Developing an intelligent tutoring system for robotic-assisted surgery instruction
Developing an intelligent tutoring system for robotic-assisted surgery instruction
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DOI：
10.1002/rcs.2037
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发表时间：
2019-11-18
影响因子：
2.5
通讯作者：
Smith, Roger
中科院分区：
文献类型：
--
作者：
Julian, Danielle;Smith, Roger
背景机器人辅助腹腔镜手术（RALS）是一项引起全球关注的手术创新。在过去的十年中，RALS病例迅速增加，2017年完成了超过75万例机器人手术。直到最近，Intuitive的da芬奇手术系统一直是美国食品和药物管理局（FDA）批准的唯一一种用于人类手术的机器人辅助手术设备。由于引入了成功利用该系统所需的技术组件和心理学技能，使用da芬奇的机器人程序需要特定的专门培训。当外科医生对学习机器人技术感兴趣时，培训的途径有限。外科医生通常接受与认知和感知技能分离的必要心理学和手术室（OR）沟通技能的指导，并且只能在1天或2天的课程中以综合方式执行这些技能。方法本文讨论了一个基于计算机的智能教学系统（ITS）的发展，以培训的认知和程序技能，需要完成基本的机器人手术新手机器人外科医生。该系统是采用广义智能框架开发的辅导工具框架。这些信息被捕获为视频、指令集和流程图，由外科医生审查其准确性，然后使用用于辅导工具的广义智能框架编码到ITS中。结论本文的目的有三个方面-（a）解释用于获得基本机器人任务背后的关键数据的过程，（B）开发入门级ITS，以训练多个基本机器人手术技能背后的认知过程和程序步骤，以及（c）提供未来的新手ITS开发人员的经验教训和未来的建议，超越最初的ITS原型。
Background Robotic-assisted laparoscopic surgery (RALS) is an operative innovation that has sparked global interest. Over the last decade, RALS cases have rapidly increased with over 750 000 robotic procedures completed in 2017. Until recently, Intuitive's da Vinci surgical system has been the only Food and Drug Administration (FDA)-approved robotic-assisted surgical device for human procedures. Robotic procedures with the da Vinci require a specific, dedicated training due to the introduction of the technological components and psychomotor skills needed to successfully utilize this system. When a surgeon becomes interested in learning robotics, there are limited avenues for training. Surgeons typically receive instruction on the necessary psychomotor and Operation Room (OR) communication skills in isolation from the cognitive and perceptual skills and may only perform these skills in an integrated manner during a 1- or 2-day course. Methods This paper discusses the development of a computer-based intelligent tutoring system (ITS) to train the cognitive and procedural skills needed to complete basic robotic suturing to novice robotic surgeons. The system was developed using the generalized intelligent framework for tutoring framework of tools. This information was captured as video, instruction sets, and flowcharts, which were reviewed for accuracy by surgeons and then encoded into an ITS using the generalized intelligent framework for tutoring tools. Conclusion The purpose of this paper was threefold-(a) explain the process used to obtain the critical data behind a basic robotic task, (b) develop an entry-level ITS to train the cognitive process and procedural steps behind multiple fundamental robotic surgery skills, and (c) provide future novice ITS developers lessons learned and future recommendations beyond the initial ITS prototype.