基于虚拟现实技术和分段操作理念的机器人辅助腹腔镜肾部分切除术培训体系的建立  

Establishment of a training system for robot-assisted laparoscopic partial nephrectomy based on virtual reality technology and segmented operation concept

作　　者：张超[1] 过菲[1] 王富博[1] 叶宸[1] 杨悦[1] 王辉清[1] 杨波[1] ZHANG Chao;GUO Fei;WANG Fu-bo;YE Chen;YANG Yue;WANG Hui-qing;YANG Bo(Department of Urology,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]海军军医大学(第二军医大学)长海医院泌尿外科,上海200433

出　　处：《第二军医大学学报》2020年第7期764-768,共5页Academic Journal of Second Military Medical University

基　　金：海军军医大学(第二军医大学)长海医院教改课题(CHJG2018017)。

摘　　要：目的针对机器人辅助腹腔镜肾部分切除术(RAPN),建立一种基于虚拟现实技术和分段操作理念的渐进式分段培训体系。方法选择1名近期取得达芬奇(da Vinci)机器人手术资格的泌尿外科医师,采用虚拟现实技术进行基础操作培训和缝合强化培训。随后将RAPN分为6个步骤,受训医师参与实际手术操作,每次手术完成其中的1个步骤,在减少对患者影响的前提下获得实践操作经验。最后受训医师独立开展RAPN。结果受训医师顺利完成虚拟现实培训。在分段操作阶段共参与手术18例,与同期上级医师独自开展的手术相比,手术时间由(134±41)min延长至(161±51)min,但差异无统计学意义(P=0.087)。术中出血量、并发症发生率和术后住院时间等围手术期指标与同期上级医师独自开展的手术相比差异均无统计学意义(P均>0.05)。通过培训后,受训医师能够独立开展RAPN。结论通过虚拟培训、分段操作的方式,可以在较好地保证手术安全性和效果的前提下培养受训医师的操作技能,使其高效、高质量地完成RAPN。Objective To establish a training system for robot-assisted laparoscopic partial nephrectomy(RAPN)based on virtual reality technology and segmented operation concept.Methods A urologist who has recently been qualified for da Vinci robotic surgery was selected to receive basic operation training and suture strengthening training using virtual reality technology.The procedures of the RAPN were divided into six steps.The trained doctor completed one step each time in the actual operation,and gained practical operation experience with minimal impact on patients.Finally,the trained urologist tried to carry out RAPN independently.Results The trained urologist successfully completed the virtual reality training,and participated in 18 cases of actual operation during the segmented operation.Compared with the operation carried out by superior doctor alone,the average operation time of the segmented operation was prolonged from(134±41)min to(161±51)min,but the difference was not statistically significant(P=0.087).There was no significant difference in perioperative indexes such as estimated blood loss,incidence of complications or postoperative hospital stay.After training,the trained urologist was able to carry out RAPN independently.Conclusion With the help of virtual reality training and segmented operation,the safety and efficacy of the RAPN can be guaranteed,and the trained urologist can complete the operation with high efficiency and quality.

关 键 词：机器人手术 腹腔镜技术 肾部分切除术 培训 虚拟现实技术 分段操作 

分 类 号：R699.2[医药卫生—泌尿科学]