Virtual reality robotic surgery warm-up improves task performance in a dry laboratory environment: a prospective randomized controlled study.
Virtual reality robotic surgery warm-up improves task performance in a dry laboratory environment: a prospective randomized controlled study.
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DOI：
10.1016/j.jamcollsurg.2013.02.012
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发表时间：
2013-06
影响因子：
5.2
通讯作者：
Satava, Richard M.
中科院分区：
文献类型：
--
作者：
Lendvay, Thomas S.;Brand, Timothy C.;White, Lee;Kowalewski, Timothy;Jonnadula, Saikiran;Mercer, Laina D.;Khorsand, Derek;Andros, Justin;Hannaford, Blake;Satava, Richard M.
术前模拟“热身”已被证明可以提高新手和经验丰富的外科医生的表现并减少错误，但现有的研究仅调查了传统的腹腔镜手术。我们假设一个简短的虚拟现实（VR）机器人热身将提高机器人的任务性能和减少错误。在一项双中心随机试验中，51名住院医生和普外科、泌尿科和妇科经验丰富的微创手术教师在VR机器人模拟器和da芬奇手术机器人上接受了经验证的机器人手术熟练度课程。一旦成功达到性能基准，外科医生随机接受3-5分钟的VR模拟器预热或在执行相似和不相似（颅内）机器人手术任务之前阅读休闲书籍10分钟。比较的主要结果是任务时间，工具路径长度，经济的运动，技术和认知错误。与对照组相比，热身组的任务时间（-29.29秒，p=0.001，95%CI-47.03，-11.56）、路径长度（-79.87 mm，p=0.014，95%CI-144.48，-15.25）和认知错误减少。在不同VR任务后，颅内的总体技术错误（0.32，p=0.020，95%CI 0.06，0.59）减少。当外科医生根据之前的机器人和腹腔镜临床经验进行分层时，经验更丰富的外科医生（n=17）在任务时间方面表现出明显的热身改善（-53.5秒，p=0.001，95%CI-83.9，-23.0）和运动经济性（0.63 mm/sec，p=0.007，95%CI 0.18，1.09），而在经验较少的队列（n=34）中，这些指标的改善在统计学上并不显著。我们观察到，在VR预热基本机器人手术任务后，不同经验的外科医生的性能有了显着提高，错误率也降低了。此外，VR热身减少了更复杂任务（机器人训练）的错误，这表明了热身的普遍性。
Pre-operative simulation “warm-up” has been shown to improve performance and reduce errors in novice and experienced surgeons, yet existing studies have only investigated conventional laparoscopy. We hypothesized a brief virtual reality (VR) robotic warm-up would enhance robotic task performance and reduce errors. In a two-center randomized trial, fifty-one residents and experienced minimally invasive surgery faculty in General Surgery, Urology, and Gynecology underwent a validated robotic surgery proficiency curriculum on a VR robotic simulator and on the da Vinci surgical robot. Once successfully achieving performance benchmarks, surgeons were randomized to either receive a 3-5 minute VR simulator warm-up or read a leisure book for 10 minutes prior to performing similar and dissimilar (intracorporeal suturing) robotic surgery tasks. The primary outcomes compared were task time, tool path length, economy of motion, technical and cognitive errors. Task time (-29.29sec, p=0.001, 95%CI-47.03,-11.56), path length (-79.87mm, p=0.014, 95%CI -144.48,-15.25), and cognitive errors were reduced in the warm-up group compared to the control group for similar tasks. Global technical errors in intracorporeal suturing (0.32, p=0.020, 95%CI 0.06,0.59) were reduced after the dissimilar VR task. When surgeons were stratified by prior robotic and laparoscopic clinical experience, the more experienced surgeons(n=17) demonstrated significant improvements from warm-up in task time (-53.5sec, p=0.001, 95%CI -83.9,-23.0) and economy of motion (0.63mm/sec, p=0.007, 95%CI 0.18,1.09), whereas improvement in these metrics was not statistically significantly appreciated in the less experienced cohort(n=34). We observed a significant performance improvement and error reduction rate among surgeons of varying experience after VR warm-up for basic robotic surgery tasks. In addition, the VR warm-up reduced errors on a more complex task (robotic suturing) suggesting the generalizability of the warm-up.
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影响因子：
5.2
作者：
Figert, PL;Park, AE;Schwartz, RW
通讯作者：
Schwartz, RW
DOI：
10.4293/108680812x13427982376185
发表时间：
2012-04
期刊：
JSLS : Journal of the Society of Laparoendoscopic Surgeons
影响因子：
--
作者：
Jenison EL;Gil KM;Lendvay TS;Guy MS
通讯作者：
Guy MS
影响因子：
3.8
作者：
Peters, JH;Fried, GM;Hoffman, K
通讯作者：
Hoffman, K
影响因子：
2.3
作者：
Lendvay, Thomas S.;Casale, Pasquale;Peters, Craig
通讯作者：
Peters, Craig
DOI：
10.1007/s00464-002-8869-8
发表时间：
2003-02-01
期刊：
Surgical endoscopy
影响因子：
--
作者：
Satava, R M;Cuschieri, A;Hamdorf, J
通讯作者：
Hamdorf, J