Apprentissage de la suture intra-corporéale sur un pelvi trainer de cœlioscopie : évaluation comparative d’un porte-aiguilles robotisé versus de porte-aiguilles classiques

Abstract : Introduction: Minimally invasive surgery is the gold standard in many surgical specialties. A new generation of semi-robotic coelioscopic instruments has been developed to compensate for the ergonomic constraints of classical instruments. The main objective was to compare novice learning curves for intracorporeal suture on a laparoscopic pelvitrainer, using conventional needle holders versus a robotized needle holder. Post training performances in difficult ergonomic conditions were additionally studied. Material and methods: The participants were students in fifth grade medicine. The needle holders used were: standard laparoscopic needle holders and Jaimy robotic coelioscopy needle holder (Endocontrol Society, Grenoble, France). Group A members used a robotic needle holder in their dominant hand and conventional needle holder in their non-dominant hand. Group B participants used two standard straight needle holders. They performed four training sessions (intracorporeal sutures) and an evaluation session (classical intracorporeal knots and vertical knots, two polygons). Results: Twenty participants were included, randomized into two groups of 10 peoples. Regarding the classical intracorporeal suture, there was a significant learning curve with a plateau reached at the third session in both groups. Post-training performances showed no significant difference between group A and group B for (median FLS score: 468 versus 474.5, p = 0.7621). There was a significant difference between group A and group B for the vertical knot (median total score: 15.75 versus 3.75, p = 0.005) but not for the polygon (median total score: 18 versus 15, p = 0.2846). Conclusion: In classic conditions, the Jaimy endocontrol needle holder allows learning as fast as with conventional instruments with equivalent performance. In ergonomically difficult conditions, Jaimy brings an advantage over conventional instruments.
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Elena Siri. Apprentissage de la suture intra-corporéale sur un pelvi trainer de cœlioscopie : évaluation comparative d’un porte-aiguilles robotisé versus de porte-aiguilles classiques. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02009711⟩

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