Chang Si Yuan, Chan Kai Siang, Oo Aung Myint
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
MOH Holdings Pte Ltd, Singapore.
Surg Innov. 2024 Apr;31(2):195-211. doi: 10.1177/15533506241232791. Epub 2024 Feb 19.
Computerized simulation (CS) of surgery in virtual reality (VR), augmented reality (AR) and mixed reality (MR) settings are used to teach foundational skills, but its applicability in advanced training is to be determined. This review aims to summarize the types of CS available for laparoscopic colorectal surgery (CRS) and its utility in assessment of proficiency.
A systematic review of CS in laparoscopic CRS was done on PubMed, Embase, Scopus and Cochrane Library databases.
Eleven relevant observational studies were identified. The most common procedure simulated was laparoscopic colectomy. Assessment using performance metrics measured by the simulator such as path length moved by laparoscopic tools, procedure time and number of discrete movements had the most consistent differentiating ability between expert and non-expert cohorts. Surgeons fared similarly in proficiency scores in assessment with CS compared to assessment with traditional cadaveric or porcine models.
CS of laparoscopic CRS may be used in assessment of proficiency using performance metrics measuring economy of movement. CS may be a viable assessment tool in advanced surgical training, but further studies should assess utility of incorporating it as a formal assessment tool in training programs.
在虚拟现实（VR）、增强现实（AR）和混合现实（MR）环境中进行手术的计算机模拟（CS）用于教授基础技能，但其在高级培训中的适用性尚待确定。本综述旨在总结可用于腹腔镜结直肠手术（CRS）的CS类型及其在评估熟练程度方面的效用。
在PubMed、Embase、Scopus和Cochrane图书馆数据库上对腹腔镜CRS中的CS进行了系统综述。
确定了11项相关的观察性研究。模拟的最常见手术是腹腔镜结肠切除术。使用模拟器测量的性能指标进行评估，如腹腔镜工具移动的路径长度、手术时间和离散动作的数量，在区分专家和非专家队列方面具有最一致的能力。与使用传统尸体或猪模型进行评估相比，外科医生在使用CS进行评估时的熟练程度得分相似。
腹腔镜CRS的CS可用于通过测量动作经济性的性能指标来评估熟练程度。CS可能是高级外科培训中一种可行的评估工具，但进一步的研究应评估将其作为培训计划中的正式评估工具的效用。
