CN112700702A - Training model for percutaneous nephrolithotomy skill under guidance of high-simulation ultrasound and X-ray and mould thereof - Google Patents
Training model for percutaneous nephrolithotomy skill under guidance of high-simulation ultrasound and X-ray and mould thereof Download PDFInfo
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Abstract
The invention relates to a training model of percutaneous nephrolithotomy skill under high simulation ultrasound and X-ray guidance and a mould thereof.A kidney model is a sample mould made of silicon rubber and resin, noble rubber with the same density as human kidney and surrounding tissues is molded in the mould and is firstly preempted in a kidney area groove of the high simulation human model, the nephroscope can be inserted through percutaneous nephropuncture under ultrasound or X-ray guidance, a renal pelvis, a renal calyx and a renal papilla can be observed through the nephroscope, percutaneous nephrolithotomy, micro-fistulization lithotomy, ultrasound-guided percutaneous nephroscope air pressure trajectory ultrasonic wave or holmium laser lithotripsy and the like are carried out, the simulation effect is highly simulated, the operation is carried out on a real patient, and the teaching effect of the training of the percutaneous nephrolithotomy skill can be obviously improved.
Description
Technical Field
The invention relates to the technical field of medical education equipment, in particular to a training model of percutaneous nephrolithotomy nephroscopy skills under the guidance of high-simulation ultrasound and X-ray and a mould thereof.
Background
In recent years, percutaneous nephroscopy and treatment techniques in urology include: the ultrasonic guided percutaneous nephrolithotomy, the ultrasonic guided percutaneous nephrolithotomy with air pressure trajectory ultrasound, holmium laser lithotripsy and the like are widely developed in domestic and foreign high medical institutions, provincial hospitals and other major hospitals, and often require experienced senior physicians and professors to operate, and young physicians require superior physicians to carry, help and carry on patients. The examination belongs to invasive examination, which is very unlikely to cause puncture failure, brings pain to patients and is very easy to cause medical disputes and even medical accidents. It is therefore difficult for young physicians to master this technique. At present, training and checking equipment for skill of epithelial nephrolithotomy of renal puncture in the world is blank, and culture of talents in the medical skill is seriously influenced, so that research and development of a training model and a mould for skill of percutaneous nephrolithotomy of renal puncture under ultrasound and X-ray guidance are very necessary.
Disclosure of Invention
The invention aims to provide a training model of percutaneous nephrolithotomy skill under the guidance of high-simulation ultrasound and X-ray and a mould thereof, which can be used for percutaneous nephrolithotomy under the guidance of ultrasound or X-ray to be placed in a nephroscope, observing a renal pelvis, a renal calyx and a renal papilla through the nephroscope, carrying out percutaneous nephrolithotomy biopsy, micro-fistulization and stone extraction, ultrasound-guidance percutaneous nephrolithotomy air pressure trajectory ultrasonic wave or holmium laser lithotripsy and the like, has high simulation effect, is operated on a real patient as well, and can obviously improve the teaching effect of the training of the percutaneous nephrolithotomy skill.
The training device fills the blank of the training device for the skill of the percutaneous nephrolithotomy in world medicine, solves the problem that the training of the skill of the percutaneous nephrolithotomy is lack of teaching devices, and is an original training model for the skill of the percutaneous nephrolithotomy under the guidance of high-simulation ultrasound and X-ray in the world and a mold thereof.
A simulation ultrasound, percutaneous nephrolithotomy nephroscopy skill training model under X-ray guidance and its mould, it includes: high simulation manikin, high simulation supersound, percutaneous nephrolithotomy nephroscopy skill training module and mould under the X line guide, its characterized in that: the high-simulation human body model is provided with a simulated head (1), a simulated neck (2) and a simulated trunk (3) which are molded by PVC or silicon rubber materials by adopting a common process mold; the training modules (4, 5) of the skills of percutaneous nephrolithotomy under the guidance of high-simulation ultrasound and X-ray are embedded in corresponding grooves (6-1, 6-2) of the left and right kidney areas at the back of the simulation manikin waist;
the manufacturing method of the module comprises the following steps:
the first step is as follows: the kidney appearance mold is manufactured, and the connection method comprises the following steps: adopting a method similar to that of a real person 1: a large kidney model 1 is used as a sample mold, is manufactured by unsaturated resin and glass fiber according to the conventional process of the known technology, and is made into an upper half concave mold (7-1) and a lower half concave mold (7-2) of the shape of the kidney including the upper section of the ureter; the two moulds are used for further copying an upper half convex mould (7-3) and a lower half convex mould (7-4) of the kidney shape;
the second step is that: manufacturing silicon rubber sample molds (8-1 and 8-2) of the internal structure of the high-simulation kidney assembly system, opening the high-simulation kidney model (9), and manufacturing the sample molds (15-1 and 15-2) by using silicon rubber in the structures of the renal pelvis (11), the renal calyx (12), the renal calyx (13) and the renal papilla (14-1 to 14-6) of the upper ureter (10); taking out after curing;
the third step: manufacturing a resin mold of a high-simulation kidney internal integration system structure, and copying the manufactured silicon rubber sample mold of the high-simulation kidney internal structure into a resin sample mold; the fourth step: manufacturing a high-simulation kidney model: coating and repairing a layer of addition type two-component silicon rubber in the two concave moulds manufactured in the first step, curing the two-component silicon rubber to form a kidney shape envelope, filling addition type two-component silicon rubber with the density substantially equal to that of the kidney of a human body in the two concave moulds, before the silicon rubber is completely solidified, internally arranging the resin sample mould manufactured in the third step, curing and taking out the two parts after mould closing, closing the two half models by using the same silicon rubber, curing and correcting the two half models to form a high-simulation kidney model comprising an upper ureter (9), and manufacturing two models (16-1 and 16-2) by the same method; the fifth step: the shape mould of the percutaneous nephrolithotomy nephroscopy skill training module (17) under the guidance of high-simulation ultrasound and X-ray is manufactured, and the manufacturing method comprises the following steps: manufacturing a sample mold of the module by sculpture mud or plasticine, and manufacturing an upper half module outline mold (18-1) and a lower half module outline mold (18-2) by a common unsaturated resin manufacturing process; and a sixth step: manufacturing highly-simulated ultrasonic and X-ray guided percutaneous nephrolithotomy skill training modules (5-1, 5-2), wherein the manufacturing method comprises the following steps: uniformly coating a layer of skin color two-component addition type silicone rubber in the upper half part appearance module mould (18-1) and the lower half part appearance module mould (18-2); injecting a double-component addition type silicon rubber with silicon rubber diluent to adjust the density and the equal density of tissues around the kidney of the human body after curing, respectively closing the two-component addition type silicon rubber with the upper half part convex mould (7-3) and the lower half part convex mould (7-4) of the shape of the kidney which are manufactured in the first step before the two-component addition type silicon rubber is not completely solidified, and finishing after curing to manufacture a percutaneous nephrolithotomy nephrolithoscopy skill training upper half part kidney shape recess module (19-1) and a lower half part kidney shape recess module (19-2) with a kidney shape recess;
the seventh step: and (3) placing the high-simulation simulated kidney model (15) into the kidney contour concave grooves of the upper half kidney contour concave module (19-1) and the lower half kidney contour concave module (19-2), closing the dies by adopting double-component addition type silicon rubber with the same density and skin color with the tissues around the human kidney, curing and finishing. Eighth step: a large syringe is adopted to extract simulated urine (common water), the simulated urine is injected into a renal pelvis (10), a renal calyx (11) and a renal calyx (12) of a high-simulation kidney model (15) of the module through an upper ureter (9), a plug (20) is used for plugging after the simulated urine is filled, and a long hemostatic forceps can be used for clamping simulated calculus or simulated pathological tissues to be sent into the renal pelvis through the upper ureter according to training requirements. The ninth step: the manufactured training modules (5-1, 5-2) of the skills of percutaneous nephrolithotomy under the guidance of high-simulation ultrasound and X-ray are embedded in corresponding grooves (6-1, 6-2) of the kidney area of the high-simulation human body model.
The invention has the advantages that: reasonable structure, simple operation, capability of training and checking the skill of percutaneous nephrolithotomy under the guidance of ultrasound and X-ray, very vivid simulation effect and remarkable improvement of teaching effect.
The invention is further described below with reference to the accompanying drawings:
description of the drawings:
FIG. 1 is a schematic view of the overall structure of the present invention
FIG. 2 is a schematic diagram of the appearance of a highly simulated kidney according to the present invention
FIG. 3 is a schematic view of the upper and lower kidney convex molds of the present invention
FIG. 4 is a schematic view of the hollow structure of the upper and lower halves of the kidney according to the present invention
FIG. 5 is a schematic view of a resin casting male mold with a kidney assembly system structure according to the present invention
FIG. 6 is a schematic view of a kidney assembly system structure casting cavity die of the present invention
FIG. 7 is a schematic view of the kidney contour pits and surrounding tissue molds of the upper and lower halves of the present invention
FIG. 8 is a schematic diagram of the upper mold half and the lower mold half of the training module for percutaneous nephroscope puncture nephroscopy of the present invention
Fig. 9 is a schematic diagram of a percutaneous nephroscope puncture nephroscopy training module according to the invention.
The specific implementation mode is as follows:
the high-simulation human body model (1) is provided with a simulated head (2), a simulated neck (3) and a trunk (4) comprising shoulders and partial thighs, and the skin of the model is molded by a PVC or silicon rubber material by adopting a common process mold of the known technology; the subcutaneous tissue and muscle are made of PU foam, and the skeleton is made of unsaturated resin and glass fiber or plastic through molding. The manufacturing method of the percutaneous nephrolithotomy nephroscopy skill training module under the guidance of high-simulation ultrasound and X-ray comprises the following steps: the first step is as follows: the method for manufacturing the kidney appearance mold comprises the following specific steps: adopting a method similar to that of a real person 1: 1, using a natural large kidney model as a sample mold, using unsaturated resin and glass fiber to copy the kidney model into an upper half concave mold (7-1) and a lower half concave mold (7-2) of the kidney shape comprising an upper ureter section (9) according to a conventional process of a known technology, trimming, sanding, and polishing after 5 times and 8 times. Then, an upper half part mould (7-1) and a lower half part mould (7-2) of the kidney shape are used for copying an upper half part convex mould (7-3) and a lower half part convex mould (7-4) of the kidney shape by the same process, and then trimming, sanding and polishing are carried out for 5 times and 8 times;
the second step is that: the method for manufacturing the silicon rubber sample mold of the high-simulation kidney internal collection system structure comprises the following steps: opening the kidney model mark from the mold closing position, manufacturing the upper and lower two half parts of the upper segment (9) of the nephroureter, the renal pelvis (10), the calyx seu fructus physalis (11), the calyx seu fructus physalis (12) and the papilla of the kidney by using silicon rubber, and taking out after curing;
thirdly, a sample mould of a resin high-simulation kidney internal collection system structure is copied, trimmed by the sample mould manufactured in the second step, sanded by 2000-mesh sand paper and polished by 5 times of No. 8 wax, and then the high-simulation kidney internal collection system structure unsaturated resin casting mould (8) comprising the ureteral upper section (9), the renal pelvis (10), the renal calyx (11) and the renal papilla (13) of the renal calyx (12) is manufactured;
the fourth step: manufacturing a high-simulation kidney model: coating and repairing a layer of addition type two-component silicon rubber in the two concave molds of the upper half part (7-1) and the lower half part (7-2) of the kidney outline including the upper ureter part, curing the two-component silicon rubber to form a kidney outline envelope, filling the addition type two-component silicon rubber with the density substantially equal to that of the human kidney in the kidney outline envelope, before the silicon rubber is completely solidified, internally arranging the resin mold of the high-simulation kidney assembly system manufactured in the third step, curing and taking out the two parts after mold closing, closing the two parts with the same silicon rubber, curing and trimming the two parts to form a high-simulation kidney model (16-1) including the upper ureter part (9), and manufacturing the same high-simulation kidney model (16-2) by the same method; the fifth step: the manufacturing method of the appearance mould for manufacturing the percutaneous nephrolithotomy nephroscopy skill training module under the guidance of high-simulation ultrasound and X-ray comprises the following steps: manufacturing a sample mold of the module by sculpture mud or plasticine, and manufacturing an upper half module outline mold (18-1) and a lower half module outline mold (18-2) by a common unsaturated resin manufacturing process; the seventh step: manufacturing highly-simulated ultrasonic and X-ray guided percutaneous nephrolithotomy skill training modules (5-1, 5-2), wherein the manufacturing method comprises the following steps: uniformly coating a layer of skin color two-component addition type silicone rubber in the upper half part appearance module mould (18-1) and the lower half part appearance module mould (18-2); injecting a double-component addition type silicon rubber with silicon rubber diluent to adjust the density and the equal density of tissues around the kidney of the human body after curing, respectively closing the two-component addition type silicon rubber with the upper half part convex mould (7-3) and the lower half part convex mould (7-4) of the shape of the kidney which are manufactured in the first step before the two-component addition type silicon rubber is not completely solidified, and finishing after curing to manufacture a percutaneous nephrolithotomy nephrolithoscopy skill training upper half part kidney shape recess module (19-1) and a lower half part kidney shape recess module (19-2) with a kidney shape recess; post-trimming, namely manufacturing a percutaneous nephrolithotomy nephrolithoscopy skill training upper half part kidney contour recess module (19-1) and a lower half part kidney contour recess module (19-2) with kidney contour recesses;
the seventh step: and (3) placing the high-simulation simulated kidney model (15) into the kidney contour concave grooves of the upper half kidney contour concave module (19-1) and the lower half kidney contour concave module (19-2), closing the dies by adopting double-component addition type silicon rubber with the same density and skin color with the tissues around the human kidney, curing and finishing. Eighth step: a large syringe is adopted to extract simulated urine (common water), the simulated urine is injected into a renal pelvis (10), a renal calyx (11) and a renal calyx (12) of a high-simulation kidney model (15) of the module through an upper ureter (9), a plug (20) is used for plugging after the simulated urine is filled, and a long hemostatic forceps can be used for clamping simulated calculus or simulated pathological tissues to be sent into the renal pelvis through the upper ureter according to training requirements. The ninth step: the manufactured training modules (5-1, 5-2) of the skills of percutaneous nephrolithotomy under the guidance of high-simulation ultrasound and X-ray are embedded in corresponding grooves (6-1, 6-2) of the kidney area of the high-simulation human body model. The concrete dimensions of the sample mold in the embodiment are 16cm in length, 12cm in width, 5cm in peripheral thickness and 7cm in center thickness, the sample mold is rectangular, the center is slightly arc-shaped and is close to the curvature of the waist and back of a human body, and an upper half module mold and a lower half module mold of the skill training module are manufactured by a common unsaturated resin and glass fiber manufacturing process;
the seventh step: manufacturing a training module for the skill of percutaneous nephrolithotomy under the guidance of high-simulation ultrasound and X-ray:
coating a layer of addition type double-component silicon rubber in an appearance mould for manufacturing the training module in the previous step, supplementing once, injecting the double-component addition type silicon rubber with the density of 0.85, namely the density of the double-component addition type silicon rubber, which is equal to the density of tissues around the kidney of a human body, after the double-component addition type silicon rubber is completely solidified, wherein the injection amount is 90% of the capacity of the mould, placing a high-simulation kidney model before the double-component addition type silicon rubber is not completely solidified;
eighth step: the simulated urine (common water) is extracted by a syringe and injected into a renal pelvis, a renal calyx and a renal calyx of the percutaneous nephrolithotomy nephroscopy skill training module under the guidance of high-simulation ultrasound and X-ray through the upper ureter, and the simulated urine is plugged by a plug after the simulated urine is filled. The training module of the skill of the percutaneous nephrolithotomy under the guidance of the high-simulation ultrasound and the X-ray is embedded in the corresponding grooves (6-1, 6-2) of the kidney area of the human body at the back of the high-simulation human body model (1), and the training of the skill of the percutaneous nephrolithotomy under the guidance of the ultrasound and the X-ray can be carried out. An ultrasonic probe of an ultrasonic diagnostic instrument can be used for scanning in a renal area, a nephroscope is inserted into a percutaneous nephroscope under the guidance of ultrasonic, a renal pelvis, a renal calyx and a renal papilla can be observed through the nephroscope, and percutaneous renal puncture biopsy, micro-fistulization and stone extraction, ultrasonic-guidance percutaneous nephroscope air pressure trajectory ultrasonic wave or holmium laser lithotripsy and the like are carried out. The skill training of percutaneous nephrolithotomy can also be carried out by injecting 60% diatrizoate meglumine into the upper ureter section of the module under the guidance of X rays. The specific operation method of the skill training of the nephroscopy is carried out according to the clinical operation routine, and the simulation effect is highly simulated, like the operation on a real patient. The invention is used for urology departments in medical colleges and teaching hospitals, and can remarkably improve the teaching effect of skill training by carrying out ultrasonic and X-ray guided percutaneous nephrolithotomy nephroscopy skill training on urologists.
Claims (3)
1. A simulation ultrasound, percutaneous nephrolithotomy nephroscopy skill training model under X-ray guidance and its mould, it includes: high simulation manikin, high simulation supersound, percutaneous nephrolithotomy nephroscopy skill training module and mould under the X line guide, its characterized in that: the high-simulation human body model is provided with a simulated head (1), a simulated neck (2) and a simulated trunk (3) which are molded by PVC or silicon rubber materials by adopting a common process mold; the training modules (4, 5) of the skills of percutaneous nephrolithotomy under the guidance of high-simulation ultrasound and X-ray are embedded in corresponding grooves (6-1, 6-2) of the left and right kidney areas at the back of the simulation manikin waist;
the manufacturing method of the module comprises the following steps:
the first step is as follows: the kidney appearance mold is manufactured, and the connection method comprises the following steps: adopting a method similar to that of a real person 1: a large kidney model 1 is used as a sample mold, is manufactured by unsaturated resin and glass fiber according to the conventional process of the known technology, and is made into an upper half concave mold (7-1) and a lower half concave mold (7-2) of the shape of the kidney including the upper section of the ureter; the two moulds are used for further copying an upper half convex mould (7-3) and a lower half convex mould (7-4) of the kidney shape;
the second step is that: manufacturing silicon rubber sample molds (8-1 and 8-2) of the internal structure of the high-simulation kidney assembly system, opening the high-simulation kidney model (9), and manufacturing the sample molds (15-1 and 15-2) by using silicon rubber in the structures of the renal pelvis (11), the renal calyx (12), the renal calyx (13) and the renal papilla (14-1 to 14-6) of the upper ureter (10); taking out after curing;
the third step: resin mold for manufacturing high-simulation kidney internal collection system structure
Copying the manufactured silicon rubber sample mold with the high-simulation kidney internal structure into a resin sample mold;
the fourth step: manufacturing a high-simulation kidney model: coating and repairing a layer of addition type two-component silicon rubber in the two concave moulds manufactured in the first step, curing the two-component silicon rubber to form a kidney shape envelope, filling addition type two-component silicon rubber with the density substantially equal to that of the kidney of a human body in the two concave moulds, before the silicon rubber is completely solidified, internally arranging the resin sample mould manufactured in the third step, curing and taking out the two parts after mould closing, closing the two parts of the mould by using the same silicon rubber, correcting and correcting after curing
Namely, the high-simulation kidney model comprising the upper ureter (9) is formed, and two models (16-1 and 16-2) are manufactured by the same method;
the fifth step: the shape mould of the percutaneous nephrolithotomy nephroscopy skill training module (17) under the guidance of high-simulation ultrasound and X-ray is manufactured, and the manufacturing method comprises the following steps: manufacturing a sample mold of the module by sculpture mud or plasticine, and manufacturing an upper half module outline mold (18-1) and a lower half module outline mold (18-2) by a common unsaturated resin manufacturing process;
and a sixth step: manufacturing highly-simulated ultrasonic and X-ray guided percutaneous nephrolithotomy skill training modules (5-1, 5-2), wherein the manufacturing method comprises the following steps: uniformly coating a layer of skin color two-component addition type silicone rubber in the upper half part appearance module mould (18-1) and the lower half part appearance module mould (18-2); injecting a double-component addition type silicon rubber with silicon rubber diluent to adjust the density and the equal density of tissues around the kidney of the human body after curing, respectively closing the two-component addition type silicon rubber with the upper half part convex mould (7-3) and the lower half part convex mould (7-4) of the shape of the kidney which are manufactured in the first step before the two-component addition type silicon rubber is not completely solidified, and finishing after curing to manufacture a percutaneous nephrolithotomy nephrolithoscopy skill training upper half part kidney shape recess module (19-1) and a lower half part kidney shape recess module (19-2) with a kidney shape recess;
the seventh step: and (3) placing the high-simulation simulated kidney model (15) into the kidney contour concave grooves of the upper half kidney contour concave module (19-1) and the lower half kidney contour concave module (19-2), closing the dies by adopting double-component addition type silicon rubber with the same density and skin color with the tissues around the human kidney, curing and finishing.
2. Eighth step: a large syringe is adopted to extract simulated urine (common water), the simulated urine is injected into a renal pelvis (10), a renal calyx (11) and a renal calyx (12) of a high-simulation kidney model (15) of the module through an upper ureter (9), a plug (20) is used for plugging after the simulated urine is filled, and a long hemostatic forceps can be used for clamping simulated calculus or simulated pathological tissues to be sent into the renal pelvis through the upper ureter according to training requirements.
3. The ninth step: the manufactured training modules (5-1, 5-2) of the skills of percutaneous nephrolithotomy under the guidance of high-simulation ultrasound and X-ray are embedded in corresponding grooves (6-1, 6-2) of the kidney area of the high-simulation human body model.
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| KR102342336B1 (en) * | 2021-05-21 | 2021-12-23 | 메디컬아이피 주식회사 | RIRS simulator |
| PL442625A1 (en) * | 2022-10-24 | 2024-04-29 | Uniwersytet Rzeszowski | Retrograde intrarenal surgery (RIRS) training apparatus |
-
2020
- 2020-12-31 CN CN202011629489.0A patent/CN112700702A/en not_active Withdrawn
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| KR102342336B1 (en) * | 2021-05-21 | 2021-12-23 | 메디컬아이피 주식회사 | RIRS simulator |
| PL442625A1 (en) * | 2022-10-24 | 2024-04-29 | Uniwersytet Rzeszowski | Retrograde intrarenal surgery (RIRS) training apparatus |
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Application publication date: 20210423 |