An Endoscopic Surgical Skill Validation System for Pediatric Surgeons Using a Model of Congenital Diaphragmatic Hernia Repair.
An Endoscopic Surgical Skill Validation System for Pediatric Surgeons Using a Model of Congenital Diaphragmatic Hernia Repair.
复制标题
使用先天性膈疝修复模型的小儿外科医生的内窥镜手术技能验证系统。
DOI：
10.1089/lap.2014.0259
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发表时间：
2015
影响因子：
1.3
通讯作者：
Taguchi T:
中科院分区：
文献类型：
--
作者：
Obata S;Ieiri S;Uemura M;Souzaki R;Matsuoka M;Katayama T;Hashizume M;Taguchi T:
目的：我们开发了一个系统，以客观地验证小儿surgics.Materials和方法的内窥镜手术技能：我们开发了一个胸腔镜模型的先天性腹股沟疝模仿新生儿的大小。受试者分为专家（n=10）和学员（n=19），每组执行两项任务（任务1，将疝出的肠从胸腔复位到腹部;任务2，使用腹膜内打结对隔膜缺损进行三次缝合结扎）。终点是完成任务1所需的时间、使用任务2时限的剩余时间计算的时间评分、完成全层缝合的数量、最大气压耐受性、隔膜变形程度和缝合后的剩余缺损面积。我们还评估了总的路径长度和速度的镊子尖端使用三维位置measurementinstrument.Results：专家有显着优越的上级结果的时间任务1，时间分数，完成全层缝合的数量，最大气压耐受性，并在任务2（所有P <.05）的隔膜变形的程度。我们发现，总的路径长度和平均速度为左钳是劣于右钳在两个任务中的培训生（bothP<.05，分别），而专家组在这些tasks.Conclusions：我们的模型可以验证内窥镜手术技能的质量，并可以区分专家和培训生儿科外科医生。即使在狭小的工作空间内，专家也可以同样出色地使用镊子执行任务。
Purpose:We developed a system to objectively verify the endoscopic surgical skills of pediatric surgeons.Materials and Methods:We developed a thoracoscopic model of congenital diaphragmatic hernia mimicking a newborn's size. The examinees were divided into Experts (n=10) and Trainees (n=19), and each group performed two tasks (Task 1, reduction of a herniated intestine from the thoracic space to the abdomen; Task 2, perform three suture ligatures of a diaphragm defect using intracorporeal knot-tying). The end points were the time required to complete Task 1, time score calculated using the residual time from the time limit for Task 2, number of complete full-thickness sutures, maximum air-pressure tolerance, degree of diaphragm deformation, and the residual defect areas after suturing. We also evaluated the total path length and velocity of the forceps tips using a three-dimensional position measurement instrument.Results:The Experts had significantly superior results for the time for Task 1, time score, number of complete full-thickness sutures, maximum air-pressure tolerance, and degree of diaphragm deformation in Task 2 (allP<.05). We found that the total path length and average velocities for the left forceps were inferior to those of the right forceps in both tasks in the Trainees (bothP<.05, respectively), whereas the Expert group showed no significant laterality in these tasks.Conclusions:Our model could validate the quality of endoscopic surgical skills and could differentiate between Expert and Trainee pediatric surgeons. The Experts could use their forceps equally well to perform tasks even in a small working space.