Evaluation of Surgical Devices Using an Artificial Pediatric Thoracic Model: A Comparison Between Robot-Assisted Thoracoscopic Suturing Versus Conventional Video-Assisted Thoracoscopic Suturing.
Evaluation of Surgical Devices Using an Artificial Pediatric Thoracic Model: A Comparison Between Robot-Assisted Thoracoscopic Suturing Versus Conventional Video-Assisted Thoracoscopic Suturing.
复制标题
使用人工儿科胸腔模型评估手术器械：机器人辅助胸腔镜缝合与传统视频辅助胸腔镜缝合之间的比较。
DOI：
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
J. Fujishiro
中科院分区：
文献类型：
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作者：
S. Takazawa;T. Ishimaru;K. Harada;Kyoichi Deie;Akinari Hinoki;H. Uchida;N. Sugita;M. Mitsuishi;T. Iwanaka;J. Fujishiro
背景
儿科机器人辅助手术越来越多地被执行，但很难在婴儿中执行此程序。在我们之前的研究中，开发了一个1岁患者的小儿胸腔镜模型，该模型用于评估手术机器人在婴儿手术中的使用。
方法
八名儿科外科医生使用da芬奇Xi机器人手术系统进行了颅内结扎和打结任务。将机器人辅助胸腔镜手术（RATS）组的任务完成时间、针操作次数和术中施加的力与视频辅助胸腔镜手术（VATS）组进行比较，后者的数据是从我们先前研究中相同的8名外科医生处收集的。
结果
在打结阶段（P = 0.016）和整个阶段（P = 0.0078），大鼠组的完成时间明显短于VATS组。在整个阶段，RATS组的操作次数明显少于VATS组（P = 0.039）。大鼠组在结扎期（P = 0.031）、打结期（P = 0.031）和全期（P = 0.031）的推力指数显著小于VATS组。在所有大鼠组病例中，模型中的第七根肋骨脱位。
结论
da芬奇手术系统可能对婴儿有用，因为其移动速度快，推力小。然而，8 mm机器人器械太大，无法用于1岁婴儿的胸腔。
BACKGROUND
Pediatric robot-assisted surgery is increasingly being performed, but it is difficult to perform this procedure in infants. A pediatric thoracoscopic model of a 1-year-old patient was developed in our previous study, and this model was used to evaluate the use of a surgical robot for infant surgery.
METHODS
Eight pediatric surgeons performed an intracorporeal suturing and knot-tying task using the da Vinci Xi Robotic Surgical System. The task completion time, number of needle manipulations, and force applied during suturing of the robot-assisted thoracoscopic surgery (RATS) group were compared with those of the video-assisted thoracoscopic surgery (VATS) group whose data had been collected from the same 8 surgeons in our previous study.
RESULTS
The RATS group showed a significantly shorter completion time than the VATS group in the knot-tying phase (P = .016) and in the total phase (P = .0078). The RATS group showed a significantly smaller number of manipulations than the VATS group in the total phase (P = .039). The RATS group showed a significantly smaller pushing force index than the VATS group in the suturing phase (P = .031), knot-tying phase (P = .031), and in the total phase (P = .031). A seventh rib in the model was dislocated in all RATS group cases.
CONCLUSIONS
The da Vinci Surgical System might be useful in infants because of fast movement and small pushing force. However, the robotic 8 mm instruments were too large for use in the thoracic cavity of the 1-year-old infant.