GB2458734A

GB2458734A - Vaginal Hysterectomy Training Device

Info

Publication number: GB2458734A
Application number: GB0806031A
Authority: GB
Inventors: Barry Whitlow
Original assignee: COLCHESTER HOSPITAL UNIVERSITY; ESSEX RIVERS HEALTHCARE NHS TRUST
Current assignee: COLCHESTER HOSPITAL UNIVERSITY; ESSEX RIVERS HEALTHCARE NHS TRUST
Priority date: 2008-04-03
Filing date: 2008-04-03
Publication date: 2009-10-07
Also published as: GB0806031D0

Abstract

A vaginal hysterectomy training device which comprises a support structure 2,3 comprising an aperture 4,5 configured to simulate the vaginal opening; a resilient member 6 positioned within the aperture 4,5; and an artificial cervix 7 and uterus each of which are positioned within the resilient member which may be two sheets of rubber or elastomeric substance bonded together (60, 65). The support structure may be constructed of wood, plastic or metal. In use the support structure, artificial cervix and artificial uterus may be re-used whilst the resilient member 6 can be replaced after it is cut.

Description

VAGINAL HYSTERECTOMY TRAINING DEVICE

The invention relates to a vaginal hysterectomy training device and to a method of vaginal hysterectomy training comprising said device.

Hysterectomy is currently the most common major operation in the world, with more than 70,000 operations performed annually in England alone. In the UK, 20% of women will have a hysterectomy by the age of 55, this percentage is even higher in the US. Literature suggests that many of these cases could be managed by vaginal hysterectomy and indeed that this should be the route of choice. Despite this, 70% of hysterectomies for benign disease in the UK and most other countries are still performed abdominally. The reason for the choice of surgical route has been shown to be training (or lack thereof) and lack of exposure in vaginal surgery leading to gynaecologists having a preference for abdominal or laparoscopic hysterectomy.

Studies have shown that surgeons should perform vaginal rather than abdominal hysterectomies whenever possible in order to cut down on complications and the length of the stay in hospital. Laparoscopic hysterectomies have some of the advantages of vaginal hysterectomies, such as shorter hospital stays and fewer complications like infection. However, the laparoscopic procedure is longer than both abdominal and vaginal hysterectomies and carries a greater risk of damaging the bladder or urethra.

With a vaginal hysterectomy, the incision is made near the top of the vagina.

The uterus is removed through the vaginal opening. This procedure is most often used in cases of uterine prolapse, or when vaginal repairs are necessary for related conditions. No external incision is made, which means there is no visible scarring. Through this incision, the surgeon can cut and tie off the ligaments, blood vessels, and fallopian tubes. The uterus is then cut free and removed through the vagina. The surgery and hospital stay are shorter than the abdominal hysterectomy and women usually return to normal activities after around four weeks. The vaginal hysterectomy is less painful than the abdominal procedure and leaves no exterior scar.

To gain confidence in surgical techniques, trainees need both quality and quantity of surgical cases. The introduction of Calman training has resulted in a decrease in practical surgical training for junior house doctors by 60%.

Additionally, 36% of trainees expressed a dissatisfaction with the number of surgical procedures that they were performing. In the same survey one fifth also rated their operative training as very poor or poor.

There is thus a great need for an effective tool to improve vaginal hysterectomy training.

Thus, according to a first aspect of the invention there is provided a vaginal hysterectomy training device which comprises a support structure comprising an aperture configured to simulate the vaginal opening; a resilient member positioned within the aperture; and an artificial cervix and uterus each of which are positioned within the resilient member.

In one embodiment, the support structure comprises two complimentary portions which engage to form the aperture configured to simulate the vaginal opening. In one embodiment, the device additionally comprises attachment means configured to attach the two complimentary portions of the support structure to one another.

In one embodiment, the attachment means comprise a clip, clasp or clamp. This embodiment of the invention has the advantage of allowing the resilient member to be fitted between the two complimentary portions of the support structure prior to clamping the portions together.

In one embodiment, the support structure is constructed from a solid material such as wood, plastics or metal material. In a further embodiment, the support structure is constructed from wood.

In one embodiment, the aperture configured to simulate the vaginal opening is conical or cylindrical in shape. In a further embodiment, the aperture configured to simulate the vaginal opening is conical in shape.

In one embodiment, the resilient member comprises a sheet of a rubber or elastomeric substance. The resilient member provides the advantage of realistically simulating the elasticity of the ligaments which hold the uterus and cervix in position within the vaginal cavity. In a further embodiment, the resilient member comprises a plurality of sheets (e.g. two) of a rubber or elastomeric substance which are bonded together to hold the artificial uterus in place while leaving the cervix exposed within the aperture. In one embodiment, the artificial cervix is located approximately halfway along the aperture.

One key advantage of the present invention is that the resilient member is the only "disposable" component of the training device following a training session.

For example, once the artificial uterus and cervix and cut from the resilient member they can be incorporated within a new resilient member and inserted between two complimentary portions of the support structure, for example, only the resilient member requires replacement. The present invention therefore provides a cheap surgical training tool. By contrast, existing training models are complex devices which are costly to manufacture and complicated to assemble.

In one embodiment, the artificial cervix and uterus are constructed from a solid material such as wood, plastics or metal material. In a further embodiment, the artificial cervix and uterus are constructed from wood.

According to a second aspect of the invention there is provided a method of vaginal hysterectomy training which comprises: (a) locating an artificial cervix within an aperture of the training device as defined hereinbefore; (b) holding the artificial cervix and applying force to said cervix; and (c) making an incision of the resilient member around the artificial cervix to remove the uterus.

According to a third aspect of the invention there is provided a vaginal hysterectomy training kit comprising the vaginal hysterectomy training device as hereinbefore defined and instructions to use said device in accordance with the method as hereinbefore defined.

In one embodiment, the kit additionally comprises a plurality of replacement resilient members as hereinbefore defined.

In one embodiment, the kit additionally comprises surgical instruments (e.g. forceps and scalpel).

The invention will now be described, by way of example only, with reference to the accompanying drawings of which: Figure 1 shows an exploded view of one embodiment of a vaginal hysterectomy training device according to the invention; Figure 2 shows a section view of one embodiment of the resilient member according to the invention; and Figure 3 shows an assembled view of the embodiment of a vaginal hysterectomy training device as shown in Figure 1.

Referring first to Figure 1, a vaginal hysterectomy training device shown generally as 1 comprises two wooden blocks 2, 3 each having a recessed portion 4, 5 such that a conical aperture defining an artificial vaginal cavity when the wooden blocks 2, 3 are brought together. The device additionally comprises a resilient member which in this embodiment comprises a rubber sheet 6 containing an artificial cervix 7 and uterus (not shown). The resilient member is shown in more detail in Figure 2 where it can be seen that the resilient member comprises two rubber sheets 60, 65 which are bonded together to hold the uterus in position leaving the cervix 7 exposed.

Figure 3 shows an assembled view of the embodiment of a vaginal hysterectomy training device as shown in Figure 1 with the additional presence of a clamp 10 to hold the two wooden blocks 2, 3 together.

In use, the rubber sheets 60, 65 holding the uterus and cervix 7 are placed between the wooden blocks 2,3 which are then attached to one another using the clamp 10. The training will therefore comprise guidance on locating the artificial cervix 7 within the aperture 20 formed by recessed portions 4, 5 of the wooden blocks 2, 3. The artificial cervix 7 is then clasped (typically using forceps) and pulled in a downwards direction by application of user pressure and an incision is then made around the artificial cervix to cut the uterus free.

For re-use of the device, the rubber sheets 60, 65 comprising the artificial cervix and uterus 7 simply require replacement and assembly between the wooden blocks 2, 3 (for example, the wooden blocks 2, 3 and wooden uterus and cervix 7 may be re-used).

Claims

CLAIMS1. A vaginal hysterectomy training device which comprises a support structure comprising an aperture configured to simulate the vaginal opening; a resilient member positioned within the aperture: and an artificial cervix and uterus each of which are positioned within the resilient member.
2. A device as defined in claim 1 wherein the support structure comprises two complimentary portions which engage to form the aperture configured to simulate the vaginal opening.
3. A device as defined in claim 2 wherein the device additionally comprises attachment means configured to attach the two complimentary portions of the support structure to one another.
4. A device as defined in claim 3 wherein the attachment means comprise a clip, clasp or clamp.
5. A device as defined in any preceding claims wherein the support structure and the artificial cervix and uterus are constructed from a solid material such as
6. A device as defined in claim 5 wherein the support structure and the artificial cervix and uterus are constructed from wood.
7. A device as defined in any preceding claims wherein the aperture configured to simulate the vaginal opening is conical or cylindrical in shape.
8. A device as defined in claim 7 wherein the aperture configured to simulate the vaginal opening is conical in shape.
9. A device as defined in any preceding claims wherein the resilient member comprises a sheet of a rubber or elastomeric substance.
10. A device as defined in claim 9 wherein the resilient member comprises two sheets of a rubber or elastomeric substance which are bonded together to hold the artificial uterus in place while leaving the cervix exposed within the aperture.
11. A method of vaginal hysterectomy training which comprises: (a) locating an artificial cervix within an aperture of the training device as defined hereinbefore; (b) holding the artificial cervix and applying force to said cervix; and (c) making an incision of the resilient member around the artificial cervix to remove the uterus.
12. A vaginal hysterectomy training kit comprising the vaginal hysterectomy training device as defined in any of claims 1 to 10 and instructions to use said device in accordance with the method as defined in claim 11.
13. A kit as defined in claim 12 which additionally comprises a plurality of replacement resilient members as defined in any of claims 1, 9 and 10.
14. A kit as defined in claim 12 or claim 13 which additionally comprises surgical instruments.
15. A vaginal hysterectomy training device substantially as hereinbefore defined.
16. A method of vaginal hysterectomy training substantially as hereinbefore defined.
17. A vaginal hysterectomy training kit substantially as hereinbefore defined.