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Simulator model to teach the digital rectal exam

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Develop a dynamic and interactive model of the anal cavity with contracting and relaxing muscles that emulate normal anorectal function

Project Overview

Anorectal disorders to include hemorrhoids, anal fissures, fecal incontinence, dyssynergic defecation, rectal prolapse are common conditions encountered in a Gastroenterology clinic.

A detailed clinical history and most importantly, a digital rectal exam (DRE) helps to diagnose these disorders. The DRE allows for the detection of anal sphincter weakness, structural irregularities and pelvic floor dysfunction. There is a good correlation between a DRE performed by experienced providers and diagnostic studies, suggesting that performance of high-quality rectal exams can reduce unnecessary diagnostic studies.

Despite its importance, the DRE is often underutilized in the clinical evaluation, particularly amongst early career physicians. In a pivotal 2012 cross-sectional study, recently graduated physicians were more likely to report inadequate DRE training compared to their senior peers. In clinical practice, early career physicians performed the DRE less often, citing perceived invasiveness, and anticipated patient refusal amongst other reasons for not performing a DRE. Conversely, senior physicians who reported confidence in performing DRE reported lower rates of patient refusals.

The goal of this project is to create an anatomic model of the pelvic floor and anorectum that will improve trainee confidence in performing the DRE and interpreting abnormal findings. This model will ideally be a female model. The materials should simulate the tension of the muscles and tissues (ex anal sphincter, levator ani muscle) abnormal structural findings such as fissure and hemorrhoids, rectocele and functional abnormalities like paradoxical contraction of the sphincter, anocutaneous reflex and sphincter weakness.

Team Picture

Team (left to right):Lokesh Kumaravel (Team Leader), Antony Amala (BSAC), Estella Torgerson (Co-BPAG), Melissa Bouharati (BWIG), Julia Lindahl (Co-BPAG), Raad Allawi (Communicator))
Team (left to right):Lokesh Kumaravel (Team Leader), Antony Amala (BSAC), Estella Torgerson (Co-BPAG), Melissa Bouharati (BWIG), Julia Lindahl (Co-BPAG), Raad Allawi (Communicator))

Contact Information

Team Members

  • Lokesh Kumaravel - Team Leader
  • Raad Allawi - Communicator
  • Julia Lindahl - BSAC
  • Melissa Bouharati - BWIG
  • Antony Amala Mahil Maran - Co-BPAG
  • Estella Torgerson - Co-BPAG

Advisor and Client

  • Prof. Walter Block - Advisor
  • Dr. Lisa Jones - Client

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