THE CONSTRUCTION AND UTILITY OF AN AMNIOCENTESIS TRAINER

OBJECTIVE: Our goal was to design an inexpensive amniocentesis trainer for instruction and practice with ultrasonography-assisted needle gui dance and the freehand technique. STUDY DESIGN: The amniocentesis trai ner was constructed from a commercially available 5.3-L storage box (N o. 5805; Rubbermaid Incorporated, Wooster, Ohio). Sonodense sperical t argets 2.3 cm in diameter were taped to the bottom, and the box was fi lled with a gelatin mixture. The box was covered with a rubber membran e from a pelviscopy trainer (United States Surgical Corp, Norwalk, Con n). After the gelatin mixture set overnight at 40 degrees F, the amnio centesis trainer was ready for use. RESULTS: When a needle is introduc ed through the membrane into the gelatin, the ultrasonographic image i s a reasonable simulation of an amniocentesis. The trainer improved th e ability of an operator to perform a freehand amniocentesis, orient t he ultrasound transducer, follow a needle with continuous ultrasonogra phic guidance, and hit a 2-cm target. The gelatin also allows for eval uation of improvement between amniocentesis attempts because a faint i mage of the needle track from prior attempts remains visible. Once bas ic amniocentesis skills are mastered, the trainer is easily modifiable so that obstacles can be added that could simulate umbilical cord and fetal extremities. CONCLUSIONS: We were able to construct an inexpens ive amniocentesis trainer that facilitates instruction in the freehand amniocentesis technique. This trainer enables an operator to master t he skills necessary to perform the technique of freehand ultrasonograp hy-guided amniocentesis under direct ultrasonographic visualization wi thout putting a patient through the discomfort of participating in the learning curve.