Assessing the learning curve associated with a novel flexible robot in the pre-clinical and clinical setting.
Assessing the learning curve associated with a novel flexible robot in the pre-clinical and clinical setting.
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DOI：
10.1007/s00464-021-08445-7
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Duvvuri U
中科院分区：
文献类型：
--
作者：
Zhu TS;Godse N;Clayburgh DR;Duvvuri U
经口机器人手术已被头颈外科医生成功用于各种手术，但受到刚性器械和视线可视化的限制。需要专门为呼吸消化道设计的非线性系统。这些新系统在培训和临床环境中的易用性对其广泛采用至关重要。住院医师、研究员和初级教员使用Medrobotics FLEX™机器人系统在解剖气道人体模型上执行四项任务：暴露并切开扁桃体、抓住会厌、触诊声突和抓住杓间间隙。这些任务每天执行一次，持续四天;在四个月的时间间隔后，受试者被要求再执行三天同样的任务。跟踪任务完成时间和总行驶距离。此外，进行了回顾性分析，分析一个主治医生的经验与机器人的临床使用。13名受试者完成了第一轮人体模型模拟，8名受试者在4个月后完成了额外的测试。受试者完成任务的速度和效率迅速提高。初级住院医师在大多数任务中最初比高级学员慢，但很快就达到了相似的效率水平。中断后，技能下降幅度最小，并通过额外的试验观察到效率继续提高。在分析的临床病例中存在显著异质性，但当分析具有相似复杂性和病理学的病例时，可证明总体手术时间明显缩短。新手用户在培训环境中迅速熟练使用FLEX™机器人系统，并在几个月后保留这些技能。如果制定了适当的训练方案，这种学习可以转化为临床环境。在本研究中，Medrobotics FLEX™机器人系统显示出作为头颈部手术工具的前景。在线版本包含补充材料，可通过10.1007/s 00464 -021-08445-7获得。
Transoral robotic surgery has been successfully used by head and neck surgeons for a variety of procedures but is limited by rigid instrumentation and line-of-sight visualization. Non-linear systems specifically designed for the aerodigestive tract are needed. Ease of use of these new systems in both training and clinical environments is critical in its widespread adoption. Residents, fellows, and junior faculty performed four tasks on an anatomical airway mannequin using the Medrobotics FLEX™ Robotic System: expose and incise the tonsil, grasp the epiglottis, palpate the vocal processes, and grasp the interarytenoid space. These tasks were performed once a day for four days; after a 4-month time gap, subjects were asked to perform these same tasks for three more days. Time to task completion and total distance driven were tracked. In addition, a retrospective analysis was performed analyzing one attending physician’s experience with clinical usage of the robot. 13 subjects completed the initial round of the mannequin simulation and 8 subjects completed the additional testing 4 months later. Subjects rapidly improved their speed and efficiency at task completion. Junior residents were slower in most tasks initially compared to senior trainees but quickly reached similar levels of efficiency. Following the break there was minimal degradation in skills and continued improvement in efficiency was observed with additional trials. There was significant heterogeneity in the analyzed clinical cases, but when analyzing cases of similar complexity and pathology, clear decreases in overall operative times were demonstrable. Novice users quickly gained proficiency with the FLEX™ Robotic System in a training environment, and these skills are retained after several months. This learning could translate to the clinical setting if a proper training regimen is developed. The Medrobotics FLEX™ Robotic System shows promise as a surgical tool in head and neck surgery in this study. The online version contains supplementary material available at 10.1007/s00464-021-08445-7.
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DOI：
10.1007/s00464-010-0985-2
发表时间：
2010-10-01
影响因子：
3.1
作者：
Rosenthal, Madelyn E.;Ritter, E. Matt;Scott, Daniel J.
通讯作者：
Scott, Daniel J.
影响因子：
2.6
作者：
O'Malley, Bert W., Jr.;Weinstein, Gregory S.;Hockstein, Neil G.
通讯作者：
Hockstein, Neil G.
影响因子：
2.6
作者：
Johnson, Paul J.;Serrano, Carlos M. Rivera;Duvvuri, Umamaheswar
通讯作者：
Duvvuri, Umamaheswar
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：
2.6
作者：
Moore, Eric J.;Olsen, Kerry D.;Kasperbauer, Jan L.
通讯作者：
Kasperbauer, Jan L.