骨科手术机器人3D模式下辅助经皮固定骶髂螺钉的学习曲线

Learning curve of orthopedic robot assisted percutaneous fixation of the sacroiliac screw in 3D mode

目的:探讨骨科手术机器人3D模式下辅助经皮固定骶髂螺钉的学习曲线。方法:回顾性分析2021年3月至2022年3月在乐清市人民医院应用天玑II骨科手术机器人在3D模式下辅助行经皮骶髂螺钉治疗骨盆后环骨折31例患者的临床资料。将31例患者根据手术日期按时间顺序进行编号,分为前、中、后期3组,将完成的第1至第10例设为前期组,第11至第20例设为中期组,第21至第31例为后期组,对3组患者的手术时间、术中出血量、并发症及骶髂螺钉位置等资料进行统计分析。结果:所有患者术后均未发生骨科手术机器人相关并发症。机器人辅助下骶髂螺钉置入的平均手术时间随手术病例数增加而显著减少,其中前期组与中、后期平均手术时间的变化差异有统计学意义(P<0.05),中期组和后期组的平均手术时间差异无统计学意义(P=0.278)。结论:天玑II骨科手术机器人辅助经皮固定骶髂螺钉的学习曲线前期较为陡峭,开展10例后可趋于平稳。骨科手术机器人3D模式下辅助治疗骨盆后环骨折是一种安全准确的方法,可提高手术精度,缩短手术时间。

Objective: To explore the learning curve of orthopedic robot assisted percutaneous fixation of the sacroiliac screw in 3D mode. Methods: Clinical data of 31 patients with orthopedic “TiRobot II” assisted percutaneous fixation of the sacroiliac screw in 3D mode in Yueqing People’s Hospital from March 2021 to March 2022 were retrospective analyzed. These patients, numbered in chronological order according to the operation date, were divided into three groups: patients from N0.1 to No.10 were the early group, patients from N0.11 to No.20 were the intermediate group, and patients from N0.21 to No.31 were the late group. The three groups were statistically analyzed according to the operation time, intraoperative bleeding volume, complications and sacroiliac screw position of patients at different stages. Results: None of the patients had postoperative orthopedic surgical robot-related complications. The mean operative time for robot-assisted sacroiliac screw placement decreased significantly with the number of surgical cases. There was significant difference between the mean operation time between the early group and middle and late period(P<0.05), but there was no significant difference in the mean operative time between the middle and late groups(P=0.278). Conclusion: The learning curve of orthopedic “TiRobot II” assisted percutaneous fixation of the sacroiliac screw in 3D mode is relatively steep in the early stage, tends to be stabilized after 10 cases. The adjuvant treatment of posterior pelvic ring fracture in 3D mode orthopedic robot assisted surgery is a safe and accurate method, which that can improve surgical accuracy and shorten operation time.