Judkins Timothy N, Oleynikov Dmitry, Stergiou Nick
Intelligent Automation, Inc, Rockville, MD, USA.
Surg Endosc. 2009 Mar;23(3):590-7. doi: 10.1007/s00464-008-9933-9. Epub 2008 Apr 29.
Robotic laparoscopic surgery has revolutionized minimally invasive surgery for the treatment of abdominal pathologies. However, current training techniques rely on subjective evaluation. The authors sought to identify objective measures of robotic surgical performance by comparing novices and experts during three training tasks.
Five novices (medical students) were trained in three tasks with the da Vinci Surgical System. Five experts trained in advanced laparoscopy also performed the three tasks. Time to task completion (TTC), total distance traveled (D), speed (S), curvature (kappa), and relative phase (Phi) were measured.
Before training, TTC, D, and kappa were significantly smaller for experts than for novices (p < 0.05), whereas S was significantly larger for experts than for novices before training (p < 0.05). Novices performed significantly better after training, as shown by smaller TTC, D, and kappa, and larger S. Novice performance after training approached expert performance.
This study clearly demonstrated the ability of objective kinematic measures to distinguish between novice and expert performance and training effects in the performance of robotic surgical training tasks.
机器人腹腔镜手术彻底改变了腹部疾病的微创手术治疗方式。然而，目前的培训技术依赖主观评估。作者试图通过在三项训练任务中比较新手和专家来确定机器人手术操作的客观指标。
五名新手（医学生）使用达芬奇手术系统进行了三项任务的训练。五名接受过高级腹腔镜手术培训的专家也完成了这三项任务。测量了完成任务的时间（TTC）、总移动距离（D）、速度（S）、曲率（kappa）和相对相位（Phi）。
训练前，专家的TTC、D和kappa显著小于新手（p < 0.05），而训练前专家的S显著大于新手（p < 0.05）。新手训练后表现明显更好，表现为TTC、D和kappa更小，S更大。新手训练后的表现接近专家水平。
本研究清楚地证明了客观运动学指标能够区分新手和专家在机器人手术训练任务中的表现以及训练效果。
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