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机器人辅助脊柱手术:在培养下一代脊柱外科医生中的作用。

Robotic-Assisted Spine Surgery: Role in Training the Next Generation of Spine Surgeons.

作者信息

Lee Jun Seok, Son Dong Wuk, Lee Su Hun, Lee Jong Hyeok, Kim Young Ha, Lee Sang Weon, Oh Bu Kwang, Sung Soon Ki, Song Geun Sung, Yi Seong

机构信息

Department of Neurosurgery, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea.

Department of Neurosurgery, Pusan National University School of Medicine, Yangsan, Korea.

出版信息

Neurospine. 2024 Mar;21(1):116-127. doi: 10.14245/ns.2448006.003. Epub 2024 Mar 31.

Abstract

OBJECTIVE

This study aimed to assess the degree of interest in robot-assisted spine surgery (RASS) among residents and to investigate the learning curve for beginners performing robotic surgery.

METHODS

We conducted a survey to assess awareness and interest in RASS among young neurosurgery residents. Subsequently, we offered a hands-on training program using a dummy to educate one resident. After completing the program, the trained resident performed spinal fusion surgery with robotic assistance under the supervision of a mentor. The clinical outcomes and learning curve associated with robotic surgery were then analyzed.

RESULTS

Neurosurgical residents had limited opportunities to participate in spinal surgery during their training. Despite this, there was a significant interest in the emerging field of robotic surgery. A trained resident performed RASS under the supervision of a senior surgeon. A total of 166 screw insertions were attempted in 28 patients, with 2 screws failing due to skiving. According to the Gertzbein-Robbins classification, 85.54% of the screws were rated as grade A, 11.58% as grade B, 0.6% as grade C, and 1.2% as grade D. The clinical acceptance rate was approximately 96.99%, which is comparable to the results reported by senior experts and time per screw statistically significantly decreased as experience was gained.

CONCLUSION

RASS can be performed with high accuracy within a relatively short timeframe, if residents receive adequate training.

摘要

目的

本研究旨在评估住院医师对机器人辅助脊柱手术(RASS)的兴趣程度,并调查初学者进行机器人手术的学习曲线。

方法

我们进行了一项调查,以评估年轻神经外科住院医师对RASS的认知和兴趣。随后,我们提供了一个使用模拟模型的实践培训项目,对一名住院医师进行培训。完成该项目后,受过培训的住院医师在导师的监督下进行机器人辅助脊柱融合手术。然后分析与机器人手术相关的临床结果和学习曲线。

结果

神经外科住院医师在培训期间参与脊柱手术的机会有限。尽管如此,他们对新兴的机器人手术领域有着浓厚的兴趣。一名受过培训的住院医师在一名资深外科医生的监督下进行了RASS。在28例患者中总共尝试植入166枚螺钉,其中2枚因刮削而失败。根据Gertzbein-Robbins分类,85.54%的螺钉评为A级,11.58%评为B级,0.6%评为C级,1.2%评为D级。临床接受率约为96.99%,与资深专家报告的结果相当,并且随着经验的积累,每枚螺钉的操作时间在统计学上显著缩短。

结论

如果住院医师接受了充分的培训,RASS可以在相对较短的时间内高精度地完成。

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