Objective assessment of robotic suturing skills with a new computerized system: A step forward in the training of robotic surgeons
Objective assessment of robotic suturing skills with a new computerized system: A step forward in the training of robotic surgeons
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使用新的计算机系统客观评估机器人缝合技能：机器人外科医生培训的进步
DOI：
10.1111/ases.12672
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发表时间：
2018
影响因子：
1
通讯作者：
Hashizume M
中科院分区：
文献类型：
--
作者：
Busch C;Nakadate R;Uemura M;Obata S;Jimbo T;Hashizume M
本研究的目的是使用一种新型的计算机化客观评估系统来评估机器人辅助缝合技术在腹腔镜肠吻合术模型上的应用。每个受试者在2-D和3-D可视化下使用达芬奇机器人辅助缝合，并使用传统的腹腔镜(CL)。使用压力测量和图像处理设备对缝合技术进行定量评估。结果三维可视化缝合(P<； 0.0 1)和CL缝合(P<； 0.0 5)的缝合速度明显快于二维可视化。3-D(P<； 0.05)和2-D(P<； 0.0 1)下放置的缝线张力明显好于CL，后者不符合可接受的缝线张力值。用CL缝合的缝合线的气压渗漏明显好于二维可视化缝合(P<； 0.05)，这不符合气压渗漏和伤口开口面积的可接受值。1例患者2-D缝合失败，2例CL缝合失败，1例3-D缝合失败。结论在机器人辅助的微创手术中，复杂的操作需要使用3-D视觉。我们的定量评估系统对于评估正在接受机器人手术培训的外科医生实习生的技能获得是有用的。
IntroductionThe purpose of this study was to assess robot‐assisted suturing skills on a laparoscopic intestinal anastomosis model by using a novel computerized objective assessment system.MethodsThis study compared the suturing skills of 13 surgically naïve participants on an artificial intestinal anastomosis model that mimics real tissue. Each examinee sutured using da Vinci robot assistance under 2‐D and 3‐D visualization and with conventional laparoscopy (CL). Pressure‐measuring and image‐processing devices were employed to quantitatively evaluate suturing skills. Five unique criteria were used to evaluate the skills of participants.ResultsSuturing under 3‐D visualization (P< 0.01) and with CL (P< 0.05) were significantly faster than under 2‐D visualization. Sutures placed under 3‐D (P< 0.05) and 2‐D (P< 0.01) visualization had significantly better suture tension than those placed with CL, which did not meet acceptable values for suture tension. Sutures placed with CL had significantly better air pressure leakage than those placed under 2‐D visualization (P< 0.05), which did not meet acceptable values for air pressure leakage and wound opening area. One participants failed to achieve full‐thickness sutures with 2‐D, two participants with CL, and one participant with 3‐D.ConclusionUsing 3‐D vision is necessary for complex maneuvering during robot‐assisted minimally invasive surgery. Our quantitative assessment system is useful for evaluating the skill acquisition of surgeon‐trainees undergoing robotic surgery training.