CN113487953A - Esophageal and gastric varices operation training model and manufacturing method thereof - Google Patents
Esophageal and gastric varices operation training model and manufacturing method thereof Download PDFInfo
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- CN113487953A CN113487953A CN202110875341.3A CN202110875341A CN113487953A CN 113487953 A CN113487953 A CN 113487953A CN 202110875341 A CN202110875341 A CN 202110875341A CN 113487953 A CN113487953 A CN 113487953A
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- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
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Abstract
The invention provides an esophageal and gastric varices operation training model and a manufacturing method thereof, and relates to the technical field of medical treatment. The invention provides an esophageal and gastric varices operation training model which comprises an esophageal and gastric module and a varices blood vessel module fixed in the esophageal and gastric module. Wherein the esophagogastric module simulates the esophagogastric of a human body; the varicose blood vessel module is an animal intestinal canal injected with glycerol and pigment, the glycerol has no obvious influence on the animal intestinal canal, the damage to the animal intestinal canal caused by injecting other liquid is avoided, the preservation of the animal intestinal canal is prolonged, and the varicose blood vessel module is tied every 1-2cm to simulate the buckling and the bulging of varicose veins in the fundus of the esophagus and stomach in a human body. The operation training model provided by the invention can fully ensure the feedback of the touch feeling and the strength of the training operation, so that doctors can obtain real and convenient skill training, the operation skill is improved, the training environment is simplified, and the investment of fields, cost, manpower and the like is saved.
Description
Technical Field
The invention relates to the technical field of medical treatment, in particular to an esophageal and gastric varices operation training model and a manufacturing method thereof.
Background
Esophageal and gastric varices are common diseases in digestive internal medicine, and are venous lesions caused by the blockage of blood passing through the liver due to liver cirrhosis and other reasons, wherein veins are in a bent shape at the fundus and the esophagus, and the walls of blood vessels are thinned; is easily broken. Once damaged, patients may be life-threatening due to excessive blood loss due to difficulties in hemostasis in the re-stomach and esophagus vessels; one important surgical treatment for esophageal and gastric varices is sclerosing and ligation of esophageal and gastric varices under a gastroscope; require doctors to operate gastroscopes to inject medicaments into blood vessels in the stomach to form thrombus hemostasis or ligation to close the blood vessels to stop bleeding.
In a historical stage, most doctors of esophageal and gastric varices adopt a teaching mode of training skills on patients, but huge medical risks are brought; in order to avoid the risks and master the operation skills, various non-human skills are trained.
1) The existing animal organs are adopted for skill training, but the animal organs purchased in the market have no blood vessels and focus, and the practice of technologies such as injection hemostasis, ligation hemostasis and the like cannot be carried out; can not be effectively used for simulating and training the esophageal and gastric varices operation.
2) The technical training is carried out by using the living animal, but the living animal is difficult to culture the focus, the animal operation needs the matching conditions of an animal operating room, an animal temporary rearing room, anesthesia equipment and the like, the investment of fields, personnel and equipment is high, the convenience is low, the training cost is very high, and a general doctor is difficult to carry out massive practice to meet the technical requirements of actual human body operation.
3) The box-type simulator is used for skill training, but the pure box-type simulator can only train basic abilities such as spatial sensation conversion, hand-eye coordination, and double-hand coordination, the skill coverage range is small, and the requirements of the operation of the esophageal-gastric varices (such as the use of energy instrument equipment, the operation steps and the like) cannot be met.
4) Skill training is performed using a 3D simulator, but human tissue is a complex multi-layered material, and 3D simulation is difficult because its properties depend on the number of layers, the thickness of the layers, the orientation of muscle fibers, humidity, temperature, etc.
In view of the above, the present invention is particularly proposed.
Disclosure of Invention
The first purpose of the invention is to provide an esophageal and gastric varices surgery training model, which can fully ensure the feedback of the touch and strength of the training operation, so that a doctor can obtain real and convenient skill training to solve at least one of the above problems.
The second purpose of the invention is to provide a manufacturing method of the training model for esophageal and gastric varices surgery, which is simple and convenient.
The third purpose of the invention is to provide the application of the glycerol in the blood simulating the surgery training model.
In a first aspect, the invention provides an esophagogastric varices operation training model, which comprises an esophagogastric module and a varices blood vessel module, wherein the varices blood vessel module is fixed in the esophagogastric module;
the varicose blood vessel module is an animal intestinal tube injected with glycerol and pigment;
the varicose blood vessel module is ligated every 1-2 cm.
As a further technical proposal, the esophagogastric module is the esophagogastric tissue of an animal;
preferably, the esophagogastric tissue of the animal comprises pig esophagogastric tissue, sheep esophagogastric tissue or cow esophagogastric tissue, preferably mini-pig esophagogastric tissue.
As a further technical scheme, the varicose blood vessel module is fixed in the esophagogastric module according to the trend of blood vessels at the lesion of the esophagogastric varicose vein.
As a further technical scheme, the fixing mode comprises suture fixing;
preferably, the fixing position of the varicose blood vessel module comprises a ligation site and a position between adjacent ligations;
as a further aspect, the animal intestine comprises a small animal intestine;
preferably, the small animal intestine comprises a chicken intestine, a duck intestine, a goose intestine or a rabbit intestine;
optionally, the diameter of the animal intestinal tube is 0.5-1 cm, and preferably 0.8 cm.
As a further aspect, the pigment comprises a red pigment;
preferably, the red pigment comprises carmine.
In a second aspect, the invention provides a method for making a training model for esophageal and gastric varices surgery, which comprises the following steps:
ligating the animal intestine filled with the glycerol and the pigment every 1-2cm to obtain a varicose blood vessel module;
and opening the esophagogastric module, turning the inside of the esophagogastric module to the outside, fixing the varicose blood vessel module in the esophagogastric module, turning the esophagogastric module back to the original shape, closing the opened gap, and manufacturing to obtain the esophagogastric varices surgical training model.
As a further aspect, the open position includes the fundus;
the length of the opened gap is 4-8 cm, and preferably 5 cm.
As a further technical scheme, after the training model for esophageal and gastric varices surgery is manufactured, the method also sequentially comprises the steps of antiseptic treatment, vacuum packaging and cryopreservation.
In a third aspect, the invention provides the use of glycerol in blood for simulating a surgical training model.
Compared with the prior art, the invention has the following beneficial effects:
the invention provides an esophageal and gastric varices operation training model which comprises an esophageal and gastric module and a varices blood vessel module fixed in the esophageal and gastric module. Wherein the esophagogastric module simulates the esophagogastric of a human body; the varicose blood vessel module is the animal intestines tube that has glycerine and pigment into, and glycerine is thick, can simulate blood, does not have obvious influence to the animal intestines, avoids injecting the damage of other liquid to the animal intestines tube, prolongs the shelf life of animal intestines tube, and the buckling and the uplift of varicose vein in human esophagus stomach fundus are simulated to varicose blood vessel module every 1 ~ 2cm ligature. The operation training model provided by the invention can fully ensure the feedback of the touch feeling and the strength of the training operation, so that doctors can obtain real and convenient skill training, the operation skill is improved, the training environment is simplified, and the investment of fields, cost, manpower and the like is saved.
The method for manufacturing the esophageal and gastric varices surgery training model is simple and convenient, and can quickly realize the manufacturing of the surgery training model.
The invention provides application of glycerol in blood simulating a surgical training model. The inventor researches and discovers that after the blood vessel is filled and frozen by using the water solution dissolved with the pigment and then thawed, the blood vessel is changed into half-filled state from the filled state, part of water is lost, and the texture of the intestinal canal wall is obviously changed; and adopt glycerine filling freezing still can keep filling state after unfreezing again, and vascular wall feel hardly changes, and in addition, glycerine is thick, and the blood can not flow completely after the simulation blood vessel that is full of has glycerine is impaled by the syringe needle, is more close with actual blood.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and other drawings can be obtained by those skilled in the art without creative efforts.
FIG. 1 is a varicose blood vessel module provided in example 1 of the present invention;
fig. 2 is an internal configuration of a training model for esophageal and gastric varices surgery provided in embodiment 1 of the present invention.
Detailed Description
Embodiments of the present invention will be described in detail below with reference to embodiments and examples, but those skilled in the art will understand that the following embodiments and examples are only illustrative of the present invention and should not be construed as limiting the scope of the present invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention. Those who do not specify the conditions are performed according to the conventional conditions or the conditions recommended by the manufacturer. The reagents or instruments used are not indicated by the manufacturer, and are all conventional products available commercially.
In a first aspect, the invention provides an esophagogastric varices operation training model, which comprises an esophagogastric module and a varices blood vessel module, wherein the varices blood vessel module is fixed in the esophagogastric module;
the varicose blood vessel module is an animal intestinal tube injected with glycerol and pigment;
the varicose blood vessel module is ligated every 1-2 cm.
It is to be noted that the esophagogastric refers to the connective esophagus and stomach tissue; the pigment is not particularly limited in the present invention, and may be carmine, for example, to better simulate the color of blood.
In the invention, the esophagogastric module simulates the esophagogastric of a human body; the varicose blood vessel module is the animal intestines tube that has glycerine and pigment into, and glycerine is thick, can simulate blood, does not have obvious influence to the animal intestines, avoids injecting the damage of other liquid to the animal intestines tube, prolongs the save of animal intestines tube, and the buckling and the uplift of varicose vein in human esophagus stomach fundus are simulated to varicose blood vessel module every 1 ~ 2cm ligature. The operation training model provided by the invention can fully ensure the feedback of the touch feeling and the strength of the training operation, so that doctors can obtain real and convenient skill training, the operation skill is improved, the training environment is simplified, and the investment of fields, cost, manpower and the like is saved.
In some preferred embodiments, the esophagogastric module is an animal's esophagogastric tissue, which is similar to that of a human, and therefore the esophagogastric tissue of the animal is used to make the esophagogastric module.
Preferably, the esophagogastric tissue of the animal includes, but is not limited to, porcine esophagogastric tissue, ovine esophagogastric tissue or bovine esophagogastric tissue, wherein the mini-porcine esophagogastric tissue is closer to the actual lesion, and therefore, the esophagogastric tissue of the mini-pig is preferably used for manufacturing the esophagogastric module.
In some preferred embodiments, the variced vascular module is fixed inside the esophagogastric module according to the vascular course at the esophagogastric varicose lesions.
In the invention, the varicose blood vessel module simulates the buckling and the bulging of varicose veins in the esophagus and stomach fundus in a human body, and the varicose blood vessel module is fixed in the esophagus and stomach module according to the actual blood vessel trend of a focus, so that the model is closer to the actual focus. It should be noted that the blood vessel directions of the lesion of different patients are also different, and that "fixing the varicose blood vessel module inside the esophagogastric module according to the actual blood vessel direction of the lesion" means that the fixed position of the varicose blood vessel module is similar to the position of the varicose blood vessel of the lesion.
In some preferred embodiments, the fixing means includes but is not limited to suture fixing, for example, glue fixing and the like can also be adopted;
preferably, the fixing position of the varicose blood vessel module comprises the ligation site and between adjacent ligations.
In the invention, the varicose blood vessel module is tied into one section every 1-2cm, and the tied parts at two ends of the section are preferably fixed for the section with the length of 1-1.5; for a section with the length of 1.5-2 cm, the varicose blood vessel module cannot be completely attached to the esophagus and stomach module only by fixing the ligation parts at the two ends of the section, so that the section needs to be fixed additionally, and the fixing position is preferably the middle part of the section.
In some preferred embodiments, the animal intestine comprises a small animal intestine.
The small animals are animals having a body shape similar to that of mature chicken, duck, goose and rabbit.
Preferably, the small animal intestine comprises a chicken intestine, a duck intestine, a goose intestine or a rabbit intestine;
optionally, the diameter of the animal intestine is 0.5-1 cm, for example, but not limited to, 0.5cm, 0.6cm, 0.7cm, 0.8cm, 0.9cm or 1cm, preferably 0.8 cm.
The animal intestinal canal is further selected and optimized, so that the manufactured varicose blood vessel module is closer to an actual focus.
In some preferred embodiments, the pigment includes, but is not limited to, pigments including red pigments;
preferably, the red pigment comprises carmine, or a pigment well known to those skilled in the art.
It should be noted that, the amount of the glycerin and the pigment is not limited in the present invention, and the color of the mixture of the glycerin and the pigment is similar to the color of the actual blood. For example, one possible way is to mix 500mL of glycerol with 5g of carmine.
In a second aspect, the invention provides a method for making a training model for esophageal and gastric varices surgery, which comprises the following steps:
ligating the animal intestine filled with the glycerol and the pigment every 1-2cm to obtain a varicose blood vessel module; and opening the esophagogastric module, turning the inside of the esophagogastric module to the outside, fixing the varicose blood vessel module in the esophagogastric module, turning the esophagogastric module back to the original shape, closing the opened gap, and manufacturing to obtain the esophagogastric varices surgical training model.
It should be noted that the opening mode of the present invention is not limited in particular, and may be, for example, a cut or a slit, so as to obtain a gap for turning the inside of the esophagogastron to the outside.
The method for manufacturing the esophageal and gastric varices surgery training model is simple and convenient, and can quickly realize the manufacturing of the surgery training model.
In some preferred embodiments, the open position includes, but is not limited to, the fundus of the stomach. Here, "fundus" refers to a part of the stomach.
The invention is not limited to the open position, and the inventor researches and discovers that the similar form of the stomach of the animal to the human is not influenced by opening and then ligating the stomach bottom of the animal, for example, the stomach bottom of the pig is obviously protruded and expanded compared with the stomach bottom of the human, and the opened and then ligated stomach bottom of the pig can retract the protruded and expanded part of the stomach of the human to be closer to the stomach of the human while the similar form of the stomach of the pig to the stomach of the human is not influenced, so the open position is preferably arranged at the stomach bottom.
The length of the opening gap is 4-8 cm, for example, but not limited to, 4cm, 5cm, 6cm, 7cm or 8cm, preferably 5 cm.
Through further optimization and adjustment of the length of the opening gap, the injury to the tissues of the esophagogastro is reduced while the esophagogastro is conveniently turned inside and outside.
In some preferred embodiments, after the training model for esophageal and gastric varices surgery is made, the steps of preservative treatment, vacuum packaging and cryopreservation are sequentially included.
In the present invention, in order to prolong the storage time of the surgical model, it is necessary to perform operations such as preservation, packaging, and freezing of the surgical model. For example, the prepared operation training model can be smeared on the surface of an organ by using a small amount of food preservative, and is stored by using a quick-freezing technology at the temperature of-18 ℃ after being vacuumized and packaged.
In a third aspect, the invention provides the use of glycerol in blood for simulating a surgical training model.
The inventor researches and discovers that after the blood vessel is filled and frozen by using the water solution dissolved with the pigment and then thawed, the blood vessel is changed into half-filled state from the filled state, part of water is lost, and the texture of the intestinal canal wall is obviously deteriorated; and adopt glycerine filling freezing still can keep filling state after unfreezing again, and vascular wall feel hardly changes, and in addition, glycerine is thick, and the blood can not flow completely after the simulation blood vessel that is full of has glycerine is impaled by the syringe needle, is more close with actual blood.
The invention is further illustrated by the following specific examples and comparative examples, but it should be understood that these examples are for purposes of illustration only and are not to be construed as limiting the invention in any way.
Example 1
A training model for esophageal and gastric varices operation is prepared by the following steps:
a chicken intestine tube having a diameter of about 0.8cm was filled with a mixture of 500mL of glycerin and 5g of carmine. Ligating into small sections every 1-2cm as shown in FIG. 1.
Cutting a notch of 5cm at the bottom of the stomach of the miniature pig, turning the stomach to the outside, and fixing the prepared varicose blood vessel on the esophageal wall and the stomach fundus according to the trend of the focus blood vessel. Fixation was performed at each ligation point. The longer section (1.5-2 cm section) is fixed by red silk thread in the middle. During fixation, the needle and the thread penetrate through the mucous membrane layer and are fixed again, and the thread is hidden below the blood vessel during fixation. The flexion and bulging of varicose veins in the fundus of the esophagus in humans is simulated as shown in figure 2.
And (4) turning the stomach back to the original shape, ligating and opening the stomach, and recovering the shape of the stomach to the original shape to prepare the esophageal and gastric varices operation training model.
Example 2
A training model for esophageal and gastric varices operation is prepared by the following steps:
a duck intestine tube with a diameter of about 0.5cm is filled with a mixture of 500mL of glycerol and 5g of carmine. Ligating into small sections every 1-2 cm.
Cutting a notch 4cm away from the bottom membrane of the goat stomach, turning the stomach to the outside, and fixing the prepared varicose blood vessel on the esophageal wall and the stomach fundus according to the trend of the focus blood vessel. Fixation was performed at each ligation point. The longer section (1.5-2 cm section) is fixed by red silk thread in the middle. During fixation, the needle and the thread penetrate through the mucous membrane layer and are fixed again, and the thread is hidden below the blood vessel during fixation. Simulating the buckling and bulging of varicose veins in the fundus of the esophagus in humans.
And (4) turning the stomach back to the original shape, ligating and opening the stomach, and recovering the shape of the stomach to the original shape to prepare the esophageal and gastric varices operation training model.
Example 3
A training model for esophageal and gastric varices operation is prepared by the following steps:
a rabbit intestine tube having a diameter of about 1cm was filled with a mixture of 500mL of glycerin and 5g of carmine. Ligating into small sections every 1-2 cm.
Cutting a notch 8cm away from the bottom membrane of the cattle stomach, turning the stomach to the outside, and fixing the prepared varicose blood vessel on the esophageal wall and the stomach bottom according to the trend of the focus blood vessel. Fixation was performed at each ligation point. The longer section (1.5-2 cm section) is fixed in the middle. The fixing mode adopts gluing. Simulating the buckling and bulging of varicose veins in the fundus of the esophagus in humans.
And (4) turning the stomach back to the original shape, ligating and opening the stomach, and recovering the shape of the stomach to the original shape to prepare the esophageal and gastric varices operation training model.
Test example 1
A chicken intestine tube having a diameter of about 0.8cm was filled with a mixture of 500mL of glycerin and 5g of carmine. Ligating into a small section every 1-2cm to obtain the varicose blood vessel model A.
A chicken intestine tube having a diameter of about 0.8cm was filled with a mixture of 500mL of physiological saline and 5g of carmine. And ligating into a small section every 1-2cm to obtain a varicose blood vessel model B.
And (3) storing the varicose blood vessel model A and the varicose blood vessel model B at-18 ℃ for 3 days, and observing the varicose blood vessel model A and the varicose blood vessel model B after thawing.
And (3) test results: the physiological saline is used as the varicose vein model B of blood and stored for 3 days at the temperature of 18 ℃ below zero, the liquid in the simulated blood vessel is obviously reduced (more than 40 percent), the simulated blood vessel is not full any more, and the state of the filling of the varicose vein in the actual case is greatly different. And glycerol is adopted as a varicose blood vessel model A of blood, the varicose blood vessel model A is stored for 3 days at the temperature of minus 18 ℃, the simulated blood vessel has no obvious change, and the filling state of the simulated blood vessel is still kept.
Finally, it should be noted that: the above embodiments are only used to illustrate the technical solution of the present invention, and not to limit the same; while the invention has been described in detail and with reference to the foregoing embodiments, it will be understood by those skilled in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some or all of the technical features may be equivalently replaced; and the modifications or the substitutions do not make the essence of the corresponding technical solutions depart from the scope of the technical solutions of the embodiments of the present invention.
Claims (10)
1. The training model for the esophageal-gastric fundus varices operation is characterized by comprising an esophageal-gastric module and a varices blood vessel module, wherein the varices blood vessel module is fixed in the esophageal-gastric module;
the varicose blood vessel module is an animal intestinal tube injected with glycerol and pigment;
the varicose blood vessel module is ligated every 1-2 cm.
2. The training model of esophageal-gastric fundoplication varices surgery according to claim 1, wherein the esophageal-gastric module is an esophageal-gastric tissue of an animal;
preferably, the esophagogastric tissue of the animal comprises pig esophagogastric tissue, sheep esophagogastric tissue or cow esophagogastric tissue, preferably mini-pig esophagogastric tissue.
3. The training model for esophageal-gastric varices surgery according to claim 1, wherein the varices blood vessel module is fixed inside the esophageal-gastric module according to the blood vessel trend at the esophageal-gastric varices focus.
4. The training model of esophageal-gastric fundoplication varices surgery according to claim 1, wherein the means of fixation comprises suturing;
preferably, the fixing position of the varicose blood vessel module comprises the ligation site and between adjacent ligations.
5. The training model of esophageal fundal varices surgery according to claim 1, wherein the animal intestine comprises a small animal intestine;
preferably, the small animal intestine comprises a chicken intestine, a duck intestine, a goose intestine or a rabbit intestine;
optionally, the diameter of the animal intestinal tube is 0.5-1 cm, and preferably 0.8 cm.
6. The training model of esophageal-gastric fundal varices surgery according to claim 1, wherein the pigment comprises a red pigment;
preferably, the red pigment comprises carmine.
7. The method for making the training model of esophageal and gastric varices surgery according to any one of claims 1 to 6, which is characterized by comprising the following steps:
ligating the animal intestine filled with the glycerol and the pigment every 1-2cm to obtain a varicose blood vessel module;
and opening the esophagogastric module, turning the inside of the esophagogastric module to the outside, fixing the varicose blood vessel module in the esophagogastric module, turning the esophagogastric module back to the original shape, closing the opened gap, and manufacturing to obtain the esophagogastric varices surgical training model.
8. The method of making as claimed in claim 7 wherein said open position includes the fundus;
the length of the opened gap is 4-8 cm, and preferably 5 cm.
9. The method for manufacturing the training model of the esophageal varices and gastric varices as claimed in claim 7, wherein the method further comprises the steps of preservative treatment, vacuum packaging and cryopreservation in sequence after the training model of the esophageal varices and gastric varices is manufactured.
10. Use of glycerol in blood to simulate a surgical training model.
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