Isisombululo esiphazamisayo se-Endoscopy yezoNyango kwi-Neurosurgery Diagnosis kunye noNyango

I-1, inguqu yempumelelo kwisiseko sokakayi kunye notyando lwethumba lepituitary

(1) Utyando lwe-Neuroendoscopic transnasal transsphenoidal (EEA)

Ukuphazamiseka kwezobuchwepheshe:

Akukho ndlela yokusikwa: Susa ithumba kwipaseji yempumlo yendalo ukunqanda ukutsalwa kwezicubu zobuchopho ngexesha le-craniotomy.

I-4K-3D inkqubo ye-endoscopic (efana ne-Storz UMFANEKISO 1 S 3D): Ibonelela nge-16 μ m ubunzulu bombono wentsimi ukwahlula imida ye-pituitary microadenomas.

Idatha yonyango:

(2) I-Fluorescent navigation endoscope

5-ALA ukuleyibhile ngefluorescent:

Ukulawulwa komlomo kwangaphambili kwe-aminolevulinic acid kubangele i-fluorescence ebomvu kwiiseli ze-tumor (ezifana neZeiss Pentero 900).

Ireyithi yokutshatyalaliswa ngokupheleleyo kwe-glioblastoma iye yanda ukusuka kwi-36% ukuya kwi-65% (NEJM 2023).

2, Unyango oluncinci lwe-ventricular kunye nezilonda ezinzulu zobuchopho

(1) I-Neuroendoscopic ye-fistula ye-ventricular yesithathu (ETV)

Iinzuzo zobugcisa:

I-3mm ye-endoscopic ye-puncture yetshaneli enye yonyango lwe-hydrocephalus ephazamisayo.

Ukuthelekiswa kotyando lwe-ventricular shunt: ukuphepha ubomi bonke bokuxhomekeka kwe-shunt, ukunciphisa izinga lokusuleleka kwi-15% ukuya kwi-1%.

Isixhobo esitsha:

I-catheter ye-balloon ehlengahlengiswayo: ukujonga ixesha lokwenyani lokuhamba kwe-stoma ngexesha lotyando (njenge-Neurovent-P).

(2) I-Endoscopic incedise ukucaciswa kwe-cerebral hemorrhage

Impumelelo yetekhnoloji:

Ngaphantsi kwefestile ye-2cm yethambo, i-endoscopic ebonakalayo ebonakalayo isetyenziselwa ukususa i-hematoma (njenge-Karl Storz MINOP system).

Izinga lokucocwa kwe-hematoma kwi-basal ganglia likhulu kune-90%, kwaye izinga lokuphucula inqaku le-GCS emva kotyando liphezulu ngama-40% kunelo lokugrumba amanzi.

I-3, ungenelelo lwe-Endoscopic kwisifo se-cerebrovascular

(1) I-Endoscopic incedise i-aneurysm clipping

Amagqabantshintshi obugcisa:

Qwalasela inxalenye yangasemva yentamo yethumba nge-30 ° endoscope ukuphepha ukunqunyulwa ngengozi komthambo womzali (njenge-Olympus NSK-1000).

Izinga elipheleleyo lokuvala i-aneurysms ye-artery yokunxibelelana yangasemva liye lanyuka ukusuka kwi-75% ukuya kwi-98%.

(2) I-Endoscopic vascular bypass graft

I-STA-MCA anastomosis:

I-2mm ultra-fine endoscope encediswayo kwi-suturing inokwanda kwe-12% kwizinga lepatency xa kuthelekiswa nokusebenza ngemicroscope.

I-4, unyango oluchanekileyo kwi-neurosurgery esebenzayo

(1) I-Endoscopic incedise ukufakelwa kwe-DBS

Utshintsho lwetekhnoloji:

Ixesha langempela lokuqwalaselwa kwe-endoscopic yeethagethi (ezifana ne-STN nuclei), ukubuyisela ukuqinisekiswa kwe-MRI ye-intraoperative.

Impazamo ye-electrode offset yezigulane ze-Parkinson's disease ingaphantsi kwe-0.3mm (utyando lwesakhelo semveli malunga ne-1mm).

(2) Ukuchithwa kwe-Endoscopic kwi-neuralgia ye-trigeminal

Uxinzelelo lweMicrovascular (MVD):

Ngokusebenzisa indlela ye-2cm ye-keyhole, i-endoscopy ibonise iindawo zokungqubuzana kweenqanawa ze-nerve, kunye nesantya esisebenzayo sokuchithwa kwe-92%.

5, Ubukrelekrele kunye neTekhnoloji yokuHamba

(1) I-AR neural navigation endoscope

Ukuphunyezwa kobugcisa:

NjengeBrainlab's Elements AR, idatha yeDICOM iqikelelwa ngexesha lokwenyani kwindawo yotyando.

Kwi-craniopharyngioma utyando, ukuchaneka kwe-pituitary stalk recognition yi-100%.

(2) Inkqubo yokulumkisa ye-AI ye-intraoperative

Ukuqondwa kweVascular AI:

NjengoSurgalign's Holosight, iphawula ngokuzenzekelayo iinqanawa ezigqobhozayo kwimifanekiso ye-endoscopic ukunciphisa ukwenzakala ngengozi.

(3) Inkqubo yokubamba isibuko serobhothi

Isipili esiphethe irobhothi:

NjengoJohnson Medical's NeuroArm, isusa ukungcangcazela kwezandla kwingcibi kwaye ibonelela ngokuzinzileyo kwe-20x yokukhulisa umfanekiso.

6. Izalathiso zobuchwepheshe bexesha elizayo

I-endoscopy ye-molecular imaging:

I-Fluorescent nanoparticles ijolise kwizilwa-buhlungu ze-CD133 ukulebhelisha iiseli ze-glioma stem.

I-biodegradable stent incedise ukudalwa kwe-fistula:

I-stent ye-magnesium alloy igcina i-patency ye-fistula ye-ventricle yesithathu kwaye ifakwe emva kweenyanga ezi-6.

I-Optogenetic endoscopy:

Ukukhuthazwa kokukhanya okuluhlaza kwemithambo-luvo yofuzo kunyango lwe-refractory epilepsy (inqanaba lovavanyo lwezilwanyana).

Itheyibhile yokuthelekisa iNzuzo yezonyango

Iingcebiso zokuphunyezwa kwesicwangciso

I-Pituitary Tumor Centre: Yakha i-EEA+i-intraoperative MRI igumbi lokusebenza elihlanganisiweyo.

Iyunithi yesifo seCerebrovascular: ixhotyiswe nge-endoscope fluorescence angiography inkqubo yemowudi yesithathu.

Ugxininiso lophando: Ukuphuhlisa isithintelo segazi ebuchotsheni esingena kwi-endoscopic fluorescent probe.

Ezi teknoloji zityhalela phambili kwi-neurosurgery ukuya kwixesha "elingaphazamisiyo" ngokusebenzisa iimpumelelo ezintathu eziphambili: ukonakala kwe-zero tensile, ukuchaneka kwenqanaba le-sub millimeter, kunye nokugcinwa kokusebenza komzimba. Kulindeleke ukuba ngo-2030, i-70% yotyando lwesiseko sokakayi luya kugqitywa ngeenkqubo zendalo ze-endoscopic.