Objective assessment of proficiency with bimanual inanimate tasks in robotic laparoscopy
Objective assessment of proficiency with bimanual inanimate tasks in robotic laparoscopy
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DOI：
10.1089/lap.2006.05101
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发表时间：
2007-02-01
影响因子：
1.3
通讯作者：
Stergiou, Nicholas
中科院分区：
文献类型：
--
作者：
Narazaki, Kenji;Oleynikov, Dmitry;Stergiou, Nicholas
目的：机器人腹腔镜手术的客观标准和最佳培训方案的发展是优先事项。然而，由于缺乏任务的复杂性和缺乏专家与新手之间的比较，试图将学习客观化的研究受到了限制。我们的目的是解决这些局限性，并评估熟练的机器人腹腔镜使用双手无生命的tasks.Materials和方法：6名专家和18名新手用户的达芬奇手术系统（创新手术，桑尼维尔，CA）进行了三个双手手术操作，其中两个在相反的方向，共5个不同的测试任务。在每个任务中，经过的时间和运动学相对于仪器的提示进行了测量和双手协调分析，以评估双臂的同时运动之间的关系。具体而言，任务完成时间，总的旅行距离的仪器提示，平均绝对相对相位的变量评估双手协调，计算每个task.Results：专家组之间的比较显示，所有任务的任务完成时间显着缩短（P < 0.05）。专家组在两项任务中的平均绝对相对相位值均显著高于非专家组（P < 0.05）。有没有显着差异，总的旅行distance.Conclusion：专家用户的达芬奇手术系统进行设计的手术任务更快，双手灵巧度比新手。双手协调分析和在这项研究中使用的任务显示，承诺成为量化熟练程度机器人腹腔镜手术所需的客观标准的重要组成部分。
Purpose: Development of objective criteria and optimum training protocols are priorities for robotic laparoscopy. However, studies that have attempted to objectify learning have been limited due to lack of task complexity and absence of comparisons between experts and novices. Our aim was to address these limitations and assess proficiency in robotic laparoscopy using bimanual inanimate tasks.Materials and Methods: Six experts and 18 novice users of the da Vinci surgical system (Innovative Surgical, Sunnyvale, CA) performed three bimanual surgical manipulations, two of them in opposite directions, for a total of five different test tasks. During each task, elapsed time and kinematics with respect to the instrument tips were measured and a bimanual coordination analysis was conducted to assess the relationship between the simultaneous movements of both arms. Specifically, task completion time, total traveling distance of the instrument tips, and mean absolute relative phase-a variable for the assessment of bimanual coordination-were calculated for each task and compared between groups.Results: The experts showed significantly shorter task completion times for all tasks (P < 0.05). Significantly higher mean absolute relative phase values were observed for the experts in two tasks (P < 0.05). There were no significant differences regarding total travel distance.Conclusion: Expert users of the da Vinci surgical system performed the designed surgical tasks faster and with higher bimanual dexterity than novices. Bimanual coordination analysis and the tasks used in this study show promise for becoming important components of the objective criteria needed to quantify proficiency in robotic laparoscopy.