主観的な知覚と客観的なビデオ分析を統合して,腹腔鏡縫合の課題を特定する:外科研修を強化するための横断的な研究
Chidozie Ogbonnaya1, Shizhou Li1,2, Changshi Tang3
1Surgical Skills Centre, Respiratory Medicine and Gastroenterology, School of Medicine, Ninewells Hospital and Medical School, Dundee Institute for Healthcare Simulation, University of Dundee, Dundee, DD1 9SY, UK.
Scientific reports
|February 13, 2026
まとめ
結び目をつなぐことや針を扱うことといった,ラパロスコピーの縫合の課題は,あらゆるレベルの外科医にとって依然として存在しています. 客観的な分析は,専門家が初心者を上回ることを明らかにし,熟練度を向上させるためのターゲットを絞ったシミュレーショントレーニングの必要性を強調しています.
科学分野:
- 最低侵襲外科手術です.
- 外科スキルの訓練訓練です.
- メディカルシミュレーションのメディカルシミュレーション
背景:
- ラパロスコープによる縫合は,重要な技術的な要求を持つ複雑な外科技術です.
- 腹腔鏡縫合の課題を理解することは,効果的なトレーニングプログラムの開発に不可欠です.
- 現在の訓練戦略は,外科医が直面する根本的な困難を十分に解決していない可能性があります.
研究 の 目的:
- 腹腔鏡縫合における重要な技術的,認知的な課題を特定する.
- 主観的な認識と客観的なパフォーマンス分析を比較する.
- 腹腔鏡縫合の熟練度のためのターゲットを絞ったトレーニング戦略の開発を参考にするために.
主な方法:
- 33人の腹腔鏡外科医 (22人の初心者,11人の専門家) を対象とした横断的な研究.
- デルフィのコンセンサスは,構造化された調査のための4つのコアサブタスクを特定しました.
- ボックス・トレーナーで実施される標準化された腹腔鏡縫合の作業は,グローバル・オペレティブ・アセスメント・オブ・腹腔鏡技能 (GOALS) のビデオ分析を用いて評価された.
主要な成果:
- 結び目 (42.4%),針の取り扱い (27.3%),縫合の緊張 (21.2%) が最も多く報告された課題でした.
- 初心者と熟練した外科医の間で,知覚された難しさの有意な違いはありません.
- 専門外科医は,すべてのGOALS指標 (P < 0.001) とともに,手術の完了までの時間において初心者を大幅に上回った.
結論:
- 腹腔鏡縫合の技術的な困難は,すべての経験レベルで存在します.
- 主観的な評価と客観的な評価を統合することで,パフォーマンスギャップの包括的な見方が得られます.
- 結び目,針の操作,効率に焦点を当てたターゲットを絞ったシミュレーショントレーニングは不可欠です.
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