Modular Comparison of Laparoscopic and Robotic Simulation Platforms in Residency Training: A Randomized Trial
Modular Comparison of Laparoscopic and Robotic Simulation Platforms in Residency Training: A Randomized Trial
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DOI：
10.1016/j.jmig.2013.06.005
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发表时间：
2013-11-01
影响因子：
4.1
通讯作者：
Kilic, Gokhan S.
中科院分区：
文献类型：
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作者：
Borahay, Mostafa A.;Haver, Mary C.;Kilic, Gokhan S.
研究目的：比较使用腹腔镜和机器人模拟培训平台获得的微创手术技能。设计：随机试验(加拿大任务组分类I)。设置：大学住院医师培训计划。研究对象：PGY1和PGY2妇产科住院医师。干预：所有住院医师完成研究前问卷(人口统计学数据和以前在微创外科手术中的经验)，然后进行模拟预测试，以评估基线的腹腔镜和机器人技能。然后，住院医生被随机分到腹腔镜组或机器人训练组，在这些训练组中，他们完成了4个基本的腹腔镜组或4个匹配的机器人模块的有指导的培训(每个模块1小时，总共4小时)。此后，居民们重复了对所有技能的定时评估。最后，他们完成了关于培训经验的研究后问卷。主要的结果衡量标准是技能完成时间的改善百分比。次级结果测量是对研究后问卷的回答。测量和主要结果：16名居民完成了研究。腹腔镜组和机器人训练组在人口统计学指标、既往的管理信息系统经验或基线腹腔镜组和机器人训练组的完成时间方面没有显著差异。在腹腔镜组中，单个腹腔镜模块的改善中位数分别为37.76%、46.43%、53.29%和66.48%，而在机器人组中分别为21.84%、21.80%、38.15%和32.98%。腹腔镜组单个机器人模块的中位数改善分别为35.42%、26.08%、22.33%和47.48%，而机器人组分别为52.70%、62.02%、67.64%和71.62%。腹腔镜组的腹腔镜组、机器人组和综合技能提高的中位数分别为50.56%、34.83%和45.52%，而机器人组分别为36.18%、64.12%和49.86%。住院医生预计使用他们接受培训的平台进行手术会更舒适；然而，机器人培训队列更喜欢他们的培训。结论：腹腔镜和机器人模拟平台在同一平台和其他平台上都显示出更好的性能。机器人平台似乎比腹腔镜平台更有优势。除了研究以外，还需要进行更大规模的研究，以比较两个平台在更高级技能方面的有效性，并比较它们对手术室熟练程度的影响。(C)2013年AAGL。版权所有。
Study Objective: To compare minimally invasive surgery (MIS) skills acquired using laparoscopic and robotic simulation training platforms.Design: Randomized trial (Canadian Task Force classification I).Setting: University residency training program.Subjects: PGY1 and PGY2 resident physicians in Obstetrics and Gynecology.Interventions: All residents completed prestudy questionnaires (demographic data and previous experience in MIS) followed by simulation pretesting to assess baseline laparoscopic and robotic skills. Residents were then randomized to laparoscopic or robotic training cohorts in which they completed proctored training of 4 basic laparoscopic or 4 matching robotic modules (1 hour per module, 4 hours total). Thereafter, residents repeated the timed assessment of all skills. Finally, they completed poststudy questionnaires about the training experience. The primary outcome measure was the percentage of improvement in skill completion time. Secondary outcome measures were answers to poststudy questionnaires.Measurements and Main Results: Sixteen residents completed the study. The laparoscopic and robotic training groups did not differ substantially on demographic measures, previous experience in MIS, or baseline laparoscopic and robotic completion times. Median improvement for individual laparoscopic modules was, respectively, 37.76%, 46.43%, 53.29%, and 66.48% in the laparoscopic cohort vs 21.84%, 21.80%, 38.15%, and 32.98% in the robotic cohort. Median improvement for individual robotic modules was, respectively, 35.42%, 26.08%, 22.33%, and 47.48% in the laparoscopic cohort vs 52.70%, 62.02%, 67.64%, and 71.62% in the robotic cohort. Median improvement in combined laparoscopic, robotic, and overall skills was, respectively, 50.56%, 34.83%, and 45.52% in the laparoscopic group vs 36.18%, 64.12%, and 49.86% in the robotic group. Residents predicted greater comfort performing surgical procedures using the platform in which they trained; however, the robotic training cohort liked their training more.Conclusions: Laparoscopic and robotic simulation platforms each demonstrated improved performance in the same and other platform. The robotic platform seems to have an edge over the laparoscopic platform. Larger studies are required in addition to studies to compare the effectiveness of both platforms in more advanced skills and to compare their effect on proficiency in the operating room. (C) 2013 AAGL. All rights reserved.