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为外科住院医师设计的机器人手术培训课程(RoSTraC)的构思和前瞻性多中心验证:从模拟到实验室培训再到手术室整合。

Conception and prospective multicentric validation of a Robotic Surgery Training Curriculum (RoSTraC) for surgical residents: from simulation via laboratory training to integration into the operation room.

机构信息

Department of Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.

Department of General, Visceral, Thorax and Vascular Surgery, University Hospital Bonn, Bonn, Germany.

出版信息

J Robot Surg. 2024 Jan 27;18(1):53. doi: 10.1007/s11701-023-01813-6.


DOI:10.1007/s11701-023-01813-6
PMID:38280113
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10821832/
Abstract

There is a lack of training curricula and educational concepts for robotic-assisted surgery (RAS). It remains unclear how surgical residents can be trained in this new technology and how robotics can be integrated into surgical residency training. The conception of a training curriculum for RAS addressing surgical residents resulted in a three-step training curriculum including multimodal learning contents: basics and simulation training of RAS (step 1), laboratory training on the institutional robotic system (step 2) and structured on-patient training in the operating room (step 3). For all three steps, learning content and video tutorials are provided via cloud-based access to allow self-contained training of the trainees. A prospective multicentric validation study was conducted including seven surgical residents. Transferability of acquired skills to a RAS procedure were analyzed using the GEARS score. All participants successfully completed RoSTraC within 1 year. Transferability of acquired RAS skills could be demonstrated using a RAS gastroenterostomy on a synthetic biological organ model. GEARS scores concerning this procedure improved significantly after completion of RoSTraC (17.1 (±5.8) vs. 23.1 (±4.9), p < 0.001). In step 3 of RoSTraC, all participants performed a median of 12 (range 5-21) RAS procedures on the console in the operation room. RoSTraC provides a highly standardized and comprehensive training curriculum for RAS for surgical residents. We could demonstrate that participating surgical residents acquired fundamental and advanced RAS skills. Finally, we could confirm that all surgical residents were successfully and safely embedded into the local RAS team.

摘要

机器人辅助手术 (RAS) 的培训课程和教育理念匮乏。目前仍不清楚如何对手术住院医师进行这项新技术的培训,以及如何将机器人技术融入到外科住院医师培训中。针对外科住院医师的 RAS 培训课程的构思,产生了一个三步骤的培训课程,包括多模式学习内容:RAS 的基础和模拟培训(第 1 步)、机构机器人系统的实验室培训(第 2 步)和结构化的手术室患者培训(第 3 步)。对于所有三个步骤,都提供了学习内容和视频教程,通过基于云的访问进行访问,以便学员可以进行独立培训。进行了一项包括七名外科住院医师的前瞻性多中心验证研究。使用 GEARS 评分分析获得的技能转移到 RAS 手术中的可转移性。所有参与者均在 1 年内成功完成 RoSTraC。通过在合成生物器官模型上进行 RAS 胃空肠吻合术,可以证明获得的 RAS 技能的可转移性。完成 RoSTraC 后,有关该手术的 GEARS 评分显著提高(17.1(±5.8)比 23.1(±4.9),p<0.001)。在 RoSTraC 的第 3 步中,所有参与者在手术室的控制台进行了中位数为 12 次(范围为 5-21 次)的 RAS 手术。RoSTraC 为外科住院医师提供了高度标准化和全面的 RAS 培训课程。我们能够证明,参加的外科住院医师掌握了基本的和高级的 RAS 技能。最后,我们能够确认所有外科住院医师都成功且安全地融入了当地的 RAS 团队。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/329d338f6f4a/11701_2023_1813_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/9e8866008e71/11701_2023_1813_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/2b0366dc3839/11701_2023_1813_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/8c03c7328415/11701_2023_1813_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/bb563b61c9e1/11701_2023_1813_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/a037afeb1ecd/11701_2023_1813_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/329d338f6f4a/11701_2023_1813_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/9e8866008e71/11701_2023_1813_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/2b0366dc3839/11701_2023_1813_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/8c03c7328415/11701_2023_1813_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/bb563b61c9e1/11701_2023_1813_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/a037afeb1ecd/11701_2023_1813_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af31/10821832/329d338f6f4a/11701_2023_1813_Fig6_HTML.jpg

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本文引用的文献

[1]
The effect of verbal feedback, video feedback, and self-assessment on laparoscopic intracorporeal suturing skills in novices: a randomized trial.

Surg Endosc. 2021-7

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