利用达芬奇机器人手术模拟训练器开展临床技能培训的探讨

Exploration of Develop Clinical Skills Training Using Da Vinci Robot Surgery Simulation

目的运用多个指标评价达芬奇机器人手术模拟训练系统在外科医师技能培训中发挥的作用。方法随机选取达芬奇外科医师中12例研究对象作为观察组(副高以上,临床工作中均接触达芬奇手术者),随机抽取12例在香港威尔士亲王医院微创医疗技术资质考核培训中心(MISSC)参加达芬奇机器人手术培训课程,获得"达芬奇主刀医师操作证"的专家教授作为对照组(副高以上,长期做达芬奇机器人手术,完成临床达芬奇机器人手术300例以上)按照研究对象划分,分为观察组(n=12)及对照组(n=12),在培训前、培训10天和培训20天(每天8个学时,每个学时45分钟)后对其进行达芬奇模拟训练考核评估。运用统计学方法,对观察组和对照组进行培训前、培训后上机成绩对照研究。结果观察组与对照组在培训前、培训10天操作成绩具有统计学意义,在培训20天后操作成绩无明显差异,统计学无意义。培训20天结束后,12例观察组在完成操作时间、经济效益、器械碰撞、超出视野范围、出血量、脏器损伤等多个评价指标操作结果显示中与对照组比较,无统计学差异。结论经过20天的虚拟培训,观察组的达芬奇虚拟训练水平显著提高,并能独立完成,与对照组的操作成绩并无明显差异,后期也可独立完成临床达芬奇手术操作。

Objective To evaluate the role of Da Vinci Robot Surgical Simulated Training System in surgeon skill training by using multiple indicators.Methods Twelve Da Vinci surgeons were randomly selected as the observation group(above deputy senior,all of them were exposed to Da Vinci surgery in clinical work).Twelve specialists and professors were randomly selected from the Minimally Invasive Medical Technical Qualification Assessment Training Center(MISSC)of Prince Wales Hospital of Hong Kong to participate in the training course of Da Vinci Robot Surgery and obtained the"Da Vinci Surgeon Operating Certificate"According to the research object,the control group was divided into observation group(n=12)and control group(n=12).The Da Vinci simulation training was evaluated before training,10 days after training and 20 days after training(8 hours per day,45 minutes per hour).Statistical methods were used to compare the performance of the observation group and the control group before and after training.Results There was statistical significance between the observation group and the control group before and after training for 10 days,but there was no significant difference between the two groups after training for 20 days.After 20 days of training,there was no significant difference between the observation group and the observation group in the operation time,economic benefits,instrument collision,beyond visual field,bleeding volume,organ damage and other evaluation indicators.Conclusion After 20 days of virtual training,the level of virtual training of Leonardo Da Vinci in the observation group has been significantly improved and can be completed independently.There is no significant difference between the operation results of the observation group and that of the control group,and the clinical operation of Leonardo Da Vinci can also be completed independently in the later stage.