腹腔镜虚拟模拟培训系统在腹腔镜初学者缝合技能训练中的作用

Value of laparoscopic virtual reality simulator in laparoscopic suture ability training of catechumen

目的探讨腹腔镜虚拟模拟培训系统在腹腔镜初学者缝合技能训练中的作用。方法腹腔镜初学者26名，完成腹腔镜基本技能虚拟模拟培训后，随机分为2组：虚拟训练组，学员继续使用腹腔镜虚拟模拟培训系统进行腹腔镜高级技能（缝合技能）模拟培训；训练箱组，学员直接转入腹腔镜普通模拟训练箱进行缝合练习。学员在进入分组前、完成培训后，分别利用我们统一自制模型，各进行1次模拟腹腔镜下肾盂、输尿管吻合操作，记录操作时间、评价吻合质量和缝合熟练程度。结果虚拟训练组学员分组前，模拟肾盂、输尿管吻合操作时间为（98±11）min，吻合质量和缝合熟练程度得分分别为3．20±0．41、3．47±0．64，完成培训后，操作时间为（53±8）min，吻合质量和缝合熟练程度得分分别为6．87±0．74、6．334-0．82，差异有显著的统计学意义（P〈0．01）。训练箱组学员分组前，操作时间为（984-10）min，吻合质量和缝合熟练程度得分分别为3．17±0．39、3．42±0．67；完成培训后，操作时间为（52±9）min，吻合质量和缝合熟练程度得分分别为6．08±0．90、6．33±0．78，差异均显著（均P〈0．01）。完成各自分组培训后，虚拟训练组与训练箱组相比，模拟。肾盂、输尿管吻合操作时间、缝合熟练程度差异无统计学意义（均P〉0．05），但吻合质量更佳，差异有统计学意义（P=0．02）。结论在初学者的腹腔镜高级缝合技能培训方面，腹腔镜虚拟模拟训练系统较传统腹腔镜模拟训练箱效果更佳。

Objective To invesgate the value of laparoscopic virtual reality simulator in laparoscopic suture ability training of catechumen. Methods After finishing the virtual reality training of basic laparoscopic skills, 26 catechumen were divided randomly into 2 groups, one group undertook advanced laparoscopic skill （suture technique） training with laparoscopic virtual reality simulator （virtual group）, another used laparoscopic box trainer （box group）. Using our homemade simulations, before grouping and after training, every trainee performed nephropyeloureterostomy under laparoscopy, the running time, anastomosis quality and proficiency were recorded and assessed. Results For virtual group, the running time, anastomosis quality and proficiency scores before grouping were （98 ± 11 ） minutes, 3.20 ± 0. 41, 3.47 ± 0. 64, respectively, after training were （53 ±8） minutes, 6. 87 ± 0. 74, 6. 33 ± 0. 82, respectively, all the differences were statistically significant （all P 〈 0. 01 ）. In box group, before grouping were （98 ± 10） minutes, 3.17 ±0. 39, 3.42 ±0. 67, respectively, after training were （52 ±9） minutes, 6.08 ± 0. 90, 6. 33± 0. 78, respectively, all the differences also were statistically significant （ all P 〈 0. 01 ）. After training, the running time and proficiency scores of virtual group were similar to box group （ all P 〉 0. 05 ）, however, anstomosis quality scores in virtual group were higher than in box group （ P = 0. 02）. Conclusion The laparoscopic virtual reality simulator is better than traditional box trainer in advanced laparoscopic suture ability training of catechumen.