RU2780289C2 - Simulator for working out manual skills in laparoscopic surgery in three-dimensional space, using image on simulator of laparoscopic stand monitor - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, namely to medical training models for acquisition and working out of manual skills in laparoscopic surgery by students of medical universities, residents, and surgeons. A simulator for working out manual skills in laparoscopic surgery in a three-dimensional space, using an image on a simulator of a laparoscopic stand monitor, is made of monolithic transparent material – polymethylmethacrylate. The simulator has face and working surfaces. The face surface is the extension of a simulator base and is represented by a vertical face and a face, which forms an angle of 130° with the vertical face. On the face surface, there are laparoscopic port simulators, brackets for fixation of a phone or a tablet, and a viewing hole for a camera. On the working surface, a means for fixation of a working table and mini-simulators is installed, the base also has 4 silicone suckers for fixation of the simulator to the surface. Exercises are worked out in two stages. First, in the three-dimensional space, without the mobile phone or the tablet, which is provide by transparency of polymethylmethacrylate, of which the simulator is made. After acquisition of base skills, the student gets to the second stage of working out surgical skills in a two-dimensional space.

EFFECT: provision of working out manual skills in laparoscopic surgery due to gradual transition from a three-dimensional space to a two-dimensional image on a monitor.

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Description

A simulation simulator for practicing manual skills in laparoscopic surgery in three-dimensional space using an image on a laparoscopic rack monitor simulator refers to the educational process in medicine for acquiring and practicing manual skills in laparoscopic surgery by university students, residents undergoing training in general and specialized surgical hospitals, and also for practicing surgeons who want to master laparoscopic surgery, improve the level of manual skills and work out individual stages and techniques of operations.

The prototype of this device is the simulator "LT Lap Tab simulator with side ports and a package" manufactured by 3bscientiflc for practicing laparoscopic skills (URL: https://www.3bscientific.ru/simulator-1t-1ap-tab-c-side-ports-i -package-1018113-w44903-3-dmed-lts-p,p_1456_26061.html). This model is represented by white panels, folding in the form of a triangular prism. The front surface is represented by a panel with two holes imitating laparoscopic ports, and a viewing hole for the camera is formed at the top and a holder is installed for fixing an image display device, such as a tablet or mobile phone. The opposite side is represented by a panel with a square hole, through which mini-simulators are installed for practicing laparoscopic skills.

The described Trainer LT Lap Tab with side ports and a package, however, has a number of disadvantages:

1. panels for the simulator are made of opaque material, which does not allow practicing the exercise in three-dimensional space with the subsequent transition to two-dimensional space, which facilitates the acquisition of laparoscopic skills;

2. the simulator does not have means of fixing to the table, which complicates the work due to its mobility during the development of skills;

3. the folded structure is relatively large;

4. there is no device for fastening and installing various mini-tablets for working out the necessary cases;

5. The proposed simulator has a high cost, despite the technological simplicity of this simulator.

When developing the proposed device, the goal was set - to create a simulation simulator for practicing manual skills in laparoscopic surgery, which will allow students to practice laparoscopic skills, according to the principle "from simple to complex", which is realized through a gradual transition from three-dimensional space to a two-dimensional image on the monitor, to have a multifunctional platform for placing mini simulators and cadaver material and have a high economic profitability.

The solution to this goal is a simulation simulator for practicing manual skills in laparoscopic surgery in three-dimensional space using an image on a laparoscopic rack monitor simulator, consisting of a sheet of transparent monolithic polymethyl methacrylate 67 * 27 cm in size, which has 2 bends (Fig. 1). The first bend is 90°, dividing the simulator into a base and a front work surface, the base has a rectangular shape with a length of 36 cm and a width of 27 cm. 0.5 cm with a formed square hole 16.2 * 16.2 cm for fixing the cork table and installing mini-trainers. The front surface is a continuation of the base of the simulator and is represented by a vertical edge 12 cm high and a edge 17 cm long, which forms an angle of 130° with the vertical edge. In the center of the working surface, a working table with a size of 16 * 16 cm is installed, consisting of a platform of polymethyl methacrylate and a cork coating fixed on it, 1 cm thick. silicone suction cups with a diameter of 4 cm. located symmetrically at the corners at a distance of 2 cm from each side of the platform. Fixing with the help of these silicone suction cups to the table surface ensures the immobility of the simulator and convenience when practicing skills, also silicone suction cups have a shock-absorbing effect, which creates comfort when practicing exercises. Holes imitating laparoscopic ports for inserting laparoscopic instruments with a length of 33 cm are formed on the front surface facing the trainee. The distance between the centers of the manipulation holes is 18 cm. laparoscopic instruments with a length of 33 cm provides access over the entire area of the working surface. The diameter of the working holes is 8 mm; they are formed at a distance of 4.1 cm from the side faces of the front surface to the center of the holes and at a distance of 5.5 cm from the line of the upper bend, forming an angle of 130°, to the center of the working holes. Working openings for manipulations are formed at an angle towards the center of the working surface. This avoids jamming of the instrument in the working hole during the insertion and removal of laparoscopic manipulators and creates a minimum backlash of the instrument in the working hole, which also ensures the convenience of practicing manual skills. Also on the front surface, a viewing hole 1.6 cm in diameter is formed at a distance from the center of the viewing hole to the line of the upper bend, forming an angle of 130° and in the center between the side faces of the front surface (Fig. 2).

On the front surface, two metal brackets are fixed, made of steel wire with a diameter of 3 mm, having a bend of 90°. The first bracket is installed 2 cm from the side face, the second is located 11 cm from the left side face, both brackets are located 8 cm upwards from the line of the upper bend, forming an angle of 130°.

The angle of inclination of the front surface, the level of mounting brackets for fixing the mobile device, the diameter and location of the viewing hole, the diameter of the working holes, create conditions for manipulations on the working surface using laparoscopic instruments with a working length of 33 cm and 0.5 cm in diameter and a viewing angle , when installing a mobile phone or tablet, as the camera lens fixes the center and captures the entire area of the work surface.

To practice exercises on a simulation simulator for practicing manual skills in laparoscopic surgery in three-dimensional space using the image on the monitor simulator of the laparoscopic rack in two stages, taking into account the principle "from simple to complex". At the beginning, the exercises are worked out in three-dimensional space, that is, without a mobile phone or tablet, this is ensured by the transparency of the polymethyl methacrylate from which the simulator is made. After acquiring basic skills, the student can move on to the second stage of practicing surgical skills in two-dimensional space. To do this, 10 install a mobile phone or tablet on the front surface and turn on the video mode of the device's camera, displaying an image on the screen, which imitates the monitor of a laparoscopic rack.

A simulation simulator for practicing manual skills in laparoscopic surgery in three-dimensional space using an image on a laparoscopic stand monitor simulator has:

- a two-stage approach to the development of laparoscopic skills, implemented by the transparency of the material and the transition from three-dimensional space to two-dimensional space;

- a working table for fixing mini-simulators and performing the necessary cases;

- a convenient device for fixing the simulator to the table surface, implemented by means of four silicone suction cups;

- high variability of surgical procedures;

- multidisciplinary approach, as it allows surgeons of vascular, abdominal, thoracic and trauma profiles to work;

- simple design and manufacturing technology;

- inexpensive economic component;

- ease of use and operation.

A simulation simulator for practicing manual skills in laparoscopic surgery in three-dimensional space using an image on a laparoscopic stand monitor simulator can be widely used among future and practicing surgeons when practicing new operations and individual stages of surgical interventions and precision manipulations due to the possibility of installing various cadaveric materials and others. special mini-trainers.

Claims (4)

A simulation simulator for practicing manual skills in laparoscopic surgery in three-dimensional space using an image on a laparoscopic stand monitor simulator, including a sheet of transparent monolithic polymethyl methacrylate 67 * 27 cm in size, which has 2 bends; the first bend is 90°, dividing the machine into a base and a front work surface, the base is rectangular with a length of 36 cm and a width of 27 cm; on the basis of the far edge from the front working surface, a plate of polymethyl methacrylate with a size of 27 * 27 cm and a thickness of 0.5 cm with a formed square hole of 16.2 * 16.2 cm is installed for fixing the table and installing mini-simulators; the front surface is a continuation of the base of the simulator and consists of two faces - a vertical 12 cm high and a face 17 cm long, forming an angle of 130 ° with the vertical face; in the center of the working surface, a working table measuring 16 * 16 cm is installed, which is a platform made of polymethyl methacrylate with a cork coating 1 cm thick fixed on it; the working surface has 4 silicone suction cups with a diameter of 4 cm, located symmetrically at the corners at a distance of 2 cm from each side of the platform; Holes imitating laparoscopic ports are formed on the front surface, the distance between the centers of the holes is 18 cm, a viewing hole 1.6 cm in diameter is formed and two metal brackets are fixed for installing a laparoscopic rack monitor imitator in the form of a phone or tablet, made of steel wire with a diameter of 3 mm and having a 90° bend; in this case, the first bracket is installed 2 cm from the side face, the second one is located 11 cm from the left side face, and both are located 8 cm up from the bend line of the front surface on the face forming an angle of 130° with the vertical face.

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