Anorectal Malformations Surgical Repair Trainer

Background

Anorectal malformations are birth defects in which the anus and rectum (the lower end of the digestive tract) fail to properly develop. They occur in an estimated 1 in 4,000 newborns and can range from mild to complex. Up to one third of babies who have genetic syndromes, chromosomal abnormalities or other congenital defects may also have anorectal malformations which may cause difficulties or the prevention of the passing of stool, constipation, urinary tract infections, and intestinal blockages. These malformations can usually only be repaired surgically, and the procedures are usually complex. However, due to the relative infrequency of this condition, it is difficult for surgeons to gain experience and there are no specialized, complex trainers to simulate the procedure.

Technology Overview

To address this unmet need and provide surgeons with a way to gain experience with no risk to patients, Boston Children's Hospital researchers have invented a high-fidelity surgical skills trainer for anorectal malformation procedures. The trainer assembly consists of a consumable module and reusable base, however the trainer could also be fabricated as a non-modular design. The module fits into the receptacle area of the base, which is a 3D-printed 3-piece hollow shell assembly, representing the pelvic region of an approximately 6-month-old patient atop a cylindrical pillow with an included storage drawer. Most importantly, the module consists of silicone-based simulated tissues contained within a rigid shell to simulate the anatomy of the inferior pelvic region.

The simulated tissues include reinforced skin, dissectible fat and reinforced thin muscle and organ structures that accommodate incision, dissection, suturing, and retraction. This training tool is intended to be used for surgical skills training under expert guidance or asynchronously. The consumable module is also able to be removed and replaced quickly, allowing sequential training sessions to occur more rapidly and different variations of the module to be used.

Applications

• Surgical practice for anorectal malformation procedures

Advantages

• Provides hands-on training at no risk to patient
• Consists of synthetic materials that are shelf stable, controllable, and consistent
• Semi realistic anatomy (in modules) and haptics with simulated tissues that hold suture
• Quick-change modules/modularity. Modules are single-use, replaceable/consumable elements
• Lightweight, portable