RU2851161C1 - Method for modelling bartholin's gland cyst in white pig for marsupialisation surgery - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to experimental obstetrics and gynaecology. A 5 cm incision is made in the skin of the perineum 4 cm lateral to the vaginal opening, the skin is separated from the subcutaneous fatty tissue with scissors, and a blind passage is created that reaches the labia. Then, a latex balloon filled with 3 ml of liquid soap is inserted through the incision into the labia. Next, two nylon sutures are applied to the incision.

EFFECT: training model that allows students to practise the practical skills of performing a Bartholin's gland cystotomy and marsupialisation technique on a large laboratory animal.

1 cl, 8 dwg, 1 ex

Description

The invention relates to the field of medicine, namely to the section of obstetrics and gynecology, and concerns the operation of marsupialization of a Bartholin gland cyst.

Bartholin's gland diseases, such as cysts and abscesses, account for 2% of all gynecological diseases. They are most often diagnosed in women of reproductive age (Clinical Guidelines for Bartholin's Gland Diseases, 2023). They tend to recur, which reduces quality of life and increases the risk of infection spreading to nearby tissues. Treatment depends on the type of cyst and associated symptoms. Marsupialization of a Bartholin's gland cyst is performed in cases of cyst recurrence, failure to insert a WORD catheter, latex allergy, or the presence of a multilocular or large cyst.

A method for modeling an abdominal abscess is known. This involves inserting a modified Foley catheter into the right iliac region of a laboratory animal through a trocar under ultrasound guidance. The balloon at the distal end of the catheter is inflated and secured with a skin duplication. (A method for modeling and treating an abdominal abscess in a surgical experiment by V.V. Alipov, A.S. Rykhlov, A.G. Musaelyan et al. Operative surgery and clinical anatomy 2023, Vol. 7, No. 2, pp. 5-12). Also known is a method for modeling a soft tissue abscess in male Chinchilla rabbits by inserting a balloon catheter (Modeling a soft tissue abscess in a surgical experiment D.A. Andreev, A.I. Urusova Bulletin of Medical Internet Conferences (ISSN 2224-6150) 2015. Volume 5. Issue 11 pp. 1374-1375). A method for modeling a fibrous liver cyst in male rabbits by inserting a two-channel catheter with a siliconized rubber balloon through a needle under ultrasound control (RU 2 394 278 C1).

The disadvantages of these methods include the time it takes for cysts and/or abscesses to form. They also require double invasive intervention. These methods also rely on small breed animals, which prevents the creation of a pathological process that would represent a realistic volume of affected tissue. In our case, we used a white pig as a laboratory animal, which allowed us to simulate a fairly large cyst, including a bilateral one, for a surgical procedure closer to real clinical practice. In our case, using a latex balloon is more cost-effective.

These methods are taken as a prototype.

The technical result of the invention is to create a training model that allows students to practice practical skills in performing an operation to open a Bartholin gland cyst and the marsupialization technique on a large laboratory animal (a white pig).

Implementation of the invention. After tracheostomy and intubation of a laboratory animal, endotracheal anesthesia is administered. The model involves making a 5-cm-long skin incision in the perineal area, 4 cm lateral to the vaginal introitus, separating the skin from the subcutaneous fat with scissors, and creating a blind passage extending to the labia. A latex balloon was filled with 3 ml of liquid soap, which simulated the secretion of the Bartholin gland, and then lowered into the pig's labia. Two nylon sutures were placed over the incision. The technique for performing a Bartholin gland cyst marsupialization is then practiced. In the area of maximum cyst protrusion, a 1-cm oval section is excised from the inner surface of the labia. The cyst is then incised, also excising the oval section. The cyst is emptied and its cavity is irrigated. The edges of the cyst wall are sutured with interrupted sutures to the adjacent edges of the skin at 12, 3, 6, 9 o’clock positions.

Brief description of the drawings:

Fig. 1. Vertical incision in the perineal area.

Fig. 2. Separation of skin from subcutaneous fat.

Fig. 3. Creating a blind move.

Fig. 4. Lowering the ball into the labia area.

Fig. 5. Suturing the incision.

Fig. 6. Cutting out an oval area measuring 1 cm from the inside of the labia.

Fig. 7. Opening of the cyst.

Fig. 8. The edges of the cyst wall are sutured with interrupted sutures to the adjacent edges of the skin at 12, 3, 6, 9 o’clock positions.

The method was used in the development of practical skills by clinical residents in simulating the operation of marsupialization of the Bartholin gland cyst on white pigs 16 times.

Implementation of the purpose of the claimed invention with the achievement of a technical result.

Example 1:

During practical training for first-year residents at the WetLab facility of the Ryazan State Medical University of the Russian Ministry of Health, a tracheostomy and intubation were performed on a laboratory animal under endotracheal anesthesia. A 5-cm-long vertical skin incision was made on the right side, 4 cm lateral to the vaginal opening (Fig. 1). The skin was separated from the subcutaneous fat with scissors, followed by the creation of a blind passage reaching the labia (Fig. 2, Fig. 3). A latex balloon was filled with 3 ml of liquid soap and inserted into the pig's labia (Fig. 4). The skin incision was sutured with two nylon sutures (Fig. 5). After which the residents worked out the technique for performing the operation of marsupialization of the Bartholin gland cyst on the right (Fig. 6, Fig. 7, Fig. 8).

Claims (1)

A method for modeling a Bartholin's gland cyst on a white pig for performing a marsupialization operation is described, which is characterized by forming a skin incision in the perineal area 4 cm lateral to the vaginal entrance with a length of 5 cm, separating the skin from the subcutaneous fat with scissors and creating a blind passage reaching the labia, then lowering a latex ball filled with 3 ml of liquid soap through the formed incision into the labia area, then placing 2 nylon sutures on the incision.