Natural orifice translumenal endoscopic surgery (NOTES): emerging trends and specifications for a virtual simulator.
Natural orifice translumenal endoscopic surgery (NOTES): emerging trends and specifications for a virtual simulator.
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自然孔腔内窥镜手术（NOTES）：虚拟模拟器的新兴趋势和规范。
DOI：
10.1007/s00464-015-4182-1
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
De,Suvranu
中科院分区：
文献类型：
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作者：
Schwaitzberg,StevenD;Dorozhkin,Denis;Sankaranarayanan,Ganesh;Matthes,Kai;Jones,DanielB;De,Suvranu
简介和研究目的正在开发虚拟经腔内窥镜手术训练器（VTEST™），以在安全无风险的环境中加速自然腔道经腔内窥镜手术（NOTES）程序和设备的开发。对于像NOTES这样快速发展的领域，必须定期进行需求分析，以发现新兴的研究趋势和对虚拟模拟器具有潜在高影响力的领域。本文提出了一项基于调查的研究，该研究是该小组在 2011 年进行的一项类似研究（Sankaranarayanan 等人，发表于 Surg Endosc 27:1607–1616, 2013）。方法在 2012 年自然孔道手术评估与研究联盟年会上分发了一份 32 点问卷。这些数据随后通过一项针对美国胃肠内窥镜协会和美国胃肠内窥镜外科医生协会成员的相同在线调查进行了扩充和分析。 结果 28 位 NOTES 专家参与了 2012 年的研究。胆囊切除术 (CE) 手术仍然是最常用的 NOTES 技术，有 18 例阳性反应 (64%)。与 2011 年相比，NOTES 阑尾切除术 (AE) 的普及率显着降低，仅有 2 例 (7%)（CE 与 AE，p<0.001），而经口内镜肌切开术 (POEM、PE) 病例数量显着增加，分别有 11 例 (39%) 呈阳性反应（PE 与 AE，p=0.013）。人们还表达了对混合技术而不是纯粹的NOTES技术的强烈偏好（82% vs. 11%，p<0.001）。其他反应与 2011 年研究中的类似，其中 VTEST™ 在开发和测试新技术和仪器方面的实用性排名特别高。结论根据本研究的结果，决定专门关注经阴道混合 NOTES 胆囊切除术手术，包括刚性和灵活的范围技术。开发虚拟 NOTES 模拟器的重要性得到了重申，POEM 被确定为未来模拟器开发的有希望的候选者。
Introduction and study aimA virtual translumenal endoscopic surgical trainer (VTEST™) is being developed to accelerate the development of natural orifice translumenal endoscopic surgery (NOTES) procedures and devices in a safe and risk-free environment. For a rapidly developing field such as NOTES, a needs analysis must be conducted regularly to discover emerging research trends and areas of potential high impact for a virtual simulator. This paper presents a survey-based study which follows a similar study conducted by this group in 2011 (Sankaranarayanan et al. in Surg Endosc 27:1607–1616, 2013).MethodsA 32-point questionnaire was distributed at the 2012 Natural Orifice Surgery Consortium for Assessment and Research annual meeting. These data were subsequently augmented by an identical online survey, targeted at the members of the American Society for Gastrointestinal Endoscopy and the Society of American Gastrointestinal and Endoscopic Surgeons, and analyzed.ResultsTwenty-eight NOTES experts participated in the 2012 study. Cholecystectomy (CE) procedure remained the most commonly performed NOTES technique, with 18 positive responses (64 %). In contrast to 2011, the popularity of the NOTES appendectomy (AE) was significantly lower, with only 2 (7 %) instances (CE vs. AE,p< 0.001), while the number of peroral endoscopic myotomy (POEM, PE) cases had increased significantly, with 11 (39 %) positive responses, respectively (PE vs. AE,p= 0.013). Strong preference toward hybrid rather than pure NOTES techniques (82 vs. 11 %,p< 0.001) was also expressed. Other responses were similar to those in the 2011 study, with the VTEST™ utility in developing and testing new techniques and instruments ranked particularly high.ConclusionBased on the results of this study, a decision was made to focus exclusively on the transvaginal hybrid NOTES cholecystectomy procedure, including both rigid and flexible scope techniques. The importance of developing a virtual NOTES simulator was reaffirmed, with POEM identified as a promising candidate for future simulator development.