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3D打印肾脏模型在软性输尿管镜技能培训中的应用价值 被引量:1
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作者 张弋 于澄钒 +5 位作者 张军晖 闫伟 肖河 周学贤 林燕丽 CHEW BH 《现代泌尿外科杂志》 CAS 2019年第11期923-926,共4页
目的探讨新型3D打印肾脏模型在软性输尿管镜技能培训中的有效性。方法上尿路结石病例CTU数据经处理输出到3D打印机制作患者特异性的肾脏模型,以10分制Likert问卷量表以及专家与初学者模型操作表现(模型培训前、后)进行对比。结果5名专家... 目的探讨新型3D打印肾脏模型在软性输尿管镜技能培训中的有效性。方法上尿路结石病例CTU数据经处理输出到3D打印机制作患者特异性的肾脏模型,以10分制Likert问卷量表以及专家与初学者模型操作表现(模型培训前、后)进行对比。结果5名专家和32名初学者纳入本研究,专家评价为总体有效性(9.6±0.5)分、图像质量(8.8±0.8)分、上尿路解剖(9.4±0.5)分、结石信息(9.8±0.4)分,以及对手术计划和培训的有效性(9.6±0.5)分。培训前,专家所有指标均显著优于初学者(P<0.003);培训后,初学者操作水平显著提高(P<0.001),探及肾盏和结石数目与专家的差别消失(P=0.228和P=0.980),探查时间和综合评分(GRS)也明显接近,初学者反馈评价均高于9分。结论图像后处理和3D打印生成肾脏模型可作为软性输尿管镜模拟培训的有效工具,可提高初学者操作水平,模型的表面、内容和构建效度得到验证。 展开更多
关键词 3D打印 肾脏模型 模拟培训 软性输尿管镜 尿路结石
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输尿管镜治疗上尿路尿路上皮癌的中期随访结果 被引量:1
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作者 张弋 于澄钒 俞波 《现代泌尿外科杂志》 CAS 2018年第10期735-738,共4页
目的探讨输尿管镜腔内治疗上尿路尿路上皮癌(UTUC)的可行性及效果。方法 2006年7月至2016年6月,回顾性收集输尿管镜治疗的UTUC患者19例。孤立肾和功能性孤立肾共7例(4/3),对侧健肾功能正常10例。术前活检均为UTUC,低级别15例、高级别4... 目的探讨输尿管镜腔内治疗上尿路尿路上皮癌(UTUC)的可行性及效果。方法 2006年7月至2016年6月,回顾性收集输尿管镜治疗的UTUC患者19例。孤立肾和功能性孤立肾共7例(4/3),对侧健肾功能正常10例。术前活检均为UTUC,低级别15例、高级别4例。采用硬性或软性输尿管镜进行肿瘤切除,记录相关临床参数并给予常规、影像及内镜随访观察。患者分为姑息性手术组和选择性手术组,比较二组差别。结果 10例为姑息性手术、9例为选择性手术。手术共23次,4例进行分期手术或再次探查。Ⅱ级及以上并发症共8例次;中位和平均随访为31月和(32.6±13.3)月。8例共11次复发,中位和平均复发11月和(15.5±13.4)月。总体复发率为42.1%(低级别30%、高级别肿瘤55.6%,P=0.260),2例接受肾输尿管全程切除手术,死亡4例,两组肿瘤大小、位置、术后病理级别和复发等无显著区别。3年总体生存率78.9%,肿瘤特异性生存88.2%,总体器官保存率73.5%。结论输尿管镜腔内手术切除是针对UTUC的一种选择方式,可以安全有效地开展,即使是对侧肾脏功能良好者。术后肿瘤分级和分期有可能变化,高复发率要求严密和长期的随访。多中心研究对探究内镜手术在治疗UTUC的地位有重要意义。 展开更多
关键词 上尿路尿路上皮癌 输尿管镜 治疗 随访
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以熟练度为依据的膀胱镜虚拟现实模拟技能培训实证的有效性 被引量:4
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作者 周学贤 于澄钒 +2 位作者 林燕丽 刘杰 张弋 《现代泌尿外科杂志》 CAS 2020年第1期46-49,共4页
目的探索以专家熟练度为依据建立软性膀胱镜技能考核标准的实证有效性。方法通过URO-Mentor模拟器获取软性膀胱镜专家(经验≥500例)技能表现数据,以其技能数据的70%[操作时间93.17 s,综合评估量表(GRS)评分15.55分]作为考核达标标准,且... 目的探索以专家熟练度为依据建立软性膀胱镜技能考核标准的实证有效性。方法通过URO-Mentor模拟器获取软性膀胱镜专家(经验≥500例)技能表现数据,以其技能数据的70%[操作时间93.17 s,综合评估量表(GRS)评分15.55分]作为考核达标标准,且要求膀胱探查率达到80%及以上,其他指标还包括:任务4的操作时间、GRS。初学者训练达标后从中随机抽取10名受试者,在专家监督下完成膀胱镜操作并评价表现。结果共20名初学者和2名专家进入研究。初学者平均达标时间13.48 h,且较初始水平操作时间显著缩短(81.60±8.83 vs.311.05±116.22,P<0.001),GRS评分显著提升(17.92±1.07 vs.8.48±1.43,P<0.001)。10名受试者经临床操作测试,均达到可独立操作水平。结论以专家熟练度的70%作为膀胱镜技能考核标准是可行的。URO-Mentor虚拟模拟器是软性膀胱镜技能考核的有效工具。 展开更多
关键词 膀胱镜 虚拟现实 熟练度 实证研究 考核标准
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Effectiveness of the UroMentor virtual reality simulator in the skill acquisition of flexible cystoscopy 被引量:5
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作者 ZHANG Yi LIU Jin-shun +3 位作者 WANG Gang yu cheng-fan ZHU He NA Yan-qun 《Chinese Medical Journal》 SCIE CAS CSCD 2013年第11期2079-2082,共4页
Background Virtual reality (VR) has been recognized as a useful modality in the training of surgical skills. With respect to basic endoscopic skill training of urology, we sought to investigate the effectiveness of ... Background Virtual reality (VR) has been recognized as a useful modality in the training of surgical skills. With respect to basic endoscopic skill training of urology, we sought to investigate the effectiveness of the UroMentorTM virtual reality simulator (VRS) in the skill acquisition of flexible cystoscopy. Methods Urologists familiar with rigid cystoscopy procedures were selected to take part in a virtual training course of flexible cystoscopy. Changes in total operating time, frequency of injury, number of digital markers inside the bladder, and the global rating scale (GRS) scores were assessed following eight repeated training sessions on the UroMentorTM. Results Eighteen urologists voluntarily took part in the study. Total operating time was significantly lower after eight sessions of training by comparison ((111±10) seconds and (511±67) seconds, respectively; P〈0.001). Additionally, the frequency of injury decreased with training from (12±2) times to (5±1) times (P〈0.001), while the number of digital markers observed increased from 9±0 to 10±1 (P=0.005). Finally, training with the UroMentor^TM resulted in a GRS increase from (1.3±0.2) points to (3.9±0.2) points (P〈0.001). Conclusion the VRS UroMentorTM can improve urologists' ability to perform flexible cystoscopy and could be used as an effective trainina tool for trainees. 展开更多
关键词 flexible cystoscopy virtual reality SIMULATOR UroMentor^TM TRAINING
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Training for percutaneous renal access on a virtual reality simulator 被引量:9
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作者 ZHANG Yi yu cheng-fan +3 位作者 LIU Jin-shun WANG Gang ZHU He NA Yan-qun 《Chinese Medical Journal》 SCIE CAS CSCD 2013年第8期1528-1531,共4页
Background The need to develop new methods of surgical training combined with advances in computing has led to the development of virtual reality surgical simulators. The PERC MentorTM is designed to train the user in... Background The need to develop new methods of surgical training combined with advances in computing has led to the development of virtual reality surgical simulators. The PERC MentorTM is designed to train the user in percutaneous renal collecting system access puncture. This study aimed to validate the use of this kind of simulator, in percutaneous renal access training. Methods Twenty-one urologists were enrolled as trainees to learn a fluoroscopy-guided percutaneous renal accessing technique. An assigned percutaneous renal access procedure was immediately performed on the PERC MentorTM after watching instruction video and an analog operation. Objective parameters were recorded by the simulator and subjective global rating scale (GRS) score were determined. Simulation training followed and consisted of 2 hours daily training sessions for 2 consecutive days. Twenty-four hours after the training session, trainees were evaluated performing the same procedure. The post-training evaluation was compared to the evaluation of the initial attempt. Results During the initial attempt, none of the trainees could complete the appointed procedure due to the lack of experience in fluoroscopy-guided percutaneous renal access. After the short-term training, all trainees were able to independently complete the procedure. Of the 21 trainees, 10 had primitive experience in ultrasound-guided percutaneous nephrolithotomy. Trainees were thus categorized into the group of primitive experience and inexperience. The total operating time and amount of contrast material used were significantly lower in the group of primitive experience versus the inexperience group (P=0.03 and 0.02, respectively). Conclusions The training on the virtual reality simulator, PERC MentorTM, can help trainees with no previous experience of fluoroscopy-guided percutaneous renal access to complete the virtual manipulation of the procedure independently. This virtual reality simulator may become an important training and evaluation tool in teaching fluoroscopy-guided percutaneous renal access. 展开更多
关键词 virtual reality simulator TM PERC Mentor percutaneous renal access training and evaluation tool
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