JP2015196075A - Training device and training program for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a training device and a training program for an endoscope capable of correctly evaluating training of an endoscope operation by an operator to improve skill of the endoscope operation in a short period of time.SOLUTION: A training device 10 for an endoscope includes: an intestinal tract model 20 into which an endoscope is inserted; sensor means 30 using linear displacement sensors 31 and flexure sensors 32 for detecting shape deformation of the intestinal tract model 20 by the endoscope inserted into the intestinal tract model 20; a controller 60 functioning as evaluation means for scoring an insertion operation of the endoscope on the basis of an amount of the deformation of the intestinal tract model 20 detected by the sensor means 30; and peristaltic movement means 40 which reduces or increases a diameter of the intestinal tract of the intestinal tract model 20 using intestinal tract contact parts 41 to reproduce peristaltic movement of the intestinal tract.

Description

  The present invention relates to an endoscope training apparatus and an endoscope in which an operator who operates an endoscope inserts the endoscope into an intestine model imitating a human intestinal tract and trains the operation of the endoscope. It relates to training programs.

  As a technique related to a conventional endoscope training apparatus, those described in Patent Documents 1 and 2 are known.

  The large intestine endoscope insertion practice device described in Patent Document 1 is configured to selectively attach any one of five types of transverse colon units and seven types of sigmoid colon units as appropriate. Moreover, in the large intestine endoscope insertion practice apparatus of patent document 1, based on the detection signal output from the distortion detector to the distortion amount detection apparatus, the control means determines the degree of pain of the patient, for example, the patient It is described that the alarm device emits a warning sound when the degree of pain exceeds a certain value.

  Further, in the endoscope training apparatus described in Patent Document 2, when the endoscope presses the inner wall of the sigmoid colon and the inner wall extends, the volume of the sigmoid colon changes, and the second chamber When the flow rate of the water pushed out from the water tank to the second water tank is measured with the second flow meter and the flow rate exceeds a predetermined value, the detection signal processing circuit breaks the inner wall of the real organ, or the subject If it feels painful, it will judge and issue a warning.

Japanese Patent Laid-Open No. 10-211160 JP 2014-6444 A

However, in the large intestine endoscope insertion practice device described in Patent Document 1, the control means determines the degree of pain of the patient, and the alarm device emits a warning sound. It is difficult to understand how much proficiency has improved.
Further, in the endoscope training apparatus described in Patent Document 2, a warning is issued when the flow rate exceeds a predetermined value, but the operation of the endoscope is accurately evaluated only by a change in the volume of the intestinal tract. Is difficult. For example, in a case where the operator has made a large deformation that causes pain to the patient when the endoscope is advanced to the intestinal tract, the volume change of the intestinal tract is small. The endoscope training device cannot detect this case.

When an operator inserts an endoscope into the intestinal tract and advances the operation of the endoscope, it is necessary to greatly deform the intestinal tract at a necessary place and suppress unnecessary deformation at a place sensitive to stimulation.
In the endoscope training apparatus, it is desirable to be able to accurately evaluate such operations so that the operator's proficiency can be improved in a short time.

  Therefore, the present invention provides an endoscope training apparatus and an endoscope that can improve an operator's proficiency in endoscope operation in a short time by accurately evaluating an endoscope operation training by an operator. The purpose is to provide a training program.

  An endoscope training apparatus according to the present invention includes an intestinal tract model into which an endoscope is inserted, sensor means for detecting shape deformation of the intestinal tract model by an endoscope inserted into the intestinal tract model, and the sensor means. Evaluation means for scoring the insertion operation of the endoscope based on the detected deformation amount of the intestinal tract model is provided.

  According to the endoscope training apparatus of the present invention, when the endoscope is inserted into the intestinal tract model, the sensor means detects the shape deformation of the intestinal tract model. Based on the amount of deformation of the intestinal tract model detected by the sensor means, the evaluation means scores the insertion operation of the endoscope, and therefore accurately evaluates the skill of the operator who operates the endoscope for operation training. Can do.

  Preferably, the intestinal tract model is provided with peristaltic movement means for reproducing the peristaltic movement of the intestinal tract. Since the peristaltic motion of the intestinal tract model is reproduced by the peristaltic motion means, the operator can perform training according to the human intestinal tract.

  The peristaltic movement means includes a string-like body wound around the intestinal tract model and being tensioned or relaxed, and a plurality of pressing bodies that press the outer peripheral surface of the intestinal tract model while the string-like body is inserted. Is desirable. The string-like body wound around the intestinal tract model is strained or relaxed, and the plurality of pressing bodies through which the string-like body is inserted presses the outer peripheral surface of the intestinal tract model, thereby reducing the diameter of the intestinal tract model on average. Because it can, you can faithfully reproduce the peristaltic movement.

  It is desirable that the pressing body is formed of an annular plate member that is inserted through the string-like body and connected. The annular plate material that is connected by inserting the string-like body sequentially contacts and presses the arc surface of the outer peripheral surface of the intestinal model along the string-like body wound around the intestine model, so that it is difficult to bend. Can also reduce the diameter of the intestinal tract model on average.

  When the intestinal tract model is reduced in diameter, the peristaltic movement means connects a plurality of pressing bodies attached to a portion that is difficult to dent with respect to a portion that easily dents the intestinal tract model, and the plurality of pressing bodies, It is desirable to provide a string-like body for approaching or separating the plurality of pressing bodies. When the diameter of the intestinal tract model is reduced, the plurality of pressing bodies attached to the difficult-to-dent portions are approached by the string-like body, so that the diameter of the intestinal tract model is reduced, or the plurality of pressing bodies are separated, so that the intestinal tract model is separated. Returns to its original state. Therefore, even if the intestinal tract model is difficult to dent, the average diameter of the intestinal tract model can be reduced.

  The string-like body is preferably formed of a metal wire that contracts when energized and returns to its original state when de-energized. If the string-like body is formed of a metal wire that shrinks when energized and returns to its original state when de-energized, it can be easily tensioned or relaxed as a string-like body by energizing or de-energizing. .

  Preferably, the sensor means is arranged along the intestinal tract model and detects a bending amount of the intestinal tract model. If the sensor means is disposed along the intestinal tract model and detects the amount of bending of the intestinal tract model, it is possible to measure the degree of pain of the patient due to the change in bending of the intestinal tract model by inserting an endoscope.

  Further, it is preferable that the sensor means has a distal end connected to the intestinal tract model and detects a movement amount of the distal end with reference to the proximal end. If the sensor means detects the amount of movement of the distal end connected to the intestinal tract model, it is possible to measure the patient's degree of pain due to deformation of the intestinal tract model due to insertion of an endoscope.

  It is desirable that the evaluation means score based on deformation amount information indicating the deformation amount of the intestinal tract model from the sensor means and time information indicating the deformation duration of the intestinal wall of the intestinal tract model. Patient suffering is affected not only by the amount of deformation in the intestinal tract model, but also by how long this deformation persisted. Therefore, the evaluation means can accurately measure the degree of pain of the patient by scoring based on the deformation amount information indicating the deformation amount of the intestinal tract model from the sensor means and the time information indicating the deformation duration of the intestinal wall. Therefore, the operator's skill can be accurately measured.

  The evaluation unit includes a storage unit that stores the deformation amount information indicating an operation of a reference endoscope as reference deformation amount information, and an operator who trains the reference deformation amount information stored in the storage unit. It is desirable that the difference with the deformation amount information when the endoscope is operated is multiplied by the time information for scoring. The evaluation means calculates the difference from the deformation amount information when the operator who trains operates the endoscope, using the deformation amount information indicating the operation of the reference endoscope as the reference deformation amount information. By multiplying the time information and scoring, if the deformation of the intestinal tract model by the operator's operation is inferior to the reference operator, it can be determined that the patient is suffering and is excellent. Thus, it can be determined that the endoscope is operated without causing pain to the patient.

  It is desirable that the evaluation means removes the deformation amount of the intestinal tract model by the peristaltic movement means from the deformation amount of the intestinal tract model detected by the sensor means. Since the intestinal tract model by the peristaltic movement means is deformed, when scoring the insertion operation by the evaluation means, the deformation amount of the intestinal tract model by the peristaltic movement means is removed from the deformation amount of the intestinal tract model detected by the sensor means. It is possible to accurately measure the deformation of the intestinal tract model by the endoscope.

  In the endoscope training apparatus of the present invention, the computer inputs deformation amount information indicating the deformation amount of the intestinal tract model whose shape is deformed by inserting the endoscope from the sensor means, and based on the deformation amount information. Thus, it can be realized by an endoscope training program that functions as an evaluation means for scoring the insertion operation of the endoscope.

  According to the endoscope training apparatus and the endoscope training program of the present invention, the evaluation means scores the insertion operation of the endoscope based on the deformation amount of the intestinal tract model detected by the sensor means. Therefore, the skill of the operator who operates the endoscope can be accurately evaluated, so that the operator's proficiency in endoscope operation can be improved in a short time.

BRIEF DESCRIPTION OF THE DRAWINGS It is a figure which shows the whole endoscope training apparatus which concerns on Embodiment 1 of this invention. It is a perspective view of the training apparatus for endoscopes shown in FIG. It is a block diagram for demonstrating the structure of the control apparatus of the training apparatus for endoscopes shown in FIG. (A) And (B) is a figure for demonstrating the intestine contact part of the training apparatus for endoscopes shown in FIG. It is a figure for demonstrating peristaltic movement of an intestinal tract model. (A) to (E) is a diagram for explaining the operation and use state of the endoscope training apparatus shown in FIG. 1, the insertion portion of the endoscope in the sigmoid colon that has become an α loop, It is a figure of the state which cancels | releases an alpha loop and advances. (A)-(C) is a figure for demonstrating operation | movement and a use condition of the training apparatus for endoscopes shown in FIG. 1, and inserts the insertion part of an endoscope in the sigmoid colon used as the alpha loop, It is a figure of the state advanced without canceling | releasing an alpha loop. It is a figure which shows the whole endoscope training apparatus which concerns on Embodiment 2 of this invention. It is a figure for demonstrating the intestine contact part of the training apparatus for endoscopes shown in FIG.

(Embodiment 1)
An endoscope training apparatus according to Embodiment 1 of the present invention will be described with reference to the drawings.
The endoscope training apparatus 10 shown in FIG. 1 includes an intestinal tract model 20, sensor means 30, peristaltic movement means 40, and evaluation means 50 (see FIG. 3).

The intestinal tract model 20 simulates the human intestinal tract, and is formed of a soft resin material or rubber material. The intestinal tract model 20 can be formed of, for example, silicone resin or polyurethane rubber. In the first embodiment, the intestinal tract model 20 includes an anus 201, a rectum 202, a sigmoid colon 203, a descending colon 204, a transverse colon 205, an ascending colon 206, a cecum 207, and an appendix 208. It is modeled on the large intestine. The intestinal tract model 20 is housed in a housing 21.
The casing 21 is formed in a box shape. As shown in FIG. 2, an opening 212 to which the anus 201 is connected is formed in the front wall 211 of the housing 21.

  As shown in FIG. 1, the sensor means 30 detects the shape deformation of the intestinal tract model 20 and outputs deformation amount information indicating the deformation amount to the evaluation means 50. The sensor means 30 includes a linear displacement sensor 31 having a distal end portion connected to the intestinal tract model 20 and a proximal end portion rotatably connected to the casing 21, and a bending sensor 32 disposed along the intestinal tract model 20. I have.

The linear displacement sensor 31 is a sensor also called a linear potentiometer. The linear displacement sensor 31 is a variable resistor having a resistance value corresponding to the protruding amount (sliding amount) of the shaft portion from the sensor body. The linear displacement sensor 31 has a distal end portion connected to the intestinal tract model 20 and a proximal end portion rotatably connected to the casing 21, so that the amount of movement of the distal end portion can be determined based on the proximal end portion. The amount of deformation of the model 20 can be detected.
The bending sensor 32 has a resistance value corresponding to the bent state, and is disposed along the intestinal tract model 20, so that the amount of bending of the intestinal tract model 20 can be detected as a deformation amount of the intestinal tract model 20. .

  In FIG. 1, the sensor means 30 is illustrated as being disposed at five locations of the intestinal tract model 20, but the sensor means 30 is a position necessary for evaluating the training of the operator who trains. Is arranged.

The peristaltic motion means 40 includes the intestinal tract contact portion 41 shown in FIG. 1, and the motion control means 42 and the drive means 43 shown in FIG.
As shown in FIG. 4A and FIG. 4B, the intestinal abutment portion 41 is wound around the intestinal tract model 20 and tensioned or relaxed, and the string-like body 411 is inserted. And a plurality of pressing bodies 412 that press the outer peripheral surface of the intestinal tract model 20.

  The string-like body 411 is formed of a metal wire that contracts when energized and returns to its original state when de-energized. As the string-like body 411, for example, Biometal (registered trademark) can be used. The pressing body 412 is formed of an annular plate member that is connected to the through hole through the string-like body 411 at the center.

  In the intestinal tract contact portion 41 shown in FIG. 4A, the pressing body 412 is disposed on the entire outer peripheral surface of the intestinal tract model 20. Further, in the intestinal tract contact portion 41 shown in FIG. 4B, when the diameter of the intestinal tract model 20 is reduced, the pressing body 412 is disposed in the portion 20b that is difficult to dent with respect to the portion 20a that is easy to dent. ing. As described above, the intestinal abutment portion 41 needs to be provided with the pressing body 412 as shown in FIG. 4A or indented as shown in FIG. 4B depending on the state of the intestinal model 20. The pressing body 412 can be disposed at a location.

  The motion control means 42 shown in FIG. 3 instructs the string-like body 411 of the intestinal abutment portion 41 to energize in order to reproduce the peristaltic motion of the intestinal tract in the intestinal tract model 20. The drive unit 43 has a function of driving a current to the string-like body 411 based on an instruction from the motion control unit 42.

The evaluation unit 50 shown in FIG. 3 includes an AD conversion unit 51, a storage unit 52, a display unit 53, and a calculation unit 54.
The AD conversion means 51 has a function of converting the analog signal from the sensor means 30 into a digital signal so that the calculation means 54 can calculate it. If the sensor means 30 outputs a digital signal, the AD conversion means 51 can be omitted.

The storage means 52 stores reference deformation amount information as reference deformation amount information. The storage means 52 can be a hard disk drive or a flash memory.
The reference deformation amount information can be deformation amount information when a skilled operator operates the endoscope, or can be deformation amount information when the endoscope is operated by an ideal procedure.
Skilled operators often have the know-how to operate the endoscope without causing pain to the subject even if it is not an ideal procedure for teaching beginners at educational institutions. Therefore, the reference deformation amount information can be an ideal procedure or a procedure by a skilled operator.

In order to make the standard deformation amount information an ideal procedure, the deformation amount of the intestinal tract model 20 is set in advance in the storage unit 52. Further, when the reference deformation amount information is a procedure by a skilled operator, some operators insert an endoscope into the intestinal tract model 20, measure the deformation amount information by the sensor means 30, and calculate an average value thereof. Thus, the reference deformation amount information can be obtained.
When the amount of deformation information is measured by several skilled operators, when the variation in the amount of deformation information increases, it is preferable that the amount of deformation information according to the ideal procedure is the reference amount of deformation information.

The display means 53 displays the display data from the calculation means 54. The display means 53 can be an LCD, an organic EL display, or a CRT.
The calculation means 54 inputs deformation amount information indicating the deformation amount of the intestinal tract model 20 detected by the sensor means 30 through the AD conversion means 51, and scores an insertion operation of the endoscope based on the deformation amount information. It has a function to do.

  As shown in FIG. 3, the motion control means 42 and the drive means 43 of the peristaltic motion means 40, the AD conversion means 51, the storage means 52, the display means 53, and the calculation means 54 of the evaluation means 50, together with the input means 61, The control device 60 is configured.

The control device 60 can be a personal computer such as a desktop type, a notebook type, or a tablet type. The motion control means 42 can be configured by hardware. The motion control means 42 can also be configured by a peristaltic motion control program that causes a computer to function as the motion control means 42.
Further, the calculation means 54 of the evaluation means 50 can be configured by an endoscope training program that causes a computer to function as the calculation means 54.

  The input means 61 can be, for example, an operation panel provided with a power button, a start button, a stop button, and the like. When the control device 60 is a desktop or notebook personal computer, the input means 61 can be a keyboard.

  The operation and use state of the endoscope training apparatus according to the first embodiment of the present invention configured as described above will be described with reference to the drawings.

  First, the power button of the input means 61 is pressed to turn on the control device 60. As the control device 60 is turned on, the motion control means 42 instructs the drive means 43 to energize the string-like body 411. When the string-like body 411 is energized or de-energized, the string-like body 411 contracts when energized and returns to its original state when de-energized.

  Due to the contraction of the string-like body 411, the pressing body 412 presses the outer peripheral surface of the intestinal wall of the intestinal tract model 20, and the intestinal tract model 20 is reduced in diameter. Moreover, when the string-like body 411 returns to the original state, the string-like body 411 expands and the intestinal tract model 20 expands in diameter. As shown in FIG. 5, the movement control means 42 transmits a wave that expands and contracts the lumen of the intestinal tract model 20 to the anus 201 to reproduce the peristaltic movement of the intestinal tract so that the stool is directed in the discharge direction.

  In the intestinal tract contact portion 41 of the peristaltic movement means 40 shown in FIG. 4 (A), the pressing body 412 formed of an annular plate material is arranged on the entire outer peripheral surface of the intestinal tract model 20. The string-like body 411 alone binds the intestinal tract model 20 one-dimensionally. However, when the pressing body 412 is provided, the string-like body 411 contracts, so that the pressing body 412 is two-dimensionally and sequentially. Since it abuts and presses, the intestinal tract model 20 can be reduced in diameter on average by also abutting on a portion that is difficult to bend.

  Further, in the intestinal tract model 20 shown in FIG. 4 (B), since there is a depression, when trying to reduce the diameter of the intestinal tract model 20 as a whole, the easily dentable portion 20a is bent first, and the difficultly dent portion 20b is bent. hard. In the case of such an intestinal tract model 20, the pressing body 412 is disposed in a portion 20 b in which the intestinal tract contact portion 41 is difficult to be recessed with respect to the portion 20 a in which the intestinal tract model 20 is easily recessed.

  Therefore, when the diameter of the intestinal tract model 20 is reduced, the plurality of pressing bodies 412 attached to the portion 20b that is difficult to be recessed approaches the string-like body 411, so that the diameter of the intestinal tract model 20 is reduced, or the plurality of pressing bodies. 412 separates and returns to the original state. Accordingly, even if the intestinal tract model 20 has a portion 20b that is difficult to be dented, the diameter of the intestinal tract model 20 can be reduced concentrically on average.

  Further, since the string-like body 411 connecting the pressing bodies 412 is formed of a metal wire that contracts when energized and returns to its original state when de-energized, the movement control means 42 instructs the energization or de-energization. Thus, the intestinal tract model 20 can be easily tensioned or relaxed by the string-like body 411.

An operator who performs training (hereinafter referred to as “trainer”) holds an endoscope and first presses the start button of the input means 61 of the control device 60 as shown in FIG. Then, the insertion portion of the endoscope to be inserted into the intestinal tract is inserted into the anus 201 of the intestinal tract model 20 through the opening 212 of the housing 21 (see FIG. 2). The reference deformation amount information stored in the storage means 52 includes deformation amount information when an experienced operator operates the endoscope, or deformation amount information when the endoscope is operated according to an ideal procedure. It is assumed that which one is used is designated in advance by the input means 61.
When the start button of the input unit 61 is pressed, the calculation unit 54 (see FIG. 3) of the evaluation unit 50 starts measuring time.

  The trainee advances the insertion portion and advances the insertion portion from the anus 201 through the rectum 202 and into the sigmoid colon 203. Here, an evaluation method for releasing the sigmoid colon 203 that has become an α loop by the right turn shortening technique and entering the descending colon 204 is shown in FIG. A description will be given based on E). 6A to 6E, an example in which a deformation of the intestinal tract model 20 is detected using the linear displacement sensor 31 will be described.

As shown in FIG. 6A, each of the linear displacement sensors 31 (31a to 31c) of the sensor means 30 is connected to the S-top portion 203a of the α loop, the rectum It is connected to the sigmoid colon transition portion 203b and a site that is closer to the anus 201 side from the sigmoid / descending colon transition portion 203c within a range of about 10 cm.
First, the trainee advances the insertion portion X of the endoscope from the anus 203a to the S top portion 203a, and fixes the intestinal tract by applying an up angle.
At this time, it is desirable that the linear displacement sensors 31a to 31c remain in the initial state even when the insertion portion X advances to the S top portion 203a. The deformation amount information indicated by the linear displacement sensors 31a to 31c at this time is an initial value.

Since the reference deformation amount information stored in the storage unit 52 is deformation amount information serving as a reference, values of initial states in which the linear displacement sensors 31a to 31c are not displaced are stored. The computing means 54 adds points if the difference between the deformation amount information from the linear displacement sensors 31a to 31c at this time and the reference deformation amount information in the initial state is zero. However, if there is a difference, an operation different from that of the reference operator is performed, so a deduction is made according to the difference.
Thus, the linear displacement sensor 31 connected to the intestinal tract model 20 can detect the amount of movement of the distal end portion of the insertion portion X as the amount of deformation of the intestinal tract model 20, so that the intestinal tract model is inserted by inserting an endoscope. The patient's degree of pain due to the 20 deformations can be measured.

Further, these scores are multiplied as time information by the deformation duration from when the linear displacement sensors 31a to 31c start to be displaced until when the displacement is completed.
This means that if the intestinal tract continues and prolongs, the patient is painful to that extent. In the operation of the endoscope, if the intestinal tract is not deformed, it is desirable that the intestinal tract is less deformed, and if the intestinal tract is required to be deformed, an operation close to the reference deformation amount information is desirable. It is desirable that the time required for deformation is short. Therefore, in the endoscope training apparatus 10, since the deformation duration is one element of scoring, the patient's degree of pain can be accurately measured, so that the skill of the trainee can be accurately measured.

  Next, the trainee rotates the insertion portion X to the right as shown in FIG. 6B from the state of FIG. In this operation, it is desirable that the rectal / sigmoid colon transition portion 203b rotates to the right and the linear displacement sensor 31b extends by the right rotation of the insertion portion X. Further, it is desirable that the linear displacement sensors 31a and 31c are not displaced even when the insertion portion X is rotated clockwise.

  Accordingly, the reference deformation amount information for the linear displacement sensor 31b indicates a value when the linear displacement sensor 31b expands from the state shown in FIG. 6A to the state shown in FIG. 6B. Further, the reference deformation amount information for the linear displacement sensors 31a and 31c indicates the value of the initial state.

  The calculation means 54 adds points if the difference between the deformation amount information from the linear displacement sensors 31a to 31c at this time and the reference deformation amount information about the linear displacement sensors 31a to 31c is 0, and the difference is increased. In some cases, points are deducted according to the difference. Further, the calculation means 54 multiplies these scores as the deformation duration from the time when the linear displacement sensors 31a to 31c start to be displaced until the time when the displacement is completed.

Next, the trainee further rotates the insertion portion X to the right as shown in FIG. 6C from the state of FIG. The α loop is released by further clockwise rotation of the insertion portion X.
In this operation, by further clockwise rotation of the insertion portion X, the rectal / sigmoid colon transition portion 203b rotates to the right, and the linear displacement sensor 31b further expands. Even at this time, it is desirable that the linear displacement sensors 31a and 31c are not displaced.

  Therefore, the reference deformation amount information for the linear displacement sensor 31b indicates a value when the state is further expanded from the state shown in FIG. Further, the reference deformation amount information for the linear displacement sensors 31a and 31c indicates the value of the initial state.

  The calculation means 54 adds points if the difference between the deformation amount information from the linear displacement sensors 31a to 31c at this time and the reference deformation amount information about the linear displacement sensors 31a to 31c is 0, and the difference is increased. In some cases, points are deducted according to the difference. Further, the calculation means 54 multiplies these scores as the deformation duration from the time when the linear displacement sensors 31a to 31c start to be displaced until the time when the displacement is completed.

Next, as shown in FIG. 6 (D), the trainee pulls the insertion portion X and pulls the sigmoid colon 203 by the distal end of the insertion portion X in the up-angle state, thereby shortening the sigmoid colon 203. To do.
In this operation, the rectal / sigmoid colon transition portion 203b is left as it is, the S top portion 203a is displaced in the direction in which the linear displacement sensor 31a extends, and the sigmoid colon / descending colon transition portion 203c is the linear displacement sensor. It is desirable to displace 31c in the contracting direction.

Therefore, the reference deformation amount information for the linear displacement sensor 31b shows the same value as the state shown in FIG. Further, the reference deformation amount information for the linear displacement sensor 31a indicates a value expanded from the initial state. Further, the reference deformation amount information for the linear displacement sensor 31c indicates a value contracted from the initial state.
The computing means 54 scores from the reference deformation amount information and the deformation amount information from the linear displacement sensors 31a to 31c at this time. Further, the computing means 54 multiplies these scores by the deformation duration.

Next, the trainee moves the sigmoid colon 203 through the descending colon by releasing the up-angle at the distal end of the insertion part X as shown in FIG. Proceed to 204.
In this operation, it is desirable that the S-top portion 203a and the rectum / sigmoid colon transition portion 203b remain as they are, and the sigmoid / descending colon transition portion 203c be displaced in the direction in which the linear displacement sensor 31c extends.

Therefore, the reference deformation amount information for the linear displacement sensors 31a and 31b shows the same value as the state shown in FIG. Further, the reference deformation amount information for the linear displacement sensor 31c indicates a value expanded from the initial state.
The computing means 54 scores from the reference deformation amount information and the deformation amount information from the linear displacement sensors 31a to 31c at this time. Further, the computing means 54 multiplies these scores by the deformation duration.

  Here, an evaluation method when the insertion portion X is inserted along the α loop without releasing the sigmoid colon 203 that has become the α loop will be described with reference to FIGS. 7A to 7C. To do. 7A to 7C, the linear displacement sensor 31 has the same position as the evaluation method when the α loop described with reference to FIG. 6A to FIG. It is.

  As shown in FIG. 7A, first, the trainee advances the insertion portion X of the endoscope straight from the anus 203a to the S top portion 203a as it is. In this state, even if the insertion portion X advances to the S top portion 203a, the linear displacement sensors 31a to 31c remain in the initial state. Since the deformation from the anus 201 to the S top portion 203a is in the initial state, the calculation means 54 calculates the difference from the deformation amount information from the linear displacement sensors 31a to 31c at this time and the reference deformation amount information in the initial state. If 0, points are added.

However, as shown in FIG. 7B, if the trainee advances the insertion portion X linearly as it is even if it reaches the S top portion 203a, the insertion portion X pushes up the S top portion 203a, so that S The top portion 203a does not extend. The trainee applies an up-angle to the insertion portion X when the linear progression of the insertion portion X becomes difficult.
By this operation, the linear displacement sensor 31a is displaced in the contracting direction, the linear displacement sensor 31b is not displaced, and the linear displacement sensor 31c is displaced in the extending direction.
Therefore, the deformation amount information from the linear displacement sensor 31a shows a contracted state from the reference deformation amount information, the deformation amount information from the linear displacement sensor 31b shows the same value as the reference deformation amount information, and the deformation from the linear displacement sensor 31c. This shows a state in which the amount information is expanded from the reference deformation amount information.

  Since such an operation in which the insertion portion X reaches the S top portion 203a in a straight line as it is is painful to the patient, the calculation means 54 deducts points based on the deformation amount information and the reference deformation amount information. To do. Further, the computing means 54 multiplies these scoring times by the deformation duration to give scoring. That is, if the duration of pain is long, the degree of deduction increases.

  Next, the trainee moves the insertion portion X straight from the state shown in FIG. 7B and lowers it as shown in FIG. 7C. Then, the trainee continues to advance the insertion portion X to the site to which the linear displacement sensor 31c is connected, and when the extension portion ceases to extend, the insertion portion X is angled up to move to the sigmoid / descending colon. It advances toward the part 203c.

By this operation, the linear displacement sensor 31a and the linear displacement sensor 31b are not displaced from the state of FIG. 7B, and the linear displacement sensor 31c is displaced in a contracting direction.
Therefore, the deformation amount information from the linear displacement sensor 31a and the linear displacement sensor 31b shows the same value as the reference deformation amount information, and the deformation amount information from the linear displacement sensor 31c is contracted from the reference deformation amount information.

Even in the operation shown in FIG. 7C, the calculation means 54 deducts points based on the deformation amount information and the reference deformation amount information in order to give pain to the patient. Further, the computing means 54 multiplies these scoring times by the deformation duration to give scoring.
As described above, the arithmetic means 54 performs not only a point addition but also a point deduction by performing an operation that causes pain to the patient, so that the operation can be evaluated as a comprehensive score.

In this way, the trainee advances the endoscope into the intestinal tract model 20. Then, when the training is completed, the stop button of the input means 61 is pressed.
The calculation unit 54 ends the time measurement when the stop button of the input unit 61 is pressed. The calculating means 54 stores from the pressing of the start button to the pressing of the stop button in the storage means 52 as time information indicating the time required for training.
The storage unit 52 stores reference time information as reference time information. The calculation means 54 calculates a difference from the time information of the trainee and the reference time information as a reference, and uses this difference as a scoring element. That is, the calculation means 54 increases the added point if it is close to the reference time information, and decreases or deducts the added point if the difference is large.

  The calculation means 54 displays the training time on the display means 53 as a result of scoring. In the example of FIG. 1, the “score” is 85 points, the training time indicating “inspection time” is 4 minutes 30 seconds, and the computing means 54 represents the degree of distress on the face based on the result of scoring. The mark is displayed in three levels.

  The computing unit 54 can display a mark representing the face based on the result of scoring, but can also display the mark on the display unit 53 according to the degree of pain in real time during the operation. For example, the scoring is performed by the computing means 54, and if the score is large, the smiley expression is expressed, and if the score is small or deductible, the painful expression is expressed. Can be corrected immediately. If the control device 60 is provided with sound generation means, for example, “Teacher, it is painful!”, “Teacher, it hurts!”, “Teacher, it hurts very much!” It can also be generated with a voice like "I can't stand it" or "Please stop!"

  As described above, according to the endoscope training device 10 according to the first embodiment, when the endoscope is inserted into the intestinal tract model 20, the sensor means 30 detects the shape deformation of the intestinal tract model 20. Based on the deformation amount of the intestinal tract model 20, the evaluation means 50 scores the insertion operation of the endoscope, so that the skill of the trainee can be accurately evaluated. Therefore, the endoscope training apparatus 10 can improve the proficiency of the endoscope operation of the trainee in a short time.

Further, the calculation means 54 of the evaluation means 50 calculates the difference from the deformation amount information when the trainee operates the endoscope using the reference deformation amount information as the reference deformation amount information, and multiplies the time information. If the deformation of the intestinal tract model 20 due to the operation of the trainee is inferior to the reference operator, it can be determined that the patient is suffering. It can be determined that the endoscope is operated without giving
In addition, since the intestinal tract model 20 is provided with the peristaltic motion means 40 that reproduces the peristaltic motion of the intestinal tract, the trainer can perform training according to the intestinal tract of the human body.

  In the above scoring, the calculation means 54 measures the deformation amount of the intestinal tract model 20 based on the displacements of the linear displacement sensors 31a to 31c. However, since the peristaltic motion of the intestinal tract model 20 is reproduced by the peristaltic motion means 40, the diameter reduction or expansion of the intestinal tract model 20 due to the peristaltic motion of the intestinal tract model 20 affects the displacement of the linear displacement sensors 31a to 31c. .

For example, when the motion control means 42 instructs the diameter increase of the intestinal tract model 20, the linear displacement sensor 31 is displaced in the contraction direction. Further, when the motion control means 42 instructs to reduce the diameter of the intestinal tract model 20, the linear displacement sensor 31 is displaced in the extending direction. Therefore, the computing unit 54 can accurately measure the deformation of the intestinal tract model 20 by the endoscope by removing the deformation amount due to the reduction or expansion of the intestinal tract model 20 as noise.
This peristaltic motion can be validated or invalidated by an instruction from the input means 61 to the motion control means 42. When the trainee trains in a state in which the peristaltic motion of the intestinal tract model 20 by the motion control means 42 is reproduced, the deformation due to the diameter reduction or expansion of the intestinal tract model 20 is removed as noise and the peristaltic motion is reproduced. Since the difficulty of the operation of the endoscope is increased as compared with the case where it is not performed, it may be added by selecting to reproduce the peristaltic motion.

  In the above example, the deformation amount of the intestinal tract model 20 is measured based on the displacements of the linear displacement sensors 31a to 31c. However, the bending sensor 32 also depends on the bending change of the intestinal tract model 20 due to insertion of the endoscope. The patient's degree of pain can be measured. Therefore, the computing unit 54 can score based on the deformation amount information indicating the bending amount from the bending sensor 32 and the reference deformation amount information stored in the storage unit 52.

  Furthermore, in the above description, as shown in FIG. 6, the sigmoid colon 203 is shortened while the insertion portion X of the endoscope is inserted into the sigmoid colon 203 with the sigmoid colon 203 in an α loop. Then, the α loop was released and the operation was directed to the descending colon 204. However, in addition to the state of the sigmoid colon 203 that has become the α loop, the intestinal tract model 20 is, for example, a sigmoid colon overlength, an N loop, a back α loop, a transverse colon overlength, or a combination thereof. Can do.

An operation for releasing the α loop of the sigmoid colon 203 by operating the endoscope and shortening the sigmoid colon 203 is the most painless insertion method. The reference deformation amount information is set so that the scoring at this time becomes a higher score.
Then, when the α loop is canceled without canceling the α loop, when the α loop is canceled halfway through the α loop, that is, when the sigmoid colon 203 is once overfilled and inserted into the descending colon 204, S Although the α loop could not be eliminated in the sigmoid colon 203, the sensor means 30 provided in the mouth side portion of the descending colon 204 determines that the α loop has been eliminated before reaching the mouth side portion of the descending colon 204. Thus, it is possible to determine that it is an ideal insertion method for the next point.

(Embodiment 2)
An endoscope training apparatus according to Embodiment 2 of the present invention will be described with reference to the drawings. 8 and 9, the same components as those in FIGS. 1 and 4B are denoted by the same reference numerals, and description thereof is omitted.

As shown in FIG. 8, in the endoscope training apparatus 10x according to the second embodiment, the intestinal tract contact portion 410 of the peristaltic motion means 40x is fixed with the pressing body attached to the intestinal tract model 20.
As shown in FIG. 9, the intestinal tract model 20 is a portion 20a in which the portion where the intestinal wall is recessed is easily recessed, and the remaining portion excluding the portion 20a that is easily recessed is a portion that is difficult to be recessed relative to the easily recessed portion 20a. 20b.

The intestinal tract contact portion 410 is formed by a plurality of pressing bodies 413 attached and fixed to the portion 20b which is difficult to be recessed, and a string-like body 411 connecting the plurality of pressing bodies 413.
In the example shown in FIG. 8, the pressing body 413 is attached to a portion 20 b of the intestinal tract model 20 that is difficult to be dented, and the adjacent pressing bodies 413 are connected to each other, and the string-like bodies 411 are connected to each other. The body 411 extends and is connected to the driving means 43 (see FIG. 3). In this way, three sets of intestinal abutment portions 410 a to 410 c are arranged in the intestinal tract model 20.

By energizing each string-like body 411 of the intestinal tract contact portions 410a to 410c, the string-like body 411 contracts and draws the pressing body 413. When the pressing bodies 413 are attracted and approach each other, the portion 20b that is difficult to dent is pressed, and the intestinal tract model 20 is reduced in diameter.
Further, by de-energizing the string-like body 411, the string-like body 411 expands and returns to the original state, and the pressing body 413 is separated, so that the portion 20b that is difficult to be recessed swells and the intestinal tract model 20 expands. Diameter.
Thus, the intestinal tract contact portion 410 can reduce the diameter of the intestinal tract model 20 on average even if the intestinal tract model 20 has a portion 20b that is difficult to be recessed.

  The endoscope training apparatuses 10 and 10x according to the first and second embodiments have been described above, but the present invention is not limited to the first and second embodiments. In the endoscope training apparatuses 10 and 10x, the intestinal tract model 20 is the large intestine, but the small intestine may also be provided. The sensor means 30 includes the linear displacement sensor 31 and the bending sensor 32. However, as the sensor means, an abrupt deformation of the intestinal tract may be detected by an acceleration sensor.

  The endoscope apparatus of the present invention is suitable for exhibition facilities such as medical education facilities, medical facilities, and science museums because an inexperienced operator can improve the operation technology of the endoscope.

10, 10 × Endoscope training apparatus 20 Intestinal model 201 Anus 202 Rectum 203 Sigmoid colon 203a S Top part 203b Rectal / sigmoid colon transition part 203c Sigmoid / descending colon transition part 204 Lower colon 205 Transverse colon 206 Ascending colon 207 Cecum 208 Appendice 20a Recessed part 20b Recessed part 21 Case 211 Front wall part 212 Opening part 30 Sensor means 31, 31a-31c Linear displacement sensor 32 Bending sensor 40, 40x Peristaltic movement means 41, 410, 410a-410c Intestinal tract Contact section 411 String body 412, 413 Press body 42 Motion control means 43 Drive means 50 Evaluation means 51 AD conversion means 52 Storage means 53 Display means 54 Calculation means 60 Control device 61 Input means X Insertion section

Claims (12)

An intestinal model into which an endoscope is inserted;
Sensor means for detecting shape deformation of the intestinal tract model by an endoscope inserted into the intestinal tract model;
An endoscope training apparatus comprising: evaluation means for scoring the insertion operation of the endoscope based on a deformation amount of the intestinal tract model detected by the sensor means.   The endoscope training apparatus according to claim 1, wherein the intestinal tract model is provided with peristaltic movement means for reproducing the peristaltic movement of the intestinal tract.   The peristaltic motion means includes a string-like body wound around the intestinal tract model and being tensioned or relaxed, and a plurality of pressing bodies that press the outer peripheral surface of the intestinal tract model while the string-like body is inserted. Item 3. The endoscope training apparatus according to Item 2.   4. The endoscope training apparatus according to claim 3, wherein the pressing body is formed of an annular plate member that is inserted and connected to the string-like body.   When the intestinal tract model is reduced in diameter, the peristaltic movement means connects a plurality of pressing bodies attached to a portion that is difficult to dent with respect to a portion that easily dents the intestinal tract model, and the plurality of pressing bodies, The endoscope training apparatus according to claim 2, further comprising a string-like body that approaches or separates the plurality of pressing bodies.   The endoscope training apparatus according to any one of claims 3 to 5, wherein the string-like body is formed of a metal wire that contracts when energized and returns to an original state when de-energized.   The endoscope training apparatus according to claim 1, wherein the sensor unit is arranged along the intestinal tract model and detects a bending amount of the intestinal tract model.   The endoscope for an endoscope according to any one of claims 1 to 6, wherein the sensor means has a distal end connected to the intestinal tract model and detects a movement amount of the distal end with reference to a proximal end. Training device.   9. The evaluation according to claim 1, wherein the evaluation means scores based on deformation amount information indicating the deformation amount of the intestinal tract model from the sensor means and time information indicating a deformation duration of the intestinal wall of the intestinal tract model. An endoscope training apparatus according to any one of the above sections.   The evaluation unit includes a storage unit that stores the deformation amount information indicating an operation of a reference endoscope as reference deformation amount information, and an operator who trains the reference deformation amount information stored in the storage unit. The endoscope training apparatus according to claim 9, wherein a score is obtained by multiplying the difference from the deformation amount information when the endoscope is operated by the time information.   The endoscope training apparatus according to claim 2, wherein the evaluation unit removes the deformation amount of the intestinal tract model by the peristaltic motion unit from the deformation amount of the intestinal tract model detected by the sensor unit. Computer
Evaluation means for inputting deformation amount information indicating the deformation amount of the intestinal tract model whose shape is deformed by inserting an endoscope from the sensor means, and scoring the insertion operation of the endoscope based on the deformation amount information Endoscopy training program characterized by functioning as

Images