Xalka Qalalaasaha ee Endoscopy-da Caafimaadka ee Cudurada Haweenka iyo Cilmi-baarista iyo Daaweynta Taranka

1. Horumarka kacaanka ee farsamada hysteroscopy

(1)Nidaamka hysteroscopy mindi qabow

Burburka tignoolajiyada:

Qorshaynta makaanikada (sida MyoSure) ®): Daabka wareega ee xawlihiisu yahay 2500rpm waxay si sax ah u saartaa fibroids-ka si looga fogaado waxyeelada kuleylka korantada ee substrate xuubka gudaha.

Nidaamka xakamaynta cadaadiska dareeraha: Joogto cadaadiska ilmo-galeenka inta u dhaxaysa 50-70mmHg (electrocautery dhaqameed>100mmHg) si loo yareeyo khatarta dheecaanka xad-dhaafka ah.

Qiimaha kiliinikada:

Waqtiga hagaajinta endometrium ka dib dib-u-soocidda fibroids-ka hoose ee xuubka ayaa laga soo gaabiyey 12 usbuuc ilaa 4 usbuuc ka dib korantada.

Heerka uurka ee dabiiciga ah ee bukaannada madhalayska ah ee qalliinka ka dib ayaa kordhay 58% (marka la barbardhigo 32% kaliya ee kooxda korantada).

(2) 3D hysteroscopy navigation

Tilmaamaha Farsamada:

Qaabaynta wakhtiga dhabta ah ee 3D (sida Karl Storz IMAGE 1 S Rubina): muujinta qoto dheer ee geeska ilmagaleenka iyo qaabka furitaanka tuubada ugxanta.

Marka lagu daro xogta MRI ka hor, saxnaanta aqoonsiga cilladaha ilmo-galeenka (sida mediastinum dhamaystiran) waa 100%.

Xaaladaha codsiga:

Qiimaynta qiyaasta isteeroscopic ee adhesions intrauterine (Asherman syndrome).

(3) Hysteroscope-ka midabaynta ee fluorescence

Horumarka tignoolajiyada:

5-ALA waxay keentaa burada protoporphyrin IX fluorescence, iyadoo la ogaanayo 91% kansarka hore ee endometrial (kaliya 65% hoosta microscopy iftiinka cad).

Marka loo eego xogta Xarunta Kansarka Qaranka ee Japan, nabarada endometrial hyperplasia ee aan caadiga ahayn ayaa la ogaan karaa.

2. Dib u dhiska farsamada laparoscopic

(1) Laparoscope ee hal deked ah (SPRS)

Nidaamka Da Vinci SP:

Jeexdin keli ah oo 25mm ah ayaa loo isticmaalaa in lagu dhammaystiro wadarta qalliinka hysterectomy, taas oo kordhisa heerka qurxinta 80% marka la barbar dhigo qalliinka daloolka ah.

Qalabka curcurka ee rukhsadda leh waxa uu gaadhaa 7-degree-of-operation operation, oo leh tolida iyo guntida saxnaanta 0.1mm.

Xogta caafimaad:

Heerka xajinta unugyada caadiga ah ee ugxan-sidaha inta lagu jiro cystectomy ugxan-sidaha ayaa ka weyn 95% (laparoscopy dhaqameed waa qiyaastii 70%).

(2) Navigation u dhow infrared fluorescence navigation (NIR)

Khariidadeynta lymphatic ICG:

Muujinta wakhtiga dhabta ah ee qanjidhada sentinel inta lagu jiro qaliinka kansarka ilmo-galeenka wuxuu yareeyaa kala-baxa qanjidhada aan loo baahnayn 43%.

Qorshaha Cusbitaalka Kansarka ee Jaamicadda Fudan: Isku darka cagaarka indocyanine iyo nanocarbon calaamadaynta laba-geesoodka ah, heerka ogaanshaha ayaa la kordhiyay ilaa 98%.

(3) Casriyeynta Platform Tamarta Ultrasonic

Harmonic ACE+7

Hagaajinta caqliga ee inta jeer ee gariir (55.5kHz ± 5%), goynta iyo xidhitaanka 5mm xididdada dhiigga isku mar.

Qadarka dhiigbaxa inta lagu jiro qaliinka saarista fibroids uterineine wuxuu ka yar yahay 50ml (electrocautery dhaqameed>200ml).

3

(1) Farogelinta hysteroscopy ee dib-u-kicinta tuubooyinka ugxan-sidaha

Isku dhafka farsamada:

0.5mm muraayad fibre ultra-fine ah (sida Olympus HYF-1T) oo ay weheliso balaadhinta siliga haga.

Nidaamka la socodka cadaadiska waqtiga dhabta ah (<300mmHg) si looga hortago dillaaca tuubada xuubka xuubka.

Saamaynta daweynta:

Heerka dib u soo celinta xannibaadda u dhow waa 92%, heerka uurka dabiiciga ah ee 6 bilood qalliinka ka dib waa 37%.

(2) Unugyada ugxan-sidaha oo barafoobay + beeritaanka endoscopic

Habka qaska:

Talaabada 1: Ka hel kortexka ugxansidaha iyada oo loo marayo laparoscopy transvaginal (iska ilaali laparotomy).

Talaabada 2: Vitrification iyo kaydinta qaboojinta.

Talaabada 3: Ku-tallaalidda Autologous ee ugxan-sidaha fossa ka dib kiimoterabiga si loo soo celiyo shaqada endocrine.

xogta

Barnaamijka Brussels ee Beljamka: Heerka ugxan-sidaha ee 68% ka dib tallaalka bukaannada qaan-gaarka ka dib.

(3) Imtixaanka soo dhaweynta endometrial (ERT)

Tignoolajiyada endoscopic molecular:

Ku ururi unugyada endometrial hoosta hysteroscopy oo go'aami daaqada la geliyo iyada oo loo marayo isku xigxiga RNA.

Hagaajinta heerka uurka ee bukaan-socodka ee soo noqnoqda ee ku guuldareystay tallaalka 21% ilaa 52%.

4. Hal-abuurnimada ugu yar ee dayactirka sagxada miskaha

(1) Mesh implatation (TVM)

Kobcinta farsamada:

Daabacaadda 3D ee mesh polypropylene shakhsi ahaaneed oo leh porosity>70% waxay yaraynaysaa khatarta caabuqa.

Robotku waxa uu caawiyay meelaynta saxda ah si looga fogaado dhaawac soo gaadho dareemaha obturator.

Saamaynta daweynta:

Heerka soo noqoshada xubnaha miskaha ee 5-sano (POP) waa in ka yar 10% (qaliinka tolida dhaqameed 40%).

(2) Nidaaminta neerfaha sacral implantation endoscopic implantation

InterStim ™ Qorshaha ugu yar ee weerarka:

Sacral 3-dalool oo daloolin hoosta cystoscopy-ga, oo leh heer wax ku ool ah oo ka badan 80% inta lagu jiro xilliga baaritaanka ka hor intaan la gelinin joogtada ah.

Heerka hagaajinta xakamaynta kaadi mareenka ee daaweynta kaadi-ceshan la'aanta kaadida ee soo noqnoqda waa 91%.

5. Tilmaamaha farsamada mustaqbalka

(1) Ogaanshaha waqtiga dhabta ah ee nabarada godka uterineine-ka AI:Nidaamka EndoFinder ee Samsung wuxuu leeyahay heerka saxda ah ee 96% si loo aqoonsado polyps endometrial iyo kansarka.

(2) Qalabka elektarooniga ah ee la nuugi karo: Qalfoofka ku salaysan magnesium ee ay samaysay Jaamacadda Waqooyi-galbeed ee Maraykanka waxay hoos u dhigtaa oo sii daysaa arrimo kor u qaadaya koritaanka 6 bilood gudahood.

(3) Ku-tallaalidda jilitaanka xubinta taranka: Ku celcelinta tallaalka uterineine-ka-tallaalidda xididdada anastomosis ee chip microfluidic.

Shaxda Isbarbardhigga Faa'iidada Clinical

Dhibcaha xanuunka ee hababka farsamada dhaqameed / waxtarka xalalka carqaladaynta

Mindida qabow hysteroscopy/dhaawaca elektiroonigga ah ee unugyada asliga ee endometrial/heerka xabagta qalliinka ka dib ayaa laga dhimay 28% ilaa 5%

Hal dalool oo hal god ah oo laparoscopic / godad badan oo leh nabarro muuqda / soo celinta nolol maalmeedka 24 saacadood qalitaanka ka dib

Heer sare oo been ah oo togan ee fluorescence falloposcopy/hysterosalpingography/meelaynta saxda ah ee xannibaadda runta ah ilaa 0.1mm

Ku-tallaalidda barafaynta unugyada ugxan-sidaha/daaweynta kemotherabi ka dib ugxan-sidaha ugxan-sidaha oo guul-darraystay / heerka soo kabashada wareegga caadada>60%

Talooyinka fulinta

Isbitaalada aasaasiga ah: waxay ku qalabaysan yihiin hysteroscopy-qeex sare iyo nidaamka mindida qabow, oo daboolaya 90% dhaawacyada intrauterine.

Xarunta Taranka: Samee goob isku dhafan oo loogu talagalay endoscopy tubbada ugxan-sidaha iyo wareejinta embriyaha.

Takhasuska Oncology: Kor u qaad soocista saxda ah ee burada adoo isticmaalaya NIR fluorescence navigation.

Farsamooyinkani waxay dib u qeexayaan heerarka qalliinka dumarka ee ugu yar ee soo gelitaanka iyada oo loo marayo saddex horumar oo asaasi ah: heerka saxda ah ee millimitirka, dhaawaca dhalmada eber, iyo dib u dhiska shaqada jireed. Waxaa la filayaa in marka la gaaro 2027, 90% qalliinnada cudurrada haweenka ee cudurrada dumarka ah ay gaari doonaan daawaynta "maalintii".