机器人辅助腹腔镜妇科手术影响患者安全的因素与优化措施

Risk factors to patient safety and optimized measures in robot-assisted laparoscopic gynecological surgery

机器人辅助腹腔镜手术(Robot-assisted Laparoscopic Surgery,RLS)是一种安全、可行的手术方式,但其操作方式可能对患者的安全性产生不良影响。通过回顾性分析相关文献,本综述总结了影响妇科RLS患者的安全因素,主要包括手术技巧及经验、术中沟通与合作、术中干扰等方面,其优化措施分别为加强医师培训、加强术中沟通与合作、避免手术中断,且医师培训模式的改变是优化手术的关键。医师培训模式的优化措施包括训练模式的转变、双控制操作台模式的引入、不同手术步骤的标准化、手术室设置和人员的标准化,以及模拟器训练评分标准和方式的多样化等,以改善RLS影响因素所带来的不利影响。

Robot-assisted laparoscopic surgery(RLS)is a safe and feasible approach to patients,but it might bring risk factors to patients during surgery.The factors affecting the safety of gynecological patients underwent RLS were summarized in this paper by analyzing relevant literatures retrospectively,including surgical skills and experience,intraoperative communication and cooperation,and intraoperative interference.The optimized measures to the three risk factors are strengthening training of physicians,improving intraoperative communication and cooperation,and avoiding intraoperative interruption.Among the three aspects,improvement of physician training mode is the key measure.Risk factors to gynecological patients in RLS could be improved through optimized measures,which including the transformation from surgeon oriented training to team training,the introduction of dual console mode,the standardization of surgical steps,the normalization of operating room staff and settings,and the diversification of simulator training scoring standards and methods.