Keyser E J, Derossis A M, Antoniuk M, Sigman H H, Fried G M
Section of Video-endoscopic Surgery, Division of General Surgery, McGill University, Montreal, Quebec, Canada.
Surg Endosc. 2000 Feb;14(2):149-53. doi: 10.1007/s004649900088.
Laparoscopic skills can be measured objectively in a video-laparoscopic cart simulator system. These scores have been shown to be sufficiently sensitive to distinguish differences in performance between residents at different levels of training. The purpose of this study was to compare a simplified mirrored-box simulator to the video-laparoscopic cart system.
A total of 22 surgical residents performed seven structured tasks in both simulators in random order. Scores reflected precision and speed. The tasks were transferring, cutting, clip + divide, looping, mesh placement + fixation, and suturing with intracorporeal and extracorporeal knots.
There were no significant differences in mean raw scores between the simulators for six of the seven tasks. Resident total scores correlated well between simulators (r = 0.68, p = 0.001). Resident ranking also correlated well (r = 0.69, p < 0. 001).
A mirrored-box simulator was shown to provide a reasonable reflection of relative performance of laparoscopic skills. Practical, effective laparoscopic skills training and evaluation can be accomplished without the need for cumbersome equipment.
腹腔镜技能可在视频腹腔镜推车模拟器系统中进行客观测量。这些分数已被证明具有足够的敏感性,能够区分不同培训水平住院医师的操作差异。本研究的目的是将一种简化的镜像盒模拟器与视频腹腔镜推车系统进行比较。
共有22名外科住院医师以随机顺序在两种模拟器中执行七项结构化任务。分数反映了精度和速度。这些任务包括转移、切割、夹闭+离断、套圈、放置+固定网片以及体内和体外打结缝合。
在七项任务中的六项任务中,两种模拟器之间的平均原始分数没有显著差异。住院医师的总分在两种模拟器之间具有良好的相关性(r = 0.68,p = 0.001)。住院医师的排名也具有良好的相关性(r = 0.69,p < 0.001)。
结果表明,镜像盒模拟器能够合理反映腹腔镜技能的相对操作水平。无需繁琐设备即可完成实用、有效的腹腔镜技能培训与评估。