Abdominopelvic region surgical training model

A surgical training model of the abdominopelvic region of a human patient's body to assist in training an operator in implantation of a pelvic sling or mesh to support any one of a rectum, urethra and pelvic floor, the implantation including the advancement of a shaped needle of a sling implantation tool via at least one medial or vaginal incision and optimally between right and left surgical skin incisions overlying the patient's respective right and left obturator foramen and respective right and left sites in a pelvic floor region to form a subcutaneous passage for the sling transversely across a portion of the urethra to simulate normal pubourethral ligament support, the sling implantation tool comprising a handle and an elongated needle coupled at a needle proximal end to the handle and extending in a curvature through two-dimensional and/or three-dimensional space to a needle distal end, the surgical model comprising:

• a relatively rigid skeletal frame shaped in conformance with at least a portion of the human pelvic girdle comprising at least portions of the right and left coxal bones each including a substantially realistic representation of at least the ischium and pubis, including the superior pubic ramus and the posterior ischiopubic pubic ramus joined at the interpubic disc, the skeletal frame defining right and left obturator foramens;
• a penetrable membrane extending substantially across at least one of the right and left obturator foramens and having a membrane puncture resistance selected to mimic the puncture resistance of the native human obturator membrane to puncture by the needle distal end;
• a mass of elastomer encasing the skeletal frame having an external shape substantially representative of the external appearance of the human abdominopelvic region including superficial features of posterior skin overlying the pubis and the body overlying the tubular member representing the urethra, the elastomer selected to present a resistance to passage of the elongated needle substantially corresponding to the resistance to passage of the elongated needle presented by the native human subcutaneous connective and muscle tissues in the abdominopelvic region adjacent the pelvic girdle;
• and
• a member shaped to represent one of the rectum, urethra and pelvic floor muscles extending in substantially physiologic relation to the skeletal frame disposed within the mass of elastomer,
• whereby the surgical trainee is able to palpate the surgical model and practice manual advancement of the elongated needle of the sling implantation tool from one or more selected simulated skin incision of the anterior skin surface and the body overlying the tubular urethra model through one or both of the respective right and left penetrable membranes and along the respective right and left posterior ischiopubic pubic ramus of the skeletal frame.

A surgical training method for training an operator in implantation of a pelvic sling to support any one of a rectum, urethra and pelvic floor muscle, to comprising:

• providing a model of the abdominopelvic region of a human patient's body comprising:
• a relatively rigid skeletal frame shaped in conformance with at least a portion of the human pelvic girdle comprising at least portions of the right and left coxal bones each including a substantially realistic representation of at least the ischium and pubis, including the superior pubic ramus and the posterior ischiopubic pubic ramus joined at the interpubic disc, the skeletal frame defining right and left obturator foramens;
• a component model of a body tissue comprising at least one of a body organ, muscle group, membrane, ligament, blood vessel, or nerve in substantially correct anatomic shape, size and relation to the skeletal frame;
• and
• a mass of elastomer encasing the component model and the skeletal frame having a flexibility, density and consistency mimicking that of tissues of the human body;
• and
• determining an incision site of the model for a simulated pelvic incision;
• and
• manually advancing an elongated surgical instrument from at least one selected simulated pelvic incision through the mass of elastomer and to at least one obturator foramen to form a pathway.

A surgical training method for training an operator in implantation of a urethral sling to support the urethra to comprising:

• providing a model of the abdominopelvic region of a human patient's body comprising:
• a relatively rigid skeletal frame shaped in conformance with at least a portion of the human pelvic girdle comprising at least portions of the right and left coxal bones each including a substantially realistic representation of at least the ischium and pubis, including the superior pubic ramus and the posterior ischiopubic pubic ramus joined at the interpubic disc, the skeletal frame defining right and left obturator foramens;
• a penetrable membrane extending substantially across at least one of the right and left obturator foramens and having a membrane puncture resistance selected to mimic the puncture resistance of the native human obturator membrane to puncture by the needle distal end;
• a mass of elastomer encasing the skeletal frame having an external shape substantially representative of the external appearance of the human abdominopelvic region including superficial features of posterior skin overlying the pubis and the body overlying the tubular member representing the urethra, the elastomer selected to present a resistance to passage of the elongated needle substantially corresponding to the resistance to passage of the elongated needle presented by the native human subcutaneous connective and muscle tissues in the abdominopelvic region adjacent the pelvic girdle;
• and
• a tubular urethra model shaped to represent the urethra extending in substantially physiologic relation to the skeletal frame disposed within the mass of elastomer,
• palpating the surgical model to locate a region of the urethra;
• and
• manually advancing the elongated needle of a surgical instrument from one or more selected simulated skin incision through the one or both of the right and left penetrable membranes and along the respective right and left posterior ischiopubic pubic ramus of the skeletal frame.

A kit for demonstrating or training medical personnel in passing an elongated surgical instrument through the skin and the underlying tissues of the abdominopelvic region of a human patient's body comprising:

• an anatomic model of the abdominopelvic region of a human patient's body comprising:
• a relatively rigid skeletal frame shaped in conformance with at least a portion of the human pelvic girdle comprising at least portions of the right and left coxal bones each including a substantially realistic representation of at least the ischium and pubis, including the superior pubic ramus and the posterior ischiopubic pubic ramus joined at the interpubic disc, the skeletal frame defining right and left obturator foramens;
• a component model of a body tissue comprising at least one of a body organ, muscle group, membrane, ligament, blood vessel, or nerve in substantially correct anatomic shape, size and relation to the skeletal frame;
• and
• a mass of elastomer encasing the component model and the skeletal frame having a flexibility, density and consistency mimicking that of tissues of the human body;
• and
• an elongated surgical instrument comprising an elongated needle adapted to be grasped to advance the elongated needle from selected simulated skin incisions through the mass of elastomer and one of the right and left obturator foramens to form a pathway.