Xalka Qalalaasaha ee Endoscopy Medical ee Cilad-sheegashada iyo Daaweynta Neurosurgery

1. Horumarka Kacaanka ee saldhigga madaxa iyo qalliinka burada pituitary

(1) Neuroendoscopic qalliinka transsphenoidal transsanal (EEA)

Burburka tignoolajiyada:

Ma jiro hab la jeexi karo: Ka saar burada iyada oo loo marayo marinka sanka ee dabiiciga ah si aad uga fogaato soo jiidashada unugyada maskaxda inta lagu jiro craniotomy.

Nidaamka endoscopic 4K-3D (sida Storz IMAGE 1 S 3D): Wuxuu bixiyaa 16 μm qoto dheer ee aragtida goobta si loo kala saaro xuduudaha microadenomas pituitary.

Xogta caafimaad:

(2) Endoscope navigation fluorescent

5-ALA calaamadaynta fluorescent:

Maamulka afka qalliinka ka hor ee aminolevulinic acid ayaa kiciyay fluorescence cas unugyada burada (sida Zeiss Pentero 900).

Wadarta heerka kala-soocidda glioblastoma ayaa ka kordhay 36% ilaa 65% (NEJM 2023).

2. Daawaynta ugu yar ee nabarrada maskaxda ee ventricular iyo moolka hoose

(1) Neuroendoscopic fistula ventricular saddexaad (ETV)

Faa'iidooyinka farsamada:

3mm endoscopic hal kanaal dalool oo loogu talagalay daaweynta hydrocephalus obstructive.

Isbarbardhigga qalliinka shunt ventricular: ka fogaanshaha nolosha oo dhan ee ku tiirsanaanta shunt, hoos u dhigista heerka caabuqa min 15% ilaa 1%.

Qalab cusub:

Kateetarka buufinta cadaadiska la hagaajin karo: la socodka wakhtiga dhabta ah ee socodka stoma inta lagu jiro qaliinka (sida Neurovent-P).

(2) Nadiifinta endoscopic ee la caawiyay ee dhiigbaxa maskaxda

Horumarka tignoolajiyada:

Hoosta daaqada lafaha 2cm, endoscopic muuqaal toos ah ayaa loo isticmaalaa si meesha looga saaro hematoma (sida Karl Storz MINOP system).

Heerka nadiifinta hematoma ee ganglia basal ayaa ka weyn 90%, iyo heerka hagaajinta dhibcaha GCS ee qalliinka ka dib ayaa 40% ka sarreeya kan qulqulka qodista.

3. Faragelinta Endoscopic ee cudurka cerebrovascular

(1) Endoscopic aneurysm caawiyay goynta

Tilmaamaha Farsamada:

U fiirso qaybta dambe ee luqunta burada oo leh 30 ° endoscope si aad uga fogaato gooyn shil ah halbowlaha waalidka (sida Olympus NSK-1000).

Heerarka xidhidhaanshaha dhammaystiran ee isgaadhsiinta xididdada xididdada dambe ayaa ka kordhay 75% ilaa 98%.

(2) Tallaalka xididdada dhiigga ee Endoscopic

STA-MCA anastomosis:

2mm ultra-fine endoscope ee la caawiyay tolidda ayaa leh 12% korodhka heerka daqliga marka la barbar dhigo hawlgalka yar yar.

4. Daaweynta saxda ah ee qaliinka neerfaha ee shaqeynaya

(1) Endoscopic kaalmayn DBS beerista

Hal-abuurka farsamada:

Waqtiga dhabta ah ee fiirsashada endoscopic ee bartilmaameedyada (sida STN nuclei), bedelida xaqiijinta MRI ee qalliinka.

Khaladaadka elektaroonigga ah ee bukaanka cudurka Parkinson waa in ka yar 0.3mm (qaliinka jir dhaqameedku waa qiyaastii 1mm).

(2) Depression Endoscopic ee neuralgia trigeminal

Depression Microvascular (MVD):

Iyadoo loo marayo habka 2cm ee godka furaha, endoscopy wuxuu muujiyay dhibcaha isku dhaca xididdada dareemayaasha, iyo heerka wax ku oolka ah ee depression wuxuu ahaa 92%.

5. Tignoolajiyada garaadka iyo hagidda

(1) AR neural navigation endoscope

Hirgelinta farsamada:

Sida Brainlab's Elements AR, xogta DICOM waxaa lagu saadaaliyay wakhtiga dhabta ah goobta qaliinka.

Qalliinka craniopharyngioma, saxnaanta aqoonsiga jirida pituitary waa 100%.

(2) Nidaamka digniinta qalliinka ee AI

Aqoonsiga xididka xididka AI:

Sida Surgalign's Holosight, waxay si toos ah u calaamadisaa weelasha dalloolada ee sawirada endoscopic si loo yareeyo dhaawacyada shilalka ah.

(3) Nidaamka haynta muraayadda Robot

Robot haya muraayad:

Sida Johnson Medical's NeuroArm, waxay meesha ka saartaa gariirada gacanta ee dhakhtarka qalliinka waxayna bixisaa weyneynta 20x deggan ee sawirka.

6. Tilmaamaha farsamada mustaqbalka

Baaritaanka molecular imaging endoscopy:

Nanoparticles Fluorescent oo beegsanaya unugyada difaaca CD133 si ay u calaamadiyaan unugyada tarma ee glioma.

Abuuritaanka fistulaha ee gacan ka geysata abuurista stent-bidegradable:

Daawaynta daawaynta ee magnesium waxa ay ilaalisaa xajinta fistula ventricle saddexaad waxana la nuugaa 6 bilood ka dib.

Endoscopy-ga indhaha:

Kicinta iftiinka buluuga ah ee neerfayaasha hidde ahaan wax laga beddelay ee loogu talagalay daawaynta suuxdinta refractory (marxaladda tijaabada xayawaanka).

Shaxda Isbarbardhigga Faa'iidada Clinical

Talooyinka fulinta

Xarunta Burada ee Pituitary: Dhis EEA + intraoperative MRI qolka qalliinka ka kooban.

Cutubka cudurka Cerebrovascular: qalabaysan endoscope fluorescence angiography saddex hab.

Diirada-saarista cilmi-baarista: Kobcinta xannibaad-maskaxeed-dhiig-maskaxeed oo gelaya baaritaanka endoscopic fluorescent.

Farsamooyinkani waxay u riixayaan qalliinka neerfaha xilli "aan ahayn invasive" iyada oo loo marayo saddex guulood oo waaweyn: waxyeellada jilicsanaanta eber, saxnaanta heerka millimitirka hoose, iyo ilaalinta shaqada jir ahaaneed. Waxa la filayaa in marka la gaadho 2030, 70% qalliinada saldhiga dhafoorka la dhamaystiro iyada oo loo marayo hababka dabiiciga ah ee endoscopic.