A new innovative laparoscopic fundoplication training simulator with a surgical skill validation system
A new innovative laparoscopic fundoplication training simulator with a surgical skill validation system
复制标题
DOI：
10.1007/s00464-016-5159-4
复制
发表时间：
2017-04-01
影响因子：
3.1
通讯作者：
Taguchi, Tomoaki
中科院分区：
文献类型：
--
作者：
Jimbo, Takahiro;Ieiri, Satoshi;Taguchi, Tomoaki
目的：我们开发并验证了一种特殊的腹腔镜胃底折叠术模拟器，用于客观的内窥镜手术技能评估系统。本研究的目的是验证外科医生的技能质量。材料和方法我们开发了一个1岁的婴儿身体模型的基础上，计算机断层扫描数据和复制的气腹模型的基础上的临床情况。受试者被分为三组：15名小儿外科专家（PSE），24名小儿外科实习生（PSN）和10名普通外科医生（GS）。他们每人必须进行三次缝合结扎，以构建Nissen包裹。评价点为任务时间、缝线放置的对称性和制作包裹时缝线结扎间隔的均匀性。结果PSE组在总时间（p < 0.01）和总路径长度（p <0.01）方面均明显上级PSN组（p < 0.01）。GS组使用双钳的速度快于其他组，PSN组使用右钳的速度快于左钳（p < 0.05）。PSE的总路径长度比GS短（p < 0.01）。结论本模型可用于验证GS与小儿外科医生之间的特征。PSE和GS都具有出色的双手协调性，可以同等地操作两种镊子，并且与PSN相比具有上级技能。PSE在手术空间冲突的情况下，操作最紧凑、准确。
Purpose We developed and validated a specific laparoscopic fundoplication simulator for use with the objective endoscopic surgical skills evaluation system. The aim of this study was to verify the quality of skills of surgeons.Materials and methods We developed a 1-year-old infant body model based on computed tomography data and reproduced pneumoperitoneum model based on the clinical situation. The examinees were divided into three groups: fifteen pediatric surgery experts (PSE), twenty-four pediatric surgery trainees (PSN), and ten general surgeons (GS). They each had to perform three sutures ligatures for construction of Nissen wrap. Evaluate points are time for task, the symmetry of the placement of the sutures, and the uniformity of the interval of suture ligatures in making wrap. And the total path length and velocity of forceps were measured to assess bi-hand coordination.Results PSE were significantly superior to PSN regarding total time spent (p < 0.01) and total path length (p < 0.01). GS used both forceps faster than the other groups, and PSN used the right forceps faster than the left forceps (p < 0.05). PSE were shorter with regard to the total path length than GS (p < 0.01). PSE showed most excellent results in the symmetry of the wrap among three groups.Conclusions Our new model was used useful to validate the characteristics between GS and pediatric surgeon. Both PSE and GS have excellent bi-hand coordination and can manipulate both forceps equally and had superior skills compared to PSN. In addition, PSE performed most compact and accurate skills in the conflicted operative space.