Skill analysis of urological robotic surgery and development of new educational method

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K20167
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Urology
• Research Institution: Kansai Medical University
• Principal Investigator: YOSHIDA Kenji 関西医科大学, 医学部, 助教 (40572673)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 手術技能分析 / 内視鏡手術 / 力覚計測

Outline of Final Research Achievements

In this study, we focused on VUA (vesicourethral anastomosis), which is part of robot-assisted radical Prostatectomy. We developed a VUA model which can measure the tractive force on the urethra, and we assessed the force direction on the urethra among surgeons’skills for different levels of surgeons. Urethral damage during VUA may occur when passing the needle through the urethra. Unnecessary urethral damage contributes to urinary incontinence. Experts manipulate the urethral tissue protectively to avoid excessive traction force. Therefore, we created a VUA training models that allow trainees to learn the strength of the traction forces on the urethra. We saw a significant difference between the two groups for task completion time and all force parameters including maximum force, force volume, and the length of time that specific excessive forces were applied to the urethra. Now, we have been developing systems which provide feedback on the traction force on the urethra.

Free Research Field

内視鏡手術教育

Academic Significance and Societal Importance of the Research Achievements

腹腔鏡操作やロボット補助操作は触感覚の欠如から、指導者のみならず術者自身も鉗子作用力の理解困難な面がある。そのため操作の特徴を伝え技術を伝達することは容易ではない。本課題では、尿道膀胱吻合モデルの作成を行い、吻合時のモデル上にある疑似尿道に加わる作用力の大きさおよび方向（垂直、水平方向）を定量化し、実際熟練者が注意を払っている点を明らかにすることが目標である。標的臓器に対する作用力を確認可能なビューワーを作成することは、技術伝達の一助となると期待できる。また将来的に開発予定であるフィードバックシステムは新たな技術教育手法として有益なものとなる可能性があると考えている。