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单孔卵巢囊肿切除术的学习曲线分析:机器人手术与传统腹腔镜技术的比较研究

Learning Curve Analysis of Single-Incision Ovarian Cystectomy: Comparative Study of Robotic and Conventional Laparoscopic Techniques.

作者信息

Kim Seongmin, Lee Seon-Mi, Seol Aeran, Lee Sanghoon, Song Jae-Yun, Lee Jae-Kwan, Lee Nak-Woo

机构信息

Gynecologic Cancer Center, CHA Ilsan Medical Center, CHA University College of Medicine, 1205 Jungang-ro, Ilsandong-gu, Goyang-si 10414, Republic of Korea.

Department of Obstetrics and Gynecology, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.

出版信息

J Pers Med. 2024 Jul 24;14(8):785. doi: 10.3390/jpm14080785.

Abstract

Ovarian cystectomy, aimed at preserving fertility, has advanced through minimally invasive surgical techniques. This study evaluates the learning curves and surgical outcomes of three such approaches: DaVinci Robotic Single-Site (RSS), DaVinci Robotic Single-Port (RSP), and laparo-endoscopic single-site surgery (LESS). To analyze the learning curves and surgical outcomes for these techniques, providing insights into their effectiveness and proficiency development. Retrospective analysis of 104 patients with ovarian tumors, divided into RSS ( = 52), RSP ( = 22), and LESS ( = 30) groups. Metrics analyzed included age, BMI, tumor size, hemoglobin drop, operative time, docking time, console time, and tumor location. No significant differences in age, BMI, transfusion rate, hemoglobin drop, or length of stay were found among the groups. RSS had larger tumors on average, and LESS had a higher occurrence rate on the right side. LESS demonstrated the shortest operative time, while RSS and RSP had comparable times. Docking and console times did not differ significantly between RSS and RSP. RSP reached proficiency faster than RSS in docking and console times, while LESS exhibited the greatest variability in operative time. RSP offers a faster and more consistent learning curve, making it advantageous for complex procedures, whereas LESS provides shorter operative times but with higher variability. These findings are crucial for surgical training and resource allocation in medical institutions.

摘要

旨在保留生育能力的卵巢囊肿切除术已通过微创手术技术取得进展。本研究评估了三种此类手术方法的学习曲线和手术结果:达芬奇机器人单部位手术(RSS)、达芬奇机器人单孔手术(RSP)和腹腔镜单部位手术(LESS)。分析这些技术的学习曲线和手术结果,以深入了解其有效性和熟练程度的发展。对104例卵巢肿瘤患者进行回顾性分析,分为RSS组(n = 52)、RSP组(n = 22)和LESS组(n = 30)。分析的指标包括年龄、体重指数、肿瘤大小、血红蛋白下降、手术时间、对接时间、控制台操作时间和肿瘤位置。各组在年龄、体重指数、输血率、血红蛋白下降或住院时间方面未发现显著差异。RSS组平均肿瘤较大,LESS组右侧发生率较高。LESS组手术时间最短,而RSS组和RSP组时间相当。RSS组和RSP组在对接和控制台操作时间上无显著差异。RSP组在对接和控制台操作时间上比RSS组更快达到熟练程度,而LESS组手术时间变异性最大。RSP组提供了更快且更一致的学习曲线,使其在复杂手术中具有优势,而LESS组手术时间较短但变异性较高。这些发现对医疗机构的手术培训和资源分配至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7609/11355174/ca3442cdb768/jpm-14-00785-g001.jpg

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