CN213751595U - Operation simulator - Google Patents

Abstract

The utility model provides a surgery simulator does not rely on clinical experience also can carry out the simulation that is similar with the operation of human reality and experiences, can master the operation of using the pipe high-efficiently. A surgical simulator (10) is provided with a body model (14) and a space forming member (18). The space forming member (18) has: a first space forming part (36) which forms a first space (Sa) corresponding to a part of an abdominal cavity of a human body; and a second space forming part (38) extending from the first space forming part (36) to form a second space (Sb) corresponding to a Douglas pouch of a human body. The second space forming portion (38) is formed in a bag shape. In the simulation method, the distal end of the catheter (200) is passed through an incision formed in the human abdomen substitute (100) to reach the second space (Sb).

Description

Operation simulator

Technical Field

The utility model relates to an operation simulator.

Background

Peritoneal dialysis has attracted attention because a patient can replace a dialysate container (bag) at home or in a work place, and it is easy to return to a work place. The peritoneal dialysis method is as follows: in a state where one end portion of a catheter (peritoneal dialysis catheter) is placed in an abdominal cavity of a patient and the other end portion is arranged outside the body, a dialysate is injected into the abdominal cavity through an inner cavity of the catheter, and after a lapse of a certain time, the dialysate in the abdominal cavity is discharged through the inner cavity of the catheter to replace the dialysate.

In order to perform the peritoneal dialysis method in this way, a catheter needs to be placed in the abdominal cavity of the patient. The physician therefore needs to master the peritoneal dialysis catheter indwelling procedure. Therefore, patent document 1 proposes a surgical simulator for grasping a surgical operation using a catheter.

Patent document 1: japanese patent No. 6133015

SUMMERY OF THE UTILITY MODEL

The present invention has been made in view of the above-mentioned problems, and an object of the present invention is to provide an operation simulator which can perform simulation experience similar to an actual operation based on a human body without relying on clinical experience, and can efficiently grasp an operation using a catheter.

One mode of the present invention is an operation simulator for training an operation using a catheter, wherein the operation simulator comprises: a hollow body model corresponding to a body of a human body; and a space forming member that is provided in the phantom to form a space corresponding to an abdominal cavity of the human body, in which an opening is formed at a position corresponding to an abdominal part of the human body, and a human abdominal substitute is provided so as to cover the opening, the space forming member including: a first space forming part which forms a first space corresponding to a part of an abdominal cavity of the human body; and a second space forming part extending from the first space forming part to form a second space corresponding to the douglas valley of the human body, the first space being communicated with the second space and being open to a side where the opening part is located, the second space forming part being formed in a bag shape.

Preferably, the first space forming part has: a first bottom wall portion located on a back side of the phantom; and a first side wall portion that protrudes upward from the first bottom wall portion, the second space formation portion including: a second bottom wall portion connected to the first bottom wall portion; a second side wall portion that protrudes upward from the second bottom wall portion and is connected to the first side wall portion; and an upper wall portion provided at a protruding end portion of the second side wall portion so as to cover the second bottom wall portion.

Preferably, the second space forming part is formed as: the height dimension of the second space along the thickness direction of the phantom becomes narrower toward the direction in which the second space-forming part extends relative to the first space-forming part.

Preferably, a convex portion extending along an extending direction of the second space formation portion with respect to the first space formation portion is provided on an inner surface of the upper wall portion.

Preferably, the second space forming part is formed as: the width dimension of the second space along the width direction of the phantom becomes narrower toward the second space-forming part with respect to the extending direction of the first space-forming part.

Preferably, an inner surface of the second bottom wall portion is inclined in a direction opposite to the upper wall portion toward the second space formation portion with respect to an extending direction of the first space formation portion.

Preferably, the space formation member has an outer edge sheet portion configured to extend from the first space formation portion to an outer side of the mannequin via the opening portion and to contact an outer surface of the mannequin.

Preferably, the space formation member is an integrally formed member of a material having flexibility.

Preferably, the space forming member is provided with a support member that is provided in the phantom and supports the space forming member.

Preferably, the support member has a bone model including a portion corresponding to a pelvis of the human body, and the bone model supports the first space forming portion.

Preferably, the support member has a bone support member for supporting the bone model at a predetermined position in the body model.

Preferably, a human organ substitute is disposed in the first space.

Preferably, the human organ substitute is formed by using a soft material to imitate the small intestine of the human body.

Another aspect of the present invention is a simulation method using a surgical simulator, the surgical simulator including: a hollow body model corresponding to a body of a human body; and a space forming member that is provided in the phantom to form a space corresponding to an abdominal cavity of the human body, wherein an opening is formed in the phantom at a position corresponding to an abdominal part of the human body, and a human abdominal substitute is provided so as to cover the opening, the space forming member including: a first space forming part which forms a first space corresponding to a part of an abdominal cavity of the human body; and a second space forming portion extending from the first space forming portion to form a second space corresponding to a douglas valley of the human body, the first space being communicated with the second space and being open to a side where the opening portion is located, the second space forming portion being formed in a bag shape, the simulation method including: an incision step of incising the human abdomen substitute; an insertion step of inserting a catheter into the first space through an incision formed in the human abdomen substitute; and a reaching step of, after the inserting step, allowing the distal end portion of the catheter to reach the second space.

According to the utility model discloses, second space formation portion forms into the bag form, consequently can make the second space approximate actual human douglas cave. Thereby, training of a surgical operation (for example, peritoneal dialysis catheter indwelling) for reaching the distal end portion of the catheter to the douglas' pouch of the human body can be performed using the surgical simulator. Therefore, a simulation experience similar to an actual surgical operation performed by a human body can be performed without depending on clinical experience, and the surgical operation using the catheter can be grasped efficiently.

Drawings

Fig. 1 is an exploded perspective view of a surgical simulator according to an embodiment of the present invention.

Fig. 2 is a top view of the surgical simulator of fig. 1.

Fig. 3 is an exploded perspective view of the support member and the space forming member of fig. 1.

Fig. 4 is a longitudinal sectional view taken along the line IV-IV (median plane) of fig. 2.

Fig. 5 is a partially omitted cross-sectional view taken along line V-V of fig. 4.

Fig. 6 is a sectional explanatory view for explaining the second space forming portion of fig. 4.

Fig. 7 is a plan view of the surgical simulator of fig. 2 with the human abdominal substitute and the human organ substitute omitted.

Fig. 8 is a flowchart showing an example of a simulation method using the surgical simulator according to the embodiment of the present invention.

Fig. 9 is a plan explanatory view showing a state in which the inner cuff and the outer cuff of the catheter are marked on the human abdomen substitute.

Fig. 10 is a plan explanatory view showing a state where the distal end portion of the catheter is inserted into the space of the space forming member.

Fig. 11 is a partially omitted vertical cross-sectional view for explaining a state in which the distal end portion of the catheter reaches the second space.

FIG. 12 is a partially omitted vertical cross-sectional view showing the state in which the inner cuff of the catheter is fixed to the peritoneum of the human abdominal substitute.

Fig. 13 is a plan explanatory view showing a state in which the rear end portion of the catheter is guided to the skin incision of the second marker.

Fig. 14 is a plan explanatory view showing a state in which the outer cuff of the catheter is fixed to the peritoneal part.

Fig. 15 is a plan explanatory view showing a state in which the dialysate bag and the dialysate collection bag are connected to the rear end portion of the catheter via the connection tube.

FIG. 16 is a partially omitted vertical cross-sectional view showing a state in which dialysate is injected into the space of the space forming member.

Fig. 17 is a partially omitted vertical cross-sectional view showing a state of collecting the dialysate in the space of the space forming member.

Description of reference numerals: 10 … surgical simulator; 14 … somatotype; 16 … support member; 18 … space forming members; 20 … human organ replacement; 22 … opening part; 30 … bone model; 32 … bone support members; 36 … a first space forming part; 38 … second space forming part; 40 … outer edge flap portions; 42 … a first bottom wall portion; 44 … a first sidewall portion; 48 … second bottom wall portion; 50 … second side wall portion; 52 … upper wall portion; 56 … convex portions; 100 … human abdominal substitute; 200 … catheter; an S … space; sa … first space; sb … second space.

Detailed Description

Hereinafter, the operation simulator and the simulation method according to the present invention will be described with reference to the drawings, taking preferred embodiments as examples.

As shown in fig. 1, a surgical simulator 10 according to an embodiment of the present invention is a device for training a surgical operation using a catheter 200 (see fig. 11 and the like), and is used in a state where a human abdomen replacement 100 is attached.

First, the human abdomen substitute 100 will be described. As shown in fig. 10 to 17, since the human abdominal substitute 100 is an apparatus that is incised and sutured in the simulation of the surgical operation using the catheter 200, the simulation is replaced with a new human abdominal substitute 100 every 1 to many times. Therefore, in the present embodiment, the surgical simulator 10 is configured not to include the human abdomen substitute 100. The surgical simulator 10 may also be a structure that includes a human abdominal proxy 100.

In fig. 1, a human abdominal substitute 100 has: a peritoneum part 102 corresponding to a peritoneal part of a human body, and a skin 104 corresponding to a skin of the human abdomen. As such a human abdomen substitute 100, for example, the abdomen of a mammal other than a human such as a pig or a cow, or an avian such as a chicken can be used, and the abdomen of a pig is particularly preferably used. This is because the abdomen of the pig is inexpensive and easily available, and its structure and structure are similar to those of the abdomen of the human body. In the present embodiment, an example in which the abdomen of a pig is used as the human abdomen substitute 100 will be described. The human abdominal substitute 100 may be composed of, for example, an abdominal membrane portion of a mammal such as a pig or a cow, and an artificial skin covering the abdominal membrane portion.

The surgical simulator 10 has a phantom 14, a support member 16, a space-forming member 18, and a human organ substitute 20.

In the surgical simulator 10 and the simulation method of the present invention, the phantom 14 is used in a supine position. That is, the phantom 14 is disposed such that the abdomen 14b is positioned above the back (back 14 c). In the surgical simulator 10 and the simulation method according to the present invention, the direction along the center axis (right-center axis) of the phantom 14 extending from the head to the feet (direction of arrow a in fig. 1 and the like) is referred to as the "longitudinal direction" when the phantom 14 lying on its back is viewed from above. When the supine body model 14 is viewed from above, the horizontal direction (the direction of arrow B in fig. 1 and the like) perpendicular to the longitudinal direction is referred to as the "width direction", and the directions (the direction of arrow C in fig. 1 and the like) perpendicular to the longitudinal direction and the width direction are referred to as the "thickness direction". The left and right of the phantom 14 correspond to the actual left and right of the human body.

The phantom 14 is placed on the support table 12. The phantom 14 may be fixed by a fixing mechanism, not shown, in a state of being placed on the support base 12. In this case, the body model 14 can be prevented from moving relative to the support base 12 in the simulation using the surgical simulator 10.

The trunk model 14 is a model corresponding to the trunk of a human body, and the inside thereof is formed in a hollow shape. The phantom 14 may be made of a relatively hard resin material, for example. The phantom 14 may also have transparency (translucency). In this case, the user can visually confirm the inside of the phantom 14 from the outside of the phantom 14. The phantom 14 may be appropriately sized according to the size and physical form of the body of the patient.

In fig. 1, 2, and 4 to 7, the trunk model 14 includes a chest portion 14a, an abdomen portion 14b (an upper abdomen portion 14bu, a lower abdomen portion 14bl, and a side abdomen portion 14bs), a back portion 14c, a waist portion 14d, a hip portion 14e, a right thigh portion 14f, a left thigh portion 14g, and a crotch portion 14 h.

In fig. 1, the abdomen portion 14b of the phantom 14 has an opening 22. The opening 22 is covered with the human abdomen substitute 100. Specifically, the opening 22 extends from the upper abdominal section 14bu to the lower abdominal section 14bl of the torso model 14 over substantially the entire area. Therefore, when the human abdominal substitute 100 is incised, or when the catheter 200 is inserted, or the like, the intervention of the phantom 14 with a medical instrument such as a scalpel or a catheter used by the operator can be suppressed. The size and shape of the opening 22 can be set as appropriate.

The phantom 14 is provided with a plurality of (6 in the present embodiment) locking members 24. The locking member 24 is formed in a band shape or a linear shape, for example, by hard resin. Both end portions of the locking member 24 are fixed to the phantom 14.

In fig. 2, the substitute human abdomen 100 is fixed to the phantom 14 by fixing the fixing band 26, which is inserted through the gap between the locking member 24 and the outer surface of the phantom 14 and the through hole 106 formed in the substitute human abdomen 100, with the fixing tool 28. At this time, the tension acting on the human abdomen substitute 100 can be adjusted by adjusting the position at which the fixing band 26 is fixed.

In fig. 1 and 2, the locking members 24 are provided on, for example, the right thigh portion 14f and the left thigh portion 14g of the torso model 14, the left and right abdominal sections 14bs (or the waist section 14d) of the torso model 14, and the left and right chest sections 14a (or the left and right shoulder sections) of the torso model 14, respectively. Therefore, the human abdominal substitute 100 can be fixed in a balanced manner with respect to the phantom 14. However, the number, position, etc. of the locking members 24 can be set as appropriate.

As shown in fig. 3 to 5, the support member 16 supports the space forming member 18 at a predetermined position in the phantom 14. The support member 16 includes a bone model 30 supporting the space forming member 18, and a support member 32 for supporting the bone model 30 at a predetermined position in the body model 14.

The bone model 30 has a lumbar spine 30a and a pelvis 30 b. The pelvis 30b includes: a sacrum 30c to which the lumbar vertebra 30a is connected, an ilium 30d provided on the left and right sides of the sacrum 30c, a pubis 30e provided on the left and right of the ilium 30d, and a coccyx 30f provided on the sacrum 30 c.

The bone supporting member 32 is disposed at a position corresponding to the waist portion 14d and the hip portion 14e in the trunk model 14 (see fig. 4). The bone supporting member 32 is made of, for example, foamed polyurethane. The constituent material of the bone supporting member 32 may be appropriately set. A recess 34 having a shape corresponding to the shape of the back surface of the bone model 30 (the lumbar vertebra 30a and the pelvis 30b) is formed on the surface of the bone supporting member 32. The back surface of the bone supporting member 32 is formed into a shape corresponding to the inner surface shape of the waist portion 14d and the hip portion 14e of the torso model 14. Therefore, the bone model 30 is supported by the bone supporting member 32 from the back side of the body model 14 toward the opening 22.

As shown in fig. 5, in a state in which the bone model 30 is disposed on the bone support member 32 placed in the phantom 14, the left and right ilia 30d are fixed in the phantom 14 by coming into contact with the inner surface of the phantom 14. That is, the left and right ilia 30d are physically supported in the body model 14 on the outer side surfaces of the left and right ilia 30 d. Thereby further stabilizing the position of the bone model 30 within the phantom 14.

The space forming member 18 is provided in the phantom 14 and forms a space S corresponding to an abdominal cavity of the human body. The space forming member 18 is an integrally formed member formed of a material having flexibility. For example, silicone having flexibility is suitably used as a constituent material of the space forming member 18. In this case, the user can insert the space forming member 18 into the phantom 14 through the opening 22 while bending the space forming member, and thus the surgical simulator 10 can be efficiently installed. However, the material of the space forming member 18 may be a resin material other than silicone. The space forming member 18 maintains a predetermined shape in the phantom 14. The space formation member 18 has transparency (translucency).

As shown in fig. 3, the space forming member 18 has a first space forming portion 36, a second space forming portion 38, and an outer peripheral sheet portion 40.

The first space forming unit 36 forms a first space Sa (see fig. 4 and 5) corresponding to a part of the abdominal cavity of the human body in the phantom 14. The first space forming portion 36 includes a first bottom wall portion 42 and a first side wall portion 44 projecting upward from an outer edge portion of the first bottom wall portion 42. In a state where the space formation member 18 is installed on the torso model 14, the first bottom wall portion 42 is supported by the lumbar vertebra 30a and the pelvis 30b of the bone model 30. The first space Sa is open upward (the side where the opening 22 is located).

A first bulging portion 46 bulging upward in a semicircular shape is provided at a central portion in the width direction of the first bottom wall portion 42 (direction along the width direction of the phantom 14). The first bulging portion 46 bulges toward (above) the opening 22. The first bulge portion 46 extends along the longitudinal direction (longitudinal direction) of the phantom 14. In a space on the back side (in a direction toward the back side of the trunk model 14, downward) of the first bulging portion 46, a lumbar vertebra 30a and a part of the sacrum 30c of the bone model 30 are arranged (see fig. 6 and 7). The shape of the bulging surface of the first bulging portion 46 may correspond to the shape of the spine of the human body.

As shown in fig. 3, 4, and 6, the second space forming unit 38 forms a second space Sb (see fig. 4) corresponding to a douglas valley of the human body in the phantom 14. Here, the douglas crater is a recess located at the lowermost part of the abdominal cavity (peritoneal cavity) of the human body. For douglas pouch, in the case of women, it is the rectouterine pouch present between the uterus and the rectum, and in the case of men, it is the rectovesical pouch present between the bladder and the rectum. That is, the douglas crater exists in both women and men. That is, the surgical simulator 10 is not a device that specifies one sex.

The second space formation portion 38 extends from the first space formation portion 36 and is formed in a bag shape. The second space Sb communicates with the first space Sa. The second space forming part 38 is inserted into the space between the pubic bone 30e and the sacrum 30c of the bone model 30 (see fig. 4). The second space formation portion 38 is formed such that: in a plan view (in a plan view) from above the phantom 14, the width dimension of the second space Sb in the width direction is narrowed in a direction in which the second space-forming portion 38 extends with respect to the first space-forming portion 36 (see fig. 6). The second space formation portion 38 is formed such that: the height dimension of the second space Sb in the thickness direction of the phantom 14 is narrowed toward the direction in which the second space forming portion 38 extends with respect to the first space forming portion 36 (see fig. 4).

The second space forming portion 38 includes a second bottom wall portion 48, a second side wall portion 50 projecting upward from the second bottom wall portion 48, and an upper wall portion 52 provided to cover a projecting end portion of the second side wall portion 50 so as to cover the second bottom wall portion 48. In fig. 4, the second bottom wall portion 48 is connected to the first bottom wall portion 42. The second bottom wall portion 48 is inclined toward the second space forming portion 38 on the opposite side of the upper wall portion 52 with respect to the direction in which the first space forming portion 36 extends. The second space forming portion 38 exists up to the space (pelvic cavity) formed by the pelvis 30 b. In other words, the second bottom wall portion 48 is connected to the first bottom wall portion while inclining in a direction away from the upper wall portion 52 toward the chest portion 14a of the torso model 14 (toward the back portion 14c of the torso model 14).

As shown in fig. 6, a second bulging portion 54 bulging upward in a semicircular shape is provided at a central portion in the width direction of the second bottom wall portion 48 (direction along the width direction of the phantom 14). The second bulging portion 54 is connected to the first bulging portion 46. The second bulge portion 54 extends along the longitudinal direction of the phantom 14. A part of the sacrum 30c and the coccyx 30f of the bone model 30 are arranged in the space inside the second bulging portion 54. The first bulge portion 46 and the second bulge portion 54 function as positioning portions of the space forming member 18 with respect to the bone model 30.

The second side wall 50 is connected to the first side wall 44 (see fig. 3 and 6). In fig. 4, the upper wall portion 52 is inclined toward the second bottom wall portion 48 toward the direction in which the second space forming portion 38 extends with respect to the first space forming portion 36. A projection 56 is provided on the inner surface of the upper wall portion 52. The projection 56 is a portion that mimics the wall of the bladder or uterus of a human being. The projection 56 extends from the root of the upper wall 52 (the boundary with the first space forming portion 36) to the extended end of the second space forming portion 38. The projection 56 extends over substantially the entire width of the inner surface of the upper wall portion 52 (see fig. 7). However, the convex portion 56 may be provided only at the widthwise central portion of the inner surface of the upper wall portion 52. The outer surface of the convex portion 56 is curved in an arc shape.

As shown in fig. 7, the outer edge thin portion 40 is formed in a ring shape so as to surround the first space forming portion 36. That is, the outer-edge sheet portion 40 is a planar member that extends from the opening 22 toward the front surface side of the phantom 14 in a state where the space forming member 18 is provided in the phantom 14. In a state where the space forming member 18 is provided in the phantom 14, the outer-edge sheet portion 40 is in contact with the outer surface of the phantom 14. The outer edge thin portion 40 is coupled to a protruding end of the first side wall portion 44. Specifically, the outer-edge sheet portion 40 includes a first lid portion 40a that contacts the chest portion 14a and the abdomen portion 14b (the upper abdomen portion 14bu and the side abdomen portion 14bs) of the torso model 14, a second lid portion 40b that contacts the side abdomen portion 14bs of the torso model 14, a third lid portion 40c that contacts the right thigh portion 14f of the torso model 14, a fourth lid portion 40d that contacts the left thigh portion 14g of the torso model 14, and a fifth lid portion 40e that contacts the crotch portion 14h of the torso model 14.

A curved portion 40f that contacts the right groin of the torso model 14 is provided at the boundary between the third cover portion 40c and the fifth cover portion 40 e. A curved portion 40g that contacts the left groin of the torso model 14 is provided at the boundary between the fourth lid portion 40d and the fifth lid portion 40 e. These inflected sections 40f, 40g function as positioning sections for the outer edge sheet section 40 with respect to the torso model 14.

As shown in fig. 1, the human organ substitute 20 is an intestinal tract model corresponding to the small intestine of a human body. The human body organ substitute 20 is disposed in the first space Sa of the first space forming portion 36 (see fig. 4). The human organ substitute 20 is an elongated cylindrical member. The body organ substitute 20 may be an elongated cylindrical member. The human body organ substitute 20 is an integrally formed member formed of a material having flexibility. Silicone, for example, is suitably used as a constituent material of the human organ substitute 20. However, the material constituting the human organ substitute 20 may be a resin material other than silicone.

The outer surface of the human organ substitute 20 may also be coated with a lubricant. As the lubricant, for example, an anionic, nonionic, cationic or amphoteric surfactant can be used. Therefore, the intestinal tract model can be made to more closely approximate the actual intestinal tract of the human body.

The surgical simulator 10 according to the present embodiment is basically a device configured as described above. Next, the setting sequence of the surgical simulator 10 will be explained.

When the surgical simulator 10 is installed, the user places the phantom 14 on the support base 12. Then, the user inserts the bone supporting member 32 from the opening 22 of the phantom 14 and arranges the bone supporting member on the inner surfaces of the waist portion 14d and the hip portion 14e of the phantom 14. Next, the user inserts the bone model 30 from the opening 22 of the phantom 14 and disposes the bone model in the recess 34 of the bone supporting member 32. At this time, in a state in which at least one of the bone model 30 and the phantom 14 is bent, the bone model 30 is disposed on the bone supporting member 32, and the right and left ilia 30d of the bone model 30 are brought into contact with the inner surface of the phantom 14 (see fig. 4). Then, the bone model 30 is pressed against the bone supporting member 32 by the restoring force of at least one of the bone model 30 and the body model 14. Thereby, the bone model 30 is fixed at a predetermined position in the phantom 14. In addition, not-shown locking portions for holding the right and left ilia 30d of the bone model 30 may be provided in the phantom 14.

Thereafter, the user inserts space-forming member 18 through opening 22 of phantom 14 and disposes it on bone model 30. At this time, the user inserts the second space forming part 38 into the space between the pubic bone 30e and the sacrum 30c of the bone model 30. In addition, the user places the second bulging portion 54 on the coccyx 30f and the sacrum 30c of the bone model 30, and places the first bulging portion 46 on the lumbar vertebra 30a of the bone model 30. Further, the user arranges the outer edge sheet portion 40 of the space forming member 18 on the outer surface of the torso model 14.

Next, the human organ substitute 20 is disposed in the first space Sa of the first space forming portion 36. Further, the human organ substitute 20 may be disposed in the first space Sa before the space forming member 18 is provided on the phantom 14.

Then, the user arranges the human abdomen substitute 100 so as to cover the opening 22 of the phantom 14. At this time, the human abdomen substitute 100 is disposed on the outer edge sheet portion 40 of the space forming member 18. Therefore, contamination of the phantom 14 by the human abdominal substitute 100 can be suppressed. The user then secures the human abdominal proxy 100 relative to the mannequin 14 using the securing straps 26. Whereby setup of the surgical simulator 10 is complete.

Next, a simulation method using the surgical simulator 10 according to the present invention will be described. In the present embodiment, an example of a simulation method for training a surgical operation using a catheter (peritoneal dialysis catheter) 200 will be described with reference to fig. 8 to 17. The simulation method shown here is an example, and various changes are caused by the product specification of the catheter 200 and the surgical operation of the medical staff. Even when these changes occur, the simulation method using the surgical simulator 10 according to the present embodiment can be applied.

First, as shown in fig. 9, the positions of the inner cuff 202 and the outer cuff 204 of the catheter 200 are marked on the outer surface of the human abdominal substitute 100 fixed to the phantom 14 (step S1 in fig. 8). In the present embodiment, a straight catheter is used as the catheter 200, but the present invention is not limited to this, and a gooseneck catheter, for example, may be used.

After that, the electrode plate 201 for the electronic scalpel is brought into contact with the human abdomen substitute 100, and then the first marker M1 corresponding to the inner cuff 202 is cut by the electronic scalpel (medical instrument) (step S2). That is, the peritoneum 102 and skin 104 of the human abdominal substitute 100 are cut open with an electronic scalpel. At this time, the edge portion constituting the peritoneum portion incision 70 may be held at four places by a pair of mosquito forceps, not shown.

Then, the metal rod-shaped probe 206 is passed through the lumen of the catheter 200, and the distal end side of the catheter 200 is inserted into the space S inside the space forming member 18 through the skin incision 72 and the peritoneum incision 70 of the first marker portion M1 (step S3, see fig. 10 and 11).

Next, the user (trainer) holds the ring portion 206a of the probe 206, and operates the catheter 200 so that the distal end portion of the catheter 200 reaches the second space Sb (corresponding to the douglas valley of the human body) of the space forming member 18 (step S4).

At this time, the user reaches the distal end of the catheter 200 to the second space Sb while paying attention to the catheter 200 without touching the body organ substitute 20. At this time, the user may insert the distal end portion of the catheter 200 into the second space Sb while contacting the protrusion 56 of the space forming member 18. Further, since the phantom 14 and the space forming member 18 have transparency, the user can easily confirm whether or not the distal end portion of the catheter 200 has reached the second space Sb of the space forming member 18 by visual confirmation from the outside.

Next, the user pulls the stylet 206 out of the catheter 200 and secures the inner cuff 202 to the peritoneal portion 102 with the absorbable suture 74. (step S5, see FIG. 12). At this time, the incised peritoneal part 102 is sutured with absorbable suture thread 74 (fig. 13). At the end of the suturing of the peritoneum portion 102, the rear end portion of the catheter 200 is exposed to the outside from the upper end of the sutured portion of the peritoneum portion 102. In step S5, as shown in fig. 12 and 13, the drainage tube 76 may be inserted near the inner cuff 202 when suturing the incised peritoneum portion 102.

Next, the second marker M2 corresponding to the outer cuff 204 is cut with an electronic scalpel (step S6). That is, only the skin 104 of the human abdominal substitute 100 is incised with an electronic scalpel.

Then, the rear end side of the catheter 200 is guided to the skin incision 78 of the second marker M2 by passing through the peritoneal part 102 and the skin 104 of the human abdominal substitute 100 with a trocar (not shown) (step S7, see fig. 13).

Next, the collagen cuff 80 is attached to the vicinity of the rear end side of the outer cuff 204 of the catheter 200, and the rear end portion of the catheter 200 is guided to a predetermined position through the gap between the peritoneum portion 102 of the human abdominal substitute 100 and the skin 104, and is exposed outside the skin 104 (step S8, see fig. 14). Thereafter, the outer cuff 204 is fixed to the peritoneal portion 102 with the absorbable suture thread 82 in a state of being disposed in the skin incision 78 (step S9).

Next, the skin 104 of the human abdominal substitute 100 is sutured with the sutures 84, 86 so that the skin incision 72 and the skin incision 78 are each completely closed (step S10, refer to fig. 15). In this state, the rear end portion of the catheter 200 is exposed to the outside of the human abdominal substitute 100.

Next, the two-strand connecting tube 88 is connected to the rear end of the catheter 200, the dialysate bag 90 filled with the dialysate L is attached to the end of one of the two strands of the connecting tube 88, and the empty dialysate collection bag 92 is attached to the end of the other of the two strands of the connecting tube 88 (step S11, refer to fig. 15).

Next, the clamp 94 on the dialysate bag 90 side is opened and the clamp 96 on the dialysate collection bag 92 side is closed, and the dialysate L in the dialysate bag 90 is injected into the space S of the space formation member 18 via the connection tube 88 and the conduit 200 in a state where the conduit 200 is in communication with the dialysate bag 90 and the communication between the conduit 200 and the dialysate collection bag 92 is blocked (step S12, see fig. 16).

After the infusion of the dialysate L is completed, the clamp 94 on the dialysate bag 90 side is closed and the clamp 96 on the dialysate recovery bag 92 side is opened, and the dialysate L in the space formation member 18 is recovered to the dialysate recovery bag 92 via the conduit 200 and the connection pipe 88 in a state where the communication between the conduit 200 and the dialysate bag 90 is blocked and the conduit 200 and the dialysate recovery bag 92 are communicated (step S13, fig. 17).

At this time, as shown in fig. 17, when the amount of the dialysate L in the space forming member 18 decreases, the dialysate L collects in the second space Sb of the space forming member 18 corresponding to the douglas valley of the human body, but the distal end portion of the catheter 200 is positioned in the second space Sb, and therefore, the dialysate L can be collected in the dialysate collection bag 92. This simulation is ended at the stage of completion of recovery of the dialysate L.

In this case, the surgical simulator 10 and the simulation method using the surgical simulator 10 of the present embodiment exhibit the following effects.

The surgical simulator 10 includes a hollow body model 14 corresponding to a body portion of a human body, and a space forming member 18 provided in the body model 14 and forming a space S corresponding to an abdominal cavity of the human body. An opening 22 is formed in the phantom 14 at a position corresponding to the abdomen 14b of the human body, and a human abdomen substitute 100 is provided so as to cover the opening 22. The space forming member 18 includes a first space forming portion 36 forming a first space Sa corresponding to an abdominal cavity of a human body, and a second space forming portion 38 extending from the first space forming portion 36 to form a second space Sb corresponding to a douglas valley of the human body. The first space Sa communicates with the second space Sb and is open to the side where the opening 22 is located, and the second space forming portion 38 is formed in a bag shape.

With this configuration, since the second space forming portion 38 is formed in a bag shape, the second space Sb can be approximated to the actual douglas valley of the human body. Thereby, training of a surgical operation (for example, peritoneal dialysis catheter indwelling) for reaching the distal end portion of the catheter 200 to the douglas' pouch of the human body can be performed using the surgical simulator 10. Therefore, a simulation experience similar to the actual surgical operation of the human body can be realized without depending on clinical experience, and the surgical operation using the catheter 200 can be grasped efficiently.

The first space forming portion 36 includes a first bottom wall portion 42 located on the back side of the phantom 14, and a first side wall portion 44 projecting upward from the first bottom wall portion 42. The second space forming portion 38 includes a second bottom wall portion 48 connected to the first bottom wall portion 42, a second side wall portion 50 protruding upward from the second bottom wall portion 48 and connected to the first side wall portion 44, and an upper wall portion 52 provided at a protruding end portion of the second side wall portion 50 so as to cover the second bottom wall portion 48.

With this configuration, the abdominal cavity (including the douglas trap) of the human body can be reproduced by the first space forming portion 36 and the second space forming portion 38.

The second space formation portion 38 is formed such that: the height dimension of the second space Sb in the thickness direction of the phantom 14 is narrowed toward the direction in which the second space forming portion 38 extends relative to the first space forming portion 36.

With such a configuration, the second space Sb can be approximated to the douglas trap of the human body.

A projection 56 is provided on the inner surface of the upper wall portion 52, and the projection 56 extends in the direction in which the second space forming portion 38 extends with respect to the first space forming portion 36.

According to such a configuration, the height dimension of the second space Sb can be easily changed by the convex portion 56.

The second space formation portion 38 is formed such that: the width dimension of the second space Sb in the width direction of the phantom 14 is narrowed toward the direction in which the second space forming portion 38 extends relative to the first space forming portion 36.

With such a configuration, the second space Sb can be further approximated to a douglas trap of a human body.

The inner surface of the second bottom wall portion 48 is inclined in the direction opposite to the upper wall portion 52 toward the direction in which the second space forming portion 38 extends with respect to the first space forming portion 36.

With such a configuration, the second space Sb can be further approximated to a douglas trap of a human body.

The space forming member 18 has an outer edge sheet portion 40 that extends from the first space forming portion 36 to the outside of the mannequin 14 through the opening 22 and is disposed so as to contact the outer surface of the mannequin 14.

With this configuration, the first space forming portion 36 and the second space forming portion 38 can be supported at predetermined positions in the phantom 14 by the outer edge sheet portion 40. Further, by disposing the human abdomen substitute 100 on the outer edge sheet portion, direct contamination of the phantom 14 by the human abdomen substitute 100 can be suppressed. Further, since the outer-edge sheet portion 40 is disposed between the substitute for human abdomen 100 and the phantom 14, the fixing stability of the substitute for human abdomen 100 is improved.

The space forming member 18 is an integrally formed member formed of a material having flexibility.

With this structure, the space forming member 18 can be easily manufactured. Further, by flexing the space forming member 18, the first space forming portion 36 and the second space forming portion 38 can be smoothly disposed in the phantom 14, and the ease of assembly of the surgical simulator 10 can be improved.

The surgical simulator 10 has a support member 16 disposed within the phantom 14 to support a space-forming member 18.

With this configuration, the first space Sa and the second space Sb can be arranged at predetermined positions in the phantom 14. Therefore, the position of the second space Sb in the phantom 14 can be approximated to the actual position of the douglas trap in the human body. Further, since the support member 16 supports the first space forming portion 36 and the second space forming portion 38 from the back side of the phantom 14, the actual position of the douglas trap in the human body can be accurately maintained even when the space forming member 18 is filled with the dialysate L.

The support member 16 includes a bone model 30 including a portion corresponding to a pelvis 30b of a human body, and the bone model 30 supports the first space forming portion 36.

With such a configuration, the position of the second space Sb in the phantom 14 can be made closer to the actual position of the douglas valley in the human body. In addition, even when the space forming member 18 is filled with the dialysate L, the actual position of the douglas crater in the human body can be accurately maintained.

The support member 16 includes a bone support member 32 for supporting the bone model 30 at a predetermined position in the phantom 14.

With such a configuration, the position of the bone model 30 in the phantom 14 can be approximated to the actual position of the bone (pelvis) in the human body. Even when the space forming member 18 is filled with the dialysate L, the actual position of the douglas crater in the human body can be accurately stabilized and maintained. In addition, the repeatability of assembly of the surgical simulator 10 can be improved with the bone support member 32.

The surgical simulator 10 includes a human body organ substitute 20 disposed in the first space Sa.

With such a configuration, when the catheter 200 hits the human organ substitute 20, it is possible to simulate the feeling of hitting the real human organ.

The human organ substitute 20 is formed of a soft material simulating the small intestine of a human body.

With this configuration, training can be performed close to the actual surgical operation.

The present invention is not limited to the above-described embodiments, and various changes can be made without departing from the scope of the present invention.

The above embodiments are summarized as follows.

The surgical simulator (10) according to the above embodiment is a surgical simulator (10) for training a surgical operation using a catheter (200), and includes: a hollow dummy (14) corresponding to a trunk of a human body, and a space forming member (18) provided in the dummy to form a space (S) corresponding to an abdominal cavity of the human body, wherein an opening (22) is formed in the dummy at a position corresponding to the abdominal part of the human body, and a human abdominal substitute (100) is provided so as to cover the opening, the space forming member comprising: a first space forming part (36) forming a first space (Sa) corresponding to a part of the abdominal cavity of the human body, and a second space forming part (38) extending from the first space forming part and forming a second space (Sb) corresponding to the Douglas pouch of the human body, wherein the first space is communicated with the second space and is opened to the side where the opening part is located, and the second space forming part is formed into a bag shape.

In the surgical simulator, the first space forming unit may include: a first bottom wall portion (42) positioned on the back side of the phantom, and a first side wall portion (44) protruding upward from the first bottom wall portion, wherein the second space forming portion includes: the wall structure comprises a second bottom wall portion (48) connected to the first bottom wall portion, a second side wall portion (50) protruding upward from the second bottom wall portion and connected to the first side wall portion, and an upper wall portion (52) provided at a protruding end portion of the second side wall portion so as to cover the second bottom wall portion.

In the surgical simulator, the second space forming portion may be formed with: the height dimension of the second space along the thickness direction of the phantom becomes smaller toward the second space-forming portion with respect to the extending direction of the first space-forming portion.

In the surgical simulator, a convex portion (56) may be provided on an inner surface of the upper wall portion, and the convex portion (56) may extend along an extending direction of the second space forming portion with respect to the first space forming portion.

In the surgical simulator, the second space forming portion may be formed with: the width dimension of the second space along the width direction of the phantom becomes narrower toward the second space-forming portion with respect to the extending direction of the first space-forming portion.

In the surgical simulator, an inner surface of the second bottom wall portion may be inclined in a direction opposite to the upper wall portion with respect to an extending direction of the second space forming portion with respect to the first space forming portion.

In the surgical simulator, the space forming member may include an outer edge sheet portion (40), and the outer edge sheet portion (40) may be disposed so as to extend from the first space forming portion to the outside of the phantom via the opening and be in contact with the outer surface of the phantom.

In the surgical simulator, the space forming member may be an integrally formed member of a flexible material.

The surgical simulator may include a support member (16) that is provided in the phantom and supports the space forming member.

In the surgical simulator, the support member may include a bone model (30) including a portion corresponding to a pelvis of the human body, and the bone model may support the first space forming portion.

In the surgical simulator, the support member may include a bone support member (32) for supporting the bone model at a predetermined position in the body model.

The surgical simulator may include a human body organ substitute (20) disposed in the first space.

In the surgical simulator, the human organ substitute may be formed by using a soft material to simulate the small intestine of the human body.

The simulation method disclosed in the above embodiment is a simulation method using a surgical simulator, the surgical simulator including: a hollow mannequin corresponding to a trunk area of a human body, and a space forming member provided in the mannequin to form a space corresponding to an abdominal cavity of the human body, wherein an opening is formed in the mannequin at a position corresponding to an abdominal area of the human body, and a human abdominal substitute is provided so as to cover the opening, the space forming member including: a first space forming portion that forms a first space corresponding to a part of an abdominal cavity of the human body, and a second space forming portion that extends from the first space forming portion to form a second space corresponding to a douglas valley of the human body, the first space communicating with the second space and being open to a side where the opening portion is located, the second space forming portion being formed in a bag shape, the simulation method including the steps of: an incision step of incising the human abdomen substitute, an insertion step of inserting a catheter into the first space through incised parts (70, 72) formed in the human abdomen substitute, and an arrival step of making the tip end of the catheter arrive at the second space after the insertion step.

Claims (13)

1. A surgical simulator for training a surgical operation using a catheter, comprising:

a hollow body model corresponding to a body of a human body; and

a space forming member provided in the phantom to form a space corresponding to an abdominal cavity of the human body,

an opening is formed in the phantom at a position corresponding to the abdomen of the human body, and a human abdomen substitute is provided so as to cover the opening,

the space forming member has:

a first space forming part which forms a first space corresponding to a part of an abdominal cavity of the human body; and

a second space forming part extending from the first space forming part to form a second space corresponding to a douglas valley of the human body,

the first space communicates with the second space and is open to a side where the opening portion is located,

the second space forming portion is formed in a bag shape.

2. The surgical simulator of claim 1,

the first space forming part has:

a first bottom wall portion located on a back side of the phantom; and

a first side wall portion protruding upward from the first bottom wall portion,

the second space forming part has:

a second bottom wall portion connected to the first bottom wall portion;

a second side wall portion that protrudes upward from the second bottom wall portion and is connected to the first side wall portion; and

and an upper wall portion provided at a protruding end portion of the second side wall portion so as to cover the second bottom wall portion.

3. The surgical simulator of claim 2,

the second space forming portion is formed as: the height dimension of the second space along the thickness direction of the phantom becomes narrower toward the direction in which the second space-forming part extends relative to the first space-forming part.

4. The surgical simulator of claim 3,

a convex portion extending along an extending direction of the second space formation portion with respect to the first space formation portion is provided on an inner surface of the upper wall portion.

5. A surgical simulator according to any of claims 2 to 4,

the second space forming portion is formed as: the width dimension of the second space along the width direction of the phantom becomes narrower toward the second space-forming part with respect to the extending direction of the first space-forming part.

6. A surgical simulator according to any of claims 2 to 4,

an inner surface of the second bottom wall portion is inclined in a direction opposite to the upper wall portion toward the second space forming portion with respect to an extending direction of the first space forming portion.

7. A surgical simulator according to any of claims 1 to 4,

the space forming member has an outer edge sheet portion arranged to extend from the first space forming portion to an outside of the mannequin via the opening portion and to contact an outer surface of the mannequin.

8. A surgical simulator according to any of claims 1 to 4,

the space forming member is an integrally formed member of a material having flexibility.

9. A surgical simulator according to any of claims 1 to 4,

the space forming member is provided with a support member that is provided in the phantom and supports the space forming member.

10. The surgical simulator of claim 9,

the support member has a bone model including a region corresponding to a pelvis of the human body,

the bone model supports the first space forming part.

11. The surgical simulator of claim 10,

the support member has a bone support member for supporting the bone model at a predetermined position in the body model.

12. A surgical simulator according to any of claims 1 to 4,

the human organ replacement is disposed in the first space.

13. The surgical simulator of claim 12,

the human organ substitute is formed by simulating the small intestine of the human body by using a soft material.

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