Chang L, Satava R M, Pellegrini C A, Sinanan M N
Department of Surgery, University of Washington Medical Center, 1959 NE Pacific Street, Box 356410, Seattle, WA 98195, USA.
Surg Endosc. 2003 Nov;17(11):1744-8. doi: 10.1007/s00464-003-8813-6. Epub 2003 Sep 10.
The incorporation of new devices into surgical practice often requires that surgeons acquire and master new skills. We studied the learning curve for intracorporeal knot tying in robotic surgery.
We developed an objective scoring system to evaluate knot tying and tested eight attending surgeons during 3 weeks of training on a surgical robot. Each performed intracorporeal knot tying tasks both before and after robotic skills training. These performances were compared to their laparoscopic knots and analyzed to determine and define skill improvement.
Baseline laparoscopic knot completion took 140 sec (range, 47-432), with a mean composite score of 77 (100 possible), whereas robotic knot tying took 390 sec, with a mean composite score of 40. After initial robotic training, times decreased by 65% to 139 sec and scores increased to 71. With more training, completion times and composite scores were improved and errors were reduced.
Like any new technology, surgical robotics requires dedicated training to achieve mastery. Initially, even experienced laparoscopists may register an inferior performance. However, after adequate training, surgeons can exceed their laparoscopic performance, completing intracorporeal knots better and faster using robotics.
将新设备应用于外科手术通常要求外科医生掌握新技能。我们研究了机器人手术中体内打结的学习曲线。
我们开发了一种客观评分系统来评估打结情况，并在外科机器人上对8名主治医生进行了为期3周的培训测试。每位医生在机器人技能培训前后都进行了体内打结任务。将这些表现与他们的腹腔镜打结情况进行比较，并进行分析以确定和定义技能提高情况。
腹腔镜打结基线完成时间为140秒（范围47 - 432秒），平均综合评分为77分（满分100分），而机器人打结时间为390秒，平均综合评分为40分。经过初步机器人培训后，时间减少65%至139秒，评分提高到71分。随着更多培训，完成时间和综合评分得到改善，错误减少。
与任何新技术一样，手术机器人技术需要专门培训才能掌握。最初，即使是经验丰富的腹腔镜医生也可能表现较差。然而，经过充分培训后，外科医生使用机器人技术可以超越他们的腹腔镜手术表现，更好更快地完成体内打结。
