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达芬奇手术虚拟现实训练的多视角分析:一项前瞻性随机对照研究。

Multi-perspective analysis of daVinci surgical virtual reality training: a prospective randomized controlled study.

作者信息

Wang Rong, Zheng Nan, Liang Yujing, Cui Haoxin, Ren Tong, Xing Wenhui, Li Yanghui

机构信息

Department of Adult Cardiac Surgery, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, 100048, China.

State Key Laboratory of Multimodal Artificial Intelligence Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.

出版信息

J Robot Surg. 2025 May 16;19(1):221. doi: 10.1007/s11701-025-02309-1.

Abstract

This study explored the impact of virtual reality (VR) training on improving the acquisition of basic robotic surgical skills by analyzing the effects of training in the daVinci Surgical System (dVSS) simulator from multiple perspectives. 27 subjects were randomly divided into a VR-training group and a control group, with the VR-training group (n = 12) receiving training on the dVSS simulator (XI) to achieve expert-specific proficiency status, and the control group (n = 15) receiving no training. All the subjects subsequently wore electroencephalography (EEG) equipment to perform 6 tasks and repeated 3 times on the dVSS simulator (SI). The Global Evaluative Assessment of Robotic Skills (GEARS) scores, dVSS scores, the National Aeronautics and Space Administration Task Load Index (NASA TLX) scores, and EEG data of all the subjects were collected to conduct a comprehensive and multi-perspective analysis for dVSS training. Learning curve analysis revealed that all trainees improved their basic robotic surgical skills and reached a steady state after training. Compared with the control group, the VR-training group received higher the GEARS scores (24.91 ± 3.36 vs. 19.68 ± 3.07; p < 0.01) and dVSS scores and lower the NASA TLX scores (40.04 ± 10.55 vs. 48.2 ± 9.88; p < 0.01). In the EEG analysis, the VR-training group had higher scores in the Beta band and the Low-gamma band in the brain regions and had greater energy activation than did the control group. This randomized controlled trial combined subjective and objective evaluations to comprehensively analyze subjects' technical and nontechnical skills. It demonstrated that training on the dVSS simulator significantly improved trainees' basic robotic surgical skills and that they could achieve better basic robotic surgical skills at lower workloads. Trial registration: The study was retrospectively registered at the Chinese Clinical Trial Center. The trial registration number (TRN) was ChiCTR2400088465, and the registration day was August 20, 2024.

摘要

本研究通过从多个角度分析达芬奇手术系统(dVSS)模拟器训练的效果,探讨虚拟现实(VR)训练对提高基本机器人手术技能习得的影响。27名受试者被随机分为VR训练组和对照组,VR训练组(n = 12)在dVSS模拟器(XI)上接受训练以达到专家级熟练水平,对照组(n = 15)不接受训练。所有受试者随后佩戴脑电图(EEG)设备在dVSS模拟器(SI)上执行6项任务并重复3次。收集所有受试者的机器人技能全球评估(GEARS)分数、dVSS分数、美国国家航空航天局任务负荷指数(NASA TLX)分数和EEG数据,以对dVSS训练进行全面和多视角分析。学习曲线分析表明,所有受训者均提高了其基本机器人手术技能,并在训练后达到稳定状态。与对照组相比,VR训练组的GEARS分数更高(24.91±3.36 vs. 19.68±3.07;p < 0.01)和dVSS分数更高,而NASA TLX分数更低(40.04±10.55 vs. 48.2±9.88;p < 0.01)。在EEG分析中,VR训练组在大脑区域的β波段和低γ波段得分更高,且能量激活比对照组更大。这项随机对照试验结合主观和客观评估,全面分析了受试者的技术和非技术技能。结果表明,在dVSS模拟器上进行训练可显著提高受训者的基本机器人手术技能,且他们能够在较低工作量下获得更好的基本机器人手术技能。试验注册:该研究在中国临床试验中心进行回顾性注册。试验注册号(TRN)为ChiCTR2400088465,注册日期为2024年8月20日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b57/12084236/0b5643c065e7/11701_2025_2309_Fig1_HTML.jpg

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