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-eejinta 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 laga soo xigtay Xarunta Kansarka Qaranka ee Japan, nabarada aan caadiga ahayn ee endometrial hyperplasia ee ka yar 1MM 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 ah 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-ga caadiga ah 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 fiber ultra-fine ah (sida Olympus HYF-1T) oo ay weheliso fidinta siliga hagaha.

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

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 + beerista 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.

Robot-ku waxa uu caawiyay meelaynta saxda ah si looga fogaado dhaawac soo gaadha neerfaha 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 teknoolajiyada mustaqbalka

(1) Waqtiga dhabta ah ee ogaanshaha nabarrada godka uterineine-ka AI:Nidaamka EndoFinder ee Samsung wuxuu leeyahay heerka saxda ah ee 96% ee lagu aqoonsanayo polyps endometrial iyo kansarka.

(2) Qalabka elektaroonigga ah ee la nuugi karo: Qalab ku salaysan magnesium oo 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 kadib 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 cudurada dumarka ay ku guuleysan doonaan daawaynta "maalintii".