整合電子非光纖內視鏡在單孔胸腔內視鏡手術之可行性

Feasibility of Integrated Electrical Non-Fiberoptic Endoscope in Single-Incision Thoracoscopic Surgery

陳治豪(Chih-Hao Chen)

指導教授 ： 張合

國立臺北科技大學/機電學院/機電科技研究所/博士(2013年)

https://doi.org/10.6841/NTUT.2013.00256

摘要

本研究在於簡化目前所使用在內視鏡手術之內視鏡組套，我們所嘗試發展的新形態內視鏡是特別有利於外科醫師所進行之單一孔洞內視鏡手術，其特性在於獨立的影像感應系統與許多整合性的功能。
我們所使用的影像感應系統為高度整合型之鏡頭兼具微小化與省電化之優勢，整體費用可因此大幅下降。
因傳統手術用之硬式內視鏡使用光纖作為光源傳導使用，有斷裂與維護成本高昂等缺失，本研究中所使用之新型內視鏡則拋棄了傳統使用光纖以傳導光源的設計，因而改用發光二極體作為主要的照明組件。同時也將此種高度整合之內視鏡導入無線傳輸模組，製造出使用上更便利且更適合擁有廣泛適用性之新型內視鏡系統。
其實用性與適用性是由淡水馬偕醫院之實驗動物中心完成動物相關內視鏡手術之測試，所測試的手術包含了肺葉切除手術, 食道切除手術, 心包膜切開術等等各式常見之胸腔手術。

關鍵字

內視鏡 ； 內視鏡手術 ； 胸腔內視鏡 ； 單孔內視鏡手術

並列摘要

The Study aims to simplify the overall design of endoscope in current application of endoscopic surgery. We tried to develop an endoscope that is particularly useful in the execution of single-port thoracoscopic surgery. The features of such endoscope consist of an independent viewing device with multiple integrated functions.
The viewing device is a complementary-metal-oxide-semiconductor(CMOS) image sensor which is integrated onto the tip of an endoscope. Using complementary-metal-oxide-semiconductor can reduce the overall cost and provides to be more energy-saving.
Conventional endoscope of rigid form takes use of optic fibers to convey the required light into the pleural space. The optic fibers had been abandoned in our design. Avoiding optic fibers can greatly reduce the potential repair costs because the fibers may be damaged after repeated use. We used light-emitting-diode(LEDs) to replace the role of optic fibers in conventional design.
In testing the feasibility, we used consecutive animal studies in the animal center of Tanshui Mackay Memorial Hospital. The tested procedure included pulmonary lobectomy, esophagectomy, wedge resection of lung, esophagomyotomy, diaphragm plication and pneumonectomy. In the end, we extended our design to wireless version as an ALL-In-One design.

並列關鍵字

endoscope ； endoscopic surgery ； thoracoscopy ； single incision endoscopic surgery

參考文獻

1. Chen, C.H., H. Chang, S.Y. Lee, H.C. Liu, T.T. Hung, and W.C. Huang, "Single-port thoracoscopic surgery can be a first-line approach for elective thoracoscopic surgery," Rev Port Pneumol. vol. 18,(6) 2012,pp.278-84.

2. Chen, C.H., W.S. Lin, H. Chang, S.Y. Lee, T.T. Hung, and C.Y. Tai, "Treatment of Bilateral Empyema Thoracis Using Unilateral Single-Port Thoracoscopic Approach," Ann Thorac Cardiovasc Surg. vol. 2013,pp.

3. Chen, C.H., S.Y. Lee, H. Chang, H.C. Liu, C.H. Chen, and W.C. Huang, "Technical aspects of single-port thoracoscopic surgery for lobectomy," J Cardiothorac Surg. vol. 7, 2012,pp.50.

4. Chen, C.H., S.Y. Lee, H. Chang, H.C. Liu, T.T. Hung, and C.H. Chen, "The adequacy of single-incisional thoracoscopic surgery as a first-line endoscopic approach for the management of recurrent primary spontaneous pneumothorax: a retrospective study," J Cardiothorac Surg. vol. 7, 2012,pp.99.

5. Reuter, M., "[Philipp Bozzini (1773-1809): The endoscopic idealist]," Urologe A. vol. 45,(9) 2006,pp.1084-8, 1090-1.