CAPTAiN导航系统助新手精准完成椎板切除术，降低失误风险。
Critical Anatomy-Preserving & Terrain-Augmenting Navigation (CAPTAiN): Application to Laminectomy Surgical Education
- 通过彩色体素分层提示关键解剖结构，实时引导钻削路径。
- 虚拟手术测试中目标解剖结构完成率提升至87.99%，较对照组提高13.57%。
- 显著降低新手与高年资医生的技能差距，适合外科教学与训练。
外科训练是现代医学的关键环节，以椎板切除术为例，其操作需精确控制钻削力度以去除骨组织，同时保护脊柱节段完整性和避免硬膜破损。尽管临床中意外撕裂发生率高达11.3%，但目前尚无辅助工具用于降低风险。患者解剖结构差异也加剧了初学者的学习难度。本研究提出CAPTAiN——一种关键解剖结构保护与地形增强导航系统，采用分层彩色体素提示提升术中解剖意识。在11名骨科住院医师及医学生参与的110例虚拟椎板切除术中，相比标准非导航方式，CAPTAiN显著提升目标解剖结构完成率（87.99% vs. 74.42%），并降低多个NASA-TLX量表维度的认知负荷。该系统有效缩小经验水平间的性能差距，使新手表现接近高年资学员。研究结果表明，CAPTAiN不仅有助于优化手术执行，还具备支持多层级技能培养的潜力。其应用前景可拓展至神经外科、耳鼻喉科等其他需要精细钻削的手术领域。
原文摘要 · Abstract (English)
Surgical training remains a crucial milestone in modern medicine, with procedures such as laminectomy exemplifying the high risks involved. Laminectomy drilling requires precise manual control to mill bony tissue while preserving spinal segment integrity and avoiding breaches in the dura: the protective membrane surrounding the spinal cord. Despite unintended tears occurring in up to 11.3% of cases, no assistive tools are currently utilized to reduce this risk. Variability in patient anatomy further complicates learning for novice surgeons. This study introduces CAPTAiN, a critical anatomy-preserving and terrain-augmenting navigation system that provides layered, color-coded voxel guidance to enhance anatomical awareness during spinal drilling. CAPTAiN was evaluated against a standard non-navigated approach through 110 virtual laminectomies performed by 11 orthopedic residents and medical students. CAPTAiN significantly improved surgical completion rates of target anatomy (87.99% vs. 74.42%) and reduced cognitive load across multiple NASA-TLX domains. It also minimized performance gaps across experience levels, enabling novices to perform on par with advanced trainees. These findings highlight CAPTAiN's potential to optimize surgical execution and support skill development across experience levels. Beyond laminectomy, it demonstrates potential for broader applications across various surgical and drilling procedures, including those in neurosurgery, otolaryngology, and other medical fields.
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