mau palena. ʻO ka hemahema nui loa o nā aniani nānā waho 2D mua loa, ʻo ia ka nele o ka hiʻohiʻona stereoscopic i ka hoʻonui ʻana i nā hale hohonu, e pili ana i nā hana ʻoki a me ka hoʻoholo ʻana i ke kauka. Ua hoʻomaikaʻi ka aniani hou 3D waho i ka pilikia o ka nele o ka stereoscopic hiʻohiʻona, akā i nā hihia liʻiliʻi, hiki i ke komo ʻana i nā aniani polarized no ka manawa lōʻihi ke hōʻeha i ka ʻeha e like me ke poʻo a me ka nausea no ke kauka, ʻo ia ke kumu o ka hoʻomaikaʻi ʻenehana i ka pae aʻe. Eia hou, i ka endoscopic cranial oki, i kekahi manawa pono e hoololi i ka microscope i ka wā o ka hana no ka mea, koi kekahi mau maʻi koko i ka fluorescence alakaʻi ʻike resection, a i ʻole ka hohonu o ka hoʻomālamalama ʻana o ke kahua hana ʻaʻole lawa. Eia hou, i ka endoscopic cranial oki, i kekahi manawa pono e hoololi i ka microscope i ka wā o ka hana no ka mea, koi kekahi mau maʻi koko i ka fluorescence alakaʻi ʻike resection, a i ʻole ka hohonu o ka hoʻomālamalama ʻana o ke kahua hana ʻaʻole lawa. Ma muli o ke kumukūʻai kiʻekiʻe o nā lako me nā kānana kūikawā, ʻaʻole i hoʻohana nui ʻia nā endoscope fluorescence no ka wehe ʻana i ka maʻi tumora. I ka wā o ke kaʻa ʻana, kū ka mea kōkua i ke kūlana kūʻē i ke kauka lapaʻau nui, a i kekahi manawa ʻike i kahi kiʻi hōʻikeʻike. Me ka hoʻohana ʻana i ʻelua a ʻoi aku paha nā hiʻohiʻona 3D, ua hoʻoponopono ʻia ka ʻike kiʻi kiʻi e ka polokalamu a hōʻike ʻia ma ka pale kōkua ma ke ʻano he 180 ° flipped, hiki ke hoʻoponopono pono i ka pilikia o ka hoʻololi ʻana o ke kiʻi a hiki i ke kōkua ke komo i ke kaʻina hana maʻalahi.

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