阶梯式培训在外科手术机器人教学中的应用探究  

Using a step-by-step training method in the teaching of robotic surgery skills

作　　者：杨琨[1] 李震[1] 袁玉峰[1] 陈志桥[1] 雷红[1] 王行环[1] Yang Kun;Li Zhen;Yuan Yufeng(ZhongNan hospital,Wultan University,WuHan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院,湖北武汉430071

出　　处：《中国高等医学教育》2018年第11期3-5,共3页China Higher Medical Education

基　　金：国家重点研发计划项目资助;项目编号2016YFC0106300;湖北省高校省级教学改革研究项目;项目编号201623

摘　　要：目的:探讨手术机器人教学过程中使用阶梯式培训的可行性和效果。方法:招募50位外科规培住院医师,随机分为2组。使用达芬奇手术模拟器(d V-Trainer)上的Match board 2的练习测定两组的初始水平。随后,A组直接在d V-Trainer上进行3小时Match board 2和5小时Thread the Rings 1练习;B组经过基础训练、腔镜基础训练、虚拟仿真训练后等阶梯式系统培训,然后在机器人模拟器上进行8小时操作,由d V-trainer自动评估系统对两组操作质量进行综合评估,进行组间比较以检验两种培训模式的效能。结果:两组Match board 2的起始水平为:(253±56) vs(236±45)(P=0. 765,方差分析),差异无统计学意义。A组培训后Match board 2的水平为(574±43),B组为(1054±67),差异有统计学意义(P=0. 002,方差分析); A组培训后Thread the Rings 1的水平为(454±67),B组为(971±90),差异有统计学意义(P=0. 001,方差分析)。结论:和直接上机训练相比,阶梯式培训的方法可以显著提高学员手术机器人操作水平,更符合手术机器人的学习曲线。Objective: To discuss the feasibility and effect of using stepped training in the teaching process of surgical robots. Methods: A total of 50 surgically trained residents were recruited and randomly divided into 2 groups. The initial levels of the two groups were determined using the practice of Match board 2 on the Da Vinci Surgery Simulator( d V-Trainer). Subsequently,Group A directly performed 3 hours of Match board 2 and 5 hours of Thread the Rings1 exercise on the d V-Trainer;Group B was trained in basic training,gyroscopic basic training,virtual simulation training,etc.,and then on the robot simulator. For 8 hours of operation,the d V-trainer automatic evaluation system was used to comprehensively evaluate the quality of the two groups of operations,and the comparison between groups was performed to test the effectiveness of the two training modes. Results: The starting level of the two groups of Match board 2was: 253 ± 56 vs 236 ± 45( P = 0. 765 analysis of variance). The difference was not statistically significant. The level of Match board 2in group A was 574 ± 43,and the difference in group B was 1054 ± 67( P = 0. 002,analysis of variance). The level of Thread the Rings1 in group A was 454 ± 67. Group B was 971 ± 90,the difference was statistically significant( P = 0. 001,analysis of variance).Conclusion: Compared with direct training,the step-by-step training method can significantly improve the operation level of the surgical robot,and it is more in line with the learning curve of the surgical robot.

关 键 词：手术机器人培训 手术机器人模拟器 达芬奇系统 阶梯式培训 微创手术 

分 类 号：G642.0[文化科学—高等教育学]