NeuroInstruments手术器械培训课件.ppt

* * 一般含碳量越高硬度越高，但是韧性就越差 * 钢的晶粒结构影响钢本身的硬度，一般含碳量越高硬度越高，但是还有一个方面，看钢的晶粒结构，比如马氏体，贝氏体，他们就要比铁素体 珠光体的硬度高，晶粒越细，强度越高，塑性、韧性越好。 * 机械性能，力学性能，金属的延展性分析，金属硬度分析 * DIN 德国标准化学会 * * * 环钻术，椎板切除术，减压术 * * * * * 骨凿， 骨锉（用于将软组织和骨膜从骨上面刮除），骨撬，凿子 * 金属脑压板 延展的平的或者有圆形柄 硅脂脑压板 一次性使用的有弹性的硅脂涂层 LEYLA牵引器 自锁特点，易弯曲的臂 * 盔状钩 神经牵引器 Gilsbach放手架 * * * * * wear resistance 耐磨性 * 解剖器；摘出器，骨锉，手术钩，手术刀，推针器，骨勺，探针 * Al Mefty 阿尔梅提 颅底外科手术专家 * 垂体器械 – 窥镜 * Operations at the skull base are among the most challenging interventions in micro surgery. The anatomic situation deep in the cranium is extremely complicated. Vital structures such as blood vessels, neural pathways and the brain stem are situated proximately to each other. * suction cannulas 吸引套管 * * * * * * * B. Braun Melsungen AG | Page TREND Instruments * B. Braun Melsungen AG | Page Skull Base Surgery Skull Base Surgery Deepest regions of the brain脑部最深的部位 Special surgical skills and techniques are necessary需要特殊的手术技巧 Complex anatomy. Delicate and vital areas解剖结构复杂，非常精细和重要的部位 Very challenging, only a region for specialists非常有挑战性，可供操作的空间狭小 The area around the skull base can be affected by: 颅底区可能受到下列疾病的侵袭 congenital malformations先天性畸形 trauma 创伤 aneurysms动脉瘤 tumours肿瘤 * B. Braun Melsungen AG | Page Approaches to the Skull Base Transcranial vs. transnasal 经颅和经鼻蝶入路 Advantages of transnasal:  ? Approach via an existing body orifice, no major surgical incision 通过人体自然体腔，无明显的手术切口 ? No retraction/damage to cerebral tissue 对脑组织无牵拉和损失 ? Minimum traumatization of the patient 患者最小的创伤 ? Best cosmetic result, no craniotomy, no hair removal, etc. 最佳美容效果，不开颅 ? Approach to pituitary via a small hole at the skull base lower risk of liquor loss ? Minimally invasive operation; patient can be discharged early 微创手术，恢复块 * B. Braun Melsungen AG | Page Skull Base Surgery Instruments for transnasal approach * B. Braun Melsungen AG | Page Classical parallel design经典平行设计 XS ?axiales Design“XS的轴设计 classical XS Classical Design XS - Mikroinstruments XS-Microinst