JP2024028562A - Human body model for puncture technique training and puncture technique training method using the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a simulator device for medical technique education that makes easy an evaluating function for sensual reproducibility and technique and an adjusting function for difficulty which could not be actualized by conventional simulators and needed for puncture technique training.

SOLUTION: There is provided a human body model that has a main body having one surface and the other surface, and a puncture target artificial internal organ arranged at a predetermined position in the main body, and the main body is so constituted that the puncture target artificial internal organ cannot be viewed from the one surface, but can be viewed from the other surface.

SELECTED DRAWING: Figure 1

COPYRIGHT: (C)2024,JPO&INPIT

Description

The present invention relates to a medical skill training simulator device and a training method for training medical professionals such as doctors in puncturing techniques using a hypodermic needle or the like.

Conventionally, there have been simulator devices for medical skill education.

This medical skill training simulator device is a simulator that can be used as a substitute for patients, and is used by medical professionals such as doctors and nurses to train them in the skills required for diagnosis and treatment.

Here, one of the medical operations that can be the subject of training is puncture procedures such as injections that are performed frequently and on a daily basis. In emergency medical settings, when a patient's condition suddenly changes or the patient goes into shock, a catheter or cannula is inserted into the femoral artery or vein to support circulation. The specific procedure for catheter placement is as follows. First, a blood vessel is secured with a puncture needle (injection needle), and then a guide wire is inserted. The guidewire remains in place and the puncture needle is removed. Puncturing a deep blood vessel by inserting a catheter or cannula along a guide wire is different from normal injections, and is highly urgent and difficult because the target blood vessel is located deep. For example, it is generally said that catheter insertion must be accomplished within one minute.

As a simulator for training injection techniques, there is one in which a blood vessel model made of vinyl tube is placed inside an arm model made of an elastic resin such as urethane. Injection training simulators are popular in educational institutions primarily for medical and nursing students.

Some injection technique simulators contain simulated blood inside the embedded blood vessel model, while others do not. Those containing simulated blood can be used for blood sampling training. By aspirating simulated blood with a syringe, the results of the blood collection procedure can be immediately evaluated. In training using a simulator, emphasis is placed on the reproducibility of the model as well as the evaluation function.

However, with the injection training simulator, there are several issues when training puncture techniques for catheter and cannula placement.

First, conventional simulators have a structure in which a blood vessel model is embedded inside a single elastic structure made of urethane, hydrogel, etc., and there is little physical change in the blood vessel wall and surrounding tissue, and the front wall of the blood vessel is penetrated. It is not possible to reproduce the minute reaction force that occurs when passing through the ball, and as a result, it is not possible to achieve a realistic training experience. In the first place, in the technique of puncturing a blood vessel, since the blood vessel has a closed cylindrical structure, it is necessary to pierce only the front wall of the blood vessel that comes into contact first, and not to damage or pierce the rear wall of the opposite side. However, with a structure in which a simulated blood vessel model made of elastic bodies is simply embedded in a single elastic body, it is difficult to distinguish between the reaction force that the needle receives from the blood vessel wall and the reaction force exerted by the surrounding tissues. Have difficulty.

Next, puncture training using a simulator requires a function that allows the trainee to instantly determine whether the target blood vessel was properly punctured or not, and whether the technique is appropriate. However, with conventional injection simulators that simulate an arm, it is not possible to determine which part the punctured needle is capturing or where within the subcutaneous tissue it is located. The problem was that the learning effect of the procedure was not enhanced because immediate evaluation was not possible.

Furthermore, since there is no function or method for adjusting the difficulty level of the puncturing technique, there is a problem in that it is not possible to provide a training model and environment that match the level of the trainee.

Therefore, the purpose of this invention is to create a simulator for medical skill education that facilitates the tactile reproducibility, procedure evaluation function, and difficulty adjustment function required for puncture technique training, which was not possible with conventional simulators. The purpose is to provide equipment.

In order to achieve the above object, according to a first aspect of the present invention,
(1) A human body model for puncture technique training,
a body having one side and another side;
a puncture target artificial organ disposed in a predetermined position within the body;
The human body model is characterized in that the main body is configured such that the puncture target artificial organ cannot be seen from one side but is visible from the other side.

(2) In the human body model described in (1) above,
The main body is
a base layer formed of a translucent elastic material and having the puncture target artificial organ installed or embedded in a predetermined position on one side;
and a non-transparent simulated fat layer installed on one surface of the base material and covering the organ model,
A human body model characterized in that the human body model is configured such that a puncture procedure for the simulated organ can be performed through the simulated fat layer.

(3) In the human body model described in (1) above,
A human body model, wherein a fibrous member is arranged around the target artificial organ within the main body.

(4) In the human body model described in (1) above,
A human body model characterized in that the target artificial organ has an outer surface and an inner surface, and the inner surface is lubricated.

According to the second aspect of the invention,
(5) A method of training puncturing techniques using a human body model,
A process of preparing a human body model,
This human body model is
a body having one side and another side;
a puncture target artificial organ disposed in a predetermined position within the body;
the main body is configured such that the puncture target artificial organ cannot be seen from one side but is visible from the other side;
performing a puncture procedure targeting a puncture target artificial organ from one side of the human body model;
After performing the puncture procedure, confirming the result of the puncture procedure from the other side of the human body model,
is provided.

Note that features other than those described above are disclosed in the following embodiment section and drawings.

FIG. 1 is a schematic configuration diagram of an artificial organ model showing the first embodiment of the present invention. FIG. 2 is a schematic diagram of puncture technique training using the artificial organ model according to the first embodiment of the present invention.

FIG. 3 is a schematic diagram of an example of use of the artificial organ model according to the first embodiment of the present invention.

FIG. 4 is a schematic diagram of an example of use of the artificial organ model according to the first embodiment of the present invention.

FIG. 5 is a schematic diagram of an example of use of the artificial organ model according to the first embodiment of the present invention.

Embodiments of the present invention will be described below with reference to the drawings.

FIG. 1 is a sectional view showing a puncture simulator, which is a human body model of this embodiment, and FIG. 2 is a perspective view showing its appearance.

(Basic configuration)
As shown in Figure 1, the structure of the puncture simulator (human body model of this invention) is as follows:
First, it has multiple structures consisting of 1) a skin layer, 2) a fat layer, 3) a fibrous layer (filling member), 4) a blood vessel model (target artificial organ), and 5) a bottom support layer. Here, the skin layer 1, the fat layer 2, and the bottom support layer 5 constitute the main body of the present invention, and these may have an inseparable integral structure.

The thickness of the fat layer No. 2 is preferably at least 1 mm, and preferably at most 20 mm. The thickness of the fat layer is proportional to the difficulty of the puncture procedure, and by adjusting the thickness of the fat layer, it is possible to reproduce training using a more difficult puncture simulator. A thickness of 10 mm is suitable for training general trainees and clinical engineers.

Silicone rubber is suitable as the material for the fat layer, but it is important that it is an elastic material, that the frictional resistance value on the needle surface during puncture is not too high, and that the physical properties are stable with little change over time. It is. Puncture is performed by applying a load of about 0.05-1.0N to a typical needle. Therefore, it is desirable to have a resistance value that allows the operator to maintain a load resolution of at least about 0.01N.

It is preferable that the fiber layer 3 and the blood vessel model 4 are connected continuously or substantially continuously. If the operator fails to penetrate the blood vessel during puncture, the fiber layer becomes entangled with the needle 6, creating a large resistance force. In other words, the fiber layer is a necessary structure for realizing an immediate evaluation function that indicates failure of the puncture procedure to the operator. In particular, by creating a boundary between the elastic structure and the fibrous structure, it becomes possible to distinguish between areas where puncture is allowed and areas where puncture is prohibited in the puncture procedure.

The blood vessel model No. 4 is divided into an artery model and a vein model. Generally, puncture for inserting a catheter or cannula is performed in the femoral artery or vein in the thigh. The artery model simulating the femoral artery is made of silicone, preferably has an inner diameter of 6 mm and an outer diameter of 8 mm, and preferably has the ability to maintain its shape to the extent that it has a lumen space inside in its natural state. That is, it has an elastic structure. On the other hand, the vein model is made of silicone and has a cylindrical structure with an inner diameter of 10 mm and an outer diameter of 11 mm, but it lacks structural shape retention, and a model in which the lumen shape is collapsed due to its own weight is appropriate. . By applying silicone oil to the inside of these blood vessel models in advance, it is clearly possible to puncture the blood vessel lumen due to the low frictional resistance when puncturing with the needle 6 or inserting the guide wire. It is possible to make the operator aware of success.

Next, 5, the bottom support layer for supporting the blood vessel model on its bottom side, which must be transparent or translucent. The transparency must be such that it is possible to visually recognize the needle 6 and the guide wire, which were unable to capture the lumen of the target blood vessel during puncture, and ideally, it is desirable to be completely transparent. Because the bottom support layer is transparent, the operator can immediately determine the success or failure of the puncture procedure by flipping the entire simulator over and visually observing the bottom during or after the puncture procedure. . That is, by making the bottom support layer transparent, it is possible to provide the simulator main body with an instant evaluation function.

The bottom support layer of this 5 is a layered structure connected to the outside of the rear wall of the vascular model of 4, which is a flexible structure with an elastic modulus close to 1 and 2. Desirably, it should not be a rigid body that does not have rubber elasticity. For example, 5) If the bottom support layer is made of a rigid material such as acrylic plate or polycarbonate, which is transparent, easy to process, and easily obtained, the operator cannot tactilely detect the reaction force from the wall of the blood vessel model during puncture. (Evided by experiment).

That is, the bottom support layer 5 must be an elastic body and have a structure that is not transparent or translucent.

In other words, the important points are 1 to 5 below.
1 Simulated fat layer on top of blood vessel model Thickness 0 - 20 mm Optimum 10 mm
2 Transparency of the bottom plate 3 Elasticity of the blood vessel fixing pedestal 4 Fibrous tissue around the blood vessel model (by getting entangled, it is recognized that it is piercing something other than the blood vessel)
5 Lubrication of the vascular lumen (difference between outer wall resistance and inner wall resistance)
According to such a configuration, it is possible to reproduce a simulator that simulates a human thigh, etc., and it is possible to efficiently and effectively train a puncture technique for inserting a catheter or a cannula. In other words, by adjusting the thickness of the fat layer structure, the difficulty of the procedure can be adjusted, and by placing and connecting fibrous tissue around the blood vessel model, it is possible to Failure can be detected or evaluated; by lubrication inside the blood vessel, success or failure of puncture inside the blood vessel can be appropriately evaluated; by making the bottom support layer transparent, evaluation can be made as necessary. Since the bottom support layer is made of an elastic material, minute reaction forces of the blood vessel wall can be recognized.

This allows the user to efficiently learn the delicate sensation of puncturing a blood vessel, similar to that experienced by humans.

(Production method)
The skin layer is shaped using silicone rubber to a size of 400 mm x 100 mm x 3 mm thickness. Next, the fat layer is shaped into a size of 350 mm x 60 mm x 10 mm.

Next, a tube-shaped artery model and vein model are formed. The artery model has an inner diameter of 6 mm, an outer diameter of 8 mm, and a length of 350 mm. The vein model has an inner diameter of 10 mm, an outer diameter of 11 mm, and a length of 350 mm. Drop 2 cc of silicone oil inside the artery model and vein model and apply it to the entire lumen surface.
Next, a 400 mm x 100 mm x 3 mm thick bottom support layer is molded using transparent silicone resin.

As for the assembly procedure, first, a bottom support layer is laid down, and the blood vessel model is adhesively fixed to the bottom support layer surface. Next, a polyester fiber with a thickness of about 10 mm is placed around the blood vessel.

Place the fat model so that it covers the top of the blood vessel.

Next, the entire body is covered with a skin layer, and the outer periphery is adhered to the bottom support layer with an adhesive margin of about 3 mm, thereby fixing the entire body and enclosing all the structures.

(evaluation)
The product of the present invention was evaluated by dialysis patients and by a specialist doctor who has experience in performing numerous puncture procedures in emergency medical settings. When puncturing was performed using a 17.5 gauge needle, the arterial model could be punctured in the first attempt (state shown in FIG. 3). Next, when puncturing the vein model was performed, the first attempt was to puncture the back wall of the blood vessel, and by flipping the entire simulator over and visually observing the transparent bottom support layer, puncture failure could be evaluated. (Situation shown in FIG. 4). In the second puncture, because the puncture was performed in a location where a blood vessel different from the target blood vessel was not located, after penetrating the fat layer, a significant increase in resistance due to the fibrous layer was perceived, and it was possible to evaluate the failure of the puncture procedure. (The state shown in FIG. 5).

In the third attempt, the guide wire was successfully punctured into the blood vessel lumen, and when the guidewire was inserted into the blood vessel lumen through the puncture needle, a smooth insertion sensation due to lubrication could be obtained. This allowed the success of the puncture to be assessed.

Through the above experiment, it is possible to accurately reproduce the failure mode and success mode in clinical practice, and it is possible to obtain the effect of being able to immediately and self-evaluate the success or failure of the puncture procedure.

Note that this invention is not limited to the one embodiment described above, and can be modified in various ways without changing the gist of the invention.

For example, in the above embodiment, the target artificial organ is a blood vessel model, but it may be another artificial organ model. Further, the filling member is not limited to fibrous materials, but any material may be used as long as it provides a feel different from that of an artificial organ.

Claims (7)

A human body model for puncture technique training,
a body having one side and another side;
a puncture target artificial organ disposed in a predetermined position within the body;
The human body model is characterized in that the main body is configured such that the puncture target artificial organ cannot be seen from one side but is visible from the other side. The human body model according to claim 1,
The human body model is characterized in that the main body is made of an elastic material and configured such that a puncture procedure can be performed on the puncture target artificial organ from the one surface. The human body model according to claim 1,
The main body is
a base layer formed of a translucent elastic material and having the puncture target artificial organ installed or embedded in a predetermined position on one side;
and a non-transparent simulated fat layer installed on one surface of the base material and covering the organ model,
A human body model characterized in that the human body model is configured such that a puncture procedure for the puncture target artificial organ can be performed through the simulated fat layer. The human body model according to claim 1,
A human body model characterized in that a filling member made of a material different from that of the target artificial organ is arranged around the target artificial organ in the main body. The human body model according to claim 4,
The human body model, wherein the filling member includes a fibrous material. The human body model according to claim 1,
A human body model characterized in that the target artificial organ has an outer surface and an inner surface, and the inner surface is lubricated. It is a method of training puncturing techniques using a human body model,
A process of preparing a human body model,
This human body model is
a body having one side and another side;
a puncture target artificial organ disposed in a predetermined position within the body;
the main body is configured such that the puncture target artificial organ cannot be seen from one side but is visible from the other side;
performing a puncture procedure targeting a puncture target artificial organ from one side of the human body model;
and, after performing the puncture procedure, confirming the result of the puncture procedure from the other side of the human body model.

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