JP2019008224A - Training simulator and training guidance method - Google Patents

Abstract

To provide a training simulator capable of suppressing an amount of liquid leaked during or after a training.SOLUTION: A training simulator includes: a simulation urinary bladder 2; and a backflow suppression member 6. The simulation urinary bladder 2 includes: a main body part 21; and a lid 22. The back flow suppressing member 6 includes a backflow suppression valve 61; and an adhering member 62. The backflow suppression valve 61 is disposed inside an exit part 211 so that a flange part 611 is brought into contact with an upper end part of the exit part 211 of the main body part 21. The adhering member 62 is provided with a through-hole 621 and arranged on the backflow suppression valve 61 by being brought into contact with the backflow suppression valve 61. The backflow suppression valve 61 has a taper structure so as to be narrow in an inner part space as it advances from the adhering member 62 to an inner part of the main body part 21a and to be brought into contact with the end part of an inner part side of the main body 21.SELECTED DRAWING: Figure 10

Description

  The present invention relates to a training simulator and a training instruction method using the same.

  Conventionally, a urinary catheter insertion model is known (Patent Document 1). The model for inserting a urinary catheter described in Patent Document 1 has a simulated urethra that simulates the urethra from the urethral opening to the bladder, and a stenosis portion is formed in a part of the simulated urethra, and the degree of the stenosis can be adjusted. A stenosis part forming mechanism and an obstruction preventing structure for preventing the simulated urethra from being obstructed are provided.

  The portion of the simulated urethra opposite to the urethral opening is connected to the simulated bladder via a stenosis formation mechanism. The attachment position of the stenosis forming mechanism corresponds to the position of the prostate with respect to the urethra.

  The stenosis formation mechanism can adjust the degree of stenosis of the simulated urethra by adjusting the amount of sandwiching the simulated urethra.

  The occlusion prevention structure prevents the simulated urethra from being crushed and closed inside when the stenosis forming mechanism sandwiches the simulated urethra.

Japanese Patent Laying-Open No. 2015-191182

  However, since the urinary catheter insertion model described in Patent Document 1 includes a blocking prevention structure, the simulated urethra is not crushed by the stenosis forming mechanism and the inside is not blocked. As a result, after inserting the catheter into the simulated bladder via the simulated urethra, guiding the urine, and then removing the catheter from the simulated urethra, all the water accumulated in the simulated bladder leaks out through the simulated urethra There is.

  Therefore, according to the embodiment of the present invention, a training simulator capable of suppressing the amount of liquid leaking during or after training is provided.

  Moreover, according to the embodiment of the present invention, a training instruction method using a training simulator capable of suppressing the amount of liquid leaking during or after training is provided.

(Configuration 1)
According to the embodiment of the present invention, the training simulator includes a simulation member, a pipe member, and a backflow suppression member. The simulated member consists of a simulated bladder or a simulated rectum. The tube member has one end in contact with the simulated member and an insertion port made of a simulated urethral opening or simulated anus at the other end. The backflow suppressing member suppresses the flow of liquid from the simulated member to the insertion port side.

  According to the configuration 1, since the training simulator includes the backflow suppressing member, the amount of liquid leaking during or after training can be suppressed.

(Configuration 2)
In Configuration 1, the simulation member is composed of a simulated bladder, the tube member is composed of a simulated urethra having one end in contact with the simulated bladder and having a simulated urethral opening at the other end, and the backflow suppressing member is connected to the simulated urethra from the simulated bladder Suppresses the flow of liquid to the

  According to the configuration 2, the backflow suppressing member suppresses the flow of liquid from the simulated bladder to the simulated urethral opening, so that it is possible to suppress the amount of liquid that leaks during or after urine training.

(Configuration 3)
In the configuration 1, the simulation member includes a simulation rectum, the tube member includes a passage member having one end in contact with the simulation rectum and a simulation anus at the other end, and the backflow suppression member is provided from the simulation rectum to the simulation anus. Suppresses the flow of liquid.

  According to the configuration 3, the backflow suppressing member suppresses the flow of the liquid from the simulated rectum to the simulated anus, so that it is possible to suppress the amount of liquid that leaks during or after the enema training.

(Configuration 4)
In any one of Configurations 1 to 3, the backflow suppression member includes a backflow suppression valve and a contact member. The backflow suppression valve suppresses the flow of liquid from the simulated member to the insertion port side. The close contact member has a passage portion that allows the catheter inserted into the tube member to pass to the simulated member side, and is in close contact with the catheter when the catheter is inserted into the passage portion.

  According to Configuration 4, the contact member is in close contact with the catheter when the catheter is inserted into the passage. Therefore, it is possible to prevent the liquid from leaking to the insertion port side through the contact member.

(Configuration 5)
In Configuration 4, the training simulator further includes a pressurizer that applies pressure to the slit portion of the check valve.

  According to the configuration 5, since the pressure can be applied to the slit portion of the check valve by the pressurizer, the force when the catheter penetrates the check valve can be adjusted.

  Therefore, the state of the urethra of the prostate cancer patient can be realized, and urination training for the prostate cancer patient can be performed.

  Further, the catheter cannot pass through the check valve.

  Therefore, a state where the catheter cannot be inserted can be experienced.

(Configuration 6)
In Configuration 1, the simulated member includes a first simulated member made of a simulated bladder and a second simulated member made of a simulated rectum. The tube member has a simulated urethra having one end in contact with the first simulated member and having a simulated urethral opening at the other end, and a passage member having one end in contact with the second simulated member and having a simulated anus at the other end. including. The backflow suppressing member includes a first backflow suppressing member that suppresses the flow of liquid from the simulated bladder to the simulated urethra mouth side, and a second backflow suppressing member that suppresses the flow of liquid from the simulated rectum to the simulated anus side. Including.

  According to the configuration 6, it is possible to suppress the amount of liquid leaked in both the urinary training and the enema training.

(Configuration 7)
In Configuration 6, the first backflow suppression member includes a first backflow suppression valve and a first contact member. The first backflow suppression valve suppresses the flow of liquid from the simulated bladder to the simulated urethral opening side. The first contact member has a first passage portion that allows the catheter inserted into the simulated urethra to pass toward the simulated bladder, and is in close contact with the catheter when the catheter is inserted into the first passage portion.

  The second backflow suppression member includes a second backflow suppression valve and a second contact member. The second backflow suppression valve suppresses the flow of liquid from the simulated rectum to the simulated anus. The second contact member has a second passage portion that allows the catheter inserted into the passage member to pass to the simulated rectum side, and is in close contact with the catheter when the catheter is inserted into the second passage portion.

  According to the structure 7, it is possible to prevent the liquid from leaking to the insertion port side through the contact member in both the urine training and the enema training.

(Configuration 8)
According to the embodiment of the present invention, the training instruction method is a training instruction method for instructing at least one of urinary tract training and enema training using the training simulator according to any one of configurations 1 to 7. A first step for instructing to insert the catheter into the simulation member from the insertion port, and a second step for instructing to remove the catheter from the simulation member after the catheter is inserted into the simulation member. .

  According to Configuration 8, the trainee can experience that the amount of liquid leaking during or after training can be suppressed.

(Configuration 9)
In Configuration 8, the simulated member is made of a simulated bladder, and the tube member is made of a simulated urethra having one end in contact with the simulated bladder and having a simulated urethral opening at the other end. The training instruction method includes a third step of instructing to supply liquid to the simulated bladder, and a fourth step of instructing to confirm that the liquid exits through the catheter after the first step. The second step is executed after the fourth step.

  According to Configuration 9, the trainee can perform urinary training while suppressing the amount of liquid leaking to the outside.

(Configuration 10)
In Configuration 9, the backflow suppression member includes a backflow suppression valve that suppresses the flow of liquid from the simulated bladder toward the insertion port, and a passage portion that allows the catheter inserted into the tube member to pass to the simulated bladder. And a close contact member that comes into close contact with the catheter when inserted into the passage, the backflow control valve has a narrow space in the direction from the simulated urethral orifice to the simulated bladder, and the end on the simulated bladder side is in contact Has a tapered structure.

  The training instruction method further includes a fifth step of instructing to set the pressure applied to the taper structure of the backflow suppression valve from the outside to be higher than the atmospheric pressure, the first step, the second step, and The fourth step is executed after the fifth step.

  According to the structure 10, since the pressure higher than atmospheric pressure is applied to the taper structure of the check valve, the force when the catheter penetrates the check valve is adjusted.

  Therefore, the state of the urethra of the prostate cancer patient is realized, and the trainee can perform urinary guidance training for the prostate cancer patient.

  Further, the catheter cannot pass through the check valve.

  Therefore, the trainee can experience a state where the catheter cannot be inserted.

  The amount of liquid that leaks during or after training can be reduced.

It is the schematic of the training simulator by embodiment of this invention. It is a top view of the genital model seen from the A direction shown in FIG. It is a top view of the genital model seen from the simulated bladder side shown in FIG. It is sectional drawing of the genital model between lines IV-IV shown in FIG. FIG. 2 is an exploded view of a simulated bladder portion shown in FIG. 1. It is a perspective view of the backflow suppression valve shown in FIG. It is sectional drawing of the backflow suppression valve between the lines VII-VII shown in FIG. It is sectional drawing of the backflow suppression valve and contact | adherence member between the lines VIII-VIII shown in FIG. It is a schematic diagram when inserting and extracting a catheter from a backflow suppressing member. It is sectional drawing of a simulation bladder and a backflow suppression member. It is sectional drawing of the genital model, the simulated bladder, and the backflow suppression member shown in FIG. It is a figure for demonstrating urination training using the training simulator shown in FIG. It is a figure for demonstrating enema training using the training simulator shown in FIG. It is the schematic of another training simulator by embodiment of this invention. It is a top view of the genital model seen from the A direction shown in FIG. It is a top view of the genital model seen from the simulated bladder side shown in FIG. It is sectional drawing of the genital model between the lines XVII-XVII shown in FIG. FIG. 15 is a cross-sectional view of the genital model, simulated bladder, and backflow suppressing member shown in FIG. 14. It is a figure for demonstrating the urination training using the training simulator shown in FIG. It is a figure for demonstrating enema training using the training simulator shown in FIG. It is a flowchart for demonstrating the training guidance method using the training simulator shown in FIG. It is a flowchart for demonstrating the detailed operation | movement of step S3 shown in FIG. It is a flowchart for demonstrating the detailed operation | movement of step S4 of FIG. It is a schematic diagram of a human body related to urine training and enema training. It is sectional drawing for demonstrating the distance of a backflow suppression valve and a contact | adherence member. It is a figure for demonstrating the arrangement | positioning relationship between a backflow suppression valve and a contact | adherence member. It is the schematic of another backflow suppression member. It is the schematic of another backflow suppression member. It is sectional drawing for demonstrating the arrangement | positioning state of the backflow suppression member shown in FIG. It is sectional drawing of another simulated urethra. It is sectional drawing which shows the state which has arrange | positioned the backflow suppression member shown in FIG. 28 to the simulated urethra shown in FIG. It is a figure which shows the arrangement | positioning state to the genital model of the backflow suppression member shown in FIG. It is a top view of another contact member.

  Embodiments of the present invention will be described in detail with reference to the drawings. In the drawings, the same or corresponding parts are denoted by the same reference numerals and description thereof will not be repeated.

  FIG. 1 is a schematic diagram of a training simulator according to an embodiment of the present invention. With reference to FIG. 1, a training simulator 10 according to an embodiment of the present invention includes a genital model 1, a simulated bladder 2, a hose 3, an adjustment member 4, and a storage container 5.

  Genital model 1 is a male male genital model. The genital model 1 includes a simulated urethra (not shown in FIG. 1) arranged so as to reach the simulated bladder 2 from the glans portion. And the genital model 1 consists of resin, for example, More specifically, it consists of urethane of super soft (for example, hardness: 0-15). The simulated bladder 2 is connected to the genital model 1. The hose 3 has one end connected to the simulated bladder 2 and the other end connected to the storage container 5. The adjustment member 4 is attached to an arbitrary position of the hose 3.

  The simulated bladder 2 receives water from the storage container 5 through the hose 3 and accumulates the received water. The hose 3 supplies water from the storage container 5 to the simulated bladder 2. The adjusting member 4 adjusts the amount of water supplied from the storage container 5 to the simulated bladder 2 by adjusting the amount by which the hose 3 is sandwiched. The adjustment member 4 can also stop the supply of water from the storage container 5 to the simulated bladder 2.

  The storage container 5 stores water. The storage container 5 supplies water to the simulated bladder 2 via the hose 3. The storage container 5 can store a maximum of 500 cc of water, for example. This 500 cc volume is the average volume of urine collected in a typical male bladder.

  FIG. 2 is a plan view of the genital model 1 viewed from the direction A shown in FIG. Referring to FIG. 2, the genital model 1 includes a simulated penis 11, a simulated urethra 12, a simulated urethral opening 13, and a simulated anus 14. One end of the simulated urethra 12 is connected to the simulated urethra mouth 13. The simulated anus 14 is located below the simulated penis 11. The simulated penis 11 and the simulated anus 14 are respectively arranged corresponding to the arrangement positions of the penis and anus of a human male.

  FIG. 3 is a plan view of the genital model 1 viewed from the simulated bladder 2 side shown in FIG. Referring to FIG. 3, genital model 1 has recesses 15 and 16 and passage member 17. Each of the recesses 15 and 16 has, for example, a circular planar shape, and is recessed from the near side to the far side on the paper surface of FIG.

  The other end side of the simulated urethra 12 penetrates the genital model 1 from the back side to the near side on the paper surface of FIG. 3 and is connected to the bottom surface of the recess 15. The passage member 17 is connected to the bottom surface of the recess 16. The passage member 17 has a simulated anus 14 at the end opposite to the recess 16 side.

  4 is a cross-sectional view of the genital model 1 taken along line IV-IV shown in FIG. Referring to FIG. 4, the simulated urethra 12 is disposed in a region from the simulated urethral opening 13 to the bottom surface 15 </ b> A of the recess 15. The simulated urethra 12 communicates with the recess 15. The simulated urethra mouth 13 is disposed at the end of the simulated urethra 12 on the side opposite to the concave portion 15 side. The passage member 17 is disposed in a region from the simulated anus 14 to the bottom surface 16 </ b> A of the recess 16. The passage member 17 communicates with the recess 16. The simulated anus 14 is disposed at the end of the passage member 17 on the side opposite to the recess 16.

  FIG. 5 is an exploded view of the simulated bladder 2 shown in FIG. With reference to FIG. 5, the training simulator 10 further includes a backflow suppressing member 6.

  The simulated bladder 2 includes a main body 21 and a lid 22.

  The main body 21 has a substantially cylindrical shape. The main body 21 has an outlet 211 at the upper end in the vertical direction. The outlet portion 211 has a substantially cylindrical shape. And the exit part 211 has the screw | thread 211A provided spirally in the outer peripheral surface.

  The lid 22 has a cylindrical shape and is hollow inside. Moreover, the lid | cover 22 has a screw part (not shown) fitted to the screw 211A on the inner peripheral surface on the inner peripheral side. The lid 22 covers the backflow suppressing member 6 and fits with the screw 211 </ b> A of the outlet portion 211 of the main body portion 21. As a result, the backflow suppressing member 6 is disposed inside the outlet portion 211.

  The backflow suppression member 6 includes a backflow suppression valve 61 and a close contact member 62. The backflow suppression valve 61 is disposed inside the outlet portion 211, and a part thereof is disposed on the upper end portion in contact with the upper end portion of the outlet portion 211. The close contact member 62 is disposed on the backflow suppression valve 61 in contact with the top of the backflow suppression valve 61.

  FIG. 6 is a perspective view of the check valve 61 shown in FIG. FIG. 7 is a cross-sectional view of the backflow suppression valve 61 between line VII-VII shown in FIG.

  Referring to FIGS. 6 and 7, backflow suppression valve 61 includes a flange portion 611, a cylindrical portion 612, and an inclined portion 613. In FIG. 6, an x-axis, a y-axis, and a z-axis are defined. The x axis is set in the width direction of the inclined portion 613, the y axis is set in the thickness direction of the inclined portion 613, and the z axis is set in the height direction of the check valve 61.

  The flange portion 611 has a donut shape. The flange portion 611 has an outer diameter R and an inner diameter r. The outer diameter R is larger than the inner diameter of the outlet portion 211 of the simulated bladder 2 and is substantially the same as the outer diameter of the outlet portion 211. The inner diameter r is larger than the outer diameter of the catheter used for training using the training simulator 10. The outer diameter R1 is set to 22 mm, for example, and the inner diameter r is set to 11 mm, for example. The thickness of the flange part 611 is 1.5 mm, for example.

  The cylindrical portion 612 is disposed in contact with the flange portion 611 so that the inner peripheral surface coincides with the inner peripheral surface of the flange portion 611. The cylindrical part 612 has the same inner diameter as that of the flange part 611 and is smaller than the inner diameter of the outlet part 211 of the simulated bladder 2. The outer diameter R2 of the cylindrical portion 612 is set to 16 mm, for example, and the length L1 of the cylindrical portion 612 is set to 3 mm, for example.

  The inclined portion 613 has a taper structure 613A provided so that the internal space gradually becomes narrower in the direction from the flange portion 611 toward the inclined portion 613. In the taper structure 613A, as the direction from the flange portion 611 toward the inclined portion 613 is reached, the internal space gradually narrows in the left-right direction (the y-axis direction in FIG. 6) on the paper surface of FIG. The taper structure is constant in the direction from the front side to the back side (x-axis direction in FIG. 7).

  On the paper surface of FIG. 7, when the left inclined portion 613 is the inclined portion 613L and the right inclined portion 613 is the inclined portion 613R, the inclined portion 613L has the contact surface 613L1, and the inclined portion 613R is the contact surface 613R1. Have The contact surfaces 613L1 and 613R1 are provided along a surface perpendicular to the flange portion 611, and the contact surface 613L1 is in contact with the contact surface 613R1.

  The inclined part 613 has a slit part 613S (see FIG. 6). The width w of the slit portion 613S is narrower than the width W of the inclined portion 613. In the slit portion 613S, the contact surfaces 613L1 and 613R1 are in contact with each other when the catheter is not inserted into the backflow suppression valve 61 in the negative z-axis direction, and the catheter is in the negative z-axis direction. When inserted into the backflow control valve 61 toward the slit portion 613S, they are separated from each other. The length L2 along the z-axis of the inclined portion 613 is, for example, 16.2 mm.

  The flange portion 611, the cylindrical portion 612, and the inclined portion 613 are integrally formed, and are made of an elastic body, for example. The elastic body is, for example, rubber, and the hardness of the rubber is, for example, 50 degrees. And the backflow suppression valve 61 is manufactured by shaping | molding using a metal mold | die.

  FIG. 8 is a cross-sectional view of the backflow suppression valve 61 and the close contact member 62 between the lines VIII-VIII shown in FIG.

  Referring to FIG. 8, the contact member 62 has a disk shape and has a through hole 621. The contact member 62 is made of an elastic body, for example. The elastic body is, for example, resin and rubber. The diameter of the through hole 621 is smaller than the outer diameter of the catheter. Then, the axis X2 of the close contact member 62 coincides with the axis X1 of the backflow suppression valve 61.

  The hardness of the contact member 62 is determined in accordance with the range of the outer diameter of the catheter 20 used for urine training and enema training.

For example, there are three outer diameters R _OUT 1, R _OUT 2, R _OUT 3 as the outer diameters of the catheter 20 used for urine training and enema training, and the relationship of R _OUT 1 <R _OUT 2 <R _OUT 3 is established. In this case, when the catheter 20 having the smallest outer diameter R _OUT 1 is inserted into the through-hole 621, the contact member 62 is brought into close contact with the outer surface of the catheter 20 having the smallest outer diameter R _OUT 1 and the largest outer diameter is obtained. Even when the catheter 20 having R _OUT 3 is inserted into the through hole 621, the hardness of the contact member 62 is determined so that the contact member 62 is in close contact with the outer surface of the catheter 20 having the maximum outer diameter R _OUT 3. Is done.

In addition, when the catheter 20 used for urinary training and enema training has only one outer diameter R _OUT 4, when the catheter 20 having the outer diameter R _OUT 4 is inserted into the through-hole 621, the catheter 20 is closely attached. The hardness of the contact member 62 is determined so that the member 62 is in close contact with the outer surface of the catheter 20 having the outer diameter R _OUT 4.

  More specifically, for example, four types of catheters having outer diameters of 4.00 mm, 4.66 mm, 5.33 mm, and 6.00 mm are assumed as the catheter 20 used for urinary training and enema training.

  When the diameter of the through hole 621 is 4 mm and the hardness of the elastic body constituting the contact member 62 is 15, a catheter with an outer diameter of 4.00 mm and a catheter with an outer diameter of 4.66 mm are inserted into the through hole 621. The contact member 62 is in close contact with the outer surface of the catheter having an outer diameter of 4.00 mm and the catheter having an outer diameter of 4.66 mm.

  However, it is difficult to insert a catheter having an outer diameter of 5.33 mm and a catheter having an outer diameter of 6.00 mm into the through hole 621.

  Therefore, when the diameter of the through hole 621 is 4 mm, if the hardness of the elastic body constituting the contact member 62 is set to 5, all of the above four types of catheters can be inserted into the through hole 621, and the contact member 62 It adheres to the outer surface of four types of catheters.

  Therefore, when the catheter 20 used for urinary training and enema training is of the type of a catheter having an outer diameter of 4.00 mm and a catheter having an outer diameter of 4.66 mm, the hardness of the elastic body constituting the contact member 62 is set to 15. If the catheter 20 used for the urine training and enema training is the above four types of catheters, the hardness of the elastic body constituting the contact member 62 may be set to 5.

  Since the diameter of the through hole 621 is smaller than the outer diameter of the catheter 20, when the catheter 20 is inserted into the through hole 621 of the close contact member 62, the close contact member 62 contracts to the outer peripheral side and comes into close contact with the outer peripheral surface of the catheter 20. .

  FIG. 9 is a schematic view when the catheter is inserted into and withdrawn from the backflow suppressing member 6. In addition, although the backflow suppression valve 61 and the close contact member 62 of the backflow suppression member 6 are originally in contact with each other, in FIG. 9, in order to make the insertion of the catheter easier to understand, the backflow control valve 61 and the close contact member 62 Is shown separately.

  With reference to (a) of FIG. 9, before inserting the catheter 20 into the backflow suppression member 6, the slit part 613S of the backflow suppression valve 61 is closed.

  With reference to (b) of FIG. 9, when the catheter 20 is inserted into the through hole 621 of the contact member 62, the contact member 62 contracts in the outer peripheral direction and comes into close contact with the outer peripheral surface of the catheter 20. When the catheter 20 is inserted into the check valve 61, the contact surfaces 223L1 and 223R1 of the taper structure 223A are separated from each other, and the slit portion 613S is opened. As a result, the catheter 20 penetrates the slit portion 613S.

  In this case, a gap GP may be formed between the catheter 20 and the end of the inclined portion 613. When the gap GP is formed, water accumulated in the main body portion 21 of the simulated bladder 2 leaks from the outer surface side of the catheter 20 to the contact member 62 through the gap GP. However, since the close contact member 62 is in close contact with the outer surface of the catheter 20, the water leaked to the close contact member 62 does not leak from between the close contact member 62 and the catheter 20 to the outside.

If the outer diameter of the catheter 20 and the _{R K,} 2 × w (w is slit portion width of 613S) when inserted into the backflow inhibiting valve 61 a catheter 20 having an outer diameter _{R K} satisfies the relationship <.pi.R _K, regurgitation Since the suppression valve 61 is formed of an elastic body, the slit portion 613S extends, and the end of the inclined portion 613 is in close contact with the outer surface of the catheter 20. As a result, the gap GP is not formed. Accordingly, water does not leak from between the outer surface of the catheter 20 and the backflow suppression valve 61.

  After inserting the catheter 20 so as to penetrate the check valve 61 in the axial direction and then pulling out the catheter 20 from the check valve 61 and the close contact member 62, the slit portion 613S of the check valve 61 is closed, as shown in FIG. The state shown in FIG.

  Returning to the state shown in FIG. 9A, the slit portion 613S of the check valve 61 receives the pressure of water accumulated in the main body portion 21 of the simulated bladder 2 on the outer surface, and the contact surfaces 613L1 and 613R1 are They are pushed in the direction of strong contact with each other. As a result, water accumulated in the main body 21 of the simulated bladder 2 does not leak through the backflow suppression valve 61.

  FIG. 10 is a cross-sectional view of the simulated bladder 2 and the backflow suppressing member 6. Referring to FIG. 10, the lid 22 of the simulated bladder 2 has a through hole 221 at the upper end. The diameter of the through hole 221 is larger than the diameter of the through hole 621 of the contact member 62. The lid 22 has a screw 22A on the inner peripheral surface. The screw 22A is fitted to the screw 211A of the outlet portion 221 of the main body portion 21.

  The backflow suppression valve 61 is disposed inside the outlet portion 211 such that the flange portion 611 is disposed on the outlet portion 211 in contact with the outlet portion 211 of the main body portion 21. The close contact member 62 is disposed on the backflow suppression valve 61 in contact with the backflow suppression valve 61. Then, the axis X1 of the backflow suppression valve 61, the axis X2 of the contact member 62, the axis X3 of the lid 22, and the axis X4 of the main body portion 21 coincide with each other.

  The lid 22 of the simulated bladder 2 is disposed so as to cover the check valve 61 and the close contact member 62, and the screw 22 </ b> A of the lid 22 is fitted to the screw 211 </ b> A of the outlet portion 211 of the main body 21. Accordingly, the lid 22 fixes the backflow suppression valve 61 and the close contact member 62.

  FIG. 11 is a cross-sectional view of the genital model 1, the simulated bladder 2, and the backflow suppressing member 6 shown in FIG. Referring to FIG. 11, when the simulated bladder 2 is inserted into the recess 15 so that the lid 22 of the simulated bladder 2 incorporating the backflow suppressing member 6 contacts the bottom surface 15 </ b> A, the through-hole 221 of the lid 22 forms the simulated urethra 12. Communicate with.

  Therefore, the catheter 20 can be inserted into the simulated urethra 12 from the simulated urethral opening 13, and the catheter 20 can be inserted into the simulated bladder 2 via the backflow suppressing member 6 as described in FIG.

  In the embodiment of the present invention, the simulated bladder 2 containing the backflow suppressing member 6 may be inserted into the recess 16 so that the lid 22 contacts the bottom surface 16A. In this case, the simulated bladder 2 including the backflow suppressing member 6 is referred to as a “simulated rectum”.

  After inserting the simulated rectum into the recess 16, the catheter 20 can also be inserted into the simulated rectum via the simulated anus 14.

  FIG. 12 is a diagram for explaining urination training using the training simulator 10 shown in FIG.

  Referring to FIG. 12, the simulated bladder 2 containing the backflow suppressing member 6 is inserted into the recess 15. The height difference ΔH, which is the difference between the height position of the lower end portion of the storage container 5 and the height position of the simulated bladder 2, is set to 50 cm, for example.

  For example, 500 cc of water is stored in the storage container 5. The amount of sandwiching the hose 3 is adjusted by the adjusting member 4, and water is supplied from the storage container 5 to the simulated bladder 2. Accordingly, water pressure is applied from the outside to the slit portion 613S of the backflow suppression valve 61, and the slit portion 613S of the backflow suppression valve 61 is in a closed state.

  When the water in the simulated bladder 2 is almost full, the catheter 20 is inserted into the simulated urethra 12 from the simulated urethral opening 13, and further, the lid 22 of the simulated bladder 2 penetrates from the end of the simulated urethra 12 on the simulated bladder 2 side. The catheter 20 is inserted into the through hole 621 of the contact member 62 through the hole 221. Thereby, the contact member 62 is in close contact with the outer surface of the catheter 20.

  When the catheter 20 is further inserted into the simulated bladder 2 side, the distal end portion of the catheter 20 opens the slit portion 613S of the check valve 61 and is inserted into the water accumulated in the main body portion 21 of the simulated bladder 2. The

  Then, the water stored in the main body 21 of the simulated bladder 2 flows from the main body 21 to the outside through the catheter 20 because the water pressure due to the height difference ΔH is applied. Thereby, water (urine) can be taken out from the simulated bladder 2.

  When a predetermined amount of water (urine) is taken out from the simulated bladder 2 via the catheter 20, the catheter 20 is pulled in the direction from the simulated bladder 2 toward the simulated urethra 12, and the catheter 20 is pulled away from the simulated bladder 2, the backflow suppressing member 6, and the simulated urethra. Remove from 12.

  In this case, when the distal end portion of the catheter 20 on the simulated bladder 2 side passes through the slit portion 613S of the backflow suppression valve 61 from the simulated bladder 2 to the simulated urethra 12 side, the water pressure accumulated in the main body portion 21 causes the water pressure due to the water to be stored in the backflow suppression valve. 61 is applied to the slit portion 613S from the outside, and the slit portion 613S is closed. Therefore, even if water remains in the main body 21 after the urine training is completed, it is possible to suppress or prevent the water in the main body 21 from leaking to the outside. In addition, the water (urine) collected between the backflow suppression valve 61 and the close contact member 62 before the distal end of the catheter 20 passes through the slit portion 613S of the backflow control valve 61 is used by the close contact member 62 on the outer surface of the catheter 20. Therefore, it is possible to prevent leakage to the outside through the space between the simulated urethra 12 and the catheter 20. After the catheter 20 is removed from the close contact member 62, water accumulated between the back flow suppression valve 61 and the close contact member 62 may leak outside through the simulated urethra 12, but the back flow control valve Since the volume of the region surrounded by 61 and the close contact member 62 is smaller than the volume of the main body 21, the amount of water leaking to the outside can be suppressed as compared with the case where the backflow suppressing member 6 is not used.

  Thereafter, when the catheter 20 is removed from the simulated urethra 12, the urinary training is completed.

  In the urine transfer training, water (urine) may be taken out through the catheter 20 until all of the water (urine) accumulated in the storage container 5 disappears.

  In urine training using the training simulator 10, by setting the height difference ΔH to a value larger than 50 cm (for example, 100 cm), the water pressure applied to the slit portion 613S of the check valve 61 can be further increased, In order to insert the catheter 20 so that the catheter 20 penetrates the slit portion 613S of the check valve 61, a stronger force is required. This condition is a condition in which the prostate is enlarged due to prostate cancer and the urethra is narrowed.

  As described above, when the training simulator 10 is used, urinary training can be easily performed for a patient who has developed prostate cancer by increasing the height difference ΔH.

  Furthermore, in urine training using the training simulator 10, the water pressure applied from the outside to the slit portion 613S of the check valve 61 is set by setting the height difference ΔH to a value larger than 50 cm (for example, 120 cm or more). The catheter 20 can be set in a state in which the catheter 20 cannot penetrate the slit portion 613S of the check valve 61. By setting to such a state, the trainee can experience the state when the catheter 20 cannot be inserted into the simulated bladder 2.

  In this way, by using the training simulator 10, the trainee can easily perform the various kinds of training described above.

  When the diameter of the hose 3 is 5 mm, the width w of the slit portion 613S of the check valve 61 is 14 mm, and the length of the slit portion 613S in the z-axis direction is 0.5 mm, the height difference ΔH is 50 cm, 100 cm, and 120 cm. The water pressure applied to the slit portion 613S is as follows.

The area of the bottom surface of the hose 3 on the simulated bladder 2 side is (0.0025 m) ² × 3.14 = 1.962 × 10 ⁻⁵ m ² . The area of the slit portion 613S is 0.0005 m × 0.014 m = 7 × 10 ⁻⁶ m ² .

Therefore, when the height difference ΔH is 50 cm = 0.5 m, the water pressure P1 applied to the slit portion 613S of the check valve 61 is P1 = 1.96 × 10 ⁻⁵ [m ² ] × 0.5 [m. ] × 9.8 [kN / m ³ ] ÷ 7 × 10 ⁻⁶ [m ² ] = 1.3734 × 10 ⁴ [N / m ² ] = 1.3734 × 10 ⁴ [Pa].

Further, when the height difference ΔH is 100 cm = 1 m, the water pressure P2 applied to the slit portion 613S of the check valve 61 is P2 = 1.96 × 10 ⁻⁵ [m ² ] × 1 [m] × 9. 8 [kN / m ³ ] ÷ 7 × 10 ⁻⁶ [m ² ] = 2.7468 × 10 ⁴ [N / m ² ] = 2.7468 × 10 ⁴ [Pa].

Furthermore, when the height difference ΔH is 120 cm = 1.2 m, the water pressure P3 applied to the slit portion 613S of the check valve 61 is P3 = 1.962 × 10 ⁻⁵ [m ² ] × 1.2 [m. ] × 9.8 [kN / m ³ ] ÷ 7 × 10 ⁻⁶ [m ² ] = 3.229616 × 10 ⁴ [N / m ² ] = 3.229616 × 10 ⁴ [Pa].

As a result, when conducting urine training for a normal patient who is not a prostate cancer patient, the atmospheric pressure was added to the water pressure P1 of 1.3734 × 10 ⁴ [Pa] in the slit portion 613S of the check valve 61. Apply water pressure to conduct urination training.

Further, when conducting urinary training for a patient with prostate cancer, the water pressure obtained by adding the atmospheric pressure to the water pressure P2 of 2.7468 × 10 ⁴ [Pa] is applied to the slit portion 613S of the check valve 61. Conduct urine training.

Furthermore, when experiencing the state where the urethra is blocked, urine training is performed by applying a water pressure equal to or higher than the pressure obtained by adding atmospheric pressure to the water pressure P3 of 3.29616 × 10 ⁴ [Pa] to the slit portion 613S of the check valve 61. I do.

  The reason why the atmospheric pressure is added to the water pressures P1, P2, and P3 is that the atmospheric pressure is applied to the upper surface of the water in the storage container 5.

  As described above, in the embodiment of the present invention, urine training is performed by applying a water pressure (pressure) higher than the atmospheric pressure to the slit 613S of the check valve 61.

  In the embodiment of the present invention, the atmospheric pressure is added to any one of the water pressures P1, P2, and P3 in the slit portion 613S of the check valve 61 using the height difference ΔH between the simulated bladder 2 and the storage container 5. Not only when conducting urinary training by applying water pressure, the simulated bladder 2 and the storage container 5 are not connected by the hose 3, but water is injected into the simulated bladder 2 and a syringe is attached to the simulated bladder 2. Then, a water pressure obtained by adding atmospheric pressure to any of the water pressures P1, P2, and P3 may be applied to the slit portion 613S of the backflow suppression valve 61 by a syringe so that the slit portion 613S of the backflow suppression valve 61 is not immersed in water. Water may be injected into the simulated bladder 2 and a pressure corresponding to a pressure obtained by adding atmospheric pressure to any of the water pressures P1, P2, and P3 may be applied to the slit portion 613S of the check valve 61 using a pump. . That is, a pressure corresponding to a pressure obtained by adding atmospheric pressure to any of the water pressures P1, P2, and P3 by any means may be applied to the slit portion 613S of the backflow suppression valve 61.

  FIG. 13 is a diagram for explaining enema training using the training simulator 10 shown in FIG.

  Referring to FIG. 13, when performing enema training using training simulator 10, hose 3, adjustment member 4, and storage container 5 are not used, and simulated rectum 7 is inserted into recess 16. The simulated rectum 7 has the same configuration as the simulated bladder 2 and incorporates a backflow suppressing member 6. The main body 21 of the simulated rectum 7 is empty.

  In this state, the catheter 20 is inserted into the passage member 17 from the simulated anus 14, and further, the catheter 20 is inserted into the through hole 621 of the close contact member 62 through the through hole 221 of the lid 22 of the simulated rectum 7. Thereby, the contact member 62 is in close contact with the outer surface of the catheter 20.

  When the catheter 20 is further inserted into the simulated rectum 7 side, the distal end portion of the catheter 20 opens the slit portion 613S of the backflow suppression valve 61 and is inserted into the main body portion 21 of the simulated rectum 7.

  Then, enema fluid is injected into the simulated rectum 7 through the catheter 20. As a result, the enema fluid is stored in the simulated rectum 7.

  Thereafter, when the catheter 20 is removed from the simulated rectum 7 via the passage member 17, the enema training is completed.

  As described above, when the training simulator 10 is used, both urination training and enema training can be performed.

  FIG. 14 is a schematic diagram of another training simulator according to the embodiment of the present invention. The training simulator according to the embodiment of the present invention may be a training simulator 10A shown in FIG.

  Referring to FIG. 14, training simulator 10A is the same as training simulator 10 except that genital model 1 of training simulator 10 shown in FIG. 1 is replaced with genital model 1A.

  The genital model 1A is a human female genital model. The genital model 1A includes a simulated urethra (not shown in FIG. 14) arranged so as to reach the simulated bladder 2 from the simulated urethral opening at the center of the paired simulated labia. The genital model 1A is made of the same material as the genital model 1.

  In the training simulator 10A, the simulated bladder 2 is connected to the genital model 1A.

  FIG. 15 is a plan view of the genital model 1A viewed from the direction A shown in FIG. Referring to FIG. 15, genital model 1 </ b> A includes simulated small labia 31, simulated urethra 32, simulated urethral opening 33, and simulated anus 34. One end of the simulated urethra 32 is connected to the simulated urethral opening 33. The simulated anus 34 is located below the simulated labia 31. The simulated labia 31 and the simulated anus 34 are arranged corresponding to the positions of the labia minorus and anus of a human female, respectively.

  16 is a plan view of the genital model 1A viewed from the simulated bladder 2 side shown in FIG. Referring to FIG. 16, genital model 1 </ b> A has recesses 35 and 36 and a passage member 37. Each of the recesses 35 and 36 has, for example, a circular planar shape, and is recessed from the near side to the far side on the paper surface of FIG.

  The other end side of the simulated urethra 32 penetrates the genital model 1A from the back side to the near side on the paper surface of FIG. The passage member 37 penetrates the genital model 1 </ b> A from the back side to the near side on the paper surface of FIG. 16 and is connected to the recess 36. The passage member 37 has a simulated anus 34 at the end opposite to the recess 36 side.

  FIG. 17 is a cross-sectional view of the genital model 1A along the line XVII-XVII shown in FIG. Referring to FIG. 17, the simulated urethra 32 is disposed in a region from the simulated urethral opening 33 to the bottom surface 35 </ b> A of the recess 35. The simulated urethra 32 communicates with the recess 35. The simulated urethral port 33 is disposed at the end of the simulated urethra 32 on the opposite side to the recess 35. The passage member 37 is disposed in a region from the simulated anus 34 to the bottom surface 36 </ b> A of the recess 36. The passage member 37 communicates with the recess 36. The simulated anus 34 is disposed at the end of the passage member 37 opposite to the recess 36.

  18 is a cross-sectional view of the genital model 1A, the simulated bladder 2 and the backflow suppressing member 6 shown in FIG. Referring to FIG. 18, when the simulated bladder 2 is inserted into the recess 35 so that the lid 22 of the simulated bladder 2 incorporating the backflow suppressing member 6 contacts the bottom surface 35 </ b> A of the recess 35, the through hole 221 of the lid 22 is formed. It communicates with the simulated urethra 32.

  Therefore, the catheter 20 can be inserted into the simulated urethra 32 from the simulated urethral opening 33, and the catheter 20 can be inserted into the simulated bladder 2 via the backflow suppressing member 6 as described in FIG.

  In the embodiment of the present invention, the simulated bladder 2 containing the backflow suppressing member 6 may be inserted into the recess 36 so that the lid 22 contacts the bottom surface 36 </ b> A of the recess 36. In this case, the simulated bladder 2 including the backflow suppressing member 6 is referred to as a “simulated rectum”.

  After inserting the simulated rectum into the recess 36, the catheter 30 can also be inserted through the simulated anus 34 into the simulated rectum.

  FIG. 19 is a diagram for explaining urination training using the training simulator 10A shown in FIG.

  Referring to FIG. 19, the simulated bladder 2 including the backflow suppressing member 6 is inserted into the recess 35. The height difference ΔH, which is the difference between the height position of the lower end portion of the storage container 5 and the height position of the simulated bladder 2, is set to 50 cm, for example.

  For example, 500 cc of water is stored in the storage container 5. The amount of sandwiching the hose 3 is adjusted by the adjusting member 4, and water is supplied from the storage container 5 to the simulated bladder 2. Accordingly, water pressure is applied from the outside to the slit portion 613S of the backflow suppression valve 61, and the slit portion 613S of the backflow suppression valve 61 is in a closed state.

  When the water in the simulated bladder 2 is almost full, the catheter 20 is inserted into the simulated urethra 32 from the simulated urethral opening 33, and further, the end of the simulated urinary tract 32 on the simulated bladder 2 side penetrates the lid 22 of the simulated bladder 2. The catheter 20 is inserted into the through hole 621 of the contact member 62 through the hole 221. Thereby, the contact member 62 is in close contact with the outer surface of the catheter 20.

  When the catheter 20 is further inserted into the simulated bladder 2 side, the distal end portion of the catheter 20 opens the slit portion 613S of the check valve 61 and is inserted into the water accumulated in the main body portion 21 of the simulated bladder 2. The

  Then, the water accumulated in the main body 21 of the simulated bladder 2 flows from the main body 21 to the outside through the catheter 20 due to the water pressure due to the height difference ΔH. Thereby, water (urine) can be taken out from the simulated bladder 2.

  When a predetermined amount of water (urine) is taken out from the simulated bladder 2 via the catheter 20, the catheter 20 is pulled in the direction from the simulated bladder 2 toward the simulated urethra 32, and the catheter 20 is moved to the simulated bladder 2, the backflow suppressing member 6, and the simulated urethra. Remove from 32.

  In this case, when the distal end portion of the catheter 20 on the simulated bladder 2 side passes from the simulated bladder 2 toward the simulated urethra 12 through the slit portion 613S of the backflow suppression valve 61, the water pressure accumulated in the main body portion 21 suppresses the backflow. Since the slit 61 is applied from the outside to the slit 613S of the valve 61, the slit 613S is closed. Therefore, even if water remains in the main body 21 after the urine training is completed, it is possible to suppress or prevent the water in the main body 21 from leaking to the outside. In addition, the water (urine) collected between the backflow suppression valve 61 and the close contact member 62 before the distal end of the catheter 20 passes through the slit portion 613S of the backflow control valve 61 is used by the close contact member 62 on the outer surface of the catheter 20. Therefore, it is possible to suppress leakage to the outside through the space between the simulated urethra 32 and the catheter 20. After the catheter 20 is removed from the close contact member 62, the water accumulated between the back flow suppression valve 61 and the close contact member 62 may leak to the outside through the simulated urethra 32. Since the volume of the region surrounded by 61 and the close contact member 62 is smaller than the volume of the main body 21, the amount of water leaking to the outside can be suppressed as compared with the case where the backflow suppressing member 6 is not used.

  Thereafter, when the catheter 20 is removed from the simulated urethra 32, the urine training is completed.

  The other explanation about the urinary training using the training simulator 10A is the same as the explanation about the urine training using the training simulator 10.

  FIG. 20 is a diagram for explaining enema training using the training simulator 10A shown in FIG.

  Referring to FIG. 20, when enema training is performed using training simulator 10 </ b> A, hose 3, adjustment member 4, and storage container 5 are not used, and simulated rectum 7 is inserted into recess 36. The simulated rectum 7 has the same configuration as the simulated bladder 2 and incorporates a backflow suppressing member 6. The main body 21 of the simulated rectum 7 is empty.

  In this state, the catheter 20 is inserted into the passage member 37 from the simulated anus 34, and the catheter 20 is further inserted into the through hole 621 of the close contact member 62 through the through hole 221 of the lid 22 of the simulated rectum 7. Thereby, the contact member 62 is in close contact with the outer surface of the catheter 20.

  When the catheter 20 is further inserted into the simulated rectum 7 side, the distal end portion of the catheter 20 opens the slit portion 613S of the backflow suppression valve 61 and is inserted into the main body portion 21 of the simulated rectum 7.

  Then, enema fluid is injected into the simulated rectum 7 through the catheter 20. As a result, the enema fluid is stored in the simulated rectum 7.

  Thereafter, when the catheter 20 is removed from the simulated rectum 7 via the passage member 37, the enema training is completed.

  Thus, when the training simulator 10A is used, both urination training and enema training can be performed.

  FIG. 21 is a flowchart for explaining a training instruction method using the training simulator 10 shown in FIG.

  Referring to FIG. 21, when training instruction is started, the instructor asks the trainee whether or not to conduct urinary training (step S1).

  In step S1, when instructed to conduct urine training, the instructor further asks the trainee whether or not to perform enema training (step S2).

  In step S2, when the instructor hears that enema training is performed, the instructor instructs the urine training using the training simulator 10 (step S3).

  Thereafter, the instructor instructs enema training using the training simulator 10 (step S4).

  In the embodiment of the present invention, step S3 may be executed after step S4 is executed.

  On the other hand, when the instructor hears that urine training is not performed in step S1, the instructor further asks the trainee whether or not enema training is performed (step S5).

  In step S5, when the instructor hears that enema training is performed, the instructor is instructed using the training simulator 10 (step S6).

  On the other hand, when it is heard in step S2 that the enema training is not performed, the instructor instructs the urine training using the training simulator 10 (step S7).

  In step S5, when the instructor hears that enema training is not performed, or after any of step S4, step S6, and step S7, the training instruction is terminated.

  A training instruction method using the training simulator 10A is also executed according to the flowchart shown in FIG.

  According to the training instruction method shown in FIG. 21, at least one of urination training and enema training can be instructed (see steps S3, S4, S6, and S7).

  FIG. 22 is a flowchart for explaining the detailed operation of step S3 shown in FIG.

  Referring to FIG. 22, when it is heard in step S <b> 2 of FIG. 21 that the instructor performs enema training, the instructor touches the end of the simulated urethra 12 with the simulated bladder 2 including the backflow suppressing member 6. Is instructed to be installed in the recess 15 (step S31).

  Then, the instructor instructs the storage container 5 to put a predetermined amount of water (step S32). Thereafter, the instructor asks the trainee whether or not to conduct urination training for a patient with prostate cancer (step S33).

  In step S33, the instructor further asks the trainee whether or not to conduct urinary training for the patient whose mock urethra 12 is obstructed when hearing that urinary training is not performed for the patient with prostate cancer (step S33). Step S34).

  In step S34, when the instructor hears that urination training is not performed for the patient whose simulated urethra 12 is blocked, the instructor calculates the height difference ΔH between the height position of the storage container 5 and the height position of the simulated bladder 2. Instruction is given to set the first height difference (for example, 50 cm) (step S35).

  On the other hand, when the instructor hears in step S33 that urination training for a prostate cancer patient is to be performed, the instructor instructs to set the height difference ΔH to the second height difference (for example, 100 cm) (step S36). ). Thereafter, the series of operations proceeds to step S38.

  On the other hand, when the instructor hears in step S34 that he / she conducts urinary conduction training for the patient whose mock urethra 12 is obstructed, the instructor instructs to set the height difference ΔH to the third height difference (for example, 150 cm). (Step S37). Thereafter, the series of operations proceeds to step S38.

  After any of Step S35, Step S36, and Step S37, the instructor instructs to supply water from the storage container 5 to the simulated bladder 2 (Step S38).

  Then, when water is supplied to the simulated bladder 2, the instructor instructs the simulated urethra 12 to insert the catheter 20 (step S39), and the catheter 20 is inserted into the simulated bladder 2 via the backflow suppressing member 6. Instruction is given to insert (step S40).

  Thereafter, the instructor asks the trainee whether the catheter 20 has been inserted into the simulated bladder 2 (step S41).

  When the instructor hears that the catheter 20 has been inserted into the simulated bladder 2 in step S41, the instructor instructs to confirm that water has been discharged from the simulated bladder 2 via the catheter 20 (step S42). ).

  Thereafter, the instructor instructs to remove the catheter 20 from the simulated bladder 2 and the simulated urethra 12 (step S43).

  On the other hand, when the instructor hears that the catheter 20 has not been inserted into the simulated bladder 2 in step S41, the instructor gives an instruction to experience a sense that the catheter 20 cannot be inserted into the simulated bladder 2 (step S44).

  And after step S43 or step S44, a series of operation | movement transfers to step S4 of FIG.

  In addition, the guidance method of urination training using 10 A of training simulators is also performed according to the flowchart shown in FIG.

  21 is also executed according to the flowchart shown in FIG. 22.

  Furthermore, step S35 of FIG. 22 is generally a step of “instructing to apply the first pressure to the slit portion of the backflow suppression valve”, and step S36 is generally “backflow suppression. Instructing to apply a second pressure higher than the first pressure to the slit portion of the valve ”is generally a step, and step S37 generally includes“ the second pressure in the slit portion of the check valve ”. Is instructed to apply a strong third pressure "step. In this case, the means for applying the first pressure, the second pressure, and the third pressure to the slit portion of the backflow suppression valve sets the height difference ΔH between the simulated bladder 2 and the storage container 5 to a predetermined height difference. Not only the method but also various means described above may be used.

  FIG. 23 is a flowchart for explaining the detailed operation of step S4 of FIG.

  Referring to FIG. 23, after step S3 in FIG. 21, the instructor instructs to insert catheter 20 from simulated anus 14 into passage member 17 (step S51).

  Then, the instructor instructs the catheter 20 to be inserted into the simulated rectum 7 through the backflow suppressing member 6 (step S52).

  Subsequently, when the catheter 20 is inserted into the simulated rectum 7, the instructor instructs the infusion of enema fluid into the simulated rectum 7 through the catheter 20 (step S53).

  Then, when the enema fluid is injected into the simulated rectum 7, the instructor instructs the catheter 20 to be removed from the simulated rectum 7 and the passage member 17 (step S54). Thereafter, the series of operations proceeds to the end of FIG.

  The enema training instruction method using the training simulator 10A is also executed according to the flowchart shown in FIG.

  The enema training instruction method shown in step S6 of FIG. 21 is also executed according to the flowchart shown in FIG.

  FIG. 24 is a schematic diagram of a human body related to urinary tract training and enema training. (A) of FIG. 24 shows a schematic diagram of a man related to urine training and enema training, and (b) of FIG. 24 shows a schematic diagram of a woman related to urine training and enema training.

  Referring to (a) of FIG. 24, in men, the prostate is disposed in a portion near the internal urethral opening of the bladder.

  On the other hand, in the training simulator 10, the backflow suppression valve 61 of the backflow suppression member 6 is disposed inside the lid 22 of the simulated bladder 2 (see FIG. 10). Then, by controlling the water pressure applied to the inclined portion 613 of the backflow suppression valve 61, the slit portion 613S of the backflow suppression valve 61 can be made difficult to open, and within the lid 22 of the simulated bladder 2 (within the prostate cancer patient) In the vicinity of the urethral opening), a urethral state in which the catheter 20 is difficult to insert can be simulated.

  Therefore, by conducting urinary training using the training simulator 10, it is possible to train a patient with prostate cancer so that urination can be successfully performed.

  Further, by conducting urinary training using the training simulator 10, it is possible to experience the sensation of inserting the catheter 20 into the urethra of a prostate cancer patient.

  In men, the urethra passes through the prostate, and damaging the prostate during insertion of the catheter 20 can cause prostatitis and bleeding.

  In the training simulator 10, the backflow suppression valve 61 is disposed at a position close to the position of the prostate. Therefore, the catheter 20 is inserted from the simulated urethral opening 13 to the backflow suppression valve 61 in the training simulator 10, and further the backflow suppression is performed. Urine guidance training can be performed so as not to damage the prostate when the catheter 20 is inserted into the main body 21 of the simulated bladder 2 through the valve 61.

  Since the region REG1 shown in FIG. 24A is disposed between the anus and the rectum, the portion corresponding to the region REG1 is used as the passage member 17 in the training simulator 10.

  In addition, since the region REG2 shown in FIG. 24B is disposed between the anus and the rectum, the portion corresponding to the region REG2 is used as the passage member 37 in the training simulator 10A.

  Since the length of the urethra is about 16 cm to 25 cm in men and 3 cm to 4 cm in women, the training simulator 10 has a simulated urethra 12 having a length of about 16 cm to 25 cm, and training. The simulator 10A has a simulated urethra 32 having a length of 3 cm to 4 cm. Therefore, urinary training can be performed using the actual length of the urethra by performing urinary training using the training simulators 10 and 10A.

FIG. 25 is a cross-sectional view for explaining the distance between the backflow suppression valve 61 and the contact member 62. Referring to FIG. 25, when the distance between the contact member 62 and the backflow suppression valve 61 and _{L A,} the distance _{L A} is increased, the volume of the region REG3 (hatched region) becomes larger, the distance _L A = 0 When the contact member 62 is in contact with the backflow suppression valve 61, the volume of the region REG3 is minimized.

  When the catheter 20 is inserted into the main body 21 of the simulated bladder 2 through the check valve 61, as described above, it is formed between the catheter 20 and the end of the inclined part 613 of the check valve 61. There is a possibility that water in the main body 21 flows into the region REG3 through the gap GP (see FIG. 9B).

  Even if water accumulates in the region REG 3 while the catheter 20 is inserted into the simulated bladder 2, the contact member 62 is in close contact with the outer surface of the catheter 20, so that water is interposed between the catheter 20 and the simulated urethra 12. Will not leak to the outside.

  However, after the catheter 20 is removed from the simulated bladder 2, the backflow suppression valve 61, the contact member 62, and the simulated urethra 12, water accumulated in the region REG3 may leak to the outside. In order to solve the problem of suppressing the leakage of water to the outside, the amount of water leaking to the outside may be made smaller than the maximum amount of water accumulated in the simulated bladder 2. That is, the volume of the region REG3 may be made smaller than the volume of the main body portion 21 of the simulated bladder 2.

Accordingly, the distance L _A is set to a distance the volume of the region REG3 is smaller than the volume of the main body portion 21 of the simulated bladder 2. Then, the distance _{L A} is most preferably set to 0 mm. This is because the amount of water leaking to the outside can be minimized.

  When the close contact member 62 is disposed closer to the simulated urethral opening 13 than the backflow suppression valve 61, urine can be introduced when the distal end portion of the catheter 20 penetrates the slit portion 613S of the backflow suppression valve 61.

  FIG. 26 is a view for explaining the arrangement relationship between the backflow suppression valve 61 and the close contact member 62. Referring to FIG. 26, the close contact member 62 may be disposed closer to the main body 21 than the backflow suppression valve 61. In this case, urine can be introduced when the distal end portion of the catheter 20 penetrates the through hole 621 of the contact member 62.

  When the distal end portion of the catheter 20 does not penetrate the slit portion 613S of the check valve 61, the water in the main body portion 21 flows into the region REG4 (hatched region) through the through hole 621 of the contact member 62. .

  Even if water flows into the region REG4, the pressure in the slit 613S of the check valve 61 is applied by the water in the region REG4, so that the water accumulated in the region REG4 is prevented from leaking to the simulated urethra 12 side. it can.

  However, if the catheter 20 is inserted into the body portion 21 of the simulated bladder 2 through the backflow suppression valve 61 and the close contact member 62 with water accumulated in the region REG4, the inclined portion 613 of the catheter 20 and the backflow suppression valve 61 There is a possibility that water accumulated in the region REG4 leaks to the outside through a gap GP (see FIG. 9B) formed between the end portions.

  In this case, in order to solve the problem of suppressing the leakage of water to the outside, the amount of water leaking to the outside may be made smaller than the maximum amount of water accumulated in the simulated bladder 2. That is, the volume of the region REG4 may be made smaller than the volume of the main body portion 21 of the simulated bladder 2.

Accordingly, the distance L _B is set to a distance the volume of the region REG4 is smaller than the volume of the main body portion 21 of the simulated bladder 2. When the contact member 62 is a distance _{L B-- min} a distance _{L B} when in contact with the front end portion of the slit portion 613S of the reverse flow suppression valve 61, the distance _{L B} is most preferably set to a distance _{L B-- min.} This is because the amount of water leaking to the outside can be minimized.

  When the catheter 20 passes through the slit portion 613S of the check valve 61 and the through hole 621 of the close contact member 62, the close contact member 62 is in close contact with the outer surface of the catheter 20, so Water does not flow into REG4.

  FIG. 27 is a schematic view of another backflow suppressing member. Referring to FIG. 27, each of training simulators 10, 10 </ b> A may include a backflow suppression member 6 </ b> A instead of backflow suppression member 6.

  The backflow suppressing member 6A is obtained by replacing the close contact member 62 of the backflow suppressing member 6 with the close contact member 62A, and is otherwise the same as the backflow suppressing member 6.

  The contact member 62A has a disk shape and has a through hole 621A. The outer diameter of the close contact member 62 </ b> A substantially matches the inner diameter of the flange portion 611 of the check valve 61. The diameter of the through hole 621A may be the same as the diameter of the through hole 621 or may be different from the diameter of the through hole 621. Generally, when the catheter 20 penetrates the through hole 621A, the catheter 20 The diameter may be in close contact with the outer surface. The diameter of the through hole 621 may be determined according to the hardness of the contact member 62A.

  The other description of the contact member 62A is the same as the description of the contact member 62 described above.

  In the backflow suppressing member 6A, the contact member 62A is disposed at an arbitrary position in the region REG5. The contact member 62A is fixed to the backflow suppression valve 61 with an adhesive, for example.

  The close contact member 62 </ b> A may be manufactured integrally with the backflow suppression valve 61. Further, in the backflow suppressing member 6A, the close contact member may be disposed in the region REG6. In this case, a close contact member 62B having a through hole 621B is used. The diameter of the through hole 621B is determined according to the outer diameter of the catheter 20 and the hardness of the contact member 62B.

  In the region REG6, since the shape of the plane perpendicular to the axis X1 of the backflow suppression valve 61 is an elliptical shape, the contact member 62B has an elliptical planar shape. The close contact member 62 </ b> B is fixed to the backflow suppression valve 61 with an adhesive, or is manufactured integrally with the backflow suppression valve 61.

  Even when each of the training simulators 10 and 10A includes the backflow suppressing member 6A, the urination training and the enema training are performed by the above-described methods, and the training instruction method using the training simulators 10 and 10A is illustrated in FIGS. This is executed according to the flowchart shown in FIG.

  FIG. 28 is a schematic view of still another backflow suppressing member. Referring to FIG. 28, each of training simulators 10, 10 </ b> A may include a backflow suppression member 6 </ b> B instead of backflow suppression member 6.

  The backflow suppression member 6B is obtained by replacing the backflow suppression valve 61 of the backflow suppression member 6 with a backflow suppression valve 61A, and is otherwise the same as the backflow suppression member 6.

  The backflow suppression valve 61A is the same as the backflow suppression valve 61 except that the flange portion 611 of the backflow suppression valve 61 is deleted and the cylindrical portion 612 is replaced with the cylindrical portion 612A.

  The cylindrical portion 612A has the same outer diameter and inner diameter as the cylindrical portion 612, and has a length longer than the length of the cylindrical portion 612 in the axis X1 direction.

  In the backflow suppression member 6B, the contact member 62 is disposed between the simulated urethra 12 and the backflow suppression valve 61A, and is in contact with the simulated urethra 12 and the backflow suppression valve 61A. And the volume of area | region REG7 enclosed by 61 A of backflow suppression valves and the contact | adherence member 62 is smaller than the volume of the main-body part 21 of the simulation bladder 2A mentioned later.

  Therefore, each of the training simulators 10 and 10 </ b> A includes a backflow suppressing member 6 </ b> B disposed at one end of the simulated urethra 12.

  FIG. 29 is a cross-sectional view for explaining the arrangement state of the backflow suppressing member 6B shown in FIG. Referring to FIG. 29, the backflow suppressing member 6 </ b> B is disposed in the recess 15 of the genital model 1. More specifically, the close contact member 62 of the backflow suppressing member 6 </ b> B is disposed on the bottom surface 15 </ b> A of the recess 15 in contact with one end of the simulated urethra 12. In this case, the close contact member 62 may be fixed to the bottom surface 15 </ b> A of the recess 15 by an adhesive, for example.

  The cylindrical portion 612 </ b> A of the backflow suppression valve 61 </ b> A is disposed in the recess 15 in contact with the contact member 62. In this case, the end portion of the cylindrical portion 612A of the check valve 61A may be fixed to the contact member 62 with an adhesive, for example.

  When the backflow suppressing member 6B is used, the simulated bladder 2A is used. The simulated bladder 2A is the same as the simulated bladder 2 except that the lid 22 of the simulated bladder 2 is deleted.

  And the exit part 211 of the main-body part 21 of the simulated bladder 2A is arrange | positioned between the recessed part 15 and the backflow suppression valve 61A so that the edge part of an axial direction may contact the bottom face 15A of the recessed part 15. FIG. In this case, the outer diameter of the outlet portion 211 of the main body portion 21 is substantially the same as the diameter of the concave portion 15, and the simulated bladder 2A is inserted by inserting the outlet portion 211 between the concave portion 15 and the check valve 61A. Is fixed to the genital model 1.

  When the simulated bladder 2A is used as a simulated rectum, the close contact member 62 of the backflow suppressing member 6B is disposed on the bottom surface 16A of the recess 16 in contact with one end of the passage member 17. In this case, the close contact member 62 may be fixed to the bottom surface 16A of the concave portion 16 by an adhesive, for example.

  Further, the cylindrical portion 612 </ b> A of the check valve 61 </ b> A is disposed in the recess 16 in contact with the contact member 62. In this case, the end portion of the cylindrical portion 612A of the check valve 61A may be fixed to the contact member 62 with an adhesive, for example.

  Even when the backflow suppressing member 6B is used in the training simulator 10, the same effect as when the backflow suppressing member 6 is used in the training simulator 10 can be obtained.

  Even when the training simulator 10A includes the backflow suppressing member 6B, the backflow suppressing member 6B is attached to the recess 35 or the recess 36 of the genital model 1A by the same method as described in FIG.

  Therefore, even when the backflow suppressing member 6B is used in the training simulator 10A, the same effect as that obtained when the backflow suppressing member 6 is used in the training simulator 10A can be obtained.

  In the backflow suppressing member 6B, the contact member 62 may be disposed closer to the main body portion 21 side of the simulated bladder 2A than the backflow suppressing valve 61A as shown in FIG. 26, and the backflow suppressing valve as shown in FIG. It may be arranged inside 61A.

  FIG. 30 is a cross-sectional view of another simulated urethra. Referring to FIG. 30, the simulated urethra 12 </ b> A is obtained by adding a space 121 to the simulated urethra 12.

  The space 121 has an axis that coincides with the axis of the simulated urethra 12 and has a cylindrical shape. The space part 121 has a diameter substantially equal to the outer diameter of the cylindrical part 612A of the check valve 61A. The space 121 has a length that is equal to or greater than the axial length of the backflow suppression valve 61A in the axial direction. The space 121 is provided at an arbitrary position between one end and the other end of the simulated bladder 12A.

  31 is a cross-sectional view showing a state in which the backflow suppressing member 6B shown in FIG. 28 is arranged on the simulated urethra 12A shown in FIG.

  Referring to FIG. 31, the backflow suppressing member 6B is disposed in the space 121 of the simulated urethra 12A. In this case, the contact member 62 is disposed closer to the simulated urethral opening 13 than the backflow suppression valve 61A. The cylindrical portion 612A of the backflow suppression valve 61A is disposed in contact with the contact member 62.

  The close contact member 62 may be disposed closer to the simulated bladder 2 than the backflow suppression valve 61A.

  FIG. 32 is a diagram showing an arrangement state of the backflow suppressing member 6B shown in FIG. 28 on the genital model. Referring to FIG. 32, genital model 1B is the same as genital model 1 except that simulated urethra 12 of genital model 1 is replaced with simulated urethra 12A and passage member 17 is replaced with passage member 17A. .

  The passage member 17A has a space 171. The space portion 171 has a cylindrical shape and has the same diameter and length as the space portion 121.

  The backflow suppressing member 6 </ b> B is disposed in the space part 121. The outlet portion 211 and the lid 22 of the simulated bladder 2A are installed in the recess 15.

  A backflow suppressing member having the same configuration as that of the backflow suppressing member 6 </ b> B is disposed in the space portion 171.

  Thus, even when the backflow suppressing member 6B is arranged at an arbitrary position between both ends of the simulated urethra 12A, water leaking to the outside can be suppressed.

  Further, when the backflow suppressing member 6B is disposed at an arbitrary position between both ends of the simulated urethra 12A, the simulated penis 11 is made of an elastic body, and therefore the portion of the simulated penis 11 adjacent to the slit portion 613S of the backflow suppressing valve 61A. By applying a force to, a force can be applied to the slit portion 613S of the check valve 61A, and a prostate cancer state can be realized.

  The genital model 1B may include a passage member 17 instead of the passage member 17A. In this case, no backflow suppressing member is disposed in the passage member 17.

  In the training simulator 10A, the genital model 1A may be deformed in the same manner as the genital model 1B, and the backflow suppressing member 6B may be disposed in the middle of the simulated urethra and / or passage member.

  Even when each of the training simulators 10 and 10A includes the backflow suppressing member 6B, urination training and enema training are performed by the methods described above, and the training instruction method using the training simulators 10 and 10A is shown in FIGS. This is executed according to the flowchart shown in FIG.

  FIG. 33 is a plan view of another contact member. Referring to FIG. 33A, the contact member 62C is the same as the contact member 62 except that the through hole 621 of the contact member 62 is replaced with a cut 621C. The cut line 621C has a cross shape and penetrates the contact member 62C in the thickness direction. The diameter of the region where the cut line 621C is disposed (the region indicated by the dotted line) is smaller than the diameter of the catheter 20.

  Referring to FIG. 33B, the contact member 62D is the same as the contact member 62 except that the through hole 621 of the contact member 62 is replaced by a cut 621D. The cut line 621D has a radial shape and penetrates the contact member 62D in the thickness direction. The diameter of the area where the cut line 621D is disposed (the area indicated by the dotted line) is smaller than the diameter of the catheter 20. In the contact member 62D, the cut 621D has a planar shape in which eight lines radially extend from the center of the contact member 62D. However, in the embodiment of the present invention, the present invention is not limited to this. 621D may have a planar shape in which two or more lines extend radially from the center of the contact member 62D in the circumferential direction.

  In the embodiment of the present invention, the through holes 621, 621A, 621B of the close contact members 62, 62A, 62B, the cut 621C of the close contact member 62C, and the cut 621D of the close contact member 62D form a “passing portion” through which the catheter 10 passes. Configure.

  In the embodiment of the present invention, the water used for urine training and the enema fluid used for enemas training are trained using the training simulator according to the embodiment of the present invention (at least urine training and enemas training). The “liquid” used in one training).

  Furthermore, in the embodiment of the present invention, the storage container 5 in which water is stored is arranged at a position higher than the arrangement position of the simulated bladder 2 (or the simulated bladder 2A), so that the backflow control valves 61 and 61A. A pressure is applied to the slit 613S. Therefore, the storage container 5 that is arranged at a position higher than the arrangement position of the simulated bladder 2 (or the simulated bladder 2A) and stores water is a “pressurizer” that applies pressure to the slits 613S of the backflow control valves 61 and 61A. Configure.

  In the above description, the backflow suppression member 6 is described as including the backflow suppression valve 61 and the contact member 62, and the backflow suppression member 6A is described as including the backflow suppression valve 61 and the contact member 62A, and the backflow suppression is described. Although it has been described that the member 6B includes the backflow suppression valve 61A and the close contact member 62, in the embodiment of the present invention, the backflow suppression member 6 includes only the backflow suppression valve 61. The backflow suppression member 6A may include only the backflow suppression valve 61 (that is, the backflow suppression member 62A may not be included), or the backflow suppression member may be included. 6B may include only the backflow suppression valve 61A (that is, the close contact member 62 may not be included). Even if the backflow suppressing members 6, 6 </ b> A, 6 </ b> B do not include the contact members 62, 62 </ b> A, 62, respectively, the simulated bladder 2, 2 </ b> A through the slit portion 613 </ b> S of the backflow suppressing valves 61, 61 </ b> A during urination training. The amount of water (urine) leaking to the outside is a part of the water (urine) accumulated in the simulated bladder 2, 2A, and the water leaking to the outside rather than the case where the backflow suppressing members 6, 6A, 6B are not used. This is because the amount of (urine) can be suppressed (that is, the problem can be solved).

  In the above description, it has been described that each of the training simulators 10 and 10A includes the storage container 5. However, in order to solve the problem of suppressing the amount of water leaking during or after training, the training simulators 10 and 10A Each may not have the storage container 5.

  Therefore, the training simulator according to the embodiment of the present invention includes a simulated member made of a simulated bladder or a simulated rectum, and a tube member having one end in contact with the simulated member and having a simulated urethral opening or simulated anus at the other end. It is only necessary to include a backflow suppressing member that prevents the flow of liquid from the simulated member to the insertion port side.

  The training instruction method according to the embodiment of the present invention is a training instruction method for instructing at least one of urinary training and enema training using the training simulator according to the embodiment of the present invention, wherein a catheter is inserted. What is necessary is just to provide the 1st step which instruct | indicates that it inserts into a simulation member from a mouth, and the 2nd step which instruct | indicates that a catheter is extracted from the said simulation member after inserting a catheter into a simulation member.

  The embodiment disclosed this time should be considered as illustrative in all points and not restrictive. The scope of the present invention is shown not by the above description of the embodiments but by the scope of claims for patent, and is intended to include meanings equivalent to the scope of claims for patent and all modifications within the scope.

  The present invention is applied to a training simulator and a training instruction method using the training simulator.

  1, 1A, 1B Genital model, 2, 2A Simulated bladder, 3 Hose, 4 Adjusting member, 5 Storage container, 6, 6A, 6B Backflow suppressing member, 10 Training simulator, 11 Simulated penis, 12, 12A, 32 Simulated urethra, 13, 33 Simulated urethral opening, 14, 34 Simulated anus, 15, 16, 35, 36 Recess, 17, 37 Passage member, 20 Catheter, 21 Body, 22 Lid, 31 Simulated labia, 211 Outlet, 61 Backflow suppression Valve, 62, 62A, 62B, 62C, 62D Contact member, 121, 171 Space part, 221, 621, 621A, 621B Through hole, 611 Flange part, 612, 612A Cylindrical part, 613 Inclined part, 613S Slit part, 613L1, 613R1 contact surface, 621C, 621D cut.

Claims (10)

A simulated member consisting of a simulated bladder or simulated rectum;
A tube member having one end in contact with the simulated member and having an insertion port made of a simulated urethral orifice or simulated anus at the other end;
A training simulator provided with the backflow suppression member which suppresses the flow of the liquid from the said simulation member to the said insertion port side. The simulated member consists of the simulated bladder,
The tube member consists of a simulated urethra having one end in contact with the simulated bladder and the simulated urethral opening at the other end,
The training simulator according to claim 1, wherein the backflow suppressing member suppresses a flow of liquid from the simulated bladder to the simulated urethral opening side. The simulated member consists of the simulated rectum,
The tube member comprises a passage member having one end in contact with the simulated rectum and the simulated anus at the other end,
The training simulator according to claim 1, wherein the backflow suppressing member suppresses a flow of liquid from the simulated rectum to the simulated anus. The backflow suppressing member is
A backflow suppression valve that suppresses the flow of liquid from the simulated member to the insertion port side;
The contact member which has a passage part which passes the catheter inserted in the tube member to the simulation member side, and adheres to the catheter when the catheter is inserted in the passage part. 4. The training simulator according to any one of 3 above.   The training simulator according to claim 4, further comprising a pressurizer that applies pressure to the slit portion of the check valve. The simulated member is
A first simulated member comprising the simulated bladder;
A second simulated member comprising the simulated rectum,
The pipe member is
A simulated urethra having one end in contact with the first simulated member and having the simulated urethral opening at the other end;
A passage member having one end in contact with the second simulated member and having the simulated anus at the other end;
The backflow suppressing member is
A first backflow suppression member that suppresses the flow of fluid from the simulated bladder to the simulated urethral orifice side;
The training simulator according to claim 1, further comprising a second backflow suppressing member that suppresses a flow of liquid from the simulated rectum to the simulated anal side. The first backflow suppressing member is
A first backflow suppression valve that suppresses the flow of fluid from the simulated bladder to the simulated urethral orifice side;
A first contact member that has a first passage for allowing the catheter inserted into the simulated urethra to pass toward the simulated bladder and that is in close contact with the catheter when the catheter is inserted into the first passage; Including
The second backflow suppressing member is
A second backflow suppression valve that suppresses the flow of liquid from the simulated rectum to the simulated anal side;
A second contact member that has a second passage portion that allows the catheter inserted into the passage member to pass to the simulated rectal side and that is in close contact with the catheter when the catheter is inserted into the second passage portion; The training simulator according to claim 6, comprising: A training instruction method for instructing at least one of urination training and enema training using the training simulator according to any one of claims 1 to 7,
A first step of instructing insertion of a catheter from the insertion port into the simulated member;
A training instruction method comprising: a second step of instructing to remove the catheter from the simulation member after inserting the catheter into the simulation member. The simulated member consists of the simulated bladder,
The tube member consists of a simulated urethra having one end in contact with the simulated bladder and the simulated urethral opening at the other end,
The training instruction method is:
A third step of instructing to supply fluid to the simulated bladder;
And a fourth step for instructing to confirm that liquid exits through the catheter after the first step;
The training instruction method according to claim 8, wherein the second step is executed after the fourth step. The backflow suppressing member is
A backflow suppression valve that suppresses the flow of liquid from the simulated bladder toward the insertion port;
A contact member that has a passage portion that allows the catheter inserted into the tube member to pass to the simulated bladder side and that comes into close contact with the catheter when the catheter is inserted into the passage portion;
The backflow control valve has a tapered structure in which a space is narrowed in a direction from the simulated urethral opening to the simulated bladder, and an end portion on the simulated bladder side is in contact with the counterflow suppression valve,
The training instruction method is:
A fifth step of instructing to set the pressure applied to the tapered structure of the check valve from outside to be higher than the atmospheric pressure;
The training instruction method according to claim 9, wherein the first step, the second step, and the fourth step are executed after the fifth step.

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