Schlottmann Francisco, Patti Marco G
Department of Surgery, University of North Carolina, 4030 Burnett Womack Building, 101 Manning Drive, CB 7081, Chapel Hill, NC, 27599-7081, USA.
Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
J Robot Surg. 2017 Dec;11(4):463-465. doi: 10.1007/s11701-017-0746-5. Epub 2017 Aug 31.
Surgical simulation avoids practicing skills in patients, allowing trainees to learn in a safe, controlled, and standardized environment. Current robotic surgical simulators available include virtual reality simulators, human cadavers, and live animals. The use of cadavers has the highest possible fidelity available to practice entire operations. Nevertheless, their cost, availability, tissue compliance, and infection risk outweigh the advantages of cadaver models. Drawbacks of using live animals include anatomical differences with humans, high costs due to their housing and handling requirements, and ethical concerns. We designed a novel robotic surgical simulator based on porcine perfused tissue blocks that allows the simulation of entire surgical procedures. Our simulation allows trainees to increase familiarity with the robotic console and its controls, as well as with the docking process. It provides an opportunity to learn not only universal skills needed in robotic surgery, such as camera and instrument targeting, but also to perform complete surgical procedures such as an antireflux procedure. The adoption of robotic simulation curricula with realistic models will decrease overall operative time while increasing resident participation.
手术模拟避免了在患者身上练习技能，使学员能够在安全、可控和标准化的环境中学习。目前可用的机器人手术模拟器包括虚拟现实模拟器、人体尸体和活体动物。使用尸体进行练习可以获得尽可能高的逼真度来模拟整个手术过程。然而，它们的成本、可获得性、组织顺应性和感染风险超过了尸体模型的优势。使用活体动物的缺点包括与人类的解剖学差异、由于饲养和处理要求导致的高成本以及伦理问题。我们设计了一种基于猪灌注组织块的新型机器人手术模拟器，可模拟整个手术过程。我们的模拟使学员能够更熟悉机器人控制台及其操作，以及对接过程。它不仅提供了学习机器人手术所需通用技能（如摄像头和器械定位）的机会，还能进行完整的手术操作，如抗反流手术。采用具有逼真模型的机器人模拟课程将减少总体手术时间，同时增加住院医师的参与度。
