WO2005083653A1 - Dispositif d'entrainement a la chirurgie laparoscopique a placement d'instruments reglable - Google Patents

Dispositif d'entrainement a la chirurgie laparoscopique a placement d'instruments reglable Download PDF

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Publication number
WO2005083653A1
WO2005083653A1 PCT/US2005/004081 US2005004081W WO2005083653A1 WO 2005083653 A1 WO2005083653 A1 WO 2005083653A1 US 2005004081 W US2005004081 W US 2005004081W WO 2005083653 A1 WO2005083653 A1 WO 2005083653A1
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WO
WIPO (PCT)
Prior art keywords
container
training device
laparoscopic
webcam
digital camera
Prior art date
Application number
PCT/US2005/004081
Other languages
English (en)
Inventor
Steve Y. Chung
Gerhard J. Fuchs
Christopher S. Ng
Original Assignee
Cedars-Sinai Medical Center
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cedars-Sinai Medical Center filed Critical Cedars-Sinai Medical Center
Publication of WO2005083653A1 publication Critical patent/WO2005083653A1/fr

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Classifications

    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
    • G09B23/285—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine for injections, endoscopy, bronchoscopy, sigmoidscopy, insertion of contraceptive devices or enemas

Definitions

  • the invention relates to the field of training devices for medical procedures. More particularly, the invention relates to a training device that may be used in connection with practicing laparoscopic surgical procedures.
  • Laparoscopic surgery also referred to as minimally invasive surgery, endoscopic surgery, and videoscopic/telescopic surgery
  • Laparoscopic techniques are used in an astonishing array of surgical procedures including gallbladder surgery (cholecystectomies), appendectomies, gastroesophogal-refiux surgery, colorectal surgery, hernia repair, spleen removal, surgical treatment of adrenal tumors, freeing of intraabdominal adhesions, cardiovascular surgery, urologic surgery, gynecologic surgery, and diagnostic laparoscopies.
  • the invention is based on a device mat may be used for training in connection with various laparoscopic procedures, and methods of using the same.
  • the device is particularly well suited to simulate real-life operating conditions and to assist in training for various operative techniques, as, for example, suturing tissues, cutting off organs and tying knots.
  • the present invention has a number of advantages over currently available training devices currently used in the art as it provides a significantly more versatile training device that can be manufactured at a markedly lower cost.
  • One embodiment of the present invention thus includes a container with at least one penetrable surface formed of a gel or similar material that can be punctured with a laparoscopic instrument, but which substantially retains its shape when the instrument is removed.
  • the penetrable surface of the training device may, for example, be constructed of Latex® or a rubber-like material, a gel or a gel-like material, or a similar material.
  • the training device also includes a webcam, digital camera or other similar real-time video device to monitor the simulated procedure performed inside the container.
  • a webcam or digital camera may be configured inside the container or on its exterior.
  • the container includes an aperture or transparent surface region through which the camera may create a video of events taking place inside the container. The video, either realtime or captured, may be transmitted to others for viewing using the Internet.
  • a light source may be included in the container or may be located outside of the container (with an aperture and/or transparent surface region similar to the aperture required for the web or digital camera) to illuminate the container's interior.
  • grips or clamps configured on adjustable arms may also be included in the container. The clamps may be used, for example, to grasp or hold in place various objects that may be used in connection with a simulated procedure.
  • a method for laparoscopic surgical training is provided.
  • the method includes any and/or all of the following: mounting one or more objects within a container as described above; inserting a surgical laparoscopic instrument or instruments through any of the at least one penetrable surface such that a first end of the surgical instrument(s) is within the container; performing a simulated laparoscopic procedure by manipulating the surgical instruments); and viewing the simulated laparoscopic procedure on a computer or other display apparatus (e.g., a television monitor) via a webcam or digital camera.
  • a computer or other display apparatus e.g., a television monitor
  • FIG. 1 is a perspective view of a training device in accordance with an embodiment of the present invention.
  • Fig. 2 A is a graphical representation depicting the time required for subjects to complete a first task using a video pelvitrainer system, a dual mirror SIMUVIEW® training system, and a webcam training system in accordance with an embodiment of the present invention.
  • Fig. 2B is a graphical representation depicting the time required for subjects to complete a second task using a video pelvitrainer system, a dual mirror SIMUVIEW® training system, and a webcam training system in accordance with an embodiment of the present invention.
  • the invention is based on a device that may be used for training in connection with various laparoscopic procedures, and methods of using the same.
  • the device is not limited to use in this particular field of art, however, as it may find application in numerous unrelated fields of art.
  • laparoscopic surgical training the device is particularly well suited to the simulation of real-life operating conditions and, therefore, to training for various operative techniques; for example, suturing tissues, cutting off organs and tying knots, although still further operative techniques may be performed, as will be readily appreciated by those of skill in the art of laparoscopy.
  • the present invention is useful in the teaching, training and improving of eye-hand coordination, manual dexterity and surgical technique.
  • a laparoscopic training device may include a container.
  • the container may be configured in any of a variety of shapes.
  • the container is roughly a cube, although it may also be, for example, spherical, cylindrical, or may be shaped so as to mimic a particular region of the human body (e.g., the pelvic or abdominal cavity) or to maximize storage and/or shipping efficiency as a commercial product.
  • Any or all of the sides of the container may independently be configured so as to be fixed or openable.
  • one or more sides of the container may be made openable; thereby providing access into the container's interior to enable one to, for instance, set up or remove objects (e.g., foam rubber simulations of human organs) for practicing a surgical technique.
  • objects e.g., foam rubber simulations of human organs
  • Such objects may be mounted and anchored on pads and/or platforms of the same or different material.
  • an object or objects can be maintained in position by one or more adjustable or malleable grips; two grips 41, 42 are illustratively depicted in Fig. 1, although any number of grips may be included in the container of the invention in still further alternate embodiments thereof. As depicted in Fig.
  • the container of the invention may include at least one penetrable surface 20.
  • the penetrable surface 20 is capable of being punctured with a laparoscopic instrument 30, but it substantially retains its shape when the instrument 30 is removed.
  • the penetrable surface 20 of the training device may, for example, be constructed of Latex® or a rubber-like material, a gel or a gel-like material, or a similar material; although additional materials that exhibit the desired properties may be used in alternate embodiments of the invention and are considered to be within the ambit thereof, as will readily be appreciated by those of skill in the art.
  • a single penetrable surface 20 is included and is configured as the top surface of the training device; however, the container may include multiple penetrable surfaces (not shown).
  • the top surface of the container need not be a penetrable surface.
  • the container may be configured such that the penetrable surface is located on one or more of the sides of the container, or at still another location. This depends, at least in part, on the overall shape selected for the container and the intended use therefor.
  • the gellike surface can be configured so as to be slidably or otherwise removable from the side of the training device to which it is mated during normal use. As such, the gel-like surface can be readily removed and replaced; particularly when it has already been used repeatedly.
  • the training device of the invention may further include a web or digital camera 80.
  • the web or digital camera 80 may be in communication with the Internet, such that operative techniques performed by a device user may be viewed and/or recorded.
  • the web or digital camera 80 may alternatively or additionally be in electronic communication with any suitable electronic device, as will be readily appreciated by those of skill in the art; for example, a digital video recorder, a computer, a local area network, or the like (not shown).
  • the webcam or digital camera may be connected to a portable or desktop computer with software that enables it to operate.
  • the web or digital camera of the invention enables one to, for example, visualize laparoscopic instrument maneuvers in real-time (e.g., on a television monitor) while the procedure is being performed. This is very similar to the manner in which actual laparoscopic surgery is performed.
  • the video taken by the web or digital camera may alternatively or additionally be broadcast over the Internet or another network or electronic mode of communication for "telementoring" or group discussions. This may be particularly valuable in connection with the invention's use as a teaching tool for students at remote locations. Furthermore, any video may be recorded by conventional systems for later viewing or archiving.
  • the web or digital camera 80 may be configured inside the container or on its exterior. In those embodiments of the invention wherein the web or digital camera 80 is configured on the exterior of the container, the container includes an aperture or transparent surface region through which the camera 80 may create a video of events taking place inside the container.
  • a light source 60 may be also included in the container or may be located outside of the container (with an aperture and/or transparent surface region similar to the aperture required for the web or digital camera 80) to illuminate the container's interior.
  • the objects located within the cavity may also include, simply by way of example, a hook and loop fastener tape set to secure it in a particular location for performing a practice procedure. Any hook and loop fastener set known in the art may be used, as for example, a Velcro® hook and loop fastener set.
  • Other apparatuses for securing, affixing, or removably mounting objects at various locations within the container may be used in alternate embodiments; for instance, snap fittings, adhesive tape, buttons, and the like.
  • Another embodiment of the invention provides a simulation method for laparoscopic techniques using a training device.
  • the method may be employed in connection with training and/or enhancing the skills of an individual in a laparoscopic procedure.
  • This simulation method includes providing a surgical training device substantially as described above.
  • One or more objects may be included or placed inside the container of the device, and may remain loose or may be affixed thereto or otherwise removably mounted therein.
  • the one or more objects may be simulative of components of internal human anatomy.
  • a webcam or digital camera included in the training device may be activated so as to record events occurring inside the container of the training device.
  • a light may be turned on to illuminate an interior of the container of the training device.
  • the simulation method may further comprise any or all of the following: removably inserting an endoscopic instrument through any site through a penetrable surface configured on the training device such that a first end of the instrument is within the container of the device while a second end of the instrument is outside the container of the device; manipulating the second end of the instrument to effect actuation and/or movement of the first end of the instrument such that an operative procedure is mimicked; viewing maneuvers of laparoscopic instruments on a display via the digital or web camera; and transmitting and/or broadcasting the maneuvers occurring within the container via the Internet.
  • EXAMPLE The Example described herein demonstrates one of various uses for the device of the present invention in connection with training for surgical procedures. The device of the present invention has many uses beyond those illustrated herein, however, and the ensuing Example is in no way intended to delineate the extent to which the device of the present invention may find application with a medical, or indeed any type of procedure.
  • a training device substantially as described above, includes a webcam, a cardboard box for a container, a desk lamp as a light source, and a home computer in electronic communication with the webcam to record and transmit video of events inside the container across the Internet.
  • This training device was evaluated against two commercially available systems: video PELVITRAINER (Karl Storz) and the dual mirror SIMUVIEW (Simulab).
  • the PELVITRAINER consists of a fiberglass box, a single lens optic laparoscope, a fiberoptic light source, an endoscopic camera, and a video monitor.
  • the SIMUVIEW trainer utilizes two offset, facing mirrors and an uncovered plastic box.
  • the time required to complete both skill tests decreased significantly for all three trainers (p ⁇ 0.01 for both tasks).
  • the inventive training device offers an inexpensive alternative for learning basic laparoscopic skills for those without prior experience in laparoscopic procedures.

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  • Engineering & Computer Science (AREA)
  • General Physics & Mathematics (AREA)
  • Health & Medical Sciences (AREA)
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  • Medical Informatics (AREA)
  • Medicinal Chemistry (AREA)
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  • Radiology & Medical Imaging (AREA)
  • Pulmonology (AREA)
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  • Pure & Applied Mathematics (AREA)
  • Business, Economics & Management (AREA)
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Abstract

L'invention concerne un dispositif d'entraînement utilisé pour simuler des interventions chirurgicales laparoscopiques. Le contenant du dispositif d'entraînement comprend une surface pénétrable en Latex® ou en matériau de type caoutchouc, en gel ou en matériau de type gel ou un matériau similaire permettant d'introduire des instruments laparoscopiques à un emplacement quelconque sans casser le dispositif. Des clamps ou des crochets réglables peuvent être compris dans le contenant du dispositif, de manière à fixer des objets, aux fins de manipulation au moyen d'outils laparoscopiques. Une webcam ou une caméra numérique peut être prévue afin de visualiser et d'enregistrer des événements à l'intérieur du dispositif d'entraînement en temps réel. La caméra (webcam ou numérique) peut être connectée à un dispositif électronique approprié quelconque (tel qu'un ordinateur), aux fins de visualisation en temps réel de déplacements dans la cavité. Les déplacements en temps réel capturés peuvent être diffusés sur Internet ou par d'autres moyens à des parties à distance.
PCT/US2005/004081 2004-02-24 2005-02-09 Dispositif d'entrainement a la chirurgie laparoscopique a placement d'instruments reglable WO2005083653A1 (fr)

Applications Claiming Priority (2)

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US54739604P 2004-02-24 2004-02-24
US60/547,396 2004-02-24

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Cited By (33)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008041021A1 (fr) * 2006-10-05 2008-04-10 Isurgicals Dispositif de formation à l'endoscopie
US7594815B2 (en) * 2003-09-24 2009-09-29 Toly Christopher C Laparoscopic and endoscopic trainer including a digital camera
US8007281B2 (en) 2003-09-24 2011-08-30 Toly Christopher C Laparoscopic and endoscopic trainer including a digital camera with multiple camera angles
CN102708745A (zh) * 2012-05-17 2012-10-03 徐州医学院 一种穿刺操作训练装置
GB2508510A (en) * 2012-10-30 2014-06-04 Truinject Medical Corp System for providing injection training
US9792836B2 (en) 2012-10-30 2017-10-17 Truinject Corp. Injection training apparatus using 3D position sensor
US9922578B2 (en) 2014-01-17 2018-03-20 Truinject Corp. Injection site training system
US10235904B2 (en) 2014-12-01 2019-03-19 Truinject Corp. Injection training tool emitting omnidirectional light
US10269266B2 (en) 2017-01-23 2019-04-23 Truinject Corp. Syringe dose and position measuring apparatus
US10290232B2 (en) 2014-03-13 2019-05-14 Truinject Corp. Automated detection of performance characteristics in an injection training system
US10500340B2 (en) 2015-10-20 2019-12-10 Truinject Corp. Injection system
US10648790B2 (en) 2016-03-02 2020-05-12 Truinject Corp. System for determining a three-dimensional position of a testing tool
US10650703B2 (en) 2017-01-10 2020-05-12 Truinject Corp. Suture technique training system
EP3675082A1 (fr) * 2010-10-01 2020-07-01 Applied Medical Resources Corporation Dispositif d'apprentissage portatif pour laparoscopie.
US10743942B2 (en) 2016-02-29 2020-08-18 Truinject Corp. Cosmetic and therapeutic injection safety systems, methods, and devices
US10810907B2 (en) 2016-12-19 2020-10-20 National Board Of Medical Examiners Medical training and performance assessment instruments, methods, and systems
US10849688B2 (en) 2016-03-02 2020-12-01 Truinject Corp. Sensory enhanced environments for injection aid and social training
US10991270B2 (en) 2013-03-01 2021-04-27 Applied Medical Resources Corporation Advanced surgical simulation constructions and methods
US11034831B2 (en) 2015-05-14 2021-06-15 Applied Medical Resources Corporation Synthetic tissue structures for electrosurgical training and simulation
US11049418B2 (en) 2013-06-18 2021-06-29 Applied Medical Resources Corporation Gallbladder model
US11100815B2 (en) 2015-02-19 2021-08-24 Applied Medical Resources Corporation Simulated tissue structures and methods
US11120708B2 (en) 2016-06-27 2021-09-14 Applied Medical Resources Corporation Simulated abdominal wall
US11158212B2 (en) 2011-10-21 2021-10-26 Applied Medical Resources Corporation Simulated tissue structure for surgical training
US11361679B2 (en) 2012-09-27 2022-06-14 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US11403968B2 (en) 2011-12-20 2022-08-02 Applied Medical Resources Corporation Advanced surgical simulation
US11450236B2 (en) 2013-07-24 2022-09-20 Applied Medical Resources Corporation Advanced first entry model for surgical simulation
US11514819B2 (en) 2012-09-26 2022-11-29 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US11587466B2 (en) 2015-07-16 2023-02-21 Applied Medical Resources Corporation Simulated dissectible tissue
US11721240B2 (en) 2015-06-09 2023-08-08 Applied Medical Resources Corporation Hysterectomy model
US11721242B2 (en) 2015-10-02 2023-08-08 Applied Medical Resources Corporation Hysterectomy model
US11854425B2 (en) 2013-07-24 2023-12-26 Applied Medical Resources Corporation First entry model
US11887504B2 (en) 2014-11-13 2024-01-30 Applied Medical Resources Corporation Simulated tissue models and methods
US11990055B2 (en) 2012-09-27 2024-05-21 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures

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DE4105892A1 (de) * 1991-02-14 1992-08-27 Arnold Dipl Ing Dr Med Pier Trainingsgeraet fuer die laparoskopische operationstechnik
US5403191A (en) * 1991-10-21 1995-04-04 Tuason; Leo B. Laparoscopic surgery simulator and method of use
US6659776B1 (en) * 2000-12-28 2003-12-09 3-D Technical Services, Inc. Portable laparoscopic trainer

Patent Citations (3)

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Publication number Priority date Publication date Assignee Title
DE4105892A1 (de) * 1991-02-14 1992-08-27 Arnold Dipl Ing Dr Med Pier Trainingsgeraet fuer die laparoskopische operationstechnik
US5403191A (en) * 1991-10-21 1995-04-04 Tuason; Leo B. Laparoscopic surgery simulator and method of use
US6659776B1 (en) * 2000-12-28 2003-12-09 3-D Technical Services, Inc. Portable laparoscopic trainer

Cited By (50)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7594815B2 (en) * 2003-09-24 2009-09-29 Toly Christopher C Laparoscopic and endoscopic trainer including a digital camera
US8007281B2 (en) 2003-09-24 2011-08-30 Toly Christopher C Laparoscopic and endoscopic trainer including a digital camera with multiple camera angles
US8323028B2 (en) 2006-10-05 2012-12-04 Mudit Matanhelia Endotrainer
WO2008041021A1 (fr) * 2006-10-05 2008-04-10 Isurgicals Dispositif de formation à l'endoscopie
US10854112B2 (en) 2010-10-01 2020-12-01 Applied Medical Resources Corporation Portable laparoscopic trainer
EP3675082A1 (fr) * 2010-10-01 2020-07-01 Applied Medical Resources Corporation Dispositif d'apprentissage portatif pour laparoscopie.
US11158212B2 (en) 2011-10-21 2021-10-26 Applied Medical Resources Corporation Simulated tissue structure for surgical training
US12014652B2 (en) 2011-10-21 2024-06-18 Applied Medical Resources Corporation Simulated tissue structure for surgical training
US11403968B2 (en) 2011-12-20 2022-08-02 Applied Medical Resources Corporation Advanced surgical simulation
CN102708745A (zh) * 2012-05-17 2012-10-03 徐州医学院 一种穿刺操作训练装置
US11514819B2 (en) 2012-09-26 2022-11-29 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US11361679B2 (en) 2012-09-27 2022-06-14 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US11990055B2 (en) 2012-09-27 2024-05-21 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US11869378B2 (en) 2012-09-27 2024-01-09 Applied Medical Resources Corporation Surgical training model for laparoscopic procedures
US8961189B2 (en) 2012-10-30 2015-02-24 Truinject Medical Corp. System for cosmetic and therapeutic training
GB2508510B (en) * 2012-10-30 2014-11-26 Truinject Medical Corp System for injection training
US10643497B2 (en) 2012-10-30 2020-05-05 Truinject Corp. System for cosmetic and therapeutic training
GB2508510A (en) * 2012-10-30 2014-06-04 Truinject Medical Corp System for providing injection training
US10902746B2 (en) 2012-10-30 2021-01-26 Truinject Corp. System for cosmetic and therapeutic training
US11854426B2 (en) 2012-10-30 2023-12-26 Truinject Corp. System for cosmetic and therapeutic training
US11403964B2 (en) 2012-10-30 2022-08-02 Truinject Corp. System for cosmetic and therapeutic training
US9792836B2 (en) 2012-10-30 2017-10-17 Truinject Corp. Injection training apparatus using 3D position sensor
US9443446B2 (en) 2012-10-30 2016-09-13 Trulnject Medical Corp. System for cosmetic and therapeutic training
US10991270B2 (en) 2013-03-01 2021-04-27 Applied Medical Resources Corporation Advanced surgical simulation constructions and methods
US11049418B2 (en) 2013-06-18 2021-06-29 Applied Medical Resources Corporation Gallbladder model
US11735068B2 (en) 2013-06-18 2023-08-22 Applied Medical Resources Corporation Gallbladder model
US11450236B2 (en) 2013-07-24 2022-09-20 Applied Medical Resources Corporation Advanced first entry model for surgical simulation
US11854425B2 (en) 2013-07-24 2023-12-26 Applied Medical Resources Corporation First entry model
US10896627B2 (en) 2014-01-17 2021-01-19 Truinjet Corp. Injection site training system
US9922578B2 (en) 2014-01-17 2018-03-20 Truinject Corp. Injection site training system
US10290232B2 (en) 2014-03-13 2019-05-14 Truinject Corp. Automated detection of performance characteristics in an injection training system
US10290231B2 (en) 2014-03-13 2019-05-14 Truinject Corp. Automated detection of performance characteristics in an injection training system
US11887504B2 (en) 2014-11-13 2024-01-30 Applied Medical Resources Corporation Simulated tissue models and methods
US10235904B2 (en) 2014-12-01 2019-03-19 Truinject Corp. Injection training tool emitting omnidirectional light
US11100815B2 (en) 2015-02-19 2021-08-24 Applied Medical Resources Corporation Simulated tissue structures and methods
US11034831B2 (en) 2015-05-14 2021-06-15 Applied Medical Resources Corporation Synthetic tissue structures for electrosurgical training and simulation
US11721240B2 (en) 2015-06-09 2023-08-08 Applied Medical Resources Corporation Hysterectomy model
US11587466B2 (en) 2015-07-16 2023-02-21 Applied Medical Resources Corporation Simulated dissectible tissue
US11721242B2 (en) 2015-10-02 2023-08-08 Applied Medical Resources Corporation Hysterectomy model
US10500340B2 (en) 2015-10-20 2019-12-10 Truinject Corp. Injection system
US10743942B2 (en) 2016-02-29 2020-08-18 Truinject Corp. Cosmetic and therapeutic injection safety systems, methods, and devices
US10849688B2 (en) 2016-03-02 2020-12-01 Truinject Corp. Sensory enhanced environments for injection aid and social training
US10648790B2 (en) 2016-03-02 2020-05-12 Truinject Corp. System for determining a three-dimensional position of a testing tool
US11730543B2 (en) 2016-03-02 2023-08-22 Truinject Corp. Sensory enhanced environments for injection aid and social training
US11830378B2 (en) 2016-06-27 2023-11-28 Applied Medical Resources Corporation Simulated abdominal wall
US11120708B2 (en) 2016-06-27 2021-09-14 Applied Medical Resources Corporation Simulated abdominal wall
US10810907B2 (en) 2016-12-19 2020-10-20 National Board Of Medical Examiners Medical training and performance assessment instruments, methods, and systems
US10650703B2 (en) 2017-01-10 2020-05-12 Truinject Corp. Suture technique training system
US10269266B2 (en) 2017-01-23 2019-04-23 Truinject Corp. Syringe dose and position measuring apparatus
US11710424B2 (en) 2017-01-23 2023-07-25 Truinject Corp. Syringe dose and position measuring apparatus

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