Department of Urology, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
Int J Med Robot. 2011 Sep;7(3):367-73. doi: 10.1002/rcs.407. Epub 2011 Aug 3.
Transurethral resection of the prostate (TURP) is a challenging operation for residents with limited endoscopic experience. A number of virtual TURP simulators have been validated in the past. This study is the first description and preliminary evaluation of a non-virtual, low-cost TURP trainer as a teaching tool for residents in urology.
Dr K. Forke's prostatic resection trainer (PRT; LS 10-2/S, Samed GmbH, Dresden, Germany) was tested during the surgical training of a resident. Under the supervision of an experienced senior surgeon, three aspects were examined: the resection trainer's approximation to reality, the ease of instruction, and the potential capability to improve surgeons' psychomotor abilities with regard to the three-dimensional (3D) guidance of the instrument. The improvement in resection speed (RS) of residents with no PRT training (control group) was also compared to the results of the PRT-trained resident.
During the PRT training, the resident displayed clear improvement in resection quality (RQ) and a 27% increase in RS (p = 0.03). In the post-training stage, the PRT-trained resident showed a more constant progress rate, to a maximum RS of 0.37 g/min (35% increase; p = 0.01), whereas the control group displayed varied RS learning curves. Composed of a synthetic material, which can be resected by standard instruments, the trainer offers a haptical experience that is particularly realistic and may provide an increased learning rate.
From the findings, we conclude that this novel PRT is suitable for daily use and offers an effective and more affordable alternative to virtual simulators. Further validation studies will follow and new fields of application will be tested.
经尿道前列腺切除术（TURP）对于内窥镜经验有限的住院医师来说是一项具有挑战性的操作。过去已经验证了许多虚拟 TURP 模拟器。本研究首次描述并初步评估了一种非虚拟、低成本的 TURP 训练器作为泌尿科住院医师的教学工具。
在住院医师的手术培训过程中，测试了 K. Forke 博士的前列腺切除术训练器（PRT；LS 10-2/S，Samed GmbH，德累斯顿，德国）。在一位经验丰富的高级外科医生的监督下，检查了三个方面：切除训练器的逼真程度、指导的易用性以及提高外科医生在仪器的三维（3D）引导方面的运动技能能力的潜力。还比较了没有 PRT 培训的住院医师（对照组）的切除速度（RS）的改善情况。
在 PRT 培训过程中，住院医师的切除质量（RQ）明显提高，RS 提高了 27%（p = 0.03）。在培训后阶段，接受 PRT 培训的住院医师显示出更稳定的进步速度，最大 RS 达到 0.37 g/min（增加 35%；p = 0.01），而对照组的 RS 学习曲线则各不相同。该训练器由一种可通过标准仪器切除的合成材料制成，提供了特别逼真的触觉体验，可能会提高学习速度。
从研究结果中，我们得出结论，这种新型 PRT 适合日常使用，是虚拟模拟器的有效且更经济实惠的替代方案。将进行进一步的验证研究，并测试新的应用领域。
