Analyse verschiedener Trainingsprogramme am Da-Vinci-Skills-Simulator

Die moderne Medizin unterliegt einem ständigen Wandel. Um mit diesem mithalten zu können, ist es absolut notwendig, die Lehrpläne und -methoden der verschiedenen Fachdisziplinen ständig anzupassen und zu verändern. Roboterassistierte Chirurgie wurde erst vor kurzer Zeit als eine vollwertige Operat...

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Bibliographic Details
Main Author: Baumhaus, Marie Gesine
Contributors: Güldner, Christian (Prof. Dr.) (Thesis advisor)
Format: Doctoral Thesis
Published: Philipps-Universität Marburg 2019
Online Access:PDF Full Text
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Modern Medicine is in a constant process of change. In order to keep up with these changes it is necessary to update the teaching curricula and methods within all medical disciplines. Robotic assisted surgery has recently been added as a validated operating method to many surgical disciplines. The increasing number of surgeries conducted with robotic assistance presents surgeons and hospitals with the question on how to properly prepare for these kinds of operations, as they require different skills than surgeries without ro-botic assistance. This study aims to analyse three different training curricula for their outcome, in order to contribute to the establishment of a universal training curriculum. For training pur-poses the company Intuitive Surgical, which manufactures one of the commonly used robotic machines, the da Vinci Surgical System, has, in cooperation with Mimic Tech-nologies, produced the da Vinci Skills Simulator (DVSS). This simulator is combined with the console of the actual machine used for operating with this system but uses animated pictures. The simulator includes a variety of different exercises with different focuses. While working on each exercise the simulator collects data from the participant for different metrics. These metrics are presented to each participant after finishing each exercise. From these metrics an overall score is calculated. For this study the results of each parameter and the overall score are recorded. The parameters recorded are „Time To Complete Exercise“, „Economy Of Motion“, „Instrument Collisions“, „Excessive Instrument Force“, „Instruments Out Of View“, „Master Workspace Range“, „Drops“ as well for certain exercise only conducted by the first group „Needle Targeting“ and „Missed Targets“. For the final task called „Energy Dissection 2“ the simulator also collects data for „Misapplied Energy Time“ „Blood Loss Volume“ and „Broken Ves-sels“. For this study 60 people are recruited and divided into three groups with 20 people each. Each group completed has a different training program each includes three exer-cises with different levels of difficulty. Each training session involves performing each exercise three times. The second training session is terminated about one week after the first training session. At the end of the second training session each participant performs two final tasks. These tasks are the same for all participants and are only performed once. The results for all parameters and the overall result are documented and compared between the groups in order to discover a difference in outcome between the groups and their respective training-curricula. For all groups a significant skill gain within all parameters is recorded. Regarding the final exercises there is no significant difference between the groups to be recorded, which leaves the conclusion that, as training with the simulator may be an effective tool to gain skills within the field of robotic surgery the selection of exercises does not seem to be that relevant for better results.