比较机器人辅助和直杆腹腔镜手术在手术新手学习曲线上的差异。
Comparing the learning curve for robotically assisted and straight stick laparoscopic procedures in surgical novices.
机构信息
Royal Marsden Hospital, London, UK.
出版信息
Int J Med Robot. 2010 Sep;6(3):306-10. doi: 10.1002/rcs.333.
INTRODUCTION
Robotically assisted laparoscopic surgery has a different learning curve to straight stick laparoscopic surgery. The learning curve for novices is likely to be different to that for experienced surgeons. We assessed the early learning curve for trainees with 18 months or less of surgical experience.
METHODS
Six surgical novices performed 120 exercises using laparoscopic instruments and a DaVinci S robot. The exercise comprised cutting out a computer-generated paper circle. Time to completion, number of instrument changes and accuracy were compared (Kruskal-Wallis test).
RESULTS
Trainees required significantly less time using the robot (326 vs. 433 s; p < 0.0001); recorded fewer mistakes (1 vs. 4.5; p < 0.0001) and fewer instrument changes (1 vs. 3; p < 0.0001). Significant improvement was demonstrated in time, number of mistakes and instrument changes for robotically-assisted laparoscopic surgery.
CONCLUSION
For surgical novices tested on an in vitro dexterity exercise, a robotically assisted laparoscopic system offers a shorter learning curve and improved accuracy compared to straight stick surgery.
简介
机器人辅助腹腔镜手术与直杆腹腔镜手术有不同的学习曲线。新手的学习曲线可能与经验丰富的外科医生不同。我们评估了具有 18 个月或更短手术经验的受训者的早期学习曲线。
方法
六名手术新手使用腹腔镜器械和达芬奇 S 机器人进行了 120 次练习。练习包括切割出一个计算机生成的纸圈。比较完成时间、器械更换次数和准确性（Kruskal-Wallis 检验）。
结果
学员使用机器人的时间明显减少（326 与 433 秒；p < 0.0001）；记录的错误更少（1 与 4.5；p < 0.0001），器械更换次数更少（1 与 3；p < 0.0001）。机器人辅助腹腔镜手术的时间、错误数量和器械更换次数均有显著改善。
结论
对于在体外灵巧性练习中测试的手术新手，机器人辅助腹腔镜系统与直杆手术相比，提供了更短的学习曲线和更高的准确性。
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