外科医生在微创和开放手术中的疲劳:当前文献综述。

IF 0.8 Q4 UROLOGY & NEPHROLOGY Urologia Journal Pub Date : 2024-11-18 DOI:10.1177/03915603241300226
Marco Campetella, Mauro Ragonese, Carlo Gandi, Francesco Pio Bizzarri, Pierluigi Russo, Nazario Foschi, Riccardo Bientinesi, Emilio Sacco
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引用次数: 0

摘要

技术进步彻底改变了手术方法,腹腔镜手术和机器人手术与传统的开腹手术相比具有显著优势。这些优势包括减少术中失血、缩短住院时间、加快恢复速度以及改善美容效果。然而,腹腔镜手术的学习曲线仍然是一个挑战。达芬奇手术系统等机器人系统解决了腹腔镜手术的许多局限性,包括活动范围有限和震颤,并提供了卓越的人体工程学设计。尽管存在成本和触觉反馈方面的问题,但远程手术和增强现实等创新技术正在增强机器人手术的潜力。此外,与开放式手术相比,机器人手术通常失血更少、并发症更少、恢复更快。机器人手术对外科医生的体力要求也较低,可减少疲劳和肌肉骨骼劳损。不过,研究也显示,许多外科医生仍然会感到不适,尤其是颈部和肩部,这就强调了人体工程学培训和改进工作站设置的必要性。综述还探讨了手术前疲劳对手术表现的影响,指出疲劳会影响在手术模拟器上的表现,尤其是住院医生。尽管如此,研究表明,在一天内连续进行手术似乎不会对患者的预后产生不利影响。总之,人体工程学干预在腹腔镜手术和机器人手术中对提高外科医生的效率和健康至关重要,需要进一步研究来优化这些手术方法,并了解疲劳对手术表现和患者预后的长期影响。
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Surgeons' fatigue in minimally invasive and open surgery: A review of the current literature.

Technological advancements have revolutionized surgical methods, with laparoscopic and robotic surgeries offering significant benefits over traditional open procedures. These benefits include reduced intraoperative blood loss, shortened hospital stays, faster recovery, and improved cosmetic outcomes. However, the learning curve for laparoscopic surgery remains a challenge. Robotic systems, like the da Vinci Surgical System, address many limitations of laparoscopic surgery, including limited range of motion and tremors, and offer superior ergonomics. Despite concerns over cost and tactile feedback, innovations like telesurgery and augmented reality are enhancing robotic surgery's potential. Moreover, robotic surgery generally results in less blood loss, fewer complications, and quicker recovery compared to open surgery. Robotic surgery tends also to be less physically demanding for surgeons, reducing fatigue and musculoskeletal strain. However, research also reveals that many surgeons still experience discomfort, particularly in the neck and shoulders, emphasizing the need for ergonomic training and improved workstation setups. The review also explores the impact of pre-procedure fatigue on surgical performance, noting that fatigue can impair performance on surgical simulators, particularly among residents. Despite this, studies showed that performing consecutive surgeries in a single day does not appear to adversely affect patient outcomes. Overall, ergonomic interventions are crucial in both laparoscopic and robotic surgeries to enhance surgeon efficiency and well-being, and further research is needed to optimize these surgical methods and understand the long-term impacts of fatigue on performance and patient outcomes.

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来源期刊
Urologia Journal
Urologia Journal UROLOGY & NEPHROLOGY-
CiteScore
0.60
自引率
12.50%
发文量
66
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