随着达芬奇机器人手术在外科领域的广泛应用，患者特殊的Trendelenburg 体位、术中的CO2 气腹和过长的手术时间，都给麻醉管理带来了巨大的挑战。在麻醉专业住院医生的规范化培训中，针对达芬奇机器人手术的术前评估、相关麻醉技术、术中管理和术后随访等教学内容，笔者采用了专项讲座、教学查房、可视化工具、现场带教和微信辅助等多模式教学方法，以提高规培医生的理论水平和临床技能。

With the wide application of Da Vinci robotic surgery in the surgical field, the patient’s special Trendelenburg position, intraoperative CO2 pneumoperitoneum and excessive operation time have brought great challenges to anesthesia management. In the standardized training of resident doctors in anesthesia, for the preoperative evaluation, related anesthesia techniques, intraoperative management and postoperative follow-up of Da Vinci robotic surgery, the author employed multi-mode teaching approaches, such as special lectures, teaching rounds, visualization tools, on-site teaching and WeChat, to improve the theoretical level and clinical skills of resident doctors.

收稿日期：2020-04-20 录用日期：2020-06-25

Received Date: 2020-04-20 Accepted Date: 2020-06-25

基金项目：海军军医大学教学研究与改革项目（JYC2015024）

Foundation Item: Teaching Research and Reform Project of Naval Medical University (JYC2015024)

通讯作者：王嘉锋，Email：jfwang@smmu.edu.cn

Corresponding Author: WANG Jiafeng, Email: jfwang@smmu. edu. cn

引用格式：刘佳，楼征，杨涛，等. 多模式教学在机器人手术麻醉教学中的应用[J]. 机器人外科学杂志，2020，1（5）：364-368.

Citation: LIU J, LOU Z, YANG T, et al. Application of multi-mode teaching on anesthesia training in robotic surgery [J]. Chinese Journal of Robotic Surgery, 2020, 1(5):364-368.

[1] Hockstein N G, Gourin C G, Faust R A, et al. A history of robots: from science fiction to surgical robotics[J]. J Robotic Surg, 2007, 1(2): 113-118. 

[2] Fabio S, Caterina F, Alessio M, et al. Robotic rectal surgery: State of the art[J]. World J Gastrointest Oncol, 2016, 8(11): 757-771. 

[3] Eddib A, Hughes S, Aalto M, et al. Impact of age on surgical outcomes after robot assisted laparoscopic hysterictomies[J]. Surg Sci, 2014, 5(3): 90-96. 

[4] 丁玲玲, 张宏, 米卫东, 等. 机器人辅助前列腺癌根治术中气腹及Trendelenburg 体位对老年患者脑血液回流的影响[J]. 南方医科大学学报, 2015, 35(5): 712-715. 

[5] 孟岩, 王嘉锋, 薄禄龙, 等. 可视化教学手段在非麻醉专业气管插管临床见习课中的应用[J]. 卫生职业教育, 2019, 37(4): 119-120. 

[6] Baltayian S. A brief review: anesthesia for robotic prostatectomy[J]. J Robot Surg, 2008, 2(2): 59-66. 

[7] Homorodea C, Olinic M, Olinic D, et al. Development of a methodology for structured reporting of information in echocardiography[J]. Med Ultrason, 2012, 14(1): 29-33. 

[8] Xu D, Abbas S, Chan V, et al. Ultrasound phantom for hands-on practice[J]. Reg Anesth Pain Med, 2005, 30(6): 593-594. 

[9] Chin J H, Seo H, Lee E H, et al. Sonographic optic nerve sheath diameter as a surrogate measure for intracranial pressure in anesthetized patients in the Trendelenburg position[J]. BMC Anesthesiol, 2015. DOI: 10. 1186/ s12871-015-0025-9. 

[10] Lee J R. Anesthetic considerations for robotic surgery[J]. Korean J Anesthesiol, 2014, 66(1): 3-11. 

[11] Awad H, Santilli S, Ohr M, et al. The effects of steep Trendelenburg positioning on intraocular pressure during robotic radical prostatectomy[J]. Anesth Analg, 2009, 109(2): 473-478. 

[12] Gainsburg D M, Wax D, Reich D L, et al. Intraoperative management of robotic-assisted versus open radical prostatectomy[J]. JSLS, 2010, 14(1): 1-5. 

[13] Yoo Y C, Kim N Y, Shin S, et al. The Intraocular Pressure under Deep versus Moderate Neuromuscular B lockade during Low-Pressure Robot Assisted Laparoscopic Radical Prostatectomy in a Randomized Trial[J]. PLOS One, 2015, 10(8): e0135412. 

[14] Kaye A D, Vadivelu N, Ahuja N, et al. Anesthetic considerations in robotic-assisted gynecologic surgery[J]. Ochsner J, 2013, 13(4): 517-524. 

[15] 丁玲玲, 张宏, 米卫东, 等. 机器人辅助根治性膀胱切除+ 原位新膀胱手术的麻醉管理[J]. 北京大学学报, 2013, 45(5): 819-822. 

[16] Fant F, Axelsson K, Sandblom D, et al. Thoracic epidural analgesia or patient-controlled local analgesia for radical retropubic prostatectomy: a randomized, double-blind study[J]. Br J Anaesth, 2011, 107(5): 782-789.