論文

査読有り 国際誌
2019年10月

Impact and Characteristics of Forceps Manipulation of Three-Dimensional in Laparoscopic Hepaticojejunostomy Mimicking a Disease-Specific Simulator: A Comparison of Expert with Trainee.

Journal of laparoendoscopic & advanced surgical techniques. Part A
  • Koji Yamada
  • ,
  • Masakazu Murakami
  • ,
  • Keisuke Yano
  • ,
  • Tokuro Baba
  • ,
  • Toshio Harumatsu
  • ,
  • Shun Onishi
  • ,
  • Waka Yamada
  • ,
  • Ryuta Masuya
  • ,
  • Seiro Machigashira
  • ,
  • Kazuhiko Nakame
  • ,
  • Motoi Mukai
  • ,
  • Tatsuru Kaji
  • ,
  • Satoshi Ieiri

29
10
開始ページ
1378
終了ページ
1382
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1089/lap.2019.0211

Purpose:
Various studies have shown the benefit of three-dimensional (3D) systems over two-dimensional (2D) systems in endoscopic surgery. However, few studies have focused on pediatric endosurgery. The purpose of this study was to assess the impact of 2D and 3D environments on the time taken and forceps manipulation by comparing experts and trainees using a laparoscopic hepaticojejunostomy simulator.
Methods:
We have developed a simulator of laparoscopic hepaticojejunostomy for congenital biliary dilatation. Seventeen participants of pediatric surgeons (4 experts and 13 trainees) performed hepaticojejunostomy using our simulator in both 2D and 3D environment. We evaluated the required time, total path length, and average velocities of bilateral forceps in both situations.
Results:
Obtained results show the findings for the required time (seconds; 2D, experts: 810.43 ± 321.64 vs. trainees: 1136.02 ± 409.96, P = .17) (seconds; 3D, experts: 660.21 ± 256.48 vs. trainees: 1017 ± 280.93, P = .039), total path length of right forceps (mm; 2D, experts: 38838.23 ± 30686.63 vs. trainees: 52005.47 ± 31675.02, P = .48)(mm; 3D, experts: 24443.09 ± 12316.32 vs. trainees: 45508.09 ± 26926.27, P = .16), total path length of left forceps (mm; 2D, experts: 131635.54 ± 71669.94 vs. trainees: 245242.48 ± 130940.25, P = .48)(mm; 3D, experts: 88520.42 ± 56766.63 vs. trainees: 230789.75 ± 107315.85, P = .024), average velocities of right forceps (mm/second; 2D, experts: 44.80 ± 21.85 vs. trainees: 44.37 ± 18.92, P = .97) (mm/second; 3D, experts: 37.28 ± 16.49 vs. trainees: 42.58 ± 14.40, P = .54), average velocities of left forceps (mm/second; 2D, experts: 156.65 ± 38.69 vs. trainees: 202.58 ± 63.80, P = .20) (mm/second; 3D, experts: 125.64 ± 44.30 vs. trainees: 219.42 ± 43.82, P < .01).
Conclusion:
The experts performed more effectively when using the 3D system. Using 3D, the total path length of the left forceps of expert pediatric surgeons was significantly shorter than trainee pediatric surgeons, and the average velocities of the left forceps tip of expert pediatric surgeons was significantly slower than trainee pediatric surgeons. These results suggest that training of assisting hand is necessary for advanced pediatric endosurgery to avoid organ injury.

リンク情報
DOI
https://doi.org/10.1089/lap.2019.0211
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31539299

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