Nakamura Takuya, Ogiwara Toshihiro, Goto Tetsuya, Fujii Yu, Miyaoka Yoshinari, Hanaoka Yoshiki, Horiuchi Tetsuyoshi, Hongo Kazuhiro
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
World Neurosurg. 2020 Feb;134:293-296. doi: 10.1016/j.wneu.2019.11.021. Epub 2019 Nov 9.
When medical devices and equipment in an operating room are connected to a network, vast amounts of data concerning the progress of the operation and the patient's condition can be comprehensively processed to improve the precision and safety of the surgical procedure. To make this possible, a next-generation networked operating room, "Smart Cyber Operating Theater" (SCOT), has been developed with medical-engineer cooperation. SCOT integrates stand-alone medical devices using the "OPeLiNK" communication interface. Using OPeLiNK, medical devices are connected and various data, such as intraoperative magnetic resonance imaging, neuromonitoring, biochemical monitoring, and navigation system, are integrated and displayed in the same timeline.
The authors succeeded in clinical tumor resection via the endoscopic endonasal approach using the SCOT system in a 79-year-old man with a large nonfunctioning pituitary adenoma. The surgeons performed the operation while sharing information in real time between all staff in the operating room and supervising expert surgeons at the surgical strategy desk. Any decisions, such as intraoperative surgical procedures, were made with discussion between the operating room and the surgical strategy desk. The patient's postoperative course was uneventful.
This is the first case report of endoscopic endonasal approach performed successfully in the SCOT. Further developments in this technology may lead to innovations in not only microscopic neurosurgery but also endoscopic neurosurgery.
当手术室中的医疗设备和器械连接到网络时，大量有关手术进展和患者病情的数据能够得到全面处理，从而提高手术过程的精准度和安全性。为实现这一目标，医疗工程师合作开发了下一代联网手术室——“智能网络手术室”（SCOT）。SCOT 使用“OPeLiNK”通信接口整合独立的医疗设备。通过 OPeLiNK，医疗设备得以连接，诸如术中磁共振成像、神经监测、生化监测及导航系统等各类数据被整合并显示在同一时间轴上。
作者使用 SCOT 系统，通过鼻内镜经鼻入路，成功为一名患有大型无功能垂体腺瘤的 79 岁男性实施了临床肿瘤切除术。手术过程中，手术团队成员在手术室全体人员与手术策略台的监督专家外科医生之间实时共享信息。诸如术中手术步骤等任何决策，都是在手术室与手术策略台之间进行讨论后做出的。患者术后恢复顺利。
这是首例在 SCOT 中成功实施鼻内镜经鼻入路手术的病例报告。这项技术的进一步发展不仅可能给显微神经外科带来创新，也可能给内镜神经外科带来创新。
