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一种基于计算机断层结肠成像数据分析的新型物理结肠镜模拟器。

A novel physical colonoscopy simulator based on analysis of data from computed tomography colonography.

作者信息

Noda Katsuhisa, Kitada Takatoshi, Suzuki Yasumoto, Colvin Hugh Shunsuke, Hata Taishi, Mizushima Tsunekazu

机构信息

Noda Genki Clinic, Kawasaki Building 1F 102, 2-6-30 Minami-Sakurazuka, Toyonaka, Osaka, 561-0882, Japan.

Kitada Clinic., Geo Kawanishi Residence Mark 1F, 1-2-6 Ohbe, Kawanishi, Hyogo, 666-0014, Japan.

出版信息

Surg Today. 2017 Sep;47(9):1153-1162. doi: 10.1007/s00595-017-1517-7. Epub 2017 May 3.

Abstract

PURPOSE

Laparoscopic surgery is now practiced widely because of its lower postoperative morbidity. As flexible endoscopy during laparoscopic surgery minimizes surgical trauma further, training in endoscopy will become more important for surgeons. Thus, we designed a physical simulator, the Noda-Kitada-Suzuki (NKS) model, which could provide the more realistic insertion of a colonoscope.

METHODS

We designed a colonoscopy simulator, based on information from computed tomography colonography scans of the anatomy and kinetic properties of the colon and rectum.

RESULTS

The transparent skeleton body of the NKS model provides instant visual feedback to the operator and the trainer. Our novel colonoscopy simulator replicates the realistic and reproducible insertion of a colonoscope from the rectum to cecum, providing authentic views of the Houston's valves, the flexures, and mucosal folds. This was verified through an objective questionnaire, with 14 of 16 colonoscopists preferring the NKS model over the previous CM15 model for training purposes. Moreover, the Modified Colonoscopy Simulator Realism Questionnaire analysis confirmed that the NKS model was significantly more realistic than the CM15 for 7 (21.2%) of the 33 items when assessed by 12 colonoscopists.

CONCLUSION

The NKS model provides a realistic training platform and may improve the quality of training in colonoscopy.

摘要

目的

由于腹腔镜手术术后发病率较低,目前其应用广泛。随着腹腔镜手术中的软性内镜检查可进一步减少手术创伤,内镜检查培训对外科医生将变得更加重要。因此,我们设计了一种物理模拟器,即野田 - 北田 - 铃木(NKS)模型,它能够提供更逼真的结肠镜插入操作。

方法

我们基于来自计算机断层扫描结肠造影的结肠和直肠解剖及动力学特性信息,设计了一种结肠镜检查模拟器。

结果

NKS模型的透明骨架主体为操作者和培训者提供即时视觉反馈。我们新颖的结肠镜检查模拟器可重现从直肠到盲肠的逼真且可重复的结肠镜插入操作,呈现出休斯顿瓣、弯曲部和黏膜皱襞的真实视图。这通过一份客观问卷得到验证,16名结肠镜检查医师中有14名在培训时更喜欢NKS模型而非之前的CM15模型。此外,改良的结肠镜检查模拟器真实感问卷分析证实,在12名结肠镜检查医师评估的33项指标中,NKS模型在7项(21.2%)指标上比CM15模型明显更具真实感。

结论

NKS模型提供了一个逼真的培训平台,可能会提高结肠镜检查的培训质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b9b/5532419/9676ea119d76/595_2017_1517_Fig1_HTML.jpg

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