RU2782873C2 - Laparoscopic simulator - Google Patents

Abstract

FIELD: medical equipment.

SUBSTANCE: invention relates to medical equipment for teaching in surgery. A laparoscopic simulator includes a base with round holes for attaching training equipment and a rectangular hole for a training mat, a cover with round holes and a mechanism for adjusting a level of the chamber attachment. The base is made streamlined at edges of a rectangular surface and is equipped with a rubberized border fixed on sides to prevent slipping. Holes of the base are evenly distributed in the front part facing a student, and they have a diameter of 5.9 mm. The mechanism for adjusting the level of chamber attachment is installed in the rear part of the base with an offset of 20 mm from the edge, it consists of black runners parallel to each other, fixed at an angle of 60 degrees. to the base, and it is made with the possibility of changing a position of a compressive element in the form of a vise, which are two elements made of black plastic in the form of parallelepipeds having hemispherical recesses facing each other. The compressive element has elongated bolts, on which a star-shaped black handle with internal thread is wound, and a compression limiter in the form of a plastic sleeve, which is part of one of parallelepipeds. A fastener of a chamber handle is made in the form of a plastic ball with a central slot, which is a guide of an elongated metal part of the chamber holder, consisting of a hollow metal tube and a black plastic handle in the form of an elongated prism. The chamber has the possibility of turning on 180 degrees in a vertical plane, and on 60 degrees in a horizontal plane. The cover of the simulator has a streamlined spherical shape with flat sidewalls parallel to each other, it is attached to the base using metal hinges, and it has the possibility of lifting using a bracket consisting of a metal rod, a plastic sleeve fixed to the free end of the rod, and a guide, and the possibility of changing an angle of inclination using the plastic sleeve moved along the guide fixed on the inner side of the cover. Round holes on the front part of the cover facing the student are evenly distributed in two arcs, and they serve to fix inserts. The radius of round holes is 40 mm, an elongated hole for chamber operation is also made in the cover, a rectangular hole located on the rear part of the cover of the simulator is made with the possibility of attaching the training silicone mat imitating skin layers using an internal flanging along the perimeter with a width of 1.3 cm, inserts are made of elastic and stretchable beige silicone with a seal along the edge for fixing in round holes of the cover. The diameter of the central hole of the cover for the introduction of a laparoscopic tool is 1 cm.

EFFECT: invention makes it possible to improve the quality of laparoscopic skills training due to the use of a full set of real devices and tools for endoscopic surgery.

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Description

The invention relates to the field of medicine, namely to medical models of training in surgery, and is intended for training surgeons, surgical teams and operating nurses in laparoscopic operations in conditions as close as possible to real ones.

A known training system for video endoscopic surgery (US 2005/0064378 A1, March 24, 2005), which includes a body that determines the training volume, in which the simulated anatomical structure is located. Openings in the body allow surgical instruments inserted into the training volume to access the anatomical structure. A digital video camera is located inside the housing to display the anatomical structure on the display. The position of the digital video camera may be fixed within the housing, or the digital video camera may be placed within the housing to capture images of different portions of the training volume. The housing preferably includes a light source configured to illuminate the anatomical structure. One or more reflectors may be used to guide an image of the anatomical structure to a digital video camera.

Also known is a device for training surgeons in the techniques of endovideosurgical interventions, and contains a transparent sealed protective housing and housing cover. The lid has a sealed silicone gasket and sealed removable ports for placement of endovideosurgical equipment and instruments. The case contains a double bottom with the formation of a container for the solution and a simulated physiological insert with clamps for implanting anatomical objects in the form of a complex of embalmed organs, extracted without violating the integrity of the oral cavity, chest cavity, abdominal cavity and pelvic cavity (RU 2 718 764, 04/14/2020).

Known training modular platform for practicing laparoscopic and manual skills of open surgery, consisting of a rectangular base and a removable prefabricated body, which consists of walls and a top cover to accommodate an endoscopic instrument and a video camera. At the same time, the base contains grooves and holes for: installing trays for practicing manual skills of open surgery, one tray is intended for working with artificial materials, and the second tray is for working with biological materials; installation of the body for practicing laparoscopic skills, while the top cover has holes in which rubber inserts are placed for working with an endoscopic instrument and a video camera, which ensure the fixation of the instrument and camera due to the friction force between the rubber insert and the tube of the endoscopic instrument - RU 164785, 20.09.2016 .

A simulator is known (US 2017/0004738, 01/05/2017), which is selected as a prototype, and includes a top cover spaced from the base to form a simulated body cavity to accommodate model organs that are hidden from the user's field of view. The top cover contains a video display, fixed insert ports, and replaceable inserts containing simulated fabric layers. The simulator has open sides for demonstration and training of lateral surgical techniques, including simulated or live tissue of the colon. The simulator contains an endoscope with an adjustable focal length for use with optical trocars. The surgical simulator can be tilted and is well suited for teaching laparoscopic surgery techniques and demonstrating surgical instruments.

The disadvantage of analogues, in comparison with the claimed technical solution, is the impossibility of using both educational and operating endoscopic cameras, the complexity of the design, the need to use additional computer equipment.

The invention eliminates these disadvantages due to the design features of the proposed device.

The claimed design is characterized by simple assembly, compactness, mobility and aesthetics. The visualization system is not integrated into the simulator, which allows the student to use his own means of displaying the image. The device contains skids for moving the camera holder to visualize different parts of the simulator.

The objective of the technical solution is to create a laparoscopic simulator that provides: comprehensive training of surgeons to work with laparoscopic equipment and the development of manual surgical skills from basic to standard surgical interventions; training surgeons in conditions as close to real as possible, as well as practicing the practical skills of surgeons and operating nurses in real time using an endoscopic camera.

The technical result of the claimed technical solution is to improve the quality of training in laparoscopic skills through the use of a complete set of real devices and instruments for endoscopic surgery; the possibility of testing the installation of trocars in conditions of realistic tactile communication through the use of elements of training equipment, such as mats for practicing the application of surgical sutures, anchors with round holes for threading.

The simulator is a prefabricated structure consisting of the following elements.

The base (Fig. 1, element 1) is a rectangular surface streamlined at the edges with a rubberized border fixed on the sides to prevent slipping on the table when working with the simulator. Round holes with a diameter of 5.9 mm, evenly distributed horizontally and vertically, are necessary for attaching elements of training equipment, such as mats for practicing surgical suture placement, anchors with round holes for threading, and others.

In FIG. 1 also shows: a mechanism for adjusting the level of the camera mount (element 2), a camera handle (element 3), a cover-body (element 4), silicone liners (element 5).

With a small indentation of 20 mm from the edge, a mechanism for adjusting the level of the camera mount is fixed (Fig. 1, Fig. 2, element 2). The design (element 2) is presented in the form of black metal skids parallel to each other, along which the position of the vise changes (element 6). The skids are fixed at an angle of 60 degrees to the base.

Vise (figure 2, element 6) - two main elements made of black plastic, having the shape of a parallelepiped, each of which has a hemispherical cavity in the faces facing the other element. The compression of the vise occurs with the help of the upper and lower elongated bolts, which have a small threaded part, on which a star-shaped handle with an internal thread is screwed. The lower compression member is used to determine the mounting level of the camera fixation device. The compression limiter is made in the form of a plastic sleeve, which is part of one of the parallelepipeds. With the help of the upper bolt, the spherical element is fixed, located in the hole formed between the two main elements of the vise.

The spherical element (figure 2, element 7) is presented in the form of a plastic ball (ball-fasteners of the camera handle) with a central slot, which is the guide of the elongated metal part of the camera holder. The camera holder (figure 3) is a structure of two main elements: a hollow metal tube (item 8) and a black plastic handle (item 3), shaped like an elongated prism.

The cover-body of the simulator has a streamlined spherical shape with two flat side walls parallel to each other. The material is gray ABS plastic 4 mm thick, the side of the lid is protected by a rubberized edging.

Fastening is made with the help of metal loops fixed on the base of the simulator. The lid-body is lifted using a metal bracket, consisting of a metal rod, a plastic sleeve fixed to the free end of the rod, and a guide. The angle of inclination of the lid is determined by moving the plastic sleeve along the guide fixed on the inner side of the lid. The arm braking effect allows you to fix the opening of the simulator at any level.

On the front part of the cover-case, facing the student, are distributed evenly along two arcs and symmetrically about the center of the holes, which have the shape of a circle with a radius of 40 mm. These holes are necessary for fixing silicone liners. Also on the front is a vertical elongated hole necessary for camera operation. Vertically relative to the mechanism of adjustment and fasteners of the camera, the angle of movement of the camera is about 180 degrees, horizontally - 60 degrees. A rectangular hole located on the back of the lid of the simulator is necessary for attaching a training silicone mat that imitates skin layers. Internal flanging along the perimeter with a width of 1.3 cm serves as a limiter and fixation of the training material.

Inserts (figure 1, element 5) are made of beige silicone selected, so that the elasticity and extensibility as close as possible to the parameters of human skin. The central hole with a diameter of 1 cm is necessary for penetration into the simulator of a laparoscopic instrument, with the help of which surgical procedures are performed. The shape of the insert has a seal along the edge for a tight fit in the hole allocated for it. A sealed collar around the center hole prevents the silicone from tearing when working with metal tools.

Example

The simulator is operated using an imaging system, endoscopic instruments and consumables. The operator, under the control of the endoscopic camera, can practice various practical skills of laparoscopic surgery, getting the maximum tactile response from the manipulations performed. Also, one of the important points is the possibility of installing various modules in the simulator for practicing practical skills. For example: basic skills module, intercorporeal suture module, cholecystectomy module, anterior abdominal wall hernia repair module, bleeding control module.

Claims (3)

1. A laparoscopic simulator, including a base with round holes for attaching training equipment and a rectangular hole for a training mat, a cover with round holes and a mechanism for adjusting the level of camera attachment, characterized in that the base is made streamlined along the edges of a rectangular surface and is equipped with a rubberized border fixed on the sides to prevent slipping, the holes of the base are evenly distributed in the front part facing the student and have a diameter of 5.9 mm; angle 60 degrees. to the base, and is made with the possibility of changing the position of the compressing element in the form of a vice, which are two elements of black plastic in the form of parallelepipeds, having hemispherical depressions facing each other, the compressing element has elongated bolts, on which a star-shaped black handle is screwed with an internal thread, and a compression limiter in the form of a plastic sleeve, which is part of one of the parallelepipeds, the fastener of the camera handle is made in the form of a plastic ball with a central slot, which is the guide of the elongated metal part of the camera holder, consisting of a hollow metal tube and a black plastic handle in the form of an elongated prism, at the same time, the camera has the ability to rotate in the vertical plane by 180 degrees, and in the horizontal - by 60 degrees, the cover of the simulator has a streamlined spherical shape with flat side walls parallel to each other, attached to the base with metal hinges and has the ability to lift opening with a bracket consisting of a metal rod, a plastic sleeve fixed on the free end of the rod, and a guide, and the possibility of changing the angle of inclination using a plastic sleeve moving along a guide fixed on the inner side of the cover, round holes on the front of the cover, facing the student, evenly distributed along two arcs and serve to fix the inserts, the radius of the round holes is 40 mm, the lid also has an elongated hole for working with the camera, a rectangular hole located on the back of the lid of the simulator is made with the possibility of attaching a training silicone mat, imitating skin layers, with the help of an internal beading along the perimeter with a width of 1.3 cm, the liners are made of elastic and extensible beige silicone with a seal along the edge for fixation in the round openings of the lid, and the diameter of the central hole of the lid for inserting a laparoscopic instrument is 1 cm. 2. The laparoscopic simulator according to claim 1, characterized in that the training equipment is a mat for practicing surgical sutures or an anchor with a round hole for threading. 3. Laparoscopic trainer according to claim 1, characterized in that the lid is made of 4 mm thick ABS plastic, and the side of the lid is protected by a rubberized edging.

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