Nio D, Bemelman W A, Balm R, Legemate D A
Department of Surgery, Academic Medical Center, Meibergdreef 9, 1100 DD Amsterdam, The Netherlands.
Surg Endosc. 2005 Aug;19(8):1071-6. doi: 10.1007/s00464-004-2178-3. Epub 2005 May 26.
Considerable training is necessary to master laparoscopic suturing and knot-tying. Robotic systems are assumed to facilitate these skills and shorten the learning curve. The effect of laparoscopic experience and robotic assistance on the learning curve of vascular anastomoses was studied.
A laparoscopically experienced surgeon and a laparoscopically inexperienced surgeon made alternating laparoscopic vascular anastomoses and robot-assisted laparoscopic vascular anastomoses using a Zeus-Aesop surgical robotic system with various prosthetic conduits and suture materials in a laparoscopic training box.
Neither laparoscopic method influenced the quality score or leakage rate, but with laparoscopic experience, significantly fewer failures were made. Suturing and knot-tying were faster with laparoscopic experience both with and without the robotic system, and fewer stitch actions and knot actions were performed. The learning curves of both surgeons were not improved by the robotic system.
Experience is the most important factor in the performance of laparoscopic vascular anastomoses. The robotic system was not helpful in shortening the learning curve.
掌握腹腔镜缝合和打结技术需要大量训练。机器人系统被认为有助于掌握这些技能并缩短学习曲线。本研究探讨了腹腔镜经验和机器人辅助对血管吻合学习曲线的影响。
一名有腹腔镜经验的外科医生和一名无腹腔镜经验的外科医生在腹腔镜训练箱中，使用宙斯-伊索手术机器人系统，交替进行腹腔镜血管吻合和机器人辅助腹腔镜血管吻合，采用各种人工血管和缝合材料。
两种腹腔镜方法均未影响质量评分或渗漏率，但有腹腔镜经验时，失败次数显著减少。无论有无机器人系统，有腹腔镜经验时缝合和打结速度都更快，且缝合动作和打结动作更少。机器人系统并未改善两位外科医生的学习曲线。
经验是腹腔镜血管吻合操作中最重要的因素。机器人系统无助于缩短学习曲线。
