A novel physical colonoscopy simulator based on analysis of data from computed tomography colonography
A novel physical colonoscopy simulator based on analysis of data from computed tomography colonography
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基于计算机断层扫描结肠成像数据分析的新型物理结肠镜检查模拟器
DOI：
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
T. Mizushima
中科院分区：
文献类型：
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作者：
K. Noda;T. Kitada;Yasumoto Suzuki;H. Colvin;T. Hata;T. Mizushima
目的腹腔镜手术因其术后发病率较低而得到广泛应用。随着腹腔镜手术中的柔性内窥镜进一步减少手术创伤，内窥镜培训对于外科医生来说将变得更加重要。因此，我们设计了一个物理模拟器，Noda–Kitada–Suzuki (NKS) 模型，它可以提供更真实的结肠镜插入。方法我们根据计算机断层扫描结肠成像扫描结肠和直肠的解剖结构和动力学特性的信息，设计了一个结肠镜模拟器。结果NKS 模型的透明骨架为操作者和培训者提供即时视觉反馈。我们新颖的结肠镜检查模拟器复制了结肠镜从直肠到盲肠的真实且可重复的插入，提供了休斯顿瓣膜、弯曲和粘膜皱襞的真实视图。这是通过客观调查问卷得到验证的，16 名结肠镜检查医师中有 14 名在培训目的时更喜欢 NKS 模型，而不是之前的 CM15 模型。此外，改进的结肠镜检查模拟器真实性问卷分析证实，当由 12 名结肠镜医师进行评估时，NKS 模型在 33 个项目中的 7 个项目（21.2%）上明显比 CM15 更真实。结论 NKS 模型提供了一个真实的训练平台，可以提高结肠镜检查的培训质量。
PurposeLaparoscopic surgery is now practiced widely because of its lower postoperative morbidity. As flexible endoscopy during laparoscopic surgery minimizes surgical trauma further, training in endoscopy will become more important for surgeons. Thus, we designed a physical simulator, the Noda–Kitada–Suzuki (NKS) model, which could provide the more realistic insertion of a colonoscope.MethodsWe designed a colonoscopy simulator, based on information from computed tomography colonography scans of the anatomy and kinetic properties of the colon and rectum.ResultsThe transparent skeleton body of the NKS model provides instant visual feedback to the operator and the trainer. Our novel colonoscopy simulator replicates the realistic and reproducible insertion of a colonoscope from the rectum to cecum, providing authentic views of the Houston’s valves, the flexures, and mucosal folds. This was verified through an objective questionnaire, with 14 of 16 colonoscopists preferring the NKS model over the previous CM15 model for training purposes. Moreover, the Modified Colonoscopy Simulator Realism Questionnaire analysis confirmed that the NKS model was significantly more realistic than the CM15 for 7 (21.2%) of the 33 items when assessed by 12 colonoscopists.ConclusionThe NKS model provides a realistic training platform and may improve the quality of training in colonoscopy.