Balasubramani Latha, Milliken David A, Shepherd John H, Ind Thomas E J
Department of Gynaecological Oncology, Royal Marsden Hospital, Fulham Road, London, SW3 6JJ, UK.
Department of Gynaecological Oncology, Somerset Cancer Centre, Musgrove Park Hospital, Taunton, TA1 5DA, UK.
J Robot Surg. 2011 Jun;5(2):137-40. doi: 10.1007/s11701-011-0248-9. Epub 2011 Jan 20.
Surgical dexterity depends on economy and precision of movements, and this can be objectively measured using electromagnetic motion analysis. We have assessed the differences in hand movements and task completion times between open, laparoscopic and robotically assisted surgery during an exercise performed in vitro. A standard surgical exercise was performed using open, standard laparoscopic (SL) and robotically assisted laparoscopic (RAL) approaches. The total duration of the exercise was studied along with the number and duration of movements required to complete the exercise in each surgical modality. The time taken to complete the exercise was significantly longer in both the SL and RAL approaches when compared to the open route. However, it was found that RAL had significantly decreased number of movements (mean difference = 24 movements, P < 0.006) but a longer duration of each movement when compared to SL (mean difference = 0.13 s, P < 0.001). This study shows objectively that the exercise took longer to complete using the RAL approach than the standard open approach. However, RAL had more purposeful movements and required fewer movements to complete the exercise compared to SL.
手术灵巧性取决于动作的经济性和精确性，这可以通过电磁运动分析进行客观测量。我们在体外进行的一项练习中评估了开放手术、腹腔镜手术和机器人辅助手术之间手部动作和任务完成时间的差异。使用开放手术、标准腹腔镜（SL）和机器人辅助腹腔镜（RAL）方法进行了一项标准的手术练习。研究了练习的总时长以及每种手术方式完成练习所需的动作数量和时长。与开放手术路径相比，SL和RAL方法完成练习所需的时间均显著更长。然而，研究发现，与SL相比，RAL的动作数量显著减少（平均差异 = 24个动作，P < 0.006），但每个动作的时长更长（平均差异 = 0.13秒，P < 0.001）。这项研究客观地表明，使用RAL方法完成练习比标准开放方法花费的时间更长。然而，与SL相比，RAL的动作更具目的性，完成练习所需的动作更少。
