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  • 张超△,花梅免△,王富博,过菲,王辉清,彭广,徐梦璐,宋丽,杨波*,盛夏,许传亮,孙颖浩.虚拟现实培训在机器人辅助腹腔镜前列腺癌根治术膀胱尿道吻合中的应用[J].第二军医大学学报,2018,39(12):1381-1384    [点击复制]
  • ZHANG Chao△,HUA Mei-mian△,WANG Fu-bo,GUO Fei,WANG Hui-qing,PENG Guang,XU Meng-lu,SONG Li,YANG Bo*,SHENG Xia,XU Chuan-liang,SUN Ying-hao.Application of virtual reality training in urethrovesical anastomosis of robot-assisted laparoscopic radical prostatectomy[J].Acad J Sec Mil Med Univ,2018,39(12):1381-1384   [点击复制]
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虚拟现实培训在机器人辅助腹腔镜前列腺癌根治术膀胱尿道吻合中的应用
张超△,花梅免△,王富博,过菲,王辉清,彭广,徐梦璐,宋丽,杨波*,盛夏,许传亮,孙颖浩
0
(海军军医大学(第二军医大学)长海医院泌尿外科, 上海 200433
共同第一作者
*通信作者)
摘要:
目的 探讨虚拟现实培训在机器人辅助腹腔镜前列腺癌根治术膀胱尿道吻合中的应用价值。方法 采用机器人模拟培训系统,对3名受训医师进行基础操作训练的吻合模拟训练,评价培训前后总体评分、吻合时间、运动距离、器械碰撞次数、器械离开视野次数和脱离目标次数等关键指标的变化。随后3名受训医师利用机器人系统对9例患者施行机器人辅助腹腔镜前列腺癌根治术中的膀胱尿道吻合,评价吻合的可靠性。结果 训练后3名受训医师总体评分由训练前的(65.0±10.8)分提高至(92.7±3.5)分,平均吻合时间由(279.0±48.0)s缩短至(119.3±12.5)s,运动距离由(459.0±59.2)cm缩短至(239.3±33.9)cm,差异均有统计学意义(P均<0.05);器械离开视野次数和脱离目标次数在训练前后无明显变化。3名受训医师均顺利完成9例患者机器人辅助腹腔镜前列腺癌根治术中的膀胱尿道吻合,平均吻合时间为(23.4±8.6)min。患者术后引流液肌酐水平未见明显升高,未见漏尿。术后第7天膀胱造影均未见造影剂外漏,术后第8天顺利拔除导尿管。结论 对泌尿外科医师进行机器人模拟系统培训可使医师迅速熟悉操作,提高术中膀胱尿道吻合的操作水平,从而高效、高质量地完成手术。
关键词:  机器人手术  前列腺肿瘤  根治性前列腺切除术  虚拟现实  培训
DOI:10.16781/j.0258-879x.2018.12.1381
投稿时间:2018-04-29修订日期:2018-06-11
基金项目:上海市自然科学基金面上项目(18ZR1438400),上海市卫生和计划生育委员会科研项目(20174Y0019).
Application of virtual reality training in urethrovesical anastomosis of robot-assisted laparoscopic radical prostatectomy
ZHANG Chao△,HUA Mei-mian△,WANG Fu-bo,GUO Fei,WANG Hui-qing,PENG Guang,XU Meng-lu,SONG Li,YANG Bo*,SHENG Xia,XU Chuan-liang,SUN Ying-hao
(Department of Urology, Changhai Hospital, Navy Medical University(Second Military Medical University), Shanghai 200433, China
Co-first authors.
* Corresponding author)
Abstract:
Objective To explore the application value of virtual reality training in urethrovesical anastomosis of robot-assisted laparoscopic radical prostatectomy. Methods Using robot simulated training system, 3 surgeons were trained by anastomotic simulation training for basic operation. The key parameters, including overall score, time to complete anastomosis, robot movement distance, instrument collision times, times of instrument out of sight and missed target times, were compared before and after training. The 3 surgeons carried out urethrovesical anastomosis in robot-assisted laparoscopic radical prostatectomy for 9 patients using robot-assisted system. The quality of anastomosis was evaluated. Results After training, the overall score of 3 surgeons was increased from 65.0±10.8 before training to 92.7±3.5, time to complete anastomosis was shortened from (279.0±48.0) s to (119.3±12.5) s, and robot movement distance was increased from (459.0±59.2) cm to (239.3±33.9) cm; and the differences were significant (all P<0.05). There were no significant changes in the times of instrument out of sight or missed target before and after training. The urethrovesical anastomosis of 9 patients were successfully performed by the 3 surgeons during robot-assisted laparoscopic radical prostatectomy, with the average anastomosis time being (23.4±8.6) min. No increased creatinine level was found in drainage fluid of the patients and no leakage of urine occurred. No leakage of contrast agents was found in cystography on the 7th day after operation, and the catheter was removed on the 8th day after operation. Conclusion Virtual reality training using robot simulated system can help urologists to get familiar with the robotic system quickly. It can improve the urethrovesical anastomosis during operation with high efficiency and quality.
Key words:  robotic surgery  prostatic neoplasms  radical prostatectomy  virtual reality  training