Department of Urology, University of California, Irvine, Orange, CA, USA.
J Endourol. 2012 Dec;26(12):1629-34. doi: 10.1089/end.2012.0328. Epub 2012 Oct 2.
Virtual reality simulators with self-assessment software may assist novice robotic surgeons to augment direct proctoring in robotic surgical skill acquisition. We compare and correlate the da Vinci Trainer™ (dVT) and da Vinci Surgical Skills Simulators (dVSSS) in subjects with varying robotic experience.
Students, urology residents, fellows, and practicing urologists with varying robotic experience were enrolled after local institutional review board approval. Three virtual reality tasks were preformed in sequential order (pegboard 1, pegboard 2, and tubes)-initially on the dVSSS and then on the dVT. The Mimic™ software used on both systems provides raw values and percent scores that were used in statistical evaluation. Statistical analysis was performed with the two-tailed independent t-test, analysis of variance, Tukey, and the Pearson rank correlation coefficient where appropriate.
Thirty-two participants were recruited for this study and separated into five groups based on robotic surgery experience. In regards to construct validity, both simulators were able to differentiate differences among the five robotic surgery experience groups in the tubes suturing task (p≤0.00). Sixty-seven percent (4/6) robotic experts thought that surgical simulation should be implemented in residency training. The overall cohort considered both platforms easy to learn and use.
Although performance scores were less in the dVT compared with the dVSSS, both simulators demonstrate good content and construct validity. The simulators appear to be equivalent for assessing surgeon proficiency and either can be used for robotic skills training with self-assessment feedback.
带有自我评估软件的虚拟现实模拟器可以帮助新手机器人外科医生在机器人手术技能获得中增加直接监督。我们比较并关联了达芬奇训练器（dVT）和达芬奇手术技能模拟器（dVSSS）在具有不同机器人经验的受试者中的表现。
在获得当地机构审查委员会批准后，招募了具有不同机器人经验的学生、泌尿科住院医师、研究员和执业泌尿科医师。受试者以顺序进行三项虚拟现实任务（钉板 1、钉板 2 和管腔）-最初在 dVSSS 上完成，然后在 dVT 上完成。两种系统上使用的 Mimic™软件提供了原始值和百分比分数，这些值用于统计评估。使用双尾独立 t 检验、方差分析、Tukey 和 Pearson 秩相关系数进行统计分析，在适当的情况下使用这些方法。
本研究共招募了 32 名参与者，并根据机器人手术经验将其分为五组。关于构效关系，两种模拟器都能够在管腔缝合任务中区分五个机器人手术经验组之间的差异（p≤0.00）。67%（4/6）的机器人专家认为应该在住院医师培训中实施手术模拟。总体队列认为这两个平台都易于学习和使用。
尽管 dVT 的绩效得分低于 dVSSS，但两种模拟器都表现出良好的内容和构效关系。模拟器似乎在评估外科医生的熟练程度方面是等效的，并且可以使用自我评估反馈进行机器人技能培训。
