RU161189U1 - SURGICAL SIMULATOR - Google Patents

Abstract

A surgical simulator having a platform for fixing the intestine, placed in the patient’s torso simulator with surgical access to the abdominal organs, characterized in that there are three compartments on the platform: one with an obliquely displaced bottom for the bowel simulator, and the second with a device for forming loop simulator of the intestine and a container for collecting intestinal contents made of elastic material and fixed to the walls of the compartment and the third with a device for rewinding the simulator of the intestine, the lumen of which is filled simulator intestinal contents, and has four layers, simulating intestinal wall shell, wherein the outer layer passes from the intestine and forms dublication simulating mesentery.

Description

The utility model relates to medical equipment, more specifically to devices for training surgical interventions on the hollow organs of the digestive tract, in particular on the intestine.

Well-known medical simulators are presented in the form of phantoms that mimic various anatomical objects of the human body. These phantoms include imitation of the vasculature, chest elasticity, components of the layered structure of the anterior-lateral wall of the abdomen or hollow organ [1-3, 5-12], which we identified as analogues.

A significant drawback of analogues is: the limited options for simulating the features of surgical intervention, for example, the inability to control the output of intestinal contents into the abdominal cavity when an intestinal suture or anastomosis is applied and to control their strength.

The prototype of the proposed model is a solution (according to the patent of the Russian Federation for utility model 6192, G09B 23/28, publ. 16.03.1998 [4]), which has a table-plate, on which two soft intestinal clamps are located parallel to each other with the possibility of changing the distance between them . On the sides and between the soft intestinal clamps, opposite each other, are three pairs of crocodile clamps. On the side of the movable intestinal clamp is a cylinder with a latch on the free edge for donning and fixing the intestine. The opposite edge of the cylinder is hermetically connected by a pipeline to a pear-blower and a pressure gauge. All of these items are located on the table-table on tripods of the same height. After the intestinal suture or anastomosis is applied, their quality is evaluated by pneumocompression, inflating the intestine with air using a pear-blower. According to the pressure gauge, the pressure level that caused the depressurization of the intestine is determined, according to which the strength of the sutures or anastomosis is judged.

A positive effect of the prototype is the ability to determine the quality of application of the intestinal suture or anastomosis, as well as impose any types of intestinal sutures and anastomoses, taking into account the anatomical features of the structure of the intestinal wall and the ability to use the simulator in any room with a demonstration of the surgical techniques necessary to perform surgical interventions on hollow organs digestive tract.

The disadvantage of the prototype is the limited reuse of the intestine, the lack of quality control overlaying an intestinal suture or anastomosis during surgery.

The objectives of the proposed utility model are: creating a simulator that improves the quality of teaching the technique of applying the intestinal suture or anastomosis by simulating a real surgical situation that makes it possible for the contents of the intestine to enter the abdominal cavity in violation of the operation technique; providing the opportunity for several trainees to perform up to 10-15 operations on one simulator of the intestine without replacing it; simplicity and reliability of work on the simulator while improving technical skills during the application of intestinal suture or anastomosis; ensuring a reduction in financial costs for the manufacture of a gut simulator, which is due to the repeated use of a gut filler (in this case, polystyrene granules) and the use of available material for the manufacture of a gut simulator.

The essence of the proposed technical solution is illustrated by drawings, which depict:

in FIG. 1 - kinetic diagram of the simulator (lateral projection);

in FIG. 2 - kinetic diagram of the simulator (top view);

in FIG. 3 - the structure of the simulator of the intestine in cross section;

in FIG. 4 - the structure of the simulator of the intestine;

in FIG. 5 is a kinetic diagram of a simulator prepared for work (side projection).

stroke axis (13), combined with a handle for rewinding (14) of the gut simulator (15). The axis 13 is provided with a spring latch (16) for fixing the bowel simulator. On the inner walls of the outer compartments (2 and 3) in the central compartment (4), a container (17) of elastic fabric, such as rubber tape, is rigidly fixed to collect granules that have fallen from the lumen (35) of the intestinal simulator (Fig. 3) when intestinal suture or anastomosis. Below the container (17), a device (18) is placed for forming a loop of a bowel simulator (Fig. 5). The device 18 consists of a vertical cylinder (19), movably worn on a rod (20), which is rigidly connected by the tablet 1. The cylinder 19 at the upper end has an oval pusher (21) and a protrusion (22) on the body, which is combined with a lifting mechanism, for example, a disk with a displaced center is an eccentric (23), the axis (24) of which is combined with the lifting handle (25). The lower end of the cylinder 19 has a flange (26) and a return spring (27), which is fixed by the protrusion (28) of the wall of the compartment 4, in the opening of which the cylinder 19 moves.

The simulator of the intestine (Fig. 3 and 4) is made in the form of a tube with a diameter of up to 30-35 mm, having outer and inner layers. The outer layer (29) imitating the peritoneum is made of thin elastic tissue, for example, non-woven, passes from the perimeter of the tube and forms a duplicate (30) imitating the mesentery. Between the sheets of duplicate there are dyed threads (31), for example, red and blue, imitating arteries and veins of the mesentery. Three inner layers imitating muscle (32), submucosal (33) and mucous (34) membranes are made of soft elastic tissue of different colors up to 1.0-1.5 mm thick, for example, foamiran. The lumen (35) of the intestine is filled with granules (36), for example, polystyrene, with a diameter of 0.25-0.5 mm.

The operating principle of the surgical simulator is shown in FIG. four.

A bowel simulator 15 fits into the outer compartment 2 and onto the freely rotating cylindrical rollers 8, as shown in FIG. 1. The free end of the simulator of the intestine is fixed by a spring latch 16 to the axis 13 of the rewinding device 10 (see Fig. 1 and 2). Then a bowel simulator loop is formed using the device 18, as shown in FIG. 5. For convenience, the mucous membrane (6) of the shell is made of soft elastic tissue of different colors with a thickness of up to 1.0-1.5 mm, for example, foamiran. The lumen (7) of the intestine is filled with granules (8), for example, polystyrene, with a diameter of 0.25-0.5 mm.

The operating principle of the surgical simulator is shown in FIG. four.

A bowel simulator 15 fits into the outer compartment 2 and onto the freely rotating cylindrical rollers 8, as shown in FIG. 1. The free end of the simulator of the intestine is fixed by a spring latch 16 to the axis 13 of the rewinding device 10 (see Fig. 1 and 2). Then a bowel simulator loop is formed using the device 18, as shown in FIG. 5. For the convenience of working on the intestine, the mesentery is fixed with a clamp (not shown conditionally). After completing all the stages of preparing the surgical simulator for work, it is placed in a case simulating the patient’s trunk (not shown conditionally) with access to the abdominal organs. The used portion of the bowel simulator is placed in a rewinder 10.

Positive effect when working with a surgical simulator:

1. Allows you to impose any kind of intestinal sutures and anastomoses, taking into account the structural features of the intestinal wall;

2. The ability to control the quality and the correct implementation of the technique of applying the intestinal suture or anastomosis during surgery, which provides the possibility of the intestinal contents leaving the intestinal lumen;

3. The closest possible imitation of the imposition of an intestinal suture or anastomosis to the conditions of a real surgical intervention;

4. The ability of several trainees to perform up to 10-15 operations on one simulator of the intestine without replacing it;

5. The simplicity and reliability of the simulator while improving technical skills during the application of intestinal suture or anastomosis and the possibility of use in any classroom;

6. Reducing financial costs for the manufacture of a gut simulator, due to the repeated use of a gut filler (in this case, polystyrene granules) and the use of available material for the manufacture of a gut simulator.

Sources of information taken into account:

1. Copyright certificate 1018147 A, G09B 23/28, publ. 05/15/1981.

2. US patent 49328790, G09B 23/28, publ. 06/12/1990.

3. RF patent 2061969, G09B 23/28, publ. 06/10/1996.

4. RF patent for utility model 6192, G09B 23/28, publ. 03/16/1998.

5. RF patent 2134913, G09B 23/28, publ. 08/20/1999.

6. RF patent 2061969, G09B 23/28, publ. 06/10/1999.

7. RF patent 2189640, G09B 23/28, publ. 09/20/2002.

8. RF patent 2370221, G09B 23/28, А61В 17/04, publ. 10/20/2009.

9. RF patent for utility model 99889, G09B 23/28, publ. 11/21/2010.

10. RF patent 2437166, G09B 23/28, publ. 12/20/2011.

11. RF patent 2459273, G09B 23/28, publ. 08/20/2012.

12. RF patent for utility model 147842, G09B 23/28, publ. 10/16/2014)

Claims (1)

A surgical simulator having a platform for fixing the intestine, placed in the patient’s torso simulator with surgical access to the abdominal organs, characterized in that there are three compartments on the platform: one with an obliquely displaced bottom for the bowel simulator, and the second with a device for forming loops of a bowel simulator and a container for collecting intestinal contents made of elastic material and fixed to the walls of the compartment, and the third with a device for rewinding a bowel simulator, the lumen of which is filled simulator intestinal contents, and has four layers, simulating intestinal wall shell, wherein the outer layer passes from the intestine and forms dublication simulating mesentery.

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