Prostate Resection System

Stage 1 :Resection - basic trainer
Stage 2: The Bristol Trainer
Stage 2: Laser Probe Prostate
Stage 2: Ureteroscopy
Transurethral Resection of the Prostate (TURP)
L&T have developed a two-stage training system for transurethral resection of the prostate; the simulation is from non-biological material which has been especially formulated for use with diathermy and laser. Once the trainee has gained confidence with the technique and instruments using the tank and slabs they are ready to go onto the next stage.

Basic Trainer

The Basic Trainer - designed as an introduction to techniques in manipulation and co-ordination. Working from a screen the trainee can practice taking strips from a flat slab (60213) or one with contours (60378) which are made from a resectable material submerged in a covered tank and earthed.

'The Bristol Trainer'

This diathermy prostate trainer made up of 8 items:

Universal Base (60325)
Universal Base Tray (60327)
Shield (60329)
Prostate Clamp (60335)
Diathermy Prostate Cover (60342)
Diathermy Prostate Lead (60370)
Diathermy Ground Plate Box (60371)
Diathermy Prostates: - one colour (60343)
- two colour (60341)

Using the Trainer:
A model simulates the internal applied anatomy of the prostate; it is secured to the same base which is used for the Laser Probe Prostate Trainer. For use, the model must be centred to a ground plate and provision is made for this in the design of the jig. A drain is provided for the evacuation of liquid.

The Diathermy Prostate:
The prostate is made from L&T resectable material which responds to diathermy in the same way as human prostatic tissue. The bulbar, urethra, veru montanum, lateral and median prostatic lobes, trigone, and ureteric orifices are all present. The prostatic tissue is surrounded by resectable material of a different colour in order to mark the prostatic capsule and therefore the limits of resection. The Diathermy Prostates (60341) and (60343) are replaceable items.

The resectable component fits into a rubber sleeve which includes a representation of the bladder. The whole is then clamped to a base which is standard for all our resectable products.

The system can be earthed using a standard soft return electrode, or using our own metal electrode system which is compatible with all diathermy equipment - Diathermy Prostate Lead (60370) and Diathermy Ground Plate Box (60371).

Resection:
The resectoscope is introduced via the distal bulbar urethra and irrigation is commenced. Resection can then proceed in a way which is strikingly similar to human tissue. Prostatic chippings can then be flushed out using an evacuator and examined as in the real operative situation.

The model was developed with invaluable input from urologists in Bristol, England and at the Royal College of Surgeons in London, England. It gives an unparalleled opportunity to learn orientation and use of the resectoscope in a safe environment. Experience in recent workshops conducted by leading urologists confirms the importance of this system in endo-urology training workshops.

Laser Probe Prostate

This model is very similar to the Diathermy Prostate and is made up of 4 items:

Universal base (60325),
Prostate Clamp (60335)
Laser Probe Prostate Cover (60354)
Replaceable item - Laser Probe Prostate (60351)

The qualities of this model are similar to the Diathermy Prostate and differ only in the size of the lumen of the urethra, which is smaller and the penis which is present on the Laser Probe Prostate Cover. The model is designed for the Interstitial Coagulation.



Ureteroscopy Trainer (60374)
This model provides an opportunity for education and practice in the techniques of Ureteroscopy and Lithotripsy in a simulated environment; offering diagnostic and treatment options which are normally only practised in the clinical situation. Training: Of course with these opportunities comes the demand for training in the use of the instruments. Our model provides an opportunity for education and practice in these techniques in an environment which simulates the operating theatre or, alternatively the model can be used in a place which is convenient for the trainer and the trainee. About the model: The model consists of representations of upper and lower urinary tracts mounted on a sturdy plastic base. The urethra has prostatic lobes and veru montanum while the bladder has a trigone with two ureteric orifices that give entry to the ureters right up to the renal cavity. A catch tray for fluid spillage is provided. The ureters and pelves have entry ports by which mock blood or artificial stones can be introduced. The response of our stones to the lithotripsy is remarkably similar to that or real urinary stones. This model can be used for rigid or semi-rigid ureteroscopy and accepts tools for lithotripsy, stents and stone retrieval. The degree of visual stimulation through the 'scope is strikingly accurate making this model ideal for use and training of these techniques. Any spectator can be forgiven for flinching when mock blood is squirted in through the urethra port!! Replaceable ureters are available: Opaque (60385) and Translucent (60388). This is a superb model for use in ureteroscopy and lithotripsy workshops.

The Ureteroscopy Model has been developed with much input from:

Mr Feneley and his colleagues at the Bristol Institute of Urology, Southmead Hospital, Bristol, England, UK
Mr. David Tolley of the Scottish Lithotriptor Centre, Western General Hospital, Edinburgh, Scotland, UK

L&T are immensely grateful for this important support from both these major centres.

Also Boston Scientific (Microvasive) have provided vital support for workshops during which the model was evaluated.

The Universal Base 60325 can be used with the Hysteroscopic Resectable Uteri
Hysteroscopic Diagnostic Uteri

See also L&T' clinical urology models: Diagnostic Prostate Trainer (60364)