Postgraduate Program in Surgical Sciences, Medical School, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Medical School, Universidade de Passo Fundo (UPF), Passo Fundo, Rio Grande do Sul, Brazil.
Service of Urology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil.
J Surg Educ. 2018 Jul-Aug;75(4):1075-1081. doi: 10.1016/j.jsurg.2017.11.005. Epub 2017 Nov 28.
OBJECTIVE: Studies addressing the effect of laparoscopic experience on robotic skills have produced conflicting results. This study aimed to compare simulated robotic surgical tasks using the virtual reality simulator dV-Trainer between laparoscopically experienced surgeons and first-year surgical residents. DESIGN: A cross-sectional study. Participants completed 4 trials of the following tasks on the dV-Trainer: Peg Board 2, Ring and Rail 1, and Suture Sponge 1. Performance was recorded using a computerized built-in scoring algorithm. Scores and metrics were compared between groups 1 and 2 and between the first and subsequent trials. SETTING: Hospital de Clínicas, Porto Alegre, Brazil, a tertiary care teaching hospital. PARTICIPANTS: Twenty laparoscopically experienced surgeons (group 1) and 20 first-year surgical residents (group 2). All participants completed the study. RESULTS: The overall scores for Peg Board 2 (738.04 ± 267.83 vs 730.39 ± 225.31; p = 0.57), Ring and Rail 1 (919.03 ± 242.69 vs 965.84 ± 222.96; p = 0.13), and Suture Sponge 1 (563.62 ± 185.50 vs 560.99 ± 152.71; p = 0.67) did not differ significantly between groups 1 and 2. Group 1 had better results for master workspace range in Peg Board 2 and Ring and Rail 1. Group 2 had higher scores for economy of motion in Peg Board 2 and Ring and Rail 1 and for excessive instrument force in Ring and Rail 1. In both groups, the overall scores in the third and fourth trials were significantly higher than those in the first trial. CONCLUSIONS: There are no significant differences in the performance of simulated robotic surgical tasks between laparoscopically experienced surgeons and laparoscopically naïve surgical residents. Some slight differences were observed in specific metrics, but these differences were not sufficient to change the final results. We may assume that laparoscopic experience should not be an essential step in the initial learning curve of robotic surgery.
目的:研究腹腔镜经验对机器人技能的影响产生了相互矛盾的结果。本研究旨在比较使用虚拟现实模拟器 dV-Trainer 的腹腔镜经验丰富的外科医生和第一年外科住院医师之间的模拟机器人手术任务。
设计:一项横断面研究。参与者在 dV-Trainer 上完成了以下四项任务的 4 次试验: Peg Board 2、Ring and Rail 1 和 Suture Sponge 1。使用计算机内置评分算法记录表现。比较两组之间和第一次与随后的试验之间的分数和指标。
地点:巴西阿雷格里港的临床医院,一家三级护理教学医院。
参与者:20 名腹腔镜经验丰富的外科医生(第 1 组)和 20 名第一年的外科住院医师(第 2 组)。所有参与者都完成了这项研究。
结果: Peg Board 2(738.04 ± 267.83 与 730.39 ± 225.31;p = 0.57)、Ring and Rail 1(919.03 ± 242.69 与 965.84 ± 222.96;p = 0.13)和 Suture Sponge 1(563.62 ± 185.50 与 560.99 ± 152.71;p = 0.67)的总体得分在两组之间没有显著差异。第 1 组在 Peg Board 2 和 Ring and Rail 1 的主工作空间范围方面有更好的结果。第 2 组在 Peg Board 2 和 Ring and Rail 1 的运动经济性方面以及 Ring and Rail 1 的过度器械力方面得分更高。在两组中,第三和第四次试验的总体得分均显著高于第一次试验。
结论:腹腔镜经验丰富的外科医生和腹腔镜新手外科住院医师在模拟机器人手术任务中的表现没有显著差异。在特定指标上观察到一些细微差异,但这些差异不足以改变最终结果。我们可以假设腹腔镜经验不应该是机器人手术初始学习曲线的必要步骤。
J Surg Educ. 2017-11-28
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J Surg Educ. 2019-7-12
J Abdom Wall Surg. 2023-11-30
J Robot Surg. 2024-1-12