Disruptive Solution Of Medical Endoscope Mu Kuyingirira Enkola Y'okussa

1、 Enkyukakyuka mu tekinologiya w’okuzuula obulwadde

1. Okukebera empewo mu masanyalaze (ENB) .

Disruptive: Okukola ku kusoomoozebwa okuzuula peripheral pulmonary nodules (≤ 2cm), omuwendo gw’abalina biopsy positivity gweyongedde okuva ku 30% mu bronchoscopy ey’ekinnansi okutuuka ku bitundu ebisukka mu 80%.

Tekinologiya Omukulu:

CT three-dimensional reconstruction+electromagnetic positioning: nga Veran Medical’s SPiN Thoracic Navigation System, esobola okulondoola ekifo ky’ebikozesebwa mu kiseera ekituufu (nga ensobi eri wansi wa mm 1).

Okuliyirira entambula y’okussa: SuperDimension TM Enkola eno emalawo okukosebwa kw’okusengulwa kw’okussa okuyita mu kuteeka mu kifo kya 4D.

Ebikwata ku bujjanjabi:

Obutuufu bw’okuzuula ebizimba by’amawuggwe ebya mm 8-10 buli 85% (okunoonyereza kwa Chester 2023).

Okukebera amangu obutoffaali mu kifo (ROSE) okugatta kuyinza okukendeeza ku budde bw’okulongoosa ebitundu 40%.

2. Okukebera ennyindo nga bayambibwako roboti

Enkola y’okukiikirira abantu:

Monarch Platform (Auris Health): Omukono gwa roboti ogukyukakyuka gutuuka ku 360 ° steering okutuuka ku 8th to 9th level bronchi.

Ion (Intuitive): 2.9mm ultra-fine catheter+shape sensing tekinologiya, ng’obutuufu bw’okuboola bwa mm 1.5.

Ebirungi ebirimu:

Omutindo gw’obuwanguzi mu kufuna ebizimba okuva mu kitundu eky’okungulu eky’amawuggwe gwongezeddwa okutuuka ku bitundu 92% (bw’ogeraageranya n’ebitundu 50% byokka ku microscopy ey’ekinnansi).

Okukendeeza ku bizibu nga pneumothorax (omuwendo gw’ebizibu<2%).

3. Okukebera endwadde za layisi eziyitibwa Confocal Laser Endoscopy (pCLE) .

Ekikulu mu by’ekikugu: Cellvizio ® Probe ya 100 μ m esobola okulaga ensengekera y’ennywanto mu kiseera ekituufu (okusalawo kwa 3.5 μ m).

Ensonga z’okusaba:

Enjawulo ey’amangu wakati wa kookolo w’amawuggwe mu kifo n’obulwadde bwa atypical adenomatous hyperplasia (AAH).

In vivo pathological evaluation of interstitial lung disease (ILD) okukendeeza ku bwetaavu bw’okulongoosa amawuggwe biopsy.

2、 Ebigonjoola ebitabangula mu kisaawe ky'obujjanjabi

1. Okuggya kookolo w’amawuggwe mu ngeri ya endoscopic

Okuggyamu eddagala mu microwave (MWA):

Nga balungamizibwa okutambulira mu masanyalaze, okuggyamu ennyindo kwatuuka ku kigero ky’okufuga mu kitundu ekya 88% (≤ 3cm tumor, JTO 2022)。

Bw’ogeraageranya n’obujjanjabi obw’amasannyalaze: tewali bulabe bwa bulwadde bwa radiation pneumonitis era businga kukwatagana na kookolo w’amawuggwe ow’omu makkati.

Okulongoosa (cryoablation):

Enkola ya Rejuvenair okuva mu CSA Medical mu Amerika ekozesebwa mu kuzzaawo ensengekera y’empewo mu bbugumu (frozen recanalization) ey’okuzibikira kw’emikutu gy’empewo egy’omu makkati.

2. Okulongoosa emisuwa (BT) .

Disruptive: Obujjanjabi bw’ebyuma ku asima ataziyiza, nga bugenderera okuggyamu ebinywa ebiseeneekerevu.

Enkola ya Alair (Boston Scientific):

Okulongoosebwa emirundi esatu kwakendeeza ku bulwadde bwa asima obw’amangu ebitundu 82% (AIR3 Trial).

Enkola erongooseddwa mu 2023 esengekeddwa eri abalwadde ba GINA ab’ekibiina eky’okutaano.

3. Enkyukakyuka ya stent y’emikutu gy’empewo

3D okukuba ebitabo personalized bracket:

Okusinziira ku CT data customization, okugonjoola complex airway stenosis (nga post tuberculosis stenosis).

Okumenya ebintu: Biodegradable magnesium alloy stent (omutendera gw’okugezesa, okunyiga mu bujjuvu mu myezi 6).

Stent efulumya eddagala:

Stents ezisiigiddwa paclitaxel ziziyiza okuddamu okukula kw’ekizimba (okukendeeza ku muwendo gw’okuddamu okusannyalala ebitundu 60%).

3、 Okukozesa mu mbeera enzibu n’ez’amangu

1. ECMO nga egattibwa wamu n’okukebera emisuwa

Okukulaakulana mu tekinologiya:

Nga bawagirwa ECMO ekwatibwako (nga Cardiohelp system), okulongoosebwa kw’ennyindo (BAL) kukolebwa ku balwadde ba ARDS.

Okukakasa obukuumi bw’emirimu eri abalwadde abalina oxygenation index<100mmHg (ICM 2023).

Omugaso gw’obujjanjabi: Lambulula obuwuka obulwaza ekifuba eky’amaanyi era otereeze enkola y’eddagala eritta obuwuka.

2. Okuyingira mu nsonga mu bwangu ku massive hemoptysis

Tekinologiya omupya ow’okuziyiza omusaayi:

Argon plasma coagulation (APC): okuziyiza omusaayi okutali kwa kukwatagana n’obuziba obufugibwa (1-3mm).

Freezing probe hemostasis: -40 °C okuggalawo emisuwa egy’ebbugumu eri wansi, omuwendo gw’okuddamu<10%.

4、 Obulagirizi bw’okunoonyereza ku nsalo

1. Okukebera ebifaananyi mu molekyu:

Fluorescent labeling of PD-L1 antibodies (nga IMB-134) okulaga mu kiseera ekituufu abaserikale microenvironment ya kookolo w’amawuggwe.

2. AI okutambulira mu kiseera ekituufu:

Enkola ya Johnson&Johnson C-SATS eteekateeka mu ngeri ey’otoma ekkubo ly’ennyindo erisinga obulungi, n’ekendeeza ku budde bw’okulongoosa ebitundu 30%.

3. Ekibinja kya roboti entonotono:

Microrobots za MIT eziyitibwa magnetic microrobots zisobola okutwala eddagala mu bifo eby’omubiri (alveolar targets) okusobola okufulumizibwa.

Omulongooti gw’okugeraageranya ebikolwa by’obujjanjabi

Ebiteeso by’ekkubo ly’okussa mu nkola

Amalwaliro agasookerwako: galina ebyuma ebikebera amaloboozi agayitibwa ultrasound bronchoscopy (EBUS) okusobola okuteekawo emitendera egy’omu makkati.

Eddwaaliro ery’omutindo ogw’okusatu: Okuteekawo ekifo eky’okuyingira mu nsonga za ENB+robot okukola okuzuula n’okujjanjaba kookolo w’amawuggwe mu ngeri ey’omuggundu.

Ekitongole ky’okunoonyereza: Essira liteekeddwa ku bifaananyi bya molekyu n’okukulaakulanya ebyuma ebivunda ebiramu.

Tekinologiya ono azzeemu okukola enkola y’obujjanjabi ey’okuyingira mu nsonga z’okussa nga bayita mu kumenyawo ebintu bisatu ebikulu: okuzaala okutuufu, okuzuula obulwadde mu ngeri ey’amagezi, n’obujjanjabi obutayingirira nnyo. Mu myaka 5 egijja, n'okukulaakulanya AI ne nanotechnology, okuzuula n'okujjanjaba ebizimba by'amawuggwe kuyinza okutuuka ku "non-invasive closed-loop management".