Vodopyanov's surgical simulator for practising technique of performing surgical sutures

Abstract

FIELD: medicine.SUBSTANCE: invention relates to simulators for practicing skills of applying surgical sutures to the skin and techniques of tying surgical knots. The simulator includes a multi-layer cushion simulating human tissues, a simulation of vessels in the tissues, and has a rectangular shape with rounded edges measuring 20 by 15 cm and a height of 1.8 cm. The simulator is made of hypoallergenic polymers and contains four layers simulating human tissues - epidermis, dermis, subcutaneous fat, muscles. Vessels of various diameters, filled with a liquid imitating blood, run in the subcutaneous layer. A flap of PVC artificial leather having a skin texture, treated with liquid release wax IZHWAX SP, is placed on a platform with legs measuring 25 by 20 cm. A part in the form of a side 1.75 mm high, printed on a 3D printer, is placed on the flap. A nylon stretch mesh with a density of 110 g / m2 is stretched over the part. The stretch mesh is fixed to the platform with clamps. A part in the form of an outer side with 'ears' 17 mm high, printed on a 3D printer, is installed on the mesh. The entire structure is completely pressed against the base using clamps so that the nylon mesh remains stretched. Platinum silicone rubber of appropriate parameters is poured into a separate container. The components are mixed and coloured with a dye for epoxy resin, and after the last layer hardens, all the existing 3D-printed sides and other parts are separated. The excess stretch mesh is cut off.EFFECT: possibility of performing training of intramuscular injection, layer-by-layer dissection of the simulator layers with a scalpel down to the underlying layers and applying sutures in hard-to-reach places, in particular on the muscle layer, fascia, aponeurosis.1 cl, 1 dwg

Description

[0001] Field of technology to which the invention relates

[0002] The invention relates to medicine and the field of education, namely to surgical simulators, training aids in surgery and traumatology, to devices, means or simulators for practicing the technique of performing surgical sutures for practicing the skills of applying surgical sutures to the skin and practicing the technique of tying surgical knots.

[0003] Technology Level

[0004] A simulator for mastering the technique of basic surgical skills is known, containing a support platform consisting of three parts, one of which contains a reservoir fixed on the support platform with a silicone pad consisting of three layers simulating the skin, subcutaneous fat and a layer of muscle fibers, and two triangular-shaped faces made of plexiglass simulating the edges of a surgical wound, between which silicone rods are stretched, fixed on clamps rigidly attached to the support platform, the other part of the platform contains a reservoir with silicone, which imitates a muscle layer with tendons and nerve fibers, the third part, simulating an artery and a vein, is made of two silicone tubes stretched over the support platform and fixed on both sides on blocks rigidly fixed on the platform, while the layers of silicone simulating the skin, subcutaneous tissue and muscle fibers, as well as a muscle layer with tendons and nerve fibers, have a color,corresponding to the real one (see patent RU No. 169921, IPC A61B 17 / 00, published on 06.04.2017, bulletin No. 10).

[0005] The disadvantage of this simulator is its limited functionality, namely the ability to master only the tendon suture technique, and the low fidelity of simulating human tissue.

[0006] Known:

[0007] 1. A device for practicing the skills of applying surgical sutures to skin and tying surgical knots, including a frame, one side of which is covered with a tightening material, while a soft elastic material imitating subcutaneous fat is built into the frame, an incision is made in the tightening material imitating a surgical wound, holes are made along both sides of the incision, and the soft elastic material has the ability to press on the tightening material to open the incision simulating a surgical wound from the inside.

[0008] 2. A device for practicing the skills of applying surgical sutures to skin and tying surgical knots according to paragraph 1, wherein the frame is made of a rectangular frame.

[0009] 3. A device for practicing the skills of applying surgical sutures to skin and tying surgical knots according to paragraph 2, wherein the rectangular frame is made with a bottom against which a soft elastic material rests on one side and against a tight-fitting material on the other opposite side.

[0010] 4. A device for practicing the skills of applying surgical sutures to skin and tying surgical knots according to paragraph 3, wherein the bottom contains a means for attaching to an external product.

[0011] 5. A device for practicing the skills of applying surgical sutures to skin and tying surgical knots according to paragraph 1, wherein the frame is made of wood.

[0012] 6. A device for practicing the skills of applying surgical sutures to skin and tying surgical knots according to paragraph 1, wherein the covering material is made of artificial leather.

[0013] 7. A device for practicing the skills of applying surgical sutures to skin and tying surgical knots according to paragraph 1, wherein the soft elastic material is a spongy material.

[0014] 8. A device for practicing the skills of applying surgical sutures to skin and tying surgical knots according to paragraph 1, wherein each hole is made with an element built into it that reinforces the edges of the holes.

[0015] 9. A device for practicing the skills of applying surgical sutures to skin and tying surgical knots according to claim 8, wherein the element strengthening the edges of the hole is made in the form of a reusable eyelet (see patent RU No. 183425, IPC A61B 17 / 00, G09B 23 / 28, published on September 21, 2018, bulletin No. 27).

[0016] The disadvantage of this device is that, despite the fact that the eyelet can be made of metal, and this will allow the holes to be used repeatedly without their natural wear, which will affect the increased reliability of the declared device, the imitation of human tissue is small.

[0017] The closest in technical essence and achieved positive effect and accepted by the authors as a prototype is:

[0018] 1. A simulator for acquiring and practicing surgical skills, including a multi-layer silicone pad simulating human tissue, wherein the multi-layer silicone pad contains five layers, the first of which imitates the skin and is flesh-colored, the second imitates the subcutaneous fat and is yellow, the third imitates the aponeurosis and is transparent, the fourth imitates the muscle layer and is red, and the fifth imitates the fascia and is transparent, while the third layer is made of two-component platinum-based silicone with a density of 1.070 g / cm 3 , and the remaining layers are made of two-component platinum-based silicone with a density of 1.040 g / cm 3 .

[0019] 2. The exercise machine according to claim 1, further comprising a polyvinyl chloride tube simulating a bloodstream and placed between layers simulating skin and subcutaneous fat (see patent RU No. 230327, IPC G09B 23 / 28, published on 27.11.2024, Bulletin No. 33).

[0020] The disadvantage of this simulator is the insufficient improvement of its characteristics and the insufficiently expanded range of possible manipulations for acquiring and practicing surgical skills.

[0021] Disclosure of invention

[0022] The objective of the proposed invention is to develop a new surgical simulator for practicing the technique of performing surgical sutures, which has improved characteristics and an expanded range of possible manipulations for acquiring and practicing surgical skills.

[0023] The technical result that can be achieved with the help of the proposed invention is to provide the possibility of training in intramuscular injection, layer-by-layer dissection of the layers of the simulator with a scalpel, bandaging and suturing of vessels of various diameters, including arteries and veins.

[0024] The technical result is achieved using the Vodopyanov surgical simulator for practicing the technique of performing surgical sutures, including a multi-layer pad simulating human tissue and imitation of vessels in tissues, while the simulator has a rectangular shape with rounded edges measuring 20 by 15 cm and a height of 1.8 cm, made of hypoallergenic polymers, containing four layers simulating human tissue - the epidermis, dermis, subcutaneous tissue, muscles, while in the subcutaneous layer there are vessels of various diameters filled with a liquid simulating blood, a flap of eco-leather with a skin texture is placed on a platform with legs 25 by 20 cm, which is treated with liquid separating wax, then a part in the form of a side 1.75 mm high is placed on the flap, a nylon stretch mesh is pulled over it, it is fixed to the platform with clamps, on the mesh is installed as a part in the form of an external edge with “ears” 17 mm high,The entire structure is pressed completely to the base using clamps so that the nylon mesh remains taut, then platinum silicone rubber of the following parameters is poured into a separate container:

[0025] Density, Shore A 00-50 Curing time, h 3 Viscosity, cP 8000 Elongation at break, % 980

[0026] in proportions of 1:1 for 30 g of component A and component B, then coloring is performed with a dye for epoxy resin color "Peach", then thoroughly mixed for 1 minute, the resulting volume of 60 ml is poured into the finished mold and distributed over its entire surface, this layer in the simulator imitates the epidermis, into which the mesh is implanted, after 40 minutes an additional part is installed on the 17 mm side, an internal border-limiter with a height of 0.7 cm, then platinum silicone rubber of the following parameters is poured into a separate container:

[0027] Density, Shore A 00-50 Curing time, h 3 Viscosity, cP 8000 Elongation at break, % 980

[0028] in proportions of 1:1 of 15 g of component A and component B, then coloring is done with a dye for epoxy resin of the color "Pink", then thoroughly mixed for 1 minute, the resulting volume of 30 ml is poured into the finished mold and distributed over its entire surface, this layer in the simulator imitates the dermis, then water at room temperature is poured into the latex tube, it is colored with a food water-soluble dye of the color "Red", the tube is sealed on both sides with an adhesive base, the tube is treated three times with a separating wax, after that a sheet of polyurethane foam is placed in the center of the inner rim mold according to the size of the inner rim and a height of 0.7 cm, cuts are made on it and a latex tube is placed inside, then platinum silicone rubber of the following parameters is poured into a separate container:

[0029] Density, Shore A 00-35 Curing time, h 2 Viscosity, cP 9300 Elongation at break, % 1000

[0030] in proportions of 1:1, 90 g of component A and component B, are painted with a dye for epoxy resin of the color "Yellow", then thoroughly mixed for 1 minute, the resulting volume of 100 ml is poured into the central part of the mold and distributed over its entire surface, this layer imitates subcutaneous fat tissue having vessels filled with imitated blood, then the product at this stage as a whole with the platform is placed in the degassing chamber for 20 minutes, after removing the product from the degassing chamber, a tulle mesh is placed on the surface, cut in such a way that it covers the layer of subcutaneous fat tissue and partially goes over the edge of the inner side of the simulator, then platinum silicone rubber of the following parameters is poured into a separate container:

[0031] Density, Shore A 50 Curing time, h 4 Viscosity, cP 11000 Elongation at break, % 650

[0032] in proportions of 1:1, 115 g of component A and component B are mixed, painted with a dye for epoxy resin in the color "Wine", then thoroughly mixed for 1 minute, the resulting mass is poured into the central part of the simulator, evenly distributed over the entire surface, this layer is an imitation of muscles, then the product is again placed in the degassing chamber for 20 minutes, 12 hours after the hardening of the last layer, all existing sides and other parts are separated from the simulator, excess stretch mesh is cut off.

[0033] Brief description of drawings and other materials

[0034] The drawing shows Vodopyanov's surgical simulator for practicing the technique of making surgical sutures in its finished form after removing the sides and other parts, viewed from a ¾ angle.

[0035] Implementation of the invention

[0036] Vodopyanov's surgical simulator for practicing surgical suture techniques is a four-layer model of human skin: epidermis, dermis, subcutaneous tissue, muscles. The subcutaneous layer contains vessels of various diameters filled with a liquid simulating blood. It is made of hypoallergenic polymers, such as platinum-based silicone. It has a food certificate and is completely safe for humans to use.

[0037] An example of a specific implementation of the invention.

[0038] The Vodop'yanov surgical simulator is rectangular with rounded edges, measuring 20 x 15 cm and 1.8 cm high. It is mounted on a 25 x 20 cm plastic platform with legs. A piece of eco-leather is placed on the platform and treated with liquid release wax. A 1.75 mm high border is placed on the border. A nylon stretch mesh is stretched over it and secured to the platform with clamps. A 17 mm high outer border with "ears" is installed on the mesh. The entire structure is pressed firmly against the base with clamps so that the nylon mesh remains taut. Next, platinum silicone rubber of the following composition is poured into a separate container:

[0039] Density, Shore A 00-50 Curing time, h 3 Viscosity, cP 8000 Elongation at break, % 980

[0040] mix 30g of component A and component B in a 1:1 ratio. Next, color the mixture with "Peach" epoxy resin dye. Mix thoroughly for 1 minute. The resulting 60ml volume is poured into the prepared mold and distributed over its entire surface. This layer in the surgical simulator simulates the epidermis, into which a mesh is implanted. When the mesh is cut, the skin edges will diverge as with real skin. After 40 minutes, an additional component is installed on the 17mm rim – an internal 0.7cm-high limiter rim. Next, platinum silicone rubber with the following parameters is poured into a separate container:

[0041] Density, Shore A 00-50 Curing time, h 3 Viscosity, cP 8000 Elongation at break, % 980

[0042] in a 1:1 ratio of 15g of component A and component B, then color with a dye for epoxy resin color "Pink", then mix thoroughly for 1 minute, pour the resulting volume of 30 ml into the finished mold and distribute it over its entire surface, this layer in the simulator imitates the dermis layer. Next, fill the latex tube with water at room temperature, color it with food water-soluble dye color "Red", seal the tube on both sides with an adhesive base, treat the tube three times with release wax to prevent inhibition of the silicone polymer, then place a sheet of polyurethane foam in the center of the inner rim mold according to the size of the inner rim and a height of 0.7 cm, make cuts on it and place the latex tube inside, then pour platinum silicone rubber of the following parameters into a separate container:

[0043] Density, Shore A 00-35 Curing time, h 2 Viscosity, cP 9300 Elongation at break, % 1000

[0044] in proportions of 1:1, 90 g of component A and component B are painted with a dye for epoxy resin of the color "Yellow", then thoroughly mixed for 1 minute, the resulting volume of 100 ml is poured into the central part of the mold and distributed over its entire surface, this layer imitates subcutaneous fat tissue having vessels filled with imitated blood, then the product at this stage as a whole with a platform is placed in a degassing chamber for 20 minutes to eliminate air bubbles, after removing the product from the degassing chamber, a tulle mesh is placed on the surface, cut in such a way that it covers the layer of subcutaneous fat tissue and partially goes over the edge of the inner side of the simulator, to give elasticity to the simulator, frame and strengthening, and the tulle mesh also improves the adhesion between the layer of subcutaneous fat tissue and the next muscle layer. Next, platinum silicone rubber with the following parameters is poured into a separate container:

[0045] Density, Shore A 50 Curing time, h 4 Viscosity, cP 11000 Elongation at break, % 650

[0046] in proportions of 1:1, 115 g of component A and component B are mixed, painted with a dye for epoxy resin in the color "Wine", then thoroughly mixed for 1 minute, the resulting mass is poured into the central part of the simulator, evenly distributed over the entire surface, this layer is an imitation of muscles, then the product is again placed in the degassing chamber for 20 minutes to eliminate air bubbles, 12 hours after the hardening of the last layer, all existing sides and other parts are separated from the simulator, excess stretch mesh is cut off.

[0047] The proposed invention, compared with the prototype and other known technical solutions, has the following advantages:

[0048] - the manufacturing technology of the surgical simulator allows for maximum imitation of skin layers and subcutaneous fat;

[0049] - the leather has the corresponding texture, as in reality, when pressed it is soft, elastic, forms folds when "pinched";

[0050] - the skin in the simulator consists of two layers: the epidermis and the dermis;

[0051] - the skin edges diverge in different directions after the incision;

[0052] - subcutaneous fat is intended for training sewing skills, contains blood vessels;

[0053] - imitation of vessels in tissues, allows you to learn the technique of suturing and ligating arteries and veins.

Claims

A surgical simulator for practicing the technique of performing surgical sutures, including a multi-layer pad simulating human tissue and imitation of vessels in tissues, characterized in that the simulator has a rectangular shape with rounded edges measuring 20 by 15 cm and a height of 1.8 cm, made of hypoallergenic polymers, containing four layers simulating human tissue - epidermis, dermis, subcutaneous tissue, muscles, while in the subcutaneous layer there are vessels of various diameters filled with a liquid simulating blood, a flap of eco-leather with a skin texture is placed on a platform with legs 25 by 20 cm, which is treated with liquid separating wax, then a detail in the form of a side 1.75 mm high is placed on the flap, a nylon stretch mesh is pulled over it, fixed to the platform with clamps, a detail in the form of an external side with "ears" 17 high is installed on the mesh mm, the entire structure is completely pressed to the base using clamps so that,To keep the nylon mesh taut, platinum silicone rubber with components A and B and the following parameters is then poured into a separate container: density, SHORE A 00-50 curing time, h 3 viscosity, cP 8000 elongation at break, % 980 in proportions of 1:1 for 30 g of component A and component B, then coloring is performed with a dye for epoxy resin color "Peach", then thoroughly mixed for 1 minute, the resulting volume of 60 ml is poured into the finished mold and distributed over its entire surface, this layer in the simulator imitates the epidermis, into which the mesh is implanted, after 40 minutes an additional part is installed on the 17 mm edge - an internal border-limiter with a height of 0.7 cm, then platinum silicone rubber with components A and B and the following parameters is poured into a separate container: density, SHORE A 00-50 curing time, h 3 viscosity, cP 8000 elongation at break, % 980 in proportions of 1:1 of 15 g of component A and component B, then coloring is done with a dye for epoxy resin of the color "Pink", then thoroughly mixed for 1 minute, the resulting volume of 30 ml is poured into the finished mold and distributed over its entire surface, this layer in the simulator imitates the dermis, then water at room temperature is poured into the latex tube, it is colored with a food water-soluble dye of the color "Red", the tube is sealed on both sides with an adhesive base, the tube is treated three times with a separating wax, after this a sheet of foamed polyurethane foam is placed in the center of the inner rim of the mold according to the size of the inner rim and a height of 0.7 cm, cuts are made on it and a latex tube is placed inside, then platinum silicone rubber with components A and B and the following parameters is poured into a separate container: density, SHORE A 00-35 curing time, h 2 viscosity, cP 9300 elongation at break, % 1000 in proportions of 1:1, 90 g of component A and component B, painted with dye for epoxy resin color "Yellow", then thoroughly mixed for 1 minute, the resulting volume of 100 ml is poured into the central part of the mold and distributed over its entire surface, this layer imitates subcutaneous fat tissue with vessels filled with imitation blood, then the product at this stage as a whole with the platform is placed in the degassing chamber for 20 minutes, after removing the product from the degassing chamber, a tulle mesh is placed on the surface, cut in such a way that it covers the layer of subcutaneous fat tissue and partially goes over the edge of the inner side of the simulator, then platinum silicone rubber with components A and B and the following parameters is poured into a separate container: density, SHORE A 50 curing time, h 4 viscosity, cP 11000 elongation at break, % 650 in proportions of 1:1, 115 g of component A and component B, painted with a dye for epoxy resin color "Wine", then thoroughly mixed for 1 minute, the resulting mass is poured into the central part of the simulator, evenly distributed over the entire surface, this layer is an imitation of muscles, then the product is again placed in the degassing chamber for 20 minutes, 12 hours after the hardening of the last layer, all existing sides and other parts are separated from the simulator, excess stretch mesh is cut off.

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