Onishi Shun, Ikee Takamasa, Murakami Masakazu, Yano Keisuke, Harumatsu Toshio, Baba Tokuro, Yamada Koji, Yamada Waka, Masuya Ryuta, Machigashira Seiro, Nakame Kazuhiko, Mukai Motoi, Kaji Tatsuru, Ieiri Satoshi
Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan.
J Laparoendosc Adv Surg Tech A. 2019 Oct;29(10):1252-1258. doi: 10.1089/lap.2019.0212. Epub 2019 Sep 11.
Training programs for developing laparoscopic suturing skills range from dry-box training to virtual simulator training. There are advantages and disadvantages to each training method; however, which training is best for medical students and young surgeons is unclear. The aim of this study was to compare the proficiency of medical students in acquiring laparoscopic suturing skills after various routes of short-term training: via a video, an expert teacher, or a virtual simulator. Seventeen medical students were registered and divided randomly into three groups: group receiving personal training while watching a training video (video group), group receiving training under the guidance of an expert (teaching group), and group receiving personal training with a virtual simulator (virtual group). The students practiced laparoscopic suturing and tying skills for 1 hour. Following their training, they performed the evaluation task of three sutures and ties using a laparoscopic fundoplication simulator. We developed a 1-year-old infant body model (body weight 10 kg) based on computed tomography data and established a pneumoperitoneum body model based on a clinical situation. The path length of the assistant forceps in the virtual group tended to be longer than in the other groups. The average acceleration of the assistant forceps in the virtual group was faster than in the other groups ( = .04). There were no significant differences in the other evaluation parameters. A long-term and combination training study should be performed to develop the best method for training medical students and inexperienced young surgeons.
培养腹腔镜缝合技能的培训项目范围从干箱训练到虚拟模拟器训练。每种训练方法都有其优缺点;然而,哪种训练对医学生和年轻外科医生最有效尚不清楚。本研究的目的是比较医学生在通过不同短期训练途径(视频、专家教师或虚拟模拟器)后获得腹腔镜缝合技能的熟练程度。17名医学生被登记并随机分为三组:观看训练视频时接受个人训练的组(视频组)、在专家指导下接受训练的组(教学组)和使用虚拟模拟器进行个人训练的组(虚拟组)。学生们练习腹腔镜缝合和打结技能1小时。训练后,他们使用腹腔镜胃底折叠术模拟器进行了三次缝合和打结的评估任务。我们基于计算机断层扫描数据开发了一个1岁婴儿身体模型(体重10千克),并根据临床情况建立了气腹身体模型。虚拟组中辅助钳的路径长度往往比其他组更长。虚拟组中辅助钳的平均加速度比其他组更快(P = 0.04)。其他评估参数没有显著差异。应该进行长期的联合训练研究,以开发出训练医学生和缺乏经验的年轻外科医生的最佳方法。