MRC Centre for Transplantation, King's College London, King's Health Partners, Department of Urology, Guy's Hospital, London, UK.
BJU Int. 2013 Feb;111(2):194-205. doi: 10.1111/j.1464-410X.2012.11270.x. Epub 2012 Jun 6.
To analyse studies validating the effectiveness of robotic surgery simulators. The MEDLINE(®), EMBASE(®) and PsycINFO(®) databases were systematically searched until September 2011. References from retrieved articles were reviewed to broaden the search. The simulator name, training tasks, participant level, training duration and evaluation scoring were extracted from each study. We also extracted data on feasibility, validity, cost-effectiveness, reliability and educational impact. We identified 19 studies investigating simulation options in robotic surgery. There are five different robotic surgery simulation platforms available on the market. In all, 11 studies sought opinion and compared performance between two different groups; 'expert' and 'novice'. Experts ranged in experience from 21-2200 robotic cases. The novice groups consisted of participants with no prior experience on a robotic platform and were often medical students or junior doctors. The Mimic dV-Trainer(®), ProMIS(®), SimSurgery Educational Platform(®) (SEP) and Intuitive systems have shown face, content and construct validity. The Robotic Surgical SimulatorTM system has only been face and content validated. All of the simulators except SEP have shown educational impact. Feasibility and cost-effectiveness of simulation systems was not evaluated in any trial. Virtual reality simulators were shown to be effective training tools for junior trainees. Simulation training holds the greatest potential to be used as an adjunct to traditional training methods to equip the next generation of robotic surgeons with the skills required to operate safely. However, current simulation models have only been validated in small studies. There is no evidence to suggest one type of simulator provides more effective training than any other. More research is needed to validate simulated environments further and investigate the effectiveness of animal and cadaveric training in robotic surgery.
分析验证机器人手术模拟器有效性的研究。系统检索了 MEDLINE(®)、EMBASE(®)和 PsycINFO(®)数据库,直至 2011 年 9 月。综述检索文章的参考文献以拓宽检索范围。从每项研究中提取模拟器名称、培训任务、参与者水平、培训持续时间和评估评分。我们还提取了可行性、有效性、成本效益、可靠性和教育影响的数据。我们确定了 19 项研究机器人手术模拟选项。市场上有五种不同的机器人手术模拟平台。共有 11 项研究寻求意见并比较了两个不同组(“专家”和“新手”)之间的表现。专家的经验从 21 到 2200 例机器人手术不等。新手组由没有机器人平台经验的参与者组成,通常是医学生或初级医生。Mimic dV-Trainer(®)、ProMIS(®)、SimSurgery 教育平台(SEP)和 Intuitive 系统已显示出表面、内容和结构有效性。Robotic Surgical SimulatorTM 系统仅经过表面和内容验证。除了 SEP 之外,所有模拟器都显示出了教育影响。没有一项试验评估过模拟系统的可行性和成本效益。虚拟现实模拟器已被证明是初级学员的有效培训工具。模拟培训最有可能作为传统培训方法的辅助手段,使下一代机器人外科医生具备安全操作所需的技能。然而,目前的模拟模型仅在小型研究中得到验证。没有证据表明一种类型的模拟器比其他模拟器提供更有效的培训。需要进一步验证模拟环境的有效性,并研究动物和尸体训练在机器人手术中的有效性。
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