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Robot assisted versus laparoscopic suturing learning curve in a simulated setting

机译：模拟环境中的机器人辅助与腹腔镜缝合学习曲线

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Background Compared to conventional laparoscopy, robot assisted surgery is expected to have most potential in difficult areas and demanding technical skills like minimally invasive suturing. This study was performed to identify the differences in the learning curves of laparoscopic versus robot assisted suturing. Method Novice participants performed three suturing tasks on the EoSim laparoscopic augmented reality simulator or the RobotiX robot assisted virtual reality simulator. Each participant performed an intracorporeal suturing task, a tilted plane needle transfer task and an anastomosis needle transfer task. To complete the learning curve, all tasks were repeated up to twenty repetitions or until a time plateau was reached. Clinically relevant and comparable parameters regarding time, movements and safety were recorded. Intracorporeal suturing time and cumulative sum analysis was used to compare the learning curves and phases. Results Seventeen participants completed the learning curve laparoscopically and 30 robot assisted. Median first knot suturing time was 611 s (s) for laparoscopic versus 251 s for robot assisted (p 0.05). Conclusion The learning curve of minimally invasive suturing shows a shorter task time curve using robotic assistance compared to the laparoscopic curve. However, laparoscopic outcomes show good end results with rapid outcome improvement.
机译：背景 与传统的腹腔镜检查相比，机器人辅助手术有望在困难区域和微创缝合等要求苛刻的技术技能方面最具潜力。本研究旨在确定腹腔镜与机器人辅助缝合的学习曲线差异。方法 新手参与者在 EoSim 腹腔镜增强现实模拟器或 RobotiX 机器人辅助虚拟现实模拟器上执行了三项缝合任务。每个参与者执行一项体内缝合任务、一项倾斜平面针转移任务和一项吻合针转移任务。为了完成学习曲线，所有任务都重复了多达 20 次，或者直到达到时间平台。记录了有关时间、运动和安全性的临床相关和可比参数。采用体内缝合时间和累积总和分析比较学习曲线和阶段。结果 17 名受试者通过腹腔镜完成了学习曲线，30 名受试者接受了机器人辅助。腹腔镜的中位首次结缝合时间为 611 秒，机器人辅助的中位0.05）。结论 与腹腔镜曲线相比，微创缝合的学习曲线显示，使用机器人辅助的任务时间曲线更短。然而，腹腔镜结果显示出良好的最终结果，并能迅速改善结果。

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