Vanni Valeria S, Ottolina Jessica, Candotti Giorgio, Castellano Laura M, Tandoi Iacopo, DE Stefano Francesca, Poppi Giorgia, Ferrari Stefano, Candiani Massimo
San Raffaele Scientific Institute for Research and Care, Milan, Italy.
San Raffaele Scientific Institute for Research and Care, Milan, Italy -
Minerva Ginecol. 2018 Feb;70(1):53-57. doi: 10.23736/S0026-4784.17.04101-6. Epub 2017 Oct 9.
The advent of flexible CO2 laser fiber to gynecology arena might represent a turning point in the use of laser energy on a large-scale basis in gynecological surgery. However, there might be some concerns regarding the degree of surgical skills required to use the flexible system. The purpose of our study is to evaluate whether flexible CO2 laser fiber is technically accessible.
Fourteen residents in Obstetrics and Gynecology without surgical experience attending laparoscopic box training with both flexible CO2 laser fiber and traditional line-of-sight CO2 laser using Lumenis AcuPulse Duo CO2 laser (Lumenis, Yokne'am Illit, Israel) were prospectively enrolled. Participants were tested at sequential time points on specific surgical tasks and results obtained with the flexible CO2 laser fiber and the traditional line-of-sight CO2 laser were compared. Results were compared by means of paired t-test and a two-tailed P value <0.05 was considered significant.
Mean grading at the beginning of training were similar between flexible fiber and line-of-sight CO2 laser. At the end of training, significant improvement in surgical skills was obtained for both techniques, with a statistically significant higher grading for flexible fiber CO2 laser compared to line-of-sight CO2 laser.
Our study found that residents without surgical experience show better skills with the flexible CO2 laser fiber delivery system compared to the standard line-of-sight CO2 laser system after a two-month training period with gynecological laparoscopic box. According to our results, flexible CO2 laser fiber delivery system is technically accessible and holds a potential in gynecological surgery.
柔性二氧化碳激光光纤进入妇科领域可能代表着激光能量在妇科手术中大规模应用的一个转折点。然而，对于使用该柔性系统所需的手术技能水平可能存在一些担忧。我们研究的目的是评估柔性二氧化碳激光光纤在技术上是否易于掌握。
前瞻性纳入了14名没有手术经验的妇产科住院医师，他们使用Lumenis AcuPulse Duo二氧化碳激光（以色列Yokne'am Illit的Lumenis公司）参加了使用柔性二氧化碳激光光纤和传统直视二氧化碳激光的腹腔镜模拟训练。在连续的时间点对参与者进行特定手术任务测试，并比较使用柔性二氧化碳激光光纤和传统直视二氧化碳激光获得的结果。通过配对t检验比较结果，双侧P值<0.05被认为具有统计学意义。
训练开始时，柔性光纤和直视二氧化碳激光的平均评分相似。训练结束时，两种技术的手术技能均有显著提高，与直视二氧化碳激光相比，柔性光纤二氧化碳激光的评分在统计学上显著更高。
我们的研究发现，在经过为期两个月的妇科腹腔镜模拟训练后，没有手术经验的住院医师使用柔性二氧化碳激光光纤输送系统比标准直视二氧化碳激光系统表现出更好的技能。根据我们的结果，柔性二氧化碳激光光纤输送系统在技术上易于掌握，在妇科手术中具有潜力。
