Department of Mechanical Engineering, Tufts University, 200 College Avenue, Medford, MA 02155, USA.
Surg Endosc. 2009 Oct;23(10):2356-63. doi: 10.1007/s00464-009-0346-1. Epub 2009 Mar 5.
Current physical laparoscopic surgical simulators provide training only for static tasks, which do not develop the more advanced hand-eye coordination skills needed to navigate the dynamic surgical environment. A novel dynamic minimally invasive training environment (DynaMITE) was developed to address this need. This study aimed to evaluate further the utility of the system as a training and skill assessment tool. Two studies were performed with a second-generation design. The authors hypothesized that the dynamic task environment would be challenging to novices and would differentiate experienced surgeons from the inexperienced by emphasising the dynamic skills gained through surgical experience.
The participants in the first study were 42 novice and experienced surgeons attending the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2007 Learning Center, whereas the second controlled laboratory study had 16 participants (5 novices and 11 experienced surgeons). The participants performed two tasks: an aiming task and an object manipulation task. Both tasks were positioned on a dynamic platform that moved in five different trajectories.
The subjective feedback from the surgeons at the SAGES Learning Center was positive. The results from the controlled study showed significant performance deterioration in the fast diagonal task compared with the task of aiming and manipulating in the static environment for both experience groups but no performance differences between the groups.
Dynamic tasks are challenging, and surgeons need to be trained specifically for these tasks. The DynaMITE system can provide training benefits for dynamic skill development, even for expert surgeons who may have had no opportunity to gain these skills through their surgical practice.
目前的物理腹腔镜手术模拟器仅提供静态任务的培训，无法培养在动态手术环境中导航所需的更高级手眼协调技能。为满足这一需求，开发了一种新型动态微创训练环境（DynaMITE）。本研究旨在进一步评估该系统作为培训和技能评估工具的效用。该系统采用第二代设计进行了两项研究。作者假设，动态任务环境对新手来说具有挑战性，并通过强调通过手术经验获得的动态技能，将经验丰富的外科医生与无经验的外科医生区分开来。
第一项研究的参与者是 42 名参加美国胃肠内镜外科医师学会（SAGES）2007 年学习中心的新手和经验丰富的外科医生，而第二项对照实验室研究有 16 名参与者（5 名新手和 11 名经验丰富的外科医生）。参与者执行了两项任务：瞄准任务和物体操作任务。这两个任务都位于一个动态平台上，该平台可以在五个不同的轨迹上移动。
SAGES 学习中心的外科医生的主观反馈是积极的。对照研究的结果表明，与在静态环境中进行瞄准和操作任务相比，在快速对角任务中，两组经验者的表现都明显恶化，但两组之间的表现没有差异。
动态任务具有挑战性，外科医生需要专门针对这些任务进行培训。即使是没有机会通过手术实践获得这些技能的专家外科医生，DynaMITE 系统也可以为动态技能发展提供培训益处。
