Isisombululo esiphazamisayo se-endoscopy yonyango kwi-urinary system unyango

I-1, ukuphumelela kwenguqu kunyango lwamatye

(1) I-Ureteroscope yedijithali (fURS)

Ukuphazamiseka kwezobuchwepheshe:

I-imaging yedijithali ye-4K (efana ne-Olympus URF-V3): isisombululo senyuka ukuya kwi-3840 × 2160, izinga lokuqatshelwa kwamatye linyuke nge-30% xa kuthelekiswa ne-fiber optic microscopy.

I-271 ° ukugoba okusebenzayo: Izinga lokuphumelela lokufikelela kwi-pelvis ye-renal liye landa ukusuka kwi-65% kwi-endoscopy yendabuko ukuya kwi-98%.

Impumelelo yeklinikhi:

I-laser ye-holmium edibeneyo (efana ne-Lumenis Pulse 120H) i-lithotripsy inokufikelela kwinqanaba elinye lokucocwa kwelitye elingaphezu kwe-90% kumatye ezintso angaphantsi kwe-2cm.

Utyando lweTubeless: Akukho ityhubhu ye-J ephindwe kabini eshiywe emva kotyando, kwaye isigulane sikhutshwa kwangolo suku.

(2) I-Ultra fine percutaneous nephroscopy (UMP)

Amagqabantshintshi obugcisa:

Ishaneli ye-13Fr (malunga ne-4.3mm): inciphisa ukuxhatshazwa nge-80% xa kuthelekiswa ne-PCNL eqhelekileyo (24-30Fr).

Inkqubo yokususwa kwamatye oxinzelelo olubi (njenge-ClearPetra): i-real-time suction of gravel, i-renal pelvis pressure <20mmHg (ukuphepha ukusasazeka kwentsholongwane).

Uthelekiso lwedatha:

(3) Uhlalutyo lwexesha langempela lokubunjwa kwamatye

I-Laser induced breakdown spectroscopy (LIBS):

Ukugqiba ngokukhawuleza ukubunjwa kwamatye (njenge-uric acid / cysteine) ngexesha lotyando kunye nesikhokelo sohlengahlengiso lokutya emva kokuhlinzwa.

Idatha evela kwiYunivesithi yaseMunich eJamani ibonisa ukuba izinga lokuphindaphinda kwamatye liye lehla nge-42%.

I-2, Ukuchaneka kunye nonyango oluncinci lwe-tumor

(1) I-laser eluhlaza okwesibhakabhaka ukususwa ngokupheleleyo kwethumba lesinyi

Iinzuzo zobugcisa:

I-laser ye-450nm ye-wavelength ngokukhethayo ikhupha amathumba, ngolawulo oluchanekileyo lwe-0.5mm.

Xa kuthelekiswa ne-electrocautery yemveli, izehlo ze-obturator reflex zehlile ukusuka kwi-15% ukuya kwi-0%.

Idatha yonyango:

Unyaka omnye wokuphindaphinda umhlaza wesinye i-nonmuscular invasive (NMIBC) yayingu-8% kuphela (24% kwiqela le-resection).

(2) I-3D eprintiweyo yokukhangela i-nephrectomy engaphelelanga

Inkqubo yokusebenza:

step 1. Shicilela imodeli yezintso elubala esekelwe data CT kwaye uphawule umda ithumba.

inyathelo2. Idityaniswe ne-fluorescence laparoscopy (efana ne-da Vinci SP) ukuze isetyenziswe ngokuchanekileyo ngelixa igcina iiyunithi eziqhelekileyo zezintso.

Isiphumo sonyango:

Isantya esibi se-tumor margins yi-100%, kwaye i-glomerular filtration rate (GFR) iyancipha kuphela nge-7%.

(3) Ukukhutshwa komphunga kwidlala lengqula (Rez ū m)

Inkqubo:

I-103 ℃ umphunga utofwa nge-urethra ukuze ukhuphe ngokuchanekileyo amadlala e-hyperplastic (ukuphepha urethral mucosa).

Izinto eziluncedo:

Iinkonzo zezigulane ezingaphandle zingagqitywa kwimizuzu ye-15, kunye nezinga lokugcinwa komsebenzi wesondo ngaphezu kwe-95% (xa kuthelekiswa ne-60% ye-TURP).

I-3, i-Endoscopic innovation yezifo ezithintelayo

(1) Inkqubo yesibiyeli ekrelekrele

I-PH ephendula i-stent ye-ureter:

Xa i-pH yomchamo ingaphezulu kwe-7, iya kwandisa ngokuzenzekelayo ukukhulula umqobo, kwaye xa i-pH iqhelekile, iya kuhoxisa (ukuphepha ukugcinwa kwexesha elide).

I-stent ye-Biodegradable:

Izinto ze-polylactic acid zixutywe ngokupheleleyo kwiinyanga ezi-6 kwaye azifuni ukususwa kwesibini.

(2) Utyando lokumiswa kwe-Endoscopic urethral

Unyango loxinzelelo lwabasetyhini lokungaphumeleli komchamo:

I-Transvaginal Urethral Tensionless Suspension (TVT-O), ixesha lotyando <20 imizuzu.

Izinga lokunyanga ngama-92%, nto leyo ethotyiweyo ngama-90% kumonzakalo xa kuthelekiswa notyando lokuvula.

4, I-Andrology kunye ne-Urology esebenzayo

(1) Ubuchule be-endoscopy ye-seminal vesicle

Izicelo zokuphumelela:

Isibuko esine-0.8mm se-ultra-thin mirror sasetyenziselwa ukubuyisela i-ejaculate nge-ejaculatory duct yonyango lwe-hematospermia (izinga lempumelelo ye-96%).

Ukufunyanwa kunye ne-electrocoagulation yamatye e-seminal vesicle / amathumba, ukugcina umsebenzi wokuzala.

(2) Ukufakelwa kwerobhothi yelungu lobudoda

Inkqubo ye-SP yeDa Vinci:

Indlela enye yomngxuma igqiba ukuchithwa kwe-corpus cavernosum, ukunciphisa umonakalo we-vascular and nerve.

Ixesha lokubuyisela emva kokusebenza kwe-erectile lincitshiswe ukusuka kwiiveki ze-6 ukuya kwiiveki ze-2.

5. Izalathiso zobuchwepheshe bexesha elizayo

(1) Inkqubo yeSilumkiso yelitye le-AI:

Njengokuhlalutya komchamo weDario Health, ukuxela kwangaphambili ingozi yamatye kwiinyanga ezi-3 kwangaphambili.

(2) Nano irobhothi endoskophu:

I-nanorobot yamagnetic ephuhliswe eSwitzerland inokususa ngokusebenzayo amatye amancinci e-pelvis ye-renal.

(3) Ukulinganisa itshiphu yelungu:

Linganisa indlela yokusebenza kwe-endoscopic kwi-chip ngaphambi kotyando ukunciphisa ijika lokufunda.

Itheyibhile yokuthelekisa iNzuzo yezonyango

Iingcebiso zokuphunyezwa kwesicwangciso

Izibhedlele eziziiprayimari: Beka phambili ukulungiswa kwe-holmium laser kunye ne-digital ureteroscope, egubungela i-90% yamatyala amatye.

Isibhedlele sodidi lwesithathu: Ukuseka iziko le-robotic endoscopy ukwenza utyando olunzima olufana ne-prostate cancer cryoablation.

Ugxininiso loPhando: Ukuphuhlisa i-endoscopy ye-molecular imaging (efana ne-PSMA ejoliswe kwi-fluorescence) ukwenzela indawo yamathumba amancinci.

Ezi teknoloji zilungisa ngokutsha iparadigm yonyango lwe-urology ngokusebenzisa izinto ezintathu eziluncedo ezingundoqo: ukuchaneka kwe-sub millimeter, ukugcinwa kokusebenza komzimba, kunye nokubuyisela ngokukhawuleza. Kulindeleke ukuba ngo-2026, i-70% yotyando lwe-urological luya kugqitywa ngokusebenzisa iinkqubo zendalo ze-endoscopic.