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TissueDB/Simulators/IUD Insertion Simulator

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IUD insertion training using cervix and vaginal canal simulator in Nigeria
User testing of IUD insertion training in Nigeria using the cervix and vaginal-canal simulator components. Image by Medical Makers (video by Nkeiruka Ameh; screenshot by Julielynn Wong).

The IUD Insertion Simulator is a low-cost trainer built from oil-based modelling clay, paper, aluminium foil and a 3D-printed uterus, for practising aseptic intrauterine-device (IUD) insertion — sounding the uterus, loading the IUD in its sterile package, setting the gauge to the sounded depth, and deploying the IUD, for copper and hormonal IUDs. It has three components: (1) a nulliparous cervix and (2) a parous cervix in modelling clay, and (3) a paper-and-foil vaginal canal wired as an "augmented feedback" circuit that sounds a buzzer when the uterine sound touches the vaginal wall, so the learner can practise a no-touch aseptic technique. The clay cervixes mount on a set of 3D-printed uterus models of varying depth for blinded insertion practice. It is a Medical Makers STARS module within the Global Surgical Training Challenge, for training nurses, midwives, and clinical officers in low- and middle-income countries.

Field Details
Features and Basic Operation An augmented-feedback circuit sounds a buzzer when the metal uterine sound touches the foil-lined vaginal wall, giving real-time feedback on a break in aseptic "no-touch" technique. Three 3D-printed uterus models of differing depth, with lids, allow blinded insertion practice.
Current Development Status Open training module for nurses, midwives, and clinical officers; built and shown in project user-testing images. The model's face, transfer, and clinical validity have not been formally studied.
Estimated Build Time and Cost US$15 (estimated)
Specialized Tools and Equipment A single-extruder fused-deposition-modeling (FDM) 3D printer with a build area of at least 141 x 148 mm, plus the printable uterus model files (STL), to make the uterus. A ruler and a pencil or chopstick for the clay cervixes, and scissors for the vaginal canal. In use, the trainer is operated with a metal uterine sound clipped into the feedback circuit.
Version Version 1
Development Team Contact Information Medical Makers (Julielynn Wong, Founder & CEO), as part of the STARS (Sexual and Reproductive Health and Rights) module of the Global Surgical Training Challenge. No public researcher email is given in the source.

The cervix and vaginal-canal dimensions follow published cervical and vaginal measurements,[1][2] and the os shapes follow documented colposcopic appearances;[3] the three uterus depths follow reported uterine dimensions.[4]

Tissues

Tissue Qty Material Cost Notes
Cervix (nulliparous) 1 Oil-based modelling clay Light pink; smooth, rounded os
Cervix (parous) 1 Oil-based modelling clay Light pink; wider "fish mouth" os


Structural Parts

Part Name Qty Material Cost Notes
3D-printed uterus (mounting body) 3 (one per depth) PLA Printed uterus models with lids for blinded insertion; the cervixes mount on its pegs. Reusable across many learners, so the per-use cost is low.
Vaginal canal (body) 1 Paper Rolled paper tube forming the vaginal canal, lined with foil for the feedback circuit.
Feedback-circuit lining 1 piece Aluminum foil Lines the inside of the vaginal canal; completes the circuit when the metal sound touches it.
Feedback buzzer 1 Buzzer Sounds when the uterine sound contacts the foil-lined wall (augmented feedback).
Feedback power source 1 9 V battery Powers the feedback circuit.
Circuit connectors As needed Alligator clips Connect the foil lining to the buzzer and battery; one clips to the metal uterine sound.
Fastening As needed Tape Secures the rolled canal and the circuit components during assembly.


Build Instructions

Phase 1: Print the uterus models

Step 1: Print the three uterus models

On a single-extruder FDM 3D printer (build area at least 141 x 148 mm), print the three uterus models (5.0, 7.0 and 10.0 cm uterine depths) and their lids in PLA. Print with no supports, no raft and no brim, at the "High Speed" profile with default infill; no post-processing is needed — the models are ready to use straight from the printer.

Verify: the three uterus models print cleanly with good first-layer adhesion, and their lids fit for blinded insertion.

Phase 2: Nulliparous cervix

Step 1: Collect supplies — light pink oil-based (stiffer) modelling clay, a ruler, and a pencil or chopstick.

Step 2: Form the cervix — roll the clay into a cylinder 2.5 cm in diameter and 3.0 cm long.

Step 3: Create the os — insert a pencil tip or chopstick through the centre to form the smooth, rounded os of a nulliparous cervix.

Step 4: Mount — fit the nulliparous cervix on the pegs of a 3D-printed uterus model.

Phase 3: Parous cervix

Step 1: Collect supplies — as Phase 2.

Step 2: Form the cervix — roll the clay into a cylinder 3.0 cm in diameter and 3.0 cm long.

Step 3: Create the os — use the pencil or chopstick tip to shape the wider "fish mouth" os of a parous cervix.

Step 4: Mount — fit the parous cervix on the pegs of a 3D-printed uterus model.

Phase 4: Vaginal canal with augmented feedback

Step 1: Form the canal — cut paper and aluminium foil to size with scissors, line the paper with the foil, and roll it into a tube 4.5 cm in diameter (14.0 cm in circumference) and 13.0 cm long; secure with tape.

Step 2: Wire the circuit — connect the foil lining to a buzzer and a 9 V battery with alligator clips, and clip one lead to the metal uterine sound, so a tone sounds when the sound touches the foil-lined wall. For safety, clip directly to the metal sound so no bare wire is exposed, and wear gloves during training.

Verify: the buzzer sounds when the uterine sound touches the canal wall and is silent when it does not.

Assembly is also shown in the module's vaginal-canal assembly video and complete assembly video.



References

  1. Londero AP, Bertozzi S, Fruscalzo A, Driul L, Marchesoni D. Ultrasonographic assessment of cervix size and its correlation with female characteristics, pregnancy, BMI, and other anthropometric features. Arch Gynecol Obstet. 2011 Mar;283(3):545-50. doi:10.1007/s00404-010-1377-5. PMID: 20145939.
  2. Bates CK, Carroll N, Potter J. The challenging pelvic examination. J Gen Intern Med. 2011 Jun;26(6):651-7. doi:10.1007/s11606-010-1610-8. PMID: 21225474.
  3. Atlas of Colposcopy: Principles and Practice. World Health Organization. Available from: https://screening.iarc.fr/atlascolpodetail.php?Index=13&e=
  4. Parmar AM, Agarwal DP, Hathila NC, Singel TC. Sonographic measurements of uterus and its correlation with different parameters in parous and nulliparous women. Int J Med Sci Educ. 2016;3(3).


Digital Resources


Simulator data
Alternative names Cervix and Vaginal Canal (with Augmented Feedback) Simulator



Simulator data
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