Surgical Devices
A surgeon can fully appreciate medical devices only after mastering all aspects of their use and effectively utilizing their full range of capabilities. Simulation training provides an excellent opportunity to achieve this proficiency.
Training exercises range from basic to advanced. The most basic exercises focus primarily on instrument control without requiring activation. As a result, the harmonic energy generator can remain off, and the endo-cutter can be used with a spent reload and no battery, ensuring cost-effective and practical training.
Harmonic™ Shears
Harmonic 1100 shears are the preferred energy device to be used in VATS simulation training:
- 36cm shaft length is preferred for VATS training and
- 20cm for thoracotomy
The simulated parenchyma can be cut quickly using the harmonic shears, typically requiring device activation for only 1–2 seconds. Prolonged activation will eventually destroy the teflon pad of the harmonic rendering it unusable
Tension...
Tissue division relies not only on application of heat but also on maintaining proper tissue tension.
Echelon™ Endo-cutter
The VATS Simulator was initially designed as a training tool to help trainees master the use of the endo-cutter.
To reduce the costs of simulation training with the Echelon™ endocutter, the stapler cartridge was modified for infinite reuse. This modification enables the stapler to perform cutting without deploying staples, providing an economical solution for repeated practice:
Used cartridge must be opened (1), and all the colored plastic drivers carefully removed from their slots (2).
Reactivation. To reactivate reloads after firing, they must be removed from the endocutter gun each time.
Then, the slider — a plastic or metal component that moves inside the cartridge — must be pulled backward (4).
Paper clip...
Using a small pointy screwdriver or paper clip, the reload can be reactivated without removing the metallic cover.
Modified Cartridge
To be able to reactivate the reload without removing it from the endocutter gun, an additional modification is required:
- Hole. A longitudinal hole must be drilled at a strategic point near the tip of the reload.
- Ramrod. A suitably sized ramrod can then be inserted through the hole to pull the driver backward, reactivating the reload while still in the gun.
Warning...
A hacked endocutter cartridge does not seal the tissue by a staple line.