Surgical Procedure Simulators

"An Educational Tool"


Hysterectomy Simulation using the Lap Sim Insert

 

Hysterectomy Simulator

Several GYN procedures can be performed on the Lap Sim Insert.
Some examples of these Procedures are: removal of ectopic pregnancy/salpingotomy x 2, Bilateral tubal ligation, Bilateral or unilateral oopherectomy Resection of Endometriosis and Hysterectomy.
Additional replacement Uterus/Bladder are available.

INSTRUCTIONS:

  • Place the Lap Sim Insert into the Laparotomy Torso.
  • Tape the torso to the OR bed to prevent movement.
  • Drape the simulator in the normal fashion.
  • Make a Transverse/Pfannenstiel incision in the center of the module.
  • Dissect through the adipose tissue using the knife, bovie or scissors until the superficial vessels are encountered. Clamp, cut and tie the vessels as needed.
  • Continue to dissect through the adipose tissue to the fascia layer. Incise the fascia with the knife and mayo scissors. Apply Ochner clamps to the superior edge of the fascia layer.
  • Bluntly dissect the fascia layer away from the muscle. Repeat this procedure on the inferior edge of the fascia, using a knife metzenbaum, or mayo scissors.
  • Grasp the peritoneum with two hemostats and incise the tissue with a knife or metzenbaum scissors.
  • Once the pelvic cavity is opened, place an O'Conner O'Sullivan retractor or other appropriate self retaining retractor.
  • Grasp the omentum and reflect it superiorly to expose the uterus. A lap sponge may be placed in the superior portion of the pelvic cavity.
  • Explore the pelvic cavity.
  • From this point the following procedures can be performed: Removal of extopic pregnancy/Salpingotomy, Bilateral Tubal ligation, bilateral or unilateral oopherectomy and finally hysterectomy.
    • For Hysterectomy:
    • Place a clamp at the fundus of the uteres. Aviod cutting or puncturing the uterus.(the uterus is filled with cotton batting)
    • Grasp the simulated round ligament, clamp cut and tie. Pedicles are cut with a knife or Metzenbaum scissors, sutures are tagged with hemostats for traction. This procedure is done on both sides.
    • Identification of the ureters should be noted by the instructor.
    • Create a bladder flap.
    • Incise the vaginal vault close to the cervix with a knife or scissors. The anterior lip of the cervix is grasped with an Allis, Kocker or tenaculum forceps. Dissect around the cervix with scissors and amputate it from the vagina. Remove the uterus.
    • Potentially contaminated instruments used on the cervix and vagina are placed in a discard basin and removed from the field. Including sponge forceps and suction.
    • Close the vaginal vault with inturrupted suture.
    • Remove the lap sponge and draw the omentum over the cavity. Close the peritoneum, fascia, and adipose layers with appropriate suture. Close the skin with staples or suture.
    • Apply dressing.