使用达芬奇Xi机器人进行机器人乳腺内动脉采集的低成本、高保真模拟模型的开发与验证。

Syed Faaz Ashraf, Laura Seese, Irsa S Hasan, Ashok N Babu, Husam H Balkhy, Bob B Kiaii, T Sloane Guy, David J Kaczorowski, Johannes Bonatti
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引用次数: 0

摘要

目的我们创建并验证了一种低成本的机器人乳内动脉(IMA)剥离模拟模型:方法:模拟模型利用小牛胎儿胸腔内部支架打开并固定在手术台上。模拟模型在为期两天的机器人心脏手术研讨会上进行了验证。每位参与者使用达芬奇Xi机器人(直觉外科,美国加利福尼亚州桑尼维尔市)摘除一个IMA。我们比较了参与者在使用模拟器前后自我报告的机器人 IMA 切除信心:结果:我们新颖的胸腔固定策略带来了稳定的结构,并允许从相同的 3 个端口进入两个 IMA。建立第一个模拟模型的费用为 176 美元,之后每个模型的费用为 133 美元。50 名参与者使用了该模拟模型:42 名心胸外科主治医师和 8 名研究员或住院医师。反馈表回复率为 78%(n = 39)。在李克特量表上,参与者对模拟机器人 IMA 切除的小腿模型的逼真度进行了评分(0 = 不逼真,10 = 非常逼真),中位数为 8 分(10 分满分)(四分位数间距 [IQR] 7 到 9)。使用模拟器前后,参与者对机器人 IMA 切除术的信心(0 = 完全没有信心,10 = 非常有信心)从中位数 5(IQR 1 到 7)增加到 9(IQR 7 到 10)(P = 0.001):该机器人 IMA 切除模拟模型经济实惠、逼真,提高了参与者对机器人 IMA 切除的信心。它可为学习机器人冠状动脉搭桥手术的外科医生提供有价值的培训工具,并允许通过基本学习曲线所需的培训频率。
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Development and Validation of a Low-Cost, High-Fidelity Simulation Model for Robotic Internal Mammary Artery Harvest Using the da Vinci Xi Robot.

Objective: We created and validated a low-cost simulation model for robotic internal mammary artery (IMA) takedown.

Methods: The simulation model utilized a calf fetus thorax cavity stented open internally and secured to a table. The simulation model was validated at a 2-day robotic cardiac surgery workshop. Each participant harvested one IMA using the da Vinci Xi robot (Intuitive Surgical, Sunnyvale, CA, USA). We compared participant self-reported confidence at robotic IMA harvest before and after using the simulator.

Results: Our novel thorax-securing strategy resulted in a stable structure and allowed access to both IMAs from the same 3 ports. The cost to set up the first simulation model was $176 and $133 for every subsequent model. Fifty participants used the simulation model: 42 cardiothoracic surgery attendings and 8 fellows or residents. The feedback form response rate was 78% (n = 39). On the Likert scale, participants rated realism of the calf model to simulate robotic IMA harvesting (0 = not realistic, 10 = highly realistic) with a median of 8 out of 10 (interquartile range [IQR] 7 to 9). Participant confidence (0 = not at all confident, 10 = very confident) in robotic IMA harvesting before and after using the simulator increased (P = 0.001) from a median of 5 (IQR 1 to 7) to 9 (IQR 7 to 10).

Conclusions: This robotic IMA harvest simulation model is affordable, realistic, and improved participant confidence in robotic IMA harvest. It may provide a valuable training tool for surgeons learning robotic coronary bypass surgery and allows for training frequency necessary to pass basic learning curves.

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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
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Minimally Invasive Video-Assisted Surgery for Concomitant Ascending Aorta and Aortic Valve Replacement via Right Infra-Axillary Thoracotomy. Results of Vertical Infra-Axillary Thoracotomy for Total Repair of Tetralogy of Fallot. The 10 Commandments for the Ross Procedure. Dealing With the Aortic Annulus: Surgical Aortic Annulus Enlargement With a Ballon Catheter. A Risk Prediction Model for Prolonged Length of Stay After Minimally Invasive Valve Surgery.
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