Matsuda Tadashi, Yoshida Kenji, Habuchi Tomonori, Kinoshita Hidefumi, Kanayama Hiro-Omi, Terachi Toshiro
1 Department of Urology and Andrology, Kansai Medical University , Osaka, Japan .
2 Department of Urology, Akita University Graduate School of Medicine , Akita, Japan .
J Endourol. 2017 Apr;31(S1):S25-S29. doi: 10.1089/end.2016.0554. Epub 2016 Sep 23.
To improve surgical education, objective and scientific skill assessments are required. There are two types of skill evaluations: assessments of basic surgical skills and assessments of overall surgical performance. To establish a reliable assessment method for surgical dissection, we measured the force applied on the tip of a surgical instrument during dissection of the renal vessels of pigs. The experiments revealed that, during surgical dissection, expert laparoscopic surgeons applied vertical force at the beginning of the stroke and then horizontal force, with minimum vertical force, at the end of the stroke. As an assessment of overall surgical performance, the Endoscopic Surgical Qualification system was developed and has been used for 12 years in Japan. More than 3700 surgeons, including urologists, were determined to have appropriate laparoscopic surgical skills after assessments of unedited videos by referees.
为了改善外科手术教育，需要客观且科学的技能评估。有两种技能评估类型：基本外科手术技能评估和整体手术表现评估。为了建立一种可靠的手术解剖评估方法，我们在猪肾血管解剖过程中测量了手术器械尖端所施加的力。实验表明，在手术解剖过程中，专业腹腔镜外科医生在行程开始时施加垂直力，然后在行程结束时施加水平力，且垂直力最小。作为整体手术表现的一种评估，内镜手术资格系统已被开发出来，并在日本使用了12年。在裁判对未编辑视频进行评估后，包括泌尿科医生在内的3700多名外科医生被确定具备适当的腹腔镜手术技能。
