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.
- 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
- 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.
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.