Kilic Gokhan Sami, Walsh Teresa M, Borahay Mostafa, Zeybek Burak, Wen Michael, Breitkopf Daniel
Department of Obstetrics & Gynecology, The University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-0587, USA.
ISRN Obstet Gynecol. 2012;2012:569456. doi: 10.5402/2012/569456. Epub 2012 Sep 2.
Objective. To assess the impact of gynecology residents' previous laparoscopic experience on the learning curve of robotic suturing techniques and the value of initial structured teaching in dry lab prior to surgery. Methods. Thirteen gynecology residents with no previous robotic surgery experience were divided into Group 1, consisting of residents with 2 or fewer laparoscopic experiences, and Group 2, consisting of residents with 3 or more laparoscopic experiences. Group 1 had a dry-laboratory training in suturing prior to their initial experience in the operating room. Results. For all residents, it took on average 382 ± 159 seconds for laparoscopic suturing and 326 ± 196 seconds for robotic suturing (P = 0.12). Residents in Group 1 had a lower mean suture time than residents in Group 2 for laparoscopic suturing (P = 0.009). The residents in Group 2, however, had a lower mean suture time on the robot compared to Group 1 (P = 0.5). Conclusion. Residents with previous laparoscopic suturing experience may gain more from a robotic surgery experience than those with limited laparoscopic surgery experience. In addition, dry lab training is more efficient than hands-on training in the initial phase of teaching for both laparoscopic and robotic suturing skills.
目的。评估妇科住院医师既往腹腔镜手术经验对机器人缝合技术学习曲线的影响,以及术前在模拟实验室进行初始结构化教学的价值。方法。将13名既往无机器人手术经验的妇科住院医师分为两组,第1组为腹腔镜手术经验2次及以下的住院医师,第2组为腹腔镜手术经验3次及以上的住院医师。第1组在进入手术室进行首次手术前,先在模拟实验室接受缝合训练。结果。所有住院医师腹腔镜缝合平均用时382±159秒,机器人缝合平均用时326±196秒(P = 0.12)。第1组住院医师腹腔镜缝合的平均用时低于第2组住院医师(P = 0.009)。然而,第2组住院医师在机器人操作上的平均缝合用时低于第1组(P = 0.5)。结论。既往有腹腔镜缝合经验的住院医师相比腹腔镜手术经验有限的住院医师,可能从机器人手术经验中获益更多。此外,在腹腔镜和机器人缝合技能教学的初始阶段,模拟实验室训练比实际操作训练更有效。