van Empel Pieter J, van der Veer Willem M, van Rijssen Lennart B, Cuesta Miguel A, Scheele Fedde, Bonjer H Jaap, Meijerink Wilhelmus J
Department of Surgery, VU University Medical Centre, Amsterdam, The Netherlands.
J Laparoendosc Adv Surg Tech A. 2012 Jan-Feb;22(1):51-60. doi: 10.1089/lap.2010.0467. Epub 2011 Dec 6.
Conforming to, among other considerations, legal and ethical concerns for patient safety, there is an increasing demand to assess a surgeon's skills prior to performance in the operating room in pursuit of higher-quality treatment. Training in minimally invasive surgery (MIS) must therefore be intensified, including team training. New methods to train and assess minimally invasive surgical skills are gaining interest. The goal of this review is to provide instructors with an overview of available MIS training tools. In this review, we discuss currently available simulators for MIS training. Applicability, validity, and construction of simulators are reviewed. Also, some of the leading training programs and assessment methods in MIS are reviewed.
A literature search was performed on studies evaluating surgical task performance on a simulator, reviewing satisfaction with laparoscopic training programs, or validating simulators or assessment methods.
Simulators may be divided into simple box trainers and computer-based systems, such as virtual and augmented simulators. All have advantages and disadvantages. An overview is provided of currently available training systems, validity, trainee assessment, and the importance of training programs in MIS.
No simulator yet provides the ability to train the entire set of required psychomotor skills or procedures for MIS. A multiyear training program combining various simulators for multiple-level training, including team training, should be constructed.
出于对患者安全的法律和伦理考量等因素，为追求更高质量的治疗，在手术室进行手术前评估外科医生技能的需求日益增加。因此，包括团队培训在内的微创手术（MIS）培训必须加强。用于培训和评估微创手术技能的新方法正受到关注。本综述的目的是为教员提供可用的MIS培训工具概述。在本综述中，我们讨论了目前可用的MIS培训模拟器。对模拟器的适用性、有效性和构造进行了综述。此外，还综述了一些领先的MIS培训计划和评估方法。
对评估模拟器上手术任务表现、腹腔镜培训计划满意度或验证模拟器或评估方法的研究进行了文献检索。
模拟器可分为简单的箱式训练器和基于计算机的系统，如虚拟模拟器和增强模拟器。所有这些都有优缺点。提供了当前可用培训系统、有效性、学员评估以及MIS培训计划重要性的概述。
尚无模拟器能够训练MIS所需的全部心理运动技能或程序。应构建一个结合各种模拟器进行多层次培训（包括团队培训）的多年培训计划。
