机器人手术与腹腔镜手术在操作层面的比较:外科医生观点调查

Robotic vs. laparoscopic surgery at the operational level: an investigation of surgeons' perspectives.

作者信息

Chen Xiaodong, Wang Theresa N, Sarin Ankit, Patel Ankit, Ali Abubaker, Samreen Sarah, Cha Jackie, Stefanidis Dimitrios

机构信息

Department of Surgery, The Ohio State University, 395 W 12th Ave, Columbus, OH, 43210, USA.

Davis Department of Surgery, The University of California, Sacramento, CA, USA.

出版信息

Surg Endosc. 2025 Sep 2. doi: 10.1007/s00464-025-12152-y.

Abstract

INTRODUCTION

The Robotics Committee of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) conducted a study of surgeons' perspectives on robotic-assisted surgery (RAS) as compared to laparoscopic surgery (LS) in four domains: performance, requirements, challenges, and surgical care outcomes.

METHODS

An exploratory sequential mixed-methods study was performed with a thematic analysis of surgeon interviews using the framework method, followed by an online survey of SAGES Robotics Committee members. Descriptive statistics, t-tests, and ANOVA were utilized for analysis.

RESULTS

Seven robotic surgeons (3 female, 4 male) were interviewed. The primary themes were that RAS outperformed LS in (1) device performance, (2) intraoperative teaching, and (3) physical fatigue. Three perceived drawbacks of RAS compared to LS were(1) requiring more resources, (2) mechanical malfunction, and (3) care delivery cost. 55 of 92 surgeon committee members (59.8%) completed the survey. 50.9% (28/55) were male, 80% (44/55) practiced in an academic setting, and 70.9% (39/55) learned RAS during residency/fellowship training. Survey results were consistent with interview themes. Participants indicated that RAS improved performance and was associated with improved patient outcomes. They recognized the relative increased cost, the lack of tactile feedback, logistical challenges, and the increased demands of operative staff. 36.4% (20/55) surgeons ranked "AI-assisted navigation/guidance" as the "most wanted" new RAS function.

CONCLUSION

The findings from this study provide useful insights into surgeon perspectives related to RAS as it compares with laparoscopy and desired areas for new RAS developments that may be helpful to surgical organizations and industry partners alike.

摘要

引言

美国胃肠和内镜外科医师协会(SAGES)机器人技术委员会开展了一项研究,对比了外科医生对机器人辅助手术(RAS)和腹腔镜手术(LS)在四个方面的看法:性能、要求、挑战及手术护理结果。

方法

采用探索性序贯混合方法研究,先用框架法对外科医生访谈进行主题分析,随后对SAGES机器人技术委员会成员进行在线调查。运用描述性统计、t检验和方差分析进行分析。

结果

采访了7名机器人外科医生(3名女性,4名男性)。主要主题为RAS在以下方面优于LS:(1)设备性能,(2)术中教学,(3)身体疲劳。与LS相比,RAS存在三个明显缺点:(1)需要更多资源,(2)机械故障,(3)护理成本。92名外科医生委员会成员中有55名(59.8%)完成了调查。50.9%(28/55)为男性,80%(44/55)在学术机构执业,70.9%(39/55)在住院医师/专科培训期间学习了RAS。调查结果与访谈主题一致。参与者表示RAS提高了手术性能,并与改善患者预后相关。他们认识到成本相对增加、缺乏触觉反馈、后勤挑战以及对手术人员的需求增加。36.4%(20/55)的外科医生将“人工智能辅助导航/引导”列为“最需要的”新RAS功能。

结论

本研究结果为外科医生对RAS与腹腔镜手术相比的看法以及新RAS可能的发展方向提供了有用见解,这可能对外科组织和行业合作伙伴都有帮助。

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