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改良内镜潜水技术,无需传统冲洗系统的内镜颅底手术:技术说明。

Modified Endoscopic Diving Technique without the Traditional Irrigation System in Endoscopic Cranial Base Surgery: Technical Note.

机构信息

Division of Neurosurgery, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, San Martino - IST University Hospital (IRCCS), Genoa, Italy.

Division of Neurosurgery, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, San Martino - IST University Hospital (IRCCS), Genoa, Italy.

出版信息

World Neurosurg. 2019 Jul;127:146-149. doi: 10.1016/j.wneu.2019.03.276. Epub 2019 Apr 5.

Abstract

BACKGROUND

We describe a modified endoscopic diving technique with an alternative irrigation system different than the one used by Locatelli et al. (CLEARVISION II, Karl Storz and Co., Tuttlingen, Germany).

METHODS

From January 2016 to October 2018, our senior surgeon performed the modified endoscopic diving technique in 76 endoscopic surgical procedures. Diving surgery was performed in all procedures to check the completeness of tumor resection, thus allowing for the removal of any residual tumor tissue.

RESULTS

In the modified endoscopic diving technique, the optic system and the irrigation source are separated into 2 independent tools, allowing surgeons to point the flow on a selected structure, whereas the endoscope can be pointed in the same direction or not. Moreover, the optic system and the irrigation source can be placed at different distances. Surgeons can control the infusion pressure and the entity of the flow.

CONCLUSIONS

The use of the modified endoscopic diving technique allows surgeons to have more settings that could be controlled and also bypasses any compatibility issues between different endoscopic systems. In addition, the reproducibility of this technique, together with the low cost of the instrumentation, could allow an easier application of the diving technique.

摘要

背景

我们描述了一种改良的内镜潜水技术,该技术采用了与 Locatelli 等人(德国卡尔史托斯公司的 CLEARVISION II)不同的替代冲洗系统。

方法

从 2016 年 1 月至 2018 年 10 月,我们的资深外科医生在 76 例内镜手术中实施了改良的内镜潜水技术。潜水手术在所有手术中进行,以检查肿瘤切除的完整性,从而可以切除任何残留的肿瘤组织。

结果

在改良的内镜潜水技术中,光学系统和冲洗源分为 2 个独立的工具,允许外科医生将水流指向选定的结构,而内镜可以指向相同的方向或不同的方向。此外,光学系统和冲洗源可以放置在不同的距离。外科医生可以控制输液压力和水流的强度。

结论

改良内镜潜水技术的使用使外科医生可以有更多的设置可以控制,并且可以绕过不同内镜系统之间的任何兼容性问题。此外,该技术的可重复性以及仪器的低成本,可以使潜水技术更容易应用。

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