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.
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.
[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.