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14名新手外科医生的单主刀机器人胆囊切除术培训:一项对300例连续病例的研究,评估培训效果和手术表现。

Single-surgeon training of 14 novice surgeons in robotic cholecystectomy: a study of 300 consecutive cases, assessing training outcomes and surgical performance.

作者信息

Coco Danilo, Leanza Silvana, Viola Massimo Giuseppe

机构信息

Department of General, Robotic and Oncologic Surgery, Giglio Foundation Hospital Cefalu', Palermo, Italy.

Department of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, LE, Italy.

出版信息

J Robot Surg. 2025 Feb 1;19(1):58. doi: 10.1007/s11701-024-02166-4.

DOI:10.1007/s11701-024-02166-4
PMID:39891856
Abstract

Robotic-assisted surgery (RAS) is a rapidly evolving field, requiring comprehensive training for widespread adoption. The aim of this study was to analyze the effectiveness of RAS cholecystectomy training in improving the technical skills and confidence of novice surgeons. Furthermore, the study examined the transferability of RAS skills to laparoscopic skills, the role of RAS cholecystectomies in reducing errors and improving patient outcomes, and identified factors that predict a successful transition from traditional laparoscopic surgery to RAS surgery. The RAST curriculum includes multimodal learning content delivered through a cloud-based platform, with three steps: basic training, simulation exercises, and structured on-patient training in the operating room. One general surgeon was trained on the Intuitive Surgical da Vinci system and assisted in performing 10 da Vinci-assisted laparoscopic cholecystectomies. In the first 300 patients who underwent robotic cholecystectomy, there were no major complications, conversions to laparoscopy, or open surgeries. The RAST curriculum demonstrates feasibility in providing a comprehensive and effective RAS training experience for surgical residents, reducing the need for extensive travel and high costs. The RAST curriculum is a promising solution for training surgical residents in RAS, with potential for widespread adoption and scalability.

摘要

机器人辅助手术(RAS)是一个快速发展的领域,需要全面培训才能广泛应用。本研究的目的是分析RAS胆囊切除术培训在提高新手外科医生技术技能和信心方面的有效性。此外,该研究还考察了RAS技能向腹腔镜技能的可转移性、RAS胆囊切除术在减少失误和改善患者预后方面的作用,并确定了预测从传统腹腔镜手术成功过渡到RAS手术的因素。RAST课程包括通过基于云的平台提供的多模式学习内容,分为三个步骤:基础培训、模拟练习和在手术室进行的结构化患者培训。一名普通外科医生在直观外科公司的达芬奇系统上接受培训,并协助进行了10例达芬奇辅助腹腔镜胆囊切除术。在最初接受机器人胆囊切除术的300例患者中,没有出现重大并发症、转为腹腔镜手术或开腹手术的情况。RAST课程在为外科住院医师提供全面有效的RAS培训体验方面显示出可行性,减少了广泛出行和高成本的需求。RAST课程是培训外科住院医师进行RAS手术的一个有前景的解决方案,具有广泛应用和可扩展性的潜力。

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本文引用的文献

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Robotic-assisted cholecystectomy versus conventional laparoscopic cholecystectomy for benign gallbladder disease: a systematic review and meta-analysis.机器人辅助胆囊切除术与传统腹腔镜胆囊切除术治疗良性胆囊疾病的系统评价和荟萃分析。
J Robot Surg. 2024 Jun 5;18(1):242. doi: 10.1007/s11701-024-01989-5.
2
Three-arm robotic cholecystectomy: a novel, cost-effective method of delivering and learning robotic surgery in upper GI surgery.三臂机器人胆囊切除术:一种新型、具有成本效益的上消化道手术中提供和学习机器人手术的方法。
J Robot Surg. 2024 Apr 23;18(1):180. doi: 10.1007/s11701-024-01919-5.
3
Comparative analysis of robotic single-site cholecystectomy outcomes between novice and expert surgeons.
机器人胰腺切除术的早期经验:对连续20例病例的回顾性队列研究
Maedica (Bucur). 2025 Jun;20(2):151-159. doi: 10.26574/maedica.2025.20.2.151.
4
A mixed-method survey study evaluating two robotic surgical training courses in Germany.一项评估德国两门机器人手术培训课程的混合方法调查研究。
J Robot Surg. 2025 Jun 21;19(1):312. doi: 10.1007/s11701-025-02493-0.
新手和专家外科医生行机器人单部位胆囊切除术结局的对比分析。
J Robot Surg. 2024 Mar 13;18(1):118. doi: 10.1007/s11701-024-01859-0.
4
Laparoscopic versus robotic cholecystectomy: a systematic review with meta-analysis to differentiate between postoperative outcomes and cost-effectiveness.腹腔镜胆囊切除术与机器人辅助胆囊切除术:一项进行荟萃分析的系统评价,以区分术后结局和成本效益。
Transl Gastroenterol Hepatol. 2024 Jan 12;9:3. doi: 10.21037/tgh-23-56. eCollection 2024.
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Comparative Safety of Robotic-Assisted vs Laparoscopic Cholecystectomy.机器人辅助与腹腔镜胆囊切除术的比较安全性。
JAMA Surg. 2023 Dec 1;158(12):1303-1310. doi: 10.1001/jamasurg.2023.4389.
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A review of the first 100 robotic cholecystectomies with a new cart-based surgical robot at a tertiary care centre.在一家三级护理中心对使用新型推车式手术机器人进行的首批100例机器人胆囊切除术的回顾。
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Eur Rev Med Pharmacol Sci. 2018 Sep;22(18):6072-6076. doi: 10.26355/eurrev_201809_15945.