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专家和受训者之间的神经外科技能表现:来自钻孔任务的证据。

Neurosurgical performance between experts and trainees: Evidence from drilling task.

机构信息

Department of Surgery, Division of Neurosurgery, University of Alberta, Edmonton, Canada.

Department of Surgery, Division of General Surgery, University of Alberta Hospital, Edmonton, Canada.

出版信息

Int J Med Robot. 2021 Oct;17(5):e2313. doi: 10.1002/rcs.2313. Epub 2021 Jul 23.

Abstract

BACKGROUND

Lumbar laminectomy is a common neurosurgery that requires precise manipulation of power drills. We examined the fine movement controls of novice neurosurgeons in drilling tasks and compared its accuracy to expert surgeons' performance.

METHODS

Four experts and three novice neurosurgeons performed a lumbar laminectomy on a three-dimensional printed spine model. Scene video and surgeons' eye movements were recorded. Independent sample t-Tests were conducted on the number of jump, total fixation durations, pre-jump fixation durations, post-jump fixation durations and jump distances over novice and expert surgeons.

RESULTS

No statistically significant differences were recorded in terms of total fixations and pre-jump fixation durations. However, novices had more jumping events, greater jump distances and longer post-jump fixation durations when compared to expert neurosurgeons.

CONCLUSION

Differences in movement accuracy and eye measures were found between expert and novice neurosurgeons during a simulated microscopic lumbar laminectomy. A more comprehensive understanding of surgeon's fine movement control mechanism and eye-hand coordination in microsurgery is essential for us before building an enhanced training protocol for surgical residents in neurosurgery.

摘要

背景

腰椎板切除术是一种常见的神经外科手术,需要精确操作电钻。我们研究了新手神经外科医生在钻孔任务中的精细运动控制,并将其准确性与专家外科医生的表现进行了比较。

方法

4 名专家和 3 名新手神经外科医生在三维打印的脊柱模型上进行了腰椎板切除术。记录了现场视频和外科医生的眼球运动。对新手和专家神经外科医生的跳跃次数、总固定时间、跳跃前固定时间、跳跃后固定时间和跳跃距离进行了独立样本 t 检验。

结果

在总固定时间和跳跃前固定时间方面,没有记录到统计学上的显著差异。然而,与专家神经外科医生相比,新手的跳跃次数更多,跳跃距离更大,跳跃后固定时间更长。

结论

在模拟显微镜下腰椎板切除术中,专家和新手神经外科医生在运动准确性和眼球测量方面存在差异。在为神经外科住院医师建立增强的培训方案之前,我们需要更全面地了解外科医生在微创手术中的精细运动控制机制和眼手协调。

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