摘要
经皮椎间孔镜腰椎间盘切除术(percutaneous endoscopic lumbar discectomy, PELD)是微创手术中成熟且主流的技术，可在内镜直视下逐步摘除钙化及突出的椎间盘，治疗腰椎间盘突出症(lumbar disc herniation, LDH)。然而，PELD术中的定位、穿刺、建立手术通道过程难度大，依赖影像引导。超声具有实时引导、无辐射等优势，在引导椎间孔穿刺中具有良好的临床应用价值。然而该技术依赖医师经验，学习曲线长，在边远地区及基层医疗单位推广难度较大。5G远程超声机器人结合了医疗机器人以及5G网络通讯技术，可以实现在医师端通过机器臂直接对远程端患者进行扫查，并通过语音交互实现对手术医师的指导。本文报道2022年4月完成的国内外首例5G远程超声引导PELD手术，证实了该技术的可行性，为保障边远地区的基层医疗需求提供了一种新的解决方案。
Abstract
Percutaneous endoscopic lumbar discectomy (PELD) is a mature and mainstream technique in minimally invasive surgery, which can gradually remove calcified and herniated intervertebral discs under direct endoscopic vision for the treatment of lumbar disc herniation (LDH). However, the process of positioning, puncture, and establishment of surgical access during PELD is difficult and relies on image guidance. Ultrasound has the advantages of real-time guidance and no radiation, and has good clinical application value in guidance of PELD. However, this technology relies on the experience of physicians and has a long learning curve, which makes it difficult to promote. The 5G remote ultrasound robot combines medical robots and 5G network communication technology, which can directly scan remote patients through the robotic arm at the doctor's end, and provide guidance to the surgeon through voice interaction. This paper reports the first 5G remote ultrasound-guided PELD surgery in China and abroad completed in Apr. 2022, which confirms the feasibility of this technology and provides a new solution to meet the needs of primary care in remote areas.
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