OPERATIVE METHOD BY NEWLY DEVELOPED ARTHROSCOPE WITH A CHANNEL FOR ENDOSCOPIC SURGERY OF TEMPOROMANDIBULAR JOINT

最近研制了一种新的关节镜，它具有内窥镜手术的通道，以及手术所需的器械。继最近研制出具有高像素数(15,000像素)的极小直径纤维内窥镜之后，我们最近又开发了一种新的关节内窥镜，旨在解决以前的问题。该关节镜结合了纤维内窥镜和手术通道(φ1.1 mm)。这种纤维内窥镜插管的长度和直径(φ2.9 mm)与最常用的前锋关节镜插管相同。同时，我们已经开发出适合通过关节镜手术通道的手术器械(探头、钳子、刀、烧灼刀等)。目的：从组织学和放射学角度评价关节镜下电灼术治疗绵羊TMJ后的组织反应。选用成年美利奴羊13只，体重约60公斤。The Instr…本研究中使用的更多的是新研制的带通道的关节镜。将电灼器插入内通道，尖端直接靠在后袋的滑膜上，以125W的功率电灼术从内侧壁到外侧壁损伤表面。然后将尖端放在结节的关节表面上，结节从内侧到外侧用电缆线损伤，直到衬里的骨暴露。于首次手术后第2、4、8、12周，麻醉剂量过大处死动物。标本脱钙后，从外侧向内侧矢状切开进行组织学观察。在初次手术后的第4周，所有的椎间盘都被穿孔。初次手术后12周，部分区域髁状突关节表面部分剥离，部分表面呈纤维性修复，关节盘移位至前方。这些变化在放射学和组织学上类似于晚期骨关节炎。结果表明，关节镜下电灼后囊滑膜松解术可诱导绵羊TMJ的骨关节炎改变。较少

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. 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 (φ1.1mm). The length and diameter (φ2.9mm) 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.). To evaluate the tissue response after arthroscopic lysis with electrocautery in the temporomandibular joint (TMJ) of sheep histologically and radiologically. Thirteen adult merino sheep, weighting about 60 kg, were used. The instr … More uments used in this study were a newly developed arthroscope with a channel. Electrocautery was inserted into the inner channel and the tip placed directly against the synovial membrane of the posterior pouch and the surface was injured from medial to lateral walls by electrocautery with a power of 125 watts. The tip is then placed against the articular surface of the tuber which was damaged from medial to lateral part with electrocortery until the underlining bone was exposed. At the 2nd, 4th, 8th, 12th week after the initial operation, the sheep were sacrificed by an anesthetic overdose. The specimens were decalcified and sagitally sectioned from lateral to medial for histologic study.At the 4th week after the initial operation, all discs were perforated. At the 12th week after the initial operation, the condylar articular surface was partly denuded in some areas, and part of the surface showed fibrous repair, and the disc was displaced to the anterior portion. These changes were radiographically and histologically similar to advanced osteoarthritis. Is was suggested that an arthroscopic lysis with electrocautery against the synovial membrane of the posterior pouch was induced the osteoarthritic change of sheep TMJ. Less