Total mesorectal excision surgical simulator
A TME surgical simulator is provided. The TME surgical simulator includes a simulated tissue layers and simulated vasculature and/or organ structures. The simulated tissue surgical simulator is adapted for but not limited to laparoscopic and/or transanal TME surgical procedures.
1 . A surgical simulator for a simulated surgical procedure, the surgical simulator comprising:
a frame having a cavity, a proximal opening, and a distal opening;
a plurality of simulated tissue layers disposed within the frame and attached, at least partially, to each other, wherein two or more of the plurality of simulated tissue layers are configured to define at least one dissection plane whereby the two or more of the plurality of simulated tissue layers are configured to be separable from each other,
wherein one or more of the plurality of simulated tissue layers are configured with an outward tension away from an interior of the cavity of the frame to simulate insufflation, with a first simulated tissue layer of the one or more plurality of simulated tissue layers and a second simulated tissue layer of the one or more plurality of simulated tissues layers having differing outward tensions away from the interior of the cavity of the frame;
wherein the plurality of simulated tissue layers comprise a simulated endopelvic fascia layer, a simulated mesorectum layer, and a simulated pelvic floor having an upper portion covering an upper portion of the frame and a lower portion attached to and covering a lower portion of the frame, the lower portion of the simulated pelvic floor extending from the proximal opening of the frame and extending beyond the distal opening of the frame; and wherein the simulated surgical procedure corresponds to a simulated total mesorectal excision (TME procedure.
2 . The surgical simulator of claim 1 , wherein a first set of adjacent simulated tissue layers of the plurality of simulated tissue layers in the at least one dissection plane have a first tactile response when being separated and due to at least one simulated tissue layer of the first set of adjacent simulated tissue layers having an outward tension away from the interior of the cavity of the frame, the first tactile response is different from a second tactile response of a second set of adjacent simulated tissue layers of the plurality of simulated tissue layers not in the at least one dissection plane when being separated.
3 . The surgical simulator of claim 2 , wherein the first tactile response corresponds to separation of the first set of adjacent simulated tissue layers in the at least one dissection plane being easier due to at least one simulated tissue layer of the first set of adjacent simulated tissue layers having an outward tension away from the interior of the cavity of the frame compared to separation of the second set of adjacent simulated tissue layers of the plurality of simulated tissue layers not in the at least one dissection plane.
4 . The surgical simulator of claim 3 , wherein the second set of adjacent simulated tissue layers of the plurality of simulated tissue layers not in the at least one dissection plane are attached to each other via adhesive to provide the second tactile response.
5 . The surgical simulator of claim 2 wherein two or more layers of the plurality of simulated tissue layers further comprises fibrous material, wherein the fibrous material is configured to provide a third tactile response during separation of the two or more layers of the plurality of simulated tissue layers comprising the fibrous material, the third tactile response being different from the first tactile response and the second tactile response.
6 . The surgical simulator of claim 1 further comprising fatty fill enclosed within the plurality of simulated tissue layers.
7 . The surgical simulator of claim 1 , wherein one or more simulated tissue layers of the plurality of simulated tissue layers comprise conductive material configured for electrosurgical energy-based dissection.
8 . The surgical simulator of claim 1 wherein the plurality of simulated tissue layers are configured to have portions with different textures from one another, a first portion having a first texture corresponding to the at least one dissection plane and a second portion having a second texture that is not within the at least one dissection plane.
9 . The surgical simulator of claim 1 , wherein the first simulated tissue layer is stretched and has an outward tension away from the interior of the cavity of the frame greater than an outward tension of the second simulated tissue layer away from the interior of the cavity of the frame, increasing difficulty of dissection in a dissection plane between the first simulated tissue layer and the second simulated tissue layer.
10 . The surgical simulator of claim 1 , wherein the first simulated tissue layer is stretched and has an outward tension away from the interior of the cavity of the frame and the second simulated tissue layer less than an outward tension of the second simulated tissue layer away from the interior of the cavity of the frame, decreasing difficulty of dissection in a dissection plane between the first simulated tissue layer and the second simulated tissue layer.
11 . A surgical simulator for a simulated surgical procedure, the surgical simulator comprising:
a frame having a proximal end and a distal end;
a plurality of simulated tissue layers disposed within the frame and attached, at least partially, to each other, wherein two or more of the plurality of simulated tissue layers are configured to define at least one dissection plane whereby the two or more of the plurality of simulated tissue layers are configured to be separable from each other, and wherein one or more of the plurality of simulated tissue layers are configured with an outward tension to simulate insufflation; and
a balloon comprises silicone and fibrous material composite and contains a fatty fill, the balloon being attached circumferentially to other silicone-based simulated tissue layers of the plurality of simulated tissue layers and extending from the proximal end of the frame to the distal end of the frame, wherein the balloon has a proximal portion at the proximal end of the frame and a distal portion at the distal end of the frame, the distal portion of the balloon being larger than the proximal portion of the balloon.
12 . The surgical simulator of claim 11 , wherein the fatty fill is configured to leak or escape when a portion of the balloon is punctured.
13 . The surgical simulator of claim 12 , wherein the fatty fill is gel like, and wherein the fatty fill is configured to retain its shape within the balloon simulating a mesorectum even if the balloon is punctured.
14 . The surgical simulator of claim 13 , wherein the balloon is configured to be removed from the plurality of simulated tissue layers, wherein the balloon is configured to comprise at least one of visual voids or lumps indicative of where the fatty fill leaked or escaped and configured to be graded thereby quantifying a performance of the simulated surgical procedure.
15 . The surgical simulator of claim 12 , wherein the fatty fill further comprises fibrous material configured to prevent unrealistic ejection of the fatty fill when the balloon is punctured.
16 . The surgical simulator of claim 11 further comprising one or more simulated organs including a simulated rectum, simulated ureter, a simulated colon, a simulated prostrate, and simulated Gonadal vessels, the simulated rectum being tubular and extending into and through the distal portion of the balloon, in which a portion of the simulated rectum is configured to be removed along with the balloon attached thereto.
17 . A surgical simulator for a simulated surgical procedure, the surgical simulator comprising:
a frame having a proximal end and a distal end;
a first simulated tissue layer disposed within the frame;
a second simulated tissue layer disposed within the frame and attached the first simulated tissue layer, the first and second simulated tissue layers being configured to define a dissection plane in which the first and second simulated tissue layers are configured to be separable from each other, at least one of the first and second simulated tissue layers being placed under circumferential tension; and
a third simulated tissue layer attached to the first simulated tissue layer and to the distal end of the frame, the third simulated tissue layer being stretched towards an interior of the frame and attached to a simulated vessel and a simulated organ, wherein the third simulated tissue layer has an upper portion attached to and covering an upper portion of the frame and a lower portion attached to and covering a lower portion of the frame, the lower portion of the third simulated tissue layer extending from a proximal opening at the proximal end of the frame and extending beyond a distal opening at the distal end of the frame;
wherein the first and second simulated tissue layers are both placed under circumferential tension and the first simulated tissue layer is circumferentially tensioned more than the second simulated tissue layer.