An analysis of the correlation between the efficacy of training using a high-fidelity disease-specific simulator and the clinical outcomes of laparoscopic surgery for congenital biliary dilatation in pediatric patients
An analysis of the correlation between the efficacy of training using a high-fidelity disease-specific simulator and the clinical outcomes of laparoscopic surgery for congenital biliary dilatation in pediatric patients
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高保真疾病特异性模拟器训练效果与腹腔镜手术治疗儿科先天性胆道扩张症临床结果的相关性分析
DOI：
10.1007/s11548-022-02793-y
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发表时间：
2022
影响因子：
3
通讯作者：
Ieiri Satoshi
中科院分区：
文献类型：
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作者：
Yamada Koji;Muto Mitsuru;Murakami Masakazu;Onishi Shun;Sugita Koshiro;Yano Keisuke;Harumatsu Toshio;Nishida Nanako;Nagano Ayaka;Kawano Masato;Yamada Waka;Matsukubo Makoto;Kawano Takafumi;Kaji Tatsuru;Ieiri Satoshi
PurposeThe本研究阐明了重复腹腔镜手术培训的有效性，使用疾病特异性模拟器，并调查了腹腔镜手术先天性胆管扩张（CBD）在儿科patients after training.MethodsA高保真腹腔镜hepaticostejunostomy模拟器的临床结局。四名小儿外科医生使用模拟器进行了三次腹腔镜肝总管空肠吻合术的练习。分析了任务期间钳子操作的细节。13例胆总管腹腔镜手术治疗在我们的机构的临床结果也进行了评估的基础上的医疗records.ResultsThe完成任务所需的时间变得显着缩短每一个连续的时间（第一：1062.18 ± 346.79秒与第三：717.44 ± 260.80秒，P= 0.039）。右侧镊子的总路径长度无显著差异（第1次：55.56 ± 23.21 m vs.第3次：28.25 ± 17.01 m，p= 0.17），左侧镊子的总路径长度（第1次：47.79 ± 20.79 m vs.第3次：31.83 ± 17.62 m，p= 0.17），右侧镊子的平均速度（第一组：58.78 ± 21.29 mm/s vs.44.98 ± 10.25 mm/s，p= 0.47），或左侧镊子的平均速度（第一组：50.39 ± 19.25 mm/s vs. 52.26 ± 19.59 mm/s，p= 0.78）。关于临床结果，所有CBD患者都接受了由没有经验的儿科医生进行的腹腔镜手术。手术时间545.53 ± 91.01 min，术中出血量24.2 ± 25.8 ml。有没有开放转换，术中不良事件，或吻合口漏。ConclusionDiseases特定的模拟器培训显着降低了任务的执行时间，提高钳操作经济。此外，模拟器培训可以提高小儿CBD患者腹腔镜肝总管空肠吻合术的手术安全性和质量。
PurposeThe present study clarified the efficacy of repeating laparoscopic surgery training using a disease-specific simulator and investigated the clinical outcomes of laparoscopic surgery for congenital biliary dilatation (CBD) in pediatric patients after training.MethodsA high-fidelity laparoscopic hepaticojejunostomy simulator was used. Four pediatric surgeons performed practice laparoscopic hepaticojejunostomy three times using the simulator. The details of forceps manipulation during the task were analyzed. The clinical outcomes of 13 CBD cases treated with laparoscopic surgery in our institution were also evaluated based on medical records.ResultsThe time required to complete the task became significantly shorter each successive time (1st: 1062.18 ± 346.79 s vs. 3rd: 717.44 ± 260.80 s,p= 0.039). There were no significant differences in the total path length of the right forceps (1st: 55.56 ± 23.21 m vs. 3rd: 28.25 ± 17.01 m,p= 0.17), total path length of the left forceps (1st: 47.79 ± 20.79 m vs. 3rd: 31.83 ± 17.62 m,p= 0.17), average velocity of the right forceps (1st: 58.78 ± 21.29 mm/s vs.44.98 ± 10.25 mm/s,p= 0.47), or the average velocity of the left forceps (1st: 50.39 ± 19.25 mm/s vs. 52.26 ± 19.59 mm/s,p= 0.78). Regarding the clinical outcome, all CBD patients underwent laparoscopic surgery performed by practiced pediatric surgeons who had no experience. The operative time was 545.53 ± 91.01 min, and the blood loss was 24.2 ± 25.8 ml. There were no cases of open conversion, intraoperative adverse events, or anastomotic leakage.ConclusionDisease-specific simulator training significantly decreased the task performance time by improving the forceps manipulation economy. In addition, simulator training may improve the operative safety and quality of laparoscopic hepaticojejunostomy in pediatric CBD patients.