Development of Hybrid Integrated Endoscope-holder System for Endoscopic Microneurosurgery
Development of Hybrid Integrated Endoscope-holder System for Endoscopic Microneurosurgery
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DOI：
10.1227/01.neu.0000139490.72543.27
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发表时间：
2004-10
期刊：
影响因子：
4.8
通讯作者：
A. Morita;Y. Okada;M. Kitano;T. Hori;M. Taneda;T. Kirino
中科院分区：
文献类型：
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作者：
A. Morita;Y. Okada;M. Kitano;T. Hori;M. Taneda;T. Kirino
目的：神经外科领域的内窥镜技术正在发展中。在神经外科的精细外科领域中，要进行复杂的双手手术，需要具有准确锁定和安全释放系统的刚性内窥镜固定装置。在这里，我们报告了一种新的混合式集成内窥镜支架系统的开发。器械：夹持器的基本概念是：1)结合视频系统和夹持器；2)操作方便、固定准确，并配备安全的释放机构；3)无论是初级内窥镜手术还是辅助内窥镜手术，它都应该能够通用。新研制了负驱动气锁系统和卡口形状的内窥镜。对25名患者进行了临床试验，并对每个原型进行了测试和修改，直到满足功能要求。对最终版本的固定和释放机构的准确性和安全性进行了测试。结果：在临床试验中遇到了8个问题，并有所改进。最终版本的固定精度优于市场上最先进的内窥镜支架。在身体头骨的模拟深部手术野中，重复插入、固定和释放过程中没有观察到危险事件。临床应用中未见明显并发症。结论：我们研制了一种高可靠性、可精确固定、易操作的混合式内窥镜支架系统。为了在当前的社会经济需求中实现更安全、更准确、更少侵入性的外科手术，多个中心的商业制造商和外科医生需要共同努力创造有用的技术。
OBJECTIVE:Endoscopic techniques in the field of neurosurgery are under development. To perform sophisticated bimanual procedures in the delicate surgical fields of neurosurgery, rigid endoscope fixation devices with accurate locking and a safe releasing system are required. Here, we report the development of a new hybrid integrated endoscope-holder system. INSTRUMENTATION:The basic concepts of the holding device were as follows: 1) it should combine both video system and holding device; 2) it should have easy maneuverability and accurate fixation and be equipped with a safe releasing mechanism; and 3) it should be able to be used universally either in a primary or an assisting endoscopic procedure. A negatively actuated air-locking system and a bayonet-shaped endoscope were newly developed. Clinical trials of 25 patients were performed, and each prototype was tested and modified until the functional requirements were fulfilled. The final version was tested for accuracy and security in fixation and releasing mechanism. RESULTS:Eight problems were encountered in the clinical trials and improved. Accuracy in fixation of the final version was superior to the most advanced endoscope-holder on the market. No dangerous events were observed during repetitive insertion, fixation, and release in the simulated deep surgical field in the cadaveric skull. No apparent complications were noted in the clinical application. CONCLUSION:We have developed a highly reliable, accurately fixable, and easily maneuverable hybrid endoscope-holder system. To achieve a safer, more accurate, and less invasive surgery in the current socioeconomic demands, commercial manufacturers and surgeons in multiple centers need to combine their efforts to create useful techniques.