S504.100 ZOE® Gynecologic Simulator User Guide User Guide
Contents
1. Figure 4e Removing skin To replace the skin simply reverse the procedure i e Figure 4b Skin completely off and turned over begin by carefully fitting the skin over each leg and then To remove the skin slide it up and over the back end of the torso S504 100 User Guide Information Changing Introitus with Vagina and With experience all of the tasks below can be done Rectum without removing the skin thereby minimizing the chance of tearing it Figures 6a and 6b illustrate how to change the introitus with vagina and rectum To remove this Changing Cervices and Uteri item detach the 4 locking pins by pulling them out figure 6a To attach a different introitus with Figures 5a and 5b illustrate how to change the vagina and rectum introduce the 4 locking pins on cervix and uterus with the skin removed A narrow the pelvic cavity holes and push them using your locking ring dark gray holds the cervix firmly in fingers Figure 6b place at the top of the vagina while the body of the uterus is attached to the cervix with the wide locking ring To separate the cervix and uterus Figure 5a insert two fingers of one hand into the vagina and grasp the cervix Gently unscrew the wide locking ring with the other hand allowing the body of the uterus to be detached and replaced with a different uterine body To change the cervix Figure 5b first detach the uterine body and unscrew the narrow locking ring then remo2. Section 3 Instructions for Use before working with ZOE Gynecologic Simulator for the first time Caution The ZOE Gynecologic Simulator is constructed of materials that approximate human skin texture therefore when handling the simulator use the same gentle technique that you would use when examining a patient Have trainees wash their hands prior to putting on examination gloves Always handle the simulator with clean hands To make it easier to insert gloved fingers or instruments into the vagina apply a few drops of dilute soap solution to the fingers or to the tip of instruments Alternatively only use a water based silicone lubricant such as K Y Jelly When palpating the abdomen or performing bimanual examinations use the pads of your fingers Do not palpate using fingernails as this may tear the skin Cleaning After the session is over clean the simulator and remove all residues if lubricant was used The simulator may be cleaned with a mild detergent or with soap and water Do not clean with harsh abrasives When thoroughly dry apply a small amount of talcum powder to return the surface to a skin like feel and appearance Note Before attempting to remove the outer skin covering the rigid plastic torso please review the how to instructions for this procedure in Section 3 Do not apply force when removing the skin from the torso Storage Store the simulator in the plast
3. round ligaments e Patent cervices for 6 8 week and 10 12 week uteri 3 each 4 nonpatent cervices for visual recognition of normal and abnormal cervices 5 patent cervices for visual recognition of normal cervices Talcum powder Flash light Soft carrying bag User Guide Note All cervices and uterine bodies corpuses are detachable see Section 5 for description Also included is a Pelvic Examination Learning Package CD The purpose of the learning package is to provide health professional instructors with additional information and performance based learning materials to Assist trainees in learning to perform pelvic examinations competently and Enable instructors to measure student performance objectively Medium skin tone is the standard simulator color however light or dark skin is available at no extra cost 3 Instructions for Use The ZOE Gynecologic Simulator is shipped assembled with normal cervix introitus with vagina and rectum anteverted uterus with round ligaments ovarian ligaments tubal fimbriae and ovaries in place Figure 2b Figure 1b Opposite End with View Port The view port Figure 1b may be used to look into the pelvis to see the simulated uterus tubes ovaries and other pelvic structures In addition the instructor can insert her his hand through the port to determine what the trainee is actually feeling i e palpating the uterus or locating an ovary on bimanual exami
4. to Demonstrate insertion of Female Condom The vagina on the 504 3 introitus has a generous distal segment suitable for fitting the distal end of a female condom over the cervix Be sure to use a dilute soap solution before initiating the procedure 13 9 10 Minute Postpartum IUD Insertion Kit Module 504 5 Optional Introduction Postpartum uterus is adapted for instrument placement of an IUD during the first 10 minutes postpartum Kit includes a removable introitus uterus assembly with locking pins Description To replace the standard introitus with vagina and rectum for the 504 5 introitus refer to Section 3 Instructions for Use With the large postpartum uterus in place use a small amount of soap and water to lubricate a set of long latex gloves fitting at least to the elbow of the student Grasp the Copper T 380 IUD along its medial axis between the forefinger and the middle finger of the hand Advance the gloved hand into the vagina past the cervix and through the uterus to the fundus At the fundus one will observe a conical device designed to trap the IUD Gently push the IUD through the trap and release the IUD Remove the gloved hand Cut the string on the IUD if needed The IUD is easily retrieved S504 100 User Guide 14 S504 100 User Guide 10 Spare Parts Removable introitus with vagina rectum 4 504 100 004 pin assembly Metal frame assembly 504 100 006 Carrying bag 504 100 007 Post
5. 12 7 Hysteroscopy kit Module 504 2 Optional uuuuuununnununnannnnannnnunnununnannnnunnnnan nun nn nun nun an nun unnn 12 ipiga oien a p ee a een ee 12 SS CUNO ON ee ee ee 12 8 48 Hour Postpartum IUD Insertion Kit Module S504 3 Optional unuuuununnnnnnunnnunnnnnnunnnnnnannn 13 TEL OGG On a O ee een ee 13 VSS CUNO ON APERAERSREHELDERERHEEPERESPEEDPESBERSEFEULNFLEREERNEFFERIUREREBESBEEOETELENSEUEESONELEEELEREERPESEFETLENLENOEODEFENELEREECHEEBEEUBREHFEECSDDER 13 Pe IN QO i e ANE E etn reece san tannin E E nieces E E O IE ENE A A A E E E E E E E E E ET 13 9 10 Minute Postpartum IUD Insertion Kit Module 504 5 Optional u zu0uununnannannunnnnnnnannannn 14 FING OGUCHION EREET E E TTET ETE TEE EAE TE E TT 14 DES CHAPUO I ae ee ee ae ee 14 EI Spare PariS eure ea ee ee ae ee RE u Ba ie nee 15 Disclaimer The ZOE Gynecologic Simulator S504 100 is to be used only as part of an approved educational program for health professionals It should not be used for clinical decision making Warning To avoid permanently staining Do not press the skin of the simulator against soiled surfaces or newsprint Do not wrap the simulator in newsprint or other printed material e g colored plastic or Saran wrap Ball point pens ink or markers permanently stain the skin Do not write on the skin of the simulator Do not use povidone iodine Betadine or other iodine containing solutions on the simulator Please read
6. Dr u Gaumard Leadership Through Innovation 504 100 ZOE Gynecologic Simulator User Guide ZOE Gynecologic Simulator is an interactive ZOE Gynecologic Simulator 13 5 1 educational system developed to assist a 2013 Gaumard Scientific Company Inc certified instructor It is not a substitute for a All Rights Reserved comprehensive understanding of the subject www Gaumard com matter and not intended for clinical decision making S504 100 User Guide S504 100 User Guide Contents 1 VITO OUCH anne 5 2 Contents of the ZOE Gynecologic Simulator unuunnnnnnnnnnnnunnunnunnunnnnnnnn nun nun nun nunnnnn nun nun nun nun nun nun nun 5 3 instructions DDr USE nennen 6 Removing and Replacing the Skin a a ee a a a en Eee u Deere 7 Changing Cervices and a a a re a a RE ge 8 Changing Introitus with Vagina and Rectum ssssssssssssrssrsnsrrnnsrnnnnrnnrsnnnrsnnnrnnnnrnnnnrnnennnnnnennnnenrnnnnnnnnnnnne rennene 8 4 Applicaton S isiin a aaa a aaa 9 Pevi EAE eannan iaaa ne ee ea aa a NA a A ee Eee 9 Speculum E AI VI IV SEN IM ee AEn teeters ER Aaaa R a AE AE Ea 9 Binon EXAMINA OT ee A EAE ENEA 9 Terva IUD Insertionee nee EE E EEEE EEEE 9 Interval Minilaparotomy and Operative Laparoscopy s ssssssssssrensrrsnsrnnnsrsnnsnnnrsnenrnnenrnnenrnnenennenennnnnnnnnennnnn 10 5 Description of Cervices and Diet 11 6 Palpation Kit Module 504 1 Optional eu nn na nn a 12 TOGA CUO 1 ai EE AE AE 12 DESCHIPUON osser E EEA AEAEE ERR
7. ervical conditions From left to right are a normal parous cervix and 3 cervices with abnormal pathologies 11 6 Palpation Kit Module 504 1 Optional Introduction S504 100 User Guide 7 Hysteroscopy kit Module 504 2 Optional Introduction The palpation kit consists of seven uteri with normal and abnormal external pathologies Description Uterus 1 Normal uterus with moderate retroversion Uterus 2 Myomatous uterus Uterus 3 Uterus with salpingitis right side Uterus 4 Uterus with salpingitis left side Uterus 5 Uterus with marked anteversion anteflexion Uterus 6 Uterus with deformation and salpingitis right side Uterus 7 Uterus with ovarian cyst left side The hysteroscopy kit consists of seven uteri with normal and abnormal internal pathologies for hysteroscopic viewing Description Uterus 1 Normal uterus with healthy internal cavity Uterus 2 Uterus with endometrial polyposis Uterus 3 Uterus with endometrial hyperplasia Uterus 4 Uterus with torsion of sloughing fibroid Uterus 5 Uterus with early carcinoma of endometrium Uterus 6 Uterus with advanced carcinoma of endometrium Uterus 7 Uterus with carcinoma of the fundus 12 8 48 Hour Postpartum IUD Insertion Kit Module 504 3 Optional Introduction s Postpartum uterus 20 week size is adapted for instrument placement of an IUD during the first 48 hours postpartum Kit includes a removable introitus with
8. es bivalve speculum Before inserting the speculum moisten the tips of the speculum blades with a few drops of dilute soap and water solution Doing this makes passing the blades through the labia easier and prevents tearing the labia Figure 7 Inserting a Bivalve Speculum S504 100 User Guide Bimanual Examination When performing the bimanual examination to determine the position and size of the internal genitalia uterus tubes and ovaries use the pads of the fingers of the abdominal hand Figure 8 Do not palpate using fingernails as doing this may tear the abdominal skin of the simulator F Figure 8 Performing a Bimanual Examination Interval IUD Insertion The ZOE Gynecologic Simulator is an excellent skill trainer for demonstrating and teaching each step of interval IUD insertion and removal in a realistic manner from performing the speculum and bimanual examination and applying a tenaculum to visualizing sounding the uterus and inserting the IUD For example instruments such as single tooth cervical tenacula can be inserted through the open speculum and repeatedly applied to those cervices with a patent cervical os Figure 9 Figure 9 Applying a Single Tooth Tenaculum Information When removing a toothed sharp tenaculum be sure the teeth are free of the cervix to avoid tearing it Before passing a sound or other instrument swab the cervix with a small amount of dilute soap and water solut
9. ic container and carrying bag provided Store ina safe place at room temperature Do not pack any sharp objects with the Simulator How to Contact Gaumard By Email www gaumard com sima gaumard com support gaumard com By Phone Toll free in the USA 800 882 6655 Worldwide 305 971 3790 Fax 305 667 6085 Office hours Monday Friday 8 00 4 30 PM EST GMT 5 Note Before contacting Gaumard you must 1 Have the Simulator Serial Number if applicable and or model number available 2 Have the Simulator available if troubleshooting is needed 1 Introduction ZOE is a full sized adult female lower torso abdomen and pelvis that combines state of art materials to create a realistic look feel and texture in addition to lifelike softness and durability It is a versatile training tool developed to assist health professionals to teach the processes and skills required to perform most ambulatory gynecologic procedures these include interval and immediate postpartum IUD insertion interval laparoscopic tubal ligation and interval and postpartum minilaparotomy The simulator is useful for demonstrating these procedures as well as providing an excellent platform on which trainees can learn how to perform the following procedures competently in a safe environment before moving on to actual patients Inspection of the vulva and vagina Vaginal speculum examination including visual recognition of normal and ab
10. ion Doing this will make passing the instrument though the cervical os easier As shown in Figure 10 the IUD inserter has been passed through the speculum then through the cervical os and into the uterine cavity In this figure half of ZOE s outer skin has been cut away In practice the instructor would remove outer skin to permit trainees to view the procedure Figure 10 Demonstrating IUD Insertion with ZOE Interval Minilaparotomy and Operative Laparoscopy In Figure 11 half the outer skin has been cut away to demonstrate how a tubal hook can be passed through the minilaparotomy incision site to capture the left Fallopian tube The tube can then be drawn up through the skin incision site occluded and then dropped back into the abdomen S504 100 User Guide Figure 11 Using the Tubal Hook in Minilaparotomy Similarly Figure 12 shows performing operative laparoscopy in this instance interval tubal occlusion using ZOE As in the previous figure half the outer skin has been cut away to demonstrate using a single puncture Laprocater First the Fallopian tube is identified then it is grasped by the extended arm of the Laprocater and the tube drawn up into the distal end of the scope This action causes a short about 2 3 cm U shaped segment of the Fallopian tube to be trapped inside in the open end of the Laparocator Next a small silicone band Falope Ring is advanced over the kinked tube then the banded
11. locking pins a duckbill cervix and uterus with simulated Fallopian tubes Description To replace the standard introitus with vagina and rectum for the S504 3 introitus refer to Section 3 Instructions for Use The figure below illustrates how to install the 48 hour postpartum uterus with the skin removed The duckbill cervix is already attached to the introitus with vagina and rectum To install the uterus hold the cervix with one hand and gently screw the wide locking ring with the other hand to set the body of the uterus in place S504 100 User Guide Applications Use of the 48 Hour Postpartum Uterus This postpartum uterus is adapted for instrument placement of an IUD during the first 48 hours postpartum With this uterus in place use a small amount of soap and water to lubricate a long curved Kelly placental forceps Using the forceps grasp the Copper T 380 IUD and advance the forceps into the vagina past the cervix and through the uterus to the fundus At the fundus release the IUD and remove the forceps Cut the string as needed The IUD may also be retrieved Use of 504 3 Introitus for Diaphragm Sizing and Fitting The vagina on the 504 3 Introitus has a generous distal segment suitable for fitting a 75 mm diaphragm using conventional procedures Attach a normal anteverted or retroverted uterus and be sure to use a dilute soap solution before initiating the procedures Use of 504 3 Introitus
12. nation And finally the port can be used to change uteri without removing the skin S504 100 User Guide As shown in Figures 2b and 3 the uteri are suspended within the pelvis by rubber tubes simulating the round ligaments The clear translucent upper half of the uterus Figure 2a and 2b allows for viewing placement of an IUD or insertion of a uterine sound To make palpation of the uterus easier the round ligaments can be shortened to bring the fundus forward as shown in Figure 3 Note All rubber tubing is interchangeable m Figure 2b Translucent anteverted uterus with round ligaments ovarian ligaments tubal fimbriae and ovaries S504 100 User Guide First carefully detach it from the back end of the torso end with the view port by lifting it up N b Figure 3 Pregnant uterus 6 8 week size with short round ligaments and ovaries Figure 4c Removing skin The skin and foam cover can be removed Figures 4 in order to change the cervices uteri and or introitus with vagina and rectum to reattach the rubber tubing or to clean the inside of the torso With the skin completely off and turned over figure Ab note that the infra umbilical and minilaparotomy incision sites are reinforced at both ends white patches to minimize tearing Figure 4d Removing skin Then remove the skin from each leg before completely removing the skin Figure 4a ZOE with cover skin removed
13. normal cervices Bimanual pelvic examination of normal and pregnant uteri Vaginal speculum examination Uterine sounding Interval IUD insertion and removal Interval laparoscopic occlusion of fallopian tubes e g Falope rings or Hulka clips Minilaparotomy both interval and postpartum tubal occlusion Manual vacuum aspiration MVA of uterine cavity Instrument placement of IUD within 48 hours postpartum with optional 48 hrs uterus Diaphragm sizing and fitting 2 Contents of the ZOE Gynecologic Simulator The simulator consists of an adult lower torso abdomen and pelvis with removable skin supported by a foam insert and metal base The simulator package contains the following Nonpregnant anteverted and retroverted uteri both with transparent half sections S504 100 User Guide 2 simulated round ligaments and 2 ovarian ligaments 2 simulated tubal fimbriae and 2 ovaries 10 simulated Fallopian tubes for practicing tubal occlusion Removable introitus with vagina and rectum and 4 locking pins 2 extra locking pins Postpartum 20 week size uterus with attached Fallopian tubes for practicing postpartum tubal occlusion Pregnant uterus 6 8 week size with short round ligaments and ovaries 1 narrow cervical locking ring for attaching the cervix and uterine body together 1 MVA Kit consisting of e 6 to 8 week size pregnant uterus with round ligaments e 10 to 12 week size pregnant uterus with
14. partum uterus 4 100 20 wk size ns Cervices 4 abnormal 504 100 009 Retroverted uterine 504 100 011 assembly Set of 10 fallopian tubes 504 100 012 Talcum powder 504 100 013 Cervices 5 normal 504 100 010 patent Early pregnancy kit 504 100 014 set of 2 cervical locking 504 100 015 rings Set of 2 locking pins 504 100 016 palpation Ovary set of 2 504 100 018 Fibrae set of 2 504 100 019 Skin repair replacement RA 504 100 15
15. section of the tube is released Successfully learning to perform this procedure takes practice and good hand eye coordination i Figure 12 Operative Laparoscopy 10 5 Description of Cervices and Uteri Information All cervices and uteri provided with the ZOE Gynecologic Simulator package can be interchanged Shown below are 4 patent cervices for visual recognition of normal cervices at the top Below from left to right An anteverted uterine body corpus with transparent upper half A pregnant uterus 6 8 week size with short round ligaments and ovaries A postpartum 20 week size uterus with attached fallopian tubes m Shown below are two uteri with round ligaments consistent with 6 18 and 10 12 week pregnancies and 3 cervices for each uterus Both can be used to practice sizing the pregnant uterus or for performing manual vacuum aspiration MVA for an incomplete miscarriage S504 100 User Guide With care single or double tooth sharp tenacula can be repeatedly applied and removed from these soft resilient cervices The simulated immediate within 48 hours postpartum uterus about 20 week size with Fallopian tubes can be attached to a cervix ZOE can then be used to practice performing tubal occlusion through the small 3 4 cm infra umbilical incision site The four cervices shown below are not patent open They can be used for identification of normal and abnormal c
16. ve the cervix and replace it with a different one a Figure 6a Removing Introitus with Vagina and Rectum Figure 5a Changing the Body of the Uterus Figure 6b Attaching Introitus with Vagina and Rectum if 4 Zz Figure 5b Changing the Cervix 4 Applications Because ZOE is a full sized adult female lower torso that has a realistic look feel and texture this simulator provides an excellent platform on which instructors can demonstrate and trainees can learn how to perform many ambulatory gynecologic procedures Several of the most common procedures that require skill competency of the trainee before attempting to perform them with patients are presented in this section Working with ZOE trainees can learn and practice these procedures in a safe environment before moving on to actual patients Pelvic Examination Using the accompanying Pelvic Examination Learning Package CD in conjunction with learning and practicing on ZOE provides trainees with the opportunity to not only learn and practice performing a pelvic examination but also to become sensitive to the woman s feelings and concerns before during and after performing the examination Being able to talk to and listen to women s concerns questions and problems is an essential component in becoming a caring and competent healthcare professional Speculum Examination When performing a speculum examination with ZOE use a medium Pederson or Grav
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