NEW DEVELOPMENT OF ARTHROSCOPE WITH A CHANNEL FOR MINIMUM INVASIVE TMJ SURGERY AND CLINICAL APPLICATION

一种具有颞下颌关节（TMJ）内窥镜通道的新型关节镜及其手术所需的器械已被开发出来。以往的TMJ内镜手术主要采用单穿刺和双穿刺两种技术。单穿刺技术又可分为盲法和目视法。盲法的缺点是无法进行精确的手术。直接目视技术的缺点是由于该技术使用的关节镜晶状体系统需要手术通道，且该内窥镜直径较厚（3.8X2.0 mm），手术损伤较高。双穿刺技术的缺点是需要大量的技巧来操纵手术器械（通过单独的套管插入）进入通过另一个套管插入的关节镜的视野。在最近开发出高像素（15000像素）的直径非常小的纤维镜之后，我们最近又开发了一种新的关节镜，旨在解决之前的问题。该关节镜结合了纤维镜和手术通道（直径1.1mm）。这种纤维镜插管的长度和直径（直径2.9毫米）与最常用的Striker关节镜插管相同。与此同时，我们已经开发了用于手术的器械，可以通过关节镜的手术通道（探针，钳，刀，烧灼刀等）。与传统技术相比，使用这种关节镜造成的手术损伤更小，并且可以进行更可靠的关节镜手术。

A new arthroscope, which has a channel for endscopic surgery of the temporomandibular joint (TMJ), and the instruments needed for this surgery have been recently developed. In the past, two techniques (single puncture and double puncture techniques) were used for endoscopic surgery of TMJ.The single puncture technique can be subdivided into the blind technique and the direct visual technique. The blind technique has a disadvantage in that a precise surgery is not possible. The direct visual technique has disadvantage in that because the arthroscopic lens systems used for this technique need a channel for surgery, and the diameter of this endoscope is thick (3.8X2.0 mm) and causes a relatively high surgical damages. The double puncture technique has a disadvantage in that much skill is needed for maneuvering the surgical instruments (inserted through a separate cannula) into the visual field of the arthroscope inserted through another cannula. Following the recent development of a very small diameter fiberscope with a high pixel number (15,000 pixel), we have recently developed a new arthroscope, designed to resolve the previous problems. This arthroscope combines a fiberscope with a surgical channel (phi1.1mm). The length and diameter (phi2.9mm) of this fiberscope cannula are identical to those of the most frequently used Striker's arthroscope cannula. At the same time, we have developed the instruments for use in surgery that would fit through the surgical channel of this arthroscope (probe, forceps, knives, cautery knives, etc.). The use of this artroscope causes less surgical damage and allows more reliable arthroscopic surgery, when compared with conventional techniques.