Intuthuko yokusetshenziswa kwe-exoscopes ezinqubweni zokuhlinzwa kwezinzwa

 

Ukusetshenziswa kweama-microscope okuhlinzwakanye ne-neuroendoscopes kuthuthukise kakhulu ukusebenza kahle kwezinqubo zokuhlinzwa kwemizwa. Noma kunjalo, ngenxa yezici ezithile ezingokwemvelo zemishini ngokwayo, inemingcele ethile ekusetshenzisweni kwemitholampilo. Ngenxa yokushoda kweama-microscope asebenzayokanye nama-neuroendoscope, kanye nokuthuthuka kwezithombe zedijithali, ukuxhumana kwenethiwekhi ye-Wifi, ubuchwepheshe besikrini kanye nobuchwepheshe bokubona, uhlelo lwe-exoscope seluvele lukhona njengebhuloho phakathi kwama-microscope okuhlinzwa kanye nama-neuroendoscope. I-exoscope inekhwalithi ephezulu yesithombe kanye nensimu yokubuka yokuhlinzwa, ukuma okungcono kwe-ergonomic, ukusebenza kahle kokufundisa kanye nokuzibandakanya kweqembu lokuhlinzwa okuphumelelayo, futhi ukusebenza kwayo kahle kufana nokwe-strical microscopes. Njengamanje, izincwadi zibika kakhulu ukungafani phakathi kwama-exoscope kanye nama-microscope okuhlinzwa ezicini zemishini yobuchwepheshe njengokujula kwensimu, insimu yokubuka, ubude bokugxila kanye nokusebenza, okungenaso isifinyezo kanye nokuhlaziywa kokusetshenziswa okuthile kanye nemiphumela yokuhlinzwa yama-exoscopes ekuhlinzeni nge-neurosurgery. Ngakho-ke, sifingqa ama-exoscope okusetshenziswa ekuhlinzeni nge-neurosurgery eminyakeni yamuva, sihlaziya izinzuzo zawo kanye nemikhawulo ekusebenzeni kwezokwelapha, futhi sinikeza izinkomba zokusetshenziswa kwe-cinical.

Umlando kanye Nokuthuthukiswa Kwezinto Ezingabonakali

Ama-microscope okuhlinza anokukhanya okujulile okuhle kakhulu, umbono wensimu yokuhlinza onesinqumo esiphezulu, kanye nemiphumela yokuthwebula izithombe ze-stereoscopic, okungasiza odokotela abahlinzayo ukuthi babone isakhiwo sezicubu ezijulile zemithambo yegazi kanye nemithambo yegazi yensimu yokuhlinza ngokucacile futhi bathuthukise ukunemba kokuhlinzwa kwe-microscope. Kodwa-ke, ukujula kwensimu ye-imakroskopu yokuhlinzwaayijulile futhi insimu yokubuka incane, ikakhulukazi lapho ikhuliswa kakhulu. Udokotela ohlinzayo udinga ukugxila ngokuphindaphindiwe futhi alungise i-engeli yendawo okuqondiswe kuyo, okunomthelela omkhulu esigqini sokuhlinzwa; Ngakolunye uhlangothi, udokotela ohlinzayo udinga ukubuka nokusebenza nge-eyepiece yesibonakhulu, okudinga ukuthi udokotela ohlinzayo agcine ukuma okuqondile isikhathi eside, okungaholela kalula ekukhathaleni. Emashumini ambalwa eminyaka edlule, ukuhlinzwa okuncane okungavamile kuye kwathuthuka ngokushesha, futhi izinhlelo ze-neuroendoscopic ziye zasetshenziswa kabanzi ekuhlinzeni izinzwa ngenxa yezithombe zazo ezisezingeni eliphezulu, imiphumela engcono yezokwelapha, kanye nokwaneliseka okuphezulu kwesiguli. Kodwa-ke, ngenxa yomzila omncane wendlela ye-endoscopic kanye nokuba khona kwezakhiwo ezibalulekile ze-neurovascular eduze komzila, kuhlanganiswe nezici zokuhlinzwa kwe-cranial njengokungakwazi ukwandisa noma ukunciphisa umgodi we-cranial, i-neuroendoscopy isetshenziswa kakhulu ekuhlinzeni isisekelo sekhanda kanye nokuhlinzwa kwe-ventricular ngezindlela zekhala nezomlomo.

Ngenxa yokushiyeka kwama-microscope okuhlinzwa kanye nama-neuroendoscope, kuhlangene nentuthuko ekuthathweni kwezithombe zedijithali, ukuxhumana kwenethiwekhi ye-WiFi, ubuchwepheshe besikrini, kanye nobuchwepheshe bokubona, uhlelo lwesibuko sangaphandle luye lwavela njengebhuloho phakathi kwama-microscope okuhlinzwa kanye nama-neuroendoscope. Ngokufanayo ne-neuroendoscopy, uhlelo lwesibuko sangaphandle luvame ukuba nesibuko sokubona kude, umthombo wokukhanya, ikhamera ecacile, isikrini sokubonisa, kanye ne-bracket. Isakhiwo esiyinhloko esihlukanisa izibuko zangaphandle ne-neuroendoscopy yisibuko sokubona kude esinobubanzi obungaba ngu-10 mm kanye nobude obungaba ngu-140 mm. Ilensi yalo ikwi-angle engu-0 ° noma engu-90 ° kuya ku-axis ende yomzimba wesibuko, enobubanzi obuqondile obungu-250-750 mm kanye nokujula kwensimu engu-35-100 mm. Ubude obude obuqondile kanye nokujula kwensimu kuyizinzuzo ezibalulekile zezinhlelo zesibuko sangaphandle kune-neuroendoscopy.

Ukuthuthuka kwesofthiwe nobuchwepheshe behadiwe kukhuthaze ukuthuthukiswa kwezibuko zangaphandle, ikakhulukazi ukuvela kwezibuko zangaphandle ze-3D, kanye nezibuko zangaphandle zakamuva ze-3D 4K ultra high definition. Uhlelo lwesibuko sangaphandle luvuselelwa njalo minyaka yonke. Ngokuphathelene nesofthiwe, uhlelo lwesibuko sangaphandle lungabona indawo yokuhlinza ngokuhlanganisa i-preoperative magnetic resonance diffusion tensor imaging, i-intraoperative navigation, kanye nolunye ulwazi, ngaleyo ndlela kusize odokotela benze ukuhlinzwa okunembile nokuphephile. Ngokuphathelene nehadiwe, isibuko sangaphandle singahlanganisa izihlungi ze-5-aminolevulinic acid kanye ne-indocyanine ze-angiography, ingalo yomoya, isibambo sokusebenza esilungisekayo, ukuphuma kwesikrini esiningi, ibanga elide lokugxila kanye nokukhulisa okukhulu, ngaleyo ndlela kufezwe imiphumela engcono yesithombe kanye nesipiliyoni sokusebenza.

Ukuqhathanisa phakathi kwe-exoscope nama-microscope okuhlinzwa

Uhlelo lwesibuko sangaphandle luhlanganisa izici zangaphandle ze-neuroendoscopy nekhwalithi yesithombe sama-microscope okuhlinzwa, luhambisana namandla nobuthakathaka bomunye nomunye, futhi lugcwalisa izikhala phakathi kwama-microscope okuhlinzwa kanye ne-neuroendoscopy. Izibuko zangaphandle zinezici zokujula okujulile kwensimu kanye nensimu ebanzi yokubuka (ububanzi bensimu yokuhlinza obungu-50-150 mm, ukujula kwensimu engu-35-100 mm), zinikeza izimo ezilula kakhulu zokuhlinzwa okujulile ngaphansi kokukhulisa okuphezulu; Ngakolunye uhlangothi, ubude obuqondile besibuko sangaphandle bungafinyelela ku-250-750mm, okuhlinzeka ngebanga elide lokusebenza futhi kube lula ukuhlinzwa [7]. Ngokuphathelene nokuboniswa kwezibuko zangaphandle, uRicciardi et al. bathole ngokuqhathanisa phakathi kwezibuko zangaphandle nama-microscope okuhlinzwa ukuthi izibuko zangaphandle zinekhwalithi yesithombe efanayo, amandla okukhanya, kanye nemiphumela yokukhulisa iye kuma-microscope. Isibuko sangaphandle singashintsha ngokushesha sisuka embonweni omncane siye embonweni omkhulu, kodwa lapho isiteshi sokuhlinzwa "sincane phezulu futhi sibanzi phansi" noma sivinjwe ezinye izakhiwo zezicubu, insimu yokubuka ngaphansi kwe-microscope ivame ukulinganiselwa. Inzuzo yesistimu yesibuko sangaphandle ukuthi ingenza ukuhlinzwa ngendlela ehlelekile, inciphise isikhathi esichithwa ukubuka insimu yokuhlinzwa nge-eyepiece ye-microscope, ngaleyo ndlela inciphise ukukhathala kokuhlinzwa kukadokotela. Uhlelo lwesibuko sangaphandle lunikeza izithombe zokuhlinzwa ze-3D ezisezingeni elifanayo kubo bonke abahlanganyeli bokuhlinzwa ngesikhathi senqubo yokuhlinzwa. I-microscope ivumela abantu ababili ukuthi basebenze nge-eyepiece, kuyilapho isibuko sangaphandle singabelana ngesithombe esifanayo ngesikhathi sangempela, okuvumela odokotela abaningi ukuba benze imisebenzi yokuhlinzwa ngesikhathi esisodwa futhi kuthuthukiswe ukusebenza kahle kokuhlinzwa ngokwabelana ngolwazi nabo bonke abasebenzi. Ngesikhathi esifanayo, uhlelo lwesibuko sangaphandle aluphazamisi ukuxhumana kwethimba lokuhlinzwa, okuvumela bonke abasebenzi bokuhlinzwa ukuthi bahlanganyele enqubweni yokuhlinzwa.

i-exoscope ekuhlinzeni kwe-neurosurgery

UGonen nabanye babike amacala angu-56 okuhlinzwa kwe-glioma endoscopic, lapho icala elilodwa kuphela elalinezinkinga (ukopha endaweni yokuhlinzwa) ngesikhathi sokuhlinzwa, ngesilinganiso sokuvela kwe-1.8% kuphela. URotermund nabanye babike amacala angu-239 okuhlinzwa kwe-transphenoidal transnasal kwama-adenoma e-pituitary, kanti ukuhlinzwa kwe-endoscopic akuzange kubangele izinkinga ezinkulu; Okwamanje, bekungekho mehluko omkhulu esikhathini sokuhlinzwa, izinkinga, noma ububanzi bokususwa phakathi kokuhlinzwa kwe-endoscopic kanye nokuhlinzwa kwe-microscopic. UChen nabanye babike ukuthi amacala angu-81 amathumba asuswe ngokuhlinzwa ngendlela ye-retrosigmoid sinus. Ngokuphathelene nesikhathi sokuhlinzwa, izinga lokususwa kwe-tumor, umsebenzi wezinzwa ngemuva kokuhlinzwa, ukuzwa, njll., ukuhlinzwa kwe-endoscopic kwakufana nokuhlinzwa kwe-microscopic. Uma kuqhathaniswa izinzuzo kanye nokungalungi kwamasu amabili okuhlinzwa, isibuko sangaphandle sifana noma siphakeme kune-microscope ngokwekhwalithi yesithombe sevidiyo, umbono wensimu yokuhlinzwa, ukusebenza, i-ergonomics, kanye nokubamba iqhaza kwethimba lokuhlinzwa, kuyilapho ukuqonda okujulile kulinganiswa njengokufana noma okuphansi kune-microscope.

i-exoscope ekufundiseni ngokuhlinzwa kwe-Neurosurgery

Enye yezinzuzo eziyinhloko zezibuko zangaphandle ukuthi zivumela bonke abasebenzi abahlinzayo ukuthi babelane ngezithombe ezifanayo zokuhlinzwa ze-3D, okuvumela bonke abasebenzi abahlinzayo ukuthi bahlanganyele kakhulu enkambisweni yokuhlinzwa, baxhumane futhi badlulisele ulwazi lokuhlinzwa, benze lula ukufundisa kanye nokuqondiswa kwemisebenzi yokuhlinzwa, bandise ukuhlanganyela kokufundisa, futhi bathuthukise ukusebenza kahle kokufundisa. Ucwaningo luthole ukuthi uma kuqhathaniswa nama-microscope okuhlinzwa, ijika lokufunda lezibuko zangaphandle lifushane kakhulu. Ekuqeqeshweni kwelabhorethri kokuthunga, lapho abafundi kanye nodokotela abahlala khona bethola ukuqeqeshwa kokubili ku-endoscope kanye ne-microscope, iningi labafundi likuthola kulula ukusebenza nge-endoscope. Ekufundiseni ukuhlinzwa kokukhubazeka kwe-craniocervical, bonke abafundi babheka izakhiwo zomzimba ezinezinhlangothi ezintathu ngokusebenzisa izibuko ze-3D, bathuthukisa ukuqonda kwabo nge-anatomy yokukhubazeka kwe-craniocervical, bathuthukisa intshiseko yabo yokuhlinzwa, futhi banciphise isikhathi sokuqeqeshwa.

I-Outlook

Nakuba uhlelo lwesibuko sangaphandle seluthuthuke kakhulu ekusetshenzisweni uma kuqhathaniswa nama-microscope nama-neuroendoscope, nalo lunemikhawulo yalo. Inkinga enkulu yezibuko zokuqala zangaphandle ze-2D kwakuwukuntuleka kombono we-stereoscopic ekukhuliseni izakhiwo ezijulile, okwathinta ukuhlinzwa kanye nokwahlulela kodokotela. Isibuko sangaphandle esisha se-3D sithuthukise inkinga yokuntuleka kombono we-stereoscopic, kodwa ezimweni ezingavamile, ukugqoka izibuko ezi-polarized isikhathi eside kungabangela ukungakhululeki njengekhanda elibuhlungu kanye nesicanucanu kudokotela ohlinzayo, okuwukugxila kokuthuthukiswa kobuchwepheshe esinyathelweni esilandelayo. Ngaphezu kwalokho, ekuhlinzeni kwe-endoscopic cranial, ngezinye izikhathi kuyadingeka ukushintshela kuma-microscope ngesikhathi sokuhlinzwa ngoba amanye ama-tumors adinga ukususwa okuqondiswa yi-fluorescence, noma ukujula kokukhanya kwensimu yokuhlinzwa akwanele. Ngaphezu kwalokho, ekuhlinzeni kwe-endoscopic cranial, ngezinye izikhathi kuyadingeka ukushintshela kuma-microscope ngesikhathi sokuhlinzwa ngoba amanye ama-tumors adinga ukususwa okuqondiswa yi-fluorescence, noma ukujula kokukhanya kwensimu yokuhlinzwa akwanele. Ngenxa yezindleko eziphezulu zemishini enezihlungi ezikhethekile, ama-endoscope e-fluorescence awakasetshenziswa kabanzi ekususweni kwe-tumour. Ngesikhathi sokuhlinzwa, umsizi umi endaweni ephambene nodokotela ohlinzayo oyinhloko, futhi ngezinye izikhathi ubona isithombe sokubonisa esijikelezayo. Kusetshenziswa izibonisi ezimbili noma ngaphezulu ze-3D, ulwazi lwesithombe sokuhlinza lucutshungulwa yisofthiwe bese luboniswa esikrinini somsizi ngesimo esingu-180 ° esiphendukile, esingaxazulula ngempumelelo inkinga yokujikeleza kwesithombe futhi senze umsizi akwazi ukuhlanganyela enkambisweni yokuhlinzwa kalula.

Ngamafuphi, ukusetshenziswa okwandayo kwezinhlelo ze-endoscopic ekuhlinzeni nge-neurospection kumele ukuqala kwenkathi entsha yokubona ngeso lengqondo ngaphakathi kokuhlinzwa ekuhlinzeni nge-neurospection. Uma kuqhathaniswa nama-microscope okuhlinzwa, izibuko zangaphandle zinekhwalithi engcono yesithombe kanye nombono wensimu yokuhlinzwa, ukuma okungcono kwe-ergonomic ngesikhathi sokuhlinzwa, ukusebenza kahle kokufundisa, kanye nokubamba iqhaza kweqembu lokuhlinzwa okuphumelelayo, kanye nemiphumela efanayo yokuhlinzwa. Ngakho-ke, ekuhlinzeni okuvamile kwe-cranial kanye nomgogodla, i-endoscope iyindlela entsha ephephile nephumelelayo. Ngokuthuthuka kanye nentuthuko yobuchwepheshe, amathuluzi amaningi okubona ngeso lengqondo ngaphakathi kokuhlinzwa angasiza ekusebenzeni kokuhlinzwa ukuze kufezwe izinkinga eziphansi zokuhlinzwa kanye nokubikezela okungcono.