达芬奇机器人手术系统模拟训练器在肝胆外科教学中的应用研究

目的 探讨达芬奇机器人手术系统模拟训练器在肝胆外科临床教学中的应用。方法 将来自重庆医科大学2019级临床医学专业的76名学生分为试验组和对照组。理论知识方面,两组采用相同的教学方法;实践操作方面,试验组采用达芬奇机器人手术系统模拟训练器（da Vinci robot surgical system simulation trainer,DVST）进行训练,对照组采用腹腔镜模拟训练器（laparoscopic simulation trainer,LST）进行训练。3个月后考核微创手术的两种基本技能：夹豆和缝合打结。采用SPSS 23.0进行独立样本t检验。结果 使用DVST考核,试验组拣豆（个/min）结果为（16.92±2.81）,对照组为（11.68±3.31）;试验组缝合打结（次/10 min）结果为（12.02±2.04）,对照组为（7.79±1.89）,试验组得分优于对照组（P<0.05）。使用LST考核时,试验组与对照组结果差异无统计学意义。问卷调查显示,试验组在提升对肝胆外科知识的学习兴趣、提升对肝胆外科手术系统的认识等5项问题的得分高于对照组（P<0.05）。结论 DVST运用于肝胆外科临床教学能显著提高学生微创手术技能,其仿真场景有助于激发学生自发进行训练的热情,有助于提高学生的临床思维能力。同时,在培养学生技能迁移能力方面,DVST明显优于LST。因此,DVST具有良好的教学应用价值,值得推广。

Application of da Vinci robot surgical system simulation trainer in hepatobiliary surgery teaching

Objective To explore the application of the da Vinci robot surgical system simulation trainer (DVST) in clinical teaching of hepatobiliary surgery.Methods Seventy-six students from the clinical medicine class of 2019 at Chongqing Medical University were divided into experimental group and control group. In terms of theoretical knowledge, the two groups adopted the same teaching methods. In terms of practical operation, the experimental group was trained using the DVST, while the control group was trained using the laparoscopic simulation trainer (LST). Three months later, two basic skills for minimally invasive surgery were assessed: bean clipping and knot tying. The SPSS 23.0 was used for the independent sample t-test.Results For assessment using DVST, the results of picking beans (grains/minute) were (16.92±2.81) in the experimental group and (11.68±3.31) in the control group; the results of suturing and knotting (times/10 minutes) were (12.02±2.04) in the experimental group and (7.79±1.89) in the control group, showing that the experimental group scored better than the control group (P<0.05). For assessment using LST, there was no significant difference in the results between the experimental group and the control group. The questionnaire survey showed that the experimental group scored higher than the control group in improving the interest in learning hepatobiliary surgery knowledge and the understanding of the hepatobiliary surgery system (P<0.05).Conclusions The application of DVST in clinical teaching of hepatobiliary surgery can significantly improve students'' minimally invasive surgical skills. Its simulation scenario helps to stimulate students'' enthusiasm for spontaneous training and improve their clinical thinking ability. Meanwhile, in terms of cultivating students'' skill transfer ability, DVST is significantly superior to LST. Therefore, DVST has good teaching application value and is worth promoting.