Araki Azumi, Makiyama Kazuhide, Yamanaka Hiroyuki, Ueno Daiki, Osaka Kimito, Nagasaka Manabu, Yamada Takahiro, Yao Masahiro
Department of Urology, Yokohama City University, Yokohama, 236-0004, Japan.
Mitsubishi Precision Co., Ltd., Kamakura, 247-8505, Japan.
Surg Endosc. 2017 Apr;31(4):1999-2005. doi: 10.1007/s00464-016-5153-x. Epub 2016 Aug 29.
Laparoscopic surgical techniques are difficult to learn, and developing such skills involves a steep learning curve. To ensure surgeons achieve a high skill level, it is important to be able to measure and assess their skills. Therefore, it is necessary to understand the performance differences between experienced and novice surgeons, as such information could be used to help surgeons learn laparoscopic skills. We examined the differences in gripping and reaction force between experienced and novice surgeons during laparoscopic surgery.
We measured the gripping force generated during laparoscopic surgery performed on pigs using forceps with pressure sensors. Several sensors, including strain gauges, accelerometers, and a potentiometer, were attached to the forceps. This study included 4 experienced and 4 novice surgeons. Each subject was asked to elevate the kidney in order to approach the renal hilus using the forceps. Throughout the experiment, we measured the gripping force and reaction force generated during the movement of the forceps in real time.
The experienced and novice surgeons exhibited similar reaction force levels. Conversely, gripping force differed significantly between the groups. The experienced and novice surgeons exhibited mean gripping force levels of 3.06 and 7.15 N, respectively. The gripping force standard deviation values for the experienced and novice surgeons were 1.43 and 3.54 N, respectively. The mean and standard deviation gripping force values of the experienced surgeons were significantly lower than those of the novice surgeons (P = 0.015 and P = 0.011, respectively).
This study indicated that experienced surgeons generate weaker but more stable gripping force than novice surgeons during laparoscopic procedures.
腹腔镜手术技术难以掌握,培养这些技能存在陡峭的学习曲线。为确保外科医生达到高技能水平,能够测量和评估他们的技能很重要。因此,有必要了解经验丰富的外科医生和新手外科医生之间的操作差异,因为此类信息可用于帮助外科医生学习腹腔镜技能。我们研究了经验丰富的外科医生和新手外科医生在腹腔镜手术过程中的抓握力和反作用力差异。
我们使用带有压力传感器的镊子测量了在猪身上进行腹腔镜手术时产生的抓握力。包括应变片、加速度计和电位计在内的几个传感器被连接到镊子上。本研究纳入了4名经验丰富的外科医生和4名新手外科医生。要求每位受试者使用镊子抬起肾脏以接近肾门。在整个实验过程中,我们实时测量了镊子移动过程中产生的抓握力和反作用力。
经验丰富的外科医生和新手外科医生表现出相似的反作用力水平。相反,两组之间的抓握力差异显著。经验丰富的外科医生和新手外科医生的平均抓握力水平分别为3.06 N和7.15 N。经验丰富的外科医生和新手外科医生的抓握力标准差分别为1.43 N和3.54 N。经验丰富的外科医生的平均抓握力值和标准差显著低于新手外科医生(分别为P = 0.015和P = 0.011)。
本研究表明,在腹腔镜手术过程中,经验丰富的外科医生产生的抓握力比新手外科医生弱,但更稳定。