First entry model
A simulated abdominal wall model that is ideal for practicing laparoscopic first entry surgical techniques is provided. The model includes a simulated abdominal wall portion captured between two frame elements of a support. The support is connectable to a surgical trainer. When connected to the trainer, the model provides a penetrable abdominal tissue portion for accessing an internal cavity of the trainer. The simulated abdominal wall includes a plurality of layers including a skin layer, a fabric posterior rectus sheath layer, a simulated fat layer of low-resilience polyurethane foam and at least two layers that provide distinctive haptic feedback upon penetration of the simulated transversalis fascia and muscle layers. The simulated abdominal wall includes a simulated umbilicus across several layers of simulated tissue.
1. A simulated tissue structure, comprising:
a support;
an artificial anatomical portion configured to simulate a region of an abdominal wall; the anatomical portion being connected to the support such that the anatomical portion is penetrable from a first side to a second side of the anatomical portion; the anatomical portion including a plurality of simulated tissue layers arranged in juxtaposition with each other; the simulated tissue layers including a simulated skin layer located above the remaining layers; each of the remaining layers having an opening extending through the layer; the simulated skin layer having a top surface and a bottom surface; the top surface of the simulated skin layer defines a first side of the anatomical portion; a tubular structure having a proximal end and a distal opening at a distal end; the distal end of the tubular structure extending through one or more openings in the remaining layers;
wherein one of the remaining layers includes a simulated peritoneum layer and a first layer; the simulated peritoneum layer having a top surface and a bottom surface; the bottom surface of the simulated peritoneum layer forming the second side of the anatomical portion; the first layer having a top surface and a bottom surface; the bottom surface of the first layer overlaying the top surface of the simulated peritoneum layer;
wherein the distal end of the tubular structure is connected to the first layer; and
wherein the proximal end of the tubular structure is connected to the simulated skin layer.
2. The simulated tissue structure of claim 1 further including a second layer having a top surface and a bottom surface; the bottom surface of the second layer overlaying the top surface of the first layer.
3. The simulated tissue structure of claim 1 wherein the distal end of the tubular structure is connected to the bottom surface of the first layer.
4. The simulated tissue structure of claim 2 wherein the second layer is made of fabric.
5. The simulated tissue structure of claim 1 wherein the first layer is made of cellular polyethylene foam.
6. The simulated tissue structure of claim 1 wherein the simulated skin layer includes an opening defining an opening at the proximal end of the tubular structure; wherein the opening is closed.
7. The simulated tissue structure of claim 1 wherein the tubular structure is connected to the top surface of the simulated skin layer and extends through the opening in the simulated skin layer.
8. A simulated tissue structure configured to simulate an abdominal wall, comprising:
a simulated skin layer having a top surface and a bottom surface;
a simulated fat layer having a top surface and a bottom surface; the bottom surface of the simulated skin layer overlaying the top surface of the simulated fat layer;
a first simulated muscle layer having a top surface and a bottom surface;
a second simulated muscle layer having a top surface and a bottom surface;
a third layer having a top surface and a bottom surface; the third layer being located between the first and second simulated muscle layers;
a fourth layer having a top surface and a bottom surface;
a fifth layer having a top surface and a bottom surface; the bottom surface of the fourth layer overlaying the top surface of the fifth layer;
a simulated peritoneum layer having a top surface and a bottom surface; the bottom surface of the fifth layer overlaying the top surface of the simulated peritoneum layer;
wherein the simulated skin layer is made of silicone and includes a tubular structure extending through one or more of the other layers; the tubular structure having an opening at the proximal end that is closed.
9. The simulated tissue structure of claim 8 wherein the fourth layer is made of fabric.
10. The simulated tissue structure of claim 8 wherein the simulated fat layer is made of memory foam.
11. The simulated tissue structure of claim 8 wherein the third layer and fifth layer are made of cellular polyethylene foam.
12. The simulated tissue structure of claim 8 wherein the third layer and fifth layer are made of cellular polyethylene foam and the fourth layer is made of fabric.
13. The simulated tissue structure of claim 8 wherein the first simulated muscle layer and the second simulated muscle layer are made of ethyl vinyl acetate foam and are red in color.
14. The simulated tissue structure of claim 8 further including a simulated adhesion attached to the bottom surface of the simulated peritoneum layer.
15. The simulated tissue structure of claim 14 wherein the simulated skin layer includes a simulated scar in a location above the simulated adhesion.
16. A surgical simulation system, comprising:
an abdominal wall model, including:
a support; and
an artificial anatomical portion configured to simulate a region of an abdominal wall; the anatomical portion being connected to the support such that the anatomical portion is penetrable from a first side to a second side of the anatomical portion; the anatomical portion including a plurality of simulated tissue layers arranged in juxtaposition with each other; the simulated tissue layers including a simulated skin layer located above the remaining layers; the simulated skin layer having a top surface and a bottom surface; the top surface of the simulated skin layer defining a first side of the anatomical portion;
a trainer, including:
a base;
a top cover having a top surface and a bottom surface; the top cover being connected to and spaced apart from the base to define an internal cavity between the top cover and the base; the top cover having a first opening;
wherein the abdominal wall model is removably located inside the first opening; the model being connected to the top cover such that penetration of the anatomical portion provides access to the internal cavity of the trainer; and
further including a simulated tissue structure located inside the cavity; and a thin layer located inside the internal cavity of the trainer between the anatomical portion and the simulated tissue structure.
17. The surgical simulation system of claim 16 wherein the thin layer is suspended inside the internal cavity.
18. The surgical simulation system of claim 16 wherein the thin layer is connected to the trainer.
19. The surgical simulation system of claim 16 wherein the thin layer is made of silicone.
20. The surgical simulation system of claim 16 wherein the thin layer is made of fabric.
21. The surgical simulation system of claim 16 wherein the thin layer is configured to flutter when insufflation gasses are delivered into the cavity such as with an insufflation trocar after piercing the anatomical portion.
22. The surgical simulation system of claim 18 wherein portions of the thin layer are not attached to the trainer.