Madigan Health Care System, Tacoma, Washington, USA.
J Urol. 2012 Sep;188(3):919-23. doi: 10.1016/j.juro.2012.05.005. Epub 2012 Jul 20.
Rapid adoption of robot-assisted surgery has outpaced our ability to train novice roboticists. Objective metrics are required to adequately assess robotic surgical skills and yet surrogates for proficiency, such as economy of motion and tool path metrics, are not readily accessible directly from the da Vinci® robot system. The trakSTAR™ Tool Tip Tracker is a widely available, cost-effective electromagnetic position sensing mechanism by which objective proficiency metrics can be quantified. We validated a robotic surgery curriculum using the trakSTAR device to objectively capture robotic task proficiency metrics.
Through an institutional review board approved study 10 subjects were recruited from 2 surgical experience groups (novice and experienced). All subjects completed 3 technical skills modules, including block transfer, intracorporeal suturing/knot tying (fundamentals of laparoscopic surgery) and ring tower transfer, using the da Vinci robot with the trakSTAR device affixed to the robotic instruments. Recorded objective metrics included task time and path length, which were used to calculate economy of motion. Student t test statistics were performed using STATA®.
The novice and experienced groups consisted of 5 subjects each. The experienced group outperformed the novice group in all 3 tasks. Experienced surgeons described the simulator platform as useful for training and agreed with incorporating it into a residency curriculum.
Robotic surgery curricula can be validated by an off-the-shelf instrument tracking system. This platform allows surgical educators to objectively assess trainees and may provide credentialing offices with a means of objectively assessing any surgical staff member seeking robotic surgery privileges at an institution.
机器人辅助手术的快速采用已经超过了我们培训新手机器人专家的能力。需要客观的指标来充分评估机器人手术技能，但熟练程度的替代指标，如运动的经济性和工具路径指标，不能直接从达芬奇机器人系统中获得。trakSTAR 工具提示跟踪器是一种广泛可用的、具有成本效益的电磁位置感测机制，可以通过该机制量化客观的熟练程度指标。我们使用 trakSTAR 设备验证了机器人手术课程，以客观地捕获机器人任务熟练程度指标。
通过机构审查委员会批准的研究，从 2 个手术经验组（新手和经验丰富者）中招募了 10 名受试者。所有受试者均使用达芬奇机器人和附在机器人仪器上的 trakSTAR 设备完成了 3 个技术技能模块，包括块转移、体腔内缝合/打结（腹腔镜手术基础）和环塔转移。记录的客观指标包括任务时间和路径长度，用于计算运动的经济性。使用 STATA 进行学生 t 检验统计。
新手组和经验丰富组各有 5 名受试者。经验丰富组在所有 3 项任务中的表现均优于新手组。经验丰富的外科医生将模拟器平台描述为培训有用，并同意将其纳入住院医师课程。
机器人手术课程可以通过现成的仪器跟踪系统进行验证。该平台使外科教育工作者能够客观地评估学员，并可能为认证办公室提供一种手段，客观地评估任何在机构中寻求机器人手术特权的外科工作人员。
