Homemade Models Reinforce Surgical Skill
Posted 10/14/2008
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All he needed was Home Depot and a little imagination.
Building off of the success of the Carl J. Shapiro Simulation and Skills Center to provide residents with a means of practicing techniques for laparoscopic surgery, Christopher Awtrey, MD, Obstetrics and Gynecology, decided to construct his own device, allowing residents and fellows in his department to narrow the focus from practicing random skills to task specific skills.
"The old way of training was see one, do one, teach one," Awtrey says. "But now residents can see one, practice, practice, practice and then do one."
Using basic materials like a plastic bucket, wood and tubing, Awtrey constructed two models of a female pelvis in his garage. One model featuring an orange bucket, rope, canvas and wood allows residents to practice the most common gynecological operation - a hysterectomy. The bucket simulates the pelvis; the cloth represents the tissue surrounding the uterus and the piece of wood symbolizes the uterus. In its entirety, the model lets residents practice clamping the tissue surrounding the uterus as they prepare to remove the uterus at varying depths.
The second model provides the opportunity to practice four laparoscopic suturing techniques: controlling the blood supply to the ovaries, closing an incision in the fascia of the abdomen, stitching closed the vaginal cuff after a hysterectomy and suturing an ovary to the pelvic wall during an ovarian transposition. A piece of wood represents the woman's pelvis. Canvas swatches simulate the vaginal cuff, the pelvic wall and the fascia or connective tissue surrounding the muscle in the abdomen. Rubber tubing takes the place of blood vessels and a ball of white yarn represents an ovary. Inexpensive and mobile, Awtrey says these models help OB/GYN residents hone their laparoscopic skills, thereby improving patient safety.
"These are portable and can be made for $30," says Awtrey. "You can buy complicated, simulators for thousands of dollars or you can inexpensively construct a model of an operation with task specific exercises to prepare residents for the operating room."
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