SURGICAL PROCEDURES TRAINING STATION

Abstract

The present invention relates to a surgical training station comprising a physical model of an anatomical structure, a three-dimensional digital model of the anatomical structure, and a work surface. The physical model of the anatomical structure is obtained from diagnostic images of a patient and corresponds to a replica of the anatomical structure, including bone, cartilage, and skin. The three-dimensional digital model allows a user of the training station to interact with a virtual representation of the anatomical structure model using augmented reality and / or virtual reality systems.

Description

SURGICAL PROCEDURES TRAINING STATION TECHNICAL FIELD

[0001] The present invention relates to models of human organs and tissues, anatomical models, and training models for surgical procedures in the field of medicine. More specifically, the present invention provides a replica of a structure from the anatomy of a real patient for training in cosmetic or corrective surgery. It also relates to a three-dimensional digital model of the physical model with which the user can interact via augmented reality and / or virtual reality before, during, or after training on the physical model. BACKGROUND OF THE INVENTION

[0002] Surgeons typically require a significant number of hours of training and practice to achieve adequate mastery of their surgical techniques, enabling them to obtain optimal results in these procedures. Generally, training in any type of surgery is conducted on real patients with the support of experts in each type of intervention, on cadavers, or, failing that, in training stations designed to simulate the soft tissues, cartilage, bones, and specific defects of the procedure.

[0003] In general, the most suitable training method is that performed on cadavers, since it allows for a more comprehensive understanding of the real-world implications of surgery on a patient, as well as the sensations necessary to adjust the force applied to each type of tissue, the depth of incisions, and other factors. However, cadaver availability is rarely available. 1901527 of 23 cadavers suitable for these trainings, either because of the specific anatomical conditions required for each type of practice, because of the difficulty of obtaining the consents required for said procedures, or because of the necessary logistical preservation requirements.

[0004] On the other hand, intervention in real patients assisted by experts has the disadvantage of being potentially dangerous for patients, because a person with little training can seriously affect sensitive structures that may involve additional complications.

[0005] Thus, one of the most suitable, economical, and easily accessible methods for surgical training is through models that approximate the actual structures to be operated on. However, the models currently on the market do not achieve a sufficiently faithful reproduction of specific structures, as well as the textures, consistencies, and hardness of real organs. An example of this is the difficulty in reproducing human nasal anatomy, which contains bones, cartilage, fat, and skin in specific areas with thicknesses and structures that are difficult to replicate.

[0006] In this same sense, it is known that performing interventions in this area, to correct nasal obstructions, cosmetic deformities or traumas is highly complex, because the surgery is performed in a small field and requires delicate handling of the tissues; therefore, the movements must be efficient and smooth enough to avoid damage. 1901527 of 23

[0007] Therefore, there is a significant need for simulators that replicate in a sufficiently faithful and anatomically correct manner different structures of living beings, so as to facilitate adequate training of surgeons prior to an intervention on real patients. BRIEF DESCRIPTION OF THE INVENTION

[0008] The present invention relates to models of human organs and tissues, anatomical models, and training models for surgical procedures in the field of medicine. In particular, the present invention provides a replica of an anatomically equivalent structure of a region of a real patient's anatomy, including bone, cartilage, and soft tissues such as muscle, skin, and fat. To obtain a representation as faithful as possible to the real organs, a careful selection of the materials for each of the replicated structures must be made so as to achieve sensations of texture, hardness, and flexibility equivalent to those of the real structures.

[0009] The models according to the present invention use information acquired from diagnostic images of a real patient, performing a segmentation and three-dimensional reconstruction of each of the structures of interest as accurately as possible, so that the thicknesses, densities, sizes and specific positions of each of them are obtained.

[0010] In one embodiment of the invention, once the three-dimensional reconstructions have been obtained by means of diagnostic images, it is possible not only to obtain the physical model that will be used in training but also the use 1901527 of 23 of the three-dimensional digital model, which can be a complement to training, since it allows the user to interact with a virtual representation through augmented reality and / or virtual reality technology.

[0011] According to one embodiment of the invention, the surgical procedure training station comprises a model of a particular anatomical structure of a patient, a three-dimensional digital model of the anatomical structure, and a work base. Preferably, the model of the anatomical structure corresponds to an anatomical configuration of an actual patient and is made of materials that simulate bones, cartilage, and soft tissues.

[0012] In some modalities, the bone structure faithfully replicates the properties of compression, tension, bending, elasticity, plasticity, rigidity, flexibility, and resistance, among others, of a real bone. This bone structure can be obtained using appropriate 3D printing technologies.

[0013] In one embodiment of the invention, the required cartilaginous structures can also be obtained by 3D printing using information obtained from diagnostic images, and then attached to the bone structure, thus forming an osteocartilaginous skeleton. As in the previous case, the selection of materials is of great importance to obtain a result that accurately represents the replicated area.

[0014] According to some embodiments of the invention, additional layers over the osteocartilaginous skeleton such as muscle, skin and fat may 1901527 of 23 to be included by means of molds designed to give the specific shapes and thicknesses of each of these layers, which can be attached directly or by means of fusion of these, to obtain a suitable fit of all the components of the model of the anatomical structure. DESCRIPTION OF THE FIGURES

[0015] Figure 1 corresponds to the surgical procedure station according to a preferred embodiment of the present invention.

[0016] Figure 2 is an illustrative image of the three-dimensional digital model of the nasal structure included in the training station according to an embodiment of the invention.

[0017] Figure 3 corresponds to a maxilla and turbinates of a bone structure produced in two parts of the anatomical structure model of the training station according to a modality of the invention.

[0018] Figure 4 shows the detail of a cartilaginous structure of the anatomical structure model of the station according to an embodiment of the invention.

[0019] Figure 5 corresponds to a mold that allows the reproduction of the air volume present within the nose in a model of an anatomical structure of the training station according to an embodiment of the invention.

[0020] Figures 6a, 6b, and 6c show an osteocartilaginous skeleton of the model of an anatomical structure of the station according to an embodiment of the invention.

[0021] Figures 7a and 7b show a layer of soft tissue covering an osteocartilaginous skeleton and the nasal mucosa in the inner part of the nose of the model of the anatomical structure of the station according to an embodiment of the invention.

[0022] Figures 8a and 8b show a layer of skin, thus 1901527 of 23 as the reinforcing mesh on the back of the same of the anatomical structure of the station according to an embodiment of the invention.

[0023] Figures 9a, 9b and 9c correspond to a work base that is part of the training station according to an embodiment of the invention. DETAILED DESCRIPTION OF THE INVENTION

[0024] The following describes some embodiments of the training station of the invention, which refer to the accompanying figures. The surgical procedure training station according to the present invention may include a model of a desired anatomical structure constructed from the particular anatomy of an actual patient. The anatomical structure included in the training station is not particularly limited and could correspond to any area of ​​the desired anatomy. In particular, areas of the head and neck such as the auricle, temporal bone, mandible and maxilla, or nasal structure, among others, are preferred.

[0025] The particular characteristics of the surgical procedure training station according to the present invention are included in detail, using as an example a model of a nasal structure.

[0026] As illustrated in Figures 1 and 2, the invention provides a surgical procedure training station (100) comprising: a model of an anatomical structure (101), a three-dimensional digital model (200) of the model of an anatomical structure (101), and a work base (900). Preferably, the The anatomical structure model (101), shown in Figure 1901527, corresponds to the anatomical structure of a patient and is made of materials that simulate bones, cartilage, and skin. The three-dimensional digital model (200) allows a user of the training station to interact with a representation of the anatomical structure model (101) using augmented reality and / or virtual reality systems. The work base (900) has means for attaching it to the surface where the training takes place and also includes mechanisms for adjusting the model's angle during training.

[0027] According to embodiments of the invention, the surgical procedure training station (100) comprises a model of an anatomical structure (101), which may correspond, for example, to a nasal structure. This model is a faithful replica of a section of a real patient with characteristics of interest for practicing surgical procedures, both functional and aesthetic, of the nose, such as septoplasty, turbinoplasty, nasal dorsum surgery, nasal tip surgery, nasal base surgery, nasal skin flap surgery, and / or non-surgical nasal procedures, among others. These characteristics of interest are selected, for example, from septal deviation, nasal hump, nasal tip deformity, and others.

[0028] The model of the anatomical structure (101) is obtained thanks to the information acquired through diagnostic images, acquired through techniques such as computed tomography, in which a volumetric helical acquisition is performed in multidetector equipment, obtaining high resolution slices in axial, sagittal and coronal planes from the base of the skull in 1901527 of 23 bone and soft tissue reconstruction algorithms. Diagnostic images can be supplemented in special cases with images obtained from additional techniques such as magnetic resonance imaging.

[0029] Once the images are obtained, a reconstruction of bone, cartilage, and soft tissues such as skin, mucous membranes, and adipose tissue, among others, can be generated by segmenting each structure of the analyzed anatomy. The precise determination of each of these structures, as well as their thickness and shape, is fundamental to achieving a realistic and functional replica for training. Thanks to the diagnostic image information and the segmentation process, it is possible to generate a complete three-dimensional digital model (200) of each of the structures of interest, which can be used during practice in the virtual simulator, as well as an input for the production of a model of an anatomical structure (101) that will be used during training.

[0030] In embodiments of the invention, the model of an anatomical structure (101) can be produced by modeling or using 3D printing technology. The 3D printing technology employed for this process can be selected from fused deposition modeling (FDM), PolyJet, electron beam fabrication (EBF3), electron beam melting (EBM), selective heat sintering (SHS), selective laser sintering (SLS), bonded projection (DSPC), layer lamination (LOM), stereolithography (SLA), ultraviolet light photopolymerization (SGC), or a suitable combination of these techniques.

[0031] As shown in Figure 3, in modalities 1901527 of 23 preferred models of the anatomical structure (101) comprises a bone structure (300), composed of the maxilla (301) and the turbinates (302). The bone structure (300) can be obtained by selective laser sintering (SLS) using nylon or polystyrene, preferably nylon 11 or nylon 12. The manufacture of the bone structure (300) by this method allows osteotomies to be performed with real surgical instruments, offering sensations similar to those of a real maxilla, since it is possible to imitate the characteristics of a real bone such as compression, tension, bending, elasticity, plasticity, rigidity, flexibility, resistance, among others.In particular embodiments of the invention, it is possible to combine the bone structure construction material (300) with, for example, salts, which can impart specific properties to the printed product, such as piezoelectric properties, thus enabling the use of a piezoelectric scalpel. Similarly, the bone structure (300) of the anatomical structure model (101) according to the present invention retains anatomical features of the maxilla, such as the lacrimal ducts (303), the maxillary sinuses (304), and the frontal sinuses (305), among others.

[0032] In one embodiment of the invention, the bone structure (300) may be a single piece or a combination of segments that are subsequently added to obtain the complete maxilla (301). Segmentation of the maxilla (301) allows for the development of interchangeable modules that facilitate the introduction of different features, for example, additional changes to the endonasal or external anatomy. In particular, in the latter case, a segment of nasal bones made from a combination of materials could be obtained. 1901527 of 23 special ones that would allow the use of technologies such as the piezoelectric scalpel.

[0033] Additionally, in preferred embodiments of the invention, the maxilla (301) comprises a channel (306) that surrounds the posterior edge of the maxilla (301), which allows the simulator to be fixed to the working base (900), orienting it in the most suitable direction depending on the working conditions.

[0034] According to one embodiment of the invention illustrated in Figure 4, the cartilaginous structures (400) of the anatomical structure model (101) correspond to a faithful replica of the patient's anatomy, including desirable defects such as deformities and deviations, while maintaining their length, thickness, height, and width. All these particular characteristics are determined and reproduced thanks to the results of the segmentation and the three-dimensional digital model (200) described above. The simulated cartilaginous structures (400) can be obtained by 3D printing using any of the technologies already mentioned, with FDM or PolyJet being preferred in this case. In embodiments of the invention, thermoplastic filaments are used for FDM technology and pure thermoplastic filaments or blends for PolyJet technology.These combinations of materials aim to obtain a Shore index of between 50 and 90, thus achieving sensations equivalent to those of real cartilage.

[0035] The soft tissues of the anatomical structure model (101) such as skin, fat tissue, muscle tissue and nasal mucosa of the model according to the present invention, require the production of molds in which 1901527 of 23 The material corresponding to each of the tissues will be injected. The molds can be produced by any of the 3D printing technologies mentioned previously, with FDM being preferred, using filaments of PLA, ABS, ASA, PET, PETG, PC, PVA, TPU, or TPE; PLA (polylactic acid) is preferred.

[0036] Preferably, in order to achieve equivalence between the anatomical structure model (101) and the actual structure, the air volumes present within the modeled areas should be included. Specifically, as illustrated in Figure 5, an element is used that allows the inclusion of the air volume present within the nose (500) in the nasal structure used as an example. The purpose of this air volume is to fill the endonasal air space, leaving only a thin silicone layer to reproduce the nasal mucosa, which surrounds the entire internal part of the nose. The characteristics of the air volume mold allow for areas of greater or lesser thickness in the model's mucosa, as needed, also facilitating the permeability of the nostrils.The mold of the air volume present inside the nose (500) can be obtained by any of the 3D printing technologies already mentioned, in this case FDM is preferred using thermoplastic filaments of TPU or TPE as printing material, preferably TPU (thermoplastic polyurethane).

[0037] In embodiments of the invention, the material selected to replicate skin, fat tissue and muscles is such that it allows a faithful reproduction of the particular characteristics of each of these tissues such as elasticity, foldability, texture, hardness, 1901527 of 23 consistency among others. In particular, Shore indices between 20 and 90 are sought. Preferably, the selected material is a peroxide- or platinum-cured silicone rubber, preferably a platinum-cured silicone, such as those known in the art as Equinox, SORTA-Clear, Smooth-Sil, Magikmold, Elkem, Bluestar, Mold Star, Dragon Skin, Rebound, Ecoflex, Body Double, Rubber Glass, Encapso-K. In some modalities, if the selected silicone so requires, a vacuum degassing process is carried out, which prevents the appearance of air bubbles and defects in the silicone when poured into the molds.

[0038] As shown in Figure 6a, the osteocartilaginous skeleton (600) according to some embodiments of the present invention comprises the maxilla (301) and the cartilaginous nasal dorsum (601), the latter being composed of the nasal septum (602) and the upper lateral cartilages (603). The attachment of the maxilla (301) and the cartilages can be achieved by overlapping the structures and securing them with a common adhesive, such as polyaddition-curing adhesives, polymerization-curing adhesives, or polycondensation-curing adhesives, preferably a polymerization-curing adhesive, which secures the cartilage to the vomer (307) and the perpendicular plate of the maxilla (309).

[0039] In some embodiments of the invention, as shown in Figures 6b and 6c, after fixation of the nasal septum (602), a nylon mesh (605) called rhinomesh can be included in the caudal and anterior portion of the cartilage using a suitable adhesive, in this case a polyaddition-cure adhesive being preferred. This mesh will subsequently integrate into the nasal mucosa that 1901527 of 23 will cover the septal cartilage (602). In preferred embodiments of the invention, the mesh is positioned from side to side, covering an area corresponding to the first 30 mm to 5 mm of the anterior septum, as well as its caudal border (604) and the nasal spine (308). The mesh simulates the adhesion characteristics of the mucoperichondrium and the so-called cross-fibers found in a real nasal septum. Likewise, the mesh allows the user to be guided during septoplasty by serving as a reference to validate the correct dissection plane.

[0040] To ensure the precise positioning of the lower lateral cartilages (606) that will form the nasal tip of the anatomical structure model (101), a 3D printed mold can be used to facilitate the correct assembly of all parts. In one embodiment of the invention, once all the elements of the osteocartilaginous skeleton (600) are in their final position, a new rhinomesh nylon mesh (605) can be placed over the elements of the nasal structure to simulate the perichondrium (e.g., over the upper lateral cartilages (603) or over the lower lateral cartilages (606)) and the periosteum (608) (over the nasal bones and the ascending ramus of the maxilla). Additionally, the presence of the mesh allows a clear reference to the dissection plane that the user must follow when performing surgery on the model of the anatomical structure (101), as well as a measurement in which the limits of the dissection plane of the back are marked at the level of the cartilages, which is usually supraperichondrial (above the mesh), and at the level of the nasal bones it is subperiosteal (below the mesh).

[0041] In preferred embodiments of the invention, given 1901527 of 23, which commonly exhibits decoupling of certain sections, for example, in the lower lateral cartilages (606) of the model of the nasal anatomical structure (101), it is desirable to reinforce the bases of the lower crura (606a) in this area. Therefore, a nylon reinforcing mesh (607) can be included, which is inserted into the premaxilla (bone) and covers the lower part of the lower crura (606a) (cartilage), in turn wrapping the bases of the lower crura (606a). This mesh is adhered with a special adhesive, adding strength and reliability to the simulator.

[0042] According to embodiments of the invention, the model of the nasal anatomical structure (101) accurately reproduces complex anatomical features such as the air space of the external valve, the internal valve, as well as the thickness of the soft tissue covering the nasal tip, the nasal dorsum, the nasal septum (602), the turbinates (302), the muscle tissue covering the external structure of the nose and the maxilla (301), among others. All of the above is achieved while maintaining the permeability of the simulator's nasal cavities. Therefore, the inclusion of soft tissues on the osteocartilaginous skeleton (600) may involve the production and use of 3D molds that allow for the precise inclusion of these features.

[0043] According to the above, as can be seen in Figures 7a and 7b, in the model of the exemplified nasal anatomical structure (101), the silicone of the muscle layer (700) attaches firmly to the osteocartilaginous skeleton (600), penetrating between the cartilaginous structures (400), which allows the recreation of the adhesion that simulates the ligaments of the nose in great detail (Pitanguy, scroll, 1901527 of 23 interdomal) enabling a better understanding of the anatomy of the nasal tip and the cartilaginous nasal dorsum (601). With the soft tissues coupled by this method, a precise anatomy is obtained, which also offers dissection sensations in the tissues comparable to the real thing in terms of consistency, texture, flexibility, among others. To achieve precise coupling of the muscle layer (700) onto the osteocartilaginous skeleton (600), it is possible to place the osteocartilaginous skeleton (600) inside a 3D printed mold, into which the selected degassed silicone for the formation of the mucous membranes (701) and the muscle (700) will be poured. The empty spaces between the mold and the osteocartilaginous skeleton (600) will thus be filled with silicone, acquiring the shape and thickness of the desired structures.

[0044] As with the production of the nasal mucosa (701) and muscle (700), the skin layer (800) shown in Figure 8a, and the subcutaneous fatty tissue of the model of the nasal anatomical structure (101) according to the exemplified embodiment of the present invention, requires the fabrication of 3D molds specifically designed with segmentation information and image processing obtained from the reference patient, and is designed to maintain the permeability of the nostrils and facilitate fusion with the alar cartilages of the osteocartilaginous skeleton (600). The selected material seeks to simulate the elasticity, hardness, and flexibility characteristics of human skin. In preferred embodiments of the invention, once the skin layer (800) is obtained, fatty tissue is added to specific areas of the posterior surface of the skin (800), which is reproduced with a silicone of similar characteristics and color to that of the 1901527 of 23 human fat.

[0045] In order to reinforce the skin (800) in the areas of greatest traction during training, in preferred embodiments as illustrated in Figure 8b, a nylon skin mesh (801) is included along the back, tip, and columella. This mesh is integrated into the skin (800) by a fusion process, which consists of fixing the nylon skin mesh (801) to the back of the skin (800). Once the nylon skin mesh (801) is in the desired position, a layer of silicone is applied, and the skin (800) and nylon skin mesh (801) assembly is placed inside a specially designed 3D mold. The mold, through pressure applied to the component parts, fuses the nylon skin mesh (801) to the back of the skin (800), creating an optimal bond between the two elements.

[0046] According to certain particular embodiments of the invention, the skin layer (800), along with all its specific features, can be attached to the osteocartilaginous structure with the muscle layer (700) already completed by means of methods known in the art, such as fusion, or by pouring silicone onto the osteocartilaginous structure and the muscle layer, the fusion method being preferred in this case. In preferred embodiments, this process is mediated by a specially designed mounting mold that uses silicone to adhere the skin (800) to the underlying structure. Once the silicone drying process is complete, the fusion of all the layers and elements that make up the simulator is finalized.

[0047] In modalities of the invention illustrated in the 1901527 of 23 Figures 9a to 9c show that the anatomical structure model (101) is accompanied by a working base (900), which allows the model to be attached to a stable surface such as a table or similar. For a proper fit, the channels (306) of the maxilla (301) fit into a rail coupling (901), which in turn fits into the central part of the clamping base (902). In some embodiments of the invention, the rail coupling (901) can be oriented in any direction, allowing the model to be adapted for right- or left-handed users, or depending on the conditions of the space where the training is taking place. Additionally, in particular embodiments of the invention, the clamping base (902) incorporates millimeter scales (903) on its sides, enabling the user to take measurements of different elements during practice.In embodiments of the invention, the rail coupling (901) further includes a multifunction wedge (904), which allows changing the tilt on an anteroposterior or lateral axis according to the user's needs.

[0048] In some embodiments of the invention, the clamping base (902) further includes a fixing system comprising a series of silicone anti-slip strips (907) on the edges of the rear area of ​​the clamping base (902), together with a clamping system (908) that can be placed on one or both of the side rails of the clamping base (902), allowing the model to be firmly fixed to the table or underlying surface.

[0049] Additionally, in particular embodiments of the invention, the working base (900) further incorporates a bridge (905) that includes an instrument fixing system (906), which in most of the steps of the 1901527 of 23 training enables optimal exposure of the simulator's anatomy, and also allows the user to have their hands free for most of the training.

[0050] The manufacturing methods for the elements of the work base (900) are not particularly limited, so they can be obtained either by any of the previously mentioned 3D printing methods or by manual modeling. 1901527 of 23 CLAIMS 1. A surgical procedure training station (100) characterized in that it comprises: a model of an anatomical structure (101), a three-dimensional digital model (200) of the model of an anatomical structure (101), and a work base (900), wherein the model of an anatomical structure (101) corresponds to an anatomical conformation of a patient and is made up of materials that simulate bones, cartilage and skin; wherein the three-dimensional digital model (200) of an anatomical structure model (101) allows a user of the training station to interact with a representation of the anatomical structure model (101) by means of augmented reality and / or virtual reality systems; and wherein the work base (900) has means of fixing it to the surface on which the training is carried out, and also has means of modifying the angle of the model during training. 2. The training station according to the Claim 1 characterized in that the model of an anatomical structure (101) is obtained from diagnostic computed tomography images. 3. The training station according to the Claim 1 characterized in that the model of an anatomical structure (101) comprises a bone structure (300), a cartilaginous structure (400) and a soft tissue structure. 1901527 of 23 4. The training station according to the Claim 3 characterized in that the soft tissue structure comprises nasal mucosa (701), muscle (700), fat and skin (800). 5. The training station according to Claim 4 characterized in that the soft tissue structure is composed of silicone rubbers. 6. The training station according to any of the preceding claims, characterized in that it further includes nylon meshes (605, 607, 801) located between the cartilage and the muscle (700). 7. The training station according to any of the preceding claims, characterized in that the model of an anatomical structure (101) is of a head or neck structure selected from the group comprising the auricle, the temporal bone, the lower or upper jaw, or the nasal structure. 8. The training station according to the Claim 8, characterized in that the model of an anatomical structure (101) is a nasal model. 9. The training station according to the Claim 1 characterized in that the working base (900) comprises a rail coupling (901), a clamping base (902) and a clamping system (908). 10. The training station according to Claim 9 characterized in that the rail coupling (901) comprises a multifunction wedge (904) for changing the tilt on an axis of the rail coupling (901). 1901527 of 23 11. The training station according to Claim 9 characterized in that the work base (900) further comprises a bridge (905) which includes a fixing system for instruments (906). Buenos Aires, July 2022 p. PAULO ANDRÉS ESCOBAR RINCÓN and ANNE MARIE LARIVIERE □ D REGISTRATION 438 1901527 of 23 SUMMARY The present invention relates to a surgical training station comprising a physical model of an anatomical structure, a three-dimensional digital model of the anatomical structure, and a work surface. The physical model of the anatomical structure is obtained from diagnostic images of a patient and corresponds to a replica of the anatomical structure, including bone, cartilage, and skin. The three-dimensional digital model allows a user of the training station to interact with a virtual representation of the anatomical structure model using augmented reality and / or virtual reality systems.

Claims

1. A surgical procedure training station (100) characterized in that it comprises: a model of an anatomical structure (101), a three-dimensional digital model (200) of the model of an anatomical structure (101), and a work base (900), wherein the model of an anatomical structure (101) corresponds to an anatomical conformation of a patient and is made of materials that simulate bones, cartilage, and skin; wherein the three-dimensional digital model (200) of the model of an anatomical structure (101) allows a user of the training station to interact with a representation of the model of an anatomical structure (101) by means of augmented reality and / or virtual reality systems; wherein the work base (900) has means for fixing it to the surface on which the training is carried out, and also has means for modifying the angle of the model during the training;wherein the model of an anatomical structure (101) comprises a bony structure (300), a cartilaginous structure (400), and a soft tissue structure; wherein the model of an anatomical structure (101) comprises a soft tissue structure including nasal mucosa (701), muscle (700), fat, and skin (800); wherein the model of an anatomical structure (101) comprises nylon meshes (605, 607, 801) located between the cartilage-simulating material and the muscle-simulating material (700); wherein the nylon mesh (605) is embedded in the caudal and anterior portions of the cartilage using a polyaddition-cured adhesive; wherein the nylon mesh (605) is integrated within the nasal mucosa covering the septal cartilage (602). Seven claims follow;