系列可视化操作器械在内窥镜下齿状突切除术中的初步应用

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摘要目的：克服目前颈椎前路内镜手术器械存在的缺点，设计带有内窥镜的系列可视化操作器械，并在尸体标本上应用此系列可视化操作器械行寰椎前弓及齿状突的切除，评价其可行性。方法：在1具新鲜成年尸体标本上应用系列可视化操作器械检验其实际应用情况。另选16具福尔马林保存的尸体标本，随机分成实验组和对照组，每组8具标本，在双通道操作配合下，实验组应用系列可视化操作器械，而对照组则应用常规手术器械，行寰椎前弓和齿状突等组织切除术，并记录手术时间及C型臂X光机的透视次数。结果：在所有尸体标本上均完成寰椎前弓和齿状突等组织的切除，基本实现预想的功能。实验组在手术时间及C型臂X光机透视的次数明显优于对照组。结论：在双通道操作配合下，系列可视化操作器械能改进目前手术器械的缺点，缩短手术时间，降低术者及患者的X射线暴露剂量，提高颈椎前路经颈内窥镜下手术的安全性和精确性。

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关键词 ：可视化操作器械, 内窥镜, 颈椎, 手术技术

Abstract：Objective: To overcome the drawbacks of the current instruments, a series of novel endoscopic instruments was designed and its feasibility in endoscopic transcervical odontoidectomy was assessed. Methods: In 1 fresh frozen adult cadaver, the series of novel endoscopic instruments was applied for endoscopic transcervical odontoidectomy. Sixteen formalin-fixed adult cadavers were randomly divided into two groups (the experimental group and the control group). In the experimental group, the series of novel endoscopic instruments was applied. And in the control group, conventional surgical instruments were applied. Cooperating between the instruments in left and right anterior transcervical approaches, all the 16 formalin-fixed cadavers underwent endoscopic transcervical odontoidectomy. The operating time and X-ray exposure frequency of the two groups were recorded. Results: In all cadavers, the anterior arch of atlas and odontoid were successfully resected. The expected advantages of the series of novel endoscopic instruments were achieved. Compared with the control group, the experimental group showed superiority in the operating time and X-ray exposure frequency. Conclusion: The series of novel endoscopic instruments can overcome the drawbacks of the current instruments for endoscopic cervical surgery. Cooperating between the instruments in left and right approaches, the series of novel endoscopic instruments can reduce the operating time and X-ray exposure frequencies, and can make the operation safer, more convenient and more accurate.

Key words： endoscopic instruments endoscope cervical spine surgical technique

收稿日期: 2016-03-01

基金资助:浙江省自然科学基金资助项目（LY14H060008）；浙江省医药卫生科技计划资助项目（平台计划-骨干人才，2015111494）；国家自然科学基金资助项目（81572214，81372014，81501933，81271663，3147114）。

通讯作者: 池永龙，主任医师，Email：chiyonglongwz@163.com。

作者简介: 林仲可（1975-），男，浙江温州人，主治医师，博士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2016/V46/I11/787

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