CN113487953B - Esophageal gastric fundus varices operation training model and manufacturing method thereof - Google Patents
Esophageal gastric fundus varices operation training model and manufacturing method thereof Download PDFInfo
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- CN113487953B CN113487953B CN202110875341.3A CN202110875341A CN113487953B CN 113487953 B CN113487953 B CN 113487953B CN 202110875341 A CN202110875341 A CN 202110875341A CN 113487953 B CN113487953 B CN 113487953B
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Abstract
The invention provides an esophageal and gastric fundus 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 fundus varices operation training model which comprises an esophageal and gastric module and a varicose blood vessel module fixed in the esophageal and gastric module. Wherein, the esophagus and stomach module simulates the esophagus and stomach of a human body; the varicose vein module is an animal intestinal canal injected with glycerol and pigment, the glycerol has no obvious influence on the animal intestinal canal, the damage of other injected liquid to the animal intestinal canal is avoided, the preservation of the animal intestinal canal is prolonged, the varicose vein module is ligated every 1-2cm, and the buckling and the uplift of varicose veins in the esophageal and gastric fundus of a human body are simulated. The surgical training model provided by the invention can fully ensure feedback of the touch feeling and the force of the training operation, so that a doctor can obtain real and convenient skill training, the surgical skill is improved, the training environment is simplified, and the investment of sites, cost, labor and the like is saved.
Description
Technical Field
The invention relates to the technical field of medical treatment, in particular to an esophageal gastric fundus varices operation training model and a manufacturing method thereof.
Background
Varicose vein at the fundus of the esophagus and stomach is a common disease of digestive system department, blood is blocked by liver due to liver cirrhosis and the like, vein lesions are caused, veins are in a buckling shape at the fundus of the stomach and the esophagus, and the blood vessel wall is thinned; is easy to be broken. Once broken, hemostasis is difficult due to the re-stomach and esophageal vessels, and patients may be life-threatening due to excessive blood loss; one important type of surgical treatment for esophageal and gastric fundus varices is gastroscopic esophageal and gastric fundus varices sclerosant treatment and ligation treatment; the doctor is required to operate the gastroscope to inject the medicament into the intragastric blood vessel to form thrombus hemostasis or ligation and closing blood vessel hemostasis.
In a history stage, most of esophageal and gastric varices doctors adopt a teaching mode of training skills on patients, but simultaneously bring about huge doctor risks; to avoid such risks and yet to be able to master the skill of the surgery, various non-human skill exercises have been developed.
1) The prior animal organ is adopted for skill training, but the animal organ purchased in the market has no blood vessel or focus, and cannot be used for practicing injection hemostasis, ligation hemostasis and other technologies; can not be effectively used for the simulated training of esophageal and gastric fundus varices operation.
2) The living animal is used for skill training, but the living animal is difficult to cultivate focus, the animal surgery needs matching conditions such as an animal operating room, an animal temporary feeding room, anesthesia equipment and the like, the investment of places, personnel and equipment is high, the convenience is low, the training cost is very high, and general doctors are difficult to practice a large amount of practice to meet the skill requirements of actual human surgery.
3) The box simulator is adopted for skill training, but the simple box simulator can only train basic capabilities such as space sense conversion, hand-eye coordination, hand-hand coordination and the like, has small skill coverage range, and can not meet the requirements of operation (such as the use of energy equipment, operation steps and the like) of varicose vein operation on the bottom of esophagus and stomach of a human body.
4) Skill training is performed using 3D simulators, but human tissue is a complex multi-layered material and is difficult to 3D simulate because its properties depend on the number of layers, thickness of layers, strike of muscle fibers, humidity, temperature, etc.
In view of this, the present invention has been made.
Disclosure of Invention
A first object of the present invention is to provide an esophageal and gastric varices surgical training model that is capable of sufficiently securing feedback of the tactile sensation and strength of the training operation so that a doctor can obtain a realistic and convenient skill training to solve at least one of the above-mentioned problems.
The second aim of the invention is to provide a manufacturing method of the esophageal and gastric fundus varices operation training model, which is simple and convenient.
A third object of the present invention is to provide the use of glycerol in blood for simulating a surgical training model.
In a first aspect, the invention provides an esophageal and gastric fundus varices surgical training model, which comprises an esophageal and gastric module and a varicose vessel module, wherein the varicose vessel module is fixed inside the esophageal and gastric module;
the varicose vein module is an animal intestinal canal injected with glycerol and pigment;
the varicose vein module is ligated every 1-2 cm.
As a further technical scheme, the esophageal gastric module is esophageal gastric tissue of an animal;
preferably, the esophageal and gastric tissue of the animal comprises porcine esophageal and gastric tissue, ovine esophageal and gastric tissue, or bovine esophageal and gastric tissue, preferably miniporcine esophageal and gastric tissue.
As a further technical scheme, the varicose vein module is fixed in the esophagus and stomach module according to the trend of blood vessels at the varicose focus of the esophagus and stomach.
As a further technical scheme, the fixing mode comprises suture fixing;
preferably, the fixed position of the varicose vein module comprises a ligation site and between adjacent ligations;
as a further technical scheme, the animal intestine comprises a small animal intestine;
preferably, the small animal intestine comprises chicken intestine, duck intestine, goose intestine or rabbit intestine;
alternatively, the diameter of the animal intestine is 0.5-1 cm, preferably 0.8cm.
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 manufacturing an esophageal gastric fundus varices operation training model, which comprises the following steps:
ligating animal intestines which are filled with glycerol and pigment every 1-2cm to obtain a varicose blood vessel module;
opening the esophageal and gastric module, turning the inside to the outside, fixing the varicose blood vessel module in the esophageal and gastric module, turning the esophageal and gastric module back to the original state, and closing the opened notch to manufacture the esophageal and gastric fundus varices operation training model.
As a further aspect, the open position comprises the fundus;
the open gap length is 4-8 cm, preferably 5cm.
As a further technical scheme, the method further comprises the steps of antiseptic treatment, vacuum packaging and freezing preservation after the esophageal and gastric fundus varicose vein operation training model is manufactured.
In a third aspect, the present 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 fundus varices operation training model which comprises an esophageal and gastric module and a varicose blood vessel module fixed in the esophageal and gastric module. Wherein, the esophagus and stomach module simulates the esophagus and stomach of a human body; the varicose vein module is an animal intestinal canal injected with glycerol and pigment, the glycerol is viscous, blood can be simulated, no obvious influence is caused on the animal intestinal canal, damage to the animal intestinal canal caused by injection of other liquid is avoided, the preservation period of the animal intestinal canal is prolonged, the varicose vein module is ligated every 1-2cm, and buckling and uplift of varicose veins in the esophageal fundus in a human body are simulated. The surgical training model provided by the invention can fully ensure feedback of the touch feeling and the force of the training operation, so that a doctor can obtain real and convenient skill training, the surgical skill is improved, the training environment is simplified, and the investment of sites, cost, labor and the like is saved.
The manufacturing method of the esophageal and gastric fundus varices operation training model provided by the invention is simple and convenient, and can quickly realize the manufacturing of the operation training model.
The invention provides the application of glycerol in blood simulating a surgical training model. The inventor researches that blood vessels are changed from full state to half full state after the blood vessels are frozen and thawed again by using the aqueous solution with the pigment, a part of water is lost, and the texture of intestinal canal walls is obviously changed; the glycerol is adopted to fill, freeze and unfreeze, the filling state can still be kept, the texture of the blood vessel wall is hardly changed, in addition, the glycerol is sticky, and blood cannot flow completely after the simulated blood vessel filled with the glycerol is pierced by the injection needle, so that the simulated blood vessel is more similar to 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 that are needed in the description of the embodiments or the prior art will be briefly described, and it is obvious that the drawings in the description below are some embodiments of the present invention, and other drawings can be obtained according to the drawings without inventive effort for a person skilled in the art.
Fig. 1 is a varicose vein module provided in embodiment 1 of the present invention;
fig. 2 is an internal configuration of an esophageal gastric fundus varices surgical training model provided in example 1 of the invention.
Detailed Description
Embodiments of the present invention will be described in detail below with reference to embodiments and examples, but it will be understood by those skilled in the art that the following embodiments and examples are only for illustrating the present invention and should not be construed as limiting the scope of the present invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention. The specific conditions are not specified, and the process is carried out according to conventional conditions or conditions suggested by manufacturers. The reagents or apparatus used were conventional products commercially available without the manufacturer's attention.
In a first aspect, the invention provides an esophageal and gastric fundus varices surgical training model, which comprises an esophageal and gastric module and a varicose vessel module, wherein the varicose vessel module is fixed inside the esophageal and gastric module;
the varicose vein module is an animal intestinal canal injected with glycerol and pigment;
the varicose vein module is ligated every 1-2 cm.
It should be noted that the esophagus and stomach refer to the connected esophagus and stomach tissue; the pigment is not particularly limited in the present invention, and may be carmine, for example, to better simulate the blood color.
In the invention, the esophageal and gastric module simulates the esophagus and stomach of a human body; the varicose vein module is an animal intestinal canal injected with glycerol and pigment, the glycerol is viscous, blood can be simulated, no obvious influence is caused on the animal intestinal canal, damage to the animal intestinal canal caused by injection of other liquid is avoided, preservation of the animal intestinal canal is prolonged, the varicose vein module is ligated every 1-2cm, and buckling and uplift of varicose veins in the bottom of esophagus and stomach in a human body are simulated. The surgical training model provided by the invention can fully ensure feedback of the touch feeling and the force of the training operation, so that a doctor can obtain real and convenient skill training, the surgical skill is improved, the training environment is simplified, and the investment of sites, cost, labor and the like is saved.
In some preferred embodiments, the esophageal gastric module is an animal's esophageal gastric tissue that is similar to that of a human, and thus the esophageal gastric module is made from the animal's esophageal gastric tissue.
Preferably, the esophageal and gastric tissue of the animal includes, but is not limited to, porcine esophageal and gastric tissue, ovine esophageal and gastric tissue, or bovine esophageal and gastric tissue, wherein the esophageal and gastric tissue of the mini-pig is closer to the actual lesion, so that the esophageal and gastric module is preferably made of the esophageal and gastric tissue of the mini-pig.
In some preferred embodiments, the varicose vein module is secured within the esophageal gastric module according to the vascular orientation at the esophageal fundus varices lesion.
In the invention, the varicose blood vessel module simulates the buckling and the bulge of varicose veins in the esophageal fundus of a human body, and the varicose blood vessel module is fixed in the esophageal fundus module according to the trend of actual blood vessels at a focus, so that the model is closer to the actual focus. It should be noted that the trend of blood vessels at the focus of different patients is also different, and the phrase "fixing the varicose blood vessel module inside the esophageal gastric module according to the trend of actual blood vessels at the focus" means that the fixing position of the varicose blood vessel module is similar to the position of the varicose blood vessel at the focus.
In some preferred embodiments, the means of fixation include, but are not limited to, suture fixation, e.g., adhesive fixation, etc. may also be employed;
preferably, the fixed position of the varicose vein module comprises a ligation site and between adjacent ligations.
In the invention, the varicose vein module is ligated into a section every 1-2cm, and the ligature parts at the two ends of the section are preferably fixed for the section with the length of 1-1.5; for a node with the length of 1.5-2 cm, the ligature positions at two ends of the node cannot be fixed completely, so that the fixation of the node is also required to be increased, and the fixation position is preferably the middle part of the node.
In some preferred embodiments, the animal intestine comprises a small animal intestine.
The small animals are animals which are similar to the body types of mature chickens, ducks, geese and rabbits.
Preferably, the small animal intestine comprises chicken intestine, duck intestine, goose intestine or rabbit intestine;
alternatively, 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 0.8cm.
The animal intestinal canal is further selected and optimized, so that the manufactured varicose blood vessel module is more approximate to an actual focus.
In some preferred embodiments, the pigment includes, but is not limited to, the pigment includes a red pigment;
preferably, the red pigment comprises carmine, or a pigment known to those skilled in the art.
The invention does not limit the dosage of glycerol and pigment, and the color of the mixed glycerol and pigment is similar to the actual blood color. For example, one possible way is to mix 500mL glycerol with 5g carmine.
In a second aspect, the invention provides a method for manufacturing an esophageal gastric fundus varices operation training model, which comprises the following steps:
ligating animal intestines which are filled with glycerol and pigment every 1-2cm to obtain a varicose blood vessel module; opening the esophageal and gastric module, turning the inside to the outside, fixing the varicose blood vessel module in the esophageal and gastric module, turning the esophageal and gastric module back to the original state, and closing the opened notch to manufacture the esophageal and gastric fundus varices operation training model.
The opening mode of the present invention is not particularly limited, and may be, for example, cutting or ripping, so as to obtain a notch to facilitate the inversion of the interior of the esophagus and the stomach to the outside.
The manufacturing method of the esophageal and gastric fundus varices operation training model provided by the invention is simple and convenient, and can quickly realize the manufacturing of the operation 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 particularly limited with respect to the open position, and the inventor finds that the open and ligature of the fundus of the animal does not affect the similar form of the stomach and the human body, for example, the fundus of the pig is obviously larger than the protruding and distended form of the fundus of the human body, and the open and ligature of the fundus of the pig can retract the distended part of the stomach more similar to the protruding and distended form of the stomach of the pig to the human body, so that the open position is preferably arranged at the fundus of the stomach.
The open notch length is 4 to 8cm, for example, but not limited to, 4cm, 5cm, 6cm, 7cm or 8cm, preferably 5cm.
By further optimizing and adjusting the length of the opening notch, the damage to the tissues of the esophagus and the stomach is reduced while the inside and outside of the esophagus and the stomach are conveniently overturned.
In some preferred embodiments, after the esophageal gastric fundus varices surgical training model is prepared, the steps of antiseptic treatment, vacuum packaging and freezing preservation are sequentially included.
In the present invention, in order to extend the preservation time of the surgical model, it is also 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 in a small amount by using a food preservative, and the model is stored by using a quick freezing technology at-18 ℃ after being vacuumized and packaged.
In a third aspect, the present invention provides the use of glycerol in blood for simulating a surgical training model.
The inventor researches that blood vessels are changed from full state to half full state after the blood vessels are frozen and thawed again by using the aqueous solution with the pigment, a part of water is lost, and the texture of the intestinal canal wall is obviously deteriorated; the glycerol is adopted to fill, freeze and unfreeze, the filling state can still be kept, the texture of the blood vessel wall is hardly changed, in addition, the glycerol is sticky, and blood cannot flow completely after the simulated blood vessel filled with the glycerol is pierced by the injection needle, so that the simulated blood vessel is more similar to actual blood.
The invention is further illustrated by the following specific examples and comparative examples, however, it should be understood that these examples are for the purpose of illustration only in greater detail and should not be construed as limiting the invention in any way.
Example 1
A training model for esophageal and gastric fundus varices surgery is prepared by the following steps:
a chicken intestine of about 0.8cm in diameter was taken and 500mL of a mixture of glycerin and 5g of carmine was injected into the chicken intestine. Ligature into a bar every 1-2cm as shown in figure 1.
Cutting a gap of 5cm at the bottom of the stomach film of a small pig, turning the inside of the stomach to the outside, and fixing the prepared curved blood vessel on the wall and the bottom of the stomach according to the trend of the focus blood vessel. Fixation was performed at each ligation point. Longer sections (1.5-2 cm sections) were fixed with red threads in the middle. The needle and line are used to pass through the mucous membrane layer for fixation, and the line is hidden under the blood vessel during fixation. Buckling and bulging of varices in the fundus of the esophagus and stomach in the human body were simulated, as shown in fig. 2.
The stomach is turned back to be original, the opening is ligated, the shape of the stomach is restored to be original, and the esophageal-gastric varices operation training model is manufactured.
Example 2
A training model for esophageal and gastric fundus varices surgery is prepared by the following steps:
a duck intestine tube with a diameter of about 0.5cm was taken, and 500mL of a mixture of glycerin and 5g of carmine was injected into the duck intestine tube. Ligature every 1-2cm to form a bar.
Cutting a notch of 4cm at the bottom film of sheep stomach, turning the inside of stomach to the outside, and fixing the prepared curved blood vessel on the wall of the food tube and the bottom of stomach according to the trend of the focus blood vessel. Fixation was performed at each ligation point. Longer sections (1.5-2 cm sections) were fixed with red threads in the middle. The needle and line are used to pass through the mucous membrane layer for fixation, and the line is hidden under the blood vessel during fixation. Simulating buckling and bulging of varices in the fundus of the esophagus and stomach in a human body.
The stomach is turned back to be original, the opening is ligated, the shape of the stomach is restored to be original, and the esophageal-gastric varices operation training model is manufactured.
Example 3
A training model for esophageal and gastric fundus varices surgery is prepared by the following steps:
a rabbit intestine tube having a diameter of about 1cm was taken, and 500mL of a mixture of glycerin and 5g of carmine was injected into the rabbit intestine tube. Ligature every 1-2cm to form a bar.
Cutting a notch of 8cm at the bottom film of the cattle stomach, turning the inner side of the stomach to the outer side, and fixing the prepared curved blood vessel on the wall of the food tube and the bottom of the stomach according to the trend of the focus blood vessel. Fixation was performed at each ligation point. Longer sections (1.5-2 cm sections) were fixed in the middle. The fixing mode adopts gluing. Simulating buckling and bulging of varices in the fundus of the esophagus and stomach in a human body.
The stomach is turned back to be original, the opening is ligated, the shape of the stomach is restored to be original, and the esophageal-gastric varices operation training model is manufactured.
Test example 1
A chicken intestine of about 0.8cm in diameter was taken and 500mL of a mixture of glycerin and 5g of carmine was injected into the chicken intestine. Ligature every 1-2cm to form a bar, and obtain the varicose vein model A.
A chicken intestine having a diameter of about 0.8cm was taken, and 500mL of a mixture of physiological saline and 5g of carmine was injected into the chicken intestine. Ligature every 1-2cm to form a bar to obtain the varicose vein model B.
And (3) placing the varicose vein model A and the varicose vein model B at the temperature of minus 18 ℃ for 3 days, and observing the varicose vein model A and the varicose vein model B after thawing.
Test results: the varicose vein model B taking normal saline as blood is stored for 3 days at the temperature of minus 18 ℃, the liquid in the simulated blood vessel is obviously reduced (more than 40 percent), the simulated blood vessel is not filled any more, and the state of varicose vein filling in actual cases is greatly different. And glycerol is used as a varicose blood vessel model A of blood, and the model A is stored for 3 days at the temperature of minus 18 ℃, so that the simulated blood vessel has no obvious change, and the filling state of the simulated blood vessel is still maintained.
Finally, it should be noted that: the above embodiments are only for illustrating the technical solution of the present invention, and not for limiting the same; although the invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some or all of the technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit of the invention.
Claims (12)
1. The esophageal and gastric fundus varices operation training model is characterized by comprising an esophageal and gastric module and a varicose blood vessel module, wherein the varicose blood vessel module is fixed inside the esophageal and gastric module;
the varicose vein module is an animal intestinal canal injected with glycerol and pigment;
ligating the varicose vein module every 1-2 cm;
the varicose vein module is fixed in the esophagus and stomach module according to the trend of blood vessels at the varicose focus of the esophagus and stomach;
the pigment is a red pigment.
2. The esophageal gastroesophageal varices surgical training model of claim 1, wherein the esophageal gastric module is esophageal gastric tissue of an animal;
the esophageal and gastric tissue of the animal comprises esophageal and gastric tissue of a pig, esophageal and gastric tissue of a sheep or esophageal and gastric tissue of a cow.
3. The esophageal gastroesophageal varices surgical training model of claim 2, wherein the esophageal stomach tissue of the animal is that of a minipig.
4. The esophageal gastric fundus varices surgical training model of claim 1, wherein the fixation means comprises suturing;
the fixed position of the varicose vein module comprises a ligature and a position between adjacent ligatures.
5. The esophageal gastric varices surgical training model of claim 1 wherein the animal intestinal canal comprises chicken intestinal canal, duck intestinal canal, goose intestinal canal or rabbit intestinal canal.
6. The esophageal gastric fundus varices surgical training model of claim 5, wherein the diameter of the animal intestinal canal is 0.5-1 cm.
7. The esophageal gastric fundus varices surgical training model of claim 6, wherein the diameter of the animal intestinal canal is 0.8cm.
8. The esophageal gastric fundus varices surgical training model of claim 1, wherein the red pigment comprises carmine.
9. A method for making a training model for esophageal gastric fundus varices surgery according to any one of claims 1-8, comprising the steps of:
ligating animal intestines which are filled with glycerol and pigment every 1-2cm to obtain a varicose blood vessel module;
opening the esophageal and gastric module, turning the inside to the outside, fixing the varicose blood vessel module in the esophageal and gastric module, turning the esophageal and gastric module back to the original state, and closing the opened notch to manufacture the esophageal and gastric fundus varices operation training model.
10. The method of claim 9, wherein the open position comprises the fundus of the stomach;
the length of the opened notch is 4-8 cm.
11. The method of claim 10, wherein the open gap length is 5cm.
12. The method according to claim 9, wherein after the esophageal gastric fundus varices surgical training model is prepared, the steps of antiseptic treatment, vacuum packaging and freezing preservation are sequentially included.
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| 徐小元 ; 丁惠国 ; 贾继东 ; 魏来 ; 段钟平 ; 令狐恩强 ; 刘玉兰 ; 庄辉 ; .肝硬化门静脉高压食管胃静脉曲张出血的防治指南.临床肝胆病杂志.2016,(第02期),第203-219页. * |
| 邓招奇，唐玉国.血管病变激光疗法的有限元模拟分析.激光杂志.2007,(第3期),第88-89页. * |
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