CAJ | 학술논문

目的：对比可弯器械和直器械在三种不同难度单孔腹腔镜操作任务中的表现。方法招募了12位无操作经验者参与基于腹腔镜手术训练器的操作任务，分别在三种操作环境（传统入路和直器械，单孔入路和直器械，单孔入路和可弯器械）下完成转移、穿线和缝合任务。结果训练后，参与者的操作技能显著提高（ P ﹤0.001）。在单孔转移和穿线中，直器械完成任务所需时间显著少于可弯器械（P ﹤0.001）；在单孔缝合中，直器械比可弯器械稍具优势，差异不明显（P =0.920）。结论可弯器械比直器械更适合用在复杂单孔操作中，而简单单孔操作中直器械更具优势。可弯器械复杂的结构和控制方式是制约其在单孔技术应用的主要因素。
목적：대비가만기계화직기계재삼충불동난도단공복강경조작임무중적표현。방법초모료12위무조작경험자삼여기우복강경수술훈련기적조작임무，분별재삼충조작배경（전통입로화직기계，단공입로화직기계，단공입로화가만기계）하완성전이、천선화봉합임무。결과훈련후，삼여자적조작기능현저제고（ P ﹤0.001）。재단공전이화천선중，직기계완성임무소수시간현저소우가만기계（P ﹤0.001）；재단공봉합중，직기계비가만기계초구우세，차이불명현（P =0.920）。결론가만기계비직기계경괄합용재복잡단공조작중，이간단단공조작중직기계경구우세。가만기계복잡적결구화공제방식시제약기재단공기술응용적주요인소。
Objective The aim of this study is to compare the performance of three - level training tasks in single - incision laparoscopic operation(SILS)using either straight instrument or steerable instrument. Meth-ods Twelve participants without any experiences of laparoscopic skills were recruited to perform three - level train-ing tasks(basic level:peg transfer,medium level:threading,advanced level:suturing)in a surgical simulator with 3 different settings:laparoscopic(LAP)approach with straight instruments,SILS approach with straight in-struments and SILS approach with steerable instruments. Results Participants' laparoscopic skills were signifi-cantly enhanced(P ﹤ 0. 001)after the experiment. For peg transfer and threading in SILS,performance time u-sing straight instruments was significantly less than that using steerable instruments(P ﹤ 0. 001);while for sutu-ring in SILS,performance using straight instruments was slightly better than with that using steerable instruments (P = 0. 920). Conclusions Steerable instruments are more suitable for complex SILS operations while straight instruments are more suitable for basic SILS operations. Structure complexity and control method of steerable instru-ments are main limitations in impeding its application in SILS.