Fuerst David, Hollensteiner Marianne, Schrempf Andreas
Annu Int Conf IEEE Eng Med Biol Soc. 2015;2015:5110-3. doi: 10.1109/EMBC.2015.7319541.
Surgical simulators provide a safe environment where novice surgeons can acquire their surgical skills. Although the number of patients with diseases of the musculoskeletal system is growing, the development of orthopedic simulators is still in it's infancy. The aim of this work was to identify simulation-based assessment parameters for a novel simulator in minimally invasive spine surgery. Apart from parameters targeting the duration and the surgeon's economy of motion during percutaneous bone access, parameters characterizing the movement smoothness were also examined with respect to their suitability. The results indicated, that the overall duration, the number of instrument movements, the number of velocity peaks and the Movement Arrest Period Ratio are the most promising predictors of expertise. Targeting performance improvement, the overall duration (p = 0.001), the number of instrument movements (p = 0.003) and the traveled instrument path length (p = 0.009) detected significant differences between subsequent trials. Using these parameters, a study can be designed targeting the validity and reliability of the simulation-based assessment.
手术模拟器提供了一个安全的环境，新手外科医生可以在其中获得他们的手术技能。尽管肌肉骨骼系统疾病患者的数量在不断增加，但骨科模拟器的发展仍处于起步阶段。这项工作的目的是确定一种新型微创脊柱手术模拟器基于模拟的评估参数。除了针对经皮骨穿刺过程中的持续时间和外科医生的动作经济性的参数外，还研究了表征运动平滑度的参数的适用性。结果表明，总持续时间、器械移动次数、速度峰值数量和运动停滞期比率是最有希望的专业技能预测指标。为了提高性能，总持续时间（p = 0.001）、器械移动次数（p = 0.003）和器械行进路径长度（p = 0.009）在后续试验中检测到显著差异。利用这些参数，可以设计一项针对基于模拟的评估的有效性和可靠性的研究。
