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Gdańscy naukowcy opracowali pierwsze na świecie narzędzie do oceny ukrwienia narządów przewodu pokarmowego

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Eksperci z Gdańskiego Uniwersytetu Medycznego oraz Politechniki Gdańskiej opracowali prototyp narzędzia służącego do śródoperacyjnego badania ukrwienia narządów przewodu pokarmowego. Urządzenie może zwiększyć efektywność wykonywanych zabiegów, a także zmniejszyć liczbę powikłań pooperacyjnych.

Prace nad nowatorskim narzędziem prowadzone są przez prof. Jacka Zielińskiego z Katedry i Kliniki Chirurgii Onkologicznej Gdańskiego Uniwersytetu Medycznego i realizowane są w ramach projektu „Metoda i urządzenie do skojarzonej oceny ukrwienia narządów przewodu pokarmowego”. Na ten cel przeznaczono fundusze w wysokości 100 tys. zł, które pochodzą z programu Inkubator Innowacyjności 4.0.

Ukrwienie tkanek ma szczególne znaczenie w chirurgii przewodu pokarmowego

Prof. Zieliński wyjaśnia, że w chirurgii stan ukrwienia tkanek jest podstawowym warunkiem gwarantującym prawidłowe gojenie ran.  Ukrwienie tkanek ma także szczególne znaczenie w chirurgii przewodu pokarmowego.

– W przypadku przewodu pokarmowego stan zaburzenia ukrwienia jest ściśle powiązany z poziomem wykonywania resekcji, począwszy od przełyku a skończywszy na dystalnej okolicy, czyli odbytnicy – wskazuje ekspert.

W praktyce klinicznej wysokie ryzyko niedokrwienia dotyczy przełyku zespalanego z żołądkiem, jelitem cienkim lub jelitem grubym. Zaburzenia ukrwienia mogą również pojawiać się w kikucie odbytnicy oraz w końcu jelita cienkiego lub grubego wykorzystywanego do zespolenia lub wyłonienia stomii.

Po dokonaniu resekcji odcinka przewodu pokarmowego, jak wyjaśniają gdańscy naukowcy, jedynym z najważniejszych warunków prawidłowego gojenia jest wykonanie zespolenia w zakresie tkanek o prawidłowym ukrwieniu, czyli o prawidłowym dopływie krwi. Błędne oszacowanie ukrwienia tkanek i sposób ich zespolenia może doprowadzić do komplikacji pooperacyjnych, co może wiązać się z koniecznością przeprowadzenia zabiegu korekcyjnego, a w najgorszym przypadku – wywołać sepsę lub spowodować zgon pacjenta.

Prototyp urządzenia do skojarzonej oceny ukrwienia narządów przewodu pokarmowego – sonda z chwytakiem wraz z elektroniczną jednostką sterującą. Źródło: gumed.edu.pl

Zwiększenie poziomu bezpieczeństwa operowanych pacjentów

Obecnie, jak wskazują gdańscy eksperci, w praktyce klinicznej ocena stanu ukrwienia tkanek, w tym przewodu pokarmowego, zależna jest głównie od doświadczenia chirurga. Ocenę tę przeprowadza się za pomocą techniki makroskopowej, czyli wzrokowej, oraz palpacyjnej (dotykowej). Wspomagającą metodą jest technika z zastosowaniem zieleni indocyjaninowej, zwanej metodą fluorescencyjną.

– Pomysł stworzenia urządzenia narodził się podczas mojej codziennej pracy w Klinice Chirurgii Onkologicznej Uniwersyteckiego Centrum Klinicznego. Wszystkie ze stosowanych powszechnie metod oceny ukrwienia tkanek dostarczają informacje obarczone dużą dozą subiektywności, co może mieć wpływ na zwiększenie ryzyka niepowodzenia zabiegu operacyjnego. Uznałem, iż warto podjąć trud stworzenia metody i urządzenia, które z jednej strony przyczyniłoby się do zwiększenia poziomu bezpieczeństwa operowanych pacjentów, a z drugiej strony podniosłoby również komfort pracy chirurga – podkreśla prof. Jacek Zieliński.

Urządzenie nieabsorbujące chirurga podczas pracy

Interdyscyplinarny zespół powołany przez prof. Zielińskiego podjął się opracowania skutecznego rozwiązania. Połączenie praktycznej wiedzy klinicznej z bioinżynierią i wykorzystanie kilku metod pomiarowych pozwoliło opracować pierwszy na świecie system do skojarzonej oceny ukrwienia narządów przewodu pokarmowego.

Urządzenie składa się z sondy wyposażonej w szereg czujników pomiarowych oraz elektronicznej jednostki sterującej. Podczas operacji sonda urządzenia wprowadzana jest do np. do jelita, dzięki czemu dostarcza zespołowi operującemu informacje o stopniu wysycenia tkanek tlenem, co z kolei ułatwia chirurgom przeprowadzenie zespolenia zapewniającego poprawne gojenie się rany.

Prof. Jerzy Wtorek, koordynator Centrum BioTechMed Politechniki Gdańskiej, podkreśla, że udało się opracować rozwiązanie nieabsorbujące chirurga podczas operacji. Ponadto, jak wyjaśnia ekspert, czas przeprowadzenia oceny z pomocą urządzenia jest akceptowalny z punktu widzenia procedury chirurgicznej.

– Dużą zaletą metody jest także możliwość, jeżeli zajdzie taka potrzeba, wielokrotnego przeprowadzania pomiarów u tego samego pacjenta, a co praktycznie nie ma wpływu na czas trwania zabiegu. Podsumowując, opracowaliśmy wielomodalne urządzenie i odpowiednie procedury pomiarowe umożliwiające ocenę ukrwienia i żywotności zespalanych tkanek. Było to możliwe dzięki kontrolowaniu dynamicznych zmian objętości krwi w badanej tkance. Metoda nie obciąża chirurga dodatkowymi i złożonymi czynnościami i mamy nadzieję, że po przeprowadzeniu badań eksperymentalnych otrzymywane wyniki będą pomocne przy podejmowaniu przez chirurga decyzji także dzięki temu, że ich interpretacja będzie jednoznaczna – wyjaśnia prof. Wtorek.

Źródło: gumed.edu.pl

Urządzenie może wpłynąć na zmniejszenie kosztów leczenia

Gdańscy badacze podkreślają, że opracowane przez nich narzędzie posiada wiele zalet. Przede wszystkim jest niewielkie i poręczne, a jego obsługa komfortowa. Narzędzie posiada także funkcję wysyłania danych drogą radiową w standardzie Bluetooth. Dane mogą być więc analizowane z pomocą większej mocy obliczeniowej niż ta zawarta w urządzeniu. Wdrożenie urządzenia podczas operacji pozwoli także na zmniejszenie powikłań pooperacyjnych, a także odsetka wykonywanych zabiegów korygujących. To z kolei przekłada się na zmniejszenie kosztów leczenia.

Naukowcy realizują prace rozwojowe wynalazku zgodnie z ustaloną strategią. Eksperci chcą podnieść gotowość technologiczną urządzenia, by mogło być stosowane w praktyce. Obecnie narzędzie będzie testowane w ramach eksperymentów medycznych na modelach świńskich. W kolejnych etapach rozwoju planowane jest przeprowadzenie badań klinicznych oraz certyfikacja urządzenia.

Źródło: gumed.edu.pl

 

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