山东大学耳鼻喉眼学报 ›› 2021, Vol. 35 ›› Issue (5): 56-61.doi: 10.6040/j.issn.1673-3770.0.2021.102

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Voxel-man ENT手术模拟系统在鼻科技能教学中的应用

巴广益,茆松,孙汐文,唐如,李志鹏,林海,张维天   

  1. 上海交通大学附属第六人民医院 耳鼻咽喉头颈外科, 上海 200233
  • 发布日期:2021-09-29
  • 通讯作者: 张维天. E-mail:drzhangwt@163.com
  • 基金资助:
    国家自然科学基金面上项目(82071014,81870700)

Application of Voxel-man ENT surgery simulation system in the training of nasal operation technique

BA Guangyi, MAO Song, SUN Xiwen, TANG Ru, LI Zhipeng, LIN Hai, ZHANG Weitian   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth Hospital, Shanghai 200233, China
  • Published:2021-09-29

摘要: 目的 探讨Voxel-man ENT手术模拟系统在鼻科解剖、内镜手术技能的培训效果。 方法 研究对象来自本科室住院医师及进修医师,合计12人,接受虚拟现实手术系统解剖训练及鼻内镜下手术技能操作,隔天训练1小时,共6周。比较训练对象前后得分,采用SPSS 26.0和Graphpad Prism 9进行配对t检验。 结果 训练对象经6周培训后,总体参与者培训后的解剖技能、手术操作评分均较训练前有提高(P<0.05)。 结论 虚拟现实手术模拟系统能明显改善鼻内镜手术教学效果,缩短内镜手术的初始学习曲线,有助于提高教学质量。

关键词: 虚拟现实, 手术模拟系统, 鼻内镜, 教学方法

Abstract: Objective To explore the effect of Voxel-man ENT surgery simulation system on the training of basic skills of nasal anatomy and nasal endoscopy for trainers with different clinical experiences. Methods A total of 12 residents and further study doctors in our department received virtual reality surgery system anatomy training and nasal endoscopic surgery skills training for 1 hour every other day for 6 weeks. The scores of the subjects were compared before and after the training, and paired t-test was performed with SPSS 26.0 and Graphpad Prism 9. Results After 6 weeks of training, the anatomical skills and surgical operation scores of the overall participants were significantly improved as compared with those before training(P<0.05). Conclusion Virtual reality surgery simulation system can obviously improve the teaching effect of nasal endoscopic surgery, shorten the initial learning curve of endoscopic surgery, and help to improve the teaching quality.

Key words: Virtual reality, Surgery simulation system, Nasal endoscope, Teaching method

中图分类号: 

  • R765.9
[1] Edmond CV Jr, Heskamp D, Sluis D, et al. ENT endoscopic surgical training simulator[J]. Stud Health Technol Inform, 1997, 39: 518-528.
[2] 周兵, 黄谦, 张罗. 鼻内镜鼻窦手术技术教学体会[J]. 耳鼻咽喉-头颈外科, 2003, 10(3): 184-185. doi: 10.3969/j.issn.1672-7002.2003.03.021 ZHOU Bing, HUANG Qian, ZHANG Luo. The teaching experience of endoscopic sinus surgery techniques [J]. Otorhinolaryngology-Head and Neck Surgery, 2003, 10(3): 184-185. doi: 10.3969/j.issn.1672-7002.2003.03.021.
[3] 吴旋, 张伟红, 文卫平. 对鼻专科医师培训系统化鼻内镜技术的带教体会[J]. 西北医学教育, 2013, 21(2): 396-398. doi:10.13555/j.cnki.c.m.e.2013.02.059. WU Xuan, ZHANG Weihong, WEN Weiping. Teachingexperience of systematic nasal endoscopic training in rhinologic specialist[J]. Northwest Medical Education, 2013, 21(2): 396-398. doi:10.13555/j.cnki.c.m.e.2013.02.059.
[4] 李丹凤, 陈福权, 石力, 等. 阶梯式多模式融合教学法在耳鼻喉科本科临床教学中的应用[J]. 山东大学耳鼻喉眼学报, 2015,?29(4): 77-79. doi: 10.6040 /j.issn.1673-3770.0.2014.349. LI Danfeng, CHEN Fuquan, SHI Li, et al. Application of stepped multi-model merged methodology in ENT clinical teaching for under-graduates[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2015, 29(4): 77-79. doi: 10.6040 /j.issn.1673-3770.0.2014.349.
[5] 温晗光, 陈缪安, 林婷婷, 等. 内镜影像系统在耳鼻咽喉科见习教学中的应用[J]. 山东大学耳鼻喉眼学报, 2014(4): 92-94. doi:10.6040/j.issn.1673-3770.0.2014.096. WEN Hanguang, CHEN Miaoan, LIN Tingting, et al. Application of endoscopic imaging system in otorhinolaryngology department?trainee teaching[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2014(4): 92-94. doi:10.6040/j.issn.1673-3770.0.2014.096.
[6] 吴喜福, 张革化. 以问题为基础学习的教学方法在耳鼻咽喉头颈外科学见习中的应用与评价[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 116-118. doi: 10.6040/ j.issn.1673-3770.0.2017.477. WU Xifu, ZHANG Gehua. Assessment of the effectiveness of problem-based learning during the probation period of the otolaryngology head and neck surgery didactic course[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(4): 116-118. doi: 10.6040/ j.issn.1673-3770.0.2017.477.
[7] 殷敏, 史雅文, 朱歆洁, 等. 耳鼻咽喉头颈外科PBL教学与住院医师规范化培训[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 154-156. doi: 10.6040/j.issn.1673-3770.1.2019.035. YIN Min, SHI Yawen, ZHU Xinjie, et al. PBL teaching and standardized training of residents in otolaryngology-head and neck surgery[J]. Otolaryngology and Ophthalmology Journal of Shandong University, 2019, 33(3): 154-156. doi: 10.6040/j. issn.1673-3770.1.2019.035.
[8] 王梓敬, 邢志敏, 王旻, 等. 鼻内镜技术临床医师培训方法探讨[J]. 中国耳鼻咽喉头颈外科, 2017, 24(1): 55-56. doi:10.16066/j.1672-7002.2017.01.016. WANG Zijing, XING Zhimin, WANG Min, et al. Discussion on training methods for clinicians of nasal endoscopy technique[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2017, 24(1): 55-56. doi:10.16066/j.1672-7002.2017.01.016.
[9] 张静, 贾婧杰, 袁虎,等. 鼻内镜解剖训练中互动教学模式探讨[J]. 解放军医学院学报, 2013, 34(1): 91-93.doi: 10.3969/j.issn.2095-5227.2013.01.034. ZHANG Jing, JIA Jingjie, YUAN Hu, et al. Application of interactive teaching model in nasal endoscopic anatomy training[J]. Academic Journal of Chinese PLA Medical School, 2013, 34(1): 91-93. doi: 10.3969/j.issn.2095-5227.2013.01.034.
[10] 齐静怀, 郭睿. 虚拟现实系统在鼻内镜颅底外科中的应用前景[J]. 中国耳鼻咽喉颅底外科杂志, 2019, 25(5): 556-560. doi:10.11798/j.issn.1007-1520.201905023. QI Jinghuai, GUO Rui. The application and prospect of virtual reality system in endoscopic skull base surgery[J]. Chinese Journal of Otorhinolaryngology-skull Base Surgery, 2019, 25(5): 556-560. doi:10.11798/j.issn.1007-1520.201905023.
[11] 韩冰, 崔淑洁. 虚拟教学系统在住院医师培训中的应用探讨和展望[J]. 中国医院管理, 2009, 29(12): 54-55. doi: 10.3969/j.issn.1001-5329.2009.12.023. HAN Bing, CUI Shujie. Discussion and prospect of the application of virtual teaching system in resident training[J]. Chinese Hospital Management, 2009, 29(12): 54-55. doi: 10.3969/j.issn.1001-5329.2009.12.023.
[12] 唐力行, 杨小健, 葛文彤. 医学模拟教学在鼻科医师鼻内镜鼻窦技术中的应用[J]. 继续医学教育, 2018, 32(12): 5-6. doi: 10.3969/j.issn.1004-6763.2018.12.003. TANG Lixing, YANG Xiaojian, GE Wentong. Application of medical simulation teaching in rhinologists endoscopic sinus technique[J]. Continuing Medical Education, 2018, 32(12): 5-6. doi: 10.3969/j.issn.1004-6763.2018.12.003.
[13] Rudman DT, Stredney D, Sessanna D, et al. Functional endoscopic sinus surgery training simulator[J]. Laryngoscope, 1998, 108(11 Pt 1): 1643-1647. doi:10.1097/00005537-199811000-00010.
[14] Diment LE, Ruthenbeck GS, Dharmawardana N, et al. Comparing surgical experience with performance on a sinus surgery simulator[J]. ANZ J Surg, 2016, 86(12): 990-995. doi:10.1111/ans.13418.
[15] Varshney R, Frenkiel S, Nguyen LH, et al. Development of the McGill simulator for endoscopic sinus surgery: a new high-fidelity virtual reality simulator for endoscopic sinus surgery[J]. Am J Rhinol Allergy, 2014, 28(4): 330-334. doi:10.2500/ajra.2014.28.4046.
[16] Varshney R, Frenkiel S, Nguyen LH, et al. The McGill simulator for endoscopic sinus surgery(MSESS): a validation study[J]. Le J D'oto Rhino Laryngol et De Chir Cervico Faciale, 2014, 43: 40. doi:10.1186/s40463-014-0040-8.
[17] Ahmed A, Ahmad M, Stewart CM, et al. Effect of distractions on operative performance and ability to multitask: a case for deliberate practice[J]. Laryngoscope, 2015, 125(4): 837-841. doi:10.1002/lary.24856.
[18] Reddy-Kolanu G, Alderson D. Evaluating the effectiveness of the Voxel-Man Tempo Surg virtual reality simulator in facilitating learning mastoid surgery[J]. Ann R Coll Surg Engl, 2011, 93(3): 205-208. doi:10.1308/003588411X56598.
[19] Schiemann T, Freudenberg J, Pflesser B, et al. Exploring the Visible Human using the VOXEL-MAN framework[J]. Comput Med Imaging Graph, 2000, 24(3): 127-132. doi:10.1016/s0895-6111(00)00013-6.
[20] Schubert R, Schiemann T, Tiede U, et al. Applications and perspectives in anatomical 3-dimensional modelling of the visible human with VOXEL-MAN[J]. Acta Anat(Basel), 1997, 160(2): 123-131. doi:10.1159/000148004.
[21] Richards JP, Done AJ, Barber SR, et al. Virtual coach: the next tool in functional endoscopic sinus surgery education[J]. Int Forum Allergy Rhinol, 2020, 10(1): 97-102. doi:10.1002/alr.22452.
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