CN114550564A - Hysteroscope operation training model, manufacturing method and application - Google Patents
Hysteroscope operation training model, manufacturing method and application Download PDFInfo
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- CN114550564A CN114550564A CN202210235814.8A CN202210235814A CN114550564A CN 114550564 A CN114550564 A CN 114550564A CN 202210235814 A CN202210235814 A CN 202210235814A CN 114550564 A CN114550564 A CN 114550564A
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Classifications
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
- G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
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- G09B23/306—Anatomical models comprising real biological tissue
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B9/00—Simulators for teaching or training purposes
Abstract
The invention relates to the technical field of surgical training model manufacturing, in particular to a hysteroscope surgical training model, a manufacturing method and application. The invention provides a method for manufacturing a hysteroscope surgery training model, which is characterized in that an isolated mammal uterus is used for simulating a uterine cavity, an isolated mammal intestinal canal is used for simulating a vagina, the intestinal canal is sutured at the bottom of the uterus, and a more real training scene is provided for a doctor through the construction of a focus in the uterine cavity and the construction of the vagina. The invention keeps broad ligament of uterus and round pillow tissue on the inner wall of the uterus when picking up the uterus body, and the perfusion head is arranged in the artery of the broad ligament mesentery, so that the uterus body has a complete vascular structure, the blood supply state can be recovered through the perfusion head, and the invention provides a blood vessel treatment method and skill training for doctors in operation, trains the consciousness for preventing complications and a treatment method after the complications appear.
Description
Technical Field
The invention relates to the technical field of surgical training model manufacturing, in particular to a hysteroscope surgical training model, a manufacturing method and application.
Background
The modern science and technology development is rapid, the medical technology is changed day by day, in recent years, the national and government have increased the security to the public health, the documents that each competent department goes out are all emphasizing the importance of the educational training to the medical quality in succession, but at present, surgeons mostly adopt the teaching mode of "teacher and apprentice" and "practice in the art", adopt the way of animal living body operation, need the training field of very specialization, the place, cost of labor are high, lead to the doctor to have training chance hardly; when the living animal is adopted, personnel in different departments need to queue up to train on different organs of the animal, time is wasted, so that the possibility of operation of a doctor is seriously insufficient, only the traditional mode of training skills on a patient is changed, the sufficient skill accumulation opportunity can be provided for the doctor, and meanwhile, the risk of hospitalization is reduced. Surgery places extremely high demands on the operating skill of the surgeon and requires a great deal of realistic training if one wants to get an effective skill accumulation for the surgeon.
The current training methods for doctors are as follows: and (3) carrying out hysteroscopy technique training by using an in-vitro pig heart and carrying out virtual simulator training by using a 3D animation and a force feedback system. Although the isolated pig heart can enable doctors to train real touch and energy equipment, the isolated pig heart does not undergo special treatment, the difference between a plurality of heart cavity structures and a uterine cavity structure is large, and myoma focuses are lacked. Although the 3D simulator is relatively convenient, human tissues are complex multi-layer materials, and since the properties thereof depend on the number of layers, the thickness of the layers, the trend of muscle fibers, humidity, temperature and the like, the difference between the picture and force feedback and the real surgery is large by using products such as plastic, silica gel and the like as a simple simulation box of the training module, and the operation touch feeling of the 3D simulation can not meet the clinical requirements all the time.
In view of this, the invention is particularly proposed.
Disclosure of Invention
The invention aims to provide a method for manufacturing a hysteroscope surgery training model, which aims to obtain a hysteroscope surgery training model with higher reality and reusability by the method, so that a doctor obtains real skill training touch and surgical skill is improved; meanwhile, the materials are convenient to obtain, the training environment requirement is simple, the investment of fields, cost, manpower and the like is saved, daily training is realized for doctors, and sufficient skill accumulation is obtained.
In order to solve the technical problems and achieve the purpose, the invention provides the following technical scheme:
in a first aspect, the invention provides a method for manufacturing a hysteroscope surgery training model, which comprises the steps of simulating a uterine cavity by using an isolated mammalian uterus, simulating a vagina by using an isolated mammalian intestinal canal, suturing the intestinal canal to the bottom of the uterus, keeping a broad ligament of the uterus and a round occipital tissue on the inner wall of the uterus, and embedding an infusion head in an artery of a broad ligament mesentery.
In alternative embodiments, the mammal is selected from a pig, a cow, a donkey, or a sheep.
In an alternative embodiment, the uterus comprises a uterus body between a cervical part and a uterine horn, the uterus body retains a broad ligament of 10-30 cm, and the top of the uterus is connected with a lateral uterine horn.
In an alternative embodiment, a method of simulating a uterine cavity with an isolated mammalian uterus comprises separating and shearing the uterine body of a removed mammalian uterus upward, leaving the uterine body and a lateral uterine horn, and suturing and ligating the opening of the uterine horn.
In an alternative embodiment, the method for simulating a vagina with an isolated mammalian intestinal canal comprises suturing the mammalian intestinal canal with a fat retention ratio of 10% to 20% to the cervical opening of the uterine fundus.
In an alternative embodiment, the length of the mammalian intestinal tube is 8-12 cm.
In an alternative embodiment, the dairy animal intestine is sutured to the cervical opening at the base of the uterus by continuous or purse string suturing.
In a second aspect, the invention provides a hysteroscopic surgery training model obtained by the method of any one of the preceding embodiments.
In a third aspect, the invention provides an application of the hysteroscope operation training model in hysteroscope simulation operation training.
In an alternative embodiment, the hysteroscopic simulated surgery includes an endometrial polyp resection simulated surgery.
The invention provides a method for manufacturing a hysteroscope surgery training model, which is characterized in that an isolated mammal uterus is used for simulating a uterine cavity, an isolated mammal intestinal canal is used for simulating a vagina, the intestinal canal is sutured at the bottom of the uterus, and a 'focus in the uterine cavity' built by using a round pillow tissue and the construction of the vagina are utilized to provide a more real training scene for a doctor. The invention keeps broad ligament of uterus and round occipital tissue on the inner wall of the uterus when picking up the uterus body, and the perfusion head is arranged in the artery of the broad ligament mesentery, so that the uterus body has a complete vascular structure, the blood supply state can be recovered through the perfusion head, various blood vessel treatment methods and skill training in operation are provided for doctors, and the consciousness for preventing complications and the treatment method after the complications occur are trained and trained. The method for manufacturing the hysteroscope operation training model is convenient in material acquisition, economical and practical, and can fully ensure repeated training of doctors to achieve sufficient skill proficiency; the training environment is fully simplified, the application is convenient, the investment of field, cost, manpower and the like is saved, and the popularization is realized.
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 real object diagram of a hysteroscopy training model provided in embodiment 1 of the present invention.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. The components of embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.
Thus, the following detailed description of the embodiments of the present invention, presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the 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.
It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, it need not be further defined and explained in subsequent figures.
In the description of the present invention, it is noted that the terms top, bottom, up, down, and the like are used in an orientation or positional relationship that is based on the orientation or positional relationship as shown in the drawings or is physiologically conventional, and are used merely for convenience in describing and simplifying the description, and are not intended to indicate or imply that the device or element so referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus, are not to be construed as limiting the invention.
In a first aspect, the present invention provides a method for making a hysteroscopic surgery training model, wherein a separated mammalian uterus is used to simulate a uterine cavity, a separated mammalian intestinal canal is used to simulate a vagina, the intestinal canal is sutured to the bottom of the uterus, a broad ligament of the uterus and a round occipital tissue on the inner wall of the uterus are retained, and an infusion head is placed in an artery of the broad ligament mesentery.
The uterus is divided into a uterine body (morphus uteri) and a cervix (cervix uteri). The body of the uterus is wide, and is located at the upper part of the uterus, the top of the uterus is called the fundus (fundus uteri), and the two sides of the fundus are called the uterine horn (cornua uteri). The cervix is narrow and cylindrical, and is located in the lower part of the uterus. The ratio of uterine body to cervix varies with age and ovarian function, with a ratio of 1: 2, women in childbearing age 2: 1, postmenopausal 1: 1. the uterine cavity (uterine cavity) is a triangle with a wide upper part and a narrow lower part, the two sides of the uterine cavity are communicated with the fallopian tube, and the tip of the uterine cavity faces downwards to the cervical canal. The uterus is an organ with a cavity wall thickness, the wall of the uterus is divided into three layers, the outer layer is a serous membrane and is a visceral layer of peritoneum; the middle layer is a strong and thick muscle layer and consists of smooth muscles; the inner layer is the mucous membrane, i.e. the endometrium, and the cycle change of hyperplasia and shedding occurs along with the menstrual cycle. The normal position of the uterus is supported by the uterine ligaments and the pelvic floor muscles and fascia, and disruption of pelvic floor tissue structure or dysfunction from any cause can lead to uterine prolapse. Wherein the broad ligaments are located at two sides of uterus and are wing-shaped double-layer peritoneal plica, and the peritoneum covering the front wall and the back wall of the uterus extends from the lateral margin of the uterus to two sides to reach the pelvic wall, so that the uterus can be limited from inclining towards two sides.
The invention simulates uterine cavity with isolated mammal uterus, and keeps broad ligament of uterus and round pillow tissue on the inner wall of uterus, and a perfusion head is arranged in artery of broad ligament mesentery, so that the uterus has complete vascular structure, and the blood supply state can be recovered through the perfusion head, thereby providing a doctor with a blood vessel treatment method and skill training in operation, training consciousness for preventing complications and a treatment method after the complications appear.
In an alternative embodiment, the mammal is selected from pigs, cattle, donkeys or sheep, and the uterus of the large mammals is very close to that of human beings, when the mammal is taken as a meat food material source, due to different acceptance degrees of consumers, food materials prepared by collecting the uterus of the large mammals are very limited, for example, pig intestines are prepared by oviducts of the uterus, and the uterus of the animals is collected to prepare a hysteroscope surgery training model, so that a new utilization way of the uterus of the animals is provided, and the advantage of low purchase price is achieved.
In an optional embodiment, the uterus comprises a uterus body between a cervical opening and a uterine horn, the uterus body retains a wide ligament of 10-30 cm, and the top of the uterus is connected with a lateral uterine horn.
In an alternative embodiment, the method for simulating the uterine cavity by using the separated mammalian uterus comprises the steps of separating and shearing upwards along the extracted uterine body of the mammalian uterus, reserving the uterine body and one side uterine horn, sewing and ligating the opening of the uterine horn, and embedding an infusion head into an artery of a broad ligament mesentery for reserving the complete one side uterine horn, so that the uterine body is provided with a complete vascular structure, and the blood supply state can be recovered through the infusion head. The suture ligation may be replaced by other conventional means such as gluing or stapling.
In an alternative embodiment, the method for simulating a vagina with an isolated mammalian intestinal canal comprises suturing the mammalian intestinal canal with a fat retention ratio of 10% to 20% to the cervical opening of the uterine fundus.
In alternative embodiments, the length of the mammalian intestinal tube is 8-12 cm, including but not limited to 8cm, 9cm, 10cm, 11cm or 12 cm.
In an alternative embodiment, the dairy animal intestine is sutured to the cervical opening at the base of the uterus by continuous or purse string suturing.
In a second aspect, the invention provides a hysteroscopic surgery training model obtained by the method of any one of the preceding embodiments.
In a third aspect, the invention provides an application of the hysteroscope operation training model in hysteroscope simulation operation training.
In an alternative embodiment, the hysteroscopic simulated surgery includes an endometrial polyp resection simulated surgery.
Some embodiments of the invention are described in detail below with reference to the accompanying drawings. The embodiments and features of the embodiments described below can be combined with each other without conflict.
Example 1
The embodiment provides a method for manufacturing a hysteroscope surgery training model, which comprises the following steps of simulating a uterine cavity by using a pig uterus in vitro, simulating a vagina by using a pig intestinal canal in vitro, sewing the intestinal canal at the bottom of the uterus, reserving broad ligaments of the uterus and round pillow tissues on the inner wall of the uterus, and placing an infusion head in an artery of the broad ligament mesentery:
(1) raw materials:
pig uterus: 10-30 cm of broad ligaments are reserved on two sides of the complete pig uterus with a complete uterine artery structure;
a pig intestine tube: the length is 8-12 cm.
(2) The manufacturing steps are as follows:
making uterine cavity
a. Separating and shearing the picked uterus upwards along the uterus body, and keeping the uterus body and one side uterine horn to obtain the uterus body between the cervical part and the opening of the uterine horn;
b. continuously suturing and ligating an opening of a uterine horn at the top end of the uterine body;
c. the uterine artery was found in the retained ligamentum latticeae, below the ovary, in which the perfusion head was placed and fixed with white silk thread.
Preparation of vagina
a. Taking a section of the pig intestine tube of about 8-12 cm, cutting off redundant grease, and leaving 10-20% of grease to simulate a vagina, so that the operation is more convenient, and materials can be saved;
b. then one end of the pig intestine pipe is sewed to the opening at the bottom of the uterus body to be connected, and continuous sewing or purse-string sewing can be used, and the water tightness of the sewing is preferably realized.
Examples 2 to 4
The uterus and the intestinal canal of cattle, donkey or sheep are respectively used in the group of embodiments, and the manufacturing method of the hysteroscope operation training model is provided, and the manufacturing steps are consistent with those of embodiment 1.
Examples 5 to 8
The group of embodiments provides hysteroscopic surgery training models obtained by the manufacturing methods described in embodiments 1-4, respectively.
Example 9
In this example, the method for performing hysteroscopic endometrial polypectomy training using the hysteroscopic surgical training model prepared from the ex vivo uterus and intestinal canal of pig described in example 5, comprises the following overall steps:
(1) the form, size and base of the polyp are observed under a mirror, and then the relation between the base of the polyp and the surrounding tissues is noticed to design the cutting technique.
(2) Resection of multiple polyps: because the uterine cavity is filled with polyps, the perfusate is insufficient, and the visual field is fuzzy, a negative pressure suction device is firstly used for sucking the intima and the polyps, the intima covered on the surfaces of the polyps is sucked, only the interstitial tissues of the polyps are left, the volume and the transverse diameter are obviously reduced, the perfusate enters, and the cutting is convenient.
(3) When the polypus is cut off, the root and the pedicle of the polypus are sleeved by the annular electrode from the distance of the polypus and then cut, and the depth of the electric cutting reaches the superficial muscle layer tissue 2-3 mm below the root and the pedicle.
The specific training operation steps are as follows:
(1) the electric cutting ring is arranged at the far side of the tissue to be cut and on the surface of the cut tissue, when the electric cutting ring is moved to start cutting, firstly, a pedal is started, and when a cutting action is sensed in a hand, a handle or a spring for cutting is moved, the electric cutting ring cuts human tissue according to the cutting requirement, and cuts the tissue at the required cutting depth along the trend, and the moving speed is generally 1 cm/s.
(2) At the end of each excision, tissue is cut from the wound surface, but only when the electric excision ring is moved into the endoscope sheath and the pedal is released, the tissue can be completely cut.
(3) The cut tissue is generally in the shape of a strip, with slightly thinner ends and thicker center, like a boat. The thickness of the tissue piece is proportional to the depth of the placement of the resecting ring, and the length of the tissue piece depends on the distance of the resecting ring and the moving sheath.
(4) The thickness of the cutting tissue is adjusted by taking the internal cervix as a fulcrum.
(5) When the tissue to be cut is thick, the head of the electric cutting sheath is slightly inclined forwards to enable the electric cutting ring to cut into the tissue, then the electric cutting ring is slightly moved to the deep part in an arc shape until the cutting is finished, and then the sheath is slightly lifted to smoothly cut the tissue.
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. A method for manufacturing a hysteroscope surgery training model is characterized in that an isolated mammal uterus is used for simulating a uterine cavity, an isolated mammal intestinal canal is used for simulating a vagina, the intestinal canal is sutured at the bottom of the uterus, a broad ligament of the uterus and a round pillow tissue on the inner wall of the uterus are reserved, and an infusion head is arranged in an artery of a broad ligament mesentery.
2. The method of claim 1, wherein the mammal is selected from the group consisting of swine, cattle, donkey and sheep.
3. The manufacturing method of claim 1, wherein the uterus comprises a uterus body between a cervical mouth and a uterine horn, the uterus body retains a broad ligament of 10-30 cm, and the top of the uterus is connected with a lateral uterine horn.
4. The method of claim 1, wherein simulating the uterine cavity with the isolated mammalian uterus comprises separating and cutting the extracted mammalian uterus upward, leaving the uterus and a lateral uterine horn, and ligating the opening of the uterine horn by suturing.
5. The method of claim 1, wherein the isolated mammalian intestine is used to simulate a vagina, and the method comprises suturing the mammalian intestine to the cervix uteri opening at the bottom of the uterus, wherein the mammalian intestine has a fat retention ratio of 10% to 20%.
6. The method of claim 5, wherein the length of the intestinal tract of the mammal is 8-12 cm.
7. The method of claim 5, wherein the intestinal canal of the dairy animal is sutured to the cervical opening of the uterine fundus via a continuous or purse string suture.
8. A hysteroscopic surgery training model obtained by the method of any one of claims 1-7.
9. Use of the hysteroscopic training model of claim 8 in hysteroscopic simulated surgical training.
10. The use according to claim 9, wherein the hysteroscopic simulated surgery includes endometrial polyp resection simulated surgery.
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2023168922A1 (en) * | 2022-03-11 | 2023-09-14 | 北京博医时代医疗科技有限公司 | Uterus model, and hysteroscope surgery training model and manufacturing method therefor |
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