Validation of a Simulation-training Model for Robotic Intracorporeal Bowel Anastomosis Using a Step-by-step Technique
Validation of a Simulation-training Model for Robotic Intracorporeal Bowel Anastomosis Using a Step-by-step Technique
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DOI：
10.1016/j.urology.2018.07.035
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发表时间：
2018-10-01
期刊：
影响因子：
2.1
通讯作者：
Goh, Alvin C.
中科院分区：
文献类型：
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作者：
von Rundstedt, Friedrich-Carl;Aghazadeh, Monty A.;Goh, Alvin C.
目的建立并验证机器人体内肠吻合的训练模型。方法通过一个简短的教学视频，对不同经验水平的外科医生进行肠吻合机器人手术模拟的指导。所有参与者都在标准化条件下完成了体内肠吻合所需的步骤。该手术包括以下步骤：用吻合器分肠(1)，在反肠角切开并打开肠肢(2)，将吻合器插入2个肠肢进行侧对侧吻合(3)，用吻合器横向闭合吻合(4)。所有模拟均使用达芬奇SI机器人系统进行。采用标准化问卷对面孔效度和内容效度进行评估。构念效度采用机器人技能全球评估评估量表（一种经过验证的全球绩效评定量表）进行评估。结果22名外科医生参与手术，其中机器人专家6名，学员16名。专家参与者对肠吻合模型的面部效度评价很高（中位数为4/5；64%同意或强烈同意），所有参与者对内容作为训练模型的评价都很高（中位数为4.5/5；100%同意或强烈同意）。使用机器人技能全球评估评估（Global evaluation Assessment of Robotic Skills）对专家和培训生的歧视证明了构式效度（新手17.6 vs专家24.7,P = .03）。结论：我们证明了肠吻合机器人手术模拟器是一个可重复和真实的模拟，允许客观的技能评估。我们建立了模型的面貌、内容和效度。这种循序渐进的技术可以用于训练外科医生，希望获得机器人体内尿转移的技能。(C) 2018爱思唯尔公司
OBJECTIVE To develop and validate a training model for the robotic intracorporeal bowel anastomosis.METHODS For simulation, surgeons with varying levels of experience were instructed about bowel anastomosis robotic surgical simulation in a short educational video. All participants performed the required steps for the intracorporeal bowel anastomosis under standardized conditions. The procedure consists of the following steps: division of the bowel with a stapler (1), incision and opening of the bowel limbs at the antimesenteric angle (2), insertion of the stapler into the 2 bowel limbs for the side-to-side anastomosis (3), and transverse closure of the anastomosis with the stapler (4). All simulations were performed using the daVinci SI robotic system. Face and content validity were assessed using a standardized questionnaire. Construct validity was evaluated using the Global Evaluative Assessment of Robotic Skills, a validated global performance rating scale.RESULTS Twenty-two surgeons participated including 6 robotic experts and 16 trainees. The expert participants rated the bowel anastomosis model highly for face validity (median 4/5; 64% agree or strongly agree), and all participants rated the content as a training model very highly (median 4.5/5; 100% agree or strongly agree). Discrimination between experts and trainees using Global Evaluative Assessment of Robotic Skills demonstrated construct validity (novice 17.6 vs expert 24.7, P = .03).CONCLUSION We demonstrate that the bowel anastomosis robotic surgical simulator is a reproducible and realistic simulation that allows for an objective skills assessment. We establish face, content, and construct validity for this model. This step-by-step technique may be utilized in training surgeons desiring to acquire skills in robotic intracorporeal urinary diversion. (C) 2018 Elsevier Inc.