三维模拟器与二维模拟器在腹腔镜初学者技能培训教学中的效果对比研究

Comparison of three-dimensional laparoscopic simulator with two-dimensional laparoscopic simulator in training of laparoscopic novices

目的对比研究三维模拟器和二维模拟器在腹腔镜初学者技能培训教学中的作用。方法前瞻性纳入2018年1月至2019年12月期间在解放军总医院参加住院医师规培的腹腔镜初学者医师,分为二维模拟器组和三维模拟器组,经过理论讲解等培训后,参与夹豆模块、派送模块、穿线模块、运针模块和缝合模块考核,对比2组考核所用的时间和失误次数。结果三维模拟器组和二维模拟器组分别入组16名和15名医师,2组医师的年龄、性别、主力手、佩戴眼镜、腹腔镜操作经历和射击类电脑游戏经历比较差异均无统计学意义(P>0.05)。2组医师在夹豆模块和派送模块中所用的时间及掉落次数比较差异均无统计学意义(P>0.05)。三维模拟器组和二维模拟器组的运针时间和穿线时间比较差异无统计学意义(P>0.05),但三维模拟器组的运针操作更加精细准确,精确穿点次数较多(P<0.05);在缝合模块中,相比于二维模拟器组,三维模拟器组所用的时间更短(P=0.02),精确穿点次数较多(P=0.03)。结论三维模拟器有助于缩短腹腔镜初学者的复杂操作时间,提高操作精确性,有助于提高腹腔镜初学者的培训效果。

Objective To compare the three-dimensional(3D)laparoscopic simulator with two-dimensional(2D)laparoscopic simulator in training of laparoscopic novices.Methods Between January 2018 and December 2019,surgical residents from Chinese PLA General Hospital were enrolled,which were grouped into 3D and 2D group.After receiving training program,novices in both two groups subject to performance examination,including bean-picking module,exchange module,transfer module,needle-manipulating module,and suture module.Times and errors were compared between the two groups for each module.Results A total of 16 novices in 3D group and 15 novices in 2D group were enrolled,and baseline characteristics including age,gender,major hand,glass wearing,laparoscopic experience,and shooting game experience were well balanced between the two groups(P>0.05).There were comparable times and errors between the two groups in terms of bean-picking module and exchange module(P>0.05).The time of transfer module and needle-manipulating module was not significant between the two groups(P>0.05),but novices in 3D group performed more precise than those in 2D group(P<0.05).In suture module,3D group had shorter time(P=0.02)and higher accuracy(P=0.03).Conclusion 3D laparoscopic simulator can shorten novice performance time in complex procedures,improve accuracy,and facilitate laparoscopic training.