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三维(3D)打印模拟器作为评估髋关节镜手术技能的可行评估工具。

A three-dimensional (3D) printed simulator as a feasible assessment tool for evaluating hip arthroscopy skills.

机构信息

Department of Industrial and Product Design, School of Design, Sichuan Fine Arts Institute, Chongqing, China.

Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2023 May;31(5):2030-2037. doi: 10.1007/s00167-022-07125-w. Epub 2022 Aug 29.

Abstract

PURPOSE

The aims of this study were (1) to develop a three-dimensional (3D) printed simulator that facilitates the simulation of surgical skills for portal placement, intra-articular identification of anatomical structures and arthroscope navigation for hip arthroscopy and (2) to concurrently examine the feasibility of using this simulator as an assessment tool to evaluate trainees' surgical competencies.

METHODS

A simulator was developed using a combination of medical imaging, computer-aided design, and 3D printing. A cross-sectional study was conducted with 29 participants divided into 3 subgroups (novice, intermediate and experienced). All participants performed related skills on the simulator, and their performance was evaluated using different assessment parameters. The participants' qualitative feedback regarding the simulator was also collected. The data collated from each group of participants were subsequently compared.

RESULTS

Significant differences were observed between the three subgroups of participants with regard to the total checklist score (F = 11.3), total Arthroscopic Surgical Skill Evaluation score (F = 92.1), overall final global rating scale score (F = 49), number of times the participants used fluoroscopy (F = 7.4), and task completion times (F = 23.5). The participants' performance in the simulated operation was correlated with their prior clinical experience. There was mainly positive feedback with regard to the fidelity and utility of the simulator in relation to the surgeons' prior clinical experience.

CONCLUSIONS

This study demonstrated that a reliable hip arthroscopic simulator can be developed for use by orthopedic surgeons to evaluate their hip arthroscopic skills before performing actual surgical operations.

LEVEL OF EVIDENCE

Level III.

摘要

目的

本研究的目的是(1)开发一种三维(3D)打印模拟器,以促进髋关节镜手术中入路点定位、关节内解剖结构识别和关节镜导航等手术技能的模拟,(2)同时考察该模拟器作为评估工具来评估学员手术能力的可行性。

方法

该模拟器采用医学影像学、计算机辅助设计和 3D 打印相结合的方法进行开发。研究采用了一项横断面研究,共纳入 29 名参与者,分为新手组、中级组和专家组 3 个亚组。所有参与者均在模拟器上完成相关技能操作,并使用不同的评估参数对其操作表现进行评估。还收集了参与者对模拟器的定性反馈。随后比较了每组参与者的数据。

结果

在总检查表评分(F=11.3)、关节镜手术技能评估总评分(F=92.1)、总体最终全局评分量表评分(F=49)、参与者使用透视次数(F=7.4)和任务完成时间(F=23.5)方面,三组参与者之间存在显著差异。参与者在模拟手术中的表现与其之前的临床经验相关。关于模拟器的逼真度和实用性,主要反馈是积极的。

结论

本研究表明,一种可靠的髋关节镜模拟器可以为骨科医生开发,以在进行实际手术操作之前评估他们的髋关节镜手术技能。

证据等级

III 级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0d5/10090017/bcb810cf69c3/167_2022_7125_Fig1_HTML.jpg

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