Hassan Iyad, Maschuw Katja, Rothmund Matthias, Koller Michael, Gerdes Berthold
Department of Visceral, Thoracic and Vascular Surgery, Philipps University of Marburg, Marburg, Germany.
Eur Surg Res. 2006;38(2):109-13. doi: 10.1159/000093282. Epub 2006 May 11.
This study aims to establish which physicians represent the suitable target group of a virtual training laboratory.
Novices (48 physicians with fewer than 10 laparoscopic operations) and intermediate trainees (19 physicians who performed 30-50 laparoscopic operations) participated in this study. Each participant performed the basic module 'clip application' at the beginning and after a 1-hour short training course on the LapSim. The course consisted of the tasks coordination, lift and grasp, clip application, cutting with diathermy and fine dissection at increasing difficulty levels. The time taken to complete the tasks, number of errors, and economy of motion parameters (path length and angular path) were analyzed.
Following training with the simulator, novices completed the task significantly faster (p = 0.001), demonstrated a greater economy of motion [path length (p = 0.04) and angular path (p = 0.01)]. In contrast, the intermediate trainees showed a reduction of their errors, but without reaching statistical significance. They showed no improvement in economy of motion and completed the task significantly slower (p = 0.03).
Novices, in comparison to intermediate trainees, tend to benefit most during their first exposure to a laparoscopy simulator.
本研究旨在确定哪些医生是虚拟训练实验室的合适目标群体。
新手（48名腹腔镜手术经验少于10次的医生）和中级受训者（19名进行了30 - 50次腹腔镜手术的医生）参与了本研究。每位参与者在开始时以及在LapSim上进行1小时的短期培训课程后，执行基本模块“夹子应用”。该课程包括任务协调、提起和抓握、夹子应用、电刀切割以及难度逐渐增加的精细解剖。分析完成任务所需的时间、错误数量和动作经济性参数（路径长度和角路径）。
在使用模拟器训练后，新手完成任务的速度明显更快（p = 0.001），动作经济性更高[路径长度（p = 0.04）和角路径（p = 0.01）]。相比之下，中级受训者的错误有所减少，但未达到统计学意义。他们在动作经济性方面没有改善，完成任务的速度明显更慢（p = 0.03）。
与中级受训者相比，新手在首次接触腹腔镜模拟器时往往受益最大。
