ES2474340B1 - Electronic device for learning and training surgical suture - Google Patents

Abstract

The present invention relates to an electronic device for learning and training surgical suture composed of a hollow board with a practice area and interchangeable and disposable sheets containing drawings representing different types of wound or cut shape.

Description

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Electronic device for learning and training surgical suture

The present invention relates to a device for the exercise of a method or procedure for learning surgical suture by health professionals who need to acquire or maintain the skills necessary for this surgical technique. Therefore, the invention is within medicine, specifically within the fields of training, training and practice of surgery.

Background of the invention or State of the art

Surgical suture is described as the technique to join tissues separated by a wound or by a surgical incision, by ligating with silk, catgut, nylon, etc. and the help of a needle. This technique, which is thousands of years old, is used to strengthen the healing of a wound during its healing process and to prevent a new injury from the healed part of the wound, due to tearing or reopening of the wound. Also, it reduces the size of the scars and minimizes the chances of infection that an open wound would have.

The teaching and practice of an adequate suture technique, consists not only in showing the form of execution of the same, but also in the proper choice of the type of suture and its correct placement along the wound. It is necessary for the student to become familiar with the application of skin, subcutaneous sutures, and other varieties of suture techniques.

This practice should not be achieved based on errors made in the patient, but through training on devices that allow health professionals to acquire the skills required to subsequently apply these techniques to the experimental animal and finally, in the clinic human

Traditionally, organs and parts of animals have been used as training devices due to their availability and low cost, although they have a number of disadvantages such as tissue petrification, which causes this form of training to be undesirable.

Based on the above, devices or simulators have been developed for training in surgical suture techniques. These devices are usually synthetic and mimic portions, organs or tissues of the human and animal body to be able to train and train the exercise of the suture.

Synthetic or physical simulators, based on devices that recreate the surgical reality that your user will find during an intervention, depending on the advances applied in their development and the objectives they pursue, can be grouped into three generations:

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one.

The first generation: formed by surgical simulators that only consider the geometric nature of human anatomy.

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The second generation: which is made up of those who also allow physical interaction with anatomical structures.

3.

The third generation: that in addition to the aforementioned characteristics of the second generation, they take into account the functional nature of the organs.

Currently, during the period of initial training of surgeons, simulators have acquired great importance due to their enormous utility to achieve the acquisition of sufficient skill in the management of surgical instruments. The different maneuvers can be performed by direct vision or with vision on monitors (in the specific case of minimally invasive surgery).

Commercially there are different models of simulators that can be used by a single person, holding the camera where appropriate by means of a mobile arm fixed to the training table, or working together two or three people performing different activities (camera, surgeon and assistant ).

In this regard, the patent with application number US6398557 “Devices, methods and dits for training in surgical techniques” stands out, the invention of which consists of a container made up of folding panels containing parts that simulate the physical properties of skin, blood vessels and other tissues. , a device for suturing and another for tying against pressure.

This simulator has the advantage that its use as a prior learning method reduces the cost of education, but its repeated use tends to weaken and destroy the material of which it is composed, reducing its effectiveness for teaching after a period of use .

This problem is partly resolved in the “suture training device” or “suture training device”, which holds international industrial property, with an application date of August 29, 2006 and international publication number WO 2008/027425 A2 . This device is characterized by having a box-shaped structure, which allows the student to practice sutures in a variety of conditions and circumstances. This invention is prepared for permanent use, since the upper part consists of a vacuum where to locate the artificial tissues for suture practice. However, the exercises he poses are extremely simple, causing his training and training function to be limited.

On the other hand, there are synthetic simulators that pose more complex exercises but are very limited to certain surgical specialties, either because they focus on training and training certain parts of the body.

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For example, US patents with application numbers US5380207 and US5137459 protect inventions that serve to practice surgical techniques encompassed within the branch of ophthalmology. The first consists of a simulator that represents the anterior portion of a human eye that has a torn iris for the practice of ophthalmological suture technique, and the second is a device for performing experimental operations practices on the eyes, which represents the front half of a human head, and which has facial features with an artificial eye socket in which the synthetic mounting eye is placed.

Two other antecedents that can be cited are the Russian invention patent RU2370221, which protects a simulator for the training of technical skills in tendon suture based on a platform formed by a wooden plate that includes two hollow plastic cylinders to fix platform support; and the Chinese CN200941261 that collects another simulator for the practice of laparoscopic cholecystectomy, representing the anterior and posterior peritoneum so that they join together to simulate an artificial pneumoperitoneum during laparoscopic surgery.

Therefore, these simulators, unlike the procedure contained herein, offer very specific and limited training solutions when establishing a complete and efficient didactic system of the surgical technique of the suture and knotting, which allows to encompass all the possible tissues, structures or organic systems in which you may have to exercise.

The only simulator that solves the above problems is the Chinese “An exercise board for surgical operation seam line” with patent number CN201066541 consisting of a geometric shaped plate or board, with a notch similar to that of the plate and several holes on its surface around the notch. Its purpose is to facilitate the practice of suturing in the initial stages of training specialists. However, this device is quite rudimentary and does not provide as complete training as the simulator and the training method described in this technical report, since it does not take into account the structure of the tissues to be sutured, nor their size, nor different degrees of difficulty in the exercises that it allows to develop.

On the other hand, regarding the method of suture training of surgeons, despite its great importance, after analyzing the state of science, it has been proven that the existing methods are heterogeneous. Thus, the greatest innovation implied by the described method is to standardize and complete the way to train, train and train surgeons in teaching the surgical technique of the suture.

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The present invention provides a simulator for learning and training the surgical suture allowing the performance of certain surgical suture exercises either through direct vision or by means of monitor vision when training in minimally invasive surgery.

The simulator must represent reality as much as possible, which implies having suitable suture tools to the tissues on which the surgical intervention is to be simulated, their response to the selected material and tools, their handling characteristics and visibility within the organism, etc. Thus the type of needle must allow entry and exit through the tissues correctly without tearing them apart.

The simulator has a training area in its upper part, where different holes are configured in which the interchangeable and disposable sheets are used to execute the indicated exercises.

These holes are connected to an electronic system that is located inside the simulator, so that when the suture needle is contacted with the two correct holes, the correctness is indicated when performing the training exercise. The arrangement of the holes on the surface of the simulator has been established taking into account the constant measurement of the arc height of a medium-sized suture curved needle and the length of the radius marked by the diameter of that same arc. Medium sized needles have been studied because they are usually the most used in anastomosis (surgical technique to suture sectioned parts of the circulatory system), although different attached holes are planned to use other types of needles.

In a preferred embodiment of the invention, the simulator, furthermore, consists of a digital display reflecting a stopwatch and the number of hits, of controls for the stopwatch, of switches for switching on and off the electronic system and a space, at the base of the simulator, where the batteries of said system are collected.

Additionally, the simulator has interchangeable and disposable sheets showing the drawings that represent the different kinds of wounds that can be treated and that will fit the surface of the simulator for the practice of the different training, consisting of cutting, suturing and knotting in different ways said sheets.

There are different sheets depending on the degree of difficulty of the training exercises: the sheets used in the initial phase of basic training contain linear engravings, those used in the later phases have circular, semicircular engravings, or combine circular or linear shapes depending on the degree of difficulty of the practice and the type of lesion that you want to simulate (Z Plasty, Dog or Starry Ear).

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simulator to perform similar exercises with vision through the monitor. In this way, in addition to continuing to improve the handling of instruments, the habit of working with two-dimensional images is achieved. This aspect is one of the most important in the concrete learning of minimally invasive surgical techniques.

From the foregoing and according to the analysis of the state of the art, the advantages of the present invention with respect to other existing devices and methods are apparent; although, below we cite the most prominent ones by way of example and not limitation:

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It substantially reduces the use of animals during surgical training, providing an ethical and moral basis in accordance with current legislation.

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Facilitates ambidextrous training.

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They allow you to simulate a wide variety of scenarios and types of wounds and cuts that a surgeon may encounter.

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It has a great didactic capacity, allowing to standardize a complete training system in surgery.

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Avoid the risks of direct training on patients.

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It has a portable and lightweight format that facilitates its handling and transport.

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It is independent, not needing additional computer systems to develop its function.

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It allows the self-evaluation of the student's abilities and the measurement of the evolution of his skills by marking the successes and establishing exercises of different difficulty

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Its industrial manufacturing is very simple.

Description of the drawings

To complete the description of the invention object of this technical report, improving the understanding of its characteristics, a design sheet is attached to said report, according to preferred examples of embodiment of the invention by way of illustration and not limitation.

Figure 1 shows a top view of the practice area of the exercises of the learning and training device, where a preferred way of placing the components thereof can be observed, without the sheets for suture exercises.

Figure 2 shows an example of suture training sheets with different engravings for performing the exercises, according to the different degrees of difficulty.

Figure 3 shows a top view of the practice area of the learning and training device, this time with an attached suture exercise sheet

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constants in the length and height of its arch that mark the distribution of the holes located in the practice area.

DISCLOSURE OF A PREFERRED EMBODIMENT OF THE INVENTION

Based on the drawings accompanying this technical report, a preferred embodiment of the invention is detailed below, by way of example.

The simulator is composed of a hollow board (1), which has in its upper part a practice area where to carry out all the training and training exercises of each phase of the training.

The practice area, represented in figure number 2, consists in its central area with a section (9) containing a set of metal holes (10). These metallic holes (10) are welded to an electrical system contained inside the simulator and connected to a battery and a light indicator (8), so that when the suture needle is contacted with the two correct holes the electrical circuit closes and the indicator light (8) is illuminated, which represents the success when performing the training exercise.

The arrangement of these metal holes (10) in the section (9) of the practice area has been established taking into account two constant measurements that are represented in figure number 5: the height of the arch of a medium-sized suture curved needle (12) and the length of the radius marked by the diameter of that same arc (13). Medium sized needles have been studied because they are usually the most used in anastomoses, although different annexed holes are planned to use other types of needles.

In order to perform the exercises, in section (9) covering all metal holes (10), interchangeable and disposable sheets (2) are coupled, with texture similar to that of skin tissue. In these sheets, as reflected in figure number 4, are engraved drawings (3) that represent the wounds to be sutured that the surgeon can find and that will vary depending on the degree of difficulty of the exercise to be performed.

The basic activity of the exercises to be performed with said sheets (2) consists, first, of making an incision with a surgical cutting instrument, to then suture and knot with needle and suture, following the representations marked by the drawings (3) of the sheets (2).

There are different plates depending on the degree of difficulty of the training and training exercises: the plates (2) used in the initial phase of basic training contain drawings (3) with linear form, those used in the later phases have drawings (3) in circular, semicircular shape, or combine circular and linear shapes increasing the degree of difficulty of the

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shown in figure number 3.

In addition, as it appears in Figures 2 and 4, the upper part 5 of the practice area consists of:

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of one or more digital screens (4 and 6),

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of the corresponding controls (7) to operate the menus of said screens,

• of the switch for switching on and off the simulator (5) 10 • and a light indicator (8).

Using the digital screens (4 and 6) and the controls (7), you can control the timer, configure the training exercise menus, check the number of hits and failures saved after the last training, etc.,

The operation of all the previous elements is produced thanks to an electronic system composed of an electrical circuit, the rest of the 20 components that connect said circuit to the screens and controls and the batteries that provide electrical energy to the entire electronic system. Both the system and the batteries are installed and hidden inside the simulator, taking advantage of its configuration in the form of a hollow board (1). In order to access these batteries, in order to change them

25 or recharge them when they have run out, there is a gate (11) at the base of the board (1).

As explained above, when the electrical circuit, digital screens (4 and 6) and the electrical circuit are connected via the electronic system

30 controls (7), the metal holes (10), the indicator light (8) and the battery, when the simulator training and training exercises are carried out, if the needle used touches the two holes (10) at the same time , the aforementioned circuit will be closed, lighting the indicator light (8) and marking on the digital screens (4 and 6) that the exercise has been carried out successfully.

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Claims (4)

image 1 1. Electronic device for learning and training surgical suture characterized in that it comprises a hollow board (1) that contains an electronic circuit and has a series of controls on its surface (7) among which is the on / off switch (5), digital displays (4 and 6), indicator light (8) and section (9) with metal holes (10) on which plates are coupled ( 2). The distance between the metal holes (10) is proportional to the height of the arc of a medium sized suture curved needle (12) and to the length of the radius marked by the diameter of that same arc (13).

2.

Electronic device for learning and training surgical suture, according to previous claims, characterized in that the sheets (2) coupled on the section (9) of the hollow board (1) are interchangeable and disposable and are made of a material with a texture that simulates the skin tissue

3.

Electronic device for learning and training surgical suture, according to previous claims, characterized in that the sheets (2) contain drawings (3) that represent different types of wound or cut shape, corresponding to the different levels of difficulty of the method exercises of training and learning.

Four.

Electronic device for learning and training surgical suture, according to previous claims, characterized by including an electronic circuit connected to pairs of metal holes (10), the indicator light (8) and a battery, so that when performing the training exercises , if the needle used touches the two holes (10) at the same time, said circuit will close and the indicator light will turn on.

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