RU2801345C1 - Microsurgical simulator - Google Patents

Abstract

FIELD: teaching aids in medicine.

SUBSTANCE: microsurgical simulator includes a platform made of transparent polymethyl methacrylate and has the following on it: a transparent pipe made of polymethyl methacrylate, a contact tape is installed on the base of the pipe with an abrasive surface up to fix the foam rubber material, an elastic latex membrane, a ball and foam rubber material. The polymethyl methacrylate cylinder is bent relative to the platform. At the base of the cylinder, a contact tape is installed with the abrasive surface up to fix the foam material; a foam material with markings is installed in the clearance of the cylinder. The cylinder of a transparent pipe made of polymethyl methacrylate is placed at an angle relative to the platform and includes an elastic latex membrane, an ethyl vinyl acetate ball and a rubber band that fixes the membrane. Two metal spring clamps are fixed symmetrically into the platform, cadaver, silicone or rubber materials are fixed between the clamps imitating the anatomical structures of the body.

EFFECT: ensuring the development of the skill of performing a microsurgical suture.

1 cl, 5 dwg

Description

The microsurgical simulator belongs to the field of medicine, namely to the operational microsurgical technique, which allows you to develop manual skills in microsurgery and master the technique of applying a microsurgical suture.

The prototype of the proposed microsurgical simulator is a device for developing basic microsurgical skills (Patent RU 2739207 C2 published: 12/21/2020 IPC G09B 23/28), which contains a body and at least one removable elastic membrane. The body is made in the form of a dome and includes protrusions and recesses that create voids between the body and the membrane, which creates a working surface with the ability to perform microsurgical actions in a variety of planes and directions.

The device described above for developing basic microsurgical skills has a number of disadvantages:

1. the lack of the possibility of step-by-step training from simple skills of microsutures on a plane to complex work on a three-dimensional working surface and the imposition of microsutures in the depth of the wound;

2. lack of opportunity to practice the skill of microvascular suture and nerve suture;

3. complex manufacturing technology of the device body.

When developing the proposed device, the task was set to create a microsurgical simulator, which has a simple and lightweight design, a method of attachment to work surfaces, cases simulating the main clinical situations of microsurgical suture and a low economic component.

The solution to this problem is a microsurgical simulator, which is represented by a platform on which there are four modules for practicing the skill of applying a microsurgical suture (Fig. 1).

Platform made of transparent polymethyl methacrylate 160*160 mm in size and 5 mm thick, on which 4 modules are located. 4 suction cups are installed at the corners of the platform, which allow you to fix the platform to the surface.

The first module is represented by a transparent pipe made of polymethyl methacrylate 30 mm high, 32 mm inner diameter, 3 mm wall thickness. It is located 30 mm from the front edge of the platform and 60 mm from the side edge. A contact tape is installed on the base of the cylinder with the abrasive surface up to fix the foam material. This module also includes an elastic latex membrane 80 * 80 mm, a ball of 40 mm in diameter made of ethyl vinyl acetate, stationery gum and foam rubber material.

This module is designed to perform a number of exercises:

1) An elastic membrane is installed on the upper part of the cylinder, in which an incision is made with a microtool. The student is asked to apply microsutures on the created defect of the elastic membrane on a horizontal plane.

2) As the student acquires microsurgical skills, the student is asked to apply microsutures according to the applied markings on the foam material at a depth of 1 cm from the upper edge of the cylinder, which imitates the application of microsurgical sutures in the depth of the surgical wound (Fig. 2-1).

3) A ball of ethyl vinyl acetate covered with an elastic membrane is installed in a cylinder. A three-dimensional working hemisphere is created on which cuts are first made for subsequent suturing (Fig. 2-2, Fig. 2-3, Fig. 2-4).

4) A ball of ethyl vinyl acetate is covered with a section of a medical bandage. It is proposed to suture the threads of the bandage or stitch the walls of adjacent threads. Exercises 3 and 4 are aimed at developing the motor skills of the hand, since the hemisphere of the ball creates many working planes, which complicates movements in the joints of the hand. This creates difficult conditions for the imposition of microsurgical sutures (Fig. 2-5).

The second module is represented by a transparent cylinder made of polymethyl methacrylate, having a 35 mm bend from the base at an angle of 45 degrees relative to the platform. The height of the cylinder is 65 mm, the inner diameter is 32 mm, the wall thickness is 3 mm. It is located 60 mm from the front edge of the platform and 5 mm from the left side edge. A contact tape is installed in the base of the cylinder with the abrasive surface up to fix the foam material. A foam material with a height of 20 mm and a diameter of 32 mm with applied markings is installed in the clearance of the cylinder. The markings are black dots indicating the points of injection and injection of the needle. The dots are centered in two rows 3 mm apart.

When performing the exercise, the platform is oriented so that the lumen of the cylinder is oriented towards the student's face. On this case, it is proposed to perform the imposition of microsurgical sutures in the depth of the wound on the foam material, according to the applied markings. (Fig. 3) This exercise simulates the stitching of anatomical structures at the depth of the wound at a certain angle.

The third module is represented by a cylinder of a transparent pipe made of polymethyl methacrylate, having an angle of 45 degrees relative to the platform. The height of the cylinder is 65 mm, the inner diameter is 32 mm, the wall thickness is 3 mm. It is located 60 mm from the front edge of the platform and 5 mm from the right side edge. Also included in this module is an elastic latex membrane, a 40 mm diameter ball made of ethyl vinyl acetate and a rubber band to fix the membrane.

This module is designed to perform a number of exercises:

1) An elastic membrane is installed on the upper part of the cylinder, due to the bending of the cylinder, the membrane faces the student at an angle of 45 degrees, which creates additional difficulty in applying microsutures. An incision is made with a microtool. The student is invited to apply microsutures on the created defect of the elastic latex membrane on the created plane, or sew a patch into the created defect, which, for example, will imitate the plasticity of the dura mater (Fig. 4-1, Fig. 4-2).

2) A ball of ethyl vinyl acetate covered with an elastic membrane is installed in the cylinder bore. Since the cylinder has a bend, the position of the ball creates new working conditions for the application of microsurgical sutures. A three-dimensional working hemisphere is created on which cuts are preliminarily applied for subsequent suturing. This exercise is aimed at developing motor skills of the hand and training the application of microsutures in difficult anatomical areas (Fig. 4-3).

The fourth module includes two metal spring clips 3 cm long. The spring clips are fixed symmetrically into the platform 3 cm from the side face and 4 cm from the rear face. The clamps are movable at the fixation points, which allows you to change the distance between the fixing surfaces. Between the clamps, it is proposed to fix the cadaver material (vessels of small diameter, nerves), as well as silicone or rubber materials imitating the anatomical structures of the body (vessels of small diameter, nerves) (Fig. 5). This module allows you to work out the skill of applying a microvascular or nerve suture.

Thus, the microsurgical simulator has the following advantages:

1) Possibility of step-by-step mastering the manual skill of applying microsutures with the complication of the clinical and anatomical situation;

2) Simulation of situations of imposition of microsurgical sutures in the depth of the surgical wound;

3) Ease of placement and fixation of cadaver material, rubber and silicone microvessel simulators;

4) The ability to work both with the use of a microscope and loupe glasses;

5) The use of silicone suction cups allows you to fix the platform of the simulator to the working surfaces.

A microsurgical simulator can be useful for teaching students and residents microsurgical techniques.

Claims (5)

Microsurgical simulator, including a platform, characterized in that the platform is made of transparent polymethyl methacrylate 160 × 160 mm in size and 5 mm thick and has: - a transparent pipe made of polymethyl methacrylate 30 mm high, 32 mm inner diameter, 3 mm wall thickness, a contact tape is installed on the base of the pipe with the abrasive surface up to fix the foam material, an elastic latex membrane 80 × 80 mm, a ball with a diameter of 40 mm made of ethyl vinyl acetate, stationery gum and foam material; - a cylinder made of polymethyl methacrylate, having a bend of 35 mm from the base at an angle of 45 ° relative to the platform, a height of 65 mm, an inner diameter of 32 mm, a wall thickness of 3 mm, while at the base of the cylinder there is a contact tape with an abrasive surface upwards to fix the foam material, into the clearance the cylinder is equipped with foam material 20 mm high and 32 mm in diameter with printed markings; - a cylinder of a transparent pipe made of polymethyl methacrylate, having an angle of 45 ° relative to the platform, the height of the cylinder is 65 mm, the inner diameter is 32 mm, the wall thickness is 3 mm, and includes an elastic latex membrane, a 40 mm diameter ball of ethyl vinyl acetate and a rubber band fixing the membrane; And - two metal spring clips 3 cm long, while the clips are fixed symmetrically into the platform 3 cm from the side face and 4 cm from the back face, cadaver, silicone or rubber materials are fixed between the clips, imitating the anatomical structures of the body.