Investigación con el sistema da Vinci® en el Hospital St Mary’s de Londres Evaluation of the use the da Vinci system at St. Mary's Hospital in London

• Main Authors: Juan David Hernández, Aristotelis Dosis, Fernando Bello, Dorothy Wang, Joao Borelli, Ara Darzi
• Format: Article
• Language: English
• Published: Asociación Colombiana de Cirugía 2005-06-01
• Series: Revista Colombiana de Cirugía
• Subjects: robótica; videocirugía; aprendizaje; análisis y desempeño de tareas; Robotics; video-assisted surgery; learning; task performance and analysis
• Online Access: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S2011-75822005000200004

Hipótesis: El sistema robótico da Vinci&#8482; permite superar las limitaciones que impone al cirujano la cirugía mínimamente invasora en términos de destreza, control del campo operatorio y ergonomía. Los estudios incluidos en esta compilación evalúan la curva de aprendizaje, la visión en tercera dimensión y el análisis de movimientos, con el propósito de comprobar las ventajas del sistema da Vinci sobre la cirugía mínimamente invasora y establecer métodos de evaluación de desempeño.<br>ypothesis: The da Vinci&#8482; Surgical System allows surgeons to overcome the limitations imposed by minimally invasive surgery (MIS) in terms of dexterity, operative field control and ergonomy. The studies included evaluate the learning curve, 3-D vision and motion analysis to reveal the system&#8217;s advantages over MIS and to establish performance assessment methods. Methods: system employed: da Vinci&#8482; Surgical System. Three comparative experiments with 11 to 13 surgeons performing different tasks looking at: learning curve comparing experienced and non-experienced surgeons, advantages of 3D over 2D vision, and advantages of robotic surgery over Minimally Invasive Surgery (MIS). Assessment: measurement of surgeon&#8217;s performance by means of a global scale for skills (OSATS) and errors count, with blind scoring by experts. Additionally, motion analysis software for MIS (ICSAD) and robotic surgery (ROVIMAS), both developed by the Department and previously validated in other studies. Statistic calculations: SPSS 10,0&#8482; software. P<0,05. Results: The learning curve rendered an OSATS score of 18 for the first attempt and 26 for the fifth (p=0,02, Cronbah alpha: 0.894). Motion analysis showed reduction in number of movements and path length (p=0,01). Comparing robotic surgery with 3-D vision vs. MIS rendered a 40% reduction in time taken (p=0,001) and 70% reduction in path length (0,008), with 93% less skill-related errors. 3-D vision was proved to be superior to 2-D in several trials. Conclusion: &#8220;Endowrist&#8221; instruments, tremor abolition, motion scaling and 3-D vision of the da Vinci&#8482; Surgical System enhance the surgeon&#8217;s dexterity and performance in robotic assisted MIS.