{"id":10326,"date":"2021-11-11T13:37:56","date_gmt":"2021-11-11T12:37:56","guid":{"rendered":"https:\/\/lifelonghearing.com\/?p=10326"},"modified":"2025-04-19T12:03:38","modified_gmt":"2025-04-19T12:03:38","slug":"pirma-robotizeta-kohleara-implantacija-austrija","status":"publish","type":"post","link":"https:\/\/lifelonghearing.com\/lv\/pirma-robotizeta-kohleara-implantacija-austrija\/","title":{"rendered":"Pirm\u0101 robotiz\u0113t\u0101 kohle\u0101r\u0101 implant\u0101cija Austrij\u0101"},"content":{"rendered":"

HEARO \u2013 celmlau\u017ea cien\u012bgs veikums kohle\u0101ro implantu \u0137irur\u0123ij\u0101<\/h1><\/div>

Septembr\u012b V\u012bn\u0113 notika pirm\u0101 robotiz\u0113t\u0101 kohle\u0101r\u0101 implant\u0101cija v\u0101ciski run\u0101jo\u0161aj\u0101 re\u0123ion\u0101. \u0136irurgs prof. Dr. Volfgangs Gstotners (Volfgang Gst\u00f6ttner) izmantoja HEARO, kas ir \u012bpa\u0161s \u0137irur\u0123isks robots kohle\u0101raj\u0101m implant\u0101cij\u0101m, pal\u012bdz\u012bbu, lai piek\u013c\u016btu iek\u0161\u0113jai ausij.<\/strong><\/p>\n<\/div>

<\/span><\/div><\/div><\/div><\/div><\/div>

Za\u013c\u0161 oper\u0101ciju zon\u0101 noz\u012bm\u0113 \u201ct\u012brs\u201d. Viss, kas ir sterils un kam t\u0101dam j\u0101paliek, ir p\u0101rkl\u0101ts ar za\u013ciem p\u0101rkl\u0101jiem: piem\u0113ram, instrumentu galds ar pincet\u0113m, skavas, skalpe\u013ci un urbji un da\u017e\u0101das ier\u012bces, kas sagatavotas lieto\u0161anai ar p\u0101rkl\u0101tas steriliem p\u0101rkl\u0101jiem. \u0136irurgu komanda lieto ar\u012b za\u013cus t\u0113rpus un \u010d\u012bbas. Un visbeidzot, ar\u012b oper\u0101ciju galds ir p\u0101rkl\u0101ts ar za\u013cu.<\/p>\n

T\u0101 sauktais \u201cgalds\u201d, kas paties\u012bb\u0101 ir d\u012bv\u0101ns, kura smaguma centrs balst\u0101s uz kvadr\u0101tveida kolonnas pamatnes, var tikt sasv\u0113rts visos virzienos un saliekties vair\u0101k\u0101s viet\u0101s. T\u0101d\u0113j\u0101di pacientu var novietot optim\u0101l\u0101 poz\u012bcij\u0101 attiec\u012bg\u0101s oper\u0101cijas veik\u0161anai.<\/p>\n

17. septembr\u012b, piecdesmit gadus vecs v\u012brietis g\u016bl\u0101s uz galda visp\u0101r\u0113j\u0101 anest\u0113zij\u0101. Vi\u0146\u0161 ir piespr\u0101dz\u0113ts ar plat\u0101m jost\u0101m, lai nevar\u0113tu izsl\u012bd\u0113t, un ar\u012b ir apkl\u0101ts ar za\u013cu p\u0101rkl\u0101ju. Vien\u012bgais redzamais laukums ir ap vi\u0146a ausi, kur veicama oper\u0101cija: kohle\u0101r\u0101 implanta ievieto\u0161ana. No griestiem telp\u0101 stiepjas tr\u012bs varenas rokas, un katr\u0101 no t\u0101m ir viena no lielaj\u0101m virsmas gaism\u0101m, kas izgaismo pacientu un \u0137irur\u0123isko zonu. Fon\u0101 ir monotona, p\u012bksto\u0161a ska\u0146a, kas n\u0101k no ier\u012bc\u0113m, kas kontrol\u0113 pacienta sirdi un elpo\u0161anu anest\u0113zijas laik\u0101.<\/p>\n

Roboti kohle\u0101ro implantu oper\u0101ciju z\u0101l\u0113 ir jaunums<\/h2>\n

Ja netr\u016bktu mikroskopu, tad oper\u0101ciju z\u0101le V\u012bnes Universit\u0101tes slimn\u012bc\u0101 AKH l\u012bdzin\u0101tos t\u0101s ierastajam izskatam katras kohle\u0101r\u0101s implant\u0101cijas s\u0101kum\u0101. T\u0101 viet\u0101 st\u016br\u012b gaida datortomogr\u0101fs un uz maziem p\u0101rvietojamiem galdi\u0146iem ir gatavi papildu datori. Tie tiks izmantoti pl\u0101no\u0161anai, \u0137irur\u0123ijas robotu kontrolei un gala p\u0101rbaudei pirmaj\u0101 robotiz\u0113taj\u0101 kohle\u0101raj\u0101 implant\u0101cij\u0101 V\u012bn\u0113.<\/p>\n

Lai gan kop\u0161 1990. gadiem ir iesp\u0113jama ar robota pal\u012bdz\u012bbu veikta oper\u0101cija ortop\u0113dij\u0101, HEARO bija pirmais robots, kas 2016. gad\u0101 tika izmantots kohle\u0101rajai implant\u0101cijai Bern\u0113, \u0160veic\u0113. \u201cP\u0113c divu desmitu gadu pieredzes neiro\u0137irur\u0123ij\u0101 un LOR mums joproj\u0101m ir vair\u0101ku milimetru novirze ar parastaj\u0101m vad\u012bbas sist\u0113m\u0101m,\u201d skaidro prof. Volfgangs Gstotners (Volfgang Gst\u00f6ttner), MD. Tom\u0113r kohle\u0101raj\u0101s implant\u0101cijas pat milimetra da\u013ca ir svar\u012bga,lai nosarg\u0101tu tuv\u0113jos asinsvadus un jut\u012bgos nervus. Tam nepiecie\u0161ama liel\u0101ka precizit\u0101te un uzticam\u012bba nek\u0101 ortop\u0113dij\u0101.<\/p>\n

HEARO kohle\u0101r\u0101s implant\u0101cijas robots kombin\u0101cij\u0101 ar datortomogr\u0101fa att\u0113lu un sejas nervu monitor\u0113\u0161anu nodro\u0161ina \u0161o precizit\u0101ti un uzticam\u012bbu. Tas ir CAS un MED-EL 10 gadu att\u012bst\u012bbas rezult\u0101ts kop\u0101 ar zin\u0101tniekiem un kl\u012bni\u0137iem.<\/p>\n

Viena roka un divi sensori<\/h2>\n

Vispirms, pacients ir r\u016bp\u012bgi novietots uz oper\u0101ciju galda: galva j\u0101novieto t\u0101, lai datortomogr\u0101fa skeneris v\u0113l\u0101k var\u0113tu rot\u0113t ap to, nepieskaroties tai. P\u0113c tam HEARO robota atsevi\u0161\u0137as da\u013cas tiek novietotas atbilsto\u0161aj\u0101 poz\u012bcij\u0101. Roka v\u0113l\u0101k vad\u012bs urbi Visjut\u012bg\u0101k\u0101 HEARO da\u013ca ir kamera. Tikl\u012bdz tas ar diviem sensoriem par\u0101d\u0101s pie pacienta auss, HEARO atg\u0101dina \u201cWall-E\u201d \u2013 robotu no \u201cPixar\u201d anim\u0101cijas filmas ar t\u0101du pa\u0161u nosaukumu, kas darbojas, lai sak\u0101rtotu haosu uz Zemes.<\/p>\n

Pirms HEARO \u201catt\u012bra ce\u013cu\u201d elektrodam, j\u0101p\u0101rliecin\u0101s, vai uz t\u0101 navig\u0101ciju var pa\u013cauties. Izejas punkts ir modelis, kas izgatavots no melnpel\u0113kas 3D drukas, kas att\u0113lo pacienta kaulu. Atz\u012bm\u0113jumadatas mirdz zil\u0101 kr\u0101s\u0101, iez\u012bm\u0113jot v\u0113lamos robota navig\u0101cijas punktus. \u201c\u0160\u012b b\u016bs n\u0101kotne visiem kohle\u0101ro implantu pacientiem,\u201d sprie\u017e prof. Dr. Kristofs Oderners (Christoph Arnoldner), kur\u0161 asist\u0113 \u0137irur\u0123ijas z\u0101l\u0113. \u0136irurgs ir prof. Dr. Volfgangs Gstotners (Wolfgang Gst\u00f6ttner). Vi\u0146\u0161 s\u0101k oper\u0101ciju ar \u012bsu skalpe\u013ca iegriezumu, mazliet nob\u012bda \u0101du s\u0101nis un atz\u012bm\u0113 mar\u0137\u0113jumus. Person\u0101ls, kas kontrol\u0113 datortomogr\u0101fa sken\u0113\u0161anu, gatavojas oper\u0101cijai, izmantojot pretradi\u0101cijas aizsardz\u012bbu.<\/p>\n

Jums ir j\u0101b\u016bt tic\u012bbai<\/h2>\n

T\u0101l\u0101k darbu paveic grupas. Prof. Gstotners (Gst\u00f6ttner) sagatavo implanta gultu, kur v\u0113l\u0101k dro\u0161i atrad\u012bsies implanta elektronika. Tehni\u0137u komanda r\u016bp\u0113jas par datortomogr\u0101fijas sken\u0113\u0161anas datiem. Oper\u0101cijas z\u0101les otr\u0101 gal\u0101 tehni\u0137i jau iedarbina dator\u0101 programmu OTOPLAN.
\nOTOPLAN, kas ar\u012b ir CAS produkts, ir specializ\u0113ts DICOM p\u0101rl\u016bks. Tas noz\u012bm\u0113, ka tas par\u0101da datus no datortomogr\u0101fa izmekl\u0113jumiem divdimensiju sekciju att\u0113los un tr\u012bsdimensiju mode\u013cos. Kohle\u0101rajai implant\u0101cijai OTOPLAN var pal\u012bdz\u0113t izv\u0113l\u0113ties atbilsto\u0161o elektrodu jau pl\u0101no\u0161anas stadij\u0101. Robotiz\u0113tai implant\u0101cijai OTOPLAN apr\u0113\u0137ina prec\u012bzu un optim\u0101lu pieeju. Dati tiek nos\u016bt\u012bti uz HEARO.<\/p>\n

Un tad, lielais moments: uz ekr\u0101na blakus darba galdam par\u0101d\u0101s v\u0101rdi \u201cHEARO-\u0136irur\u0123ija\u201d ar start\u0113\u0161anas pogas ikonu. Visjut\u012bg\u0101k\u0101 da\u013ca ir inicializ\u0101cija, kas j\u0101veic s\u0101kum\u0101. Ja proced\u016bru iztrauc\u0113, piem\u0113ram, piespiedu kust\u012bba pie oper\u0101ciju galda, to atk\u0101rto dro\u0161\u012bbas labad. Katr\u0101 gad\u012bjum\u0101 ekr\u0101n\u0101 tiek par\u0101d\u012bts pa\u0161reiz\u0113jais progress un nor\u0101d\u012bjumi par turpm\u0101kajiem so\u013ciem. P\u0113c da\u017eiem klik\u0161\u0137iem robota roka p\u0101rvietojas pie pacienta galvaskausa. \u201d<\/p>\n

P\u0113c tam \u0137irurgam vairs nav iesp\u0113jas iejaukties, vien\u012bgi piln\u012bb\u0101 p\u0101rtraukt oper\u0101ciju. \u0160is ir jauns solis, kas man bija mazliet sve\u0161s, \u201c\u0161o br\u012bdi raksturo kohle\u0101ro implantu speci\u0101lists Gstotnera (Gst\u00f6ttner) kungs. Oper\u0101ciju z\u0101l\u0113 vi\u0146\u0161 tagad var br\u012bvi sakrustot rokas: \u201cTas ir k\u0101 kaln\u0101 k\u0101p\u0113jam: no br\u012b\u017ea, kad tu ie\u0137eries virv\u0113, tev j\u0101uzticas virvei.\u201d Izmantojot ped\u0101\u013cus, vi\u0146\u0161 kontrol\u0113 robotu, kas patst\u0101v\u012bgi izurbj elektrodam kan\u0101lu. \u201cTas \u013coti at\u0161\u0137iras no cit\u0101m robotiz\u0113t\u0101m sist\u0113m\u0101m, kur robots tikai atk\u0101rto \u0137irurga roku kust\u012bbas.\u201d<\/p>\n

Minim\u0101la invaz\u012bva piek\u013cuve iek\u0161\u0113jai ausij, pateicoties HEARO<\/h2>\n

Robots kontrol\u0113ti urbjas kaul\u0101, l\u0113ni un saudz\u012bgi. Tas tikai uz \u012bsu br\u012bdi aptur darbu datortomogr\u0101fijas kontroles laik\u0101 un p\u0113c tam turpina. Kohle\u0101ro implant\u0101ciju laik\u0101 cilv\u0113ka kaula kars\u0113\u0161ana urb\u0161anas un mal\u0161anas laik\u0101 parasti rada tipisku smaku. Nedaudz min\u016btes v\u0113l\u0101k elektrodu kan\u0101ls ir gatavs un piek\u013cuve kohlejai ir br\u012bva.<\/p>\n

T\u0101 viet\u0101, lai relat\u012bvi pla\u0161i atv\u0113rtu vid\u0113jo ausi savienojumam ar iek\u0161\u0113jo ausi, HEARO no galvaskausa virsmas l\u012bdz kohlejai atst\u0101j tikai 1,8 milimetru mazu caurumu, caur kuru prof. Gstotners (Gst\u00f6ttner) ievieto elektrodu. \u0160eit tiek likts liet\u0101 lielais mikroskops, kas pa to laiku ir p\u0101rvietots atpaka\u013c oper\u0101ciju z\u0101l\u0113. Telemetrija un gal\u012bgais datortomogr\u0101fa sken\u0113jums apstiprina implanta un elektroda funkcionalit\u0101ti un pareizu novietojumu. V\u0113l\u0101k, sist\u0113mas aktiviz\u0113\u0161anas laik\u0101, datortomogr\u0101fa att\u0113ls var pal\u012bdz\u0113t optimiz\u0113t frekvences sadal\u012bjumu, programm\u0113jot audio procesoru.<\/p>\n

Monotonais nov\u0113ro\u0161anas sign\u0101ls no anesteziologa iek\u0101rtas joproj\u0101m pa br\u012bdim iep\u012bkstas fon\u0101, kam\u0113r \u0137irurgs prof. Gstotners (Gst\u00f6ttner) aizver br\u016bci. \u201cTopo\u0161ajiem \u0137irurgiem nav slikti joproj\u0101m apg\u016bt parasto kohle\u0101ro implant\u0101ciju,\u201d prof. Gstotners (Gst\u00f6ttner) v\u0113l\u0101k konsult\u0113s savus kol\u0113\u0123us cit\u0101s kl\u012bnik\u0101s. Ikdienas lieto\u0161anai kl\u012bnik\u0101 HEARO vi\u0146am \u0161\u0137iet p\u0101r\u0101k laikietilp\u012bgs un darbasp\u0113ka-ietilp\u012bgs. \u201cBet tas ir ieskats kohle\u0101r\u0101s implant\u0101cijas n\u0101kotn\u0113.\u201d N\u0101kotne, kas jau s\u0101kusies V\u012bnes universit\u0101tes slimn\u012bc\u0101 \u2013 AKH.<\/p>\n

\n

Robotiz\u0113ta kohle\u0101r\u0101 implant\u0101cija ar HEARO<\/strong><\/p>\n

Kohle\u0101r\u0101s implant\u0101cijas laik\u0101 2021. gada 17. septembr\u012b p\u0113c prof. Dr. Volfganga Gstotnera (Volfgang Gst\u00f6ttner) l\u016bguma V\u012bnes Universit\u0101tes slimn\u012bc\u0101 kohle\u0101rais robots HEARO veica ar\u012b kohleostomiju \u2013 iek\u0161\u0113j\u0101s auss atv\u0113r\u0161anu. Tas bija jaunums ne tikai Austrijai, bet visam v\u0101ciski run\u0101jo\u0161ajam re\u0123ionam! HEARO izveides posm\u0101 Bernes universit\u0101tes slimn\u012bc\u0101 \u0160veic\u0113 tika veiktas devi\u0146as implant\u0101cijas, bet kohleju vienm\u0113r bija atv\u0113ru\u0161i \u0137irurgi. P\u0113c HEARO CE sertifik\u0101cijas 2020.gad\u0101 oper\u0101cijas notika Antverpen\u0113, Be\u013c\u0123ij\u0101 un visbeidzot V\u012bn\u0113.<\/p>\n

HEARO neaizst\u0101s \u0137irurgu vai \u0137irurgu komandu. Robotu vienm\u0113r kontrol\u0113s un vad\u012bs \u0137irurgs, k\u0101 ar\u012b b\u016bs j\u0101seko datortomogr\u0101fijas ier\u012bcei un OTOPLAN programmat\u016brai.<\/p>\n

HEARO kohle\u0101ro implantu oper\u0101cijas pirmsoper\u0101cijas pl\u0101no\u0161ana ir sare\u017e\u0123\u012bta, bet \u013coti prec\u012bza. Oper\u0101cijas laik\u0101 tiek veikti tr\u012bs zema l\u012bme\u0146a datortomogr\u0101fa sken\u0113jumi. Elektrodu kan\u0101la urb\u0161ana ar HEARO aiz\u0146em tikai aptuveni desmit min\u016btes. Tom\u0113r, \u0146emot v\u0113r\u0101 prec\u012bzo sagatavo\u0161anu pirms oper\u0101cijas un kontroles pauzes oper\u0101cijas laik\u0101, kop\u0113jais oper\u0101cijas laiks ar robotu ir ilg\u0101ks nek\u0101 ar parast\u0101s kohle\u0101r\u0101s implant\u0101cijas laiks.<\/p>\n

\u201cVissvar\u012bg\u0101kais ir tas, ka HEARO proced\u016bra \u013cauj \u0137irurgiem atv\u0113rt minim\u0101li invaz\u012bvu pieeju kohlejai un izv\u0113l\u0113ties ide\u0101lu poz\u012bciju, lai piln\u012bb\u0101 ievietotu netraumatisko elektrodu bloku kohlej\u0101,\u201d teica MED-EL vad\u012bt\u0101js doktors Ingeborgs Hohmairs (Ingeborg Hochmair). \u0160is s\u012bkais caurums samazina \u0137irur\u0123isko ietekmi uz pacientu un paaugstina kvalit\u0101ti un dro\u0161\u012bbu.<\/p>\n

Lai ieg\u016btu pla\u0161\u0101ku inform\u0101ciju par HEARO un OTOPLAN, apmekl\u0113jiet\u00a0www.cascination.de<\/a>, www.medel.pro\/products\/otoplan<\/a>, MED-EL Germany YouTube atska\u0146o\u0161anas sarakstu OTOPLAN un atbilsto\u0161\u0101s Podcast\u00a0https:\/\/podtail.com\/podcast\/med-el-podcast\/<\/a>\u00a0epizodes.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"

Septembr\u012b V\u012bn\u0113 notika pirm\u0101 robotiz\u0113t\u0101 kohle\u0101r\u0101 implant\u0101cija v\u0101ciski run\u0101jo\u0161aj\u0101 re\u0123ion\u0101.<\/p>\n","protected":false},"author":4,"featured_media":31952,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[418],"tags":[416,417,422,412],"class_list":["post-10326","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zinatne","tag-accessories","tag-ci","tag-hearing-implant-reliability","tag-hearing-implants"],"yoast_head":"\nPirm\u0101 robotiz\u0113t\u0101 kohle\u0101r\u0101 implant\u0101cija Austrij\u0101<\/title>\n<meta name=\"description\" content=\"Septembr\u012b V\u012bn\u0113 notika pirm\u0101 robotiz\u0113t\u0101 kohle\u0101r\u0101 implant\u0101cija v\u0101ciski run\u0101jo\u0161aj\u0101 re\u0123ion\u0101 ar robota HEARO pal\u012bdz\u012bbu.\" \/>\n<meta name=\"robots\" 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