CAJ | 학술논문

目的探讨腹腔镜虚拟模拟机在腹腔镜技能培训中的有效性. 方法 2012年2月至10月选取30名医学生和22名泌尿外科医生(独立完成腹腔镜手术例数＜10例)参加腹腔镜技能培训,在腹腔镜虚拟模拟机上进行移物、电灼、剪切和缝合操作,培训时间为5d,每天2h.问卷调查比较培训前后腹腔镜虚拟模拟机客观评分和综合评估量表(GRS)评分结果. 结果 30名医学生培训后与培训前比较,移物时间分别为(110.3±25.6)、(198.7±52.3)s,电灼时间分别为(233.2±39.7)、(484.6± 157.6)s,剪切时间分别为(118.6±35.1)、(272.3±75.6)s,精度误差面积分别为(58.0±34.8)、(92.4±56.1)mm2,缝合时间分别为(80.2±38.3)、(280.6± 110.1)s,电灼效率分别为(90.4±5.0)％、(83.5±6.4)％,缝合准确率分别为(92.5±16.3)％、(68.5±24.2)％,GRS分别为(20.0±1.1)、(7.5±1.2)分,差异均有统计学意义(P＜0.05).22名泌尿外科医生培训后与培训前比较,移物时间分别为(103.1士16.7)、(171.4±42.6)s,电灼时间分别为(210.3±17.4)、(397.0士129.8)s,剪切时间分别为(97.1±9.6)、(311.6± 171.6)s,精度误差面积分别为(7.2±3.6)、(30.1± 18.8) mm2,缝合时间分别为(84.5±29.3)、(328.1± 128.8)s,电灼效率分别为(91.7±7.3)％、(81.4±9.1)％,缝合准确率分别为(96.0±7.2)％、(69.9±22.2)％,GRS分别为(25.2±1.9)、(13.8±1.5)分,差异均有统计学意义(P＜0.05).调查问卷结果显示25名(83.4％)医学生认为腹腔镜虚拟模拟培训对临床实习帮助明显或非常有帮助,16名(72.7％)泌尿外科医生认为模拟培训对提高腹腔镜操作能力帮助明显或非常有帮助. 结论通过腹腔镜虚拟模拟机进行培训可提高腹腔镜基本操作技能,有可能成为一种有效的腹腔镜技能培训方法.
목적 탐토복강경허의모의궤재복강경기능배훈중적유효성. 방법 2012년2월지10월선취30명의학생화22명비뇨외과의생(독립완성복강경수술례수＜10례)삼가복강경기능배훈,재복강경허의모의궤상진행이물、전작、전절화봉합조작,배훈시간위5d,매천2h.문권조사비교배훈전후복강경허의모의궤객관평분화종합평고량표(GRS)평분결과. 결과 30명의학생배훈후여배훈전비교,이물시간분별위(110.3±25.6)、(198.7±52.3)s,전작시간분별위(233.2±39.7)、(484.6± 157.6)s,전절시간분별위(118.6±35.1)、(272.3±75.6)s,정도오차면적분별위(58.0±34.8)、(92.4±56.1)mm2,봉합시간분별위(80.2±38.3)、(280.6± 110.1)s,전작효솔분별위(90.4±5.0)％、(83.5±6.4)％,봉합준학솔분별위(92.5±16.3)％、(68.5±24.2)％,GRS분별위(20.0±1.1)、(7.5±1.2)분,차이균유통계학의의(P＜0.05).22명비뇨외과의생배훈후여배훈전비교,이물시간분별위(103.1사16.7)、(171.4±42.6)s,전작시간분별위(210.3±17.4)、(397.0사129.8)s,전절시간분별위(97.1±9.6)、(311.6± 171.6)s,정도오차면적분별위(7.2±3.6)、(30.1± 18.8) mm2,봉합시간분별위(84.5±29.3)、(328.1± 128.8)s,전작효솔분별위(91.7±7.3)％、(81.4±9.1)％,봉합준학솔분별위(96.0±7.2)％、(69.9±22.2)％,GRS분별위(25.2±1.9)、(13.8±1.5)분,차이균유통계학의의(P＜0.05).조사문권결과현시25명(83.4％)의학생인위복강경허의모의배훈대림상실습방조명현혹비상유방조,16명(72.7％)비뇨외과의생인위모의배훈대제고복강경조작능력방조명현혹비상유방조. 결론 통과복강경허의모의궤진행배훈가제고복강경기본조작기능,유가능성위일충유효적복강경기능배훈방법.
Objective To evaluate the validity of laparoscopic basic skills training on the virtual reality simulator.Methods 30 medical students and 22 urology doctors (less than 10 procedures performed) were enrolled for laparoscopic visual reality training from February 2012 to October 2012.Each participant was tested in 5 days by laparoscopic tasks (peg transfer,electrocautery,patten cutting and knot tying) of virtual reality simulator.The scores before and after the training were recorded and analyzed.Participants filled out questionnaires regarding their previous experiences,opinions of the usefulness of laparoscopic visual reality training before and after the training.Results 30 medical students after the training and training before,the time consumption in peg transfer (110.3-±25.6 s and 198.7±52.3 s,P=0.000),electrocautery (233.2±39.7 s and 484.6±157.6 s,P=0.000),patten cutting(118.6±35.1 s and 272.3±75.6,P=0.000),knot tying (80.2±38.3 s and 280.6±110.1 s,P=0.000) and area of accuracy error (58.0±34.8mm2 and 92.4±56.1mm2,P=0.000),while improved electrocautery efficiency (90.4±5.0) ％ and (83.5±6.4％,P =0.000,suturing accuracy rate (92.5 ± 16.3) ％ and (68.5 ± 24.2) ％,P =0.000 and GRS scores (25.2± 1.9 & 7.5± 1.2,P =0.000) after 5-day training.22 urology doctors after the training and training before,the time consumption in peg transfer (103.1 ± 16.7 s and 171.4± 42.6 s,P =0.004),electrocautery (210.3±17.4 s and 397.0±129.8 s,P=0.027),patten cutting (97.1±9.6 s and 311.6±171.6 s,P=0.000),knot tying (84.5±29.3 s and 328.1±128.8 s,P=0.002) and area of accuracy error (7.2±3.6 mm2 and 30.1 ± 18.8 mm2,P =0.009),while improved electrocautery efficiency (91.7 ± 7.3) ％ and (81.4 ±9.1) ％,P =0.004,suturing accuracy rate (96.0± 7.2) ％ and (69.9± 22.2) ％,P =0.006 and GRS scores (20.0± 1.1 and 13.8± 1.5,P =0.000) after 5-day training.At the end of training,most of the participants rated laparoscopic virtual reality training as " obviously helpful" or " very helpful".Conclusions Laparoscopic virtual reality training could be helpful to improve the laparoscopic basic skills.