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普通外科住院医师在外科培训期间对机器人辅助手术的认知。

General surgery residents' perception of robot-assisted procedures during surgical training.

作者信息

Farivar Behzad S, Flannagan Molly, Leitman I Michael

机构信息

Icahn School of Medicine at Mount Sinai, New York, New York; Department of Surgery, Mount Sinai Beth Israel, New York, New York.

Icahn School of Medicine at Mount Sinai, New York, New York; Department of Surgery, Mount Sinai Beth Israel, New York, New York.

出版信息

J Surg Educ. 2015 Mar-Apr;72(2):235-42. doi: 10.1016/j.jsurg.2014.09.008. Epub 2014 Oct 31.

Abstract

INTRODUCTION

With the continued expansion of robotically assisted procedures, general surgery residents continue to receive more exposure to this new technology as part of their training. There are currently no guidelines or standardized training requirements for robot-assisted procedures during general surgical residency. The aim of this study was to assess the effect of this new technology on general surgery training from the residents' perspective.

METHODS

An anonymous, national, web-based survey was conducted on residents enrolled in general surgery training in 2013. The survey was sent to 240 Accreditation Council for Graduate Medical Education-approved general surgery training programs.

RESULTS

Overall, 64% of the responding residents were men and had an average age of 29 years. Half of the responses were from postgraduate year 1 (PGY1) and PGY2 residents, and the remainder was from the PGY3 level and above. Overall, 50% of the responses were from university training programs, 32% from university-affiliated programs, and 18% from community-based programs. More than 96% of residents noted the availability of the surgical robot system at their training institution. Overall, 63% of residents indicated that they had participated in robotic surgical cases. Most responded that they had assisted in 10 or fewer robotic cases with the most frequent activities being assisting with robotic trocar placement and docking and undocking the robot. Only 18% reported experience with operating the robotic console. More senior residents (PGY3 and above) were involved in robotic cases compared with junior residents (78% vs 48%, p < 0.001). Overall, 60% of residents indicated that they received no prior education or training before their first robotic case. Approximately 64% of residents reported that formal training in robotic surgery was important in residency training and 46% of residents indicated that robotic-assisted cases interfered with resident learning. Only 11% felt that robotic-assisted cases would replace conventional laparoscopic surgery in the future.

CONCLUSIONS

This study illustrates that although the most residents have a robot at their institution and have participated in robotic surgery cases, very few residents received formal training before participating in a robotic case.

摘要

引言

随着机器人辅助手术的持续开展,普通外科住院医师在培训过程中越来越多地接触到这项新技术。目前,普通外科住院医师培训期间没有关于机器人辅助手术的指南或标准化培训要求。本研究的目的是从住院医师的角度评估这项新技术对普通外科培训的影响。

方法

对2013年参加普通外科培训的住院医师进行了一项全国性的匿名网络调查。该调查发送至240个经毕业后医学教育认证委员会批准的普通外科培训项目。

结果

总体而言,64%的应答住院医师为男性,平均年龄29岁。一半的回复来自第一年住院医师(PGY1)和第二年住院医师(PGY2),其余来自PGY3及以上级别。总体而言,50%的回复来自大学培训项目,32%来自大学附属医院项目,18%来自社区项目。超过96%的住院医师表示其培训机构有手术机器人系统。总体而言,63%的住院医师表示他们参与过机器人手术病例。大多数人回答他们协助进行了10例或更少的机器人手术病例,最常见的活动是协助机器人套管针置入以及机器人的对接和脱开。只有18%的人报告有操作机器人控制台的经验。与低年资住院医师相比,高年资住院医师(PGY3及以上)参与机器人手术病例的比例更高(78%对48%,p<0.001)。总体而言,60%的住院医师表示他们在第一例机器人手术病例之前没有接受过任何先前的教育或培训。约64%的住院医师报告机器人手术的正规培训在住院医师培训中很重要,46%的住院医师表示机器人辅助病例干扰了住院医师的学习。只有11%的人认为机器人辅助病例将来会取代传统的腹腔镜手术。

结论

本研究表明,虽然大多数住院医师所在机构有机器人且参与过机器人手术病例,但很少有住院医师在参与机器人手术病例之前接受过正规培训。

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