This application claims priority to German Patent Application No. DE 20 2013 100 701.3 filed Feb. 15, 2013, which is hereby incorporated by reference in its entirety.
This application relates to a simulator for simulation of surgical procedures, particularly in cardiac and thoracic surgery.
For training and continuing education of surgeons, it is necessary to simulate complex procedures and to train on simulators.
One task consists of making available a cost-advantageous simulator for simulation of surgical procedures, particularly minimally invasive and video-assisted procedures, particularly in cardiac and thoracic surgery.
This task is accomplished, by means of a simulator for simulation of surgical procedures, particularly in cardiac and thoracic surgery, having the features and structures disclosed herein.
The simulator for simulation of surgical procedures, particularly in cardiac and thoracic surgery, has a frame having a first wall and a second wall, wherein a passage opening is disposed in the first wall, wherein a variable wall can be inserted on the second wall in at least two different positions, and wherein the variable wall has at least one opening. In this connection, the first wall and the second wall are particularly disposed at an angle to one another, particularly at a right angle. The frame simulates the chest of the patient; the passage opening simulates the access to the chest of the patient. The instruments required for the surgical procedure are introduced into the housing through the passage opening, with the surgeon operating the instruments outside of the housing. Different difficulties can be simulated by means of the variable wall, which can be disposed in different positions relative to the first wall, because the distance between the variable wall, on which a surgical procedure is to be performed, and the passage opening is therefore variable. The opening in the variable wall allows accommodation of an artificial body part on which a surgical procedure is to be performed.
An advantageous further development of the disclosure provides that at least two variable walls can be disposed on the second wall, so that different artificial body parts can be disposed relative to one another.
A particularly preferred embodiment of the disclosure provides that the frame is part of a housing having a bottom part and a lid part, wherein the bottom part has the first wall, the second wall, and three further walls. The lid part allows a view into the housing when the lid is open, and therefore into the chest, in order to be able to see directly what activities are being performed. When the housing is closed, a minimally invasive procedure with video camera support can be practiced.
According to a particularly simple design embodiment of the simulator, it is provided that the variable wall can be inserted into grooves that are disposed in or on the walls. This allows particularly simple and stable attachment of the variable wall in the frame or housing.
In an alternative, an artificial body part can be inserted directly into the opening in the variable wall. Depending on the type of artificial body part, however, it is preferred if an attachment apparatus for an artificial body part is disposed on the variable wall.
The holding apparatus and/or attachment apparatus can preferably be configured as a plate that can be attached to the variable wall, particularly with screws, which plate has an opening, in order to be able to clamp artificial body parts in place between the variable wall and the plate.
Preferably, the variable wall has two openings, into which artificial body parts, for example in the form of cylindrical foam elements or rubber elements or in the form of rolled foam elements or rubber elements, can be inserted.
A particularly preferred embodiment of the disclosure provides that a setup element, for example a setup flap, a setup bracket or a setup foot is disposed on the frame of the housing, in order to be able to tilt the frame or housing and to facilitate access through the passage opening.
A preferred embodiment of the disclosure provides that the simulator has a camera and a light source, in order to be able to observe the surgical activities in accordance with a minimally invasive procedure, by way of the video camera, when the housing is closed or when the frame is covered with a cover plate or a cloth cover.
The simulator preferably has at least one hollow tube, particularly preferably multiple hollow tubes having different lengths, for insertion into the passage opening. In this way, different thicknesses of the chest wall can be simulated, and thereby the difficulty of the simulation can be increased, step by step, because the movement possibilities of the surgical instruments are increasingly restricted with an increasing length of the hollow tube.
It is advantageous if the simulator has a plastic cuff, for example a silicone cuff, for insertion into the passage opening. This cuff particularly forms a soft contact edge. Furthermore, it is possible to attach suture material to the plastic cuff during the simulation.
The simulator preferably comprises at least one artificial body part and/or a template for the production of an artificial body part for insertion into the opening of the variable wall. The artificial body part can be, for example, a piece of cloth, for example a microfiber cloth, which can simulate a heart valve, or a foam rubber part, for example in the form of a cylinder or a rectangular element that can be rolled up to form a cylinder, which can simulate a heart muscle. The templates merely represent the outline of the artificial body part and can be transferred to a piece of cloth, for example a microfiber cloth, a foam rubber part, or the like, in order to subsequently produce the artificial body part accordingly, particularly to cut it out.
In a preferred embodiment, an edge, particularly the upper edge of the variable wall, has recesses into which surgical instruments can be laid. In this way, it is made possible to stow the surgical instruments required for the simulation in the housing, and also to transport them without damage.
Preferably, the frame or the housing and the variable walls are made of wood or plastic or metal, for example aluminum, which allows particularly simple and cost-advantageous production.
The disclosure will be explained in detail below, using the following figures. These show:
a is a top view of the setup flap according to
Different views of a housing 10 of a simulator for simulation of surgical procedures, particularly in cardiac and thoracic surgery, are shown in
The bottom part 12 has a wall 15 that forms the bottom wall and four walls 16, 18, 20, 22. The housing 10 simulates the chest of a patient. The housing 10 can be made, for example, of wood or plastic or metal, for example aluminum.
The wall 16, which forms the front side of the bottom part 12, has a passage opening 24, through which access into the housing 10 is made possible. The passage opening 24 particularly simulates the operation access to the patient.
Surgical instruments, particularly those required for the surgical procedure, can be introduced into the housing 10 with their distal end, through the passage opening 24, while the proximal ends remain outside the housing 10, in order to be able to simulate a minimally invasive surgical procedure.
The wall 16 can be reinforced by a reinforcement plate 25, which is particularly attached on the inside of the wall 16, for example glued on. The reinforcement plate 25 has an opening 25a that aligns with the passage opening 24.
A hollow tube 60 can be inserted into the passage opening 24, which tube is produced from Plexiglas, for example (cf.
At least one, preferably multiple variable walls 30, 40, 50 can be inserted into the bottom part 12 of the housing 10. For this purpose, multiple grooves 26 that run parallel to one another are disposed on the opposite walls 18, 22. The grooves 26 can either be disposed directly in the walls 18, 22. Alternatively, a grooved plate 28 (cf.
The variable wall 30 (cf.
The variable wall 40 (cf.
The variable wall 50 (cf.
In order to facilitate access into the housing 10, the housing 10 has a setup flap 70 on its underside (cf. also
For simulation of a surgical procedure, particularly in cardiac or thoracic surgery, the housing 10 can be used as follows.
The hollow tube 60 having the desired length is inserted into the passage opening 24. The greater the length of the hollow tube 60, the more restricted the movement possibility for the surgical instruments inserted into the interior of the housing 10 through the hollow tube 60.
The variable wall 30 is equipped with artificial body parts as follows. The simulator 10 preferably comprises two templates 90, 95 (cf.
The one artificial body part can be produced from a piece of cloth, for example a microfiber cloth, as an element having a centric opening 91, using the template 90, while the other artificial body part can be produced from a piece of cloth, for example a microfiber cloth, as an element having an approximately arc-shaped cross-section 92, using the template 95, in order to represent an approximately semicircular flap that simulates a heart valve. The two artificial body parts according to templates 90, 95 are attached to the variable wall 30, using the plate 34, in such a manner that they are clamped in place between the variable wall 30 and the plate 34, in such a manner that the opening 91 of the body part according to the template 90 comes to lie in front of the opening 32, and the semicircular element of the body part according to the template 95 comes to lie in front of the opening 91 of the body part 90. The variable wall 30 is inserted into the bottom part 12 at a desired distance from the passage opening 24.
Artificial body parts that simulate heart muscle parts are inserted into the two openings 42, 44 of the variable wall 40. For this purpose, a piece of foam rubber in a cylindrical shape, or a foam rubber element in a rectangular shape, which has been rolled up into a cylinder, is inserted through the openings 42, 44. The variable wall 40 is disposed in the bottom part 12 in such a manner that it is disposed behind the variable wall 30, from the viewing direction of the passage opening 24.
In a simple simulation, the lid part 14 can remain open and a surgical procedure, for example suturing on an artificial heart valve, can be carried out with a direct view of the instruments and the artificial body parts in the manner of the templates 90, 95.
In a more difficult simulation, the lid part 14 can be closed and the surgical procedure can be carried out using further surgical instruments for lighting and imaging, for example an endoscope. Alternatively, a light source and a camera can be disposed on a holder 80 in the housing, and these are used to transmit what is happening in the interior of the housing 10 to a screen. In order to allow power supply and image transmission by means of cables, the housing can have a passage opening in one of the walls 16, 18, 20, 22, in order to be able to conduct the cables from the camera and/or the light source to the outside.
All of the components required for the simulation can be stowed in the housing 10. For stowing and transport, also of the surgical instruments required for the simulation, the variable wall 50 is inserted into one of the grooves 26 that preferably has the greatest distance from the passage opening 24. In addition, the variable wall 30, for example, also has recesses 31 on its top edge, so that the surgical instruments can be laid into the recesses 31, 52 parallel to the walls 22, 18, and can be held securely during transport, as indicated with a dot-dash line in
A second exemplary embodiment of a simulator is shown in
The simulator for simulation of surgical procedures, particularly in cardiac or thoracic surgery, has a frame 100 that has a first wall 16′, which forms the front side in the present exemplary embodiment, and a second wall 18′, which forms the bottom wall in the present exemplary embodiment.
The first wall 18′ can be attached to the wall 16′ by way of a screw connection by means of a screw 102 and/or by way of a journal connection by means of two journals 18b, which can be inserted into corresponding recesses 16b in the wall 16′.
The passage opening 25 is disposed in the first wall 16′. The hollow tubes 60 can be inserted into the passage opening 25 in the manner described for the first exemplary embodiment.
In this connection, the wall 18′ is preferably disposed at a distance from a side edge of the wall 16′ and particularly at a right angle to the wall 16′, wherein the passage opening 25 is disposed in the wall 16′ on one side of the wall 18′, and the part of the wall 16′ disposed on the other side of the wall 18′ forms a setup foot 104 for the simulator.
In
The simulator according to the second exemplary embodiment can be equipped, in analogous manner, with body parts according to the templates 90, 95 for simulation of the heart valves or corresponding templates 90, 95, and, if necessary, further additional body parts for simulation of heart muscle parts, with hollow tubes 60 and/or a plastic cuff, with a camera and/or a light source, and, if necessary, with corresponding surgical instruments.
A simulation can take place in the same manner as with the simulator according to the first exemplary embodiment. In order to prevent a direct view of the simulated operation being performed, the frame 100 can be covered with a cloth. Alternatively, a cover plate 110 can be attached to the wall 16′ by means of one or more screws 112 (cf.
Number | Date | Country | Kind |
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20 2013 100 701.3 | Feb 2013 | DE | national |