OBJECTIVES

Development of a simulation platform for training and evaluating the Sentinel Lymph Node Biopsy (SLNB). This minimal invasive surgery technique is practiced by dermatologists (melanoma cancer) and gynecologists (breast and vulva cancers) in people who have already been diagnosed with cancer.

THE TECHNIQUE

A sentinel lymph node (SLN) is defined as the first lymph node to which cancer cells are most likely to spread from a primary tumor. Sometimes, there can be more than one. During this procedure, the sentinel lymph node is identified, removed, and examined to determine whether cancer cells are present.

• A negative SLNB result suggests that cancer has not yet spread to nearby lymph nodes or other organs.
• A positive SLNB result indicates that cancer is present in the sentinel lymph node and that it may have spread to other nearby lymph nodes and other organs.

PROCEDURE

1. Locate the sentinel lymph node (or nodes)
2. Inject a radioactive substance (Tc99m) near the tumor. This substance drains directly through the lymphatic vessels to the SLN
3. Locate the points of highest radiation index with a gamma probe (where de SLN is located)
4. Remove the node and analyze it

CONTRIBUTION

Collaboration in the design and implementation of the training platform, contributing with the know-how in the design of complex anatomical structures, active vascularity, etc. as well as in the development of technologies for the measurement and evaluation of the execution of the surgical technique.

SENTISIM

SENTISIM is a project of technological development in health in which participate the Unit of Clinical Management of Dermatology of the Hospital Universitario Virgen Macarena of Seville, and the Division of Robotics and Vision of the Centre of Research in Biomedical Engineering of the Technical University of Catalonia (CREB UPC).

Each unit of the platform is integrated by an interactive synthetic pad that simulates the anatomy and function of the inguinal region, and a module that controls the physiological functions (arterial pulse and hemorrhage).

The synthetic simulation pad consists of:

• Multi-layer and multi-fabric structure that reproduces the soft parts of the inguinal region (skin, subcutaneous cellular tissue, muscles)
• Individual anatomical structures (veins, arteries, lymph nodes) and their functions (arterial pulse, nerve impulse, blood circulation)
• Navigation system for pre- and intraoperative identification of the SLN, with a control and monitoring software for learning.

The control module guarantees the control, navigation and fulfilment of the physiological functions incorporated in the simulator. It consists of:

• Arterial pulse generation device
• Bleeding simulation layers
• Navigation device: SLN with signal emission and customized hand probewith no need to use radioactive substance.
• Software: Receives, analyses and stores data from the different sensors, generating signals for the synthetic pad and the user interface. When the exercise is finished, the software evaluates the training session through data analysis.