Cadaveric simulator to mimic bleeding

We wish to develop a model to mimic pulmonary circulation that is apt to train the fellows training in thoracic surgery and other surgeons interested in thoracic surgery. This will impart necessary surgical skills to handle pulmonary vasculature during pulmonary resectional surgery.

We are using soft embalmed cadavers for training as the texture of organs in these cadavers match the consistency and tissue handling properties close to the live tissues. However lack of bleeding does not allow the participants to have a 'real-life situation'. Developing a cadaveric simulator that bleeds will match this further closer to a live surgery being performed.

Once developed we will pilot test the simulator and develop a checklist to help in self appraisal. This will include the time of dissection and the number of bleeding episodes encountered during the exercise among other parameters. 

We are using soft-embalmed cadavers for training in thoracic surgery. The consistency of organs in such cadavers mimic closely to that of live tissues. Our experience of training in these modules has been good except that it lacks bleeding that is so very important to take care of during surgery.

We wish to develop a technique to simulate pulmonary circulation. The pulmonary vasculature will be flushed out initially of any clots and the pulmonary artery and vein will be cannulated. A solution mimicking blood then can be circulated with the help of a roller pump. While dissection, if there is injury to a blood vessel there would be bleeding that will need to be tackled by the trainer. This will give him a real-life experience. In case of uncontrolled bleeding or difficulty in arresting haemorrhage, the pump will be turned off and the vessel will be repaired by the trainer and the dissection would continue further. 

The model can be improved further to simulate pulsatile bleeding in arterial circulation.

Psychomotor skills to handle the pulmonary vasculature during pulmonary and hilarity dissection while performing pulmonary resection surgery.

Haemorrhage during pulmonary surgery remains a crucial problem and is a major limiting factor during the initial curve of learning. The simulation of bleeding will help the trainer in being careful not to injure vessels and also to control the haemorrhage and repair the damaged vessels in case of vascular injury. These are essential skills for any thoracic surgeon. 

This model will be of help to the surgeons pursuing advanced training in thoracic surgery and other practitioners who are interested in thoracic surgery. At present there are few surgeons committed to pulmonary surgery. Most of the cardiovascular-thoracic surgeons practice cardiac surgery alone and there is a felt need of training of specialists committed to pulmonary surgery. As bleeding during thoracic surgery is dramatic, sudden and massive that may be life threatening, training even under supervision is not without risk. This simulator will help train the surgeons well and with repeated practice sessions, we hope that the surgical skills of the trainee would improve making them safer surgeons to practice thoracic surgery. 

We have a team of workers in SET (Skill, e-learning and Telemedicine) facility at our Institute. We have the facility of procuring, storing and embalming cadavers, the team comprises of the the ground-level workers and the faculty of Anatomy and Forensic Medicine. Other workers employed in our wet laboratory will also help in the basic work of cadaver and simulator handling.

We have a large team of educators and technical experts of various specialities. For the purpose of this project we have a team of 3 surgeons dedicated to thoracic surgery who will help in further designing and improvising the model as it takes the practical shape. 

We have a good constellation of educators and other workers. We are open to include any other specialised person as per the need of the proposed project.