Maemura Kosei, Mataki Yuko, Kurahara Hiroshi, Kawasaki Yota, Mori Shinichirou, Iino Satoshi, Sakoda Masahiko, Ueno Shinichi, Shinchi Hiroyuki, Natsugoe Shoji
Department of Digestive Surgery, Breast and Thyroid Surgery Field of Oncology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima Japan.
Clinical Oncology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima Japan.
Ann Gastroenterol Surg. 2017 Jun 7;1(2):129-135. doi: 10.1002/ags3.12010. eCollection 2017 Jun.
Laparoscopic surgical training using a box trainer facilitates mastery of laparoscopic surgery. Few studies have investigated whether visualizing the surgical field in the box trainer improves performance of laparoscopic surgical procedures during laparoscopic training. An original box trainer equipped with a transparent top made of mesh covered with a latticed structure was developed and used for evaluation of novices during laparoscopic training. Three tasks (levels 1 to 3) involving organ handling while setting the surgical field were arranged to evaluate the efficacy of training. Forty-five students were divided into three groups: group A, students without practical training; group B, students trained using the covered box trainer; and group C, students trained using the transparent box trainer. Completion time of each task before and after training was compared. Training significantly reduced the operating time, with a significant difference between the level 1 task and the levels 2 (<.001) and 3 (<.0001) tasks. There was no significant difference in operating time between the levels 2 and 3 tasks. Overall time reduction rate in group C was significantly shorter than that in group A, but not in group B. The time reduction rate for the level 3 task was lowest in group C, with a statistically significant difference existing in group A (<.001). Visual feedback during surgery through the transparent top of the laparoscopic box trainer helped reduce the learning time required to carry out laparoscopic surgery.
使用箱式训练器进行腹腔镜手术训练有助于掌握腹腔镜手术。很少有研究调查在箱式训练器中可视化手术视野是否能提高腹腔镜训练期间腹腔镜手术操作的表现。开发了一种配备由覆盖有格子结构的网眼制成的透明顶部的原始箱式训练器，并用于评估腹腔镜训练期间的新手。安排了三项涉及在设置手术视野时进行器官操作的任务（1至3级）来评估训练效果。45名学生被分为三组：A组，没有实践训练的学生；B组，使用带盖箱式训练器训练的学生；C组，使用透明箱式训练器训练的学生。比较了训练前后每项任务的完成时间。训练显著缩短了操作时间，1级任务与2级（<.001）和3级（<.0001）任务之间存在显著差异。2级和3级任务的操作时间没有显著差异。C组的总体时间减少率明显短于A组，但B组并非如此。C组3级任务的时间减少率最低，A组存在统计学显著差异（<.001）。通过腹腔镜箱式训练器的透明顶部在手术期间进行视觉反馈有助于减少进行腹腔镜手术所需的学习时间。
