中国的机器人外科学杂志 | ISSN 2096-7721 | CN 10-1650/R

腔镜手术机器人操作培训中国专家共识(2024 版)

Chinese expert consensus on endoscopic robot-assisted surgical operation training (2024)

作者:何达,张培茗,顾一纯,张天逸,张明伟,汪茹,邢倩,罗雅双,符雨嫣,亓文博,程云章,金春林

Vol. 5 No. 5 Oct. 2024 DOI: 10.12180/j.issn.2096-7721.2024.05.042 发布日期:2024-11-28
关键词:腔镜手术机器人;培训基地;操作培训;考核流程;专家共识

作者简介:

腔镜手术机器人通过控制台对机械臂的精准操控实现复杂手术操作,可以扩展外科医生的手术能力, 近年来在我国发展迅速。腔镜手术机器人技术复杂,开展标准化的腔镜手术机器人操作培训是临床应用的基础。本 共识汇集相关领域专家意见,并结合我国腔镜手术机器人操作培训的实际情况和前期实践,其内容涵盖培训基地管 理、培训过程、培训考核、质量管理等方面,旨在推进我国腔镜手术机器人操作培训标准建设。

Endoscopic surgical robots can achieve complex surgical operations through the precise control of robotic arms by the surgeon’s console, which can expand surgeon’s surgical capabilities. Standardized operation training of endoscopic surgical robot is the basis for clinical application. By bringing together the opinions of experts in related fields, combining the actual situation and previous practice of laparoscopic surgical robot operation training in China, this consensus was finally finished. Its covers training base management, training process, training assessment, quality management and other aspects, aiming to promote the construction of endoscopic surgical robot operation training standards in China.

稿件信息

收稿日期:2024-07-19  录用日期:2024-08-26 

Received Date: 2024-07-19  Accepted Date: 2024-08-26 

基金项目:国家卫生健康委医院管理研究所《公立医院精细化管理与评价研究项目》面上项目(NIHA23JXH014);上海市医院 协会医院管理研究基金(X2023049) 

Foundation Item: General Program to Public Hospital Fine Management and Evaluation Research Project of Hospital Management Research Institute of National Health Commission (NIHA23JXH014); Hospital Management Research Fund of Shanghai Hospital Association(X2023049) 

通讯作者:金春林,Email:jinchunlin@shdrc.org 

Corresponding Author: JIN Chunlin, Email: jinchunlin@shdrc.org 

引用格式:何达,张培茗,顾一纯,等 . 腔镜手术机器人操作培训中国专家共识(2024 版)[J]. 机器人外科学杂志(中英文), 2024,5(5):1001-1007. 

Citation: HE D, ZHANG P M, GU Y C, et al. Chinese expert consensus on endoscopic robot-assisted surgical operation training (2024)[J]. Chinese Journal of Robotic Surgery, 2024, 5(5): 1001-1007.

参考文献

[1] Namdarian B, Dasgupta P. What robot for tomorrow and what improvement can we expect?[J]. Curr Opin Urol, 2018, 28(2): 143-152. 

[2] Boškoski I, Costamagna G. Endoscopy robotics: current and future applications[J]. Dig Endosc, 2019, 31(2): 119-124. 

[3] Kaan H L, Ho K Y. Robot-assisted endoscopic resection: current status and future directions[J]. Gut Liver, 2020, 14(2): 150-152. 

[4] Adhikari K, Penmetsa G K, Krishnappa D, et al. Revolutionizing urology: the advancements and applications of robotic platforms[J]. J Robot Surg, 2024, 18(1): 106. 

[5] 付宜利 , 潘博 . 微创外科手术机器人技术研究进展 [J]. 哈尔滨 工业大学学报 , 2019, 51(1): 1-15. 

[6] Szold A, Bergamaschi R, Broeders I, et al. European Association of Endoscopic Surgeons (EAES) consensus statement on the use of robotics in general surgery[J]. Surg Endosc, 2015, 29(2): 253-288. 

[7] Gordon Z N, Angell J, Abaza R. Completely intracorporeal robotic renal autotransplantation[J]. J Urol, 2014, 192(5): 1516-1522. 

[8] Breda A, Gausa L, Territo A, et al. Robotic-assisted kidney transplantation: our first case[J]. World J Urol, 2016, 34(3): 443-447. 

[9] Clavijo R, Carmona O, de Andrade R, et al. Robot-assisted intrafascial simple prostatectomy: novel technique[J]. J Endourol, 2013, 27(3): 328-332. 

[10] Hu J C, Gandaglia G, Karakiewicz P I, et al. Comparative effectiveness of robot-assisted versus open radical prostatectomy cancer control[J]. Eur Urol, 2014, 66(4): 666-672. 

[11] Moon A S, Garofalo J, Koirala P, et al. Robotic surgery in gynecology[J]. Surg Clin N Am, 2020, 100(2): 445-460. 

[12] de Paula Andres M, Borrelli G M, Abrão M S. Advances on minimally invasive approach for benign total hysterectomy: a systematic review[J]. F1000Research, 2017. DOI: 10.12688/ f1000research.11523.1. 

[13] Gupta N, Miranda Blevins D O, Holcombe J. A comparison of surgical outcomes between single-site robotic, multiport robotic and conventional laparoscopic techniques in performing hysterectomy for benign indications[J]. Gynecol Minim Invasive Ther, 2020, 9(2): 59-63. 

[14] Melfi F M, Menconi G F, Mariani A M, et al. Early experience with robotic technology for thoracoscopic surgery[J]. Eur J Cardiothorac Surg, 2002, 21(5): 864-868. 

[15] LIANG H R, LIANG W H, ZHAO L, et al. Robotic versus videoassisted lobectomy/segmentectomy for lung cancer: a metaanalysis[J]. Ann Surg, 2018, 268(2): 254-259. 

[16] JIN R S, ZHENG Y Y, YUAN Y, et al. Robotic-assisted versus videoassisted thoracoscopic lobectomy: short-term results of a randomized clinical trial (RVlob Trial)[J]. Ann Surg, 2022, 275(2): 295-302. 

[17] Guerra F, Pesi B, Amore Bonapasta S, et al. Does robotics improve minimally invasive rectal surgery? Functional and oncological implications[J]. J Dig Dis, 2016, 17(2): 88-94. 

[18] Kim H I, Han S U, Yang H K, et al. Multicenter prospective comparative study of robotic versus laparoscopic gastrectomy for gastric adenocarcinoma[J]. Ann Surg, 2016, 263(1): 103-109. 

[19] Shiomi A, Kinugasa Y, Yamaguchi T, et al. Robot-assisted rectal cancer surgery: short-term outcomes for 113 consecutive patients[J]. Int J Colorectal Dis, 2014, 29(9): 1105-1111. 

[20] 闫志远 , 梁云雷 , 杜志江 . 腹腔镜手术机器人技术发展综述 [J]. 机器人技术与应用 , 2020(2): 24-29. 

[21] MEI H, TANG S T. Robotic-assisted surgery in the pediatric surgeons’ world: current situation and future prospectives[J]. Front Pediatr, 2023. DOI: 10.3389/fped.2023.1120831. 

[22] 汤绍涛 . 机器人手术在小儿外科中的发展现状及展望 [J]. 机器 人外科学杂志 ( 中英文 ), 2021, 2(4): 241-247. 

[23] Peters B S, Armijo P R, Krause C, et al. Review of emerging surgical robotic technology[J]. Surg Endosc, 2018, 32(4): 1636-1655. 

[24] Gosrisirikul C, Don Chang K, Raheem A A, et al. New era of robotic surgical systems[J]. Asian J Endosc Surg, 2018, 11(4): 291-299. 

[25] Kurniawan N, Keuchel M. Flexible gastro-intestinal endoscopyclinical challenges and technical achievements[J]. Comput Struct Biotechnol J, 2017. DOI: 10.1016/j.csbj.2017.01.004. 

[26] Tsui C, Klein R, Garabrant M. Minimally invasive surgery: national trends in adoption and future directions for hospital strategy[J]. Surg Endosc, 2013, 27(7): 2253-2257. 

[27] Gomes P. Surgical robotics: reviewing the past, analysing the present, imagining the future[J]. Robotics and Computer-Integrated Manufacturing, 2011, 27(2): 261-266. 

[28] 贾卓敏 , 马鑫 , 艾星 , 等 . 达芬奇机器人手术系统在泌尿外科手 术中的优势 [J]. 现代泌尿外科杂志 , 2018, 23(5): 328-331. 

[29] 张旭 , 高江平 , 符伟军 , 等 . 机器人辅助腹腔镜在泌尿外科手 术中的临床应用 ( 附 500 例报告 )[J]. 微创泌尿外科杂志 , 2014, 3(1): 4-7. 

[30] Sridhar A N, Briggs T P, Kelly J D, et al. Training in robotic surgeryan overview[J]. Curr Urol Rep, 2017, 18(8): 58. 

[31] Bonatti J, Wallner S, Winkler B, et al. Robotic totally endoscopic coronary artery bypass grafting: current status and future prospects[J]. Expert Rev Med Devices, 2020, 17(1): 33-40. 

[32] Foote J R, Valea F A. Robotic surgical training: where are we?[J]. Gynecol Oncol, 2016, 143(1): 179-183. 

[33] Palagonia E, Mazzone E, Naeyer G, et al. The safety of urologic robotic surgery depends on the skills of the surgeon[J]. World J Urol, 2020, 38(6): 1373-1383. 

[34] Vickers A, Savage C, Bianco F, et al. Cancer control and functional outcomes after radical prostatectomy as markers of surgical quality: analysis of heterogeneity between surgeons at a single cancer center[J]. Eur Urol, 59(3): 317-322. 

[35] Thompson J E, Egger S, Böhm M, et al. Superior biochemical recurrence and long-term quality-of-life outcomes are achievable with robotic radical prostatectomy after a long learning curve updated analysis of a prospective single-surgeon cohort of 2206 consecutive cases[J]. Eur Urol, 73(5): 664-671. 

[36] Collins J W, Tyritzis S, Nyberg T, et al. Robot-assisted radical cystectomy (RARC) with intracorporeal neobladder-what is the effect of the learning curve on outcomes?[J]. BJU Int, 113(1): 100-10715. 

[37] Larcher A, Muttin F, Peyronnet B, et al. The learning curve for robotassisted partial nephrectomy: impact of surgical experience on perioperative outcomes[J]. Eur Urol, 2019, 75(2): 253-256. 

[38] Suh I, Mukherjee M, Oleynikov D, et al. Training program for fundamental surgical skill in robotic laparoscopic surgery[J]. Int J Med Robot, 2011, 7(3): 327-333. 

[39] Dulan G, Rege R V, Hogg D C, et al. Content and face validity of a comprehensive robotic skills training program for general surgery, urology, and gynecology[J]. Am J Surg, 2012, 203(4): 535-539. 

[40] Tausch T J, Kowalewski T M, White L W, et al. Content and construct validation of a robotic surgery curriculum using an electromagnetic instrument tracker[J]. J Uro, 2012, 188(3): 919-923. 

[41] 陈紫嫣 , 文志勇 , 杨琨等 . 手术机器人培训标准化过程中的关 键问题分析及应对 [J]. 武汉大学学报 ( 医学版 ), 2024, 45(02): 165-168. 

[42] Zorn K C, Gautam G, Shalhav A L, et al. Training, credentialing, proctoring and medicolegal risks of robotic urological surgery: recommendations of the society of urologic robotic surgeons[J]. J Urol, 2009, 182(3): 1126-1132. 

[43] Santok G D, Raheem A A, Kim L H, et al. Proctorship and mentoring: its backbone and application in robotic surgery[J]. Investig Clin Urol, 2016, 57(Suppl 2): S114-S120. 

[44] Smith R, Patel V, Satava R. Fundamentals of robotic surgery: a course of basic robotic surgery skills based upon a 14-society consensus template of outcomes measures and curriculum development[J]. Int J Med Robot, 2014, 10(3): 379-384. 

[45] 机器人手术系统辅助实施心脏手术技术及培训管理规范 [Z]. 中 国人民解放军总医院 , 2015. 

[46] 叶明侠 , 李震 , 俞凌 , 等 . 机器人手术技能教学在妇科微创手 术培训中的应用 [J]. 机器人外科学杂志 ( 中英文 ), 2021, 2(5): 396-401. 

[47] 王小芹 , 杨琨 , 黎勤 , 等 . 手术机器人规范化培训系统的构建 [J]. 医学新知杂志 , 2019, 29(3): 337-340. 

[48] Rusch P, Kimmig R, Lecuru F, et al. The Society of European Robotic Gynaecological Surgery (SERGS) pilot curriculum for robot assisted gynecological surgery[J]. Arch Gynecol Obstet, 2018, 297(2): 415-420. 

[49] 杨溯 , 郭威 , 吴晗 , 等 . 胸外科医生机器人手术培训模式 : 瑞金 医院单中心研究 [J]. 中国胸心血管外科临床杂志 , 2020, 27(8): 918-921. 

[50] 国家卫生健康委办公厅关于印发国家限制类技术目录和临床应 用管理规范 (2022 年版 ) 的通知 [J]. 中华人民共和国国家卫生 健康委员会公报 , 2022, (4): 10. 

[51] Schreuder H W, Wolswijk R, Zweemer R P, et al. Training and learning robotic surgery, time for a more structured approach: a systematic review[J]. BJOG, 2012, 119(2): 137-149. 

[52] Burke J R, Fleming C A, King M, et al. Utilising an accelerated Delphi process to develop consensus on the requirement and components of a pre-procedural core robotic surgery curriculum[J]. J Robot Surg, 2023, 17(4): 1443-1455.

本期文章
[1] 华东地区首例经口入路腔镜甲状腺癌根治术中吲哚菁绿荧光甲状旁腺血管造影术(附手术视频) [2] 腔镜手术机器人操作培训中国专家共识(2024 版) [3] 达芬奇手术机器人在肺癌治疗中的应用进展(附手术视频) [4] 5G 通信技术在机器人手术中的应用 [5] 基于奥马哈系统的管理方案联合排尿功能训练对机器人辅助原位新膀胱术后患者的影响 [6] 精准化护理在泌尿外科机器人辅助手术中的应用效果及其对护理满意度的影响 [7] 手术室保温策略与医护团队精准护理在达芬奇机器人辅助腹腔镜手术中的协同效应研究 [8] 多模式镇痛配合加速康复外科护理在机器人辅助根治性膀胱切除术中的应用 [9] ERAS 护理模式在达芬奇机器人辅助解剖性肝切除术中的应用效果 [10] 经口机器人与非机器人手术治疗舌根肿瘤的疗效对比 [11] 机器人辅助上尿路手术患者术后焦虑抑郁影响因素分析及管理策略研究 [12] 机器人辅助甲状腺癌根治术的效果及对切口愈合的影响 [13] 机器人辅助腹腔镜肝切除术后谵妄危险因素分析及定量预警模型建立与验证分析 [14] ERAS 理念下达芬奇机器人与单孔胸腔镜肺叶切除术患者术后康复和疼痛的对比研究 [15] 输尿管逆行冷缺血技术在机器人辅助复杂性肾部分切除术中的应用研究 [16] 达芬奇机器人辅助乙状结肠癌外侧入路优先的定型化根治手术技术要点(附手术视频) [17] 机器人辅助全体内回肠代输尿管术治疗输尿管全段撕脱伤后输尿管全段狭窄或缺如的临床效果分析(附手术视频) [18] 经腹入路机器人辅助切除原发性腹膜后神经鞘瘤的初步应用(附手术视频) [19] 自主式口腔种植机器人术中常见故障及应对策略 [20] 两种腔内吻合方法在机器人辅助远端胃切除术后毕Ⅱ式消化道重建中的应用比较 [21] 免打结双倒刺线手工缝合法在机器人辅助全胃切除术中的应用及疗效分析(附手术视频) [22] ERSA 理念护理模式配合康复机器人辅助训练在重型颅脑损伤术后患者下肢康复护理中的运用效果 [23] 机器人辅助步态训练联合常规训练对严重烧伤后下肢运动及平衡功能障碍患者影响的前瞻性随机对照研究 [24] 不同术后镇痛方式对机器人辅助胸外科手术患者的镇痛效果比较 [25] 上肢康复机器人联合镜像疗法对脑卒中患者上肢运动功能及日常生活活动能力的疗效 [26] 基于 CiteSpace 的智能可穿戴运动康复系统在康复医学领域的研究热点与趋势分析 [27] ROSA 机器人辅助脑深部电刺激术中麻醉优化的探讨 [28] 基于酮咯酸和芬太尼的患者自控镇痛对机器人辅助根治性前列腺切除术后急性肾损伤的作用比较 [29] 丙泊酚靶控输注麻醉对机器人辅助根治性前列腺切除术患者的影响 [30] 基于加速康复理论的精细化护理对机器人辅助膝关节置换术患者的围手术期应用效果 [31] 基于 ERAS 理念的多学科协作新护理模式在机器人辅助股骨转子间骨折手术中的应用 [32] 机器人辅助全膝关节置换术中系统性手术室护理 配合措施及效果分析 [33] 机器人辅助经皮微创椎弓钉内固定术治疗单节段胸腰椎压缩性骨折的临床疗效分析 [34] 基于加速康复理论的精细化护理对机器人辅助膝关节单髁置换术患者的影响 [35] Robocare 全程干预模式对机器人辅助闭合复位钉棒系统内固定术后患者心理状态及功能康复效果的影响 [36] 信息识别技术联合 Mako 机器人辅助关节置换术的应用 [37] 2D 透视引导机器人辅助腰椎间盘摘除椎间融合内固定手术治疗腰椎间盘突出症的临床疗效 [38] 机器人辅助近端防旋髓内钉内固定治疗老年股骨粗隆间骨折预后不良的预测研究及策略分析 [39] 机器人辅助全膝关节置换术治疗膝骨关节炎临床效果研究 [40] 机器人辅助下经皮空心螺钉内固定治疗跟骨骨折术后并发症影响因素及模型预测分析 [41] 骨科手术机器人在骨盆骨折手术中的应用 [42] 机器人辅助手术对胸腰段骨折患者置钉准确性、创伤程度及预后的影响(附手术视频) [43] 机器人辅助技术在骨伤科的应用及展望
印象笔记
有道云笔记
微博
QQ空间
微信
二维码
意见反馈