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虚拟现实手术模拟器能否提高眼科医生非优势手的功能?

Can virtual reality surgical simulator improve the function of the non-dominant hand in ophthalmic surgeons?

机构信息

Department of Ophthalmology, Cairo University, Egypt.

出版信息

Indian J Ophthalmol. 2022 May;70(5):1795-1799. doi: 10.4103/ijo.IJO_2652_21.

DOI:10.4103/ijo.IJO_2652_21
PMID:35502075
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9333039/
Abstract

PURPOSE

Phacoemulsification surgery requires the use of both hands; however, some surgeons may not be comfortable using their non-dominant hand, especially in critical steps such as chopping. This work aims at assessing whether a virtual reality simulator can help cataract surgeons train their non-dominant hand using the capsulorhexis module.

METHODS

This was a prospective observational study including thirty ophthalmic surgeons; none of them had previous training on the EyeSi surgical simulator. Twenty-three were experienced, and seven were intermediate surgeons. Surgeons were asked to perform capsulorhexis three times using their dominant hand and then using their non-dominant hand. A performance score based on efficiency, target achievement, instrument handling, and tissue treatment was calculated by the simulator.

RESULTS

A significant improvement in the score of surgeons using their non-dominant hand from the first trial (69.57 ± 18.9) to the third trial (84.9 ± 9.2) (P < 0.001) was found, whereas such improvement was not noted with the dominant hand (P = 0.12). Twenty-six surgeons managed to reach 90% of the mean score achieved by dominant hand by using their non-dominant hand, 11 (36.7%) from the first trial, seven (23.3%) from the second, and eight (26.7%) from the third.

CONCLUSION

Cataract surgeons showed significant improvement in the scores of their non-dominant hands with simulator training. Thus, it is possible to safely train non-dominant hands for difficult tasks away from the operating room, which would be a fruitful addition to residency training programs.

摘要

目的

超声乳化白内障手术需要双手操作;然而,一些外科医生可能不习惯于使用非优势手,尤其是在劈核等关键步骤中。本研究旨在评估虚拟现实模拟器是否可以帮助白内障外科医生使用撕囊模块训练其非优势手。

方法

这是一项前瞻性观察研究,共纳入 30 名眼科外科医生;他们均无 EyeSi 手术模拟器的先前培训经验。其中 23 名是经验丰富的外科医生,7 名是中级外科医生。要求外科医生使用优势手和非优势手各完成 3 次撕囊操作。模拟器根据效率、目标达成、器械操作和组织处理计算出基于表现的评分。

结果

发现使用非优势手的外科医生的评分从第一次试验(69.57 ± 18.9)到第三次试验(84.9 ± 9.2)显著提高(P < 0.001),而使用优势手时则没有这种提高(P = 0.12)。26 名外科医生使用非优势手成功达到了优势手平均得分的 90%,其中 11 名(36.7%)在第一次试验中,7 名(23.3%)在第二次试验中,8 名(26.7%)在第三次试验中。

结论

白内障外科医生在使用模拟器进行训练后,其非优势手的评分显著提高。因此,有可能在手术室外安全地训练非优势手完成困难任务,这将是住院医师培训计划的有益补充。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d913/9333039/78ba71d071be/IJO-70-1795-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d913/9333039/78ba71d071be/IJO-70-1795-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d913/9333039/78ba71d071be/IJO-70-1795-g001.jpg

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本文引用的文献

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Kitchen ophthalmic surgeon: Recipe for operation success in work-from-home era.厨房眼科医生:居家办公时代的手术成功秘诀。
Indian J Ophthalmol. 2021 Oct;69(10):2851-2852. doi: 10.4103/ijo.IJO_721_21.
2
Ophthalmic Surgical Simulation in Training Dexterity in Dominant and Nondominant Hands: Results From a Pilot Study.眼科手术模拟训练优势手和非优势手的灵活性:一项初步研究的结果
J Surg Educ. 2016 Jul-Aug;73(4):699-708. doi: 10.1016/j.jsurg.2016.01.014. Epub 2016 Mar 24.
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Simulation-based certification for cataract surgery.基于模拟的白内障手术认证。
Acta Ophthalmol. 2015 Aug;93(5):416-421. doi: 10.1111/aos.12691. Epub 2015 Feb 26.
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Development of a virtual reality training curriculum for phacoemulsification surgery.开发白内障超声乳化手术虚拟现实培训课程。
Eye (Lond). 2014 Jan;28(1):78-84. doi: 10.1038/eye.2013.211. Epub 2013 Sep 27.
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Intensive cataract training: a novel approach.强化白内障培训:一种新方法。
Eye (Lond). 2013 Jun;27(6):742-6. doi: 10.1038/eye.2013.54. Epub 2013 Apr 19.
6
Safety of nondominant-hand ophthalmic surgery.非优势眼眼科手术的安全性。
J Cataract Refract Surg. 2012 Dec;38(12):2112-6. doi: 10.1016/j.jcrs.2012.07.030. Epub 2012 Oct 16.
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Impact of simulator training on resident cataract surgery.模拟器训练对住院医师白内障手术的影响。
Graefes Arch Clin Exp Ophthalmol. 2013 Mar;251(3):777-81. doi: 10.1007/s00417-012-2160-z. Epub 2012 Sep 25.
8
Influence of surgery simulator training on ophthalmology resident phacoemulsification performance.手术模拟器训练对眼科住院医师白内障超声乳化手术表现的影响。
J Cataract Refract Surg. 2011 Oct;37(10):1756-61. doi: 10.1016/j.jcrs.2011.04.032. Epub 2011 Aug 15.
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Construct validity of a surgical simulator as a valid model for capsulorhexis training.手术模拟器在囊外晶状体切除术训练中的建构效度:有效性模型。
J Cataract Refract Surg. 2010 Nov;36(11):1835-8. doi: 10.1016/j.jcrs.2010.05.020.
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Impact of a structured surgical curriculum on ophthalmic resident cataract surgery complication rates.结构化手术课程对眼科住院医师白内障手术并发症发生率的影响。
J Cataract Refract Surg. 2009 Nov;35(11):1956-60. doi: 10.1016/j.jcrs.2009.05.046.