Suturing technique surgical training model

Abstract

To provide a surgical training model for training surgical suturing techniques.SOLUTION: The training model can be formed as a sheet of simulated tissue having at least one cut with markings arranged on either side of the cut. The markings can be formed of a first layer of resilient simulated tissue material having a color that contrasts with a color of the remainder of the sheet of simulated tissue material. The sheet of simulated tissue material can have several cuts having different configurations and orientations to facilitate suturing training for a variety of tissue orientations. The sheet of simulated tissue material can further include holes positioned to be mounted on a base of a surgical training system. The sheet of simulated tissue material can be manufactured by casting a marking layer and casting a tissue layer over the marking layer.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to and the benefit of U.S. Provisional Patent Application No. 62 / 586,369, entitled "Suturing Skills Surgical Training Model," filed November 15, 2017, which is incorporated by reference in its entirety.

[0002] This application relates generally to surgical training tools and, specifically, but not exclusively, to simulated tissue structures and models for teaching and practicing various surgical operations and procedures associated with laparoscopic, endoscopic and minimally invasive surgery. [Background technology]

[0003] Medical students and experienced physicians learning new surgical procedures must undergo extensive training before they are qualified to operate on human patients. This training involves learning the correct techniques to cut, penetrate, clamp, grasp, staple, cauterize, and suture a variety of tissue types using a variety of medical devices. The range of possibilities that trainees may encounter is wide. For example, organs and patient anatomies and diseases are presented differently. The thickness and consistency of various tissue layers also vary from body part to body and from patient to patient. Different procedures require different skills. Furthermore, trainees must hone their skills in a variety of anatomical environments influenced by factors such as the size and condition of the patient, the type of target tissue and the adjacent anatomical landscape, and whether these tissues are easily accessible or relatively difficult to access.

[0004] Minimally invasive surgery requires the acquisition of skills of a different nature than open surgery. Some skills are transferable (bimanual dexterity, steadiness, etc.) while others must be acquired through deliberate practice and training. These include basic psychomotor skills such as tissue handling, needle manipulation, and suture tying. These psychomotor skills are necessary for surgeons to transition to minimally invasive practice. It is essential that surgical trainees demonstrate proficiency in these psychomotor skills before applying them to practice in the operating room. For this reason, surgical simulation trainers and models provide a valuable, safe, and effective means for the development and fine-tuning of minimally invasive surgical techniques.

[0005] Numerous training aids, trainers, simulators and model organs are available for one or more aspects of surgical training. However, there is a need for model organs or simulated tissue elements that are likely to be encountered that can be used to practice endoscopic, laparoscopic, minimally invasive and transluminal surgery. In laparoscopic or minimally invasive surgery, a small incision as short as 5-10 mm is made through which a trocar or cannula is inserted to access the body cavity and form a channel for the insertion of a camera such as a laparoscope. The camera provides a live-streaming video of the captured images that are displayed to the surgeon on one or more monitors. At least one additional small incision is made through which another trocar / cannula is inserted to form a pathway through which surgical instruments can be passed to perform the procedure that is observed on the monitor. Typically, the target tissue site, such as the abdomen, is insufflated by delivering carbon dioxide gas to expand the body cavity and create a working space large enough to safely accommodate the surgeon's scope and instruments. Insufflation pressure within the tissue cavity is maintained by using special trocars. Laparoscopic surgery has many advantages over open surgery, including smaller incisions resulting in less pain, less bleeding, and a shorter recovery time.

[0006] Laparoscopic or endoscopic minimally invasive surgery requires a higher skill level compared to open surgery because the clinician does not directly view the target tissue. The target tissue is viewed on a monitor that displays a portion of the surgical site accessed through a small opening. Thus, the clinician must practice visual judgment of tissue planes in a two-dimensional viewing plane, three-dimensional depth perception, manual instrument movement, suturing, precise cutting, and manipulation of tissue and instruments. Typically, a model simulating a particular anatomy or procedure is placed in a simulated pelvis trainer that hides the anatomical model from direct visualization by the practitioner. The simulated pelvis trainer provides a functional, inexpensive, and practical means to train surgeons and trainees in basic and representative skills used in laparoscopic surgery, such as grasping, manipulating, cutting, tying, suturing, stapling, cauterizing, and how to perform specialized surgical procedures that utilize these basic skills. The simulated pelvis trainer is also an effective sales tool to demonstrate the medical equipment required to perform these laparoscopic procedures.

[0007] One of the skills that requires practice as mentioned above in laparoscopic or minimally invasive surgery is cutting and suturing. Intracorporeal suturing and tying requires high precision and strong manual dexterity. Such skills must be mastered by all surgeons interested in pursuing minimally invasive techniques. To date, it has been found that suturing skills acquired via the box trainer suturing model transfer to the operating room. [Prior art documents] [Patent documents]

[0008] [Patent Document 1] US Patent Application Publication No. 14 / 037,005 [Patent Document 2] U.S. Pat. No. 8,764,452 Summary of the Invention [Problem to be solved by the invention]

[0009] The main challenges that a learner faces during laparoscopic suturing include psychomotor control, visuospatial orientation, thread tying, tissue processing, needle manipulation, needle positioning, needle insertion, and suture strength and safety assessment. In light of these challenges, there is a need for a cutting and suturing practice model. It is also desirable to have a model that not only simulates certain anatomical structures, but also presents the anatomical structures at certain surgical steps or phases, or isolates certain surgical steps so that a trainee can practice in a simulated laparoscopic environment. This model is then placed in a simulated laparoscopic environment, such as a laparoscopic trainer, which at least partially hides the model from direct visualization. As in a real surgery, cameras and monitors provide visualization to the practitioner. After practicing the technique, it is further desirable that such a model allows for easy, fast, and low-cost repetitive practice. In view of the above, it is an object of the present invention to provide a surgical training device that realistically simulates anatomical structures, isolates such anatomical structures, and presents such anatomical structures at certain surgical steps or phases to also allow repetitive practice. The use of simulation trainers has been proven to greatly increase the skill level of new laparoscopists and is an ideal tool for training future surgeons in non-surgical settings. There is a need for such improved realistic and effective surgical training models. Laparoscopic suturing is a method of sealing lacerations, incisions or cuts made in tissues and organs within the abdominal cavity. Suturing can be performed on a variety of anatomical structures depending on the surgical procedure being performed. Laparoscopy, and particularly laparoscopic suturing, is a surgical skill for which a model is needed that allows the skill to be learned and practiced. This training needs to be performed on a physical model that allows the surgeon or surgical resident to get tactile feedback of the tissue reaction. This tactile feedback is important for the trainee to learn the appropriate force level to apply to the tissue while suturing. [Means for solving the problem]

[0010] In some embodiments, a surgical training model for training suturing techniques is provided. The model includes a sheet of simulated tissue material defining a suture pad. The sheet includes a first layer of simulated tissue material, a second layer of simulated tissue material, and at least one cut. The first layer of simulated tissue material is defined by a plurality of markings. The second layer of simulated tissue material hardens relative to the first layer of simulated tissue material. The at least one cut is formed in the sheet of simulated tissue material. The markings of the first layer are disposed on either side of the at least one cut.

[0011] In some embodiments, a surgical training model for training suturing techniques is provided. The surgical training model includes a sheet of simulated tissue material defining a suture pad. The sheet has an upper surface and a lower surface defining a thickness therebetween. The sheet includes a first cut, a first plurality of markings, a second cut, a second plurality of markings, a third cut, and a third plurality of markings. The first cut penetrates the sheet of simulated tissue material from the upper surface to the lower surface. The first plurality of markings are disposed on opposite sides of the first cut. The second cut penetrates the sheet of simulated tissue material from the upper surface to the lower surface. The second plurality of markings are disposed on opposite sides of the second cut. The third cut penetrates the sheet of simulated tissue material from the upper surface to the lower surface. The third plurality of markings are disposed on opposite sides of the third cut.

[0012] In some embodiments, a method for manufacturing a surgical training model for training suturing techniques is provided. The method includes the steps of preparing a mold, preparing a marking mold, applying wet silicone to the marking mold, positioning the marking mold, and casting the wet silicone. The mold includes a well sized and shaped to correspond to the surgical training model. The marking mold is sized to fit within the well of the mold. A plurality of holes are formed within the marking mold. During application of the wet silicone to the marking mold, the wet silicone fills the holes of the marking mold. During positioning of the marking mold, the marking mold is positioned within the well of the mold. During casting of the wet silicone, the wet silicone is cast over the marking mold positioned within the mold. [Brief description of the drawings]

[0013] [Figure 1] FIG. 13 is a top partial perspective view of an embodiment of a suture pad attached to a post of a base. [Diagram 2] FIG. 2 is a top view of the suture pad of FIG. 1. [Diagram 3] FIG. 1 is a top perspective view of a suture pad mold. [Figure 4] FIG. 2 is a top perspective view of a marking die. [Diagram 5] FIG. 4 is a top perspective view of a marking die within a well of the die of FIG. 3. [Figure 6] FIG. 1 is a top perspective view of a suture pad including sutures. [Figure 7] FIG. 1 is a top perspective view of a suture pad including sutures. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0014] FIG. 2 illustrates an embodiment of a suture pad 10. In the illustrated embodiment, the suture pad 10 is a sheet of tissue simulating material having an upper surface 12 and a lower surface 14 that define a thickness therebetween. This thickness is substantially uniform throughout the pad and is approximately 5 millimeters. The thickness and characteristics of the pad 10 are ideally designed to simulate tissue re-approximation by skilled laparoscopic suturing. The suture pad 10 has a perimeter 18 that in one variation defines a rectangle as shown in FIG. 2. The shape of the perimeter can be any suitable shape. The suture pad 10 is formed of silicone, low durometer silicone, or other suitable polymeric material such as KRATON® or a thermoplastic elastomer. The low durometer allows the suture pad 10 to have tactile feedback that simulates soft tissue. The material is selected to simulate the elasticity, needle resistance, and handling characteristics of living tissue that may be encountered in the operating room. The material can also be other rubber-like materials or thermoset plastic materials having a soft durometer.

[0015] In one variation, the suture pad 10 includes a layer of fabric or mesh embedded within the thickness of the pad. The fabric or mesh is preferably a two-way or four-way stretch material such as stretch nylon, spandex, or a stretch nylon / spandex blend mesh or fabric. The fabric or mesh material is elastic, porous, and weighs approximately 79 grams per square yard. The suture pad 10 may also include reinforcements, fibers, dyes, and surface texturing in addition to or in place of the mesh or fabric material. The upper and lower surfaces 12, 14 of FIG. 2 are smooth and do not include surface texturing. The suture pad 10 is flexible and stretchable. The mesh, fabric, fiber, or other filler material provides reinforcement to the silicone so that the sheet can hold sutures or stretch without tearing during manipulation or connection to a base. To train the user in tissue techniques, the mesh, fabric, fiber, or other filler material may be omitted to create a pad that is less elastic, more easily damaged, and more likely to tear during manipulation, thereby increasing the difficulty of the exercise.

[0016] The suture pad 10 includes at least one cut 20. The cut 20 is a simulated tear formed in the suture pad 10. In FIG. 2, three cuts 20a, 20b, 20c are shown in the suture pad 10. Typically, the cut 20 extends across the thickness of the pad 10 from the upper surface 12 to the lower surface 14. One or more cuts may employ partial cuts 20 that do not extend the entire thickness. The cut 20 may be of any shape. For example, the cut 20 may be a straight line or a curve. The curve may be a closed or open curve, and multiple cuts 20 may be employed in combination to define sutures of varying difficulty or different practice orientations. The cuts are strategically placed in different orientations to allow the learner to match their skillset to the various tissue orientations encountered in the operating room. The suture pad 10 of FIG. 2 includes two straight cuts 20a, 20b and one curved cut 20c oriented relative to one another to provide a variety of practice orientations. Although the two straight cuts 20a, 20b are shown perpendicular to one another, the invention is not so limited. The two cuts 20 can be at any angle relative to one another, can mimic actual suture lines associated with a particular organ or encountered in an actual surgery, or can be designed to teach a particular skill, train hand dominance, practice different suture run styles, etc. Each cut 20 includes two oppositely disposed inner surfaces that are substantially perpendicular to the upper and lower surfaces 12, 14 and face one another.

[0017] The two inner surfaces of the cutting portion 20 are closely juxtaposed when joined, and therefore it may be difficult for a user to distinguish between the cutting portions. The suture pad 10 stretches when attached to a base, which may open the cutting portion 20 and define a large space between the inner surfaces that requires a large force to join the inner surfaces when suturing. In the variation shown in FIG. 2, the first cutting portion 20a is approximately 4.0 centimeters in length, the second cutting portion 20b is approximately 3.5 centimeters in length, and the third cutting portion 20c is approximately 4.0 centimeters in length. FIG. 2 is not drawn to scale. The cutting portions 20 are preformed, and in one variation, the cutting portions 20 are not preformed so that the user can make the incision as part of a skills training exercise. The suture pad 10 may further include small preformed apertures 22 near the periphery that are sized and configured to mount the pad 10 on a base. The variation of FIG. 2 includes four apertures 22 at each corner of the rectangular pad.

[0018] The suture pad 10 further includes a plurality of markings 24 disposed on either side of the cut 20. The markings 24 are disposed in a first row 26 on one side along the length of the cut 20 and a second row 28 on the opposite side along the length of the cut 20. The first row 26 of the markings 24 is directly opposite the second row 28 of the markings 24. The markings 24 in each row are equally spaced apart from one another. Specifically, the markings 24 are spaced apart from one another by approximately 5 millimeters. The center-to-center distance between each marking in the same row is approximately 5 millimeters. The distance across the tear between the two rows 26, 28 is approximately 10 millimeters. Each row is approximately 5 millimeters away from the tear. As can be seen in FIG. 2, for a cut 20 having a curved shape, the markings 24 on the inside of the curve will necessarily be closer together than the markings 24 on the outside of the curve. The number of markings 24 along the tear may vary and depends on the length of the cut 20. For example, a cut 20 having a length of about 4 millimeters will have 10 markings in each row for 9 suture passes (10 including the knot), resulting in a total of 20 markings 24. A cut 20 having a length of about 3.5 millimeters will have 9 markings in each row for 8 suture passes (9 including the knot), resulting in a total of 18 markings 24. The knot and the last suture passed, including the marking 24 at the end of the cut 20, will extend slightly beyond the length of the laceration. The marking dots serve as a precise target for the end user to insert the needle. The distance between each pair of markings provides a standard distance at which the suture passes should be made and a standard distance between the suture bites that will close the incision.

[0019] In one variation, the markings 24 are small circular dots having a diameter of about 1 / 16 inch. The markings 24 are not limited to having a circular shape. For example, the markings 24 can be an X, a solid circle, an open circle, a square, a star, or any other shape that conveys with a fair degree of accuracy the target for the length and size of the cut. The markings 24 are dark or any suitable color that provides a visual contrast to the color of the pad 10 to the user. The markings have a color that provides high color contrast with the silicone portion of the suture pad 10 that contains the preformed incision. The color contrast between each portion of the suture pad 10 is a black dot paired against a light flesh-colored rectangular footprint.

[0020] The markings 24 may be applied to the pad 10 in any number of suitable ways. For example, the markings 24 may be inked, stamped, printed, and the like. The markings 24 may be visibly applied to the top surface 12 or just beneath the top surface. For example, the markings may be printed onto an embedded fabric layer or an intermediate silicone layer prior to molding the final silicone layer, and be visible through the transparent or translucent silicone in which they are embedded. Alternative methods of applying the markings 24 are described below.

[0021] FIG. 3 shows a mold 30. The mold 30 includes wells 32 sized and shaped to correspond to the desired size and shape of the suture pad 10. A marking mold 34, shown in FIG. 4, is prepared. The marking mold 34 includes a number of holes 36 formed therein. The holes 36 are sized and shaped to correspond to the desired size and shape of the markings 24 to be formed on the pad 10. As shown in FIG. 5, the marking mold 34 is sized to fit inside the wells 32 of the mold 30. FIG. 5 shows the marking mold 34 positioned inside the wells 32 of the mold 30. The method of making the suture pad 10 including the markings 24 involves applying wet silicone having a dark / contrasting color to the color of the pad 10 to the marking mold 34 such that the wet silicone fills each of the holes 36. The excess wet silicone is wiped off and the silicone inside the holes 36 is allowed to cure. Next, the marking mold 34 with the cured silicone inside the hole 36 is placed / nested in the well 32 of the mold 30, and then the flesh-toned wet silicone for the pad is poured into the well 32 and cured in addition to and / or over the marking mold with the cured black silicone. The uncured silicone of the pad 10 adheres to the cured silicone inside the hole 36 as it cures. In one variation, the flesh-toned layer is not filled to the top of the mold so that the mesh layer or markings can be added after the first flesh-toned silicone layer has cured. After the mesh / fabric / reinforcement and / or marking layers are added, more flesh-toned silicone is added to form a second flesh-toned silicone layer to complete the thickness of the suture pad. The flesh-toned layers adhere to each other due to the adhesive properties of the silicone, thus encapsulating the mesh layer between them. The mesh layer acts as a reinforcement to hold the various sutures under various forces. The second silicone layer can be transparent and / or translucent so that any markings can be seen through it. After the silicone has cured, the pad with the markings 24 attached is removed from the mold 30. A marking mold is not used if the markings are embedded in the layer, printed onto the fabric layer, or printed onto the first silicone layer.The flesh-colored silicone layer can adhere to the black dots due to the adhesive properties of the silicone. An additional silicone adhesive can be used on top of each pair of black dots to further reinforce the adhesion between the dots and the flesh-colored layer. The resulting markings 24 are raised relative to the top surface 12. Once all of the silicone layers have cured, the suture pad 10 is placed in the center of the cutting die to cut an incision in the center of each pair of dots. The length of the incision can vary. In one variation, these lengths are at least 4.0 cm and 3.5 cm to capture the multiple suture threads, 9 and 8, respectively. Additional suture threads can be threaded along each length to accommodate knots.

[0022] The markings 24 serve as targets for threading the suture and are intended to guide the learner towards an ideal needle insertion point around the laceration. The user practices suturing the laceration by threading the needle and suture through the center of the markings 24. An assessment of the user's skill is easily made by observing whether the needle and suture pass through the center of the markings. Thus, the suture pad 10 provides a tool for the user to learn, practice and improve their suturing technique. The markings 10 also serve as a means to easily assess the user's skill. The placement of the markings allows for a reflective assessment of suturing performance based on target accuracy. An exemplary suture 42 placement is shown in FIG. 6. FIG. 7 shows the suture pad after completion of the suturing practice. As can be seen in FIG. 7, some sutures hit the target markings 24 and others did not. Some suture practice exercises use a typical 2-O coated vicryl (polyglactin) dyed suture approximately 70 cm long, which can be cut to four times the length of the laceration for optimal operation with the suture pad 10. Other exercises can utilize various suture types and lengths and needles with the suture pads described herein. The user can employ a simple continuous suture thread to perform sutures in all three lacerations / orientations.

[0023] The flesh-tone portion of the suture pad 10 can be textured. The textured surface allows for easy gripping and manipulation of the suture pad 10. To further simulate training on fragile tissue, the mesh layer can be removed. The durometer used for the flesh-tone portion of the suture pad 10 can be made of a mixture of at least two different silicone durometers, low and high, to obtain a realistic tactile feedback response similar to that of intraperitoneal tissue. The rectangular footprint of the suture pad 10 can also be reshaped into various sizes or shapes when training a specific procedure involving suturing. The incision 20 can include angled and straight incisions. The suture pad can include any number of incisions. The length of the incision can also be less than 4.0 cm or 3.5 cm. The color of the suture pad 10 is not limited to flesh-tone and black. However, the colors of the target 24 and the underlying silicone layer should provide contrast to each other so that the end user can distinguish each feature.

[0024] In another variation, the markings 24 are embedded into the suture pad 10 rather than spreading outward above the upper surface 12. In another variation, the markings 24 are stamped with a different ink, such as a marker, or a silicone pigment or silicone ink. In one variation, the markings 24 are holes in the suture pad 10 having any suitable target shape. The pairs or rows of markings 24 can also be a combination of differently shaped markings to make training more challenging, for example by requiring the user to thread a suture only through pairs of corresponding geometric shapes. In another variation designed to provide suture width specific training, the dots can be represented as rectangular features on either side of the incision. Also, continuous sutures can be placed into the spaces between each dot pair to increase the number of uses of the suture pad 10.

[0025] As shown in FIG. 1, the suture pad 10 of the present invention is typically attached to a base 38. The base 38 is a platform that serves as a bottom support for the suture pad 10 and is sized and configured to prevent the base 38 and pad 10 from tipping over. The platform is formed of any material, such as metal or plastic. The base 38 is heavy enough to maintain its stability during manipulation by a user. The base 38 includes posts 40. Generally, four posts 40 are connected to the base 38. Each post 38 is elongated and cylindrical in shape and has a proximal end connected to the base 38 and a distal end extending upwardly from the base 38. In one variation, the distal end includes a tapered portion that terminates in a tip surface that is not sharp to avoid injuring a user, but is sharp enough to penetrate a hole in the suture pad 10 for attachment to the base 38. Each post 40 includes at least one circumferential notch extending radially inwardly and configured to receive the thickness of the pad 10 therein to prevent the pad 10 from sliding up and down the post 40. An exemplary base is described in U.S. Patent Application Publication No. 14 / 037,005, filed Sep. 25, 2013, entitled "Surgical training model for laparoscopic procedures," which is incorporated herein by reference in its entirety.

[0026] The suture pad 10 is connected to the posts 34 and is essentially suspended a fixed distance from the base. As shown in FIG. 1, the suture pad 10 is mounted between and connected to the posts 40 in a slightly stretched tension state. The tension of the suture pad 10 can be adjusted by angling the posts 40 or by stretching and perforating close locations along the simulated tissue portion of the suture pad 10. Placing the suture pad 10 on a base has the advantage of allowing further manipulation of tissue orientation. The use of silicone for the suture pad makes the pad flexible, allowing the pad to be oriented in a vertical or horizontal position and any angle between when assembled on the base. This provides multiple planar views of the suture pad, allowing for spatially challenging training of this skill.

[0027] The suture pad 10 may be used alone or may be attached to the base 38. In either case, the suture pad 10 alone or attached to the base 38 may be placed inside a surgical training device for suturing practice in a laparoscopic environment. Typically, the surgical training device is configured to mimic a patient's torso, such as the abdomen. An example of a surgical training device is described in U.S. Patent No. 8,764,452, entitled "Portable Laparoscopic Trainer," which is incorporated herein by reference in its entirety. The surgical training device provides a body cavity that is substantially hidden from a user and configured to receive a suture pad therein. The body cavity and the suture pad disposed therein are accessed through a tissue simulation area in the trainer that is penetrated by a user using a laparoscopic device. The surgical trainer is a useful tool for teaching, practicing, and demonstrating various surgical procedures and associated instruments in a simulation of a patient undergoing a surgical procedure. Surgical instruments are inserted into the body cavity through the tissue simulation area and through predetermined apertures in a top cover. The suture pad 10 can be connected to the trainer with a clip. If the base 38 is used, it can be held in place using a patch of hook-and-loop fastening material (VELCRO®) attached to the base and to the floor of the trainer. A video display monitor provides the user with a view of a simulated surgical field within the body cavity of the trainer via a camera, such as an endoscope.

[0028] In use, a user attaches at least one suture pad 10 to the posts 40 connected to the base 38. If the suture pad 10 includes preformed apertures 22, attachment of the suture pad 10 involves locating an aperture 22 on each post 34 and sliding the simulated tissue portion 36 to rest within one of the at least one notch 42 formed in the posts 34. The suture pad 10 is attached to all four posts 40. Fewer posts may be used to suspend the suture pad 10. The notches have the advantage of allowing the entire suture pad 10 to be attached at an angle such that one side or at least one corner of the suture pad 40 is attached to an upper or lower notch relative to the other corners and posts. If the suture pad 10 does not include preformed apertures 22, the tapered distal ends of the posts 40 may be used to pass the apertures 22 through any point in the pad 10. Thus, a user can select the tension of the suture pad 10 when attaching the suture pad 10 to a post 40. For example, when attaching the suture pad 10 by drilling an aperture 22 in the suture pad 10, the suture pad 10 can be selectively stretched to be as tight or loose as the user desires before drilling at least a second aperture 22, such as for attaching the suture pad 10 to another post 40. The fabric-reinforced silicone material prevents the aperture 22 from widening.

[0029] The suture pad 10 provides a realistic platform that presents simulated sutureable tissue for training in a laparoscopic environment. Clinicians use certain instruments, such as graspers, cutters, needles, sutures, laparoscopes, endoscopes, and trocars, when practicing certain techniques, such as cutting and suturing. When the suture pad, supported on a post, comes into contact with such instruments, the simulated tissue structure flexes and bends under the force, deflecting to a certain degree depending on the tension of the attachment. This dynamism of the suture pad advantageously mimics realistic live tissue that collapses, moves, and bends during real manipulation. It also feels different when cutting and suturing are performed against a suture pad that is suspended and in tension, allowing a certain amount of deflection. These simulations, advantageously provided by the suture pad 10 of the present invention, are particularly useful when practicing laparoscopic surgical techniques, where users can fine-tune their depth perception and tissue manipulation skills while suturing, cutting, and puncturing in a simulated laparoscopic environment. The present invention provides a guided suture placement model for the development of laparoscopic suturing skillset through deliberate practice.

[0030] The suture pad exhibits responses that simulate those of soft tissues found within the abdominal cavity. The suture pad 10 allows for laparoscopic suturing training, so it can be grasped and manipulated using laparoscopic instruments such as laparoscopic scissors, graspers, and Maryland forceps. The pad is also sturdy enough to hold various types of sutures that may be encountered within a surgical procedure. The suture pad 10 is sturdy enough to withstand suturing, but fragile enough so that the strength and force required to perform a suture resembles the tissue responses encountered during laparoscopic surgery. Since the target laparoscopic skill of the suture pad is suturing, the suture pad allows for the learning and practice of multiple suture orientations. The suture pad also allows for the performance of laparoscopic running sutures, such as simple running sutures. The suture pad can be secured to a base with a frontal or angled orientation to accommodate multiple planar views. The suture pad includes multiple lacerations or incisions to allow for multiple suture passes to maximize learning and training. The suture pad also allows the end user to form knots and final sutures to allow for complete training of suturing techniques. The suture pad has multiple laceration or incision orientations to be sutured to encourage mastery of multiple suture orientations. This allows for visual and movement challenges at a level of difficulty suited to the trainee. The suture pad also allows the in-service surgeon or surgical resident to demonstrate dexterity and precision through suture movement. Trainees can practice their laparoscopic dexterity by having a suture pad with precise suturing targets. The suture pad also allows these targets to serve as assessable indicators of the trainee's laparoscopic suturing dexterity. The suture pad has clear targets with consistent spacing between lacerations or incisions and between each successive pair of precise target markings on the pad to allow for objective assessment. The spacing between targets is selected to facilitate robust suture placement. Deviation from the suture targets can also cause the suture to lose integrity and fail to reattach tissue. Additionally, the material properties of the suture pad are such that the user can practice applying the appropriate amount of tension to the suture.If the user applies too much force or tension to the suture, the tissue will become too chich or over-attached, if the suture is too loose, the user will find that tears will remain open and the tissue cannot be reattached.

[0031] Although several embodiments have been shown and described in detail with reference to exemplary embodiments, those skilled in the art will recognize that various changes in form and detail may be made therein without departing from the spirit and scope of the invention as defined in the following claims. [Explanation of symbols]

[0032] 10 Suture Pad 14 Bottom side 20a First cutting portion 20b Second cut portion 20c Third cut 22 Aperture 24 Marking 38 Base 40 pillars

Claims

1. A surgical training model for training suturing techniques, comprising: A sheet of tissue simulating material defining a suture pad, a first layer of simulated tissue material; a second layer of simulated tissue material disposed above the first layer of simulated tissue material; a sheet of simulated tissue material comprising: a plurality of precise target markings disposed at a plurality of locations on the sheet of simulated tissue material corresponding to where a suture should pass, the plurality of precise target markings allowing a user to evaluate the suturing; one or more of the plurality of precise target markings are disposed on a fabric layer disposed between the first layer of simulated tissue material and the second layer of simulated tissue material. A surgical training model.

2. A surgical training model for training suturing techniques, comprising: A sheet of tissue simulating material defining a suture pad, a first layer of simulated tissue material; a second layer of simulated tissue material disposed above the first layer of simulated tissue material; a sheet of simulated tissue material comprising: a plurality of precise target markings disposed at a plurality of locations on the sheet of simulated tissue material corresponding to where a suture should pass, the plurality of precise target markings allowing a user to evaluate the suturing; one or more of the plurality of precise target markings are disposed on an intermediate silicone layer located between the first layer of simulated tissue material and the second layer of simulated tissue material. A surgical training model.

3. A surgical training model for training suturing techniques, comprising: A sheet of tissue simulating material defining a suture pad, a first layer of simulated tissue material; a second layer of simulated tissue material disposed above the first layer of simulated tissue material; a sheet of simulated tissue material comprising: a plurality of precise target markings disposed at a plurality of locations on the sheet of simulated tissue material corresponding to where a suture should pass, the plurality of precise target markings allowing a user to evaluate the suturing; the second layer of simulated tissue material is translucent or transparent, and one or more of the plurality of precise target markings are visible through the second layer of simulated tissue material; A surgical training model.

4. one or more of the plurality of precision target markings is a black circle dot; A surgical training model according to any one of claims 1 to 3.

5. one or more of the plurality of precision target markings are visibly distinct from the first simulated tissue material layer, the second simulated tissue material layer, or both simulated tissue material layers. A surgical training model according to any one of claims 1 to 3.

6. further comprising a reinforcing layer configured to retain a suture; A surgical training model according to any one of claims 1 to 3.

7. The reinforcing layer includes a mesh layer.

7. A surgical training model according to claim 6.

8. the first layer of simulated tissue material and the second layer of simulated tissue material are attached to one another using a silicone-to-silicone connection; A surgical training model according to any one of claims 1 to 3.

9. two or more of the plurality of precision target markings are grouped together and have the same geometric shape; A surgical training model according to any one of claims 1 to 3.

10. The method further comprises at least one cut portion penetrating the first simulated tissue material layer and the second simulated tissue material layer. A surgical training model according to any one of claims 1 to 3.

11. the plurality of precision target markings are arranged on either side of the at least one cut in a direction along which the sheet of tissue simulating material extends; The surgical training model of claim 10.

12. each of said plurality of precision target markings is disposed at a center-to-center distance of 5 millimeters from one another; 12. The surgical training model of claim 11.

13. the rows on either side of the at least one cut are spaced apart from the at least one cut by 5 millimeters; 12. The surgical training model of claim 11.

14. each of the plurality of precision target markings having a diameter of 1 / 16 inch (1.59 mm); A surgical training model according to any one of claims 1 to 3.

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