Medical simulator for learning the technique of laparotomy wound suturing

摘要

The useful model refers to medicine and the field of education, in particular to equipment for practical training of students of medical universities, residents, and surgeons to various methods of suturing a laparotomic wound. ;The purpose of the useful model is to create a device that allows one to master various ways of sewing tissues in conditions close to real ones.;The proposed simulator is a rigid frame measuring 36 × 40 cm, at the corners of its lower surface are attached round legs of soft rubber to prevent sliding on the table. The frame contains 2 clips for fixing a removable material that imitates human tissue (peritoneum, aponeurosis, subcutaneous fat, skin). To simulate the peritoneum a polyethylene film of various thickness is used, to imitate aponeurosis, artificial skin of various density and thickness, subcutaneous fat layer - foam rubber, leather - natural leather of various types. The standard size of the material to be clamped into the clamp is 32 × 6 cm. The maximum width of the material protruding from the clamp is 4 cm, but can be reduced to 1.5 cm if necessary. On the free edges of the imitation tissue of the human material, located at certain distances between themselves and from the edges of the alleged wound. The choice of the above distances depends on the choice of the method of suturing and facilitates the training of the skill of visual evaluation of the length of stitches and the distances between them. This will make it possible to apply the seams technically correctly. The first clamp that fastens the material is stationary and is located on one of the edges of the frame, corresponding to its size of 32 cm. The second clamp, whose length also corresponds to the width of the frame, is movable and parallel to the first, freely moving relative to the side frames of the frame along channels cut in them . Through these channels and the openings of the edges of the clamps in the projection of each of their channels, bolts are assembled connecting the parts together and fixing with the wing nut the specified parts in the required position, when suturing is done without tension. In the case of tension, these nuts must be loosened for free movement of the clamp. To simulate the tension of the sewn tissues, it is possible to fix the spring tensinometer between the movable clamp and the adjusting screw located in the wall hole of the fixed bar that connects the side strips on the side opposite to the stationary clamp. The degree of tension is changed by means of an adjusting screw located in the hole in the thickness of the stationary strip. In the channels of the side strips, 1 clamp of the movable clamp is mounted to limit the diastase between the edges of the tissue to be weighed while tensioning them. Fixators freely move through the channels and tighten, taking into account the choice of the value of diastase. In the case of tension, these nuts must be loosened for free movement of the clamp. To simulate the tension of the sewn tissues, it is possible to fix the spring tensinometer between the movable clamp and the adjusting screw located in the wall hole of the fixed bar that connects the side strips on the side opposite to the stationary clamp. The degree of tension is changed by means of an adjusting screw located in the hole in the thickness of the stationary strip. In the channels of the side strips, 1 clamp of the movable clamp is mounted to limit the diastase between the edges of the tissue to be weighed while tensioning them. Fixators freely move through the channels and tighten, taking into account the choice of the value of diastase. In the case of tension, these nuts must be loosened for free movement of the clamp. To simulate the tension of the sewn tissues, it is possible to fix the spring tensinometer between the movable clamp and the adjusting screw located in the wall hole of the fixed bar that connects the side strips on the side opposite to the stationary clamp. The degree of tension is changed by means of an adjusting screw located in the hole in the thickness of the stationary strip. In the channels of the side strips, 1 clamp of the movable clamp is mounted to limit the diastase between the edges of the tissue to be weighed while tensioning them. Fixators freely move through the channels and tighten, taking into account the choice of the value of diastase. To simulate the tension of the sewn tissues, it is possible to fix the spring tensinometer between the movable clamp and the adjusting screw located in the wall hole of the fixed bar that connects the side strips on the side opposite to the stationary clamp. The degree of tension is changed by means of an adjusting screw located in the hole in the thickness of the stationary strip. In the channels of the side strips, 1 clamp of the movable clamp is mounted to limit the diastase between the edges of the tissue to be weighed while tensioning them. Fixators freely move through the channels and tighten, taking into account the choice of the value of diastase. To simulate the tension of the sewn tissues, it is possible to fix the spring tensinometer between the movable clamp and the adjusting screw located in the wall hole of the fixed bar that connects the side strips on the side opposite to the stationary clamp. The degree of tension is changed by means of an adjusting screw located in the hole in the thickness of the stationary strip. In the channels of the side strips, 1 clamp of the movable clamp is mounted to limit the diastase between the edges of the tissue to be weighed while tensioning them. Fixators freely move through the channels and tighten, taking into account the choice of the value of diastase. The degree of tension is changed by means of an adjusting screw located in the hole in the thickness of the stationary strip. In the channels of the side strips, 1 clamp of the movable clamp is mounted to limit the diastase between the edges of the tissue to be weighed while tensioning them. Fixators freely move through the channels and tighten, taking into account the choice of the value of diastase. The degree of tension is changed by means of an adjusting screw located in the hole in the thickness of the stationary strip. In the channels of the side strips, 1 clamp of the movable clamp is mounted to limit the diastase between the edges of the tissue to be weighed while tensioning them. Fixators freely move through the channels and tighten, taking into account the choice of the value of diastase.;In order to work out the suturing skill in the depth of the wound, in particular the peritoneum and aponeurosis, as happens with pronounced subcutaneous fat, two removable U-shaped wire frames 4 cm in height and 30 cm in length are provided, with free edges attached at the edges of the clamps.