3D影像可以改善新手和有经验的术者应用达芬奇机器人系统的外科操作

Methods:
Four tasks were performed by 12 surgeons with varying experience. Performance times anderrors were recorded using both 2dimensional and 3-dimensional vision for each task.
Results:
Performance time and error rates for all 4 skills confirm a significant advantage using 3-dimensional vision. Performance times were reduced by 34% to 46% using 3dimensional imaging for all participants with statistical significance. Error rates were reduced by 44% and 66%.
Skill 1: bead transfer and drop
In this drill, beads were transferred from 1 cylinder to another. Two opaque plastic cylinders measuring 1.75 cm in diameter and 1.2 cm in height were securely fashioned on a platform 5 cm apart. The platform was positioned at a 15°angle from the horizon facing the camera at an oblique angle. The long-tip forceps was used for the right-hand instrument and the cadiere forceps for the left-hand instrument. Ten beads were placed at the bottom of 1 plastic cylinder. The participants were required to grasp the bead in the cylinder and bring the bead to the middle of the cylinders. The bead was then transferred from 1 instrument to the other and dropped into the second cylinder. The starting position was both instruments touching at a mark in the center of the 2 cylinders. The end position was defined as the drop of the fifth bead into the second cylinder. The skill was performed from right to left and then from left to right.Errors were recorded and included any dropped beads or beads that were ejected from the cylinders.
Conclusion:
Independent of the biomechanical advantages of the da Vinci Robot System, 3-dimensional vision allows for significant improvement in performance times a inexperienced residents and advanced laparoscopic surgeons.
Materials and Methods
Six resident and 6 attending surgeons, after attending a half-day, on-site da Vinci system training program (Intuitive Surgical), were invited to perform 4 exercises. All standardized skills were performed by using the da Vinci Robot System. The robot system consists of a surgeon console, patient side cart including 2 robotic arms and 1 endoscope arm, and image-processing equipment. A detailed description of the system is described in the literature[5]. The robot system scale was set at fine on the surgeon console. The participant was seated for all skills at the surgeon console. The camera was positioned 35° to the horizon and 9 to 10 cm from the objects for all skills. Both the 3-dimensional and 2-dimensional skills were performed by using the da Vinci system and console.
Three-dimensional imaging improves surgical performance for both novice and experienced operators using the da Vinci Robot System
王希龙
Background:
This study was designed to evaluate the impact of 3-dimensional vision on the performance of resident and experienced surgeons using the da Vinci Robot System (Intuitive Surgical, Sunnyvale, CA).
Skill 3: threading
In this drill, the platform was designed with 4 eyes fixedto dowels 3 cm apart and positioned at 45°to the participant. A 4.0 braided suture was cut to 17.5 cm length. The right hand held a large needle driver, whereas the left held a cadiere forceps. The starting position was defined as holding the suture in the right instrument at the most anterior eye. The suture was passed to the left instrument for positioning, grasped by the needle holder, and then positioned for suturing through the eyes. The needle was passed through the eyes starting at the eye most distant from the participant. The needle was passed through the eye and then grasped by the left instrument. The end time was defined as grasping with the left instrument and pulling through the needle through the eye.
Each participant was instructed concerning the specific skills to be performed, including start and end positions.The participants were given adequate time to practice the skills 2 to 3 times under 2-dimensional vision before starting the data collection. Questions concerning the specific skills were answered before, during, and after the practice tasks, but no assistance was given for manipulation of the instruments. The identical sequence of skills was performed by all participants under the identical conditions. In the first 2 skills, the performance of the dominant and nondominant hand was assessed. The third skill was performed primarily with the right hand, and for the fourth skill the participant was allowed to perform the task with either instrument. Each skill was performed 3 times with half of the participants using 2-dimensional vision first followed by 3-dimensional vision and the other half starting with 3-dimensional vision followed by 2 dimensional vision to