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为什么腹腔镜医师可能选择三维视图:SICE(意大利内窥镜和新技术外科学会)对三维与二维腹腔镜的全面 HTA 报告摘要。

Why laparoscopists may opt for three-dimensional view: a summary of the full HTA report on 3D versus 2D laparoscopy by S.I.C.E. (Società Italiana di Chirurgia Endoscopica e Nuove Tecnologie).

机构信息

Montichiari Surgery, ASST degli Spedali Civili di Brescia, V.le Ciotti 154, 25018, Montichiari (BS), Italy.

Centre for Health Economics, Social and Health Care Management, LIUC-Università Carlo Cattaneo, Castellanza (VA), Italy.

出版信息

Surg Endosc. 2018 Jun;32(6):2986-2993. doi: 10.1007/s00464-017-6006-y. Epub 2018 Jan 24.

Abstract

BACKGROUND

Three-dimensional view in laparoscopic general, gynaecologic and urologic surgery is an efficient, safe and sustainable innovation. The present paper is an extract taken from a full health technology assessment report on three-dimensional vision technology compared with standard two-dimensional laparoscopic systems.

METHODS

A health technology assessment approach was implemented in order to investigate all the economic, social, ethical and organisational implications related to the adoption of the innovative three-dimensional view. With the support of a multi-disciplinary team, composed of eight experts working in Italian hospitals and Universities, qualitative and quantitative data were collected, by means of literature evidence, validated questionnaire and self-reported interviews, applying a final MCDA quantitative approach, and considering the dimensions resulting from the EUnetHTA Core Model.

RESULTS

From systematic search of literature, we retrieved the following studies: 9 on general surgery, 35 on gynaecology and urology, both concerning clinical setting. Considering simulated setting we included: 8 studies regarding pitfalls and drawbacks, 44 on teaching, 12 on surgeons' confidence and comfort and 34 on surgeons' performances. Three-dimensional laparoscopy was shown to have advantages for both the patients and the surgeons, and is confirmed to be a safe, efficacious and sustainable vision technology.

CONCLUSIONS

The objective of the present paper, under the patronage of Italian Society of Endoscopic Surgery, was achieved in that there has now been produced a scientific report, based on a HTA approach, that may be placed in the hands of surgeons and used to support the decision-making process of the health providers.

摘要

背景

腹腔镜普通外科、妇科和泌尿科手术中的三维视图是一种高效、安全和可持续的创新。本文是对三维视觉技术与标准二维腹腔镜系统进行比较的全健康技术评估报告中的节选。

方法

为了研究与采用创新的三维视图相关的所有经济、社会、伦理和组织影响,实施了一项健康技术评估方法。在一个由八名在意大利医院和大学工作的专家组成的多学科团队的支持下,通过文献证据、经过验证的问卷和自我报告的访谈收集定性和定量数据,应用最终的 MCDA 定量方法,并考虑欧盟netHTA 核心模型产生的维度。

结果

从系统的文献检索中,我们检索到以下研究:普通外科 9 项,妇科和泌尿科 35 项,均为临床研究。考虑到模拟环境,我们包括:8 项关于陷阱和缺点的研究,44 项关于教学的研究,12 项关于外科医生信心和舒适度的研究,以及 34 项关于外科医生表现的研究。三维腹腔镜对患者和外科医生都有优势,并被证实是一种安全、有效和可持续的视觉技术。

结论

本报告的目的是在意大利内镜外科学会的赞助下实现的,即根据 HTA 方法制作了一份科学报告,该报告可提供给外科医生使用,以支持医疗保健提供者的决策过程。

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