Division of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, OH, USA.
J Am Coll Surg. 2010 Aug;211(2):250-5. doi: 10.1016/j.jamcollsurg.2010.04.002.
The aim of this study was to compare the human cadaver model with an augmented reality simulator for straight laparoscopic colorectal skills acquisition.
Thirty-five sigmoid colectomies were performed on a cadaver (n = 7) or an augmented reality simulator (n = 28) during a laparoscopic training course. Prior laparoscopic colorectal experience was assessed. Objective structured technical skills assessment forms were completed by trainers and trainees independently. Groups were compared according to technical skills and events scores and satisfaction with training model.
Prior laparoscopic experience was similar in both groups. For trainers and trainees, technical skills scores were considerably better on the simulator than on the cadaver. For trainers, generic events score was also considerably better on the simulator than on the cadaver. The main generic event occurring on both models was errors in the use of retraction. The main specific event occurring on both models was bowel perforation. Global satisfaction was better for the cadaver than for the simulator model (p < 0.001).
The human cadaver model was more difficult but better appreciated than the simulator for laparoscopic sigmoid colectomy training. Simulator training followed by cadaver training can appropriately integrate simulators into the learning curve and maintain the benefits of both training methodologies.
本研究旨在比较人体尸体模型与增强现实模拟器在直式腹腔镜结直肠技能习得上的差异。
在腹腔镜培训课程中，对一具尸体（n=7）或增强现实模拟器（n=28）进行了 35 例乙状结肠切除术。评估了之前的腹腔镜结直肠经验。由培训师和学员独立完成客观结构化技术技能评估表。根据技术技能和事件评分以及对培训模型的满意度对组进行比较。
两组的腹腔镜经验相似。对于培训师和学员来说，模拟器上的技术技能评分明显高于尸体模型。对于培训师来说，模拟器上的通用事件评分也明显高于尸体模型。两种模型上主要的通用事件是在使用牵引时出现错误。两种模型上主要的具体事件是肠穿孔。尸体模型的总体满意度优于模拟器模型（p<0.001）。
对于腹腔镜乙状结肠切除术培训，人体尸体模型比模拟器更难，但更受青睐。模拟器培训后再进行尸体培训，可以适当将模拟器纳入学习曲线，并保持两种培训方法的优势。
