Blavier Adélaïde, Gaudissart Quentin, Cadière Guy-Bernard, Nyssen Anne-Sophie
National Fund of Scientific Research, Cognitive Ergonomics Laboratory, University of Liège, place du 20-Août, 9à B-4000 Liège, Belgium.
Am J Surg. 2007 Jul;194(1):115-21. doi: 10.1016/j.amjsurg.2006.10.014.
The purpose of this study was to evaluate the perceptual (2-dimensional [2D] vs. 3-dimensional [3D] view) and instrumental (classical vs. robotic) impacts of new robotic system on learning curves.
Forty medical students without any surgical experience were randomized into 4 groups (classical laparoscopy with 3D-direct view or with 2D-indirect view, robotic system in 3D or in 2D) and repeated a laparoscopic task 6 times. After these 6 repetitions, they performed 2 trials with the same technique but in the other viewing condition (perceptive switch). Finally, subjects performed the last 3 trials with the technique they never used (technical switch). Subjects evaluated their performance answering a questionnaire (impressions of mastery, familiarity, satisfaction, self-confidence, and difficulty).
Our study showed better performance and improvement in 3D view than in 2D view whatever the instrumental aspect. Participants reported less mastery, familiarity, and self-confidence and more difficulty in classical laparoscopy with 2D-indirect view than in the other conditions.
Robotic surgery improves surgical performance and learning, particularly by 3D view advantage. However, perceptive and technical switches emphasize the need to adapt and pursue training also with traditional technology to prevent risks in conversion procedure.
本研究旨在评估新型机器人系统对学习曲线的感知（二维[2D]视图与三维[3D]视图）和器械（传统与机器人）方面的影响。
40名无任何手术经验的医学生被随机分为4组（3D直视或2D间接视的传统腹腔镜手术组、3D或2D的机器人系统组），并重复进行6次腹腔镜任务。在这6次重复操作后，他们用相同技术但在另一种观察条件下（感知转换）进行2次试验。最后，受试者用他们从未使用过的技术进行最后3次试验（技术转换）。受试者通过回答一份问卷（对掌握程度、熟悉程度、满意度、自信心和难度的印象）来评估自己的表现。
我们的研究表明，无论器械方面如何，3D视图下的表现和进步均优于2D视图。与其他条件相比，参与者报告在2D间接视的传统腹腔镜手术中掌握程度、熟悉程度和自信心较低，难度更大。
机器人手术可提高手术表现和学习效果，特别是借助3D视图的优势。然而，感知和技术转换强调了也需要采用传统技术进行适应和持续训练，以防止在转换手术过程中出现风险。
