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Robotic Surgical Skills: Acquisition, Maintenance, and Degradation

机译:机器人手术技巧:获取,维护和降级

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Background and Objectives: The degradation in robotic skills that occurs during periods of robotic surgical inactivity in newly trained surgeons was measured. The role of animate training in robotic skill was also assessed. Methods: Robotically na?ve resident and attending surgeons underwent training with the da Vinci? robot on needle passage (DN), rocking ring transfer peg board (RPB), and running suture pod tasks (SP). Errors were established to convert actual time to adjusted time. Participants were deemed “proficient” once their adjusted times were within 80% of those set by experienced surgeons through repeated trials. Participants did not use the robot except for repeating the tasks once at 4, 8, and 12 weeks (tests). Participants then underwent animate training and completed a final test within 7 days. Results: Twenty-five attending and 29 resident surgeons enrolled; 3 withdrew. There were significant increases in time to complete each of the tasks, and in errors, by 4 weeks (Adjusted times: DN: 122.9 ± 2.2 to 204.2 ± 11.7, t=6.9, P<.001; RPB: 262.4 ± 2.5 to 364.7 ± 8.0, t=12.4, P<.001; SP: 91.4 ± 1.4 to 169.9 ± 6.8, t=11.3, P<.001). Times decreased following animate training, but not to levels observed after proficiency training for the RPB and SP modules. Conclusions: Robotic surgical skills degrade significantly within 4 weeks of inactivity in newly trained surgeons. Animate training may provide different skills than those acquired in the dry lab.
机译:背景与目的:测量了在新近训练的外科医生进行的机器人外科手术无效期间机器人技能的下降情况。还评估了动画培训在机器人技能中的作用。方法:以机器人方式对天真的住院医师和外科医生进行达芬奇培训。针通道(DN),摇环转移钉板(RPB)和运行缝线吊舱任务(SP)上的机器人。建立了将实际时间转换为调整时间的错误。一旦参与者的调整时间在有经验的外科医生通过反复试验确定的调整时间的80%之内,就被认为是“熟练”。除了在第4、8和12周(测试)重复一次任务外,参与者没有使用机器人。然后,参与者进行了动画培训,并在7天内完成了最终测试。结果:有25名主治医师和29名住院医师参与了研究; 3退出了。完成每项任务的时间和错误显着增加了4周(调整时间:DN:122.9±2.2至204.2±11.7,t = 6.9,P <.001; RPB:262.4±2.5至364.7 ±8.0,t = 12.4,P <.001; SP:91.4±1.4至169.9±6.8,t = 11.3,P <.001)。在进行动画训练后,时间减少了,但没有达到RPB和SP模块的熟练训练后所观察到的水平。结论:在新近训练的外科医生不活动的4周内,机器人手术技能会明显下降。动画培训所提供的技能可能不同于干实验室中获得的技能。

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