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泌尿外科机器人手术的安全性取决于外科医生的技能。

The safety of urologic robotic surgery depends on the skills of the surgeon.

机构信息

ORSI Academy, Melle, Belgium.

Department of Urology, Onze Lieve Vrouw Hospital, Aalst, Belgium.

出版信息

World J Urol. 2020 Jun;38(6):1373-1383. doi: 10.1007/s00345-019-02901-9. Epub 2019 Aug 19.

Abstract

PURPOSE

To assess the available literature evidence that discusses the effect of surgical experience on patient outcomes in robotic setting. This information is used to help understand how we can develop a learning process that allows surgeons to maximally accommodate patient safety.

METHODS

A literature search of the MEDLINE/PubMed and Scopus database was performed. Original and review articles published in the English language were included after an interactive peer-review process of the panel.

RESULTS

Robotic surgical procedures require high level of experience to guarantee patient safety. This means that, for some procedures, the learning process might be longer than originally expected. In this context, structured training programs that assist surgeons to improve outcomes during their learning processes were extensively discussed. We identified few structured robotic curricula and demonstrated that for some procedures, curriculum trained surgeons can achieve outcomes rates during their initial learning phases that are at least comparable to those of experienced surgeons from high-volume centres. Finally, the importance of non-technical skills on patient safety and of their inclusion in robotic training programs was also assessed.

CONCLUSION

To guarantee safe robotic surgery and to optimize patient outcomes during the learning process, standardized and validated training programs are instrumental. To date, only few structured validated curricula exist for standardized training and further efforts are needed in this direction.

摘要

目的

评估现有文献证据,讨论机器人环境下手术经验对患者结局的影响。这些信息用于帮助理解我们如何制定一个学习过程,使外科医生能够最大限度地保证患者安全。

方法

对 MEDLINE/PubMed 和 Scopus 数据库进行文献检索。经过小组互动同行评审后,纳入了发表在英语中的原始和综述文章。

结果

机器人手术需要高水平的经验来保证患者安全。这意味着,对于某些手术,学习过程可能比预期的要长。在这种情况下,广泛讨论了有助于外科医生在学习过程中提高手术效果的结构化培训计划。我们确定了一些结构化的机器人课程,并证明对于某些手术,经过课程培训的外科医生在其初始学习阶段可以达到与高容量中心经验丰富的外科医生至少相当的手术效果率。最后,还评估了非技术技能对患者安全的重要性及其在机器人培训计划中的纳入。

结论

为了保证机器人手术的安全,并在学习过程中优化患者的手术效果,标准化和经过验证的培训计划是必不可少的。迄今为止,只有少数结构化的经过验证的课程用于标准化培训,在这方面还需要进一步努力。

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