Igisubizo kibangamiye endoskopi yubuvuzi mugupima no kuvura indwara zo munda

1 break Iterambere ridahwitse murwego rwo gusuzuma

1. Wireless Capsule Endoscopy (WCE)

Guhungabanya: Gukemura byimazeyo "ikibanza gihumye" cyo gusuzuma amara mato hanyuma usimbuze ubwoko bubabaza bwo gusunika ubwoko buto bwo mu mara endoscope.

Kuzamura tekinike:

AI yafashije kwisuzumisha: nka PillCam SB3 ya Given Imaging, ifite tekinoroji yo kugereranya imiterere, AI ihita yerekana ingingo ziva amaraso / ibisebe (sensitivite> 90%).

Magnetic igenzurwa na capsule gastroscopy (nka NaviCam yo muri Anhan Technology): kugenzura neza kuzunguruka kwa capsule kumurima wa magnetiki yo hanze ituma hasuzumwa neza igifu, kandi ukuri kwipimisha hakiri kare kanseri yigifu bigereranywa na gastroscopi gakondo (> 92%).

Biopsy capsule (icyiciro cyubushakashatsi): nka micro clamp capsule yakozwe nitsinda ryubushakashatsi bwa koreya yepfo, rishobora kugenzurwa kure kugirango ritangwe.

2. Ubwenge bwanditse bwa tekinoroji ya endoskopi

Kwerekana amashusho ya Narrowband (NBI):

Ihame: 415nm / 540nm urumuri rugufi rwongera urumuri rwimitsi itandukanye.

Ingaruka zibangamira: Igipimo cyo kumenya kanseri yo mu gifu cya mbere cyavuye kuri 45% muri endoskopi yumucyo usanzwe igera kuri 89% (ukurikije igipimo cy’Ubuyapani JESDS).

Guhuza amashusho (LCI):

Ibyiza: Algorithm ya Fuji yemewe ifite 30% yo kumenyekana cyane kuri gastrite yimbere na metaplasia yo munda ugereranije na NBI.

3. Laser Endoscopy ya Confocal (pCLE)

Ikimenyetso cya tekiniki: Diameter ya probe ni 1,4mm gusa (nka sisitemu ya Cellvizio), igera kurwego nyarwo rwo kwitegereza kurwego rwo hejuru inshuro 1000.

Agaciro ka Clinical:

Kumenyekanisha ako kanya dysrettia ya Barrett's esophageal kugirango wirinde biopsies.

Agaciro keza ko guhanura mugukurikirana ibisebe bya colitis kanseri yo mu bwoko bwa 98%.

2 solutions Ibisubizo byimpinduramatwara murwego rwo kuvura

1. Gutandukanya endoskopique mucosal (ESD)

Iterambere ry'ikoranabuhanga:

Icyuma cyamashanyarazi ya Bipolar (nka FlushKnife BT): kwinjiza saline bigabanya ibyago byo gutobora.

CO ₂ laser yafashijwe: guhumeka neza kurwego rwa subucosal, ubwinshi bwamaraso <5ml.

Amakuru y’ubuvuzi:

Igipimo cyo kuvura kanseri yo mu gifu kare kirenga 95%, naho imyaka 5 yo kubaho igereranywa no kubaga gakondo (hejuru ya 90%).

Ubushakashatsi bwa DDW muri Amerika bwerekana ko igipimo rusange cyo kwandura ibibyimba bikura bikura (LST) birenze 3cm ni 91%.

2. Kubaga Endoskopique ikoresheje cavite karemano (ICYITONDERWA)

Uburyo bwo kubaga abahagarariye:

Cholecystectomy ya transgastricike: Olympus TriPort ikoreshwa na endoskopi myinshi, kandi ibiryo bikoreshwa nyuma yamasaha 24 nyuma yo kubagwa.

Transpendal appendectomy: Ikipe ya koreya yepfo ivuga ikibazo cyambere cyatsinze isi muri 2023.

Ibikoresho by'ibanze: Igice cyuzuye gifunze clamp (nka OTSC) ®） Gukemura ikibazo gikomeye cya ICYITONDERWA - gufunga umwobo.

3. Endoskopi yuzuye-yuzuye (EFTR)

Icyerekezo cyerekana: Kuvura ibibyimba byo mu nda (GIST) bikomoka kumitsi yimbere.

Urufunguzo rwa tekinike: Laparoscopic endoscopic kubaga hamwe (LECS) irinda umutekano.

Ibikoresho bishya byo kudoda (nka OverStitch) ™） Menya neza ubudodo bwuzuye.

3 Scheme Gahunda ihuriweho yo gusuzuma no kuvura ibibyimba

1. Endoskopi iyobowe na radiofrequency gukuraho (EUS-RFA)

Umuti wa kanseri yandura: Urushinge rwa 19G rwinjijwe mu iperereza rya RF, kandi igipimo cy’ibanze cyari 73% (≤ 3cm ikibyimba).

Ugereranije no kubaga kumugaragaro, igipimo cyo kugabanuka cyaragabanutse kiva kuri 35% kigera kuri 8%. Gukoresha kanseri y'umwijima: Gukuraho Duodenal ibibyimba muri caudate lobe y'umwijima.

2. Kubagwa kwa Fluorescent kubaga endoskopi

Ikoreshwa rya label ya tekinoroji: Gutera inshinge mbere yo gutangira, hafi ya infrarafarike ya endoskopi (nka Olympus OE-M) kugirango yerekane amazi ya lymphatike. Ubwuzure bwa lymph node gutandukana mugihe cyo kubaga kanseri yo munda byongerewe 27%.

Intego ya fluorescente igerageza (icyiciro cyubushakashatsi): nka MMP-2 enzyme yitabira ibisubizo, byumwihariko kuranga metastase nto.

4 Guhanga udushya mubihe byihutirwa kandi byitaweho

1. Amaraso akomeye ya gastrointestinal

Ifu ya Hemostray hemostatike:

Mugihe cyo gutera endoskopi, hashyizweho inzitizi ya mashini, hamwe na hemostasis igipimo cya 92% (Amaraso ya Forrest Grade Ia).

Hejuru ya Clip Clip (OTSC):

O "Bear Claw" igishushanyo, gufunga ibisebe hamwe na diameter ya 3cm.

2. Endoscopic decompression yo guhagarika amara

Kwiyongera kwicyuma (SEMS):

Ubuvuzi bwikiraro kuburibwe bubi, hamwe nubutabazi burenga 90% mumasaha 48.

Gukata lazeri nshya (nka Niti-S) ™） Kugabanya igipimo cya 5%.

5 direction Icyerekezo cy'ikoranabuhanga kizaza

1. AI sisitemu yo gufata ibyemezo mugihe nyacyo:

Kimwe na Cosmo AI ™ Mu buryo bwikora menya umuvuduko wo gukuramo mugihe cyo gusuzuma colonoscopi, kugabanya adenoma yabuze kwisuzumisha (ADR yiyongereyeho 12%).

2. Impanuka ya capsule endoscope:

Magnesium alloy frame + polylactic aside shell, yashonga mumubiri mugihe cyamasaha 72 nyuma yo kugenzurwa.

3. Micro robot endoscope:

"Origami robot" yo muri ETH Zurich irashobora gutezwa imbere muburyo bwo kubaga icyitegererezo.

Imbonerahamwe yo Kugereranya Imbonerahamwe

Ibitekerezo byo gushyira mubikorwa

Ibitaro byatsi: Ibyingenzi bigomba guhabwa umwanya wo guha ibikoresho bya magnetiki capsule gastroscopy + sisitemu ya hemostatike ya OTSC.

Ibitaro byo mu cyiciro cya gatatu: Birasabwa gushinga ikigo cya ESD + EUS-RFA cyita ku barwayi ba kanseri byibasiye.

Icyerekezo cyubushakashatsi: Wibande kuri pathologiya ya AI isesengura-nyaryo + endoskopi yangiza.

Izi tekinoroji zirimo kubaka paradigima yo gusuzuma no kuvura indwara zifata igifu binyuze munzira eshatu zingenzi: zidatera, zisobanutse, kandi zifite ubwenge. Porogaramu nyayo igomba guhuzwa no gutandukanya abarwayi kugiti cyabo no kubona ibikoresho byubuvuzi.