Four Clinical Technology students (Fenne, Inge, Sophie en Zara) worked on this project under the supervision of:
Fredrick Bahati Mbise, Dr. Obstetric Gynaecologist (KCMC), Jos van Roosmalen, Prof. Dr. Obstetric Gynaecologist (LUMC), Thomas van den Akker, Prof. Dr. Obstetric Gynaecologist (LUMC) and Roos Oosting, Assistant Professor (TU Delft)
When a caesarean section is not performed properly, complications can occur. One of these complications is a connection between the bladder and the uterus, also called a vesicouterine fistula (VUF). This complication hardly occurs in the Netherlands, but due to insufficient training of surgeons in low- and middle-low-income countries, VUFs are a major problem there.
Women with a VUF experience constant incontinence, with all the psychosocial consequences that entails. Research has shown that training on a physical model significantly improves knowledge and skills and thus reduces the complication rate. That is why we have built a phantom of the pregnant belly for our bachelor end project, so that surgeons from low- and middle-low-income countries can train on it. For this project, we traveled to one of those middle-low-income countries, Tanzania. There, we studied the local context, talked to surgeons and attended caesarean sections. In addition, we conducted a literature study to determine the most crucial step in performing a caesarean section if VUF is to be prevented. This literature study showed that this is the step in which the bladder is displaced from the uterus.
With this knowledge, we started the design process.
Our goal: a sustainable, locally produced phantom for less than 50 euros, on which bladder displacement can be practised.
To obtain the final result, we went through three iterations and an interim validation. In addition, we kept in close contact with our supervisor in Tanzania about local producibility and we visited the LUMC to get feedback from experienced surgeons on the quality of the bladder shear.
The final design can be seen in the figure. In addition to the essential organs, such as the bladder, the uterus and the skin, the peritoneum and the bones have also been incorporated into the phantom. We are very proud of our result. With this phantom we have met all our design requirements: the phantom is sustainable, locally producible thanks to a manual, under 50 euros and the bladder shear can be performed adequately on the phantom.
It doesn't end here; we will hand over the project to an enthusiastic student of the master Biomedical Engineering who will continue working on the project.
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