Gukemura ibibazo bya Endoscopi yubuvuzi mugusuzuma no kuvura Neurosirurgie

1 break Impinduka zimpinduramatwara mu gihanga no kubaga ikibyimba cya pituito

(1) Kubaga Neuroendoscopic transnasal transsphenoidal kubaga (EEA)

Ihungabana ry'ikoranabuhanga:

Nta buryo bwo gutemagura: Kuraho ikibyimba unyuze mu mazuru asanzwe kugirango wirinde gukwega ubwonko mugihe cya craniotomy.

Sisitemu ya 4K-3D ya endoskopi (nka Storz IMAGE 1 S 3D): Itanga uburebure bwa 16 m m bwimyumvire yumurima kugirango itandukanye imbibi za microadenoma ya pituito.

Amakuru y’ubuvuzi:

(2) Fluorescent yogukoresha endoscope

5-ALA fluorescent labels:

Gutegura umunwa mbere ya acide aminolevulinic yateje fluorescence itukura mu ngirabuzimafatizo (nka Zeiss Pentero 900).

Igipimo rusange cyo kwanga glioblastoma cyavuye kuri 36% kigera kuri 65% (NEJM 2023).

2 treatment Kuvura byibuze kuvura ibikomere byubwonko bwimbitse kandi bwimbitse

(1) Fistula ya gatatu ya Neuroendoscopic (ETV)

Ibyiza bya tekiniki:

3mm endoskopi yumuyoboro umwe wokuvura hydrocephalus ibuza.

Kugereranya kubaga amashanyarazi ya ventricular: kwirinda ubuzima bwawe bwose kwirinda shunt, kugabanya ubwandu kuva 15% kugeza 1%.

Ibikoresho bishya:

Guhindura umuvuduko wa ballon catheter: kugenzura-igihe nyacyo cyo gutembera kwa stoma mugihe cyo kubagwa (nka Neurovent-P).

(2) Endoskopi yafashijwe gukuraho amaraso yubwonko

Iterambere ry'ikoranabuhanga:

Munsi yidirishya ryamagufwa ya 2cm, endoscopic visual visualisation ikoreshwa mugukuraho hematoma (nka sisitemu ya Karl Storz MINOP).

Ikigereranyo cyo gukuraho hematoma muri basal ganglia kirenze 90%, kandi igipimo cyo kuzamura amanota ya GCS nyuma yibikorwa kiri hejuru ya 40% ugereranije n’amazi yo gucukura.

3 intervention Kwivanga kwa endoskopi yindwara zubwonko

(1) Endoskopi ifasha gukuramo aneurysm

Ibyingenzi bya tekinike:

Itegereze igice cyinyuma cy ijosi ryikibyimba hamwe na 30 ° endoskopi kugirango wirinde gutungurwa kubwimpanuka yimitsi yababyeyi (nka Olympus NSK-1000).

Igipimo cyuzuye cyo gufunga inyuma ya arteri aneurysms yavuye kuri 75% igera kuri 98%.

(2) Endoscopic vascular bypass graft

STA-MCA anastomose:

2mm ultra-nziza endoskopi ifasha kudoda ifite ubwiyongere bwa 12% ugereranije na microscopique.

4 treatment Kuvura neza muri neurosurgie ikora

(1) Endoskopi yafashijwe gushiramo DBS

Guhanga udushya mu ikoranabuhanga:

Igihe nyacyo endoskopi yitegereza intego (nka STN nuclei), gusimbuza intangiriro ya MRI igenzura.

Ikosa rya electrode yo gukuraho abarwayi ba Parkinson barwaye munsi ya 0.3mm (kubaga gakondo ni nka 1mm).

(2) Endoscopic decompression ya trigeminal neuralgia

Microvascular decompression (MVD):

Binyuze muburyo bwa 2cm urufunguzo, endoskopi yerekanaga ingingo zamakimbirane yimitsi, kandi igipimo cyiza cya decompression cyari 92%.

5 Technology Ikoranabuhanga ryubwenge nogukoresha

(1) AR neural navigation endoscope

Gushyira mu bikorwa tekinike:

Kimwe na Brainlab Ibintu AR, amakuru ya DICOM ateganijwe mugihe nyacyo cyo kubaga.

Mu kubaga craniopharyngioma, kumenya neza ibimenyetso bya pitoito ni 100%.

(2) Sisitemu yo kuburira AI

Kumenyekanisha imitsi AI:

Kimwe na Holosight ya Surgalign, ihita iranga imiyoboro itobora mumashusho ya endoskopi kugirango igabanye impanuka.

(3) Sisitemu yo gufata indorerwamo

Indorerwamo ifata robot:

Kimwe na NeuroArm ya Johnson Medical, ikuraho guhinda umushyitsi kubaga kandi itanga ubunini bwa 20x bwishusho.

6 direction Icyerekezo cy'ikoranabuhanga kizaza

Molecular imaging endoscopy:

Fluorescent nanoparticles yibasira antibodiyite ya CD133 kugirango yandike ingirabuzimafatizo ya glioma.

Biodegradable stent yafashijwe kurema fistula:

Magnesium alloy stent ikomeza kwihanganira fistula ya gatatu ya ventricle kandi ikinjira nyuma y'amezi 6.

Endogenopi ya optogenetike:

Gukurura urumuri rwubururu rwa neuron yahinduwe genetique yo kuvura igicuri cyangiritse (icyiciro cyubushakashatsi bwinyamaswa).

Imbonerahamwe yo Kugereranya Inyungu

Ibyifuzo byingamba zo gushyira mubikorwa

Pituitar Tumor Centre: Kubaka icyumba gikoreramo cya EEA + intraoperative MRI.

Igice cyindwara zifata ubwonko: zifite ibikoresho bya endoscope fluorescence angiography sisitemu eshatu.

Ubushakashatsi bwibanze: Gukora inzitizi yubwonko bwamaraso yinjira muri endoskopi fluorescent probe.

Izi tekinoloji zirasunika kubaga neurosurgie mugihe "kitari igitero" binyuze mubintu bitatu byingenzi: kwangirika kwa zeru, kwangirika kwa milimetero, no kubungabunga imikorere ya physiologiya. Biteganijwe ko mu 2030, 70% yo kubaga ibihanga bya gihanga bizarangira hakoreshejwe uburyo bwa endoskopique.