Introduction: A surgical video review is an emerging tool for quality improvement, especially in complex surgeries such as laparoscopic partial nephrectomy (LPN). Assessing and measuring the warm ischemia time (WIT) d...Introduction: A surgical video review is an emerging tool for quality improvement, especially in complex surgeries such as laparoscopic partial nephrectomy (LPN). Assessing and measuring the warm ischemia time (WIT) during LPN by dividing it into the time used for resection (ResT), time used for reconstruction (RecT) and intermediate time (IntT) has not been performed before. This study aimed to analyze the factors that can influence all these surgical times and assess their impact on positive surgical margins (PSM) and complication rates. Methods: We evaluated 36 surgical video recordings from patients who underwent LPN and measured WIT, ResT, RecT and IntT with a stopwatch. Factors such as tumor characteristics and surgeon experience were also recorded. SPSS software was used to identify the predictor factors for all these surgical times and to correlate the ResT with PSM and RecT with the complication rate. Results: We recorded a mean WIT of 887 seconds. The mean ResT, RecT and IntT were 240 (27.2% of WIT), 473 (52.6% of WIT) and 173 s (20.2% of WIT), respectively. We found a moderate correlation between the WIT (p = 0.030), IntT and the R.E.N.A.L. score (p = 0.019). The surgeon with less than 100 LPN had significantly longer WIT, ResT, and RecT values, with means of 977 (p = 0.015), 268 (p = 0.019) and 530 seconds (p = 0.015), respectively. No correlation was found between ResT and PSM (p = 0.418);however, a strong correlation was found between RecT and the probability of developing complications (p = 0.012). Conclusion: The surgeon’s experience influences WIT, ResT, and RecT, but not IntT, which depends on tumor complexity. RecT affects the probability of developing complications. IntT represents a fifth of the WIT and efforts to reduce the WIT should focus on reducing the IntT for complex tumors, by improving surgical planning.展开更多
目的对比三维计算机断层扫描支气管血管成像(three-dimensional computed tomography bronchography and angiography,3D-CTBA)联合胸腔镜手术视频与单纯影像归档和通信系统(picture archiving and communication systems,PACS)联合胸...目的对比三维计算机断层扫描支气管血管成像(three-dimensional computed tomography bronchography and angiography,3D-CTBA)联合胸腔镜手术视频与单纯影像归档和通信系统(picture archiving and communication systems,PACS)联合胸腔镜手术视频在胸外科临床教学中的应用效果。方法选择2021年5—10月在苏州大学附属第一医院胸外科临床实习的102名实习生作为研究对象,将其随机分为教改组及传统组各51名。教改组实施3D-CTBA联合胸腔镜手术视频教学方法,传统组则实施单纯PACS系统联合胸腔镜手术视频教学方法。实习结束后比较两组学生的教学满意度、理论考核和实践操作考核成绩。结果两组实习生理论考核成绩和操作考核成绩及格率比较,教改组的理论考核成绩为(84.14±5.70)分,传统组的理论考核成绩为(83.95±5.26)分,差异无统计学意义(P>0.05)。教改组的实践考核成绩(89.66±4.88)分明显高于传统组(75.19±5.65)分,差异有统计学意义(P<0.05)。结论对比单纯PACS联合胸腔镜手术视频的教学方式,3D-CTBA联合胸腔镜手术视频在胸外科临床实践教学中能更明显提高学生对于肺部解剖的理解,提高其实践操作能力,教学效果满意。展开更多
本文拟通过总结当前手术视频采集设备的种类和应用现状,以期为手术视频采集设备的选用提供参考。采用文献检索的方法,从知网、万方、Web of Science、PubMed等主要国内外数据中收集手术视频采集的相关文献和资料进行综述。手术视频采集...本文拟通过总结当前手术视频采集设备的种类和应用现状,以期为手术视频采集设备的选用提供参考。采用文献检索的方法,从知网、万方、Web of Science、PubMed等主要国内外数据中收集手术视频采集的相关文献和资料进行综述。手术视频采集根据摄像头、手术设备和术者之间的关系可以分为非集成式、设备集成式和术者集成式,目前已在医院实现推广应用。手术视频能够完整的展现整个手术过程,因其独特的教育价值已广泛用于外科医师教育中。手术视频采集设备不仅可以用于外科医师教育,还具备提高医疗质量和手术效率的潜力,随着设备和应用程序的发展,手术视频将成为重要的临床资料。展开更多
文摘Introduction: A surgical video review is an emerging tool for quality improvement, especially in complex surgeries such as laparoscopic partial nephrectomy (LPN). Assessing and measuring the warm ischemia time (WIT) during LPN by dividing it into the time used for resection (ResT), time used for reconstruction (RecT) and intermediate time (IntT) has not been performed before. This study aimed to analyze the factors that can influence all these surgical times and assess their impact on positive surgical margins (PSM) and complication rates. Methods: We evaluated 36 surgical video recordings from patients who underwent LPN and measured WIT, ResT, RecT and IntT with a stopwatch. Factors such as tumor characteristics and surgeon experience were also recorded. SPSS software was used to identify the predictor factors for all these surgical times and to correlate the ResT with PSM and RecT with the complication rate. Results: We recorded a mean WIT of 887 seconds. The mean ResT, RecT and IntT were 240 (27.2% of WIT), 473 (52.6% of WIT) and 173 s (20.2% of WIT), respectively. We found a moderate correlation between the WIT (p = 0.030), IntT and the R.E.N.A.L. score (p = 0.019). The surgeon with less than 100 LPN had significantly longer WIT, ResT, and RecT values, with means of 977 (p = 0.015), 268 (p = 0.019) and 530 seconds (p = 0.015), respectively. No correlation was found between ResT and PSM (p = 0.418);however, a strong correlation was found between RecT and the probability of developing complications (p = 0.012). Conclusion: The surgeon’s experience influences WIT, ResT, and RecT, but not IntT, which depends on tumor complexity. RecT affects the probability of developing complications. IntT represents a fifth of the WIT and efforts to reduce the WIT should focus on reducing the IntT for complex tumors, by improving surgical planning.
文摘目的对比三维计算机断层扫描支气管血管成像(three-dimensional computed tomography bronchography and angiography,3D-CTBA)联合胸腔镜手术视频与单纯影像归档和通信系统(picture archiving and communication systems,PACS)联合胸腔镜手术视频在胸外科临床教学中的应用效果。方法选择2021年5—10月在苏州大学附属第一医院胸外科临床实习的102名实习生作为研究对象,将其随机分为教改组及传统组各51名。教改组实施3D-CTBA联合胸腔镜手术视频教学方法,传统组则实施单纯PACS系统联合胸腔镜手术视频教学方法。实习结束后比较两组学生的教学满意度、理论考核和实践操作考核成绩。结果两组实习生理论考核成绩和操作考核成绩及格率比较,教改组的理论考核成绩为(84.14±5.70)分,传统组的理论考核成绩为(83.95±5.26)分,差异无统计学意义(P>0.05)。教改组的实践考核成绩(89.66±4.88)分明显高于传统组(75.19±5.65)分,差异有统计学意义(P<0.05)。结论对比单纯PACS联合胸腔镜手术视频的教学方式,3D-CTBA联合胸腔镜手术视频在胸外科临床实践教学中能更明显提高学生对于肺部解剖的理解,提高其实践操作能力,教学效果满意。
文摘本文拟通过总结当前手术视频采集设备的种类和应用现状,以期为手术视频采集设备的选用提供参考。采用文献检索的方法,从知网、万方、Web of Science、PubMed等主要国内外数据中收集手术视频采集的相关文献和资料进行综述。手术视频采集根据摄像头、手术设备和术者之间的关系可以分为非集成式、设备集成式和术者集成式,目前已在医院实现推广应用。手术视频能够完整的展现整个手术过程,因其独特的教育价值已广泛用于外科医师教育中。手术视频采集设备不仅可以用于外科医师教育,还具备提高医疗质量和手术效率的潜力,随着设备和应用程序的发展,手术视频将成为重要的临床资料。
