RU145797U1 - DEVICE FOR TEACHING DOCTORS TO MANUAL SKILLS OF LAPAROSCOPIC CHOLECYSTECTOMY - Google Patents

Abstract

A device for training surgeons in manual skills of laparoscopic cholecystectomy, containing a model in the form of an anatomical preparation with preserved soft tissues subjected to polymer embalming, characterized in that an inlet for an endoscope is made in the navel; on the projection of the path of the endoscope from the inlet to the bed of the gallbladder on the surface of the skin of the abdomen are placed at the same distance from each other metal plates - beacons, made with the possibility of transmitting to the computer a signal about the path of the tip of the endoscope; a U-shaped incision was made on the anterior abdominal wall above the gallbladder with the formation of a window with a folding flap to the gallbladder bed, the gallbladder replaced by a mannequin fixed at the points of natural fixation of the gallbladder.

Description

The utility model relates to the field of medicine, in particular to the field of abdominal surgery and can be used to train surgeons in the skills of endoscopic cholecystectomy, one of the most frequently performed endoscopic surgeries.

In recent years, SILS (Single Incision Laparoscopic Surgery) or single laparoscopic access surgery has been increasingly used. This is a modern minimally invasive technology, with the help of which surgical intervention is carried out through one trocar access. The essence of this method is to perform a laparoscopic cholecystectomy through a special port (device) that is inserted in the umbilical region. The diameter of this port is 23-24 mm. Laparoscopic instruments and a laparoscope with a diameter of 5 mm are passed through it. After the operation is completed, the device along with the gallbladder is removed from the abdominal cavity. A cosmetic suture is applied to a small wound in the umbilical region. The advantages of this method of laparoscopic treatment of calculous cholecystitis over conventional laparoscopic access are the reduction in the number of punctures on the abdominal wall, the reduction of pain after surgery, quick rehabilitation and the best cosmetic effect. Maximum benefits of S.I.L.S. open with large and multiple stones in the gallbladder, as the surgeon is forced with conventional laparoscopy to expand the puncture in the navel to extract the diseased organ.

Currently, there are special mechanical (static) endoscopic models designed to contribute to the faster development of coordination of movements by the future endoscopist and effective training in the management of the endoscope. Simple, inexpensive, and widely available materials are used to create these types of models of the gastrointestinal tract. One of the first models was created in the late 1960s and was intended for the training of rigid proctosigmoscopy. The first rubber models of the colon and upper gastrointestinal tract were created after the advent of flexible endoscopes. They allowed not only to learn how to insert an endoscope, but also to recognize various pathologies, such as polyps. After the appearance of pancreatobiliary endoscopy, a model of the upper parts of the gastrointestinal tract with bile ducts was created.

Computer simulators:

Known simulators that were originally used in aviation for training pilots. Based on them, simulators for use in medicine were developed. The first creators of endoscopic computer simulators set requirements for them. In this type of simulators, as the endoscope moves along the artificial gastrointestinal tract, information from the sensors is transmitted to a computer, where it is processed and the resulting image is displayed on the monitor. Special devices provide tactile feedback. Images are displayed using interactive video technology when they are stored on a laser disk; using computer graphics modeling, when images are generated by a computer; or using a combination of the two above methods. Recent advances in computer technology have led to a significant improvement in the capabilities of video technology.

Known computer simulators company Johnson and Johnson (USA) NEW Johnson & Johnson Wound Management, computer simulators Simbionix. SIMBIONIX, founded in 1997, is a world leader in the development of virtual technologies used to create medical computer simulators. The use of computer simulators in the training of doctors in high-tech diagnostic and treatment methods has become one of the most important achievements in world educational activities of the last decade.

It is known that doctors teach manual skills using both animals under anesthesia and their individual organs and tissues (Ex vivo models).

The disadvantages of the known models are the impossibility of providing high visibility and informational content of training, the high cost of equipment, the inability to create an environment close to real during the training period.

The purpose of the utility model is to provide visual and informative learning.

The goal is achieved in that the device containing the model in the form of an anatomical preparation with preserved soft tissues subjected to polymer embalming, contains an entrance hole for the endoscope made in the navel area; on the projection of the path of the endoscope from the inlet to the bed of the gallbladder on the surface of the skin of the abdomen are placed at the same distance from each other metal plates - beacons, made with the possibility of transmitting to the computer a signal about the path of the tip of the endoscope; a U-shaped incision was made on the anterior abdominal wall above the gallbladder with the formation of a window with a folding flap to the gallbladder bed, the gallbladder replaced by a mannequin fixed at the points of natural fixation of the gallbladder

Figure 1 presents a General view of the device. The device contains a breadboard (1) in the form of an anatomical preparation with preserved soft tissues subjected to polymer embalming, contains an inlet for an endoscope made in the navel area (2); on the projection of the path of the endoscope (3) from the inlet (2) to the bed of the gallbladder (4) on the surface of the skin of the abdomen metal plates are placed at the same distance from each other - beacons (5), configured to transmit a signal to the computer (6) about the path of advancement of the endoscope tip (3); on the anterior abdominal wall above the gallbladder region (4), a U-shaped incision was made with the formation of a window with a folding flap (7) to the gallbladder bed (4), the gallbladder (4) being replaced by a mannequin fixed at the points of natural fixation of the gallbladder.

The operation of the device.

A trained surgeon through a trocar inserted into the inlet for an endoscope (2), made in the navel area of the model (1), inserts an endoscope (3) and advances it by looking at the screen of the endovidiomonitor. In case of deviation from the intended path of advancement of the endoscope tip, the signal from the beacon plate (5) enters the computer (6) with sound and light signals, the path is corrected. The path between 1-2 beacons corresponds to the endoscope section above the anterior vaginal wall of the rectus abdominis muscle; in the area of the 2nd beacon - the endoscope tip is carried out through the front wall of the vagina of the rectus abdominis muscle; the path between 2-3 beacons corresponds to the area of the endoscope tip through the fibers of the rectus abdominis muscle; in area 3 of the beacon, the endoscope tip is planned to be drawn through the back wall of the vagina of the rectus abdominis muscle; the path between 3-4 beacons corresponds to - the advancement of the tip under the back wall of the vagina towards the bed of the gallbladder.

The endoscope is brought to the gallbladder mockup (4), it is selected, the gallbladder bed is plasticized and brought out. The well window (7) allows you to visually verify the correctness of the manipulation. A U-shaped incision allows you to readily allow the benefit to be repeated in a short time. The benefits of endoscopic surgery.

A large incision, usually used in traditional surgery, significantly injures muscle tissue. In this regard, pain occurs after surgery, and the healing period of the wound takes quite a long time. Small punctures made during endoscopic surgery do not injure muscle tissue. As a result of this, patients:

- they experience much less pain after surgery, which can eliminate the need for prescribing painkillers;

- spend less time in the hospital;

- they recover faster, they can quickly return to normal life and go to work;

- have no worries about the postoperative scar.

According to the proposed scheme, it is possible to create simulators for teaching doctors the skills of endovidiosurgery for the treatment of diseases of other organs and tissues.

Claims (1)

A device for training surgeons in manual skills of laparoscopic cholecystectomy, containing a model in the form of an anatomical preparation with preserved soft tissues subjected to polymer embalming, characterized in that an inlet for an endoscope is made in the navel; on the projection of the path of the endoscope from the inlet to the bed of the gallbladder on the surface of the skin of the abdomen are placed at the same distance from each other metal plates - beacons, made with the possibility of transmitting to the computer a signal about the path of the tip of the endoscope; a U-shaped incision was made on the anterior abdominal wall above the gallbladder with the formation of a window with a folding flap to the gallbladder bed, the gallbladder replaced by a mannequin fixed at the points of natural fixation of the gallbladder.