Keeb xeeb xeeb los ntawm cov khoom siv kho mob, Veress Needle tsim los ntawm Manners Technology tau hloov zuj zus mus rau hauv ib qho ntawm cov pob zeb tsim kho tshiab uas ua rau muaj kev cuam tshuam me me ntawm kev phais. Kev tshuaj xyuas nws ze li ib puas xyoo- txoj kev loj hlob mus ntev thiab kwv yees nws txoj hauv kev nyob rau hauv qhov kev txiav tawm tshiab- cov thev naus laus zis ua rau pom qhov pom ntawm cov cuab yeej kho mob tshiab tau hloov pauv kev phais niaj hnub no.

Keeb Kwm Keeb Kwm: Los ntawm Pulmonary Tuberculosis Therapy mus rau Laparoscopic Access

Xyoo 1932, tus kws kho mob Hungarian János Veress tau tsim lub caij nplooj ntoos hlav -shielded puncture koob los ua kev kho mob pneumothorax rau cov neeg mob tuberculosis, ib qho kev kho mob tsim los ua kom cov kab mob hauv lub ntsws thiab pab kho. Nws qhov kev tsim qauv tseem ceeb yog qhov yooj yim: lub tswv yim ntse yuav tsum tau tho rau ntawm phab ntsa thoracic, tab sis lub ntsej muag ntse ua rau muaj kev pheej hmoo tuag taus ntawm lacerating pulmonary cov ntaub so ntswg ib zaug hauv cov kab noj hniav pleural. Txhawm rau daws qhov tsis zoo no, nws tau tsim lub caij nplooj ntoos hlav-loaded retractable blunt obturator, uas springs rau pem hauv ntej cia li thaiv lub ntse cannula thaum poob ntawm cov ntaub so ntswg tsis kam. Ntau xyoo tom qab, Fabkis gynecologist Raoul Palmer pioneered nws qhov chaw kho mob siv los tsim pneumoperitoneum nyob rau hauv laparoscopy, forging ib tug enduring daim ntawv cog lus ntawm Veress Needle thiab minimally invasive phais.

Technical Debate: Parallel Development of Closed and Open Entry Techniques

Txoj kev kaw - txoj kev nkag uas siv Veress Needle tau nyob ntev ntawm cov txheej txheem laparoscopic nkag rau nws txoj kev xa tawm sai, yooj yim ntawm kev siv thiab qhov loj me me. Loj - cov kev tshawb fawb soj ntsuam tau tshaj tawm nws cov nqi saws mus txog 81% hauv cov txheej txheem gynecological thiab 48% hauv kev phais plab. Txawm li cas los xij, nws qhov muag tsis pom kev nkag mus tau ib txwm ua rau muaj kev txhawj xeeb txog kev kho mob ntawm cov txheej txheem teeb meem. Xyoo 1971, Harrith Hasson tau qhia txog qhov qhib - nkag Hasson cov txheej txheem, uas yog ib qho kev phais plab me me tso cai rau cov txheej txheem anatomical dissection nyob rau hauv kev pom ncaj qha ua ntej blunt trocar insertion rau hauv cov kab noj hniav peritoneal. Tshem tawm qhov muag tsis pom kev, qhov kev xaiv no muaj kev ruaj ntseg zoo tshaj plaws, tshwj xeeb tshaj yog rau cov neeg mob siab - cov neeg mob uas muaj kev pheej hmoo ntawm kev phais plab ua ntej, txawm hais tias lub sijhawm ua haujlwm ntev dua thiab cov tawv nqaij loj dua me ntsis. Ntau xyoo ntawm kev sib cav txog kev kho mob tsis tu ncua tseem hais txog qhov zoo ntawm txhua txoj hauv kev nrog cov kev tshawb pom tsis sib haum thoob plaws cov kev tshawb fawb tshawb fawb; Qhov kev pom zoo thoob ntiaj teb yog tias cov kws phais neeg muaj peev xwm yuav tsum paub ob qho tib si cov tswv yim thiab kev xaiv tus kws txiav txim rau tus neeg mob lub cev thiab cov chaw kho mob.

Tam sim no cov kev sib tw thiab kev tsim kho dua tshiab

Kev tsim kho kom zoo nkauj tau nthuav dav thoob plaws hauv kev lag luam txhawm rau txhim kho Veress Needle qhov kev nyab xeeb profile. Kev kho dua tshiab suav nrog ntau dua - lub caij nplooj ntoos hlav rhiab heev thiab ua kom zoo dua bevel geometry kom txo qis cov ntaub so ntswg nkag mus. Qhov tseem ceeb tshaj plaws, cov txheej txheem kev soj ntsuam kev soj ntsuam cov txheej txheem suav nrog kev xav, dai poob thiab intra- kev soj ntsuam plab plab tau tsim los txhawm rau txo qis kev pheej hmoo. Meanwhile, visualization technology tau muab kev koom ua ke rau hauv thawj lub plab nkag mus ua haujlwm. Qhov tshwm sim ntawm optical trocars ua rau muaj tseeb-lub sij hawm endoscopic pom ntawm cov phab ntsa hauv plab ua tiav thaum lub sij hawm pib trocar, txo qis qhov tshwm sim ntawm visceral thiab vascular raug mob.

Yav tom ntej Outlook: Kev txawj ntse thiab kev ua haujlwm sib koom ua ke

Saib ua ntej, qhov classic Veress Needle architecture yog npaj los hloov mus rau qhov kev txawj ntse thiab kev sib koom ua ke. Embedded micro-sensing sawv cev rau txoj kev loj hlob zoo. Tom ntej no- cov cuab yeej tsim tawm tuaj yeem ua ke cov tshuab hluav taws xob me me thiab cov khoom siv hluav taws xob kho qhov muag kom xa tawm tiag-lub sijhawm cov ntaub so ntswg tiv thaiv profileing thiab intraoperative imagery thaum lub sij hawm cannulation, pab cov kws phais hauv kev sib txawv ntawm cov ntaub so ntswg xws li tawv nqaij, fascia, musculature thiab peritoneum, nrog rau ua ntej- nyob rau hauv emptively {6} adhesions. Kev sib xyaw nrog cov duab navigation yog lwm qhov kev sib tw: preoperative CT lossis MRI datasets tuaj yeem synchronized nrog intraoperative ultrasound los yog electromagnetic navigation platforms los tsim tiag-lub sij hawm peb-dimensional puncture trajectories, enabling tiag tiag duab{10}} coj cannulation.

Tsis hais txog kev ua haujlwm thev naus laus zis ua ntej, Veress Needle tus qauv tsim lub tswv yim ntawm kev nyab xeeb kev nyab xeeb tau qhib los ntawm precision mechanical engineering khaws cov nqi kho mob tsis tuaj yeem hloov pauv. Cov neeg tsim khoom xws li Manners Technology txuas ntxiv ua kom zoo dua machining tolerances, substrate cov ntaub ntawv kev ua tau zoo thiab ntev -lub sij hawm kev cia siab ntawm cov cuab yeej siv thaum nrhiav kev sib koom ua ke ntawm cov pov thawj kev tsim qauv thiab lub xeev- ntawm--art digital technologies. Kev hloov zuj zus los ntawm cov cuab yeej tshwj xeeb rau kev kho mob pneumothorax mus rau hauv lub hauv paus kev siv cuab yeej uas tau qhib lub sijhawm laparoscopic, Veress Needle txoj kev loj hlob ncua sij hawm qhia txog tias cov cuab yeej kho mob tau nce qib li cas hauv kev teb rau kev hloov kho cov cai. Txawm hais tias kev rov ua dua yav tom ntej yuav zoo li yuav siv cov kev tsim kho kom zoo dua qub, nws lub hom phiaj tsim los tiv thaiv tus neeg mob kev nyab xeeb yuav tsis hloov pauv.