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腹腔镜模拟训练效果的客观评价

Objective evaluation on training effects of basic laparoscopic surgical skills

作者: 张燕群  王殊轶  吕坤勇  叶莎莎  宋成利 
单位:上海理工大学医疗器械与食品学院(上海200093)
关键词: 双目视觉导航仪;眼动仪;腹腔镜手术技能;训练效果评价 
分类号:R318.6
出版年·卷·期(页码):2016·35·5(497-502)
摘要:

目的 目前国内尚无结合腹腔镜模拟训练者的手眼运动特征对其训练效果进行客观评价的研究。本文主要利用Micron Tracker双目视觉导航仪和眼动仪,通过分析训练者的手眼运动特征对腹腔镜模拟手术的训练效果进行评价。方法 利用Micron Tracker双目视觉导航仪采集并记录器械尖端运动的三维坐标,计算器械运动的总路径长度;利用眼动仪采集并记录训练者的操作时间和眼动信息,并计算出注视率、眼跳率和眼跳幅度,来评价腹腔镜手术训练效果。结果 随着操作次数的增加,训练者的熟悉程度增加。第30次训练操作与第1次训练操作相比较:操作时间减小了58.18%,呈现减小趋势,并趋于稳定;右手器械总路径长度减少了63.95%,左手器械总路径长度减少了56.28%,左手器械总路径长度小于右手器械总路径长度,且均呈减少趋势并趋于稳定;眼跳率减小了20.81%,呈现减小的趋势;眼跳幅度增大了28.39%,呈现增大趋势;而眼动注视率和注视持续时间平均值并没有显著性变化(P>0.05)。结论 基于手眼运动特征的参数(操作时间、左右手总路径长度、眼跳率和眼跳幅度等)可以作为腹腔镜手术技能培训效果的客观评价指标。


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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