Department of Surgery, St. Marienkrankenhaus Siegen, Siegen, Germany.
Department of medical statistics and biomathematics, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer, Mannheim, Germany.
Surg Technol Int. 2021 May 20;38:29-36. doi: 10.52198/21.STI.38.SO1424.
The advent of robotic surgery has highlighted the advantages of articulation. This dry-lab study examined the dexterity and learning effect of a new articulated laparoscopic instrument: the ArtiSential® forceps (LIVSMED, Seongnam, Republic of Korea).
A peg board task was designed. Three groups of volunteers with varying levels of laparoscopic expertise were organized to perform the task: expert, intermediate and novice. The participants performed the task using articulated and straight instruments, once before a 30-min training session and once afterwards. The times required to perform the task were recorded. The performances were analyzed and compared between the groups as well as between the straight and articulated instruments.
The experts were significantly faster than the novices with both instruments before the 30-min training session (p = 0.0317 for each instrument). No significant time difference was found among the three groups after the 30-min training session. The decrease in the time required to perform the peg-transfer task with the articulated instrument was significantly greater in the novice and intermediate groups (p = 0.0159 for each group). No significant difference in time reduction was observed between the groups with the straight instrument. Regardless of the user, the articulated device was associated with faster task performance than the straight device after 8 hours of training (p = 0.0039).
The ArtiSential® articulated device can improve dexterity. A significantly greater learning effect was observed in the novice and intermediate groups in comparison with experts. A plateau in the learning curve was observed after a few hours of training.
机器人手术的出现凸显了活动度的优势。本干式实验室研究考察了一种新型铰接式腹腔镜器械——ArtiSential®夹（LIVSMED，韩国城南）的灵巧度和学习效果。
设计了一个销钉板任务。组织了三组具有不同腹腔镜专业知识水平的志愿者来完成任务：专家、中级和新手。参与者使用铰接式和直式器械各完成一次任务，一次是在 30 分钟培训课程之前，一次是在之后。记录完成任务所需的时间。分析并比较了组间以及直式和铰接式器械之间的表现。
在 30 分钟培训课程之前，专家使用两种器械都比新手快（每种器械 p = 0.0317）。30 分钟培训课程后，三组之间没有明显的时间差异。在新手和中级组中，使用铰接器械完成销钉转移任务所需的时间明显减少（每组 p = 0.0159）。在直式器械中，各组之间的时间减少没有显著差异。无论使用者是谁，经过 8 小时的培训，铰接器械的任务执行速度都明显快于直式器械（p = 0.0039）。
ArtiSential®铰接器械可以提高灵巧度。与专家相比，新手和中级组的学习效果更为显著。经过几个小时的培训后，学习曲线出现了一个平台期。
