机器人辅助与腹腔镜缝合学习曲线的可转移性

Transferability of the robot assisted and laparoscopic suturing learning curves.

作者信息

Leijte E, De Blaauw I, Rosman C, Botden S M B I

机构信息

Department of Surgery, Radboud University Medical Centre, Geert Grooteplein 10 Route 618, 6500HB, Nijmegen, The Netherlands.

Department of Paediatric Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.

出版信息

J Robot Surg. 2024 Jan 27;18(1):56. doi: 10.1007/s11701-023-01753-1.

Abstract

Robot assisted surgery (RAS) is increasingly used, and besides conventional minimally invasive surgery (cMIS) surgeons are challenged to learn an increased array of skills. This study aimed to assess the influence of both learning curves on each other. A prospective randomized crossover study was performed. Participants without cMIS or RAS experience (Groups 1 and 2), and cMIS experienced, (Group 3) were recruited. Three suturing tasks (intracorporal suturing, tilted plane and anastomosis needle transfer) were performed on the EoSim cMIS simulator or RobotiX RAS simulator up to twenty repetitions. Subsequently, Groups 1 and 2 performed the tasks on the other modality. Outcomes were simulator parameters, validated composite and pass/fail scores. In total forty-three participants were recruited. Overall RAS suturing was better in Group 1 (cMIS followed by RAS tasks) and 3 (RAS tasks) versus Group 2 (RAS followed by cMIS tasks) for time (163 s and 157 s versus 193 s p = 0.004, p = 0.001) and composite scores (92/100 and 91/100 versus 89/100 p = 0.008, p = 0.020). The cMIS suturing was better for Group 2 versus 1 (time 287 s versus 349 s p = 0.005, composite score 96/100 versus 94/100 p = 0.002). Significant differences from the RAS suturing pass/fail were reached earlier by Group 3, followed by Groups 1 and 2 (repetition six, nine and twelve). In cMIS suturing Group 2 reached significant differences from the pass/fail earlier than Group 1 (repetition four versus six). Transferability of skills was shown for cMIS and RAS, indicating that suturing experience on cMIS or RAS is beneficial in learning either approach.

摘要

机器人辅助手术(RAS)的应用越来越广泛,除了传统的微创手术(cMIS)外,外科医生还面临着学习更多技能的挑战。本研究旨在评估两种学习曲线之间的相互影响。进行了一项前瞻性随机交叉研究。招募了没有cMIS或RAS经验的参与者(第1组和第2组)以及有cMIS经验的参与者(第3组)。在EoSim cMIS模拟器或RobotiX RAS模拟器上进行三项缝合任务(体内缝合、倾斜平面和吻合针转移),最多重复20次。随后,第1组和第2组在另一种模式上执行任务。结果包括模拟器参数、经过验证的综合评分和通过/失败评分。总共招募了43名参与者。总体而言,在时间方面(163秒和157秒对193秒,p = 0.004,p = 0.001)和综合评分方面(92/100和91/100对89/100,p = 0.008,p = 0.020),第1组(先进行cMIS然后进行RAS任务)和第3组(RAS任务)的RAS缝合比第2组(先进行RAS然后进行cMIS任务)更好。第2组的cMIS缝合比第1组更好(时间287秒对349秒,p = 0.005,综合评分96/100对94/100,p = 0.002)。第3组比第1组和第2组更早达到RAS缝合通过/失败的显著差异(分别在第6次、第9次和第12次重复)。在cMIS缝合中,第2组比第1组更早达到通过/失败的显著差异(分别在第4次和第6次重复)。cMIS和RAS都显示出技能的可转移性,这表明在cMIS或RAS上的缝合经验对学习任何一种方法都有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34b5/10821960/3184a67fb5f9/11701_2023_1753_Fig1_HTML.jpg

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