Njira yosokoneza ya endoscopy yachipatala mu chithandizo chamkodzo

1 、 Kusintha kopambana pamwala mankhwala

(1) Digital ureteroscope (fURS)

Kusokonezeka kwaukadaulo:

Kujambula kwa digito kwa 4K (monga Olympus URF-V3): chigamulo chinawonjezeka kufika ku 3840 × 2160, chiwerengero cha kuzindikira miyala chinawonjezeka ndi 30% poyerekeza ndi fiber optic microscopy.

271 ° yopindika mwachangu: Kupambana kofikira m'chiuno mwa aimpso kwawonjezeka kuchoka pa 65% mu endoscopy yachikhalidwe kufika 98%.

Kupambana kwachipatala:

Kuphatikizika kwa laser holmium (monga Lumenis Pulse 120H) lithotripsy kumatha kukwaniritsa mwala umodzi chilolezo chopitilira 90% pamiyala ya impso pansi pa 2cm.

Opaleshoni yopanda machubu: Palibe chubu la J lomwe limasiyidwa pambuyo pa opaleshoni, ndipo wodwalayo amatulutsidwa tsiku lomwelo.

(2) Ultra fine percutaneous nephroscopy (UMP)

Zowunikira zaukadaulo:

13Fr channel (pafupifupi 4.3mm): amachepetsa kupwetekedwa mtima ndi 80% poyerekeza ndi PCNL wamba (24-30Fr).

Dongosolo lochotsa miyala yamphamvu (monga ClearPetra): kuyamwa kwenikweni kwa miyala, kuthamanga kwa pelvis yaimpso <20mmHg (kupewa kufalikira kwa matenda).

Kuyerekeza kwa data:

(3) Kusanthula nthawi yeniyeni ya mapangidwe a miyala

Laser-induced breakdown spectroscopy (LIBS):

Nthawi yomweyo dziwani mapangidwe a miyala (monga uric acid / cysteine) panthawi ya opaleshoni ndikuwongolera kusintha kwazakudya pambuyo pa opaleshoni.

Deta yochokera ku yunivesite ya Munich ku Germany ikuwonetsa kuti miyala yobwerezabwereza yatsika ndi 42%.

2, Kulondola komanso kusokoneza chithandizo cha zotupa

(1) Blue laser kuchotsa kwathunthu kwa chotupa cha chikhodzodzo

Ubwino waukadaulo:

Laser ya 450nm wavelength imachotsa zotupa, ndikuwongolera mozama kwa 0.5mm.

Poyerekeza ndi electrocautery yachikhalidwe, zochitika za obturator reflex zatsika kuchoka pa 15% kufika pa 0%.

Zambiri zachipatala:

Mlingo wobwereza wa chaka chimodzi wa khansa ya chikhodzodzo yopanda minofu (NMIBC) inali 8% yokha (24% mu gulu la resection).

(2) Kuyenda kosindikizidwa kwa 3D kwa nephrectomy pang'ono

Njira yogwirira ntchito:

sitepe 1. Sindikizani chithunzi cha impso chowonekera potengera deta ya CT ndikuyika malire a chotupacho.

sitepe2. Kuphatikizidwa ndi fluorescence laparoscopy (monga da Vinci SP) kuti achotsedwe bwino ndikusunga mayunitsi abwinobwino a aimpso.

Zochizira:

Mlingo woyipa wa m'mphepete mwa chotupa ndi 100%, ndipo kuchuluka kwa kusefera kwa glomerular (GFR) kumangotsika ndi 7%.

(3) Prostate steam ablation (Rez ū m)

Njira:

103 ℃ nthunzi imabayidwa kudzera mumkodzo kuti iwonongeke bwino kwambiri (kupewa mucosa ya mkodzo).

Ubwino:

Ntchito zakunja zimatha kutha mkati mwa mphindi 15, ndikusunga ntchito yogonana yopitilira 95% (poyerekeza ndi 60% ya TURP).

3, Endoscopic luso la matenda obstructive

(1) Wanzeru bracket system

PH imayankha ureter stent:

Pamene pH ya mkodzo ili pamwamba pa 7, imangowonjezereka kuti ithetse vuto, ndipo pH ikakhala yabwinobwino, imabwereranso (kupewa kusungidwa kwa nthawi yayitali).

Biodegradable stent:

Zinthu za polylactic acid zimakhazikika mkati mwa miyezi 6 ndipo sizifunikira kuchotsedwa kwachiwiri.

(2) Opaleshoni ya Endoscopic kuyimitsidwa kwa mkodzo

Chithandizo cha kupsinjika kwa mkodzo kwa akazi:

Transvaginal Urethral Tensionless Suspension (TVT-O), nthawi ya opaleshoni <20 mphindi.

Machiritso a mankhwalawa ndi 92%, omwe ndi kuchepetsa 90% kuvulala poyerekeza ndi opaleshoni yotsegula.

4, Andrology ndi Functional Urology

(1) Njira ya seminal vesicle endoscopy

Mapulogalamu opita patsogolo:

Kalilore wocheperako kwambiri wa 0.8mm adagwiritsidwa ntchito pobwezeretsa umuna kudzera munjira yotulutsa umuna pochiza hematospermia (kupambana kwa 96%).

Kupeza ndi electrocoagulation ya seminal vesicle miyala / zotupa, kusunga chonde ntchito.

(2) Kuika maloboti a prosthesis ya mbolo

Da Vinci SP System:

Njira imodzi ya dzenje imamaliza kugawanika kwa corpus cavernosum, kuchepetsa kuwonongeka kwa mitsempha ndi mitsempha.

Nthawi yobwezeretsa ya postoperative erectile ntchito yafupikitsidwa kuchokera ku masabata a 6 mpaka masabata a 2.

5. Mayendedwe aukadaulo amtsogolo

(1) AI Stone Chenjezo System:

Monga kusanthula mkodzo wa Dario Health AI, kulosera zangozi yamwala miyezi 3 pasadakhale.

(2) Nano robot endoscope:

Magnetic nanorobot opangidwa ku Switzerland amatha kuchotsa mwachangu miyala yaying'ono yam'chiuno.

(3) Kuyerekeza kwa Chip cha Organ:

Tsanzirani njira yopangira endoscopic pa chip musanachite opaleshoni kuti muchepetse kupindika kwa kuphunzira.

Table Yofananira ya Phindu Lachipatala

Malingaliro okhazikitsa njira

Zipatala za pulayimale: Ikani patsogolo kasinthidwe ka holmium laser ndi ureteroscope ya digito, yophimba 90% yamilandu yamwala.

Chipatala chachitatu: Khazikitsani malo opangira ma robotic endoscopy kuti achite maopaleshoni ovuta monga khansa ya prostate cryoablation.

Cholinga cha kafukufuku: Kupanga ma endoscope a ma cell (monga PSMA targeted fluorescence) kuti adziwe zotupa zazing'ono.

Ukadaulo uwu ukukonzanso mawonekedwe a chithandizo cha urology kudzera pazabwino zitatu zazikulu: kulondola kwa millimeter, kusungitsa magwiridwe antchito a thupi, komanso kukonzanso mwachangu. Zikuyembekezeka kuti pofika 2026, 70% ya maopaleshoni amkodzo adzamalizidwa kudzera munjira zachilengedwe za endoscopic.