Justo-Janeiro Jaime M, Pedroza-Meléndez Alejandro, Prado Eduardo, Theurel-Vincent Gustavo, Vázquez-de Lara Luis G
Facultad de Medicina, Benemérita Universidad Autónoma de Puebla. Servicio de Cirugía, Hospital General de Puebla Eduardo Vázquez Navarro, Puebla, Mexico.
Cir Cir. 2007 Jan-Feb;75(1):19-23.
Simulators are effective devices for the development of certain skills needed in laparoscopic surgery. Bench models with laparoscopy equipment, virtual reality and mirror boxes have been used; however, they have limitations such as the need for laparoscopy equipment, high cost or a considerable mismatch with reality.
We undertook this study to test a simulator as a training device that allows the acquisition of eye-hand coordination and two-dimensional spatial orientation without the need of laparoscopic equipment. The simulator consists of a box with an internal light and a color video CCD connected to a television set. Quality of vision, illumination and adequacy as training equipment was assessed by experienced laparoscopic surgeons. Thereafter, 12 general surgeons without experience in laparoscopic surgery and 18 surgery trainees performed seven different drills after a short course on basic skills and knot-tying laparoscopic techniques. The time to completion of each task was recorded at the beginning and after 10 practices of 30-min each.
Ten experienced surgeons qualified with the simulator with a mean of 42 points (40-44 from a 44 total). There were significant reductions in the final times of all participants. Paired t-test was significant in all the measurements. The mean time decreased 31.8% (from 1108 +/- 96 to 755 +/- 107 sec) with a 95% confidence interval of 15.1-48.5%.
The simulator tested in this study helps to develop laparoscopic surgical skills economically and without the need for laparoscopic equipment. This laparoscopy training equipment is novel and original in its design.
模拟器是培养腹腔镜手术所需某些技能的有效设备。已使用配备腹腔镜设备、虚拟现实和镜箱的台式模型；然而，它们存在局限性，如需要腹腔镜设备、成本高或与实际情况存在较大差距。
我们开展本研究以测试一种模拟器作为训练设备，该设备可在无需腹腔镜设备的情况下培养眼手协调能力和二维空间定向能力。该模拟器由一个内部有灯的盒子和一个连接到电视机的彩色视频CCD组成。经验丰富的腹腔镜外科医生评估了视觉质量、照明情况以及作为训练设备的适用性。此后，12名无腹腔镜手术经验的普通外科医生和18名外科实习生在接受了关于基本技能和腹腔镜打结技术的短期课程培训后，进行了七种不同的训练。记录了每项任务开始时以及每次30分钟共10次练习后的完成时间。
10名经验丰富的外科医生通过了该模拟器的测试，平均得分为42分（满分44分，得分范围为40 - 44分）。所有参与者的最终时间均有显著减少。配对t检验在所有测量中均具有显著性。平均时间减少了31.8%（从1108 ± 96秒降至755 ± 107秒），95%置信区间为15.1 - 48.5%。
本研究中测试的模拟器有助于经济地培养腹腔镜手术技能，且无需腹腔镜设备。这种腹腔镜训练设备在设计上新颖独特。
