V kv\u011btnu se k radosti v\u00fdvoj\u00e1\u0159\u016f, l\u00e9ka\u0159\u016f a hlavn\u011b pacient\u016f\npoda\u0159ilo certifikovat p\u0159\u00edstroj, kter\u00fd d\u00e1v\u00e1 v\u011bt\u0161\u00ed \u0161anci na uzdraven\u00ed pacient\u016fm s\nonkologick\u00fdm onemocn\u011bn\u00edm. P\u0159itom do posledn\u00ed chv\u00edle nebylo jist\u00e9, zda\ncertifikaci p\u0159\u00edstroje neohroz\u00ed zav\u00e1d\u011bn\u00ed nov\u00e9 certifika\u010dn\u00ed direktivy.<\/p>\n\n\n\n
T\u00fdm v\u00fdvoj\u00e1\u0159\u016f z T\u00e1borska vyvinul v kooperaci s l\u00e9ka\u0159i tzv.\nmikroatomiz\u00e9r. D\u00edky tomuto p\u0159\u00edstroji budou moci pacienti se zhoubn\u00fdm\nonkologick\u00fdm onemocn\u011bn\u00edm b\u0159i\u0161n\u00ed dutiny, u kter\u00fdch nezabrala klasick\u00e1\nchemoterapie, podstoupit inovativn\u00ed l\u00e9\u010dbu.<\/p>\n\n\n\n
Mikroatomiz\u00e9r si lze zjednodu\u0161en\u011b p\u0159edstavit jakou nerezovou\ntrubi\u010dku s integrovanou tryskou. Je ur\u010den\u00fd ke sprejov\u00e1n\u00ed siln\u011b koncentrovan\u00fdch\nchemoterapeutik v b\u0159i\u0161n\u00ed dutin\u011b metodou PIPAC (tlakov\u00e1 intraperitone\u00e1ln\u00ed\nchemoterapie). Na v\u00fdvoji pracovali v\u00fdvoj\u00e1\u0159i ze Sob\u011bslavi v \u010dele s Radimem\nSk\u00e1lou, Gabrielou Sk\u00e1lovou a ve spolupr\u00e1ci s 1. chirurgickou klinikou V\u0161eobecn\u00e9\nfakultn\u00ed nemocnice (VFN).<\/p>\n\n\n\n
Na p\u0159\u00edstroj u\u017e \u010dekali pacienti<\/p>\n\n\n\n
Podle v\u00fdvoj\u00e1\u0159e Radima Sk\u00e1ly byl st\u011b\u017eejn\u00edm faktorem cel\u00e9ho\nprojektu a z\u00e1rove\u0148 jakousi nezn\u00e1mou \u010das. Nezn\u00e1mou, kter\u00e1 do cel\u00e9ho projektu\nvn\u00e1\u0161ela neust\u00e1l\u00fd tlak na v\u0161echny z\u00fa\u010dastn\u011bn\u00e9 strany. Na pacienty, jejich rodiny,\nl\u00e9ka\u0159e i v\u00fdvoj\u00e1\u0159e.<\/p>\n\n\n\n
\u201eCertifika\u010dn\u00ed proces zdravotnick\u00e9ho prost\u0159edku je z\u00e1le\u017eitost\nb\u011b\u017en\u011b trvaj\u00edc\u00ed a\u017e roky. Naproti tomu tu byli pacienti, kte\u0159\u00ed tento \u010das nem\u011bli a\no kter\u00fdch jsme ji\u017e v t\u00e9 dob\u011b v\u011bd\u011bli. V pr\u016fb\u011bhu certifikace se na n\u00e1s s \u017e\u00e1dostmi\no poskytnut\u00ed prost\u0159edku obracely samotn\u00e9 rodiny pacient\u016f,\u201c vzpom\u00edn\u00e1 Radim\nSk\u00e1la. Bez certifikace p\u0159itom nebylo mo\u017en\u00e9 prost\u0159edek dostat na s\u00e1ly.<\/p>\n\n\n\n
Co by pomohlo onkologick\u00fdm pacient\u016fm nejv\u00edce?<\/p>\n\n\n\n
To je velmi komplikovan\u00e1 a \u0161irok\u00e1 ot\u00e1zka. Onkologick\u00e1 l\u00e9\u010dba prod\u011blala v posledn\u00edch desetilet\u00edch neuv\u011b\u0159iteln\u00fd v\u00fdvoj. St\u00e1le se objevuj\u00ed nov\u00e9 l\u00e9ky a terapeutick\u00e9 postupy, o kter\u00fdch se na\u0161im p\u0159edch\u016fdc\u016fm ani nezd\u00e1lo. Obrovsk\u00fd v\u00fdvoj prod\u011blala i diagnostika n\u00e1dorov\u00fdch onemocn\u011bn\u00ed, jak na \u00farovni klinick\u00e9, tak laboratorn\u00ed. Samoz\u0159ejm\u011b tento kvalitativn\u00ed i kvantitativn\u00ed skok nebyl zadarmo a modern\u00ed onkologick\u00e1 l\u00e9\u010dba je n\u00e1sobn\u011b dra\u017e\u0161\u00ed, ne\u017e p\u0159edchoz\u00ed generace l\u00e9k\u016f. Za tuto cenu jsme schopni n\u011bkter\u00e1 onemocn\u011bn\u00ed zcela vyl\u00e9\u010dit, ale na druhou stranu jsou zde skupiny diagn\u00f3z, kde se za desetilet\u00ed a ohromn\u00e9 investice do v\u00fdzkumu nic nezm\u011bnilo na progn\u00f3ze. Asi nejv\u011bt\u0161\u00ed pokrok by byl, kdybychom onemocn\u011bn\u00ed dok\u00e1zali diagnostikovat v\u010das, p\u0159\u00edpadn\u011b identifikovat potenci\u00e1ln\u00ed nemocn\u00e9 ohro\u017een\u00e9 vznikem n\u00e1doru a m\u00edt k dispozici n\u00e1stroj, kter\u00fd zabr\u00e1n\u00ed vzniku onemocn\u011bn\u00ed. To je pochopiteln\u011b vzd\u00e1len\u00e1 budoucnost.<\/p>\n\n\n\n
doc. MUDr. David Hoskovec, PhD., prim\u00e1\u0159 1. chirurgick\u00e9\nkliniky VFN Praha<\/p>\n\n\n\n
Certifikaci bylo nav\u00edc nutn\u00e9 stihnout do 21. kv\u011btna kv\u016fli\np\u0159echodu na novou unijn\u00ed direktivu, ke kter\u00e9 v sou\u010dasn\u00e9 dob\u011b \u010cesk\u00e1 republika\nnedisponuje jedinou notifikovanou osobou. \u201e\u010cesk\u00e1 republika p\u0159ijala novou unijn\u00ed\ndirektivu, ke kter\u00e9 nen\u00ed a nebyla p\u0159ipravena. Pozapomn\u011blo se na to, \u017ee \u010desk\u00e9\nfirmy budou tak\u00e9 v r\u00e1mci unijn\u00edho trhu zdravotnick\u00e9 prost\u0159edky vyr\u00e1b\u011bt,\u201c\nvysv\u011btluje Radim Sk\u00e1la.<\/p>\n\n\n\n
S certifikac\u00ed ale nakonec usp\u011bli. \u201eP\u0159\u00edstup \u010desk\u00e9 notifikovan\u00e9\nosoby byl velmi tvrd\u00fd, nestrann\u00fd, profesion\u00e1ln\u00ed a do detail\u016f pe\u010dliv\u00fd. M\u016f\u017eete\nsestrojit kvalitn\u00ed, bezpe\u010dnou a pot\u0159ebnou v\u011bc, pokud v\u0161ak \u0159\u00e1dn\u011b nepop\u00ed\u0161ete a\nnezvalidujete v\u0161echny jednotliv\u00e9 procesy s n\u00ed spojen\u00e9 do absolutn\u00edho detailu,\npak ji tak\u00e9 neocertifikujete. To znamen\u00e1, \u017ee ji jako v\u00fdrobce nem\u016f\u017eete\nposkytnout pacientovi.<\/p>\n\n\n\n
P\u0159\u00edtomnost \u010desk\u00e9 notifikovan\u00e9 osoby zahr\u00e1la podstatnou roli\nv cel\u00e9m projektu. Pokud bychom m\u011bli certifikovat nap\u0159\u00edklad v N\u011bmecku nebo ve\nFrancii, pak si dnes s naprostou jistotou dovol\u00edm tvrdit, \u017ee bych cel\u00fd projekt\nukon\u010dil,\u201c \u0159\u00edk\u00e1 Radim Sk\u00e1la a dod\u00e1v\u00e1, \u017ee p\u0159ek\u00e1\u017ekou pro mal\u00e9 v\u00fdvojov\u00e9 t\u00fdmy i mal\u00e9\na st\u0159edn\u011b velk\u00e9 v\u00fdrobce m\u016f\u017ee b\u00fdt i takov\u00e1 z\u00e1le\u017eitost, jakou je p\u0159elo\u017een\u00ed tis\u00edc\u016f\nnikdy nekon\u010d\u00edc\u00edch stran odborn\u00fdch technicko-l\u00e9ka\u0159sk\u00fdch text\u016f dokumentace, kter\u00e1\nse nav\u00edc pravideln\u011b reviduje, do n\u011bm\u010diny, francouz\u0161tiny \u010di angli\u010dtiny.<\/p>\n\n\n\n
Nejde o standardn\u00ed l\u00e9\u010dbu<\/p>\n\n\n\n
Docent David Hoskovec z 1. chirurgick\u00e9 kliniky VFN Praha,\nkter\u00fd je jedn\u00edm z autor\u016f mikroatomiz\u00e9ru, vysv\u011btlil, \u017ee od p\u0159elomu stolet\u00ed je v\n\u010cR pou\u017e\u00edvan\u00e1 metoda HIPEC (hypertermick\u00e9 intraopera\u010dn\u00ed chemoterapie), kter\u00e1\npacient\u016fm s n\u011bkter\u00fdmi diagn\u00f3zami a s posti\u017een\u00edm pob\u0159i\u0161nice nab\u00edz\u00ed v\u00fdkon, kter\u00fd\nje m\u016f\u017ee uzdravit, ale p\u0159i v\u011bt\u0161\u00edm rozsahu onemocn\u011bn\u00ed tato metoda tak\u00e9 selh\u00e1v\u00e1.\nPro tyto pacienty je nyn\u00ed mo\u017en\u00e9 pou\u017e\u00edt v\u00fd\u0161e zm\u00edn\u011bnou metodu PIPAC, kter\u00e1 se\nprov\u00e1d\u00ed pr\u00e1v\u011b pomoc\u00ed \u010desk\u00e9ho mikroatomiz\u00e9ru.<\/p>\n\n\n\n
\u201eJe pochopiteln\u00e9, \u017ee zaveden\u00ed do klinick\u00e9 praxe je\u0161t\u011b\nneznamen\u00e1, \u017ee tato l\u00e9\u010dba bude onkology v\u0161eobecn\u011b p\u0159ij\u00edm\u00e1na a indikov\u00e1na,\nnicm\u00e9n\u011b z\u00e1jem na onkologick\u00fdch pracovi\u0161t\u00edch o ni je. A stejn\u011b jako u metody\nHIPEC zde bude chv\u00edli trvat, ne\u017e se dostane do \u0161irok\u00e9ho pov\u011bdom\u00ed,\u201c zm\u00ednil David\nHoskovec. P\u0159esto, \u017ee d\u00edky mikroatomiz\u00e9ru a metod\u011b PIPAC z\u00edskaj\u00ed pacienti novou\nnad\u011bji na uzdraven\u00ed, je nutn\u00e9 zd\u016fraznit, \u017ee jde st\u00e1le o l\u00e9\u010dbu experiment\u00e1ln\u00ed,\nnikoli standardn\u00ed.<\/p>\n\n\n\n
\u201eV zahrani\u010dn\u00ed literatu\u0159e je \u0159ada \u00fadaj\u016f o relativn\u011b vysok\u00e9\nefektivit\u011b metody, kter\u00e1 v n\u011bkter\u00fdch p\u0159\u00edpadech vede k v\u00fdrazn\u00e9 redukci posti\u017een\u00ed\npob\u0159i\u0161nice. Zat\u00edm ale chyb\u00ed data o dlouhodob\u00e9m \u00fa\u010dinku t\u00e9to l\u00e9\u010dby, co\u017e je pochopiteln\u00e9\nvzhledem ke kr\u00e1tk\u00e9 dob\u011b, kdy je nitrob\u0159i\u0161n\u00ed sprejov\u00e1n\u00ed v\u016fbec pou\u017e\u00edv\u00e1no. U\u017e te\u010f\nje jasn\u00e9, \u017ee jde o l\u00e9\u010dbu bezpe\u010dnou, dob\u0159e tolerovanou, zat\u00ed\u017eenou mal\u00fdm\nmno\u017estv\u00edm komplikac\u00ed a ne\u017e\u00e1douc\u00edch vedlej\u0161\u00edch \u00fa\u010dink\u016f,\u201c dod\u00e1v\u00e1 docent, kter\u00fd je\nvd\u011b\u010dn\u00fd za to, \u017ee mohl spolupracovat s v\u00fdvoj\u00e1\u0159i ze Sob\u011bslavi.<\/p>\n\n\n\n
\u201eMus\u00edm se s obdivem zm\u00ednit o neuv\u011b\u0159iteln\u00e9 pr\u00e1ci t\u00fdmu\nv\u00fdvoj\u00e1\u0159\u016f, kte\u0159\u00ed ve velmi kr\u00e1tk\u00e9 dob\u011b dok\u00e1zali vyvinout origin\u00e1ln\u00ed \u010desk\u00fd\nmikroatomiz\u00e9r pro nitrob\u0159i\u0161n\u00ed pod\u00e1n\u00ed chemoterapie pouh\u00fdch 10 let pot\u00e9, co byla\nmetoda poprv\u00e9 pou\u017eita ve sv\u011bt\u011b,\u201c sd\u011blil.<\/p>\n\n\n\n
O p\u0159\u00edstroj je z\u00e1jem ve sv\u011bt\u011b<\/p>\n\n\n\n
A\u010dkoliv od certifikace mikroatomiz\u00e9ru neuplynul ani m\u011bs\u00edc,\nu\u017e nyn\u00ed dost\u00e1vaj\u00ed jeho tv\u016frci urgentn\u00ed popt\u00e1vky s \u017e\u00e1dostmi ze zem\u00ed Beneluxu,\nJi\u017en\u00ed Ameriky, Turecka, N\u011bmecka, \u0160v\u00fdcarska a Rakouska. P\u0159esto se ale \u010de\u0161t\u00ed\npacienti nemus\u00ed ob\u00e1vat, \u017ee by se na n\u011b kv\u016fli vysok\u00e9mu z\u00e1jmu o p\u0159\u00edstroj\nzapomn\u011blo. \u201ePrioritn\u00ed jsou dod\u00e1vky pro \u010desk\u00e9 a slovensk\u00e9 kliniky. Z\u00e1jem a\npot\u0159eby zahrani\u010d\u00ed jsou sp\u00ed\u0161e benefitem. Koneckonc\u016f i to je vlastn\u011b d\u016fvod, pro\u010d\njsme na mikroatomiz\u00e9r ji\u017e ve f\u00e1zi v\u00fdvoje vyobrazili znaky \u010cesk\u00e9ho lva. Tento\nsymbol je pro n\u00e1s ka\u017edodenn\u00edm z\u00e1vazkem,\u201c \u0159\u00edk\u00e1 Radim Sk\u00e1la.<\/p>\n\n\n\n
Podle n\u011bj za \u00fasp\u011bchem cel\u00e9ho projektu nen\u00ed jen skupina\nsob\u011bslavsk\u00fdch v\u00fdvoj\u00e1\u0159\u016f. Bez prov\u011b\u0159en\u00fdch dodavatel\u016f, bez 1. chirurgick\u00e9 kliniky VFN\na Fakulty strojn\u00edho in\u017een\u00fdrstv\u00ed Vysok\u00e9ho u\u010den\u00ed technick\u00e9ho v Brn\u011b (FSI V\u00daT\nBrno) by nemohli b\u00fdt \u00fasp\u011b\u0161n\u00ed.<\/p>\n\n\n\n
\u201eV prvn\u00ed \u0159ad\u011b bych cht\u011bl pod\u011bkovat panu docentu Hoskovcovi,\nkter\u00fd s my\u0161lenkou cel\u00e9ho projektu p\u0159i\u0161el. Za to, \u017ee m\u011b oslovil. Za to, \u017ee se na\nv\u00fdvoji mikroatomiz\u00e9ru p\u0159\u00edmo jako l\u00e9ka\u0159 pod\u00edlel. Na sv\u011bt\u011b je minimum l\u00e9ka\u0159\u016f,\nkte\u0159\u00ed jsou sou\u010dasn\u011b autory konstruk\u010dn\u00edch \u0159e\u0161en\u00ed zdravotnick\u00fdch prost\u0159edk\u016f. D\u00e1le\nbych cht\u011bl pod\u011bkovat profesoru Janu Jedelsk\u00e9mu a jeho t\u00fdmu doktorand\u016f z FSI V\u00daT\nBrno, kte\u0159\u00ed ov\u011b\u0159ili, zda je n\u00e1\u0161 n\u00e1vrh vhodn\u00fd, a pomohli zpracovat \u010d\u00e1st anal\u00fdzy\nrizik z pozice strojn\u00edho in\u017een\u00fdrstv\u00ed.<\/p>\n\n\n\n
Cel\u00fd projekt byl z\u00e1rove\u0148 prov\u011brkou na\u0161ich dodavatel\u016f, kter\u00e9\njsme \u010dasto stav\u011bli do nelehk\u00fdch pozic ve smyslu te\u010f a tady, proto\u017ee v\u010dera bylo\npozd\u011b. Pod\u011bkov\u00e1n\u00ed pat\u0159\u00ed tak\u00e9 v\u0161em extern\u00edm dodavatel\u016fm, jednotliv\u00fdm oper\u00e1tor\u016fm\na sv\u00e1\u0159e\u010d\u016fm na d\u00edln\u011b, bez jejich\u017e zku\u0161enost\u00ed, um\u011bn\u00ed a citu by mikroatomiz\u00e9ry\nnikdy nevznikly,\u201c shrnuje Radim Sk\u00e1la. Sob\u011bslavsk\u00fd v\u00fdvoj\u00e1\u0159 u\u017e nyn\u00ed p\u0159em\u00fd\u0161l\u00ed nad\nt\u00edm, jak pacient\u016fm pomoci je\u0161t\u011b v\u00edc.<\/p>\n\n\n\n
\u201eJi\u017e nyn\u00ed v\u00edme, jak by samotnou efektivitu sprejov\u00e1n\u00ed\ncytostatik bylo mo\u017en\u00e9 pos\u00edlit, zejm\u00e9na za pomoci robotiky. Nen\u00ed pochyb o tom,\n\u017ee bychom spole\u010dn\u011b s FSI V\u00daT Brno a tuzemsk\u00fdmi klinikami takov\u00e9ho robota bez\nv\u011bt\u0161\u00edch probl\u00e9m\u016f sestavili v \u0159\u00e1dech t\u00fddn\u016f. Tady je ale zcela z\u0159ejm\u00e9, \u017ee n\u00e1m\ndirektivy neumo\u017en\u00ed do budoucna uveden\u00ed takov\u00e9ho zdravotnick\u00e9ho prost\u0159edku na\ntrh,\u201c zam\u00fd\u0161l\u00ed se Radim Sk\u00e1la, kter\u00fd se se sv\u00fdm t\u00fdmem nyn\u00ed zam\u011b\u0159\u00ed na\nvyhodnocov\u00e1n\u00ed \u00fa\u010dinnosti mikroatomiz\u00e9r\u016f.<\/p>\n\n\n\n
\u201eDokud nebudou vytvo\u0159en\u00e9 vhodn\u00e9 podm\u00ednky pro certifikace\nzdravotnick\u00fdch prost\u0159edk\u016f v \u010cR a celkov\u011b k v\u00fdvoji, pak se domn\u00edv\u00e1m, \u017ee nem\u00e1\njak\u00fdkoliv smysl se do t\u011bchto n\u00e1ro\u010dn\u00fdch aktivit znovu pou\u0161t\u011bt,\u201c uzav\u00edr\u00e1.<\/p>\n\n\n\n
Ivana Vlnov\u00e1<\/p>\n\n\n\n
\u010ceskobud\u011bjovick\u00fd den\u00edk<\/p>\n\n\n\n
https:\/\/ceskobudejovicky.denik.cz\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" V kv\u011btnu se k radosti v\u00fdvoj\u00e1\u0159\u016f, l\u00e9ka\u0159\u016f a hlavn\u011b pacient\u016f poda\u0159ilo certifikovat p\u0159\u00edstroj, kter\u00fd d\u00e1v\u00e1 v\u011bt\u0161\u00ed \u0161anci na uzdraven\u00ed pacient\u016fm s onkologick\u00fdm onemocn\u011bn\u00edm. P\u0159itom do […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":18804,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-36227","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/36227","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=36227"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/36227\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/18804"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=36227"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=36227"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=36227"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}