TOTBV-03: SIMULATION DEVICE TO INSTRUCT, ASSESS AND PROVIDE FEEDBACK ON ABDOMINAL WALL MYOFASCIAL CLOSURE TECHNIQUES
Beatrice Caballero; Texas Tech University Health Sciences Center

What problem in education is addressed by this work?:
There is a strong need for a standardized way to compare different abdominal wall closure techniques and materials under physiologic conditions. Current models utilize a synthetic abdominal wall made of polyurethane matrix mounted on a tensile testing machine, however, it is important to create a more realistic model. This device will incorporate intra-abdominal pressures, intra-abdominal contents and abdominal muscle activity to represent human anatomy as much as possible.

Describe the intervention:
The intervention involves the development of a simulator using porcine abdominal walls mounted on a tensile machine in addition to intraabdominal contents created via several layers of polymers and gel. Surgical residents will be asked to close three incised samples, each using a different technique and suture material. The purpose is to evaluate the biomechanical effects of suture bite size, intersuture distance and suture material using a 3D image correlation system to capture strain patterns as well as direct visual evaluation with photographic documentation.

Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome:
This test device could be reproduced and implemented at other institutions providing an easily accessible tool for training in abdominal wall myofascial closures and evaluating the effect of a suboptimal closure technique. Limitations include the inability to simulate tissue healing, as it is an anatomical model without perfusion as well as the potential inability to collaborate with other departments to create the entire device. However, valuable surgical skills can still be developed by using a model that accurately simulates human abdominal wall biomechanics.