Liu Yishu, Cai Liping, Zhao Jingyu
Medical Simulation Center, The Third Affiliated Hospital, Naval Medical University, Shanghai, China.
Clinical Education Center, The First Affiliated Hospital, Naval Medical University, Shanghai, China.
J Robot Surg. 2025 Sep 12;19(1):597. doi: 10.1007/s11701-025-02742-2.
This study evaluated the dual-console collaborative training mode for robotic Surgical skills using the da Vinci Surgical System. In a randomized controlled trial, 24 PGY-1 residents were assigned to either dual-console training or single-console training. The SimNow simulator assessed operative efficiency, recording errors, such as Misapplied Energy, Instrument-Instrument Collisions, and Instruments Out of View. Operative skills were evaluated using the GEARS scale during pig iliac artery dissection, and cognitive load was measured with the NASA-TLX scale. Results indicated that the dual-console group scored significantly higher on the SimNow assessment and exhibited greater surgical efficiency and safety (P < 0.05). This group also achieved higher GEARS scores, with notable improvements in Depth Perception, Efficiency, and Autonomy (P < 0.01) but no significant difference in Force Sensitivity. The dual-console group reported lower NASA-TLX total scores (P < 0.001), indicating lower cognitive load across dimensions, such as mental demand, temporal demand, effort, frustration, and performance (P < 0.05). In conclusion, dual-console training enhances operative safety and efficiency by optimizing cognitive load through real-time feedback and spatial guidance. This mode is effective for early skill acquisition in high-risk surgical procedures.
本研究使用达芬奇手术系统评估了机器人手术技能的双控制台协作训练模式。在一项随机对照试验中，24名一年级住院医师被分配到双控制台训练组或单控制台训练组。SimNow模拟器评估手术效率，记录错误情况，如能量误应用、器械-器械碰撞和器械视野外情况。在猪髂动脉解剖过程中使用GEARS量表评估手术技能，并用NASA-TLX量表测量认知负荷。结果表明，双控制台组在SimNow评估中的得分显著更高，且表现出更高的手术效率和安全性（P < 0.05）。该组在GEARS评分上也更高，在深度感知、效率和自主性方面有显著提高（P < 0.01），但在力敏感性方面无显著差异。双控制台组报告的NASA-TLX总分较低（P < 0.001），表明在心理需求、时间需求、努力程度、挫折感和表现等维度上的认知负荷较低（P < 0.05）。总之，双控制台训练通过实时反馈和空间引导优化认知负荷，提高了手术安全性和效率。这种模式对于高风险手术程序的早期技能习得是有效的。
