PDF(Pubmed)
Abstract：
When combined with healthcare pressures, the exponential growth of robotic-assisted surgery (RAS) has impacted UK-based training outcomes, including the learning curve to competency. Aim: To ascertain the current provision of RAS and investigate differences in access to minimal access surgical (MAS) facilities and training across the UK. A two-armed electronic survey was conducted. The first arm questioned clinical leads regarding robotic practice and future training provisions. The second investigated trainee and trainers\' perceptions of MAS training and facilities. 64% (52/81) of responding trusts utilise a robotic system. The majority (68% [55/81]) have plans to expand or acquire a system within 3 years. 171 responses from 112 UK and Republic of Ireland hospitals were collected for Arm 2. Laparoscopic categories queried whether trainees had access to a formal curriculum, training days and sim-boxes. Most consultants (51.9%) and trainees (51.6%) reported that there was no formal local training curriculum for robotic surgery. Combined responses demonstrated 42.1% (n = 195/463) said \"yes\", 39.5% (n = 183) \"no\" and 18.4% (n = 85) \"don\'t know\". For combined robotic categories (simulation, training days and operative lists) 28.3% (n = 134/473) responded \"yes\", 51.6% (n = 244) said \"no\" and 20.1% (n = 95) said \"don\'t know\". This study provides insight into the current provision of robotic-assisted surgery at UK trusts and highlights the need to facilitate regular clinical training and equitable access to MAS simulation within a formal curriculum. This may aid regulation of training in parallel with the expansion of robotic practice and avoid a significant skill acquisition gap and risks to patient safety.
摘要：
当与医疗保健压力相结合时，机器人辅助手术（RAS）的指数增长影响了英国的培训成果，包括能力的学习曲线。目的：确定RAS的当前规定，并调查英国各地在获得最低限度手术（MAS）设施和培训方面的差异。进行了双臂电子调查。第一方对有关机器人实践和未来培训规定的临床线索提出了质疑。第二个调查了受训者和培训师对MAS培训和设施的看法。64%(52/81)的回应信托使用机器人系统。大多数（68％）计划在3年内扩展或购买系统。收集了来自112家英国和爱尔兰共和国医院的171份回复。腹腔镜类别询问受训者是否可以使用正式课程，培训日和sim-boxes。大多数顾问（51.9％）和受训人员（51.6％）报告说，没有正式的机器人手术培训课程。综合反应显示42.1%(n=195/463)表示“是”，39.5%(n=183)“不”和18.4%(n=85)“不知道”。对于组合机器人类别(模拟，培训天数和手术名单)28.3%(n=134/473)回答“是”，51.6%(n=244)说“不”，20.1%(n=95)说“不知道”。这项研究提供了对英国信托机构当前提供的机器人辅助手术的见解，并强调了在正式课程中促进定期临床培训和公平访问MAS模拟的必要性。这可以帮助与机器人实践的扩展并行地调节训练,并且避免显著的技能获取差距和对患者安全的风险。
