機械手臂手術醫師之訓練

Robotic Surgery Training in Surgeon

達文西手術系統自2000年上市以後，全球應用此套手術系統的手術總量逐年增加，在2012年大約有二十萬台，但2016年已經突破75萬台，以婦產科及泌尿外科佔大宗，可見全球外科醫師使用此套系統來手術是一種趨勢。但隨著手術量增加，術中發生的不良事件甚至永久損傷或死亡的事件逐年增加；不管是病人、手術醫師或是機械臂本身的因素，都是因為訓練不足造成的。目前各國官方並沒有提出完整訓練計劃，提供外科醫師訓練使用，在美國也只有一些大學醫院成立達文西手術訓練，依照廠商建議的訓練目標及内容，提出一系列在基礎或臨床的訓練計劃。在台灣目前雖然有30台以上的達文西手術系統，但仍然沒有有官方或醫學中心提供一套完整的訓練計劃，本篇主要是在闡述此新科技的醫學裝置，使用者仍然需要經過訓練才會使用，並試著提出初步的訓練計劃，希望能提供給初學者使用，以減少因使用不當造成不良後果的發生機率。

Since the da Vinci® Surgical System gained approval by the U.S. Food and Drug Administration (FDA) in 2000. The Surgical Systems operate in hospitals worldwide with increasing in surgeries number, with an estimated 200,000 surgeries conducted in 2012 and over 750,000 in 2016, most commonly for hysterectomies and prostate surgeries. From above evidence, surgery by using the robotic system will become a trend among surgical treatment choice. However the adverse accidents, even the permanent injury, increased in number obviously according to da Vinci® surgery case number increased year by year. The main cause of adverse accident is due to inadequate training or training program, no matter does the patient, surgeon or mechanical factor. Up to now, there is no training program that official supported or donated and offer to surgeon training. Some da Vinci® training program has been designed under the produce company offered guideline in several centers of American university. Until now, there is no training program in Taiwan, even though over 30 da Vinci® surgical systems have been set up. We tried to design a complete training plan and program for surgeon who intended to involve these surgical filed.