Multiskill Exercises for Laparoscopic Instrumentation

Abstract

A surgical training model for teaching, practicing, and assessing motor and cognitive skills associated with laparoscopic surgery is provided. The surgical training model has at least some portions (e.g., limbs) that are manipulable by a user to manipulate these portions in a desired manner to interact with other portions of the surgical training model. A force sensing mechanism can also be included to notify the user when a force applied to one or more portions of the surgical training model exceeds a predetermined amount.

Description

[Technical field]

[0001] This application claims priority to and the benefit of U.S. Provisional Patent Application No. 63 / 297,408, entitled “Multiskill Exercise for Laparoscopic Instrumentation,” filed January 7, 2022, the entirety of which is incorporated herein by reference.

[0002] This application relates generally to surgical training systems, and more particularly to surgical training systems for teaching, practicing, and assessing motor and cognitive skills associated with laparoscopic surgery. [Background technology]

[0003] Patent Documents 1 and 2 describe prior art. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] U.S. Patent Application Serial No. 13 / 248,449 [Patent Document 2] U.S. Patent Application Serial No. 15 / 895,707 Summary of the Invention [Problem to be solved by the invention]

[0005] Various challenges arise when a user (e.g., a surgeon) performs laparoscopic surgery relying on indirect visualization footage (e.g., captured images) obtained from within a patient through a laparoscopic camera. Some challenges associated with the use of indirect visualization may include, but are not limited to, the user's hand-eye coordination and the user's awareness of how to manipulate laparoscopic instruments being used during a laparoscopic procedure. Additionally, some laparoscopic procedures may challenge the user to perform motion-related tasks using both hands simultaneously. Thus, a need exists for a surgical training system that provides the requisite training to prepare a user to perform motion-related tasks using indirect visualization associated with laparoscopic surgery. [Means for solving the problem]

[0006] According to various embodiments, a surgical training model is described herein. The surgical training model is made of a body with one or more holes positioned at predetermined locations on the body. The model also includes a post having a proximal end and a distal end. The proximal end of the post is attached to the body while the distal end extends away from the body. The model is made such that a user uses one hand to manipulate a portion of the body with a first surgical instrument while using the other hand to manipulate the post through a second surgical instrument. The model is intended to provide training for a user to use both hands simultaneously. In at least the above-described model embodiments, a user is guided to advance the distal end of the post through one or more holes associated with the body.

[0007] According to various embodiments, another surgical training model is described. The surgical training model has a body with two or more holes at predetermined locations on the body and a post attached to the body and extending away from the body. With respect to the two or more holes, the holes are configured to be positioned by a user to form a connecting opening. The connecting opening is then used as a point through which the user will advance the distal end of the post.

[0008] According to various embodiments, another surgical training model is described. The surgical training model has a plurality of limbs, each having a proximal end and a distal end. The limbs are layered on top of one another at their proximal ends. The limbs also each have one or more holes. The surgical model also has a post attached to a proximal end of the limbs, the post having a distal end extending away from the limbs. A user is guided to manipulate one or more of the limbs such that one or more holes associated with each of the limbs can be positioned such that a distal end of the post can pass therethrough.

[0009] According to various embodiments, another surgical training model is described. The surgical training model has a body having at least one connector at a first predetermined location and a corresponding connector at a second predetermined location. The surgical training model is designed such that a user manipulates the body to connect these two connectors together.

[0010] According to various embodiments, another surgical training model is described. The surgical training model has a body made of a plurality of limbs, each having a proximal end and a distal end extending away from a center of the body. Each of the plurality of limbs has a connector at the distal end of the limb. There is another connector at the center of the body. Each of the limbs of the body is configured to be manipulated such that one of the connectors associated with the limb can be connected to the connector at the center of the body.

[0011] According to various embodiments, a method of training is described. The method includes providing a phantom, such as using one of the phantoms described above. The phantom can have a body with one or more holes and a post. The phantom is designed so that a user uses one surgical instrument to manipulate a portion of the body and another surgical instrument to manipulate a portion of the post to advance a distal end of the post through one or more of the holes in the body.

[0012] According to various embodiments, a method of training is described. The method includes providing a model, such as using one of the models described above. The model can include two or more bodies. The model is designed such that a user connects two connectors using one surgical instrument to manipulate a portion of the body having a first connector and another surgical instrument to manipulate a different portion of the body having a second connector.

[0013] The present invention can be understood by reference to the following description in conjunction with the accompanying drawings in which reference numerals designate like parts throughout the drawings. [Brief description of the drawings]

[0014] [Figure 1] FIG. 1 is an exemplary multi-skill training model. [Diagram 2] 2 is a diagram of an exemplary multi-skill training model similar to FIG. 1 highlighting one or more elongated portions and force sensing mechanisms implemented therein. [Diagram 3] FIG. 1 illustrates an exemplary multi-skill training dummy having an operating plane. [Figure 4A] FIG. 1 illustrates an exemplary laparoscopic training task. [Figure 4B] FIG. 1 illustrates an exemplary laparoscopic training task. [Figure 5A] FIG. 1 illustrates stages associated with an exemplary laparoscopic training task. [Figure 5B] FIG. 1 illustrates stages associated with an exemplary laparoscopic training task. [Figure 5C] FIG. 1 illustrates stages associated with an exemplary laparoscopic training task. [Figure 5D] FIG. 1 illustrates stages associated with an exemplary laparoscopic training task. [Figure 6A] 1 illustrates a method for completing an exemplary laparoscopic training task. [Figure 6B] 1 illustrates a method for completing an exemplary laparoscopic training task. [Figure 7] FIG. 1 illustrates various planes associated with an exemplary multi-skill training model. [Figure 8A] 1A-1C illustrate a user interacting with posts and / or limbs of an exemplary multi-skill training dummy. [Figure 8B] 1A-1C illustrate a user interacting with posts and / or limbs of an exemplary multi-skill training dummy. [Figure 9A] 13A-13C illustrate an embodiment of a force perception mechanism associated with an embodiment of a multi-skill training model. [Figure 9B] 13A-13C illustrate an embodiment of a force perception mechanism associated with an embodiment of a multi-skill training model. [Figure 9C] 13A-13C illustrate an embodiment of a force perception mechanism associated with an embodiment of a multi-skill training model. [Figure 10A] 1A-1C show exemplary support structures and materials incorporated into the body near the axis of symmetry. [Figure 10B] 1A-1C show exemplary support structures and materials incorporated into the body near the axis of symmetry. [Figure 11] FIG. 1 illustrates an exemplary embodiment of a multi-skills training model. [Figure 12] FIG. 1 illustrates an exemplary embodiment of a multi-skills training model. [Figure 13] FIG. 1 illustrates an exemplary embodiment of a multi-skills training model. [Figure 14] FIG. 1 illustrates an exemplary embodiment of a multi-skills training model. [Figure 15] FIG. 1 illustrates an exemplary embodiment of a multi-skills training model. [Figure 16] FIG. 1 illustrates an exemplary embodiment of a multi-skills training model. [Figure 17] FIG. 1 illustrates an exemplary embodiment of a multi-skills training model. [Figure 18] FIG. 1 illustrates an exemplary embodiment of a multi-skills training model. [Figure 19] FIG. 1 illustrates an exemplary embodiment of a multi-skills training model. [Figure 20] FIG. 1 illustrates an exemplary embodiment of a multi-skills training model. [Figure 21] FIG. 1 is a diagram of an exemplary surgical trainer. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0015] According to various embodiments, a surgical training system is provided, and various views of various embodiments of an exemplary surgical training system and aspects thereof are shown in the figures. One such surgical training system includes a surgical training phantom that is compatible with a laparoscopic trainer system to facilitate a user's development of the necessary motor and cognitive skills used during laparoscopic surgery. For example, exemplary motor and cognitive skills can include, but are not limited to, simultaneous active use of both hands, bimanual dexterity, hand-eye coordination, depth perception, instrument movement / rotation, and force perception. Users of the surgical training system described herein can include both novice users, such as residents or students, and more experienced users, such as practicing surgeons.

[0016] FIG. 1 illustrates an exemplary embodiment of a surgical training dummy (hereinafter referred to as a multi-skill dummy 100) designed to develop motor and cognitive skills used during laparoscopic surgery. In some embodiments, the multi-skill dummy 100 is configured to be compatible with and received by a laparoscopic trainer 2100. An exemplary laparoscopic trainer 2100 is illustrated in FIG. 21. The laparoscopic trainer 2100 is configured to simulate laparoscopic conditions that a user may encounter during a laparoscopic procedure. FIG. 23 illustrates an embodiment in which the multi-skill dummy 100 is used while in the laparoscopic trainer 2100.

[0017] Returning to FIG. 1 , the exemplary multi-skill training mannequin 100 includes at least four different elements designed to interact with each other to facilitate the development of a user's motor and cognitive skills. These four elements are the body 110, the post 120, a component associated with a force sensing mechanism (e.g., the peg 130), and the base 140. Further details regarding these four elements are provided below. It should be noted that other embodiments of the multi-skill training mannequin 100 are contemplated (some of which are discussed below) that may include fewer than the four highlighted elements. Furthermore, other embodiments of the multi-skill training mannequin 100 may have different versions (e.g., having different configurations, shapes) of the same elements than those shown in FIG. 1 . In any case, these other embodiments of the multi-skill training mannequin 100 enable different approaches by which the described surgical training system may facilitate the development of a user's motor and cognitive skills related to surgery, particularly laparoscopic surgery.

[0018] Continuing with reference to FIG. 1, the exemplary embodiment includes a body 110. The body can be designed to be generally planar. The body 110 can have a thickness ranging between 0.05 inches and .1 inches. In various embodiments, the thickness of the body 110 can be uniform. In other embodiments, the thickness of the body 110 at the center can be different than the thickness of the body 110 at the outermost portion. For example, the center of the body 110 can have a thickness of .1 inches and tapers toward the outermost portion of the body 110.

[0019] In some embodiments, the body 110 can be formed with one or more elongated portions (referred to herein as limbs 200, as seen in FIG. 2) extending away from its center. Each of the limbs 200 can have the same configuration as one another with respect to their width, length, and thickness. In various embodiments, each of the limbs 200 can differ from one another with respect to one or more of their width, length, and / or thickness.

[0020] In various embodiments, the body 110 can have multiple different sets of openings. As shown in FIG. 1, there can be a first set of openings 115 at the end of each of the limbs 200 furthest from the post 120. As shown in this figure, the first set of openings 115 can be located at a predetermined location along each of the limbs 200, such as at the distal end of each of the limbs 200. In various embodiments, each limb 200 can have additional openings located at predetermined locations along its length. These additional openings can be in the same location on each limb 200. In various embodiments, these additional openings along the length of the limb 200 can be in various locations across each of the different limbs 200.

[0021] The body 110 further includes at least a second set of openings near its center and near the posts 120. As shown, the second set of openings is configured to interface with components (e.g., pegs 130) involved in implementing a force sensing mechanism for the multi-skill practice model 100. The force sensing mechanism (implemented by the pegs 130) is designed to monitor and characterize the amount of force being applied to each portion (e.g., the body 110 and / or the posts 120) of the multi-skill practice model 100. In various embodiments, the second set of openings can be positioned at a predetermined location on the body 110. In various embodiments, the second set of openings can be aligned with the first set of openings 115. In various embodiments, the second set of openings can be positioned offset from the first set of openings 115. 1 illustrates an example number of first and second opening sets 115 and it is contemplated that other embodiments may have more or fewer openings associated with the first and / or second opening sets as desired. Additionally, in various embodiments, the characteristics associated with the first opening set 115 may be similar or the same as the openings associated with the second opening set.

[0022] In various embodiments, the body 110 further includes at least one central opening for the post 120. In some embodiments, the central opening for the post 120 is located in the center of the body 110, the base 140, or both. This allows the post to be attached / secured to some point directly below the base 110 and / or the base 140 and threaded through the body 110 and / or the base 140. In various embodiments, the post 120 can be located in various locations on the body 110, the base 140, or both that are not in the center. A corresponding opening for the post 120 can be provided in one or more of the various locations. In various embodiments, the diameter of the central opening for the post 120 can range from 7 / 32 inches to 17 / 64 inches. It is believed that the central opening for the post 120 corresponds to the diameter / cross-sectional area of ​​the post 120. In various embodiments, the diameter / cross-sectional area of ​​the central opening for the post 120 will be smaller than the diameter / cross-sectional area of ​​the post 120 to allow for an interference type connection.

[0023] In various embodiments, the body 110 can be positioned on the base 140 corresponding to a working plane 300. The working plane 300 is generally defined by a rectangular shape superimposed on the multi-skill phantom 100 of FIG. 3. In various embodiments, both the body 110 and the base 140 can be generally planar. In some embodiments, the body 110 and / or the base 140 can be non-planar, e.g., curved or contoured (e.g., following the contour of a simulated organ). In various embodiments, the base 140 is sized to fit within a surgical trainer. For example, the base 140 can be 6 inches by 6 inches in size, although other sizes are available and contemplated.

[0024] In various embodiments, the body 110 is aligned / positioned to be axisymmetric about an axis of symmetry 310 that is perpendicular or transverse to the working plane 300 as shown in FIG. 3. In various embodiments, the post 120 may be positioned at the axis of symmetry 310. Other embodiments are contemplated in which the body 110 is not aligned / positioned in an axisymmetric manner (e.g., off-centered with respect to the base 140). Additionally, the post 120 may be positioned at various locations other than the axis of symmetry 310 of the multi-skills training model 100. Additionally, other embodiments (which may or may not include an axis of symmetry) may be provided in which multiple posts 120 are included within the multi-skills training model 100 and thus positioned at various locations throughout.

[0025] Referring again to FIG. 1, in various embodiments, the base 140 has a second set of openings configured to receive one or more pegs 130. The pegs 130 are used to implement a force sensing mechanism for the multi-skill model 100. In general, the force sensing mechanism provides a feature for the multi-skill model to notify a user that excessive force has been detected when the user interacts with portions of the multi-skill model. Excessive force corresponds to an amount of force that may result in trauma during an actual surgical procedure. It is therefore desirable to notify the user of the occurrence of excessive force. In various embodiments, the notification that the user has applied excessive force (through the force sensing mechanism) corresponds to the body 120 becoming detached from one or more of the pegs 130.

[0026] According to various embodiments, the force sensing mechanism using the peg 130 shown in FIG. 1 can be inserted or glued to the base 140. In various embodiments, the peg 130 can be configured with the base 140 (as a monolithic structure). In various embodiments, the peg 130 can be used to implement the force sensing mechanism, although other structures are possible and contemplated and described herein. Additionally, the structures used to implement the force sensing mechanism can vary in shape or size. In various embodiments, the peg 130 (shown in FIG. 1) extends approximately perpendicularly from the base 140 and can include a neck portion (e.g., having a nominal diameter of 5 / 16″) and a spherical top (or head) portion. The exemplary peg 130 introduces a resistive force to a portion of the body 110 to prevent the body 110 from being detached from the peg 130. In particular, the neck portion of the peg 130 is configured to provide the primary resistive force against the body 110. Generally, the peg 130 will have a diameter or cross-sectional area that is slightly larger than the diameter or cross-sectional area of ​​the second set of openings that are adapted to receive it.

[0027] 1 is configured to interface with the body 110 through a second set of openings in the body 110 to provide a releasable connection between the body 110 and the base 140. More specifically, the releasable connection formed between the body 110 and the pegs 130 is an interference type fit that prevents the body 110 from becoming detached from the pegs 130 attached to the base 140 due to a resistive force existing between the body 110 and the pegs 130.

[0028] Although an exemplary embodiment of the peg 130 is described above, various embodiments can utilize other forms of the peg 130, each having a variety of different shapes and different sizes that provide different characteristics for the removable connection (e.g., an interference type fit) with the body 110. By modifying aspects of the peg 130 and / or the body 110, the characteristics for the removable connection between the peg 130 and the body 110 can be adjusted, i.e., affecting how difficult or easy it is for the body 110 to separate from the peg 130. The force sensing mechanism (embodied, for example, by the peg 130 in this embodiment) teaches the user how to learn to control and manage the amount of force applied to a portion of the multi-skill training mannequin 100 to minimize and prevent tissue trauma. A visual cue (e.g., the detachment of the body 110 from the peg 130) is provided to notify the user when excessive force is detected.

[0029] In various embodiments, the post 120 is positioned at the center of the multi-skill training mannequin 100. In various embodiments, the post 120 can have a variety of lengths, but it is believed that the post 120 needs to be long enough to allow the first set of openings 115 associated with one or more limbs associated with the body 110 to interface with the post 120. However, the length of the post 120 should not be excessively long such that the tip of the post 120 is larger than the dimensions (e.g., height) of the surgical trainer or larger than the frame field of view (e.g., 5'') captured by a laparoscopic / imaging device within the surgical trainer.

[0030] In various embodiments, the post 120 of the multi-skill dummy 100 is configured to be a solid (i.e., non-hollow) tubular structure. In various other embodiments, the post 120 can be a hollow tubular structure. In various embodiments, the post 120 can be made of a material capable of undergoing stretching along its length (e.g., along the axis of symmetry shown in FIG. 2). The post 120 can be at least partially folded when in a resting (i.e., unstretched) state. The post 120 can be held in tension when stretched and can be induced to point in any number of different directions. Additionally, in various embodiments, the post 120 also has the ability to bend in at least one direction.

[0031] In various embodiments, the posts 120 can be flexible. In some embodiments, the posts 120 of the multi-skill training mannequin 100 can be solid or rigid rods that do not have the ability to bend or extend. In yet other embodiments, the multi-skill training mannequin 100 can have posts 120 configured to have different shapes, cross sections, and / or configurations than those described herein. Furthermore, the posts 120 of the multi-skill training mannequin 100 can have a variety of different degrees of extension or stiffness based on any combination of flexible and rigid materials that can be used to manufacture the posts 120. Various different types of posts 120 are described below with respect to various different embodiments.

[0032] In various embodiments, the bendable body 110 and / or post 120 of the multi-skill dummy 100 provides interactivity between the body 110 and the post 120. In some embodiments, both the body 110 and the post 120 of the multi-skill dummy 100 can be manufactured from a variety of different types of elastomeric materials that allow both to bend and curve, thereby providing interactivity between them. The flexibility between the body 110 and the post 120 allows a user to manipulate one or both of the body 110 and the post 120 in a variety of ways in relation to performing laparoscopic training tasks (described in more detail below) to develop motor and cognitive skills related to laparoscopic surgery.

[0033] In some embodiments, the base 140 of the multi-skills training model 100 can be manufactured from a material that provides a rough surface in contact with the body 110. The rough surface associated with the base 140 can minimize / prevent interference of the body 110 with the base 140, e.g., "stickiness" of the contact between the body 110 and the base 140. In this manner, the connection between the body 110 and the base 140 may not affect the force perception mechanism where "stickiness" may inadvertently add additional resistance that would prevent the body 110 from being detached from the peg 130. Furthermore, in other embodiments, the base 140 of the multi-skills training model 100 can be manufactured from the same or similar material as the body 110 and the post 120. The use of a material that provides any inherent "stickiness" between the body 110 and the base 140 may introduce an additional factor that affects (e.g., increases) the predetermined force threshold for the force perception mechanism between the body 110 and the peg 130.

[0034] In addition, other embodiments are contemplated that can be used to prevent or reduce adhesion or sticking between the body 110 and the base 140. For example, the body 110 and / or the base 140 can have any number of surface features positioned on their respective surfaces to prevent or reduce adhesion or sticking. These surface features can facilitate movement of a portion of the body 110 away from the base 140. In various embodiments, an anti-adhesion coating or layer can be attached to or integrated with one or more of the body 110 and / or the base 140 to prevent or reduce adhesion or sticking. In various embodiments in which the multi-skill training model 100 has a multi-layered body 110, these surface features can be used to minimize or prevent adhesion or sticking between adjacent layers of the body 110.

[0035] As seen in Figures 4A and 4B, a user can manipulate the post (Figure 4A) and one or more limbs (Figure 4B) while performing a laparoscopic training task. In various embodiments, the multi-skill training model 100 is designed to have a user perform one or more different laparoscopic training tasks to develop the user's motor and cognitive skills applicable to laparoscopic surgery. One such laparoscopic training task is referred to as "Limb in Body."

[0036] 5A-5D, these figures illustrate steps for an exemplary laparoscopic training task (e.g., "Limb in Body") that a user may perform using the multi-skill training mannequin 100. In particular, the exemplary laparoscopic training task includes separate steps that a user may need to perform in order to complete it.

[0037] An exemplary first step would be to have the user manipulate the post and one of the limbs simultaneously. In particular, it is contemplated that the user will use two different laparoscopic devices to control and manipulate the post and one of the limbs. For example, the user could control the post with the left hand gripping the left laparoscopic device (as seen in FIG. 4A) while controlling the limb with the right hand gripping the right laparoscopic device (as seen in FIG. 4B). Both the post and limb can be controlled and manipulated simultaneously (as seen in FIG. 5A).

[0038] As described above, the multi-skill mannequin 100 is symmetrical, which allows the user to switch hands to perform laparoscopic training tasks using the multi-skill mannequin 100. In particular, in some tasks, the user can use the right hand to manage the post while the left hand operates the limbs on the left side of the multi-skill mannequin 100. When performing a task involving the limbs on the right side of the multi-skill mannequin 100, the user can use the left hand to manage the post while the right hand operates the limbs on the right side. The symmetry (around the z-axis) of the multi-skill mannequin 100 allows the user to use both hands to perform similar (but opposite) laparoscopic training tasks. This gives the multi-skill mannequin 100 a user-dominant capability. In other words, a laparoscopic surgery task being performed with the user's hands in one role set on one side of the multi-skill mannequin 100 will have a symmetrical corresponding task that is considered to utilize the user's hands in the opposite role set on the other side of the multi-skill mannequin 100. In this manner, laparoscopic surgery tasks performed through the multi-skill mannequin 100 facilitate the development of bimanual dexterity.

[0039] As seen in FIG. 5B, the user would be guided to manipulate the opening of the limb relative to the post. In particular, the user would manipulate the opening at the end of the limb to allow the top of the post to pass through the opening in the limb. The user can then manipulate the limb down the length of the post, thereby completing the laparoscopic task for that limb, as seen in FIG. 5C. In various embodiments, the opening of the limb may need to pass through some obstruction (e.g., knob 125), which indicates that the limb has moved a sufficient distance down the post.

[0040] In various embodiments, the user can repeat the above task with other limbs, as seen in FIG. 5D. With each of the various limbs surrounding the post, the same steps of manipulating the limb opening relative to the post remain, but different challenges arise. For example, the direction in which the limb extends away from the post may affect the user's depth perception. Furthermore, the amount of force that is acceptable to continue performing the laparoscopic training task may be reduced due to tension added to the body as more limbs are connected to the post through their respective openings. Any excessive force applied by the user when interacting with a subsequent limb may cause the body to detach from one or more of the pegs.

[0041] As mentioned above, the post 120 can have an obstruction 125 that can be used to indicate how far down the length of the post 120 the user must pull the limb. Exemplary obstructions 125 are shown in FIGS. 6A and 6B. The obstruction 125 (e.g., a knob) can be a feature added to the post 120 and can include a portion that is larger than an adjacent portion of the post 120 and has a larger cross-sectional area than the limb opening 115. In various embodiments, the obstruction 125 can have a variety of sizes that differ from the limb opening 115. If the size of the obstruction 125 is equal to or larger than the limb opening 115, force may be required by the user to pass the obstruction 125 of the post 120 through the limb opening 115.

[0042] In order for a laparoscopic training task to be considered completed when an obstacle 125 is present, a laparoscopic training task may require the user to move the limb opening through the obstacle 125 (e.g., move the body 110 along the post 120 and down the obstacle 125). As shown in this figure, an example scenario is shown in which the user has moved the limb opening 115 to a position above the obstacle 115 (see FIG. 6A). After the user exerts a certain amount of force on the limb, the opening 115 can pass through the obstacle 125, thereby positioning the limb below the obstacle 125 on the post 120 (see FIG. 6B). The latter scenario corresponds to the user solving / completing the laparoscopic training task for that limb. However, this act of passing through the obstacle 125 must be completed without exerting an excessive amount of force on the limb and / or the post 120, which could potentially cause the body 110 to become detached from one or more pegs 130.

[0043] In various embodiments, the multi-skill training mannequin 100 can have various cross-sectional shapes for the obstacles 125 of the posts 120 that are different from a circular / spherical shape. Such exemplary embodiments are described below in which the cross-sectional shapes are different shapes, such as triangular (see FIGS. 15 and 20). In various embodiments, the limb openings 115 are believed to have a cross-sectional shape similar to that of the posts and obstacles so that the user can manipulate the limb openings down the length of the post and exert an amount of force on the limb that allows the limb openings 115 to pass through the obstacles 125.

[0044] In some embodiments, a force perception mechanism is incorporated with the multi-skill mannequin to increase the difficulty of completing laparoscopic training tasks by imposing force requirements or force thresholds. Because there may be a discrepancy between the amount of force a user exerts on a surgical device, e.g., a laparoscopic device, and the corresponding force that the surgical device exerts on the tissue being operated on, the force perception mechanism is provided as a teaching tool to allow a user to master and practice the application of forces with a surgical device using the multi-skill mannequin 100.

[0045] In various embodiments, the force sensing mechanism is configured to have a predetermined force threshold that corresponds to an acceptable amount of force that a user can exert before the force sensing mechanism notifies the user of the moment that too much force has been used during a laparoscopic procedure. In various embodiments, the structures (e.g., pegs) used to implement the force sensing mechanism can each have the same predetermined force threshold. In various embodiments, a subset of the structures implementing the force sensing mechanism can have a different predetermined force threshold compared to other sets of structures.

[0046] In various embodiments, the force sensing mechanism is used to teach and train the user regarding the amount of force being transmitted to tissue through the laparoscopic device used by the user. In various embodiments, a laparoscopic training task can include a user interacting with the post 120 (see FIG. 8A ) and / or interacting with at least one of the limbs of the body 110 (see FIG. 8B ). Interaction with each of these aspects of the multi-skill training mannequin 100 may decouple a portion of the body 110 from one or more structures (e.g., pegs 130) used to implement the force sensing mechanism for the multi-skill training mannequin 100. By using the force sensing mechanism, the user can train regarding how to minimize or manage the amount of force being applied to the multi-skill training mannequin 100 during a laparoscopic training task (using a laparoscopic device) so that a corresponding acceptable amount of force applied during an actual laparoscopic procedure does not cause trauma to tissue and / or organs. Often times, there is a discrepancy between how much force a user exerts on the proximal end of the laparoscopic device and how much of the user exerted force is actually transferred from the distal end of the laparoscopic device to the tissue and / or organs, resulting in the unanticipated application of forces that can cause trauma to tissue and / or organs during an actual laparoscopic procedure.

[0047] 9A-9C show embodiments of the force sensing mechanism used in the multi-skill mannequin 100. In particular, each of these figures shows a scenario in which a user exerts a force through a laparoscopic device that is greater than that permitted by the defined force threshold for the force sensing mechanism. In each of these cases, a portion of the body 110 becomes disengaged / disengaged from one or more pegs 130 used to implement the force sensing mechanism on the multi-skill mannequin 100. These figures illustrate exemplary embodiments in which the body 110 becomes disengaged from one (see FIG. 9A), two (see FIG. 9B), or all (see FIG. 9C) of the pegs 130 implemented on the multi-skill mannequin 100. Additionally, it is shown where the user exerts force on various parts of the multi-skill mannequin 100, such as the limbs (FIGS. 9A and 9B) and the posts 120 (FIG. 9C).

[0048] In various embodiments, the amount of force allowed, tested, evaluated, or assessed (i.e., the predetermined force threshold) can be modified between different versions of the multi-skill exercise model 100. For example, the size and shape of the pegs 130, the materials from which the body 110, the pegs 130, and / or the base 140 are manufactured, and the type of connection (e.g., the degree of fit) between the pegs 130 and the body 110 can be altered to adjust the predetermined force threshold, thereby affecting how much force a user can exert on the multi-skill exercise model 100 before the body 110 becomes detached from one or more of the pegs 130. Additionally, embodiments are contemplated that can allow for the placement of the pegs 130 such that user force application in one direction has a higher predetermined force threshold compared to other directions.

[0049] When the body 110 becomes detached / disengaged from at least one peg 130, the occurrence is used as a visual indicator to the user that the user has applied too much force through the laparoscopic device to the multi-skill training mannequin 100. In various embodiments, this indicator can be used to inform the user that a laparoscopic training task has failed. In some embodiments, the requirement can indicate that failure of the laparoscopic training task corresponds to detachment / disengagement of the body 110 from two or more pegs 130. In some embodiments, the requirement can indicate that failure of the laparoscopic training task corresponds to detachment / disengagement of the body 110 from a particular one or more pegs 130. In this manner, the force perception mechanism is configured to train the user on how to control the amount of force being applied by the laparoscopic device. The force perception mechanism can be used to train the user on how much force is acceptable during a laparoscopic procedure by providing feedback (e.g., visual) regarding when too much force is applied based on when the body 110 becomes detached from a peg during the performance of a laparoscopic training task. If a user applies too much force during an actual laparoscopic procedure, the tissue being operated on may be traumatized. A more detailed discussion of the force perception mechanism and other embodiments is provided in co-pending application "Force Perception Mechanism for Physical Laparoscopic Simulation Models," the entire disclosure of which is incorporated herein by reference as if fully set forth herein.

[0050] The motor and cognitive skills developed by the multi-skill training mannequin 100 are advantageous due to the nature of laparoscopic procedures. For example, exemplary motor and cognitive skills developed may include hand-eye coordination that would enable a user to adapt to the challenging process of relying on indirect visualization of the area of ​​interest undergoing laparoscopic surgery acquired from an imaging device (e.g., laparoscope, endoscope, or camera) and perform the surgical procedure relying on indirect visualization when used in conjunction with a surgical trainer. In particular, indirect images are images captured using an image capture device inside the surgical trainer (or inside the patient's body in an actual laparoscopic procedure) and displayed on a display screen (see FIG. 22) for the user to view. In various embodiments, the display screen may be associated with the surgical trainer, while other embodiments may have a display screen separate from the surgical trainer.

[0051] Another example of a motor and cognitive skill developed by the multi-skill mannequin 100 is depth perception. Because laparoscopic procedures are essentially performed using two-dimensional indirect vision, depth perception is a necessary skill that allows a user to determine how far an object is from the distal end of the surgical instruments being used in three-dimensional space by relying on a two-dimensional image of this same space.

[0052] Typically, a user is required to make spatial determinations using two-dimensional video input provided by an image capture device in a three-dimensional space when performing a laparoscopic procedure in the same three-dimensional space. However, the video input may be imaged from one or more planes (e.g., xz, yz, and xy) relative to the respective axes (e.g., x, y, and z), and may not all be precisely captured as two-dimensional video inputs. An exemplary diagram of the various planes is provided in FIG.

[0053] In an exemplary scenario, when a laparoscopic camera images from the x direction, the position of an object or feature located at the same x coordinate or yz plane (or any number of planes parallel to the yz plane) can be easily perceived. The user does not need to analyze new sensory information to drive the motion between objects in the same x coordinate, yz plane, or planes parallel to the yz plane. However, as the x coordinate becomes variable, depth perception may become more difficult since it may become more difficult to determine the distance of an object from the focus of the laparoscopic device. Furthermore, it may be difficult to manipulate an instrument relative to an object / feature using only a two-dimensional visualization (e.g., a display screen) in three-dimensional space. To aid in training depth perception skills, the multi-skilled training mannequin 100 allows each of the limbs to be positioned at a different axial position using the axial symmetry associated with the limbs. In this way, a user can be trained to move a laparoscopic device in a primary plane (e.g., xy plane, xz plane, yz plane), as well as in planes different from the primary planes, allowing the user to determine and interpret movements of the laparoscopic device in three-dimensional space, all while observing these same movements on a two-dimensional visualization image.

[0054] In addition, in the case of the multi-skill mannequin 100 using axial symmetry about the symmetry axis shown in FIG. 2 or about the z-axis shown in FIG. 7, the multi-skill mannequin 100 can also use planar symmetry about the xz plane (shown in FIG. 7). Thus, in various embodiments, laparoscopic training tasks performed using the right side (with respect to the limbs and post 120) of the multi-skill mannequin 100 will have a symmetrical corresponding task in which the roles of the tools used are reversed (e.g., the roles of the user's hands are swapped). This facilitates the development of the user's bimanual dexterity. Furthermore, the multi-skill mannequin 100 is manufactured to be user handedness agnostic.

[0055] It should be noted that the above-mentioned features of the multi-skill training mannequin 100 being axially symmetrical and / or planarly symmetrical may be present in various embodiments. However, in various embodiments, a particular multi-skill training mannequin 100 may not have both axial and planar symmetry. For example, embodiments are contemplated in which the multi-skill training mannequin 100 utilizes multiple limbs of various lengths, multiple limbs with various amounts of openings, different spacing between limb openings, non-linear posts, and / or various combinations thereof. Each of these contemplated embodiments may have a body that is axially symmetrical but not planarly symmetrical, and vice versa.

[0056] As mentioned above, to simulate laparoscopic surgery, the multi-skill training mannequin 100 can be compatible with a surgical trainer. The surgical trainer simulates a laparoscopic procedure by obscuring the user's view of the multi-skill training mannequin 100 and instead relying on one or more sources of indirect visualization (e.g., a captured image of the mannequin positioned on a display screen) for the user. An exemplary surgical trainer can be seen, for example, in FIG. 21. An exemplary embodiment showing one or more different multi-skill training mannequins 100 inside a surgical trainer can be seen, for example, in FIG. 23.

[0057] The multi-skill training mannequin 100 can be mechanically secured or otherwise connected (e.g., glued) to the surgical trainer through its base 140. The connection between the base 140 of the multi-skill training mannequin 100 and the surgical trainer allows the multi-skill training mannequin 100 to remain stationary while the user manipulates portions of the multi-skill training mannequin 100 (e.g., the body 110 and / or the post 120). In some embodiments, the base 140 may not be used. Instead, the surgical trainer can be directly connected / attached to at least a portion of the body 110 and / or the post 120 of the multi-skill training mannequin 100. In some embodiments, the surgical trainer can accommodate two or more different multi-skill training mannequins 100.

[0058] 9A-9C, a force perception mechanism is present in the exemplary multi-skill training mannequin 100 to train a user to adapt to and visualize the amount of force exerted during the performance of a laparoscopic training task. The body 110 is configured to detach from the peg 130 when the amount of force exerted against all or a portion of the mannequin (e.g., limbs and / or posts 120) exceeds a predetermined force threshold. The predetermined threshold amount of force can be customized based on the type of connection (e.g., an interference fit) that exists between the peg 130 and the body 110. For example, by changing the shape and / or size of the peg, or the material from which the peg and / or body 110 are manufactured, the body 110 can be made easier or harder to detach from the peg 130. A change in the ease with which the body 110 can detach from the peg 130 corresponds to a change in the associated predetermined force threshold (and the acceptable force available for the multi-skill training mannequin).

[0059] In various embodiments, the number and type of structures used to implement the force sensing mechanism are designed to detect forces acting on the multi-skill dummy 100. In some embodiments, an exemplary force can be detected by the multi-skill dummy 100 when a user pulls the limb and / or post 120 through a laparoscopic device. Additionally, when a portion of the limb and / or post 120 is in an extended state, the pulling force used to extend the body 110 and / or post 120 can be transmitted to the peg 130. In response to the pulling force, a reactive frictional force will be exerted on the peg 130. The reactive frictional force provides resistance to the body 110 being disconnected from the peg 130. However, if the pulling force transmitted to the peg 130 exceeds the existing frictional force exerted between the body 110 and the peg 130, the body 110 can be disconnected from the peg 130. The forces exerted on the multi-skill mannequin 100 and subsequently transferred to the one or more pegs 130 may differ based on where the exerted force occurs (e.g., pulling on the post 120 or pulling on a limb of the body 110), which in turn may translate into different amounts and types of forces exerted on the multi-skill mannequin 100. Thus, different types of forces may affect how the body 110 becomes detached from the one or more pegs 130.

[0060] In addition to managing the amount of force being applied to the multi-skill practice mannequin 100, other features are also implemented to develop a user's motor and cognitive skills for laparoscopic surgery. In particular, other versions of the multi-skill practice mannequin 100 are contemplated and described herein. These additional embodiments of the multi-skill practice mannequin provide for variations in the shape, size, and / or location of one or more features (e.g., body, posts, base) that can affect how a user is able to perform laparoscopic training tasks and further affect how a user's motor and cognitive skills for laparoscopic surgery are developed.

[0061] In some embodiments, the body 110 can have additional support structures that provide additional support for the posts 120. The additional support structures can be positioned about the axis of symmetry and / or can be connected with openings in the body 110 to which the posts are connected. Exemplary support structures can be seen, for example, in Figures 10A and 10B. For example, Figures 10A and 10B show support structures and materials that are incorporated (e.g., molded) into the body 110 near the axis of symmetry. In some embodiments, the support structures can be manufactured separately from the body 110 and then attached to the body 110 to provide support.

[0062] The support structure can be configured to act as a reinforcement for the body 110 and prevent damage to portions of the body 110 where the post 120 contacts the body 110 or when an excessive amount of force is applied to the body 110 and / or the post 120. For example, the support structure can be configured to distribute a user applied force more evenly on the body 110 and / or the post 120, thereby affecting two or more different pegs 130. The distribution of the user applied force can allow for an increase in the overall amount of force that can be tolerated on the body 110 and / or the post 120 before the body 110 becomes detached from one or more pegs. Additionally, the support structure can include areas (e.g., indented spaces) that can be used to connect and fasten the post 120 to the body 110 using, for example, an adhesive (as shown in FIG. 10A).

[0063] 11A and 11B show another embodiment of a multi-skill training dummy 100. In the exemplary multi-skill training dummy 100 (shown in FIG. 11A), the dummy has a body 110 including several limbs extending away from its center, a post 120 located at the center of the dummy, several pegs 130 used to implement a force sensing mechanism, and a base 140. The multi-skill training dummy 100 shown in FIG. 11 shares many similar features with the previous multi-skill training dummy 100 discussed above (e.g., shown in FIG. 1), but this variation provides an example of how multiple changes can affect the laparoscopic training task being performed by a user. For example, the body 110 of the multi-skill training dummy 100 shown in FIG. 11A and 11B includes multiple limbs, each with two separate openings (one at the distal end of the limb away from the post and one at the proximal end of the limb close to the post). The proximal opening can be configured to receive a first peg and the distal opening can be configured to receive a second peg. The second peg can be provided to hold the limbs immobile until a user selects a particular limb for performing a laparoscopic training task. In various embodiments, it is contemplated that the second peg can be used to identify the amount of force being applied to the limb, while the first peg can be used to monitor the amount of force being applied to the limb during performance of the laparoscopic training task with respect to the force sensing mechanism. In some embodiments, performance of the laparoscopic training task can also guide the user to avoid disconnecting nearby limbs from their respective pegs interfacing with their proximal openings. In other embodiments, the limbs can have more than two openings spaced along the limb between the distal and proximal ends of the limb such that more than two pegs can be used (e.g., additional pegs can be positioned between the proximal and distal ends of the limb).

[0064] In various embodiments, a predetermined force threshold is required to detach a portion of the body (e.g., a limb) from a connected peg. In various embodiments, the predetermined force threshold required to detach a limb from a peg at its proximal end may be different than the predetermined force threshold required to detach a limb from a peg located at another location on the same limb or even a peg located at another limb. For example, in one embodiment, the predetermined threshold of force required to detach a limb from a peg at its distal end may be less than the predetermined threshold of force required to detach a limb from a peg at its proximal end. Thus, various embodiments may utilize structures having different shapes, sizes, configurations, and / or compositions, such as pegs located at the distal end of the limb and the proximal end of the limb, or any combination thereof, to define different force thresholds.

[0065] 11B, the limb is configured to be detachable from a peg (shown in FIG. 11A) located at its distal end. Additionally, the limb also has the ability to detach from a peg located at its proximal end. In various embodiments, the user may be instructed (when performing an exemplary laparoscopic training task) to navigate the distal end of the limb (now with an exposed opening) toward the post, exerting sufficient force to remove the limb from the peg set located at the distal end without detaching the limb from the other peg set at the proximal end of the limb.

[0066] In one embodiment, when there are two or more pegs positioned along the length of the limb between the proximal and distal ends of the limb, an exemplary laparoscopic training task may require the user to only detach the most distal peg (i.e., the peg furthest from the post). The user may then be guided to navigate the post through the most distal opening of this same limb without detaching the limb from any of the other pegs connected to the limb, and the laparoscopic training task being performed may be considered a failure if the limb becomes detached from any of the other pegs. In other embodiments, the user may be allowed to detach the limb from all pegs connected to a particular limb, but may not be allowed to apply any force that would detach the other limbs from their respective pegs.

[0067] FIG. 12 illustrates another embodiment of a multi-skill dummy. In this embodiment, the posts are rigid materials that cannot be stretched, bent, or otherwise manipulated using a laparoscopic device. For example, the rigid posts can be made of solid (e.g., metal) rods. In various embodiments, the rigid posts can be made of hollow (metal) rods. The exemplary multi-skill dummy illustrated in FIG. 12 does not implement a force perception mechanism. However, in various embodiments, a force perception mechanism for one or more of the limbs can be implemented, as described above in various embodiments.

[0068] In the embodiment illustrated in FIG. 12, an exemplary laparoscopic training task can instruct the user to navigate one of the openings at the distal end of the limb to the post. The openings associated with each of the limbs can be different sizes corresponding to the peg and / or post to which it is connected. In various embodiments, additional openings can be provided that can facilitate grasping and manipulating the limb with a laparoscopic device. Because the rigid post cannot be manipulated (e.g., bent, curved), the user can be guided to move one of the limbs to the post using one hand or one instrument to complete the laparoscopic training task. In some embodiments, the user can be instructed to use two hands to simultaneously manipulate two different limbs against the rigid post.

[0069] 13A and 13B show various other embodiments of the multi-skill training mannequin. In particular, the limbs of the illustrated multi-skill training mannequin have multiple openings associated with each of them. These multiple openings can be positioned at predetermined locations along the length of the limb (as shown in FIG. 13A) and / or aligned with the distal end of the limb using adjacent tabs (as shown in FIG. 13B). One particular laparoscopic training task for the multi-skill training mannequin of FIG. 13A and 13B is to have a user align multiple openings of the same limb so that all openings form one interlocking opening. Interlocking of openings may require the user to use one or both hands to bend and fold the limb on itself so that two separate openings align. After all openings of the same limb are aligned, the user can then navigate (using one or both hands) the post to pass through the interlocking opening.

[0070] Although the posts (shown in FIGS. 13A and 13B) are rigid posts, various other embodiments may have similar features as those described above. For example, the multi-skill training dummy shown in FIGS. 13A and 13B may be flexible or at least not very rigid in some variations (e.g., made of elastic or flexible materials). In various embodiments, the rigid posts may have the ability to undergo deformation or to be biased to return (e.g., bounce back) to a resting state (e.g., extending straight from the base) in some embodiments. These alternative variations on the rigid posts may pose additional challenges regarding how a user may need to manipulate the interlocking opening and / or post to complete a laparoscopic training task.

[0071] 13A and 13B can be configured to develop simultaneous two-handed use of a user to use both laparoscopic devices to grasp and manipulate a limb so that multiple openings associated with the limb can be aligned. Additionally, two hands may still be required to maintain the multiple openings in an interlocking state while placing a rigid post through the interlocking opening.

[0072] 14A and 14B show another embodiment of a multi-skill training dummy. In various embodiments, the post can be made of a rigid material, although this and other other embodiments can have semi-rigid or flexible posts. Referring at least to the embodiment shown in FIG. 14A, the post has several different steps positioned along the length of the rigid post. These steps can be placed at predetermined intervals on the rigid post that are equal distances from each other. In each step, the rigid post can have a different cross-sectional shape (e.g., triangular, square, pentagonal, circular) configured to match one or more openings associated with the limbs of the body. Furthermore, each of these steps reduces in cross-sectional shape size as one transitions from the bottom of the post to its top, thereby dictating the order of the limbs that will be aligned with the post.

[0073] Continuing with reference to Figure 14A, in various embodiments, there is a corresponding number of bodies that include several separate limbs. These bodies can be separate and layered on top of one another. In some embodiments, the limbs (each having a different cross-sectional shape and / or having different sized openings) can all be connected as a single body.

[0074] For the separate and layered body embodiments, there is an opening in the center of each of the bodies that allows a rigid post to connect to each of the bodies. Each of these limbs has a distal opening with a cross-sectional shape and / or size that corresponds to one of the cross-sectional shapes and / or sizes of the rigid post. For example, if the rigid post has four steps, each with a different cross-sectional shape and size, there will be four bodies, each with a different set of limbs, each with a distal opening that corresponds to the cross-sectional shape and size of one of the four steps associated with the post. In some embodiments, the separate layers can have one or more limbs with distal openings that do not share the same cross-sectional shape and size. Additionally, in various embodiments, multiple limbs that share the same cross-sectional shape and size can be color-coded with the same color. In some embodiments, each of the separate bodies can be made of different materials to facilitate distinguishing between the various layers, while in other embodiments, each of the bodies can be made of the same material.

[0075] With reference to FIG. 14B, an exemplary laparoscopic training task associated with this embodiment of the multi-skill training model may include a user inserting the distal openings of various limbs with corresponding steps on a rigid post. The user would be guided to identify a limb having a distal opening that corresponds to the cross-sectional shape and size of the lowest step on the rigid post. The user would then manipulate one limb using one or both hands, or two limbs simultaneously, to align the limb's opening with the rigid post. The user would then navigate each limb's opening down the post until it matches the matching cross-sectional shape of the step being worked on. With all limbs for the lowest step identified and threaded over the rigid post, the user would then proceed to the next highest step on the rigid post and identify, manipulate, and align the limb set that matches its cross-sectional shape and size.

[0076] In some embodiments, the bodies can be positioned (layered) in the order in which the limbs are expected to be threaded onto the rigid post. As shown in FIG. 14B, the top base layer may correspond to the lowest step on the rigid post, while the bottom body layer may correspond to the highest step on the rigid post. In other embodiments, the bodies can be positioned in an order that differs from the order of the steps associated with the rigid post. In some embodiments, various limbs having various different cross-sectional shapes can all be connected as a single body. Additionally, in various embodiments, one or more bodies can be rotatable about the rigid post, thereby requiring the user to orient the opening of each one of the limbs relative to the rigid post.

[0077] 15 shows another embodiment of a multi-skill dummy, in which the post has a variety of irregular shapes that protrude in different directions along its length. These irregular shapes form cross-sectional shapes for the post at various sections along the length of the post. These cross-sectional shapes correspond to the shape of the distal opening of each of the limbs of the body, but at different orientations.

[0078] With regard to the limbs, these limbs are positioned at the bottom of the post. The limbs are connected to the post in a manner that allows them to have the ability to rotate around the rigid post. For example, each of the limbs can have an opening configured to receive the post. In this case, the post can be connected and secured to the base, or in some embodiments, the bottom-most limb, such that it does not have the ability to be removed. This connection maintains the above-mentioned connection between the post and each of the limbs.

[0079] As shown in Figure 15, each of the limbs can be separate from one another and / or layered on top of one another at a central location near the post. However, in various embodiments, two or more limbs can be connected as a single body that may still be rotatable about the post. In various embodiments, the post has a higher stiffness than one or more of the limbs, and / or in various embodiments, one or more limbs are bendable while the post does not or resists bending or flexing.

[0080] During the performance of a laparoscopic training task, the user will be guided to navigate the limb opening over and through the post by bending and flexing the limb. The user will then need to rotate the limb accordingly to align the particular limb opening with the irregular shape protruding on the post so that the limb can pass through each level and manipulate it further down the post. Thus, the limb is then rotated to a different location around the post so that the orientation of the opening can be passed through the next irregular shape further down the post, and so on.

[0081] In various embodiments, the limb and / or body can be essentially stationary with the post being rotatable about the center of the limb and / or body. In a variation of the laparoscopic training task, the user can be guided to rotate the post to orient the limb opening relative to the post such that the limb opening can pass through each of the irregularities in the post as the limb progresses down the length of the post.

[0082] FIG. 16 shows another embodiment of a multi-skill training dummy. In this multi-skill training dummy, the post can have a non-linear shape. As shown in this figure, the post can have a wavy profile. At the bottom of the post is a body that includes several limbs, each with a distal opening. The body can be rotatable around the rigid post. In some embodiments, the post can be rotatable relative to the body (considered immobile). In various embodiments, the limbs can be separate and / or layered one above the other and still be rotatable around the post. In various embodiments, the post has a higher rigidity than one or more of the limbs, and / or in various embodiments, one or more limbs are bendable while the post does not or resists bending or bending.

[0083] To perform a laparoscopic training task, the user will be guided to manipulate the distal opening of each limb of the body along the post. This may require the user to bend / flex the limb using one or both laparoscopic devices to advance the limb down the post. In some cases, the user may need to adjust the orientation of the limb to realign the limb's opening with the post to advance the limb down the length of the post. In some variations, the user may be required to rotate the post and / or limb or body to advance the limb's opening down the post.

[0084] FIG. 17 shows another embodiment of a multi-skill dummy. In this multi-skill dummy, the post has a helical shape. In addition, the multi-skill dummy includes several limbs stacked down the post. The post can connect each of the limbs to each other, thereby allowing the limbs to rotate around the post. In some embodiments, the limbs can connect each to each other to form a single body. In various embodiments, the post has a higher stiffness than one or more of the limbs, and / or in various embodiments, one or more limbs are bendable while the post does not or resists bending or bending.

[0085] 16, a user (performing an exemplary laparoscopic training task) will be guided to thread each limb opening along the helical post by adjusting the orientation of the opening by bending / flexing and / or rotating the limb. Additionally, the user can adjust the orientation of the limb by rotating the limb relative to the post to allow the limb opening to progress down the length of the post.

[0086] In some embodiments, the limbs may be immobile and the post may be rotatable instead. Thus, a laparoscopic training task may guide the user to rotate the post to advance the limb opening down the length of the post. In various embodiments, one or more of the limbs and the post are rotatable.

[0087] 18A and 18B show another embodiment of the multi-skill exercise dummy. In this embodiment, the multi-skill exercise dummy includes a generally planar body with several limbs extending away from the center. In various embodiments, the multi-skill exercise dummy does not include a post, and there are no openings at the distal ends of the limbs as in the above-mentioned embodiment. Instead, each of the distal ends of the limbs has a snap mechanism built into or attached thereto. Furthermore, the center of the multi-skill exercise dummy is provided with a snap mechanism counterpart that corresponds to at least one of the snap mechanisms of one of the limbs. In some embodiments, each of the snap mechanisms can be manufactured as a separate part and embedded in or otherwise connected to each of the limbs. In some embodiments, the snap mechanisms can be formed (molded) as a unit with the body. In some embodiments, each of the limbs can be separate from each other.

[0088] In some embodiments, each of the limbs can have a snap mechanism (e.g., a male part) that has the ability to snap into place with a female snap mechanism counterpart (e.g., a female counterpart) at the center of the model. To perform a laparoscopic training task, the user is guided to manipulate one of the limbs' distal ends (by bending and folding the limb) to cause the male part of the mechanism at the end of the limb to snap into the female part at the center of the multi-skill practice model. Thereafter, the user would be guided to remove the limb that is currently snapped into the center of the model so that another limb can be selected and snapped into the center.

[0089] In some embodiments, the distal end of each of the limbs can have a predetermined number of different shapes. The center of the multi-skill training model will have one female snap mechanism configured to connect to a corresponding shape of at least one of the limbs' distal ends. To perform a laparoscopic training task, a user would need to identify which distal end has a snap mechanism with a shape that matches the shape of the one at the center of the multi-skill training model and move that distal end of that limb to snap into the center snap mechanism counterpart.

[0090] In addition, in various embodiments, the underside of each of the limbs of the multi-skill exercise model (shown in FIG. 18B) can have additional female snap mechanisms that are believed to correspond to one or more of the male snap mechanisms of the other limbs. These female snap mechanisms on the underside of the limbs are believed to act as additional snap mechanism counterparts similar to those at the center of the multi-skill exercise model. By using this arrangement of counterparts on the underside of the limbs, when the user snaps a limb into the center of the multi-skill exercise machine, the underside of the limb is exposed to reveal the additional female snap mechanisms. The user can then be guided to identify the next limb to be interacted with and move it to snap into the center of the multi-skill exercise model. Thus, the limbs can be snapped together, one on top of the other, with the snap mechanisms found at the center of the model as well as on both sides of the limb.

[0091] 19A and 19B show another embodiment of a snap mechanism. The snap mechanism (shown in FIG. 19A) can be considered to have a male and female counterpart. For example, the male part of the snap mechanism can include a snap base having structures (e.g., pegs) extending from the snap base. In contrast, the female counterpart can include a base having an opening configured to receive the structure of the male part.

[0092] The structures for the male part can have any number of different cross-sectional shapes. For example, these cross-sectional shapes can be non-circular (square, star, triangle). The female counterpart will have an opening that corresponds to the cross-sectional shape for the male part. When snapped together, the structures for the male part (e.g., pegs) can be fully received by the female counterpart such that the snap bases of both the male part and female counterpart are adjacent to each other. In various embodiments, the structures for the male part can be longer than the width of the snap base of the female counterpart and / or the depth of the opening of the female counterpart, in which case the snap base of the male part and the snap base of the female counterpart can be spaced apart based at least on the difference between the size of the structures and the width of the snap base and / or the depth of the opening associated with the female counterpart.

[0093] FIG. 20 illustrates another embodiment of a multi-skill dummy. In this multi-skill dummy, the dummy includes a body having limbs extending away from its center. Additionally, there is a post at the center of the dummy. The post has a single non-circular cross-sectional shape. However, this non-circular cross-sectional shape has different orientations at different locations along the length of the post, thus giving the post a non-uniform shape along its length. The limb associated with the body of the multi-skill dummy has at least one opening at a distal end of the limb having the same non-circular cross-sectional shape as the post.

[0094] In various embodiments, the limbs can be separate from one another (i.e., separate bodies), but all layered on top of one another to be connected to a rigid post. Additionally, the individual limbs can be rotatable relative to the post. In various embodiments, the post has a higher stiffness than one or more of the limbs, and / or in various embodiments, one or more limbs are bendable while the post does not or resists bending or flexing.

[0095] To perform a laparoscopic training task, the user would be guided to manipulate one of the distal ends of the limbs down the post. To do so, the user would move the opening onto the post (by bending / flexing the limb). To manipulate the limb down the length of the post, the user would be guided to rotate the post (while the body remains stationary), thereby allowing the limb opening to pass through each of the non-circular cross sections and progress down the length of the post. In other embodiments, the user can be guided to rotate the body relative to a stationary post to allow the limb opening to pass through successive cross sections of the post. In other embodiments, the user can be guided to rotate both the body and the post to allow the limb opening to pass through successive cross sections of the post.

[0096] 21 is an exemplary embodiment of a surgical trainer. The surgical trainer 2100 is designed to practice laparoscopic or other minimally invasive surgical procedures. In particular, the surgical trainer 2100 can be designed to simulate the torso or abdominal area of ​​a patient.

[0097] The surgical trainer 2100 includes a body cavity 2105 that is substantially hidden from a user, for example, by a top cover 2115. The body cavity 2105 is configured to receive a simulated or live tissue or organ model or training model. As applicable to the present disclosure, it is contemplated that the body cavity 2105 is adapted to receive any one of the multi-skill training models (shown in FIGS. 1-20) described above. An exemplary embodiment is shown in FIG. 23, in which the surgical trainer has one multi-skill training model within the body cavity 2105. It should be noted that in various embodiments, more than one multi-skill training model can be accommodated within the body cavity 2105.

[0098] The body cavity 2105 is accessible through one or more pre-existing openings 2130 positioned in the top cover 2115. The pre-existing openings 2130 are configured to receive one or more laparoscopic devices (e.g., grasping forceps, dissectors) used by a user to practice a surgical technique (e.g., laparoscopic surgery) on tissue or a training phantom (e.g., a multi-skill training phantom) positioned within the body cavity 2105. Although the body cavity 2105 is shown accessible through the pre-existing openings 2130, other means of accessing the body cavity 2105 can be provided. For example, a hand-assisted access device or a single site port system for accessing the body cavity 2105 can be used with the surgical trainer 2100.

[0099] The surgical trainer 2100 includes a top cover 2115 connected to and spaced from a base 2120 by at least one leg 2125. In some embodiments, for example as shown in FIG. 21, the surgical trainer 2100 can have multiple legs 2125. As mentioned above, in embodiments, the surgical instrument 2100 is configured to simulate a laparoscopic condition. The top cover 2115 can be manufactured to represent the front of a patient, and the space between the top cover 2115 and the base 2120 generally represents the inside or cavity 2105 of the patient's body where organs are believed to reside. Thus, the surgical trainer 2100 is a useful tool for teaching, practicing, and demonstrating various surgical procedures and associated instruments in a simulation of a patient undergoing a surgical (e.g., laparoscopic) procedure.

[0100] In some embodiments, the base 2120 can include a model receiving area 2135 or tray. The model receiving area 2135 or tray is designed to support or hold simulated tissue models or live tissue as well as other practice models, such as the multi-skill training models described herein, on a platform. Extendible wires can be attached to the model and clips to help hold the model on the base 2120. The clips can then be attached to the base 2120 at different locations 2140 within the surgical trainer 2100. The extendible wires are stretched and clipped to hold the model in place substantially beneath the pre-existing openings 2130. Other means for holding a model (e.g., tissue model, live tissue, practice model) include a patch of hook-and-loop fastening material (VELCRO®) secured to the base 2120 within the model receiving area 2135 such that it is removably connectable to a complementary piece of hook-and-loop fastening material (VELCRO®) secured to the model.

[0101] In some embodiments, a video display monitor 2145 may be provided that is hinged to the top cover 2115. The video display monitor 2145 is shown in a closed orientation in FIG. 21. In contrast, an exemplary embodiment of the video display monitor 2145 in an open orientation can be seen in FIG. 22. The video monitor 2145 may be connected to various vision systems for delivering images thereto. For example, a laparoscope inserted through one of the pre-existing openings 2130 or a webcam positioned within the body cavity 2105 (used to observe the procedure simulation) may be connected to the video monitor 2145 and / or a mobile computing device (not shown) for providing images to a user. Similarly, recording or delivery means may be provided and integrated with the surgical trainer 2100 to provide audio and visual capabilities. Means are also provided for connecting to a portable memory storage device such as a flash drive, a smart phone, a digital audio or video player, or other digital mobile device for recording the training procedure and / or for playing pre-recorded videos on the monitor for evaluation purposes. Connection means for providing audiovisual output on a screen larger than the video monitor 2145 are also possible and may be provided for the surgical trainer 2100 in various embodiments. In another embodiment, the top cover 2115 may not include a video monitor 2145, but instead contain features that allow for connection of the surgical trainer 2100 to a laptop computer, mobile digital device, or tablet on which the audiovisual output can be viewed. The connection features may be wired and / or wireless.

[0102] When assembled, the top cover 2115 is positioned directly above the base 2120, and the legs 2125 are positioned substantially circumferentially to interconnect the top cover 2115 and the base 2120. The top cover 2115 and the base 2120 are of substantially the same shape and size and have substantially the same peripheral contour. The lumen 2105 is partially or totally hidden from view. In some embodiments (shown in FIG. 21 ), the legs 2125 can include openings to allow ambient light to illuminate the lumen 2105 as brightly as possible. Additionally, the openings in the legs 2125 can advantageously allow the surgical trainer 2100 to be as lightweight as possible for portability reasons. In some embodiments, the top cover 2115 is detachable from the legs 2125, and the legs 2125 are further detachable from the base 2120 or foldable, such as by hinges. This allows the trainer 2100 in its disassembled state to have a low height allowing for easy portability.

[0103] In summary, the surgical trainer 2100 provides a simulated body cavity 2105 that is hidden from a user. The body cavity 2105 is configured to receive at least one surgical model (e.g., a multi-skill practice model) accessible through at least one opening 2130 in the top cover 2115. In this manner, a user can access the model contained within the surgical trainer 2100 in a manner that can be used to practice laparoscopic or endoscopic minimally invasive surgical techniques. Further detailed exemplary surgical trainers are also described in U.S. Patent Application No. 13 / 248,449, filed September 29, 2011, entitled "Portable Laparoscopic Trainer," and U.S. Patent Application No. 15 / 895,707, filed February 13, 2018, entitled "Laparoscopic Training System," the entire contents of both of which are incorporated herein by reference.

[0104] In accordance with various embodiments, the surgical training systems described herein include phantoms configured to facilitate the training and development of motor and cognitive skills believed to be useful in the practice of laparoscopic surgery. The present disclosure describes various embodiments, each of which includes variations on one or more of the body, posts, structures used to implement force sensing mechanisms, and / or bases that provide the phantom with different features with which a user can interact when using the phantom to perform laparoscopic training tasks.

[0105] According to various embodiments, the multi-skill training model includes one or more posts, a body, a force perception mechanism implementing structure, a base, or any combination thereof. In various embodiments, the one or more posts can be elongated tubes. In various embodiments, the one or more posts, the body, or any combination thereof can be made of an elastomeric material. In various embodiments, the one or more posts, the body, or any combination thereof can be made of silicone, and in various embodiments, the same material. In various embodiments, the one or more posts, the body, or any combination thereof can be stretchable, flexible, and / or bendable. In various embodiments, the one or more posts have a proximal portion fixed relative to the one or more bodies and / or bases and a distal portion bendable relative to the one or more bodies and / or bases. In various embodiments, the one or more posts have a proximal portion that extends away from the one or more bodies and / or bases and a distal portion that curves back toward the one or more bodies and / or bases. In various embodiments, the one or more posts are made of a material that is stiffer than the one or more bodies, has no bending properties, is less flexible than the one or more bodies, or any combination thereof. In various embodiments, the one or more posts or portions thereof can be curved, straight, spiraled, and / or follow a non-linear path.

[0106] The one or more bodies include one or more limbs in various embodiments. In various embodiments, the body includes a central portion from which the one or more limbs extend. In various embodiments, the one or more posts have a length greater than the one or more limbs of the body. In various embodiments, the one or more posts are extensible to a length greater than the one or more limbs of the body. In various embodiments, the one or more posts, limbs, and / or any combination thereof are bendable and / or movable to contact and / or interact with one another. In various embodiments, the one or more posts have a thickness or define a cross-section that is greater than a thickness or cross-section of the one or more bodies. In various embodiments, the one or more bodies and / or limbs are moveable and / or rotatable relative to the posts. In various embodiments, the one or more bodies are stackable and / or positionable on top of one another. In various embodiments, the one or more bodies are sized, shaped, and / or oriented differently from one another. In various embodiments, one or more limbs of one or more bodies are shorter than other limbs of other bodies.

[0107] In various embodiments, the force sensing mechanism includes one or more pegs. In various embodiments, the one or more pegs are cylindrical, and in various embodiments, have a hemispherical or chamfered top. In various embodiments, the one or more pegs are connected and / or connectable to one or more bases of the model and / or trainer. In various embodiments, the one or more pegs are elongated and have a length or height that is less than the one or more posts. In various embodiments, the one or more pegs have a thickness and / or height that is greater than the thickness or height of the one or more bodies.

[0108] In various embodiments, one or more bodies include one or more openings or apertures. In various embodiments, one or more openings are connected and / or connectable to one or more posts and / or pegs. In various embodiments, one or more openings in one or more central portions and / or in one or more limbs of one or more bodies are connected and / or connectable to one or more pegs and / or one or more posts. In various embodiments, one or more openings in one or more bodies have an interference fit with one or more posts and / or pegs. In various embodiments, one or more openings in one or more limbs can be aligned one above the other. In various embodiments, one or more limbs can be folded onto itself.

[0109] In various embodiments, one or more limbs include one or more protrusions and / or recesses. In various embodiments, one or more central portions of one or more bodies include one or more protrusions and / or recesses that are correspondingly connectable to one or more protrusions and / or recesses of one or more limbs. In various embodiments, one or more protrusions and / or recesses of one or more limbs are correspondingly connectable to one or more protrusions and / or recesses of the same limbs. In various embodiments, one or more limbs include one or more protrusions and / or recesses on their upper and / or lower surfaces. In various embodiments, one or more protrusions and / or recesses on the upper surface of one or more limbs are correspondingly connectable to one or more protrusions and / or recesses on the lower surface of another of the one or more limbs.

[0110] In various embodiments, the post extends and / or is extendable along an axis and one or more limbs of the one or more bodies extend along one or more axes transverse to the axis along which the post extends. In various embodiments, the post extends and / or is extendable along an axis perpendicular to the axis along which the one or more limbs extend. In various embodiments, the post extends and / or is extendable along an axis of symmetry and one or more limbs of the one or more bodies are symmetrically positioned about the axis of symmetry. In various embodiments, the base extends along a plane parallel to the plane along which the one or more limbs extend.

[0111] In various embodiments, one or more posts have one or more slots or protrusions positioned along their length. In various embodiments, one or more openings in one or more limbs can be threaded or pulled over one or more slots or protrusions in one or more posts. In various embodiments, one or more openings in one or more limbs are removably connectable to one or more slots or protrusions in one or more posts. In various embodiments, one or more slots or protrusions positioned along one or more posts have different shapes, sizes, orientations, or any combination thereof relative to one another. In various embodiments, one or more openings in one or more bodies have different shapes, sizes, orientations, or any combination thereof relative to one another. In various embodiments, one or more openings in one or more bodies are shaped, sized, and / or oriented to correspondably fit one or more slots or protrusions in one or more posts.

[0112] In various embodiments, the base is made of a material that is more rigid than the one or more posts, the body, or any combination thereof. In various embodiments, the one or more bases are made of plastic and / or made of the same material as the one or more pegs. In various embodiments, the one or more bases are sized and / or shaped to fit within a surgical trainer. In various embodiments, the multi-skill training model is sized and / or shaped to fit within a surgical trainer. In various embodiments, the one or more bases and / or body are positioned to prevent or reduce adhesion or tackiness and / or facilitate movement of portions of the one or more bodies away from the bases and / or each other. In various embodiments, an anti-adhesion coating or layer is attached to or incorporated within the one or more bases and / or body. In various embodiments, an anti-adhesion layer is provided separately and positioned between the base and the body.

[0113] In various embodiments, the model includes a body, a post, a number of pegs used to implement the force perception mechanism, and a base. In some embodiments, one or both of the body and / or base can be planar. The body can be configured to be flexible and made of an elastic material. Additionally, the body includes a number of limbs extending from its center, each having at least one opening at a distal end. In other embodiments, additional openings along the length of the limbs are also provided. The openings associated with the limbs and / or located at the center of the body are configured to interface with the number of pegs and / or the post. Thus, these openings facilitate the establishment of a detachable connection between the body and the base by the pegs. The post is positioned at a central (e.g., axisymmetric) location of the body. The post can be rigid or flexible. In some embodiments, the flexible post can be stretchable. Additionally, the flexible post can be biased toward a predetermined location. The post may include features such as obstacles or protrusions that guide the user to orient the opening at the distal end of the limb to pass and manipulate the structure down its length. The pegs connected to the base interface with the body through a number of openings near the center of the body and are configured to have a predetermined force threshold. When the user exerts a force on the model (through the body and / or the post) and the applied force exceeds the predetermined force threshold, the body around one or more of the pegs may be detached. The base may attach the model to a surgical trainer whereby the body rests on top of the base and is removably connected through the pegs. However, in some embodiments, the base may be removable from the model.

[0114] In various embodiments of the model, the extensible body includes an opening at the center configured to receive the post. The extensible body further includes a plurality of limbs extending away from the post. Each of the limbs includes two openings, one opening located at the distal end of the limb and the other opening located at the proximal end of the limb. Each of these two openings associated with the limb is configured to interface with a peg. In other embodiments, the limbs can include more than two openings, each configured to receive an additional peg. The post of this embodiment of the model can be flexible or rigid. The body can rest on a base. The base can be connected to each of the pegs. In another embodiment, the base can be omitted.

[0115] In various embodiments of the model, the extensible body includes an opening at its center configured to interface with a rigid post. The extensible body further includes a plurality of limbs extending away from the post. Each of the limbs includes a plurality of openings positioned at a distal end thereof, a first group of openings configured to interface with a peg and a second group of openings configured to interface with the rigid post, the first group of openings being a different size than the second group of openings. In some embodiments, the openings are the same size, thereby allowing each opening to interface with both the peg and the rigid post.

[0116] In various embodiments of the model, the extensible body includes an opening in the center that is configured to interface with the rigid post. The extensible body further includes a plurality of limbs that extend away from the post. Each of the limbs includes a plurality of openings along the length of the limb from a proximal end close to the post to a distal end away from the post. In some embodiments, the openings along the limb are evenly spaced from each other and are configured to allow the user to bend / fold the body so that the openings can be placed one above the other to form interlocking openings. In some embodiments, the limb can include a second group of openings located at its distal end and functioning to interface with a peg. The size of the second group of openings is different from the size of the opening along the length of the limb and configured to interface with the post. In another embodiment, the limb can further include a tab or extension of the body located perpendicular to the length of the limb at the distal end of the structure. The tab further includes an opening configured to overlap with another opening associated with the length of the limb before interfacing with the post.

[0117] In various embodiments, the model includes multiple layers of bodies, each body including multiple limbs. In some embodiments, the various bodies are color coded. Each limb of the same body has an opening of a predetermined shape, and the limbs of the various bodies have different predetermined shapes from each other. At the center of the body is a rigid post with multiple steps. At each different step, the cross section of the post has the same shape as one of the predetermined shapes associated with the openings of the limbs of the body. In some embodiments, the order of the bodies layered down the post (top to bottom) corresponds to the reverse order of the steps associated with the post (bottom to top).

[0118] In various embodiments, the phantom includes a plurality of bodies layered beneath and connected to a post. The plurality of bodies include limbs extending from and rotatable about the post. An opening exists at a distal end of each limb, each of the openings sharing the same shape. The post includes a plurality of protrusions at predetermined locations along its length. At each of the predetermined locations along the length of the post, the post and protrusions form a cross-section similar to the shape of the opening associated with the limb. However, each of the protrusions along the length of the post have a different orientation from one another, such that a user is guided to rotate the limb such that the opening at the distal end of the limb aligns with the protrusion on the post as the limb is pulled down the length of the post.

[0119] In various embodiments, the phantom includes a body and a nonlinear post. The body includes a plurality of limbs extending from the nonlinear post, each having an opening at a distal end. The post, having a nonlinear shape, includes a combination of vertical, horizontal and curved subsections. The nonlinear shape of the post guides the user to orient the opening at the distal end of the limb so that the limb can progress along the length of the post.

[0120] In various embodiments, the phantom includes multiple bodies layered beneath a nonlinear post. The multiple bodies include separate limbs extending from and rotatable about the nonlinear post. Additionally, each of the structures has an opening at a distal end of the limb configured to interface with the nonlinear post. The nonlinear post has a helical shape that guides a user to orient the opening at the distal end of the limb around the nonlinear post and rotate the limb to manipulate the limb along its length.

[0121] In various embodiments, the model includes a flexible body. The flexible body includes a plurality of limbs extending away from the center of the model. At the center of the model is a snap mechanism counterpart configured to snap with one or more of the snap mechanisms found at the end of each of the limbs of the body. In some embodiments, each of the limbs can have a plurality of snap mechanisms, each having a different shape. The snap mechanism counterpart located at the center of the model is configured to have a shape that matches one of the shapes of the snap mechanisms at the distal ends of the limbs. In some embodiments, each of the limbs can have a snap mechanism counterpart with a geometric shape on an opposite (e.g., bottom) surface of the snap mechanism located on the top surface of the body. The snap mechanism counterpart on the opposite surface of one limb is configured to snap with a matching snap mechanism on the top surface of the body of a different limb that shares the same shape.

[0122] In various embodiments, the model includes a flexible body. The flexible body includes a plurality of limbs extending away from the center of the model. At the end of each one of the limbs is an opening having a geometric non-circular shape. At the center of the model is a post. The post is rotatable while the body is stationary. In some embodiments, the post can be stationary and the body is rotatable about the post. The post has a plurality of sections, each having the same cross-sectional shape as the opening in the limb. However, each adjacent section on the post is at a different orientation. Thus, the post guides the user to rotate the post while one of the limbs is manipulated down the post to pass each section of the post through the opening.

[0123] In various embodiments, a surgical trainer can be provided that is configured to simulate a patient's torso or abdominal region during laparoscopic surgery. The surgical trainer includes a top, a bottom, and a number of legs that form an enclosure or body cavity. A user's direct view of any model housed within the surgical trainer is obstructed, thereby requiring the user to rely on indirect images, for example, acquired by a camera within the surgical trainer and displayed on a display screen outside the surgical trainer. The surgical trainer is configured to house one or more different models (as described above) within the body cavity. The surgical trainer is configured to allow for entry of one or more laparoscopic devices into a predetermined location within the surgical trainer, for example, through a top cover or through an opening positioned within the top cover.

[0124] Although the present invention has been described in certain specific embodiments, many additional modifications and variations will be apparent to those skilled in the art. It is therefore to be understood that the present invention can be implemented using other ways than those specifically described, including various changes in size, shape, and material, without departing from the scope and spirit of the present invention. For example, those skilled in the art should be able to use these examples to derive various different implementations that retain the main functions of the surgical training system described throughout this disclosure. Some of these embodiments utilize descriptions that are specific to structural and / or method-related steps, but it is to be understood that such subject matter is not necessarily limited to those specifics (e.g., the functionality of a feature may be distributed differently across more than one component or may be implemented using a combination of components different from those explicitly shown above). The present embodiments should therefore be considered in all respects as illustrative and not restrictive.

[0125] The above description is also provided to enable any person skilled in the art to make and use the above-mentioned devices or systems and to practice the methods described herein, and to clarify the best mode of practicing the invention contemplated by the inventor. However, various modifications may still be apparent to those skilled in the art. These modifications are considered to be within the disclosure of the present invention. Different embodiments or aspects of such embodiments may be shown in various figures and described throughout the specification. However, it should be noted that although each embodiment and aspect thereof is shown or described separately, these embodiments and aspects may be combined with one or more of the other embodiments and aspects thereof, unless expressly stated otherwise. Not specifying each combination is merely intended to facilitate the reading of the specification. [Explanation of symbols]

[0126] 100 Multi-skill exercise model 110 Main unit 115 First set of openings 120 Posts 130 Peg

Claims

1. A surgical training model, comprising: a body having one or more holes at predetermined locations; a post having a proximal end and a distal end, the proximal end being attached to the body and the post extending away from the body; Including, the body is configured to be manipulated to advance the distal end of the post through one of the one or more holes. model.

2. The surgical training model of claim 1 , wherein the post is rigid.

3. the post has a non-circular cross section; the one or more holes have a shape corresponding to the cross-section of the post; 3. A surgical training model according to claim 1.

4. 4. The surgical training model of claim 1, wherein the post is flexible and configured to be manipulated simultaneously with the body to advance the distal end of the post through one of the one or more holes.

5. the post further includes a protrusion near the proximal end; the body is configured to be manipulated down the length of the post past the projection; The surgical training model according to any one of claims 1 to 4.

6. The surgical training model according to claim 1 , wherein the main body includes a plurality of limbs.

7. the body is removably attached to a base at one or more predetermined locations; and wherein the detachment of the body from the base at the one or more predetermined locations notifies a user that a force greater than a predetermined amount was detected during the manipulation of the body and / or the post.

7. A surgical training model according to claim 1.

8. 8. The surgical training model of claim 7, wherein the body has holes configured to removably attach the base to the body at the one or more predetermined locations through pegs associated with the base.

9. The surgical training model of any one of claims 1 to 8, further comprising a surgical trainer configured to receive the surgical training model within its lumen.

10. A surgical training model, comprising: a body having two or more holes at predetermined locations; a post having a proximal end and a distal end, the proximal end being attached to the body and the post extending away from the body; Including, the body is configured to be manipulated such that positioning of the two or more holes forms a coupling opening and to advance the post through the coupling opening. model.

11. The body includes a plurality of limbs; each of the plurality of limbs having the two or more holes configured to form the connecting opening; A surgical training model according to claim 10.

12. 12. The surgical training model of claim 11, wherein the two or more holes on each of the plurality of limbs are positioned along a length of each limb.

13. 12. The surgical training model of claim 11, wherein the two or more holes on each of the plurality of limbs are located at a distal end of the limb.

14. A surgical training model, comprising: a plurality of limbs having a proximal end and a distal end, each of the plurality of limbs being layered on top of one another at their proximal ends, each of the plurality of limbs having one or more holes; a post having a proximal end and a distal end, the proximal end being attached to the proximal ends of the plurality of limbs, the post extending away from the plurality of limbs; Including, each of the plurality of limbs is configured to be manipulated to advance the distal end of the post through its respective aperture; model.

15. 15. The surgical training model of claim 14, wherein each of the one or more holes in the plurality of limbs has a predetermined shape and size.

16. 16. The surgical training model of any one of claims 1 to 15, wherein the diameter of the post decreases from its proximal end to its distal end.

17. 17. The surgical training model of any one of claims 1 to 16, wherein the post includes a predetermined number of subsections, each subsection having a different cross-sectional shape and size.

18. 20. The surgical training model of claim 17, wherein at least one of the one or more holes of the plurality of limbs corresponds to the cross-sectional shape and size of one of the subsections of the post.

19. 19. The surgical training model of any one of claims 1 to 18, wherein the post has a plurality of protrusions having different cross-sectional shapes along the length of the post.

20. the one or more holes have a predetermined shape and a predetermined size corresponding to the cross-sectional shape defined by the plurality of projections on the post; the plurality of limbs are rotatable relative to the post to align the one or more holes with the cross-sectional shape defined by the plurality of protrusions as the limbs are manipulated along the length of the post.

20. A surgical training model according to claim 19.

21. 21. The surgical training model of any one of claims 1 to 20, wherein the post has a non-linear profile along the length of the post.

22. 22. The surgical training model of any one of claims 1 to 21, wherein the post has a wavy profile.

23. 23. The surgical training model of any one of claims 1 to 22, wherein the post has a helical profile.

24. 24. The surgical training model of claim 1, wherein the limbs are rotatable with the post or a proximal end of each of the limbs on a central axis.

25. A surgical training model, comprising: Main unit, Including, the body having at least one connector at a first predetermined location and a corresponding connector at a second predetermined location; The body is configured to be manipulated so that the two connectors are connected to one another. model.

26. 26. The surgical training model of claim 25, wherein the two connectors include a snap mechanism.

27. one of the two connectors includes a structure having a predetermined shape; the other connector has an opening corresponding to said predetermined shape; 26. A surgical training model according to claim 25.

28. A surgical training model, comprising: a body having a plurality of limbs, each limb having a proximal end and a distal end extending away from a center of the body; Including, each of the plurality of limbs having a connector at the distal end; The center of the body has another connector; the body is configured to be manipulated such that one of the connectors at the distal ends of the plurality of limbs is connected to the connector at the center of the body. model.

29. each of the connectors at the distal end of each of the plurality of limbs has a different shape; the connector at the center of the body has a shape corresponding to one of the connectors at the distal ends of the plurality of limbs; the body is configured to be manipulated such that the limbs having the shape that matches the connector at the center of the body are connected to one another; 29. A surgical training model according to claim 28.

30. each of the plurality of limbs further includes a connector on an opposing side of the body having a different shape than the connector on the body; the body is configured to be manipulated such that after one of the limbs is connected to the connector at the center of the body, a next limb having a matching shape is configured to be connected to the opposite connector, now visible at the center of the body.

30. A surgical training model according to claim 29.

31. A method of training using the model of claim 1 or claim 14, comprising the steps of: manipulating a portion of the body using a first surgical instrument; manipulating a portion of the post using a second surgical instrument; manipulating one of the one or more holes associated with the body toward the distal end of the post; advancing the distal end of the post through the one hole; The method includes:

32. 32. The method of claim 31, further comprising manipulating the portion of the body down a length of the post, wherein a protrusion is positioned near the proximal end of the post.

33. 33. The method of claim 31 or claim 32, further comprising manipulating the portion of the body down a length of the post having a non-linear profile.

34. 34. The method of claim 32 or claim 33, wherein the manipulating the portion of the body comprises rotating at least a portion of the body or limb relative to the post.

35. providing a surgical model having a body with one or more holes and a post, the post having a proximal end and a distal end, the post being attached to the body at the proximal end and the distal end extending away from the body; manipulating a portion of the body using a first surgical instrument; manipulating a portion of the post using a second surgical instrument; manipulating a portion of the body having the one or more holes toward the distal end of the post; advancing the distal end of the post through one of the one or more holes in the body; How to train including:

36. 36. The method of claim 35, further comprising manipulating the body from the distal end of the post down to the proximal end of the post.

37. 37. The method of claim 36, wherein the maneuvering of the body down the post comprises maneuvering the body past a protrusion positioned near the proximal end of the post.

38. 38. The method of claim 36 or claim 37, wherein the manipulating the body down the post comprises redirecting the body to accommodate a non-linear profile of the post.

39. rotating the body about the post to maneuver the body down the post having a different cross-sectional shape; a shape of the one or more holes in the body corresponding to the cross-sectional shape and the orientation of the cross-sectional shape associated with the post; 39. The method of claims 36 to 38.

40. providing a surgical model having a body with two or more connectors; manipulating a portion of the body associated with a connector using a first surgical instrument; using a second surgical instrument to manipulate different portions of the body associated with different connectors; manipulating the two connectors together such that they are connected to each other; How to train including:

Images