WO2019036819A1 - Device that allows simulation of and training on different puncture techniques - Google Patents

Device that allows simulation of and training on different puncture techniques Download PDF

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Publication number
WO2019036819A1
WO2019036819A1 PCT/CL2018/050064 CL2018050064W WO2019036819A1 WO 2019036819 A1 WO2019036819 A1 WO 2019036819A1 CL 2018050064 W CL2018050064 W CL 2018050064W WO 2019036819 A1 WO2019036819 A1 WO 2019036819A1
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Prior art keywords
puncture
techniques according
puncture techniques
allows
simulating
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PCT/CL2018/050064
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Spanish (es)
French (fr)
Inventor
Arnoldo Javier RIQUELME PÉREZ
Iván Alberto CARO PINTO
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Pontificia Universidad Católica De Chile
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Publication of WO2019036819A1 publication Critical patent/WO2019036819A1/en

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    • 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
    • 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
    • G09B23/30—Anatomical models

Definitions

  • the present invention is part of the technical field of devices, devices or systems for simulation of actions in a context of education and training of clinical procedures, and in particular, in a device that allows to simulate a tissue to be used in training sessions in application of injections, or performing other clinical procedures that require puncture. More specifically, a device that allows the simulation and training of different puncture techniques, such as Z puncture, among other techniques.
  • Teaching and learning in simulated environments is an effective alternative to direct learning in real patients, to obtain skills of technical and non-technical skills. It is vital to include the performance of non-surgical procedures, such as for example abdominal paracentesis, within the training plan for non-specialist doctors, since these are terminal competencies that every doctor needs to master for their future professional practice.
  • the teaching of these techniques is currently done under the tutorial model which is based on the exposure of students to real patients according to opportunities, which often do not occur or the number of times necessary to acquire skills is insufficient.
  • the main disadvantages lie in non-standardized education and in ethical problems related to patient safety.
  • the simulation emerges as an educational tool to perform a training in a controlled, valid and safe environment.
  • An important aspect of a simulated environment corresponds to the quality presented by the different elements used in the simulation.
  • it is of great importance the characteristics of the devices intended to be used in simulation of clinical procedures that require puncture, since it is not obvious how to simulate realistically a living tissue, and more particularly, how the material used in the simulation model responds.
  • the resistance that the material presents to a puncture procedure is similar to the resistance of a living tissue
  • the simulation material allows it to fold realistically, that the number of times the material can receive punctures be high, between
  • the characteristic of the material to allow a realistic fold is of the utmost importance, since several puncture techniques require to perform tissue folding in order to carry out a puncture technique in a successful manner.
  • the technique of injection in Z that is used for administration of drugs by intramuscular route, requires that the person who will perform the puncture, using the non-dominant hand, displaces the skin and the subcutaneous tissue by pulling the skin laterally or down the puncture site. Keeping the skin tight, insert the needle quickly and gently into the muscle at a 90 ° angle.
  • the simulation device also requires simulating the response of the living tissue against the deployment or sliding of the same, while generating a seal in place of the puncture once the needle is removed.
  • the present invention allows to simulate this technique of injection in Z, in addition to other techniques that require skin folds or slides to be carried out.
  • CN203456001 U in its summary describes a model for intravenous injections.
  • the configuration of several layers to simulate tissue is mentioned, however, no reference is made to a feature that allows performing a procedure that requires skin folding or sliding, such as a Z injection.
  • CN202058357U describes a wristband that has several layers that allow to simulate human tissue.
  • the wristband is designed to allow the practice of intradermal injections. There is no mention of a feature that allows performing a procedure that requires skin folding or sliding, such as a Z injection.
  • CN202013685U describes a sleeve that can be placed on a person's foot. This sleeve has different layers that allow to simulate human tissue. There is no mention of the advantage of being able to perform a procedure that requires skin folding or sliding, such as a Z injection.
  • CN201340684Y describes a model for performing abdominocentesis practices.
  • the model is a torso, which includes simulations of cavities, blood, blood vessels, and allows the installation of a bag with liquid that can be filled after practice. It does not mention characteristics that allow carrying out a procedure that requires skin folding or sliding, such as a Z injection.
  • US2009142741A1 is a document cited by the inventors, which describes a device for training paracentesis / thoracocentesis. It is mentioned that it is constructed of silicone, elastomers, rubber, and / or elastic polymer. It does not mention the characteristics of the evaluated invention, which makes it possible to perform a procedure that requires skin folding or sliding, such as a Z injection.
  • CN201213050Y describes a model for practicing paracentesis in pneumothorax and hydrothorax. It is indicated that the model comprises components that simulate ribs, lungs, nerves, blood vessels, and that it includes bags with air and liquid to allow the simulation of paracentesis in pneumothorax and hydrothorax. No reference was found to the characteristics that allow performing a procedure that requires skin folding or sliding, such as a Z injection.
  • the present invention corresponds to a device that allows performing simulations of puncture techniques in a clinical context, where the device allows to simulate puncture techniques that require the displacement or folding of the skin to be carried out, as, for example, the technique of injection in Z.
  • the present invention corresponds to a device that allows simulations of puncture techniques.
  • the device corresponds to a piece of material that allows the simulation of skin, in particular said simulation contemplates the flexibility of the skin, the adiposity of the fat, and the resistance of the muscle.
  • the simulation of these characteristics is achieved in the present invention by means of the combination of some materials in defined proportions.
  • the device is made up of 3 layers of different characteristics:
  • a first layer located towards the outside of the device, which is the layer that will receive the puncture from the outside; 2.
  • a third layer located towards the interior of the device, which is not visible to the user during the puncture.
  • the first and third layers are composed of a silicone-based material, such as, for example, silicone rubber, cured by condensation, silicone rubber, cured by addition.
  • a silicone-based material such as, for example, silicone rubber, cured by condensation, silicone rubber, cured by addition.
  • silicones produced by the Smooth-On company such as Mold Star® Series, Dragon Skin® Series, Ecoflex® Series, Smooth-Sil TM Series, Rebound TM Series, SORTA- Clear® Series, Equinox® Series, Body Double® Series, Skin Tite®, Psycho Paint®, EZ- Brush® Vac Bag Silicone, Solaris®, Rubber Glass®, Encapso® K, EZ ⁇ Spray®, among others.
  • the second layer is composed of a spongy material and a friction-generating material.
  • the spongy material making up the second layer is selected from a polyethylene foam, a low density foam.
  • the friction material composing the second layer is selected from a natural cellulose microfiber, a flexible liquid-containing bag, wherein said containing bag may be made of latex, natural rubber or rubber.
  • the silicone-based material is a layer of rubber silicone with a shore hardness of at least between 8-1 OA, preferably a shore hardness of 10A to 30A, and a thickness of between 1 mm and 3 mm, preferably 1, 5mm, or a dragon silk silicone (Dragon skin® silicone).
  • the polyethylene foam making up the second layer has a density of between 14 and 18 kg / m 3 , preferably 16 kg / m 3 and a thickness of between 2 and 4 mm, preferably 3 mm.
  • the low density foam that composes the second layer with a Shore hardness of 10A to 30A, of white color has a density of between 14 and 18 kg / m 3 , and a thickness of between 2 and 4 mm .
  • the device has a rectangular shape, and covers an area between 20cm 2 and 70cm 2 .
  • the device has an irregular shape, and covers an area between 20cm 2 and 70cm 2 .
  • the device is sealed at its edges, more specifically, the sealing of the edges of the device is performed by means of a seam, using adhesive silicone, liquid silicone adhesives, Sil-Poxy can also be used , special adhesive for silicones, Permnabond for gluing natural rubber or with mechanical joints by placing metal pieces type clasp.
  • the device of the invention is sufficiently adaptable to allow its use in different configurations.
  • the device can be adapted and placed on an open face of a box and thus configure a portable puncture simulation apparatus, useful for example in the practice of simple puncture techniques such as intramuscular injections.
  • the device can be adapted and placed on an open face or face of a phantom intended to simulate a more complex puncture procedure, such as on a phantom of abdominal cavity to allow the practice of abdominocentesis or paracentesis procedures.
  • the device can be combined in a more complex configuration, on an open face of a phantom containing simulated internal organs, so that in this configuration the person receiving the training should avoid puncturing the internal simulated organs by accident.
  • the device of the present invention it is possible to contain simulated organs and tissues ex-vivo animal obtained from slaughtering industries for educational purposes so that the device of the present invention can also be used in the Surgery training and obtaining samples for biopsies.
  • the device described here given its characteristics, allows the simulation and practice of different puncture techniques that require some level of displacement of the skin and / or muscles close to the puncture area, such as for example of bayonet puncture, oblique puncture, pigtail technique, Seldinger technique, simulation of Trucut biopsies, as well as other procedures that require special puncture techniques, such as the installation of laparoscopic and arthroscopic portals, or the installation of drain tubes.
  • different puncture techniques that require some level of displacement of the skin and / or muscles close to the puncture area, such as for example of bayonet puncture, oblique puncture, pigtail technique, Seldinger technique, simulation of Trucut biopsies, as well as other procedures that require special puncture techniques, such as the installation of laparoscopic and arthroscopic portals, or the installation of drain tubes.
  • foam was used polyethylene of 20x20 cm and 3 mm thick, of generic manufacture, microfiber cloths of 20x20 cm, of generic manufacture, and silicones of standard manufacture of density 30 kg / m 3 in the inner layers and density 10 kg / m 3 in the outer layers.
  • the sealing of the patch was made by the edges with silicone adhesive of standard manufacture.
  • Example 2 Application of the device of the invention to a phantom of abdominal paracentesis
  • the prototypes were built using a special 3D printer system.
  • the final model was constructed from a wooden base, a plastic structure in the form of an abdomen with a hole in the left iliac fossa where the device of the present invention, described in the previous example, corresponding to a grid was inserted. of polyester that simulates the flexibility of the skin, the adiposity of the fat and the resistance of the muscle. Inside it was added a flexible receptacle with colored liquid. In its totality the phantom had an approximate weight of 5 kg, dimensions of 1, 2 m x 0.8 m.
  • the technique in Z consists in performing a traction of the skin of approximately 2 cm towards caudal with the hand that is not punctured, with which the skin will move with respect to the underlying muscular plane.
  • the puncture should be done slowly, going from the skin to the peritoneum.
  • the skin does not come loose until the needle has penetrated the peritoneum and the fluid comes out.
  • the skin will slide to its original position and thanks to this retraction the superposition of the cutaneous and peritoneal puncture points will be avoided, decreasing the persistent dripping of ascitic fluid towards the outside .
  • the needle Once the needle is located in the peritoneal cavity, the needle will be stabilized to ensure flow.
  • the patch simulates the layers of the abdominal wall.
  • Pre-session evaluation baseline diagnosis of one student from each sub-group and the rest of the group observes, one of them evaluates, independently of the tutor, his or her partner using the same evaluation guideline.
  • the instructional video is presented with stops in the critical aspects, to solve doubts or to emphasize systematic errors observed in the students who performed the pre-session procedure.
  • the sequential activities of the workshop included the taking of informed consent, the collection of the necessary materials and the implementation of standard precautionary measures. Then the puncture site was identified, asepsis was performed in the area and local anesthetic injection. Subsequently, the samples were punctured and collected and, after this, the site was removed and occluded. Finally, a list of post procedure indications was made.
  • the present invention has industrial application in that it can be produced in the simulator industry for clinical training.

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Abstract

The present invention relates to a device that allows puncture techniques to be simulated in a clinical context, the device allowing the simulation of puncture techniques that require the skin to be moved or folded, for example, the Z-track injection technique.

Description

DISPOSITIVO QUE PERMITE LA SIMULACIÓN Y ENTRENAMIENTO DE DISTINTAS  DEVICE THAT ALLOWS THE SIMULATION AND TRAINING OF DIFFERENT
TÉCNICAS DE PUNCIÓN PUNCTURE TECHNIQUES
CAMPO TÉCNICO TECHNICAL FIELD
La presente invención se enmarca en el campo técnico de aparatos, dispositivos o sistemas para simulación de acciones en un contexto de educación y entrenamiento de procedimientos clínicos, y en particular, en un dispositivo que permite simular un tejido para ser utilizado en sesiones de entrenamiento en aplicación de inyecciones, o realización de otros procedimientos clínicos que requieren punción. Más específicamente, un dispositivo que permite la simulación y entrenamiento de distintas técnicas de punción, como por ejemplo punción en Z, entre otras técnicas.  The present invention is part of the technical field of devices, devices or systems for simulation of actions in a context of education and training of clinical procedures, and in particular, in a device that allows to simulate a tissue to be used in training sessions in application of injections, or performing other clinical procedures that require puncture. More specifically, a device that allows the simulation and training of different puncture techniques, such as Z puncture, among other techniques.
ANTECEDENTES Y ARTE PREVIO BACKGROUND AND PREVIOUS ART
La enseñanza y aprendizaje en ambientes simulados constituye una alternativa efectiva al aprendizaje directo en paciente reales, para la obtención de competencias de habilidades técnicas y no técnicas. Es de vital importancia incluir la realización de procedimientos no quirúrgicos, tal como por ejemplo paracentesis abdominal, dentro del plan de formación para médicos no especialistas, ya que se trata de competencias terminales que todo médico necesita dominar para su futura práctica profesional. La enseñanza de estas técnicas se realiza actualmente bajo el modelo tutorial el cual se basa en la exposición de los alumnos a pacientes reales de acuerdo a oportunidades, las cuales muchas veces no se presentan o el número de veces necesarias para adquirir las competencias es insuficiente.  Teaching and learning in simulated environments is an effective alternative to direct learning in real patients, to obtain skills of technical and non-technical skills. It is vital to include the performance of non-surgical procedures, such as for example abdominal paracentesis, within the training plan for non-specialist doctors, since these are terminal competencies that every doctor needs to master for their future professional practice. The teaching of these techniques is currently done under the tutorial model which is based on the exposure of students to real patients according to opportunities, which often do not occur or the number of times necessary to acquire skills is insufficient.
Las principales desventajas radican en una educación no estandarizada y en problemas éticos relacionados con la seguridad del paciente. La simulación surge como herramienta educacional para realizar un entrenamiento en ambiente controlado, válido y seguro.  The main disadvantages lie in non-standardized education and in ethical problems related to patient safety. The simulation emerges as an educational tool to perform a training in a controlled, valid and safe environment.
Un aspecto importante de un ambiente simulado corresponde a la calidad que presentan los distintos elementos utilizados en la simulación. En particular, y en el caso de la presente invención, resulta de gran importancia las características de los dispositivos destinados a ser utilizados en simulación de procedimientos clínicos que requieren punción, puesto que no es obvio cómo simular de manera realista un tejido vivo, y más particularmente, de cómo responde el material utilizado en el modelo de simulación. Por ejemplo, que la resistencia que el material presenta frente a un procedimiento de punción sea similar a la resistencia que presenta un tejido vivo, que el material de simulación permita su pliegue de forma realista, que el número de veces que el material puede recibir punciones sea elevado, entre  An important aspect of a simulated environment corresponds to the quality presented by the different elements used in the simulation. In particular, and in the case of the present invention, it is of great importance the characteristics of the devices intended to be used in simulation of clinical procedures that require puncture, since it is not obvious how to simulate realistically a living tissue, and more particularly, how the material used in the simulation model responds. For example, that the resistance that the material presents to a puncture procedure is similar to the resistance of a living tissue, that the simulation material allows it to fold realistically, that the number of times the material can receive punctures be high, between
i otras características técnicas que permitan una simulación lo más realista posible. i other technical characteristics that allow a simulation as realistic as possible.
En particular, la característica del material de permitir un pliegue realista es de suma importancia, pues varias técnicas de punción requieren realizar pliegue de tejido a fin de llevar a cabo una técnica de punción de manera exitosa. En un ejemplo específico, la técnica de inyección en Z que se utiliza para administración de fármacos por vía intramuscular, requiere que la persona que realizará la punción, utilizando la mano no dominante, desplace la piel y el tejido subcutáneo tirando de la piel lateralmente o hacia abajo del lugar de punción. Manteniendo la piel tensada, se inserte rápida y suavemente la aguja en el músculo en un ángulo de 90°. Considerando esta técnica que requiere un pliegue o deslizamiento del tejido para realizar la punción, es que el dispositivo de simulación requiere simular también la respuesta del tejido vivo frente al despliegue o deslizamiento del mismo, a la vez que se genera un sello en el lugar de la punción una vez que la aguja se retira.  In particular, the characteristic of the material to allow a realistic fold is of the utmost importance, since several puncture techniques require to perform tissue folding in order to carry out a puncture technique in a successful manner. In a specific example, the technique of injection in Z that is used for administration of drugs by intramuscular route, requires that the person who will perform the puncture, using the non-dominant hand, displaces the skin and the subcutaneous tissue by pulling the skin laterally or down the puncture site. Keeping the skin tight, insert the needle quickly and gently into the muscle at a 90 ° angle. Considering this technique that requires a fold or slide of the tissue to perform the puncture, is that the simulation device also requires simulating the response of the living tissue against the deployment or sliding of the same, while generating a seal in place of the puncture once the needle is removed.
La presente invención permite simular esta técnica de inyección en Z, además de otras técnicas que requieren realizar pliegues o deslizamientos de piel para llevarse a cabo.  The present invention allows to simulate this technique of injection in Z, in addition to other techniques that require skin folds or slides to be carried out.
Para evaluar el contexto en el que se enmarca la presente invención, se realizó una búsqueda en bases de datos de patentes a fin de encontrar documentos relevantes o similares a la presente invención. A continuación, se presenta un breve resumen de los documentos más relevantes que fueron detectados en dicha búsqueda.  To evaluate the context in which the present invention is framed, a search was made in patent databases in order to find relevant or similar documents to the present invention. Below is a brief summary of the most relevant documents that were detected in the search.
CN203456001 U en su resumen describe un modelo para inyecciones intravenosas. Se menciona la configuración de varias capas para simular tejido, sin embargo, no se hace referencia a una característica que permita realizar un procedimiento que requiera pliegue o deslizamiento de la piel, como por ejemplo una inyección en Z.  CN203456001 U in its summary describes a model for intravenous injections. The configuration of several layers to simulate tissue is mentioned, however, no reference is made to a feature that allows performing a procedure that requires skin folding or sliding, such as a Z injection.
CN202058357U describe una muñequera que presenta varias capas que permiten simular tejido humano. La muñequera está diseñada para permitir la práctica de inyecciones intradérmicas. No se menciona una característica que permita realizar un procedimiento que requiera pliegue o deslizamiento de la piel, como por ejemplo una inyección en Z.  CN202058357U describes a wristband that has several layers that allow to simulate human tissue. The wristband is designed to allow the practice of intradermal injections. There is no mention of a feature that allows performing a procedure that requires skin folding or sliding, such as a Z injection.
CN202013685U describe una manga que puede colocarse en el pie de una persona. Dicha manga presenta distintas capas que permiten simular tejido humano. No se menciona ventaja de poder realizar un procedimiento que requiera pliegue o deslizamiento de la piel, como por ejemplo una inyección en Z.  CN202013685U describes a sleeve that can be placed on a person's foot. This sleeve has different layers that allow to simulate human tissue. There is no mention of the advantage of being able to perform a procedure that requires skin folding or sliding, such as a Z injection.
CN201340684Y describe un modelo para realizar prácticas de abdominocentesis. El modelo es un torso, que incluye simulaciones de cavidades, sangre, vasos sanguíneos, y que permite la instalación de un saco con líquido que puede rellenarse luego de las prácticas. No menciona características que permitan realizar un procedimiento que requiera pliegue o deslizamiento de la piel, como por ejemplo una inyección en Z. CN201340684Y describes a model for performing abdominocentesis practices. The model is a torso, which includes simulations of cavities, blood, blood vessels, and allows the installation of a bag with liquid that can be filled after practice. It does not mention characteristics that allow carrying out a procedure that requires skin folding or sliding, such as a Z injection.
US2009142741A1 es un documento citado por los inventores, que describe un dispositivo para entrenamiento de paracentesis/toracocentesis. Se menciona que está construido por silicona, elastómeros, goma, y/o polímero elástico. No menciona las características de la invención evaluada, que permita realizar un procedimiento que requiera pliegue o deslizamiento de la piel, como por ejemplo una inyección en Z.  US2009142741A1 is a document cited by the inventors, which describes a device for training paracentesis / thoracocentesis. It is mentioned that it is constructed of silicone, elastomers, rubber, and / or elastic polymer. It does not mention the characteristics of the evaluated invention, which makes it possible to perform a procedure that requires skin folding or sliding, such as a Z injection.
CN201213050Y describe un modelo para practicar paracentesis en neumotorax e hidrotórax. Se indica que el modelo comprende componentes que simulan costillas, pulmones, nervios, vasos sanguíneos, y que comprende bolsas con aire y líquido para permitir la simulación de paracentesis en neumotorax e hidrotórax. No se encontró referencia a las características que permiten realizar un procedimiento que requiera pliegue o deslizamiento de la piel, como por ejemplo una inyección en Z.  CN201213050Y describes a model for practicing paracentesis in pneumothorax and hydrothorax. It is indicated that the model comprises components that simulate ribs, lungs, nerves, blood vessels, and that it includes bags with air and liquid to allow the simulation of paracentesis in pneumothorax and hydrothorax. No reference was found to the characteristics that allow performing a procedure that requires skin folding or sliding, such as a Z injection.
RESUMEN DE LA INVENCIÓN SUMMARY OF THE INVENTION
La presente invención corresponde a un dispositivo que permite realizar simulaciones de técnicas de punción en un contexto clínico, donde el dispositivo permite simular técnicas de punción que requieren el desplazamiento o pliegue de la piel para ser llevadas a cabo, como, por ejemplo, la técnica de inyección en Z.  The present invention corresponds to a device that allows performing simulations of puncture techniques in a clinical context, where the device allows to simulate puncture techniques that require the displacement or folding of the skin to be carried out, as, for example, the technique of injection in Z.
DESCRIPCIÓN DETALLADA DE LA INVENCIÓN DETAILED DESCRIPTION OF THE INVENTION
La presente invención corresponde a un dispositivo que permite realizar simulaciones de técnicas de punción. En una realización general, el dispositivo corresponde a un trozo de material que permite la simulación de piel, en particular dicha simulación contempla la flexibilidad de la piel, la adiposidad de la grasa, y la resistencia del músculo. La simulación de estas características se logra en la presente invención por medio de la combinación de algunos materiales en proporciones definidas.  The present invention corresponds to a device that allows simulations of puncture techniques. In a general embodiment, the device corresponds to a piece of material that allows the simulation of skin, in particular said simulation contemplates the flexibility of the skin, the adiposity of the fat, and the resistance of the muscle. The simulation of these characteristics is achieved in the present invention by means of the combination of some materials in defined proportions.
En una realización más específica, el dispositivo está elaborado 3 capas de distintas características:  In a more specific embodiment, the device is made up of 3 layers of different characteristics:
1 . Una primera capa, ubicada hacia el exterior del dispositivo, que es la capa que recibirá la punción desde el exterior; 2. Una segunda capa intermedia; one . A first layer, located towards the outside of the device, which is the layer that will receive the puncture from the outside; 2. A second intermediate layer;
3. Una tercera capa, ubicada hacia el interior del dispositivo, que no es visible al usuario durante el momento de punción.  3. A third layer, located towards the interior of the device, which is not visible to the user during the puncture.
En una realización particular, la primera y tercera capa están compuestas por un material basado en silicona, como por ejemplo goma de silicona curada por condensación, goma de silicona curada por adición. Se pueden mencionar como ejemplos representativos de productos comercialmente disponibles, pero sin intención de limitar el alcance de la presente invención siliconas producidas por la empresa Smooth-On, tales como Mold Star® Series, Dragón Skin® Series, Ecoflex® Series, Smooth-Sil™ Series, Rebound™ Series, SORTA- Clear® Series, Equinox® Series, Body Double® Series, Skin Tite®, Psycho Paint®, EZ- Brush® Vac Bag Silicone, Solaris®, Rubber Glass®, Encapso® K, EZ~Spray®, entre otras. In a particular embodiment, the first and third layers are composed of a silicone-based material, such as, for example, silicone rubber, cured by condensation, silicone rubber, cured by addition. Representative examples of commercially available products, but without intent to limit the scope of the present invention, are silicones produced by the Smooth-On company, such as Mold Star® Series, Dragon Skin® Series, Ecoflex® Series, Smooth-Sil ™ Series, Rebound ™ Series, SORTA- Clear® Series, Equinox® Series, Body Double® Series, Skin Tite®, Psycho Paint®, EZ- Brush® Vac Bag Silicone, Solaris®, Rubber Glass®, Encapso® K, EZ ~ Spray®, among others.
En una segunda realización particular, la segunda capa está compuesta por un material esponjoso y un material generador de fricción. In a second particular embodiment, the second layer is composed of a spongy material and a friction-generating material.
En una realización específica, el material esponjoso que compone la segunda capa se selecciona entre una espuma de polietileno, una espuma de baja densidad.  In a specific embodiment, the spongy material making up the second layer is selected from a polyethylene foam, a low density foam.
En una realización más específica, el material de fricción que compone la segunda capa se selecciona entre una microfibra de celulosa natural, una bolsa de material flexible que contiene líquido, donde dicha bolsa contenedora puede ser de látex, caucho natural o goma. In a more specific embodiment, the friction material composing the second layer is selected from a natural cellulose microfiber, a flexible liquid-containing bag, wherein said containing bag may be made of latex, natural rubber or rubber.
En una realización específica, el material basado en silicona es una capa de silicona de caucho con una dureza shore de al menos entre 8-1 OA, preferentemente una dureza shore de 10A a 30A, y un espesor de entre 1 mm y 3 mm, preferentemente 1 ,5mm, o una silicona seda de dragón (Dragón skin® silicone). In a specific embodiment, the silicone-based material is a layer of rubber silicone with a shore hardness of at least between 8-1 OA, preferably a shore hardness of 10A to 30A, and a thickness of between 1 mm and 3 mm, preferably 1, 5mm, or a dragon silk silicone (Dragon skin® silicone).
En otra realización específica, la espuma de polietileno que compone la segunda capa tiene una densidad de entre 14 y 18 kg/m3, preferentemente 16 kg/m3 y un espesor de entre 2 y 4 mm, preferentemente 3mm. In another specific embodiment, the polyethylene foam making up the second layer has a density of between 14 and 18 kg / m 3 , preferably 16 kg / m 3 and a thickness of between 2 and 4 mm, preferably 3 mm.
En otra realización específica, la espuma de baja densidad que compone la segunda capa con una dureza Shore de 10A a 30A, de color blanco, tiene una densidad de entre 14 y 18 kg/m3, y un espesor de entre 2 y 4 mm. In another specific embodiment, the low density foam that composes the second layer with a Shore hardness of 10A to 30A, of white color, has a density of between 14 and 18 kg / m 3 , and a thickness of between 2 and 4 mm .
En otro aspecto de la invención, el dispositivo tiene una forma rectangular, y cubre un área de entre 20cm2 y 70cm2. In another aspect of the invention, the device has a rectangular shape, and covers an area between 20cm 2 and 70cm 2 .
En otro aspecto de la invención, el dispositivo tiene forma irregular, y cubre un área de entre 20cm2 y 70cm2. En otra realización de la invención, el dispositivo se encuentra sellado en sus bordes, más específicamente, el sellado de los bordes del dispositivo se realiza por medio de una costura, utilizando silicona adhesiva, adhesivos de silicona líquida, también se puede utilizar Sil-Poxy, adhesivo especial para siliconas, Permnabond para pegado de caucho natural o con uniones mecánicas colocando piezas metálicas tipo corchete. In another aspect of the invention, the device has an irregular shape, and covers an area between 20cm 2 and 70cm 2 . In another embodiment of the invention, the device is sealed at its edges, more specifically, the sealing of the edges of the device is performed by means of a seam, using adhesive silicone, liquid silicone adhesives, Sil-Poxy can also be used , special adhesive for silicones, Permnabond for gluing natural rubber or with mechanical joints by placing metal pieces type clasp.
En otro aspecto, el dispositivo de la invención es lo suficientemente adaptable para permitir su utilización en distintas configuraciones. Por ejemplo, en una realización, el dispositivo puede adaptarse y colocarse sobre una cara abierta de una caja y así configurar un aparato de simulación de punción portátil, útil por ejemplo en la práctica de técnicas de punción simples como inyecciones intramusculares. En otra realización, el dispositivo puede adaptarse y colocarse sobre una cara o faceta abierta de un fantoma destinado a simular un procedimiento de punción más complejo, como por ejemplo sobre un fantoma de cavidad abdominal para permitir la práctica de procedimientos de abdominocentesis o paracentesis. En aún otra realización, el dispositivo puede combinarse en una configuración más compleja, sobre una cara abierta de un fantoma que contiene órganos internos simulados, de manera que en esta configuración la persona que reciba el entrenamiento deberá evitar puncionar por accidente los órganos internos simulados.  In another aspect, the device of the invention is sufficiently adaptable to allow its use in different configurations. For example, in one embodiment, the device can be adapted and placed on an open face of a box and thus configure a portable puncture simulation apparatus, useful for example in the practice of simple puncture techniques such as intramuscular injections. In another embodiment, the device can be adapted and placed on an open face or face of a phantom intended to simulate a more complex puncture procedure, such as on a phantom of abdominal cavity to allow the practice of abdominocentesis or paracentesis procedures. In yet another embodiment, the device can be combined in a more complex configuration, on an open face of a phantom containing simulated internal organs, so that in this configuration the person receiving the training should avoid puncturing the internal simulated organs by accident.
En otra realización, y debido a las características del dispositivo de la presente invención, es que se pueden contener órganos simulados y tejidos ex-vivo animal obtenido de industrias faenadoras con fines educacionales de manera que el dispositivo de la presente invención también puede usarse en el entrenamiento de cirugías y obtención de muestras para biopsias.  In another embodiment, and due to the characteristics of the device of the present invention, it is possible to contain simulated organs and tissues ex-vivo animal obtained from slaughtering industries for educational purposes so that the device of the present invention can also be used in the Surgery training and obtaining samples for biopsies.
En otro aspecto de la presente invención, el dispositivo aquí descrito, dadas sus características, permite la simulación y práctica de distintas técnicas de punción que requieren algún nivel de desplazamiento de la piel y/o músculos cercanos al área de punción, como por ejemplo técnica de punción en bayoneta, punción oblicua, técnica "pig tail", técnica Seldinger, realización de simulación de biopsias Trucut, como también otros procedimientos que requieren técnicas especiales de punción, como por ejemplo la instalación de portales laparoscópicos y artroscópicos, o la instalación de tubos de drenaje.  In another aspect of the present invention, the device described here, given its characteristics, allows the simulation and practice of different puncture techniques that require some level of displacement of the skin and / or muscles close to the puncture area, such as for example of bayonet puncture, oblique puncture, pigtail technique, Seldinger technique, simulation of Trucut biopsies, as well as other procedures that require special puncture techniques, such as the installation of laparoscopic and arthroscopic portals, or the installation of drain tubes.
EJEMPLOS EXAMPLES
Ejemplo 1 : Elaboración dispositivo de simulación de punción  Example 1: Elaboration of puncture simulation device
Para la fabricación de las capas del dispositivo de la invención se utilizó espuma de polietileno de 20x20 cm y 3 mm de espesor, de fabricación genérica, paños de microfibra de 20x20 cm, de fabricación genérica, y siliconas de fabricación estándar de densidad 30 kg/m3 en las capas interiores y densidad 10 kg/m3 en las capas exteriores. El sellado del parche fue realizado por los bordes con silicona adhesiva de fabricación estándar. For the manufacture of the layers of the device of the invention foam was used polyethylene of 20x20 cm and 3 mm thick, of generic manufacture, microfiber cloths of 20x20 cm, of generic manufacture, and silicones of standard manufacture of density 30 kg / m 3 in the inner layers and density 10 kg / m 3 in the outer layers. The sealing of the patch was made by the edges with silicone adhesive of standard manufacture.
Ejemplo 2: Aplicación del dispositivo de la invención a un fantoma de paracentesis abdominal Example 2: Application of the device of the invention to a phantom of abdominal paracentesis
Se diseñaron y desarrollaron fantomas o modelos para la realización del procedimiento (paracentesis abdominal). La metodología incluyó el diseño conceptual del prototipo, basado en un análisis cualitativo de necesidades educacionales de docentes clínicos incluyendo características como: transportabilidad, facilidad de lavado, capacidad para re-utilización, fidelidad, bajo costo y seguridad para el uso de los alumnos. Los prototipos fueron construidos mediante un sistema especial en impresora 3D. El modelo final fue construido a partir de una base de madera, una estructura de plástico en forma de abdomen con un agujero en la fosa ilíaca izquierda en donde se insertó el dispositivo de la presente invención, descrito en el ejemplo anterior, correspondiente a un cuadriculo de poliéster que simula la flexibilidad de la piel, la adiposidad de la grasa y la resistencia del músculo. En su interior se agregó un receptáculo flexible con líquido coloreado. En su totalidad el fantoma tenía un peso aproximado de 5 kg, dimensiones de 1 ,2 m x 0,8 m.  They were designed and developed phantoms or models for the performance of the procedure (abdominal paracentesis). The methodology included the conceptual design of the prototype, based on a qualitative analysis of the educational needs of clinical teachers including characteristics such as: portability, ease of washing, capacity for re-use, fidelity, low cost and safety for student use. The prototypes were built using a special 3D printer system. The final model was constructed from a wooden base, a plastic structure in the form of an abdomen with a hole in the left iliac fossa where the device of the present invention, described in the previous example, corresponding to a grid was inserted. of polyester that simulates the flexibility of the skin, the adiposity of the fat and the resistance of the muscle. Inside it was added a flexible receptacle with colored liquid. In its totality the phantom had an approximate weight of 5 kg, dimensions of 1, 2 m x 0.8 m.
La técnica en Z consiste en realizar una tracción de la piel de aproximadamente 2 cm hacia caudal con la mano que no se encuentra puncionando, con lo que la piel se desplazará con respecto al plano muscular subyacente. La punción debe realizarse lentamente pasando desde la piel hasta el peritoneo. Mientras la aguja avanza debe aspirarse suavemente, pero no de manera continua, disminuyendo de esta manera los riesgos de perforación. La piel no se suelta hasta que la aguja ha penetrado el peritoneo y el fluido sale. En el momento en que la aguja se encuentra en la cavidad peritoneal, la piel se deslizará a su posición original y gracias a esta retracción se evitará la superposición de los puntos de punción cutánea y peritoneal, disminuyendo el goteo persistente de líquido ascítico hacia el exterior. Una vez ubicada la aguja en la cavidad peritoneal se procederá a estabilizar la aguja para asegurar el flujo. El parche simula las capas de la pared abdominal.  The technique in Z consists in performing a traction of the skin of approximately 2 cm towards caudal with the hand that is not punctured, with which the skin will move with respect to the underlying muscular plane. The puncture should be done slowly, going from the skin to the peritoneum. As the needle advances, it should be aspirated gently, but not continuously, thus decreasing the risks of perforation. The skin does not come loose until the needle has penetrated the peritoneum and the fluid comes out. At the moment when the needle is in the peritoneal cavity, the skin will slide to its original position and thanks to this retraction the superposition of the cutaneous and peritoneal puncture points will be avoided, decreasing the persistent dripping of ascitic fluid towards the outside . Once the needle is located in the peritoneal cavity, the needle will be stabilized to ensure flow. The patch simulates the layers of the abdominal wall.
Ejemplo 3: Taller de paracentesis abdominal Example 3: Workshop of abdominal paracentesis
Se realizó un estudio piloto con los alumnos que se encontraban en la rotación ambulatoria de gastroenterología como parte de un curso integrado. Este taller inicialmente incluyó una exposición con apoyo de video sin demostración por docentes, y entrega de debriefing al final de cada procedimiento por parte del docente en grupos de 7 a 8 alumnos por sesión.A pilot study was conducted with the students who were in the ambulatory rotation of gastroenterology as part of an integrated course. This workshop initially included an exhibition with video support without demonstration by teachers, and debriefing at the end of each procedure by the teacher in groups of 7 to 8 students per session.
Los alumnos que participaron de la rotación ambulatoria de gastroenterología en cuarto año de pregrado de medicina (n=120) asistieron a un taller (sesión de 3 horas de duración) de paracentesis abdominal. A continuación, se describen las actividades en orden cronológico.The students who participated in the ambulatory gastroenterology rotation in the fourth year of undergraduate medicine (n = 120) attended a workshop (3-hour session) of abdominal paracentesis. Next, the activities are described in chronological order.
1. Preparación de los fantomas y mesa con insumos requeridos en el procedimiento. 1. Preparation of the phantoms and table with supplies required in the procedure.
2. Recepción de los alumnos, explicación de las actividades durante la sesión y división del grupo en 2 sub-grupos de 4 alumnos cada uno, a cargo de un tutor por fantoma.  2. Reception of the students, explanation of the activities during the session and division of the group into 2 sub-groups of 4 students each, in charge of a tutor by phantom.
3. Evaluación pre-sesión (diagnóstico basal) de un alumno de cada sub-grupo y el resto del grupo observa, uno de ellos evalúa, de manera independiente del tutor, a su compañero(a) utilizando la misma pauta de evaluación.  3. Pre-session evaluation (baseline diagnosis) of one student from each sub-group and the rest of the group observes, one of them evaluates, independently of the tutor, his or her partner using the same evaluation guideline.
4. Se realiza debriefing a cada alumno con modelo plus-delta.  4. Each student is debriefed with a plus-delta model.
5. Se presenta el video instruccional con detenciones en los aspectos críticos, para resolver dudas o hacer énfasis en errores sistemáticos observados en los alumnos que realizaron procedimiento pre-sesión.  5. The instructional video is presented with stops in the critical aspects, to solve doubts or to emphasize systematic errors observed in the students who performed the pre-session procedure.
6. Docente realiza demostración en tiempo real ("Master class') en el fantoma y el segundo tutor cumple el papel de arsenalero(a).  6. Teacher performs real-time demonstration ("Master class') in the phantom and the second tutor fulfills the role of arsenalero (a).
7. Cada alumno(a) realiza la punción de manera secuencial mientras el resto del grupo evalúa, apoya al compañero como arsenalero(a) u observa.  7. Each student performs the puncture sequentially while the rest of the group evaluates, supports the partner as an arsenalero or observes.
8. Debriefing breve luego de cada procedimiento.  8. Short debriefing after each procedure.
9. Cierre de la sesión.  9. Closure of the session.
Las actividades secuenciales del taller incluían en primer lugar la toma de consentimiento informado, la recopilación de los materiales necesarios y la implementación de medidas de precaución estándar. Luego se identificó el sitio de punción, se realizó asepsia de la zona e inyección de anestésico local. Posteriormente se procedió a la punción y recolección de las muestras y finalizado esto, la retirada y oclusión del sitio. Finalmente se realizó un listado de indicaciones post procedimiento.  The sequential activities of the workshop included the taking of informed consent, the collection of the necessary materials and the implementation of standard precautionary measures. Then the puncture site was identified, asepsis was performed in the area and local anesthetic injection. Subsequently, the samples were punctured and collected and, after this, the site was removed and occluded. Finally, a list of post procedure indications was made.
El estudio piloto, realizados en alumnos de pregrado, mostraron que los estudiantes que realizaron 2 punciones (n=69) mejoraron sus destrezas de 13,36±4,46 (55,7%) en el primer intento a 22,3±1 ,83 (92,9%) p<0,001 , después de recibir las instrucciones. Los alumnos que realizaron sólo una punción (n=178) tuvieron 21 ,66±2,79 puntos (90%) lo que no fue significativamente distinto respecto a la segunda evaluación de los alumnos que hicieron 2 punciones (22,3 puntos, 92,9 %, p 0,079). El cumplimiento de la pauta de observación directa demuestra un aprendizaje significativo por parte de los estudiantes de pregrado.The pilot study, conducted in undergraduate students, showed that students who performed 2 punctures (n = 69) improved their skills from 13.36 ± 4.46 (55.7%) on the first attempt to 22.3 ± 1 , 83 (92.9%) p <0.001, after receiving instructions. The students who performed only one puncture (n = 178) they had 21, 66 ± 2.79 points (90%), which was not significantly different from the second evaluation of the students who had 2 punctures (22.3 points, 92.9% , p 0.079). Compliance with the direct observation pattern demonstrates significant learning on the part of undergraduate students.
En cuanto a resultados en otros ejemplos de un taller de simulación en paracentesis, Barzuk (2011), demostró que un taller de paracentesis con ultrasonido de alta fidelidad tenía un desempeño del procedimiento pre y post intervención de entrenamiento de 33% (SD=15,2%) a 92,7% (SD=5,4%) en residentes de medicina interna. (Barsuk JH, Cohén ER, Vozenilek JA, O'Connor LM, McGaghie WC & Wayne DB. (2012). Simulation-based education with mastery learning improves paracentesis skills. Journal of gradúate medical education, 4 (1), 23-27.) Regarding results in other examples of a simulation workshop in paracentesis, Barzuk (2011), showed that a paracentesis workshop with high fidelity ultrasound had a performance of the pre and post training intervention procedure of 33% (SD = 15, 2%) to 92.7% (SD = 5.4%) in internal medicine residents. (Barsuk JH, Cohen ER, Vozenilek JA, O'Connor LM, McGaghie WC & Wayne DB. (2012) .Simulation-based education with mastery learning improves paracentesis skills Journal of gradúate medical education, 4 (1), 23-27 .)
APLICACIÓN INDUSTRIAL INDUSTRIAL APPLICATION
La presente invención tiene aplicación industrial por cuanto se puede producir en la industria de simuladores para entrenamiento clínico.  The present invention has industrial application in that it can be produced in the simulator industry for clinical training.

Claims

REIVINDICACIONES
1 . Dispositivo que permite realizar simulaciones de técnicas de punción CARACTERIZADO porque el dispositivo corresponde a un trozo de material que permite la simulación de piel, donde el dispositivo está elaborado por 3 capas de distintas características:  one . Device that allows simulations of puncture techniques CHARACTERIZED because the device corresponds to a piece of material that allows skin simulation, where the device is made by 3 layers of different characteristics:
a. una primera capa, ubicada hacia el exterior del dispositivo, que es la capa que recibirá la punción desde el exterior;  to. a first layer, located towards the outside of the device, which is the layer that will receive the puncture from the outside;
b. una segunda capa intermedia;  b. a second intermediate layer;
c. una tercera capa, ubicada hacia el interior del dispositivo, que no es visible al usuario durante el momento de punción.  c. a third layer, located towards the interior of the device, which is not visible to the user during the puncture.
2. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 1 , CARACTERIZADO porque la primera y tercera capa están compuestas por un material basado en silicona. 2. Device for simulating puncture techniques according to claim 1, characterized in that the first and third layers are composed of a material based on silicone.
3. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 2, CARACTERIZADO porque el material basado en silicona corresponde a goma de silicona curada por condensación, o goma de silicona curada por adición. 3. Device for simulating puncture techniques according to claim 2, characterized in that the silicone-based material corresponds to silicone rubber cured by condensation, or silicone rubber cured by addition.
4. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 1 , CARACTERIZADO porque la segunda capa está compuesta por un material esponjoso y un material generador de fricción. 4. Device for simulating puncture techniques according to claim 1, characterized in that the second layer is composed of a spongy material and a friction-generating material.
5. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 4, CARACTERIZADO porque el material esponjoso que compone la segunda capa se selecciona entre una espuma de polietileno, una espuma de baja densidad. Device for simulating puncture techniques according to claim 4, characterized in that the spongy material making up the second layer is selected from a polyethylene foam, a low density foam.
6. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 4, CARACTERIZADO porque el material de fricción que compone la segunda capa se selecciona entre una microfibra de celulosa natural, o una bolsa de material flexible que contiene líquido. Device for simulating puncture techniques according to claim 4, characterized in that the friction material making up the second layer is selected from a natural cellulose microfiber, or a flexible material bag containing liquid.
7. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 6, CARACTERIZADO porque dicha bolsa contenedora puede ser de látex, caucho natural o goma. Device for simulating puncture techniques according to claim 6, characterized in that said containment bag can be of latex, natural rubber or rubber.
8. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 2 o 3, CARACTERIZADO porque el material basado en silicona es una capa de silicona de caucho con una dureza shore de al menos entre 8-30A, y un espesor de entre 1 mm y 3 mm. Device for simulating puncture techniques according to claim 2 or 3, characterized in that the silicone-based material is a layer of rubber silicone with a shore hardness of at least 8-30A, and a thickness of between 1 mm and 3 mm.
9. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 5, CARACTERIZADO porque la espuma de polietileno que compone la segunda capa tiene una densidad de entre 14 y 18 kg/m3, y un espesor de entre 2 y 4 mm. 9. Device for simulating puncture techniques according to claim 5, CHARACTERIZED because the polyethylene foam that makes up the second layer has a density of between 14 and 18 kg / m 3 , and a thickness of between 2 and 4 mm.
10. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 5, CARACTERIZADO porque la espuma de baja densidad que compone la segunda capa con una dureza Shore de 10A a 30A, de color blanco, tiene una densidad de entre 14 y 18 kg/m3, y un espesor de entre 2 y 4 mm. 10. Device for simulating puncture techniques according to claim 5, CHARACTERIZED because the low density foam that composes the second layer with a Shore hardness of 10A to 30A, white, has a density of between 14 and 18 kg / m 3 , and a thickness between 2 and 4 mm.
1 1 . Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 1 , CARACTERIZADO porque el dispositivo tiene una forma rectangular, y cubre un área de entre 20cm2 y 70cm2. eleven . Device that allows simulations of puncture techniques according to claim 1, CHARACTERIZED because the device has a rectangular shape, and covers an area between 20cm 2 and 70cm 2 .
12. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 1 , CARACTERIZADO porque el dispositivo tiene forma irregular, y cubre un área de entre 20cm2 y 70cm2. Device that allows to perform simulations of puncture techniques according to claim 1, CHARACTERIZED because the device has irregular shape, and covers an area between 20cm 2 and 70cm 2 .
13. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 1 , CARACTERIZADO porque el dispositivo se encuentra sellado en sus bordes. Device for simulating puncture techniques according to claim 1, characterized in that the device is sealed at its edges.
14. Dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 13, CARACTERIZADO porque el sellado de los bordes del dispositivo se realiza por medio de una costura, utilizando silicona adhesiva, adhesivos de silicona líquida, también se puede usar Sil-Poxy adhesivo especial para siliconas, Permnabond para pegado de caucho natural o con uniones mecánicas colocando piezas metálicas tipo corchete. Device for simulating puncture techniques according to claim 13, characterized in that the sealing of the edges of the device is carried out by means of a seam, using adhesive silicone, liquid silicone adhesives, Silk can also be used. Poxy special adhesive for silicones, Permnabond for gluing natural rubber or with mechanical joints by placing metal pieces clasp type.
15. Uso de un dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 1 , CARACTERIZADO porque el dispositivo puede adaptarse y colocarse sobre una cara abierta de una caja y así configurar un aparato de simulación de punción portátil, útil por ejemplo en la práctica de técnicas de punción simples como inyecciones intramusculares. 15. Use of a device that allows simulations of puncture techniques according to claim 1, CHARACTERIZED because the device can adapting and placing on an open face of a box and thus configuring a portable puncture simulation apparatus, useful for example in the practice of simple puncture techniques such as intramuscular injections.
16. Uso de un dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 1 , CARACTERIZADO porque el dispositivo puede adaptarse y colocarse sobre una cara o faceta abierta de un fantoma destinado a simular un procedimiento de punción más complejo. 16. Use of a device that allows simulations of puncture techniques according to claim 1, wherein the device can be adapted and placed on an open face or face of a phantom intended to simulate a more complex puncture procedure.
17. Uso de un dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 16, CARACTERIZADO porque el procedimiento de punción más complejo es sobre un fantoma de cavidad abdominal para permitir la práctica de procedimientos de abdominocentesis o paracentesis. 17. Use of a device that allows performing simulations of puncture techniques according to claim 16, CHARACTERIZED because the most complex puncture procedure is on a phantom of abdominal cavity to allow the practice of abdominocentesis or paracentesis procedures.
18. Uso de un dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 1 , CARACTERIZADO porque el dispositivo puede combinarse en una configuración más compleja, sobre una cara abierta de un fantoma que contiene órganos internos simulados, de manera que en esta configuración la persona que reciba el entrenamiento deberá evitar puncionar por accidente los órganos internos simulados. 18. Use of a device that allows to perform simulations of puncture techniques according to claim 1, CHARACTERIZED because the device can be combined in a more complex configuration, on an open face of a phantom containing simulated internal organs, so that in In this configuration, the person receiving the training should avoid puncturing the simulated internal organs by accident.
19. Uso de un dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 1 , CARACTERIZADO porque se pueden contener órganos simulados y tejidos ex-vivo animal obtenido de industrias faenadoras con fines educacionales de manera que el dispositivo de la presente invención también puede usarse en el entrenamiento de cirugías y obtención de muestras para biopsias. 19. Use of a device that allows simulations of puncture techniques according to claim 1, characterized in that simulated organs and tissues ex-vivo animal obtained from slaughtering industries can be contained for educational purposes so that the device of the present invention It can also be used in the training of surgeries and obtaining samples for biopsies.
20. Uso de un dispositivo que permite realizar simulaciones de técnicas de punción de acuerdo a la reivindicación 1 , CARACTERIZADO porque permite la simulación y práctica de distintas técnicas de punción que requieren algún nivel de desplazamiento de la piel y/o músculos cercanos al área de punción, como por ejemplo técnica de punción en bayoneta, punción oblicua, técnica "pig tail", técnica Seldinger, realización de simulación de biopsias Trucut, como también otros procedimientos que requieren técnicas especiales de punción, tal como instalación de portales laparoscópicos y artroscópicos, o la instalación de tubos de drenaje. 20. Use of a device that allows simulations of puncture techniques according to claim 1, CHARACTERIZED because it allows the simulation and practice of different puncture techniques that require some level of displacement of the skin and / or muscles close to the area of puncture, such as, for example, bayonet puncture technique, oblique puncture, pigtail technique, Seldinger technique, simulation of Trucut biopsies, as well as other procedures that require special puncture techniques, such as the installation of laparoscopic and arthroscopic portals, or the installation of drainage pipes.
PCT/CL2018/050064 2017-08-21 2018-08-04 Device that allows simulation of and training on different puncture techniques WO2019036819A1 (en)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP4618509B2 (en) * 2006-02-02 2011-01-26 Ｎｏｋ株式会社 Injection practice equipment
CN202013685U (en) * 2011-03-30 2011-10-19 浙江海洋学院 Venipuncture practice foot sheath
CN202058357U (en) * 2011-03-30 2011-11-30 浙江海洋学院 Intradermal injection practice wristband
CN203456001U (en) * 2013-07-23 2014-02-26 南京中医药大学 Intravenous injection model
US8944825B2 (en) * 2011-09-01 2015-02-03 Kerry Reid-Searl Teaching prop
JP2015069073A (en) * 2013-09-30 2015-04-13 大衛株式会社 Injection training device

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP4618509B2 (en) * 2006-02-02 2011-01-26 Ｎｏｋ株式会社 Injection practice equipment
CN202013685U (en) * 2011-03-30 2011-10-19 浙江海洋学院 Venipuncture practice foot sheath
CN202058357U (en) * 2011-03-30 2011-11-30 浙江海洋学院 Intradermal injection practice wristband
US8944825B2 (en) * 2011-09-01 2015-02-03 Kerry Reid-Searl Teaching prop
CN203456001U (en) * 2013-07-23 2014-02-26 南京中医药大学 Intravenous injection model
JP2015069073A (en) * 2013-09-30 2015-04-13 大衛株式会社 Injection training device

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