Medsim

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MEDSIM SIMULATOR

Rowena Madar rowmad@hotmail.co.uk

Satthaporn Barnes s.c.barnes@hotmail.co.uk

PROBLEM SPACE AND RATIONALE

“Poor needle insertion technique can lead to both minor and major complications”

Rowena Madar & Satthaporn Barnes

Needle insertion is a common procedure in medical care. It is used in a variety of different operations ranging from taking patients bloods, anaesthetising a patient and is also a primary stage of minimally invasive surgery. Although there are many different ways and techniques used to Insert a needle they all share similar characteristics and require an understanding of both visual and tactile response. Poor needle insertion technique can lead to both minor and major complications. For this and many other reasons, improving teaching practices for such procedures has become an increasing focus in medicine. FRAMING THE PROBLEM

One needle insertion technique that carries considerable risk is the Veress needle procedure. The Veress needle technique is favoured by gynecologists in the UK, and the first, most critical stage laparoscopic surgery, attributed to 50% of all complications in this procedure. The needle is blindly inserted into the abdomen to inflate it, the operator relying heavily on two distinct ‘gives’ felt as the needle transcends the fascia and the peritoneum to determine that the needle has sufficiently advanced into the peritoneal cavity. At this point, the needle should immediately stop advancing, for fear of tearing the bowel. Currently a trainee gynecologist’s first experience of using a Veress needle is during surgery when inserting it into a real patient.

The project was undertaken by a multidisciplinary team of 4 master’s students. This included two product designers, a medical engineer and a mechanical engineer with the aim to make a professional Veress and lumbar puncture needle training system by optimising the mechanical, computational and design elements, suitable for use in surgery training. In particular, the designers focused on the user’s learning experience through tutorials and anatomical diagrams in an interface and a realistic product casing. UNIVERSITY OF LEEDS 51 PRODUCT DESIGN

PROBLEM SPACE AND RATIONALE

Similarly, lumbar puncture is another common needle insertion procedure often used to collect Cerebrospinal fluid (CSF) and required preliminary to spinal anesthesia. Associated risks with incorrect technique include postoperative headaches and very occasionally, brain stem herniation. Technical skills necessary for lumbar puncture procedure involve finding the correct inter-vertebral space and passing the needle into it. While relatively straightforward with the average patient, accurate needle insertion becomes more challenging when patients are obese, pregnant, elderly or uncooperative, requiring the operator to have both skill and experience.


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