手术手势可用于评估机器人辅助手术中的手术能力:模拟 RARP 的有效性研究。
Surgical gestures can be used to assess surgical competence in robot-assisted surgery : A validity investigating study of simulated RARP.
机构信息
Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR & Education, The Capital Region of Denmark, Ryesgade 53B, 2100, Copenhagen, Denmark.
Department of Urology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
出版信息
J Robot Surg. 2024 Jan 20;18(1):47. doi: 10.1007/s11701-023-01807-4.
To collect validity evidence for the assessment of surgical competence through the classification of general surgical gestures for a simulated robot-assisted radical prostatectomy (RARP). We used 165 video recordings of novice and experienced RARP surgeons performing three parts of the RARP procedure on the RobotiX Mentor. We annotated the surgical tasks with different surgical gestures: dissection, hemostatic control, application of clips, needle handling, and suturing. The gestures were analyzed using idle time (periods with minimal instrument movements) and active time (whenever a surgical gesture was annotated). The distribution of surgical gestures was described using a one-dimensional heat map, snail tracks. All surgeons had a similar percentage of idle time but novices had longer phases of idle time (mean time: 21 vs. 15 s, p < 0.001). Novices used a higher total number of surgical gestures (number of phases: 45 vs. 35, p < 0.001) and each phase was longer compared with those of the experienced surgeons (mean time: 10 vs. 8 s, p < 0.001). There was a different pattern of gestures between novices and experienced surgeons as seen by a different distribution of the phases. General surgical gestures can be used to assess surgical competence in simulated RARP and can be displayed as a visual tool to show how performance is improving. The established pass/fail level may be used to ensure the competence of the residents before proceeding with supervised real-life surgery. The next step is to investigate if the developed tool can optimize automated feedback during simulator training.
为了通过对模拟机器人辅助根治性前列腺切除术(RARP)中一般外科手势的分类来收集外科能力评估的有效性证据,我们使用了 165 段新手和经验丰富的 RARP 外科医生在 RobotiX Mentor 上进行 RARP 手术三个部分的视频记录。我们使用不同的外科手势对手术任务进行注释:解剖、止血控制、夹的应用、针处理和缝合。使用空闲时间(仪器运动最小的时间段)和活动时间(每当注释外科手势时)分析手势。使用一维热图、蜗牛轨迹描述外科手势的分布。所有外科医生的空闲时间百分比相似,但新手的空闲时间更长(平均时间:21 秒对 15 秒,p < 0.001)。新手使用的外科手势总数更高(阶段数:45 对 35,p < 0.001),与经验丰富的外科医生相比,每个阶段的时间也更长(平均时间:10 秒对 8 秒,p < 0.001)。新手和经验丰富的外科医生的手势模式不同,这可以从不同的阶段分布看出。一般外科手势可用于评估模拟 RARP 中的外科能力,并且可以作为一种视觉工具显示性能的提高。建立的通过/失败水平可以在进行监督下的真实手术之前用于确保住院医生的能力。下一步是研究开发的工具是否可以在模拟器训练期间优化自动反馈。