Hello, I'm Dr. Koduri. I'm from India, Hyderabad. Training surgeons in this era for special surgery is a difficult task because you need a model which is as close to the human anatomy as possible. Obtaining such models is an expensive endeavor and we were faced with this situation when we were conducting a workshop in 2017. And so we have found a way which is very easy on your purse to train the residents and also to make the workshop more meaningful. So these are the materials that we used. These are masks. This is a potato starch that you can get from any supermarket. And this is a terracotta or any kind of a pot of this size which is about 4 inches or 5 inches by 3. And this is the bathroom sealant. It's the silicone sealant. And this is the epoxy compound which is quick drying. And this is a lubricant. And this is oil to make it supple in order to shape the, you know, made silicone products. And these are the colors that we use so that to resemble either a muscle or an internal organ. And these are just scissors and a knife. And we have a plastic vessel and a spatula. Here we have the terracotta model. And this is supposed to be a bladder. And here we have put the epoxy compound, quick drying one, so that we will put the silicone on top of it. This is the end product of all this work. And we are going to fashion this into a bladder now. This is the finished product. And what we are going to do is we are going to let it dry for about 10 hours. After which we make an incision on the surface which we think is the anterior surface. And break the inside terracotta piece and take the pieces out. After that you have a bladder and a urethra. And you can use a cystoscope easily to demonstrate the cystoscopy procedure. Here we are cutting open the model anteriorly to demonstrate the insides of the silicone bladder. This opening will be viewed later. Watch the grooves made by the epoxy compound. Depict the trigone and also the urethral opening right in the center. Also watch the entry of the left urethra into the bladder. And the external appearance of the right urethra which have been made with melton catheters. Surgeons can practice cystoscopy and scenting of the urethras on this model. This model has been made to demonstrate TVT and TOT. As you can see the anterior abdominal wall has been made accessible as well as the obturator fossa. Now you are going to demonstrate the attachment of the erector longus tendon. And the space beneath it where you are going to enter which is at the level of the clitoris. And now you are going to put your fingers in the vagina and go underneath the pubic ramus. And at the entry point which is below the erector longus. You are going to put the trocher in at a 45 degree angle and perforate the obturator membrane. And then follow your fingers in the vagina and come out of the vagina. As you are watching right now the tip of the trocher is outside. And then you thread the mesh into this. And if you need to do a TVT then you do the same dissection in an upward direction. Then the trocher has to come up close to the midline. And watch out for the external iliacs on either side. Now take out the whole thing and see how it is made. Now you can see that these muscles have been placed in the anatomical position that they should be. That is the erector longus tendon which is the raised one under which the entry point of the trocher will be. And you can also see the erector brevis, the gracilis muscle. And finally underneath that you see the erector magnus which is a wider muscle. And also you can then watch the obturator vessels over there. Now as you can see the positioning of the pelvis makes the orientation of the muscles different. And that will also be appreciated by the residents. The beauty of this model is that it is only $25 and it can be remade again all over. The next model we made was made for laparoscopic sacrocolpopexy. The model was made and placed inside the lap trainer with a spatula inside the vagina. We made the aorta and inferior vena cava, middle sacral vessels, the bifurcation, the ureters with their anatomical relationships intact. We also made the bladder and the vagina and the rectum out of other materials like foam. After putting the sacrum in place we closed the whole of this display with a gauze like transparent cloth and then put it in the lap trainer. The sacrum itself was made from silicone and a mold of the sacrum and was supported by wooden blocks so that the sacral promontory and the hollow of the sacrum were clearly visualized through the scope. A laparoscopic sacrocolpopexy was then performed using gauze as the mesh.

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potato starch model

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