RU2806054C1 - Simulator for practicing manipulations on the vessels of the femoral and patellone region - Google Patents

Abstract

FIELD: teaching aids in medicine.

SUBSTANCE: simulator for practicing manipulations on the vessels of the thigh and patella includes vessel simulators, a device for pumping a pulsating fluid flow, and a control unit with software are proposed. The simulator is a resilient and elastic simulator of the thigh and groin with bone landmarks and holes in the femoral and patella regions for visualization of blood vessels, truncated from above by a horizontal plane above the navel, outwards — sagittal behind the navel, along the back surface — by a frontal plane passing along it. In projections of access to the femoral and patella arteries, cavities are made in the simulator of the thigh and groin to accommodate replaceable blocks, which are solid silicone blocks with simulators of the skin, muscles, and femoral or patella arteries. The arteries are hidden by muscle bundles arranged in the form of stretched valves. Bony landmarks are placed with the possibility of designating tactile landmarks: femoral, patella, pubic with a portion of the ischial, iliac in the region of the anterior superior spine. The control unit is configured to collect data on the time intervals for performing manipulations using a pressure sensor and monitor the results of their implementation. Vessel simulators are a closed system of tubes with a device for pumping a pulsating liquid. The ratios of the inner diameter and wall thickness of the vessels are selected in the following femoral region: 10–12/1–1.5mm; in the patella 6–8/1 mm.

EFFECT: ensuring the development of operations on the femoral and patellar arteries in areas typical for access and close to real conditions.

1 cl, 6 dwg

Description

The present invention relates to medicine, to devices for training doctors in the specialties of professional and educational standards: “surgery”, “cardiovascular surgery”, “anesthesiology and resuscitation”, “radiology and ultrasound diagnostics”. The simulator is designed for practicing operations on the femoral and patellar arteries in typical access areas.

Currently, for training skills in accessing vessels, the device “The VI Box - Pulsatile Wet Lab Box” (https://lifelikebiotissue.com/shop/cardiac/vi-box) is known, into which the operating block “Embedded Femoral Groin Model” is installed. . The simulator includes synthetic vessels that realistically replicate the tissue of arteries and veins. The basis of the operating unit is a material that allows the use of ultrasound navigation when performing manipulations. The simulator is equipped with a mechanism that pumps a pulsating and constant flow of liquid.

The disadvantages of the device are:

a) the operating module is made of hydrophilic materials, which have a limited period of operation and are accompanied by certain difficulties in maintaining and transporting replaceable units;

b) the primitive execution of the model does not allow realistic visualization of anatomical areas;

c) the high cost of a replaceable unit limits the widespread use of the simulator in practical training;

d) the tissues surrounding the vessels, as well as the imitation of the skin, are quite slippery and rough under tactile and operational influence.

Among domestic devices, the invention “Universal simulator for teaching Doppler measurements, puncture and catheterization of vessels under ultrasound control” is known (patent RU 2739667C1, IPC No. G09B 23/286, 12/28/2020). The simulator allows you to perform invasive manipulations under ultrasound guidance. The device is represented by a container for liquid, which communicates with a rotary pump, which provides peristaltic supply of liquid. It is noted that it is possible to change the rotor rotation speed. The ultrasound unit contains simulators of vessels of different diameters, which are arranged in a serpentine manner.

The disadvantages of the device are:

a) a rotary pump does not provide the most realistic simulation of vascular peristalsis, since it cannot provide sufficient fluid pressure in the tubing system;

b) the lack of a software and hardware solution for error analysis does not allow us to fully judge the correctness of invasive manipulations;

c) the continuous course of a vessel of different diameters, located in a serpentine manner, does not correspond to the ideas of topographic human anatomy, which can contribute to the consolidation of false skills and knowledge;

d) the absence of vein and nerve simulators in the ultrasound module limits the training capabilities of the device.

The proposed technical solution allows us to eliminate the identified shortcomings of analogues. The invention is based on the task of creating a more accurate model of the simulator.

The solution to this problem is ensured by the fact that the simulator for practicing manipulations on the vessels of the thigh and patellar region, including vessel simulators, a device for injecting a pulsating fluid flow and a control unit with software, is an elastic and elastic simulator of the thigh and groin with bone landmarks and holes in the femoral and suprapatella areas for visualization of blood vessels, truncated from above by a horizontal plane above the navel, outwardly by a sagittal plane behind the navel, along the posterior surface by a frontal plane running along it; in the access projections to the femoral and patellar arteries, cavities are made in the femoral and groin simulator to accommodate replaceable blocks, which are solid silicone blocks with simulators of skin, muscles and the femoral or patellar arteries, while the arteries are hidden by muscle bundles located in the form of tensioned flaps, bone landmarks are placed with the ability to designate tactile landmarks: femoral, patella, pubic with the sciatic area, iliac in the area of the anterior superior spine; the control unit is configured to collect data on time intervals for performing manipulations using a pressure sensor and monitoring the results of their implementation; vessel simulators are a closed system of tubes with a device for injecting pulsating liquid; and the ratio of the internal diameter and wall thickness of the vessels is selected in the femoral region: 10-12/1-1.5 mm; in the patella region 6-8/1 mm.

Making the simulator from elastic elastic materials provides a clearer understanding of tactile interactions with tissues. The presence of blocks also makes it possible to more accurately familiarize yourself with the areas of the muscles being studied. The presence of a control unit with software provides the ability to control the execution of skills.

The invention is illustrated in Fig. 1, which shows the general guidelines of the model, FIG. 2, which shows the existing bony landmarks, FIG. 3, which shows the arrangement of technical cavities, FIG. 4, which shows operational approaches. In fig. 5 shows the control unit, Fig. 6 - device controls.

The simulator is made of artificial materials that are safe for human health, closely resembling real tissue in terms of visual and tactile characteristics (including when exposed to, for example, an incision, a puncture), and is represented by an elastic, elastic imitation of the hip and groin with bone landmarks and the presence of holes in the femoral and suprapatella areas for visualization of the vessels of the same name. The anatomical model (Fig. 1) has boundaries and is truncated by planes: from above - horizontal above the navel 1, from the outside - sagittal 2 behind the navel, along the back surface - frontal 3 by a quarter along the model.

The leg is placed in a position corresponding to the typical position on the operating table, namely with the hip abducted outward and the knee slightly bent (Fig. 1). In the access projections (Fig. 2) to the femoral and patellar arteries, impressions are made - cavities for replaceable blocks of 4 different types. In the area of both approaches, areas of muscles located in the form of tense flaps (sartorius, adductor, gracilis, biceps, etc.) are marked as an obstacle.

The simulator includes areas of bone imitation (Fig. 3) to indicate tactile (during palpation) landmarks: part of the ilium in the area of its anterior superior spine 5, pubis with the ischium area 6, femur 7, patella 8.

The simulator contains a closed system of tubes (shown as a continuous and dotted line in Fig. 4). The simulator can be supplemented with a pulsating fluid injection device, a remote control program (control unit) (Fig. 5) and device controls (Fig. 6).

Replacement block variations:

- a single block with skin cover, muscle valves and artery. One-piece silicone block, fibrous, stretchable, implying step-by-step isolation of the artery before work. The one-piece block allows you to practice ultrasonic microinvasive skills on the neurovascular bundle (puncture, catheterization);

- the surgical area already contains an incision. The skin is spread to the sides. Deeper, in the middle, there are 2 bundles of muscles, made in the form of “ajar gates”, in the depths of which the artery is located. The femoral or patellar artery is hidden by muscle bundles and is the subject of the task. Training the skill involves the use of an additional tool (retractor) or an assistant.

- with a free-lying artery. Paved walls, wide space. The artery is located at the bottom of a deep wound measuring 15x7 cm.

Vessel variations (internal diameter / wall thickness, mm):

- femoral area: 10-12/1-1.5;

- patellar region: 6-8/1.

The software is designed for the version of the simulator with a pulsating pump and allows you to control one or more (2, 3, 4, 10, etc.) connected simulators via a network based on a Wi-Fi data transmission channel. As a result of the operation of the product in the control unit of Fig. 6, the following data is collected, namely, the parameters are registered: profile name, access speed - from start to the time of vessel clamping (the pressure sensor registers the absence or change of current and marks the time period between the specified parameters, the time of the actual operation (before removing the holder) , control (visual, hardware) of work results.

Formal control of the performance of skills is carried out, among other things, using rating assessment methods.

The software performs the following functions:

Turning the simulator on and off from the remote control and directly from the offer.

By activating the pressure sensor, it describes the time intervals for performing a specific operation.

Contains a standard skills assessment application (approved by the accreditation council), as well as a specially developed complex 5-point algorithmic application for assessing current data using an adapted multi-level system for complex assessment of practical skills.

This educational product is intended for practicing surgical interventions on blood vessels in the specified areas, and also implies the use of the model as a whole when demonstrating the performance of surgical skills. In the areas intended for surgical intervention, blocks with vessels are located, with and without the possibility of pulsation. When the start command is activated on the control unit, pulsating liquid is supplied to the closed system of vessels. The pulsating area enters the imitation of the arteries of the femoral and patellar region, as well as through technical breaks in the vascular system in the vestibule of the popliteal block to achieve loss of pulsation into the vein of the patellar region.

Claims (1)

A simulator for practicing manipulations on the vessels of the thigh and patellar region, including vessel simulators, a device for injecting a pulsating fluid flow and a control unit with software, characterized in that it is an elastic and elastic simulator of the thigh and groin with bone landmarks and holes in the femoral and patellar regions for visualization of blood vessels, truncated from above by a horizontal plane above the navel, outwardly sagittally behind the navel, along the posterior surface by the frontal plane running along it; in the access projections to the femoral and patellar arteries, cavities are made in the femoral and groin simulator to accommodate replaceable blocks, which are solid silicone blocks with simulators of skin, muscles and the femoral or patellar arteries, while the arteries are hidden by muscle bundles located in the form of tensioned flaps, bone landmarks are placed with the ability to designate tactile landmarks: femoral, patella, pubic with the sciatic area, iliac in the area of the anterior superior spine; the control unit is configured to collect data on time intervals for performing manipulations using a pressure sensor and monitoring the results of their implementation; vessel simulators are a closed system of tubes with a device for injecting pulsating liquid; and the ratio of the internal diameter and wall thickness of the vessels is selected in the femoral region: 10-12/1-1.5 mm; in the patella region 6-8/1 mm.