mwptpay; Jiwapy; ehSf;F ehs; Gjpa fz;Lgpbg;Gfs; muq;Nfwp tUfpd;wd. mwptpay; Jiwapy; fz;Lgpbf;fg;gLk; Gjpa tp\aq;fs; gw;wpa jfty;fs; mwptpay; mjprak; gFjpapy; njhluhf ntsptUfpwJ. ,jpy; fle;j rpy thuq;fshf Nuhgl;Lfs; vdg;gLk; kdpj ve;jpuq;fs; gw;wpa jfty;fs; ,lk; ngw;W tUfpwJ. fle;j thuk; kUj;Jt Jiwapy; Nuhgl;Lfspd; gq;F gw;wpa jfty;fs; ,lk; ngw;wJ. ,e;j ,jopy; MgNu\d; nra;Ak; Nuhgl;Lfs; Fwpj;j jfty;fs; ,lk; ngWfpwJ. rpf;fyhd MgNu\d; vd;W fUjg;gLk; ,Uja MgNu\d; kw;Wk; %is euk;gpay; mWit rpfpr;irapy; lhf;lu;fSf;F cjTfpd;wd. Nuhgl;Lfs;. ,e;j MgNu\d;fs; Jy;ypakhf elf;f lhf;lUf;F cjTk; tifapy; MgNu\d; nra;Ak; Nuhgl;Lfs; cUthf;fg;gl;Ls;sd. ,J gw;wpa jfty;fs; ,e;j ,jopy; ,lk; ngWfpwJ.

MgNu\d; nra;Ak; Nuhgl;Lfs;

Nuhgl; %yk; mWit rpfpr;ir vd;gJ xU nray;Kiw MFk;. xU fk;g;a+l;lupy; Vw;fdNt nrYj;jg;gl;l> gjpT nra;ag;gl;l GNuhfpuhk; (Programme) %yk; jpl;lkpl;L nra;ag;gLk; gzpNa Nuhgl; mWit rpfpr;ir MFk;.

,d;Dk; nrhy;yg; Nghdhy; kUj;Jt epGzu;fs;> xU MgNu\Df;F Kd;$l;bNa jpl;lkpl;L topKiwfisf; ifahz;L rpwg;ghf> ntw;wpfukhf elj;jp Kbf;fpd;whu;fNsh mJ Nghd;Nw kUj;Jt epGzu;fSf;F cjtpahf my;yJ kUj;Jt epGzu;fSf;F gjpyhf Nuhgl;Lfs; gzpGupfpd;wd.

Nuhgl;Lfspd; jd;dpaf;f jpwd;fs; %yk; ngwg;gLk; gad;fs; Vuhsk;. Fwpg;gpl;l GNuhfpuhk;fs; %yk; Nuhgl;Lfspd; ,af;fq;fis kpfj; Jy;ypakhfTk; mNj rkaj;jpy; kpfTk; jpwikahfTk; nray;gl itg;gJ ,jd; rpwg;gk;rkhFk;. Nuhgl;Lfs; jq;fs; gzpapy; kpFe;j ftdKk;> rupahd jpir NtfKk;> KLf;F NtfKk;> kpfj; Jy;ypakhfTk; nray;gLfpd;wd. xU rpW kapupio msT $l jtWfs; epfoh tz;zk; jpwk;gl ifahSfpd;wd.

Nuhgl;Lfspd; jd;dpaf;f jpwd;fshy; kPs; epfo;T (Repeated) gzp kw;Wk; ek;gfj;jd;ik %yk; vz;zw;w gad;fs; Vw;gLfpd;wd.

fhy Neuj;ij fzf;fpLk; NghJ Nuhgl;Lfs; Kd;dzp tfpf;fpd;wd. gy fl;lq;fis cs;slf;fpa mWit rpfpr;irapd; NghJ> xU fl;lj;ij Kbj;j gpwF mLj;j fl;lj;jpw;F nry;tjw;F kdpj kUj;Jt epGzu;fs; Nghy Nahrpf;fhky; my;yJ jaq;fhky; klkl vd;W gzpfis Kbj;J tpLfpd;wd.

,e;j nray; jpwd;fs;> rpy rkaq;fspy; Mgj;jpy; nfhz;L Ngha; tpl;L tpLfpd;wd vd;Wk; rpyu; $Wfpd;wdu;. Mdhy; Nuhgl;Lfs; nra;j jtWfs; vy;yhk; guprPypf; fg;gl;L myrp Muha;e;J ,j;jifa jtWfs; kPz;Lk; Vw;glhjthW GNuhfpuhk;fs; nra;ag;gl;L tUfpd;wd.

,d;Dk; rpyu; mWit rpfpr;irfspy; topKiwfis jpl;lkpLtjw;F fhy tpuaq;fs; Mfpd;wd vd;fpwhu;fs;. ,Ue;jhYk; xU rpwg;ghd jpl;lkpLjy; kw;Wk; mWit rpfpr;ir topKiwfs; %yk; ,e;j fhy tpuaj;ij jtpu;f;fyhk;.

xt;nthU mWit rpfpr;irf;Fj; Njitahd 'mWit jpwd; jpl;lkpLjy;" (Surgical Planning) vt;thW jpl;lkpLfpd;wd vd;gij ghu;g;Nghk;.

mWitj; jpwd; jpl;lkpliy 3 Kf;fpa gpupTfshf gpupf;fyhk;. mit

1. Nehahspapd; cliy cUtgpk;gq;fs; (image) vLg;gJ.

2. ,e;j gpk;gq;fs; %yk; vLf;fg;gLk; Gifg;glq;fis itj;J Kg;gupkhz (3D) khjpupahf khw;WtJ.

3. mWit rpfpr;irf;fhd jpl;lkpLjy; kw;Wk; xj;jpif.

Nuhgl;il NehahspAld; ,izf;Fk; gjptpizg;G Kiwfs; (Registration)

Nuhgl;> Nehahsp gjptpizg;G Kiw vd;gJ Vw;fdNt Nuhgl;Ld; Vw;wg;gl;l Nehahspapd; Nll;lhTld; rpfpr;irg; ngwg;NghFk; NehahspAld; Vw;gLj;jpf; nfhs;Sk; cwT KiwNa MFk;. ,jpy; ,uz;L Kf;fpa fl;lq;fs; cs;sd. Nuhgl;Lld; Nehahspia ,izg;gJ kw;Wk; mWit rpfpr;ir gjptpizg;G Kiw MFk;.

Nuhgl;il NehahspAld; ,izg;G Vw;gLj;JtJ Nuhgl; mWit rpfpr;irf;F Njitahd Kf;fpakhd mk;rkhFk;. Vw;fdNt $wpaJNghy; Nuhgl;Lfs; Kd; eputikg;G (Programme) topf;fhl;Ljypd;gb nray;gLtjhy;> ,e;j eputikg;G mikg;gJ rpfpr;ir ngWk; Nehahspapd; epiy (Position) NtWgl;lhy; Vw;gLk; khw;W msTfs; fzf;fpy; vLj;Jf; nfhs;sg;gl Ntz;Lk;.

mt;thW fzf;fpy; vLj;Jf; nfhs;sg;glh tpl;lhy; Nehahspf;F Mgj;J Vw;gl tha;g;Gs;sJ. vdNt Nuhgl; KOf;f KOf;f jd;dpr;irahf ,af;fj;jpw;F cl;gLj;jhky; rpy ntspf;fl;lisfs; %yKk; ,af;fj;jpw;F cl;gLtJ kpfTk; ghJfhg;ghd ek;gfj;jd;ik cs;sjhfTk; tpsq;Fk;.

kUj;Jtu;fshy; nra;ag;gLk; mWit rpfpr;irapd; NghJ rpfpr;irf;F VJthf Nehahspfis epiynfhs;sr; nra;J (gLf;f itg;gJ Nghd;w) ghuk;gupa KiwahFk;. mjhtJ fhypd; nkhopapy; mWit rpfpr;ir nra;Ak; NghJ fhy; mirahky; ,Ug;gjw;fhf fhiy fl;LtJ> %isg; gFjpapy; mWit rpfpr;ir Nkw;nfhs;Sk;NghJ jiy mirahky; itg;gjw;fhf 'fpshk;g;" nra;ag;gLtJ Nghd;w Kiwfs; ifahsg;gLfpd;wd. Nuhgl; %yk; nra;ag;gLk; mWit rpfpr;irfSf;F ,Nj Kiwfs; ifahsg;gLfpd;wd. 

Nll;lhf;fisAk; rpfpr;ir Nkw;nfhs;Sk; Nehahspapd; cly; $Wfs; %yk; fpilf;Fk; Nll;lhitAk; itj;J xNu khjpupahd nghJthd Fwpg;Gfis Vw;gLj;jpf; nfhs;sg;gLfpwJ. ,e;j nghJf;Fwpg;Gfs; Nuhgl; kpfTk; ghJfhg;ghf ,aq;f toptif nra;fpd;wd. ,g;nghOJ Fwpg;Gfis vl;Ltjw;F Muk;g epiy Af;jpfs; ifahsg;gLfpd;wd.

,e;j Kjy; kw;Wk; tof;fkhd Kiw vd;gJ mWit rpfpr;irf;FKd; Nehahspapd; cly; $Wfis njs;sj;njspthf mwpe;J nfhs;sg;gLtJ. ,jw;F /gpLrpay;]; (Fiducials) vdg;gLk; milahsf; FwpaPl;L fUtp (Markder) gad;gLfpwJ. ,jd; %yk; mwpag;gLk; Nehahspapd; cly; $Wfs; Vw;fdNt Vw;wg;gl;l Nll;lhf;fis Jy;ypakhf xg;gpl;Lg; ghu;j;J xOq;FgLj;JfpwJ. ,e;j gpbrpay;i] cgNahfpf;Fk; NghJ NehahspfSf;F kpFe;j typia Vw;gLj;JfpwJ. /gpLrpay;]; Kiwf;F khw;whf Nkw;gug;G gjptp izg;G Kiw (Surface Based Registration) gad;gLj;jg;gLfpwJ.

Nuhgl; mWit rpfpr;ir Kiwfis nray;gLj;jy;

Nuhgl;fs; jd;dpr;irahf> Vw;fdNt Vw;wg;gl;l eputikg;Gfspd;gb epfo;fhyj;jpy; gzpahw;Wk; jd;ik nfhz;lJ. POMA ,ae;jpuf;if Nghd;w njhopw;rhiy Nuhgl;Lfis gad;gLj;jg;gLfpd;wd. Vndd;why; Nuhgl;Lfis tbtikj;J jahupg;gjw;F kpf mjpfkhf nghUs; nrythfpwJ. Nuhgl;by; Muha;r;rp kw;Wk; Nkk;gLj;Jk; gzpf;F Njitg;gLk; %yjdk; gyNfhb &ghahFk;. kw;Wk; rpfpr;irf;F cfe;jjukhd Nuhgl;Lfs; jahupf;f KbAk; vd;gJ KO cj;jputhjKk; fpilahJ. NkYk; Nuhgl; rpfpr;irf;F Vw;w ghJfhg;G top Kiwfs; kw;Wk; ju epu;zaq;fs; fpilahJ. kUj;Jt epGzUk; ,ijf; ifahStJ kw;Wk; guhkupg;Gf;F Njitahd njhopy; El;gj;jpYk; ifNju;e;jtuhf ,Uj;jYk; mtrpakhfpwJ. ,t;thW mWit rpfpr;ir Nkw;nfhs;Sk;NghJ ,ae;jpuf; NfhshW Vw;gl;lhy; Vw;gLk; tpisTfSf;F Nuhgl; jahupg;Gf; fk;ngdpfs; nghWg;Ngw;f jaq;Ffpd;wd. vJ vg;gbNah ,g;Nghijf;F njhopw;rhiy Nuhgl;Lfspy; gzp mWit rpfpr;irf;F Vw;w gpuj;jpNaf Nuhgl;Lfs; tpiutpy; ntsptu ,Uf;fpd;wd. Nuhgl; mWit rpfpr;irf;F Vw;w topKiwfs; xU Kiw ifahsg;gl;Ltpl;ljhy; NkYk; mjd;gpwF ,e;j Kiwfs; Nkk;gLj;jg;gl;L ek;gfj;jd;ik nfhz;l Nuhgl;L fs; ntsptuj; njhlq;Fk;. mg;nghOJ Nuhgl;Lfs; mWit rpfpr;iria Nkw;nfhs;Sk;NghJ kUj;Jt epGzu;fs; iff;fl;bf; nfhz;L ftdpj;Jf; nfhz; bUe;jhy; NghJk;.

topKiwfis kjpg;gply; (Evolution of Procedures):

ve;j xU mWit rpfpr;irf;Fk; topKiwfis kjpg;gply; vd;gJ mWit rpfpr;irfs; xd;wpize;j gFjpahFk;. kUj;Jt epGzu;fs; gy;NtW fl;lq;fs; nfhz;l mWit rpfpr;irfs; Nkw;nfhs;Sk;NghJ xt;nthU fl;lk; Kbe;j gpwF mLj;jLj;j fl;lq;fs; nry;tjw;F Kd; rpfpr;ir gzpfis rup ghu;j;Jf; nfhs;Sk; tha;g;Gfs; kpf kpf FiwT. mWit rpfpr;irfs; Kbe;j gpwF rpfpr;ir jpUg;jpaspf;fg;glhtpl;lhy; kPz;Lk; KjypypUe;J rpfpr;irfs; Nkw;nfhz;Nlh my;yJ Fwpg;gpl;l fl;lj;ij kPz;Lk; nra;Njh rup nra;a Ntz;bajpUf;fpwJ. Mdhy; Nuhgl; %yk; nra;ag;gLk; mWit rpfpr;irfs;> Kiwahf xt;nthU fl;lg;gzpiaAk; Jy;ypakhf rupahf Kbj;Jf; nfhLf;fpd;wd. ,jdhy; kUj;Jt epGzu;fistpl Nuhgl;Lfs; jpwk;gl gzpahw;Wfpd;wd. ,jw;F vLj;Jf;fl;lhf nraw;if ,Lg;G vYk;G nghUj;JtJ MFk;. ,jw;F kpfj;Jy;ypakhd mWit rpfpr;ir Nkw;nfhs;tJ mtrpakhfpwJ. ,t;thW nraw;if ghfq;fis vYk;G ,izg;GfSld; nghUj;jg;gLk;.

Jy;ypa msT rjtpfpjk; Nuhgl;Lfs; 83 rjtpfpjk; MFk;. kdpj kUj;Jtu;fshy; Nkw;nfhs;sg;gLk; NghJ 33 rjtpfpjk; MFk;. ,jpy; ,Ue;Nj Nuhgl;Lfspd; jpwikfs; ntspg;gLfpwJ.

Nuhgl;Lfs; jpwikahf gzpahw;WtNjhL Kbe;J tpltpy;iy> gy mWit rpfpr;irfs; Nkw;nfhs;Sk; NghJ nrytpdq;fSk; Fiwfpd;wd.

*** 

;

Nuhgl; cjtpAld; mWit rpfpr;irfs;

Nuhgl; cjtpAld; gy mWit rpfpr;irfs; ntw;wpfukhf elj;jg;gl;L tUfpd;wd. ,tw;wpy; Nkd;gl;l njhopy; El;gk; %yk; fhNuhdup jkdp khw;W top mWit rpfpr;ir (Coronary Artery Bypass Surgery) Nkw;nfhs;sg;gLfpwJ. ,r;rpfpr;irf;fhf Nehahspapd; clk;gpy; xU rhtpJ}u mstpw;F Jisaplg;gl;L mjd; %yk; Nkw;nfhs;sg;gLfpwJ. ,J khw;Wtop mWit rpfpr;ir Kiwapy; ngupa khw;wk; nfhz;Ltug; NghfpwJ vd;fpwhu;fs; epGzu;fs;. ,k;Kiwapd; Nehf;fk; Nehahspapd; clk;gpy; Vw;gLj;jg;gLk; Jisapy; msitf; Fiwg;NjhL> rpfpr;ir Kbe;J Nehahspfs; tPL jpUk;Gk; fhy Neuj;ijAk; ntFthf Fiwf;Fk; vd;gNj.

,e;j mWit rpfpr;irapd; tpjp Kiwfs;:-

1. tpyh vYk;GfSf;F ,ilg;gl J}uj;jpy; gFjpapy; %d;W rpwpa Jisfs; Vw;gLj;jg;gLfpwJ.

2. Nuhgl;bd; fuq;fs; kw;Wk; xU rpwpa Nfkuh ,j;Jisapd; %yk; cl; nrYj;jg;gLfpwJ.

3. ,izf;fg;gl;l ,af;f czupfs; (Motion Sensors) %yk; mWit rpfpr;ir epGzu;fs; Nuhgl;bd; ,af;fj;ij fl;Lg;gLj;j toptif nra;fpwJ. ,jd;gpwF mWit rpfpr;irf;Fj; Njitahd rhjdq;fs; Nuhgl; fuj;Jld; ,izf;fg;gLfpwJ. mWit rpfpr;ir epGzu; fzpdp Kd; mku;e;J nfhz;L Nehahspapd; clypy; cl;nrYj;jg;gl;l Nfkuhtpy; ,izg;Gg; ngw;w ,uz;L nyd;]; (fz;Zf;F xd;W tpjkhf) nghUj;jg;gl;L fz;fhzpj;J top tif nra;fpwJ. ,jd; %yk; Nehahspapd; cly; ghfq;fis Kg;gupkhz fhl;rpahf;fg;gLfpwJ. cl;nrYj;jg;gl Jy;ypakhd Nfkuhtpd; ,af;fq;fs; fhyhy; ,af;fg;gLk; ghfk; (Foot Pedal) %yk; fl;Lg;gLj;jg;gLfpwJ. ,jd; %yk; epGzu;fs; clypd; ghfq;fis "[{k;" nra;J ngupjhfNth rpwpajhfNth fhzyhk;. mJkl;Lky;y mWit nra;ag;gLk; ghfj;jpy; fhl;rpia cldbahf khw;wp ghu;gjw;Fk; top nra;fpwJ.

4. Nehahspapd; clypd; cl;nrYj;jg;gl;l cl;fhl;b (Endoscopic) rhjdj;jpy; ,uz;L fuq;fSld; ,af;fq;fs; epGzupd; iffshy; fl;Lg;gLj;jg;gLfpwJ. ,f;fuj;jpd; Kidfs; ,izf;fg;gl;l kpfr; rpwpa rhjdq;fs; epGzupd; iffs; kw;Wk; kzpf;fl;bd; ,af;fj;jpy; msit ntFthf Fiwj;jpUf;fpwJ. ,jd; %yk; kw;w mWit rpfpr;ir Nghyy;yhky; (Nuhgl; ,y;yhky;) ,e;j Nuhgl; cjtpAld; nra;ag;gLk; mWit rpfpr;irfs; kpfj; Jy;ypakhfTk; epGzupd; if ,af;fq;fs; kpf vspjhfTk; tpsq;FfpwJ.

5. EZf;fkhf ntl;Ljy; (Microscopic Cutting) kw;Wk; ijj;jy; jpwq;fs; %yk; cl;fhl;b (Endoscopic) Kiwiag; gad;gLj;jp ntw;wpfukhf mWit rpfpr;irfs; Nkw;nfhs;sg;gLfpwJ. ,t;thW midj;J Nuhgl;Lfspd; ,af;fq;fSk; fl;Lg;gLj; jg;gLtjhy; Nuhgl;bd; ghfq;fs; jd;dpr;irahf ,aq;FtJ Kw;wpYk; jtpu;f;fg;gLfpwJ.

***

Nuhgl; mWit rpfpr;ir fUtp mikg;G.

Nuhgl; cjtpAld; mWit rpfpr;ir.

euk;G rpfpr;irf;fhf Nehahspia gLf;f itj;jpUj;jy;

***

mLj;j ,jopy;:-



njhiyNgrp Jiw gw;wpa mwptpay; njhopy;El;g jfty;fs; ,lk; ngWfpd;wd.

jfty; njhFg;G:

vk;.N[.vk;.,f;ghy;> Jgha;.

***