Whittaker George, Aydin Abdullatif, Raveendran Sinthuri, Dar Faizan, Dasgupta Prokar, Ahmed Kamran
1 Department of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, UK.
2 MRC Centre for Transplantation, King's College London, London, UK.
Asian Cardiovasc Thorac Ann. 2019 Jan;27(1):23-29. doi: 10.1177/0218492318813457. Epub 2018 Nov 11.
Training for robot-assisted thoracic lobectomy remains an issue, prompting the development of virtual reality simulators. Our aim was to assess the construct and face validity of a new thoracic lobectomy module on the RobotiX Mentor, a robotic surgery simulator. We also aimed to determine the acceptability and feasibility of implementation into training.
This prospective, observational, and comparative study recruited novice (n = 16), intermediate (n = 9), and expert (n = 5) participants from King's College London, the 25th European Conference on General Thoracic Surgery, and the Society of Robotic Surgery conference 2018. Each participant completed two familiarization tasks followed by the Guided Robotic Lobectomy module and an evaluation questionnaire. Outcome measures were compared using Mann-Whitney U tests.
Construct validity was demonstrated in 12/21 performance evaluation metrics. Significant differences between groups were found in all metrics including: time taken to complete module, vascular injury, respect for tissue, number of stapler firings, time instruments out of view, number of instrument collisions, and number of movements. Participants deemed aspects of the simulator (mean 3/5) and module (3/5) as realistic and rated the simulator as both acceptable (3.8/5) and feasible (3.8/5) for robotic surgical training.
Face validity, acceptability, and feasibility were established for the thoracic lobectomy module of the RobotiX Mentor simulator. Moderate evidence of construct validity was also demonstrated. With further work, this simulation module could help to reduce the initial part of the learning curve for trainees and decrease the risk of errors during live training.
机器人辅助胸段肺叶切除术的培训仍然是一个问题，这促使了虚拟现实模拟器的开发。我们的目的是评估机器人手术模拟器RobotiX Mentor上一个新的胸段肺叶切除术模块的结构效度和表面效度。我们还旨在确定将其应用于培训的可接受性和可行性。
这项前瞻性、观察性和比较性研究从伦敦国王学院、第25届欧洲普通胸外科会议以及2018年机器人外科学会会议招募了新手（n = 16）、中级（n = 9）和专家（n = 5）参与者。每位参与者完成两项熟悉任务，随后进行引导式机器人肺叶切除术模块和一份评估问卷。使用曼-惠特尼U检验比较结果指标。
在21项性能评估指标中的12项中证明了结构效度。在所有指标中发现组间存在显著差异，包括：完成模块所需时间、血管损伤、对组织的尊重、吻合器击发次数、器械不在视野中的时间、器械碰撞次数和动作次数。参与者认为模拟器的各个方面（平均3/5）和模块（3/5）是现实的，并将模拟器评为对于机器人手术培训既可接受（3.8/5）又可行（3.8/5）。
为RobotiX Mentor模拟器的胸段肺叶切除术模块确立了表面效度、可接受性和可行性。也证明了适度的结构效度证据。通过进一步的工作，这个模拟模块可以帮助减少学员学习曲线的初始部分，并降低现场培训期间的错误风险。
