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机器人手术训练中的虚拟现实模拟:系统评价与荟萃分析。

Virtual reality simulations in robotic surgery training: a systematic review and meta-analysis.

作者信息

Kawashima Kazuho, Nader Francis, Collins Justin W, Esmaeili Ali

机构信息

Division of Surgery & Interventional Science, University College London, London, UK.

Department of Plastic and Reconstructive Surgery, Royal Free NHS Foundation Trust, Pond St, London, NW3 2QG, UK.

出版信息

J Robot Surg. 2024 Dec 17;19(1):29. doi: 10.1007/s11701-024-02187-z.

Abstract

OBJECTIVE

To compare VR simulations with other training methods regarding improvements in objective assessment scores and task completion times.

METHOD

A database search was conducted on 20 May 2024 across Central, MEDLINE, EMBASE, Web of Science, and Scopus. Included were randomised controlled trials comparing VR simulations to other training methods, assessing objective scores and task times. The Risk of Bias-2 tool was used for bias assessment.

RESULTS

Eighteen studies were included. VR significantly improved objective scores (n = 339, SMD 1.04, 95% CI 0.40-1.69, P = 0.002) and reduced task completion times (n = 357, SMD of -1.08, 95% CI of as - 2.05 to - 0.12, P = 0.03) compared to no additional training. VR was as effective as dry lab training for improving scores (n = 213, SMD -0.47, 95% CI - 1.34 to 0.41, P = 0.30) and task times (n = 98, SMD - 0.37, 95% CI - 1.51 to 0.78, P = 0.53). However, one study found wet lab training significantly reduced task times compared to VR (n = 20, SMD of 1.7, 95% CI of 0.65-2.76, P = 0.002). No significant differences were found when VR alone was compared to VR with expert advice.

CONCLUSION

VR is more effective than no additional training and is as effective as dry lab training in robotic skill acquisitions. Therefore, VR is effective in enhancing robotic surgery skills and warrants an expanded role in surgical training programmes.

摘要

目的

比较虚拟现实(VR)模拟与其他训练方法在客观评估分数和任务完成时间改善方面的情况。

方法

于2024年5月20日在CENTRAL、MEDLINE、EMBASE、科学引文索引和Scopus数据库进行检索。纳入比较VR模拟与其他训练方法、评估客观分数和任务时间的随机对照试验。采用偏倚风险-2工具进行偏倚评估。

结果

纳入18项研究。与无额外训练相比,VR显著提高了客观分数(n = 339,标准化均数差1.04,95%置信区间0.40 - 1.69,P = 0.002)并缩短了任务完成时间(n = 357,标准化均数差为 -1.08,95%置信区间为 -2.05至 -0.12,P = 0.03)。在提高分数(n = 213,标准化均数差 -0.47,95%置信区间 -1.34至0.41,P = 0.30)和任务时间(n = 98,标准化均数差 -0.37,95%置信区间 -1.51至0.78,P = 0.53)方面,VR与模拟实验室训练效果相当。然而,一项研究发现,与VR相比,实体实验室训练显著缩短了任务时间(n = 20,标准化均数差1.7,95%置信区间0.65 - 2.76,P = 0.002)。将单纯VR与有专家建议的VR进行比较时,未发现显著差异。

结论

在机器人技能习得方面,VR比无额外训练更有效,且与模拟实验室训练效果相当。因此,VR在提高机器人手术技能方面有效,值得在手术训练项目中发挥更大作用。

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