JP2004049479A - Training device for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a training device for an endoscope capable of enabling the insertion technique of the endoscope and capable of learning and enhancing a treatment technique using the endoscope. <P>SOLUTION: In the training apparatus for the endoscope having a false internal organ, the false internal organ is constituted of two or more of formation layers 30 and 31 therefor. In the training apparatus for the endoscope having the false internal organ constituted of a plurality of layers, the formation layers of the false internal organ are constituted so that the outside layer 31 is constituted of a material harder than that of the inside layer 30. <P>COPYRIGHT: (C)2004,JPO

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a training device for an endoscope, and more particularly, to a training device for an endoscope that can acquire a treatment technique using an endoscope.
[0002]
[Prior art]
As is well known, in general, the large intestine in the human body has a more complicated shape than other organs that can perform endoscopy, so that advanced technology is required to insert an endoscope into the large intestine. Is done.
[0003]
Japanese Patent Application Laid-Open No. Hei 10-212160 discloses means for inserting an endoscope and reproducing the state of the colon of a plurality of types of patients in order to learn the technique for inserting an endoscope for the large intestine. 2. Description of the Related Art There has been proposed an endoscope insertion training device having a pseudo large intestine organ (a large intestine model in a human body) provided therein.
[0004]
[Problems to be solved by the invention]
By the way, in recent years, under an endoscope, after injecting a local injection solution into the submucosa immediately below the cancer cells present in the mucous membrane and exfoliating the mucous membrane, an endoscopic procedure in which only the mucous membrane containing the cancer cells is excised is performed. Endoscopic treatments such as endoscopic mucosal resection and polypectomy for removing polyps with a high-frequency snare have been performed, and the role of endoscopes in medicine has changed from diagnosis to treatment.
[0005]
However, the invention proposed in the above-mentioned Japanese Patent Application Laid-Open No. H10-211160 and the various training devices for endoscopes conventionally proposed are all aimed at learning the technique of inserting an endoscope, It is not intended to learn endoscopic treatments and procedures.
[0006]
An object of the present invention has been made in view of the above circumstances, and is not limited to an insertion technique of an endoscope, but is also an endoscope capable of acquiring and improving treatment and treatment techniques using the endoscope. To provide a training device for use.
[0007]
Means and Action for Solving the Problems
In order to achieve the above object, a training device for an endoscope according to the present invention is a training device for an endoscope having a simulated organ, wherein the simulated organ is constituted by two or more layers. And
[0008]
Further, the training device for an endoscope is a training device for an endoscope having a simulated organ composed of a plurality of layers, wherein the formation layer of the simulated organ has a layer outside the inner layer formed of a hard material. It is characterized by having done.
[0009]
Further, the training device for an endoscope is a training device for an endoscope having a simulated organ composed of a plurality of layers. In the training device for an endoscope, the material of the layer forming the simulated organ is heated more than the material of the outer layer. It is characterized by comprising a material having high conductivity.
[0010]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings.
[0011]
First, prior to describing an embodiment of the present invention, an outline of an endoscope training apparatus having a simulated organ to which the present invention is applied will be described. In addition, the pseudo organ is exemplified by a large intestine organ in a human body, and the endoscope training apparatus is configured by a human body model including a pseudo torso incorporating each organ from a stomach organ to the large intestine organ. I have.
[0012]
FIG. 1 is a perspective view of a training device for an endoscope for a large intestine as viewed obliquely from the upper left, and FIGS. 2 (a) and 2 (b) and FIGS. FIG. 4 is an enlarged cross-sectional view and a front view of a holding mechanism for the rotation shaft of the pseudo torso which is rotatably mounted, and FIG. 4 shows the second rotation shaft fixed to a position deviated from the rotation center axis of the pseudo torso. It is the principal part expansion perspective view which showed that it is.
[0013]
As shown in FIG. 1, a training apparatus 1 for an endoscope for a large intestine has a pseudo torso 2 having a pseudo organ therein, a fixed base 3, a pair of rotating shafts 4 of the pseudo torso 2, A pair of columns 5 that stand upright at the center of both ends in the longitudinal direction of the base 3 and support the rotation shaft 4 respectively, and one end surface of the pseudo torso 2 corresponding to the lower side of the human body, are bored and viewed from the inside. The main part is constituted by a pseudo anus 17 having an opening serving as a mirror insertion opening and an abdominal cover 13 disposed on the upper surface of the pseudo torso 2 so as to be openable and closable.
[0014]
The left side of the pseudo torso 2 in FIG. 1 corresponds to the upper side of the human body, and the right side corresponds to the lower side of the human body.
[0015]
As shown in FIG. 2, the pair of rotating shafts 4 are disposed on the center axis of the simulated body 2, and one end of each of the rotating shafts 4 is rotatably mounted on a bearing portion 40, which will be described later, formed in the column 5. The other end is fixed to the center of the end surface on the upper side of the human body, and the other end is fixed to the end surface on the lower side of the human body so as to sandwich the pseudo anus 17 as shown in FIGS. Is connected to the second rotation shaft 29 having a U-shape. That is, the rotating shaft 29 is fixed to the anus-side surface of the simulated body 2, and both ends of the U-shape are fixed at an arbitrary position at the same height as the rotating center of the rotating shaft 4. The other end of the rotating shaft 4 is fixed to the center of the part.
[0016]
Thus, the pseudo torso 2 is rotatably supported by the fixed base 3 by the rotating shaft 4 supported by the pair of columns 5 and the second rotating shaft 29. The training device includes a rotation mechanism that supports the pseudo torso 2 so as to be rotatable in a girth direction.
[0017]
Next, a holding mechanism for holding the pseudo torso 2 stationary at predetermined rotation angles will be described with reference to FIGS. 2 (a), 2 (b) and 3 (a), 3 (b).
As shown in FIG. 2 (a), a portion of the rotating shaft 4 pivotally supported by the column 5 has a click spring 6 buried therein, and is urged by the spring 6 to project outward. A click stop mechanism having a hemispherical protruding portion 7 is provided, and a circular bearing portion 40 provided on the support column 5 is hemispherical at 90 ° intervals at positions facing each other. Four cutouts 8 projecting outward are provided.
[0018]
With the holding mechanism configured as described above, the pseudo torso 2 is rotated at every 90 degrees by the urging of the click spring 6 so that the pseudo torso 2 has a click feeling by the notch 8 as shown in FIG. At this angle, thereby reproducing the postural change such as the lateral position or the supine position performed in the actual endoscopy, and in the held state, the protrusion 7 The engagement with the notch 8 enables stable training of the endoscope.
[0019]
The four notches 8 of the bearing portion 40 formed in the support 5 are provided at every 90 degrees. However, the number of the notches 8 can be increased to reproduce the posture at various angles. You may do it.
[0020]
Further, the second rotation shaft 29 fixed to the end face on the anal side of the pseudo torso 2 has a bifurcated U-shape. This is to prevent the hand of the operator holding the endoscope insertion portion 18 from interfering with the rotating shaft 4 when training while inserting the endoscope into the pseudo torso 2. It has been devised.
[0021]
Further, as means for preventing the hand of the surgeon from interfering with the rotating shaft 4, as shown in FIG. 4, a line connecting two axes of the second rotating shaft 29 and a horizontal plane of the pseudo torso 2 are formed. The interference may be further avoided by shifting the angle by θ.
[0022]
The second rotation shaft 29 fixed to the anus-side surface of the pseudo torso 2 is formed in a bifurcated U-shape. However, the present invention is not limited to this. In order to avoid interference between the rotating shaft and the rotating shaft, if the position is shifted from the rotating center and the height is the same as the rotating center of the rotating shaft 4, the shaft may be fixed by one shaft. Needless to say.
[0023]
Next, the internal structure of the pseudo torso 2 will be described. FIG. 5 is a top view of the pseudo torso in the endoscope training apparatus, and FIG. 6 is a cross-sectional view taken along the line VI-VI ′ of FIG.
[0024]
As shown in FIGS. 5 and 6, a large intestine organ model 9 made of an elastic body is disposed inside the pseudo torso 2, and the periphery is made of an elastic body like a real human body. A stomach organ model 10, a small intestine organ model 11, and a pancreas organ model 12 are arranged while pressing a part of the large intestine organ model 9 like an actual human body.
[0025]
Further, as described above, the abdominal cover 13 made of an elastic body is attached to the pseudo torso 2 so as to be openable and closable, and this abdominal cover 13 is also fixed to the pseudo torso 2 (abdomen cover closed state). ) Has a structure in which a part of the large intestine organ model 9 is pressed similarly to an actual human body. At this time, the abdomen cover 13 and the pseudo torso 2 are fixed by magic tape (registered trademark) 14 provided respectively.
[0026]
As shown in FIG. 7, the abdominal cover 13 is formed in a bag shape to reproduce abdominal states of various patients, and the abdominal cover 13 is made slim or obese by discharging or injecting air or the like. The state of the patient may be reproduced.
[0027]
With this configuration, it is difficult for air to advance to the distal end due to external pressure on the large intestine organ model 9 by another organ model or an abdominal cover, and the air is transmitted from the endoscope in the large intestine organ model 9. Even if it is done, the air does not reach the cecum immediately, so that the environment at the time of inserting the actual colonoscope can be reproduced.
[0028]
As a means for making it difficult for air to advance to the distal end, as shown in FIG. 8, protruding folds 15 may be alternately projected into the large intestine organ model 9.
[0029]
Next, the internal structure of the large intestine organ model will be described.
9 is a longitudinal sectional view of the anal sphincter model in a state where the endoscope of the endoscope training apparatus for the large intestine is inserted, and FIG. 10 shows the anal sphincter model of FIG. It is the principal part perspective view of the pseudo trunk | drum which showed that it was.
[0030]
As shown in FIG. 9, the simulated anus 17 includes an external opening of the large intestine organ model 9, an anal sphincter model 16, an airtight ring 19, and a box 20. Except for the anal end face, it is airtight.
[0031]
This is because the anal sphincter model 16 made of an elastic body is disposed in the pseudo anus 17 provided on the lower end face of the pseudo torso 2, and an opening 16 a formed in the center of the anal sphincter model 16. When the insertion section 18 of the endoscope is inserted into the large intestine organ model 9, the inside of the large intestine organ model 9 is airtight because the inner diameter of the opening 16a is set smaller than the outer diameter of the endoscope insertion section 18. Will be secured.
[0032]
With this structure, in a state in which the endoscope insertion portion is inserted into the large intestine organ model 9, air does not leak out of the large intestine organ model 9 even if air is supplied from the endoscope. It can be sent inside, providing an environment equivalent to the actual endoscope insertion state.
[0033]
Furthermore, the opening 16a formed in the anal sphincter muscle model 16 is thinner as it proceeds in the radial direction, and when the large intestine organ model 9 is filled with air too much, air is forced out of the organ. Is leaked, so that the large intestine organ model 9 is not excessively filled with air.
[0034]
Since the outer diameter of the insertion portion of the colonoscope differs depending on the endoscope model, the inner diameter of the opening 16a formed in the anal sphincter model 16 and the outer diameter of the endoscope insertion portion 18 are different. In order to maintain the optimal relationship, the anal sphincter model 16 is replaceable with respect to the pseudo torso 2 as shown in FIG.
[0035]
That is, in the anal sphincter model 16 that is detachable from the pseudo torso 2, the hermetic ring portion 19 made of an elastic body is protrudingly provided on the outer periphery of the opening 16a on the pseudo torso 2 side. When the anal sphincter model 16 is stored in the box portion 20 provided around the anus 17, when the airtight ring portion 19 is compressed and an endoscope is inserted, airtightness in the large intestine organ model 9 can be ensured. It has become.
[0036]
FIG. 11 is a diagram showing a large intestine organ model of a training apparatus for an endoscope for a large intestine with a long S-shaped colon model attached thereto, and FIG. 12 is a diagram showing a small S-shaped colon model in a large intestine organ model. FIG. 13 is a view showing a fitting method between the large intestine organ model and the S-shaped colon model, and FIG. 14 is a view showing a fitted state between the large intestine organ model and the S-shaped colon model. FIG.
[0037]
It is generally said that insertion of an endoscope for a large intestine is difficult in the sigmoid colon, and in order to realize this state, in the large intestine organ model 9, only the sigmoid colon is replaced by another part. It is softer by thinning it. This makes it easier for the S-shaped colon to extend when the endoscope is inserted, making it difficult to insert.
[0038]
In addition, the S-shaped colon is different depending on the race, and it is generally said that Japanese are long as shown in FIG. 11 and European and American are short as shown in FIG.
[0039]
In the training apparatus 1 for colonoscopy, the S-shaped colon model 21 made of an elastic body is detachably attached to the large-intestine organ model 9 in order to realize various states of the S-shaped colon. It has a configuration.
[0040]
As shown in FIG. 13, an airtight convex portion 22 made of an elastic body is protruded from an outer periphery of an end portion of the large intestine organ model 9 to which the S-shaped colon model 21 is attached. The S-shaped colon model 21 is provided with a hermetically sealed groove 23 made of an elastic material. When the S-shaped colon model 21 is attached to the large intestine organ model 9, as shown in FIG. By fitting the hermetic convex portion 22 and the hermetic groove portion 23 to each other, they are locked while closely contacting each other. With this configuration, the large intestine organ model 9 and the S-shaped colon model 21 are detachably connected to each other so as to secure airtightness.
[0041]
FIG. 15 is a diagram illustrating a method of experiencing a suction of a bodily fluid in the large intestine in the training apparatus for the colonoscope, and FIG. 16 is a diagram illustrating a method of reproducing adhesion of the large intestine.
[0042]
As shown in FIG. 15, the intestinal wall of the large intestine organ model 9 is provided with a thick injection part 24 at several places over the entire length thereof, and the needle part 26 of the syringe 25 is penetrated through the injection part 24. By placing the liquid in the large intestine organ model 9, it is possible to experience the suction of bodily fluids when the endoscope is inserted. Further, the injection part 24 is made of a thick and elastic body integral with the large intestine organ model 9, and the through hole is closed by its own elasticity even after the needle part 26 of the syringe 25 is removed. And a structure that can maintain airtightness.
[0043]
In addition, the colonoscope may be difficult to insert due to adhesion between the large intestine and other organs after laparotomy, making it difficult to control the large intestine. Therefore, as shown in FIG. 16, in the training apparatus 1 for an endoscope for large intestine, the locking ring 27 is protruded at several places on the outer wall of the large intestine organ model 9 over the entire length, while the inner surface of the pseudo torso 2 is provided. Also, several locking ring portions 27 are provided on the outer wall of other organ models including the small intestine organ model 11 and the like, and the locking ring portions 27 are engaged with the hooks 28 at an arbitrary position to achieve adhesion. It can be reproduced.
[0044]
As described above, in the training apparatus of the endoscope for the large intestine to which the present invention is applied, various devices are devised so as to approach the same state as when the endoscope is inserted into the actual large intestine.
[0045]
Next, a description will be given of a configuration of a large intestine organ model capable of training for endoscopic treatment in the thus configured training apparatus for an endoscope for large intestine.
FIG. 17 is a longitudinal sectional view showing a wall structure of a large intestine organ model in an endoscope training apparatus according to an embodiment of the present invention, and FIG. 18 is a view using a syringe needle in the large intestine organ model of FIG. FIG. 19 is a longitudinal sectional view showing a state in which a local injection liquid is injected, FIG. 19 is a longitudinal sectional view showing a state in which an inflated portion of an inner wall is cut off using a high-frequency snare, and FIG. It is the longitudinal cross-sectional view which showed the state which cut off using a snare.
[0046]
As shown in FIG. 17, in one embodiment of the present invention, the wall forming the large intestine organ model 9 is configured such that both the inner wall 30 and the outer wall 31 are formed of two layers of elastic material from the inside to the outside. The inner wall portion 30 and the outer wall portion 31 are superposed and fixed with an elastic adhesive 32.
[0047]
Here, the characteristics of the inner wall portion 30 and the outer wall portion 31 will be described. The material of the inner wall portion 30 is softer than the material of the outer wall portion 31 and is made of a material having high thermal conductivity. Is harder than the inner wall portion 30 and is made of an insulating material.
[0048]
Next, a case of training an endoscopic procedure will be described.
First, with the endoscope insertion portion inserted into the large intestine organ model 9, as shown in FIG. 18, the needle portion 34 of the injection needle 33 is viewed through the treatment tool insertion channel of the endoscope. The local injection liquid is injected from the distal end of the mirror insertion portion into the elastic bonding portion 32 through the inner wall portion 30.
[0049]
At this time, since the outer wall portion 31 is made of a hard material as described above, even if the needle portion 34 is punctured into the two-layer forming layer, the needle portion 34 abuts against the outer wall portion 31 and the elastic bonding portion 32 This makes it easier to inject the local injection solution into the device.
[0050]
On the other hand, since the inner wall portion 30 is made of a soft material as described above, when a local injection liquid is injected into the elastic bonding portion 32, the inner wall portion 30 swells, and the inner wall portion 30 is placed in the large intestine organ model 9. Form a ridge.
[0051]
Subsequently, as shown in FIG. 19, the high-frequency snare 35 is extended from the distal end of the insertion portion via the treatment instrument insertion channel of the endoscope, and the high-frequency snare 35 The snare portion 36 is locked, and in this state, the ridge is tied off while a high-frequency current is applied. At this time, since the outer wall portion 31 is formed of an insulator, and the high frequency current is concentrated on the inner wall portion 30 having high thermal conductivity, the bulging of the inner wall portion 30 is efficiently performed without damaging the outer wall portion 31. The part can be resected.
[0052]
If the formation layer of the large intestine organ model 9 is composed of two layers in this manner, after injecting a local injection solution into the submucosa immediately below the cancer cells existing in the mucous membrane and exfoliating the mucous membrane, the mucosa contains cancer cells. It is possible to simulate an endoscopic mucosal resection in which only the mucous membrane is removed, and to perform training for improving the technical ability of endoscopic treatment.
[0053]
Also, as shown in FIG. 20, if the pedicled polyp portion 37 is provided on the inner wall portion 30, it is possible to train a so-called polypectomy in which a polyp is excised using an endoscopic high-frequency snare 35. . At this time, the outer wall portion 31 is made of an insulator, and the high-frequency current is concentrated on the inner wall portion 30 having high thermal conductivity, so that the polyp portion is efficiently provided without damaging the outer wall portion 31. Training to resect 37 can be performed.
[0054]
In the present embodiment, the large intestine organ model is targeted. However, the present invention is not limited to this, and it goes without saying that the present invention may be applied to other organ models such as stomach and duodenum for the purpose of treatment.
[0055]
[Appendix]
According to the embodiment of the present invention as described in detail above, the following configuration can be obtained. That is,
(1) In a training device for an endoscope having a simulated organ,
The training apparatus for an endoscope, wherein the simulated organ has a formation layer formed of two or more formation layers.
[0056]
(2) The training device for an endoscope according to Supplementary Note 1, wherein the two or more formation layers are configured such that a layer outside the inner layer is made of a hard material.
[0057]
(3) The training device for an endoscope according to Supplementary Note 2, wherein the material forming the inner layer is a material having higher thermal conductivity than the material forming the outer layer.
[0058]
(4) The training device for an endoscope according to Supplementary Note 2, wherein the material constituting the outer layer is an insulator.
[0059]
(5) The training device for an endoscope according to Supplementary Note 2, wherein the inner layer and the outer layer are joined with an elastic adhesive.
[0060]
(6) In a training device for an endoscope having a simulated organ,
A pseudo torso containing the pseudo organ,
A simulated anus opened at one end surface of the simulated body,
A rotating mechanism for rotatably supporting the pseudo torso in the torso direction,
A holding mechanism for holding the pseudo torso stationary at predetermined rotation angles,
A training device for an endoscope, comprising:
[0061]
(7) The rotating mechanism has a rotating shaft fixed to both end surfaces of the pseudo torso, and the rotating shaft on the one end surface side where the pseudo anus is opened is rotated by the rotation of the pseudo torso. 7. The training device for an endoscope according to claim 6, wherein the training device for an endoscope is fixed to the one end surface at a position deviated from the moving center axis.
[0062]
【The invention's effect】
As described above, according to the present invention, by forming the simulated organ forming layer into two or more layers, not only the endoscope insertion technique but also the actual endoscopic treatment can be simulated, In addition, it is possible to provide an endoscope training apparatus capable of acquiring and improving an endoscopic treatment technique using an endoscope training model.
[Brief description of the drawings]
FIG. 1 is an external perspective view of a training device for an endoscope for a large intestine as viewed obliquely from the upper left side,
FIG. 2 is an enlarged cross-sectional view and a front view of a rotating mechanism and a holding mechanism of the pseudo fuselage;
FIG. 3 is an enlarged cross-sectional view and a front view showing operations of a rotating mechanism and a holding mechanism of the pseudo torso;
FIG. 4 is an enlarged perspective view of a main part showing a state in which a second rotation shaft is fixed at a position deviated from a rotation center axis of the pseudo torso;
FIG. 5 is a top view showing a state in which the abdominal cover of the pseudo torso in the training device for an endoscope is removed.
FIG. 6 is a sectional view taken along the line VI-VI ′ of FIG. 5;
FIG. 7 is an essential part cross-sectional view showing a state in which the abdominal cover presses the large intestine pseudo-organ;
FIG. 8 is an enlarged cross-sectional view in which a fold is arranged in a simulated large intestine organ;
FIG. 9 is a longitudinal cross-sectional view of an anal sphincter model attached to a pseudoanus of a large intestine pseudo-organ,
10 is an essential part perspective view of the pseudo torso showing a state in which the anal sphincter model of FIG. 9 is detachably attached to the pseudo anus of the pseudo torso,
FIG. 11 is a front view showing a state in which a long sigmoid colon model is attached to a large intestine organ model in a training apparatus for an endoscope for large intestine;
FIG. 12 is a front view showing a state in which a short sigmoid colon model is attached to a large intestine organ model in the training apparatus for an endoscope for large intestine;
FIG. 13 is an enlarged sectional view of a main part showing a method of fitting the large intestine organ model and the S-shaped colon model,
FIG. 14 is an enlarged sectional view of a main part showing a fitted state of a large intestine organ model and an S-shaped colon model,
FIG. 15 is an enlarged sectional view of a main part showing a method of reproducing suction of bodily fluid in the large intestine in the training device for the large intestine endoscope,
FIG. 16 is an enlarged front view of a main part showing a method of reproducing adhesions of the large intestine;
FIG. 17 is an enlarged partial longitudinal sectional view showing a wall structure of a large intestine pseudo-organ showing one embodiment of the present invention;
18 is an enlarged partial longitudinal sectional view showing a state in which a local injection solution is injected into the formation layer of the large intestine simulated organ of FIG. 17 using an injection needle;
FIG. 19 is an enlarged partial longitudinal sectional view showing a state in which an inner wall portion is cut using a high-frequency snare in a ridge of a cambium of the large intestine simulated organ of FIG.
FIG. 20 is an enlarged partial longitudinal sectional view showing a state in which a polyp portion formed in a formation layer of a simulated large intestine organ is excised using a high-frequency snare.
[Explanation of symbols]
1: Training device for endoscope 30: Inner wall (forming layer)
31 ... outer wall part (formation layer)

Claims (3)

In a training device for an endoscope having a simulated organ,
The training device for an endoscope, wherein the formation layer of the simulated organ is composed of two or more layers. In a training device for an endoscope having a pseudo-organ composed of a plurality of layers,
The training device for an endoscope, wherein the layer forming the pseudo organ has a layer outside the inner layer made of a hard material. In a training device for an endoscope having a pseudo-organ composed of a plurality of layers,
The training device for an endoscope, wherein the formation layer of the simulated organ is made of a material having a higher thermal conductivity than a material of an outer layer.

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