Virtual Reality Warm-up Before Robot-assisted Surgery: A Randomized Controlled Trial
Virtual Reality Warm-up Before Robot-assisted Surgery: A Randomized Controlled Trial
复制标题
机器人辅助手术前的虚拟现实热身：随机对照试验
DOI：
10.1016/j.jss.2021.01.037
复制
发表时间：
2021
影响因子：
2.2
通讯作者：
Smith, Roger
中科院分区：
文献类型：
--
作者：
Kelly, Jason D.;Kowalewski, Timothy M.;Brand, Tim;French, Anna;Nash, Michael;Meryman, Lois;Heller, Nicholas;Organ, Nancy;George, Evalyn;Smith, Roger
试验设计这是一项随机对照试验。背景术中错误与外科医生的技能和技能下降的间歇性不活动。本研究的目标是确定最佳的虚拟现实（VR）热身课程，以引发外科医生的技术技能和验证的好处，在手术室。Materials and methodsSurgeons随机接受六个审判会议的指定一组的VR模块上的达芬奇技能模拟器，以确定最佳的VR热身课程，以总理的技术技能。在完成他们的课程后，根据标准任务的表现评估热身效果。最佳热身课程是从具有最佳任务时间和基于视频回顾的技术技能的组中选择的。然后招募机器人辅助手术经验丰富的外科医生，在手术前接受或不接受热身。手术前15分钟的技能由不知情的外科医生和群众工作者审查以及工具运动指标进行评估。干预措施是在人类机器人辅助手术之前进行VR热身。使用客观的性能指标和视频审查，使用机器人技能工具的全球评估评估来测量热身效果。线性混合效应模型与随机截距为每个外科医生和非参数修改的Friedman tests被用于analysis.ResultsThe组执行只有一个运行缝合任务的模拟器上平均31.3秒比组执行其他模拟任务，并有最高的全球评估评估机器人技能得分从41名外科医生谁参加。这被选为最佳课程。此后，34名外科医生使用相应的视频和工具运动数据完成了347例手术。技能没有统计学上的显着差异，观察与热身intervention.ConclusionsWe的结论是，机器人VR热身前进行手术的早期阶段不影响外科医生的技术技能。
Trial designThis was a randomized controlled trial.BackgroundIntraoperative errors correlate with surgeon skill and skill declines with intervals of inactivity. The goals of this research were to identify the optimal virtual reality (VR) warm-up curriculum to prime a surgeon's technical skill and validate benefit in the operating room.Materials and methodsSurgeons were randomized to receive six trial sessions of a designated set of VR modules on the da Vinci Skills Simulator to identify optimal VR warm-up curricula to prime technical skill. After performing their curricula, warm-up effect was assessed based on performance on a criterion task. The optimal warm-up curriculum was chosen from the group with the best task time and video review–based technical skill. Robot-assisted surgery–experienced surgeons were then recruited to either receive or not receive warm-up before surgery. Skill in the first 15 min of surgery was assessed by blinded surgeon and crowdworker review as well as tool motion metrics. The intervention was performing VR warm-up before human robot-assisted surgery. Warm-up effect was measured using objective performance metrics and video review using the Global Evaluative Assessment of Robotic Skills tool. Linear mixed effects models with a random intercept for each surgeon and nonparametric modified Friedman tests were used for analysis.ResultsThe group performing only a Running Suture task on the simulator was on average 31.3 s faster than groups performing other simulation tasks and had the highest Global Evaluative Assessment of Robotic Skills scores from 41 surgeons who participated. This was chosen as the optimal curriculum. Thereafter, 34 surgeons completed 347 surgeries with corresponding video and tool motion data. No statistically significant differences in skill were observed with the warm-up intervention.ConclusionsWe conclude that a robotic VR warm-up before performing the early stages of surgery does not impact the technical skill of the surgeon.