GB2505391A

GB2505391A - Surgical skills training device

Info

Publication number: GB2505391A
Application number: GB201206675A
Authority: GB
Inventors: Taufiek Konrad Rajab; Douglas Smink
Original assignee: Individual
Current assignee: Individual
Priority date: 2012-04-16
Filing date: 2012-04-16
Publication date: 2014-03-05
Also published as: GB201206675D0

Abstract

The present invention is a book with integrated surgical skills training elements. The skills training elements are interleaved with the text of the book and allow students to learn the theory of medical practice and then to perform technical aspects of surgical operations. The training elements may comprise perforated sheets, layered suture pads and tubular elements, simulating skin and blood vessels, and allow the user to practice ligature skills, such as threading and knot tying.

Description

Book structure with integrated surgical skills training elements

Background

Medical, dental and veterinary students and practitioners must undergo extensive training before they are optimally qualified to perform surgery. In particular, tying of surgical knots using the various specialised techniques. ligation of vessds and dissection of tissue pkines requires specific theoretical knowledge as well as practice.

In general, a student's specific training for a surgical procedure is initially limited to medical textbooks, lectures and observation of others. Subsequently students often practice with the aid of specialized simulation devices before performing surgery in the operating room. Such specialized training devices are well described in prior art (e.g. US patent 6398557 and many others).

However, the limitations of currently described surgical skills training devices are legion. An ideal surgical skills training device is realistic, versatile, always available to the student and cheap. However, previously designed surgical skills training devices are usually available only in settings such as clinical skills laboratories in medical schools and hospitals. Rarely do students own personal simulation devices because such devices are often expensive. Furthermore the use of such simu'ation r devices is limited because they are unwieldy, bulky and complex. Therefore they are not easily portable to be calTied by the student and available whenever idle time O presents itself. Finally the previously described simulation devices focus only on the practical aspects of surgical skills training without providing guidance about the theoretical background of the practiced surgical skills. (\J

Statement of invention

The present invention is a book structure with integrated surgical skills training elements. The advantage of this invention is to provide a surgical skills training device that is easily portable and provides students with simultaneous opportunity to practice surgical skills combined with information on the necessary theoretical

background.

Detailed description

Techniques that lend themselves to practicing in accordance with the invention include, for example, different basic knot tying techniques (surgeon's knot, square knot, one-handed techniques, two-handed techniques, etc.), sensitive knot tying of delicate tissues with direct feedback when excessive tension is applied, ligature of vessel or other targets and dissection. The invention is easily portable and provides both the theoretical background regarding the surgical skills as well as an opportunity to practice surgical techniques. This is achieved by combining a book structure with integrated surgical skills training elements. The invention thus allows the student to read about the theoretical background as well as practice the respective surgical skills

I

whenever they have the convenient book structure at hand. The invention also makes it possible for trainees to conveniently practice various techniques in their own time.

The invention is similar in principle to other patented book structures such as US 3,918,180 ("Puppet Book Structure"), US 7,328,790 ("Book with CD Holder"), US 4.372,044 ("Combined Book, Flannelboard and Hand Puppet"), US 5,746,637 ("Children's Book Construction") and US 4,608,024 ("Book with Puppet").

One form of the present invention is a unique surgical skills training device. Other forms include a unique method for surgical skills practice and a unique kit for surgical training. According to the invention, there is a book structure which includes one or more surgical skills training elements for practicing surgical skills which are integrated into on one or more pages of the book, or the book cover. Preferably the surgical skills training elements are integrated into the relevant pages which also describe the theoretical background of the surgical skill.

In one embodiment of the invention, the surgica' skills training element may be as simple as a perforation to thread a ligature through. which then forms an anchor upon which the practiced knots can be tied. The perforation may be re-inforced with other materials such as plastic foil or metal to prevent the ligature from cutting through the page of the book.

C\J in another embodiment of the invention, multiple pages are perforated. The ligature is thread through more than one of the perforated pages. in this way the weight of the pages that anchor the ligature can be regulated. The student knows that he is applying too much tension when a set number of pages are lifted off by gravity while tying. As 0 the student advances in their knot tying skills they will require less and less pages as anchors and tie the knots without the pages lifting off.

In another embodiment of the invention, the perforation includes a slit that connects to the perforation to the border of the page. If too much tension is applied to the ligature it will sfide through the slit, again providing the student with clear feedback that they probably applied too much tension.

In another embodiment of the invention, the surgical skills training element is made from shaped rigid material. The shaped rigid material is integrated into the page or the cover of the book. The shape of the material provides the structure on which to practice the various surgical skills. Differently shaped plastic disks provide tasks with progressively increased difficulty. The plastic may be shaped in the form of a knob, hook, triangle, tube or other shape that is suitable for anchoring a ligature or practicing the necessary surgical skills. For example a narrow bar that terminates in a bulge may be used to simulate a vessel for ligation. The size of the bulge determines how easily knots can be placed on the bar. If the bar is short, and has a convex shape then placing perfect knots can be a rather difficult task. In this way students may be presented with a series of tasks that are more difficult as they advance in their study through the book and their surgical skills develop.

In another embodiment of the invention, the surgical skills training element is made from shaped flexible material. The flexible nature of the material may simulate natural tissues such as blood vessels more closely than rigid material. 1-lowever, it also adds additional difficulty to the surgical task. A flexible strand of several millimeters length may simulate the tip of a bleeding blood vessel for ligation.

In another embodiment of the invention, a multilayered surgical skills training element is integrated into the pages of the book or attached onto the pages to simulate tissue planes. This may be used for practicing dissection while reading about important theoretical principles of dissection, such as traction and counter-traction.

In another embodiment of the invention, the surgical skills training element consists of a thickened layer of materiaL This layer may forms an integral pail of the page or book cover. Alternatively it may be attached onto the page or book cover. This thickened layer may be used to simulate fissues for placement of stitches with a needle while reading about important theoretiS principles of placing needles such as the angie of entry for the needle, and the optimal position of the needle in the needle driver.

In another embodiment the thickened layer may simulate tissue to which another structure can be sutured to simulate fixation of a mesh or skin graft.

In another embodiment of the invention, the thickened layer simulates tissue such as skin to practice incision with a scalpel. At the same time the information printed on the pages provides important background information and notes, e.g. advice to avoid C\J skiving arid the correct way to hold the scalpel. r

In another embodiment of the invention, the thickened layer has a slit. This may simulate muscle tissue for splitting parallel fibers.

In another embodiment of the invention, the thickened layer has a slit to simulate an incision. This may be used to simulate closure of tissues, while reading about important theoretical principles of tissue closures, such as the relative advantages of interrupted and running sutures.

In another embodiment of the invention, the surgical skills training element consists of a flexible material. Two elements made from flexible material may be placed at a defined distance to simulate closure of tissues under tension as well as tying knots under tension. The distance and the flexibility of the surgical skills elements may be regulated to give different levels of tension, which leads to a spectrum of difficulty of the training task. This may simulate different scenarios where tissues are closed under more or less tension. This surgical skills training element may ako illustrate the important theoretical principles of closing tissues under tension (e.g. danger of sutures pulling through tissue, advantage of surgeon's knot for closure of tissues under tension ete). while reading about these relevant theoretical background.

From this description, it will be evident that there are a number of changes, adaptations and modifications of the described training elements to simulate different surgical skills at vanous graded levels of difficulty. These changes, adaptations and modifications will be apparent to those practitioners skilled in the art. Thus, by way of example and not of limitation, the surgica' skills training element described here may have different shapes, and it may be made from paper, plastic or metaL The surgical skills training element maybe contained within the pages of the book, the front cover.

the back cover or the binding. However, it is intended that all such variations not departing from the spirit of the invention be considered as within the scope of the invention and limited solely by the claims appended to this disclosure.

DISTINGUISHING NOVEL FEATURES

A large number of surgical training devices are described in prior art. e.g. US 6,398,557 ("Devices, methods and kits for training in surgical techniques"), US 4,773,864 ("Apparatus for enhancing surgical skills"), US 6,336,812 ("Clinical andlor surgical training apparatus") and US 6,780,016 ("Human surgical trainer and methods for training"). Some of these are portable, e.g. US 7,575.434 ("Surgery practice kit") and US 6,488,507 ("Portable surgical trainer").

The most important novel feature of the disclosed invention is the combination of a book with surgical skills training elements. In this respect the invention is similar in principle to other inventions that combine a book structure with additional functionality, such as US 3,918,180 ("Puppet Book Structure"), US 7,328,790 ("Book with CD Holder"), US 4.372,044 ("Combined Book, Flannelboard and Hand Puppet"), US 5,746,637 ("Children's Book Construction") and US 4,608,024 ("Book with Puppet").

The combination of the book structure with surgical skills training elements provides students with the opportunity to practice surgical skills combined with simultaneous information on the necessary theoretical background. Furthermore, the many pages of the book provide ample space for lots of different and versatile surgical training r elements. As the user progresses through the book the difficulty of the tasks may be designed to increase. A variety of different surgical skills training elements are (0 disclosed, which are optimized for the purpose of combination with a book structure. aD

Claims

Claims I. A book structure comprising a plurality of pages bound together along one edge with covers and one or more surgical skills training elements, which are integrated into the said pages and / or cover and I or binding.
2. The book structure of claim 1 wherein the surgical training elements for a particular surgical skill are located on the same pages that describe the theoretical background relating to the respective surgical skill.
3. The book structure of claim I wherein a surgical training element for tying knots is connected to one or more pages in a way that undue tension exerted during tying will be indicated by lifting the pages into the air.
4. The book structure of claim 1 wherein the surgical training element consists of perforations that allows threading of a ligature thread for practicing surgical knots.
5. The book structure of claim 5 wherein the perforations are strengthened with plastic or metal, preventing cutting of the ligatures through the pages.C1⁄41
6. The book structure of claim 5 wherein the training element includes a slit that r connects the perforation to the edge of the page, thus causing slipping of the ligature if undue tension is applied.0
7. The book structure of claim 1 wherein the training element consists of specially formed structures that are favorable for practicing ligature skills.
8. The book structure of claim 8 wherein the training dement is shaped like a knob.
9. The book structure of claim 8 wherein the training dement has a terminal thickening to allow easier knot tying for beginners.
10. The book structure of claim 8 wherein the training dement is shaped like a hook.
11. The book structure of claim 8 wherein the training element is triangular shaped with or without serrations.
12. The book structure of claim 8 wherein the training dement is tubular.
13. The book structure of claim 1 wherein the training element consists of multiple layers that can be used for practicing dissection.
14. The book structure of claim 1 wherein the training element consists of material with properties similar to skin that can be used for practicing incision.
15. The book structure of claim 1 wherein the training element consists of material with a slit that can be used for practicing closure of a wound with sutures.
16. The book structure of claim 13 wherein the layers are connected by Velcro. (4 r (0 aD