Kusokoneza njira ya endoscope mu matenda a mafupa a msana ndi chithandizo

1, Kupambana kosinthika pakuchita opaleshoni ya msana yocheperako

(1) Opaleshoni ya Endoscopic Spinal (FESS)

Kusokonezeka kwaukadaulo:

Percutaneous single channel njira: Complete intervertebral disc resection ndi 7mm incision (opaleshoni yotseguka yachikhalidwe imafuna 5cm incision).

Mawonekedwe ozungulira ma saw system (monga Joimax TESSYS): Pulitsani molondola ma spurs a mafupa kuti musawononge mitsempha.

Zambiri zachipatala:

(2) UBE (Unilateral Dual Channel Endoscopy) njira

Ubwino waukadaulo:

Khazikitsani njira yowonera 12mm ndi njira ya 8mm kuti mukwaniritse "opaleshoni yotseguka ngati malo opangira opaleshoni".

Oyenera lumbar spinal stenosis, decompression range ndi yaikulu katatu kuposa njira imodzi.

Zida zatsopano:

Radiofrequency ablation bipolar electrocoagulation (monga ArthroCare Coblation): hemostasis yeniyeni pamene imateteza mizu ya mitsempha.

(3) Endoscopic assisted spinal fusion (Endo LIF)

Kupambana kwaukadaulo:

Poika chipangizo cha 3D chosindikizidwa (chokhala ndi porosity ya 80%) kupyolera mu katatu ka Kambin, kukula kwa mafupa kunawonjezeka ndi 40%.

Kuphatikizidwa ndi O-arm navigation, kulondola kwa kuyika kwa misomali ndi 100% (fluoroscopy yachikhalidwe ndi pafupifupi 85%).

2, Kukweza kwa paradigm kwaukadaulo wa arthroscopic

(1) 4K Ultra HD Arthroscopy System

Zowunikira zaukadaulo:

Sensa ya Sony IMX535 imapereka lingaliro la 10 μ m, ndikuwonjezera kuchuluka kwa misozi ya meniscus mpaka 99%.

Monga Shi Lehui's 4K Insight system, imathandizira chiwonetsero cha HDR cha synovial vascular morphology.

(2) Roboti yothandizira arthroscopy

MAKO Orthopedic Robot:

Submillimeter mlingo yeniyeni osteotomy (zolakwika 0.1mm), ndi mphamvu mzere kupatuka zosakwana 1 ° pambuyo okwana mawondo m'malo opaleshoni.

Mu 2023, kafukufuku wa JBJS adawonetsa kuti zaka 10 zakupulumuka kwa ma prostheses zakwera kuchokera ku 90% mpaka 98%.

(3) Ukadaulo wowongolera wachilengedwe

Endoscopic bone marrow stimulation + PRP jakisoni:

Pambuyo pa microfracture mu cartilage defect area, platelet rich plasma (PRP) anabayidwa, ndipo makulidwe a fibrocartilage regeneration anafika 2.1mm (njira zachikhalidwe zokha 0.8mm).

Kulowetsedwa kwa collagen scaffold: monga Geistlich Cholro Gide, wopangidwa ndi sutured ndi wokhazikika pansi pa maikulosikopu.

3, Njira zochepetsera zowononga zoopsa komanso zamankhwala zamasewera

(1) Endoscopic kukonza kwa Achilles tendon

Zaukadaulo:

Dual channel endoscopy (monga Arthrex SpeedBridge) imamaliza kuluka ndi kuwotcha, ndi mphamvu yoposa 30% kuposa opaleshoni yotsegula.

Nthawi yobwezeretsa pambuyo pa opaleshoni yafupikitsidwa kuchokera ku masabata a 12 mpaka masabata a 6.

(2) Endoscopic kutulutsidwa kwa carpal tunnel syndrome

MicroAire System:

Dulani chingwe chopingasa chadzanja ndi 3mm incision, ndi nthawi ya opaleshoni yosakwana mphindi zisanu.

Kuvulala kwa mitsempha yapakatikati kwatsika kuchokera ku 3.5% mu njira zachikhalidwe kufika ku 0.2%.

(3) Kukonzekera kwathunthu kwa endoscopic ya kuvulala kwa rotator cuff

Knotless suture njira:

Gwiritsani ntchito FiberTape yokhala ndi mbale yachitsulo ya loop (monga Arthrex SwiveLock), yolimba kwambiri kuposa 500N.

Chiwopsezo cha misozi chatsika kuchoka pa 20% pa opaleshoni yotsegula kufika pa 8%.

4, Ukadaulo Wanzeru ndi Navigation

(1) AR Navigation Endoscopy System

Kukhazikitsa mwaukadaulo:

Microsoft HoloLens 2 imaphimba deta ya CT kuti iwonetse zenizeni zenizeni za pedicle screw njira.

Zambiri zakuchipatala cha Beijing Jishuitan: Mlingo wolondola wa kuyika misomali ndi 100%, ndipo kuchuluka kwa ma X-ray ndi ziro.

(2) AI intraoperative zisankho kuthandizira

Ma algorithms ophunzirira mozama:

Dongosolo la Johnson&Johnson VELYS limangosinthiratu kuchuluka kwa meniscus resection kutengera njira yolumikizirana.

Chepetsani nthawi ya opareshoni ndi 25% kuti mupewe kutulutsa kwambiri.

(3) Zida za endoscopic zozindikira kupanikizika

SmartDrill:

Kuwunika kwanthawi yeniyeni ya kuthamanga kwa kubowola, kungoyimitsa kuzungulira polowa mkati mwa khosi la vertebral (zolakwika <0.1mm).

5. Mayendedwe aukadaulo amtsogolo

Nano arthroscopy:

Kalilore wa maginito wa 1mm wopangidwa ku Switzerland amatha kulowa mgulu la interphalangeal.

Ma implants anzeru odzikonzekeretsa:

Shape memory alloy stent imakulitsa kutentha kwa thupi kukonza scoliosis.

Digital Twin Surgery Preview:

Tsanzirani njira zama endoscopic papulatifomu ya metaverse potengera data ya CT ya wodwala.

Table Yofananira ya Phindu Lachipatala

Malingaliro okhazikitsa njira

Zipatala za Grassroots: zokhala ndi UBE dual channel system, zophimba 80% ya matenda osokonekera m'chiuno.

Sports Medicine Center: Kumanga nsanja ya 4K arthroscopy + biotherapy.

Cholinga cha kafukufuku: Kupanga ma implants a magnesium alloy endoscopic (monga zomangira zophwanyika).

Ukadaulo uwu ukukankhira maopaleshoni a mafupa kuti apite ku "nthawi yovuta kwambiri" kudzera pazabwino zake zitatu zazikuluzikulu za "magawo ang'onoang'ono a centimita, kuwonongeka kwa ziro zamapangidwe, ndikuchira msanga". Zikuyembekezeka kuti pofika chaka cha 2028, 60% ya maopaleshoni a msana ndi olowa adzamalizidwa kudzera munjira zachilengedwe kapena ma incision pansi pa 5mm.