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腹腔鏡模擬訓(xùn)練效果的客觀評價

Objective evaluation on training effects of basic laparoscopic surgical skills

作者: 張燕群  王殊軼  呂坤勇  葉莎莎  宋成利 
單位:上海理工大學(xué)醫(yī)療器械與食品學(xué)院(上海200093)
關(guān)鍵詞: 雙目視覺導(dǎo)航儀;眼動儀;腹腔鏡手術(shù)技能;訓(xùn)練效果評價 
分類號:R318.6
出版年·卷·期(頁碼):2016·35·5(497-502)
摘要:

目的 目前國內(nèi)尚無結(jié)合腹腔鏡模擬訓(xùn)練者的手眼運(yùn)動特征對其訓(xùn)練效果進(jìn)行客觀評價的研究。本文主要利用Micron Tracker雙目視覺導(dǎo)航儀和眼動儀,通過分析訓(xùn)練者的手眼運(yùn)動特征對腹腔鏡模擬手術(shù)的訓(xùn)練效果進(jìn)行評價。方法 利用Micron Tracker雙目視覺導(dǎo)航儀采集并記錄器械尖端運(yùn)動的三維坐標(biāo),計算器械運(yùn)動的總路徑長度;利用眼動儀采集并記錄訓(xùn)練者的操作時間和眼動信息,并計算出注視率、眼跳率和眼跳幅度,來評價腹腔鏡手術(shù)訓(xùn)練效果。結(jié)果 隨著操作次數(shù)的增加,訓(xùn)練者的熟悉程度增加。第30次訓(xùn)練操作與第1次訓(xùn)練操作相比較:操作時間減小了58.18%,呈現(xiàn)減小趨勢,并趨于穩(wěn)定;右手器械總路徑長度減少了63.95%,左手器械總路徑長度減少了56.28%,左手器械總路徑長度小于右手器械總路徑長度,且均呈減少趨勢并趨于穩(wěn)定;眼跳率減小了20.81%,呈現(xiàn)減小的趨勢;眼跳幅度增大了28.39%,呈現(xiàn)增大趨勢;而眼動注視率和注視持續(xù)時間平均值并沒有顯著性變化(P>0.05)。結(jié)論 基于手眼運(yùn)動特征的參數(shù)(操作時間、左右手總路徑長度、眼跳率和眼跳幅度等)可以作為腹腔鏡手術(shù)技能培訓(xùn)效果的客觀評價指標(biāo)。


Objective At present, there is no objective evaluation on laparoscopic simulation training effect based on hand-eye motion characteristics. The objective of this study is to evaluate basic laparoscopic surgical skill training effect based on Micron Tracker binocular vision navigator and eye tracking system. Methods The tip motion path length of the laparoscopic instrument was calculated, according to the spatial coordinate collected by Micron Tracker binocular vision navigator. Eye motion parameters of trainers were recorded by eye tracking system. Complete time, fixation time, saccadic rate and saccadic amplitude parameters were computed based on eye motion to evaluate training effects. Results With the increase of trials, performance of the trainer was enhanced and become stable. Compared the last trail with the first one: the complete time decreased 58.18%, the right path length decreased 63.95%, the left path length decreased 56.28%, the left path length was always less than the right path length. Saccadic rate decreased 20.81% with the downtrend, saccadic amplitude increased 28.39% with the uptrend.There is no significant difference (P>0.05) in fixation rate and the mean fixation time. Conclusions Hand-eye motion parameters (complete time, instrument motion path length, saccadic rate and saccadic amplitude) can be used as objective indicators to evaluate training effect.

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