2016 年 18 巻 2 号 p. 80-86
Pediatric minimally invasive surgery requires advanced surgical skills ; however, the small number of pediatric patients limits opportunities for junior pediatric surgeons to learn and practice these skills. Thus, a neonatal thoracic cavity model was developed to simulate thoracoscopic repair of esophageal atresia in neonates. In this study, the ribcage of a 13-day-old patient was produced in rapid prototyping and covered with a 10-mm thick sheet into which three surgical instrument ports were inserted and fixed. An esophagus model, an 8-mm polyvinyl-alcohol tube, was placed inside the ribcage, with the upper end fixed to a force sensor. A position tracking system integrating optical and electromagnetic systems was developed, which achieved a 99.8% tracking ratio. In preliminary experiments, four pediatric surgeons performed suturing on the esophagus model, and the task completion time, tool path, and force applied on the esophagus model were measured. All subjects successfully completed the tasks and thereafter answered to a questionnaire. The result of the questionnaire shows that the model has a potential as a skill assessment and training tool for pediatric surgeons. In the future, pediatric surgeons with different skill levels will be recruited to perform surgical skill assessment, and the model will be validated.