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评估操纵杆引导式机器人镜管持镜器与人工持镜者的效率:一项前瞻性试验。

Evaluation of the Efficiency of a Joystick-Guided Robotic Scope Holder Compared to That of Human Scopists: A Prospective Trial.

机构信息

Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Department of Surgery, Nogi Hospital, Hyogo, Japan.

出版信息

Surg Innov. 2023 Oct;30(5):564-570. doi: 10.1177/15533506231157039. Epub 2023 Feb 14.

Abstract

PURPOSE

This study aimed to compare motions of the laparoscope tip during a laparoscopic task in a training box using a recent joystick-guided robotic scope holder to those manipulated by human scopists. We hypothesized that laparoscopic manipulation could be positively affected by robotic scope holders due to the elimination of unintentional movement.

METHODS

Twelve surgeons participated as operators, and eight medical doctors participated in this study. Among the human scopists, five were trained surgeons and three were novices who had no experience with laparoscopic surgery. A validated laparoscopic task was used to evaluate the path length of the laparoscope tip using an optical position tracker and operative time. The operators performed the designated camera task under three different laparoscopic manipulations: using a joystick-guided robotic scope holder, expert human scopists, and novice scopists.

RESULTS

The median path lengths (cm) of the laparoscopic tip were 94.0, 110.0, and 122.2 in the robotic scope holder, expert, and novice groups, respectively. The path lengths in the robotic scope holder group were significantly shorter than those in the other groups (P < .01). The median operative times (seconds) were 136.6, 66.4, and 62.3 in the robotic scope holder, expert, and novice groups, respectively. The operative time of the robotic scope holder group was significantly longer than that of the other groups (P < .001).

CONCLUSION

A robotic scope holder can provide shorter camera movement owing to the stable holding and intentional scope manipulation by the operator, although it requires a longer operative time than a human assistant.

摘要

目的

本研究旨在比较使用新型操纵杆引导式机器人持镜器进行腹腔镜训练箱腹腔镜操作时的镜端运动与人类持镜者操作时的运动。我们假设由于消除了无意识的运动,机器人持镜器可以对腹腔镜操作产生积极影响。

方法

12 名外科医生作为操作者参加了此项研究,8 名内科医生参与了此项研究。在人类持镜者中,5 名是经过培训的外科医生,3 名是没有腹腔镜手术经验的新手。使用已验证的腹腔镜任务,通过光学位置跟踪器评估腹腔镜尖端的路径长度,并记录手术时间。操作者在三种不同的腹腔镜操作下完成指定的摄像任务:使用操纵杆引导式机器人持镜器、经验丰富的人类持镜者和新手持镜者。

结果

腹腔镜尖端的中位路径长度(cm)分别为机器人持镜器组 94.0cm、专家组 110.0cm 和新手组 122.2cm。机器人持镜器组的路径长度明显短于其他组(P <.01)。机器人持镜器组的中位手术时间(秒)分别为 136.6 秒、66.4 秒和 62.3 秒。机器人持镜器组的手术时间明显长于其他组(P <.001)。

结论

由于操作员的稳定握持和有意的镜端操作,机器人持镜器可以提供更短的镜端移动距离,尽管它比人类助手需要更长的手术时间。

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