TissueDB/Tissues/Umbilical Cord
License: CC-BY-SA-3.0 by Johnlancer123
In surgical simulation the umbilical cord is modelled where a trainee has to tell one congenital abdominal wall defect from another: omphalocele is a defect of the cord itself, in which the intestinal contents do not return to the abdominal cavity after physiological herniation, whereas gastroschisis is an incomplete closure of the abdominal wall, usually to the right of the umbilicus, exposing the fetal intestine — so on a gastroschisis model the cord has to read as separate from the herniated bowel.[1]
Materials
| Material | Visual | Tactile | Simulator | Notes |
|---|---|---|---|---|
| Latex tourniquet tube | Abdominal Wall Defect Simulator (Medeiros) | Represents the umbilical cord, kept separate from the herniated bowel.[1] |
Things to Look Out For
- Placing the cord clamp too close to the viscera — in the published validation one expert marked the model down with the comment "The cord clamp seems to be too close to the viscera", and the authors list moving the clamp away from the viscera among the improvements planned for the next version of the model. The clamp should mark the cord, not crowd the herniated bowel.[1]
- Adding blood around the defect — another expert commented that "The presence of blood could be confusing in the possibility of bowel damage", and the authors list removing the blood makeup among their planned improvements. Blood applied near the cord and defect invites the trainee to read an injury that is not part of the diagnosis being taught.[1]
- Letting the cord read as continuous with the bowel — the authors set out as a design prerequisite that the model must demonstrate the umbilicus, the defect, the exposed abdominal loop and the differences between gastroschisis and omphalocele. A cord that is not clearly separate from the herniated loops removes one of the signs the trainee is being taught to distinguish.[1]
Related Structures
- Umbilicus — the navel, marking the site where the cord attached; a distinct tissue from the cord itself
- Abdominal Wall — the wall whose incomplete closure produces gastroschisis
- Bowel — the herniated intestinal contents the cord must stay visibly separate from on the gastroschisis model
References
[edit source]- ↑ 1.0 1.1 1.2 1.3 1.4 Medeiros GA, Gualberto IJN, da Silva CHND, Diniz AMB, de Santana JBF, Volpe FP, Gadde R, Mazzo A, de Oliveira RC, Sbragia L. "Development of a low-cost congenital abdominal wall defect simulator (WALL-GO) for undergraduate medical education: a validation study." BMC Medical Education 2023;23(1):966. DOI: 10.1186/s12909-023-04929-3. PMID: 38102605. PMC10724958. Licensed CC BY 4.0.