Trejos Ana Luisa, Siroen Karen, Ward Christopher D W, Hossain Shahan, Naish Michael D, Patel Rajni V, Schlachta Christopher M
Department of Electrical and Computer Engineering, University of Western Ontario, London, ON, Canada.
Canadian Surgical Technologies and Advanced Robotics, Lawson Health Research Institute, 339 Windermere Road, London, ON, Canada.
Surg Endosc. 2015 Dec;29(12):3655-65. doi: 10.1007/s00464-015-4122-0. Epub 2015 Mar 5.
Training surgeons in minimally invasive surgery (MIS) requires surgical residents to operate under the direction of a consultant. The inability of the instructing surgeon to point at the laparoscopic monitor without releasing the instruments remains a barrier to effective instruction. The wireless hands-free surgical pointer (WHaSP) has been developed to aid instruction during MIS.
The objective of this study was to evaluate the effectiveness and likeability of the WHaSP as an instructional tool compared with the conventional methods. Data were successfully collected during 103 laparoscopic cholecystectomy procedures, which had been randomized to use or not use the WHaSP as a teaching tool. Audio and video from the surgeries were recorded and analyzed. Instructing surgeons, operating surgeons, and camera assistants provided feedback through a post-operative questionnaire that used a five-level Likert scale. The questionnaire results were analyzed using a Mann-Whitney U test.
There were no negative effects on surgery completion time or instruction practice due to the use of the WHaSP. The number of times an instructor surgeon pointed to the laparoscopic screen with their hand was significantly reduced when the WHaSP was utilized (p < 0.001). The questionnaires showed that WHaSP users found it to be comfortable, easy to use, and easy to control. Compared to when the WHaSP was not used, users found that communication was more effective (p = 0.002), locations were easier to communicate (p < 0.001), and instructions were easier to follow (p = 0.005).
The WHaSP system was successfully used in surgery. It integrated seamlessly into existing equipment within the operating room and did not affect flow. The positive outcomes of utilizing the WHaSP were improved communication in the OR, improved efficiency and safety of the surgery, easy to use, and comfortable to wear. The surgeons showed a preference for utilizing the WHaSP if given a choice.
对外科住院医师进行微创手术（MIS）培训时，需要他们在顾问指导下进行操作。指导外科医生在不松开器械的情况下指向腹腔镜监视器存在困难，这仍然是有效指导的障碍。无线免提手术指针（WHaSP）已被开发出来，以辅助微创手术中的指导工作。
本研究的目的是评估与传统方法相比，WHaSP作为一种教学工具的有效性和受欢迎程度。在103例腹腔镜胆囊切除术中成功收集了数据，这些手术被随机分为使用或不使用WHaSP作为教学工具。记录并分析手术的音频和视频。指导外科医生、主刀医生和摄像助手通过使用五级李克特量表的术后问卷提供反馈。使用曼-惠特尼U检验分析问卷结果。
使用WHaSP对手术完成时间或指导实践没有负面影响。使用WHaSP时，指导外科医生用手指向腹腔镜屏幕的次数显著减少（p < 0.001）。问卷显示，使用WHaSP者认为它舒适、易用且易于控制。与不使用WHaSP相比，使用者发现沟通更有效（p = 0.002），位置更容易沟通（p < 0.001），指令更容易理解（p = 0.005）。
WHaSP系统在手术中得到成功应用。它无缝集成到手术室现有的设备中，不影响手术流程。使用WHaSP的积极成果包括手术室沟通改善、手术效率和安全性提高以及易于使用和佩戴舒适。如果有选择，外科医生更倾向于使用WHaSP。
