JP2024031062A - Medical procedure simulator and procedure training method - Google Patents

Abstract

[Problem] Suitable for training procedures involving multiple organs within the abdominal cavity. A medical procedure simulator 1 includes a liver model 110, a spleen model 120, a stomach model 130, a small intestine model 140, and a large intestine model 150, which are organ models corresponding to the liver, spleen, stomach, small intestine, and large intestine, respectively. are doing. These models are housed in a container 200. The container 200 has a transparent or translucent side wall and an opening 210 that opens toward the front. [Selection diagram] Figure 1

Description

The present invention relates to a medical technique simulator and a technique training method.

Medical procedure simulators have been developed for the purpose of training in surgical procedures. The simulator disclosed in Patent Document 1 is one such simulator, and includes an organ model for training laparoscopic procedures on the colon.

Japanese Patent Application Publication No. 2021-120760

Conventional simulators including Patent Document 1 are equipped with a limited number of organ models depending on the purpose. For this reason, conventional simulators are not suitable for training procedures that involve procedures involving multiple organs within the abdominal cavity, such as, for example, trauma surgery training.

An object of the present invention is to provide a medical technique simulator suitable for training techniques involving multiple organs within the abdominal cavity, and a medical technique training method using the same.

The medical procedure simulator of the present invention includes a liver model, a spleen model, a small intestine model, and a large intestine model, which are organ models corresponding to the liver, spleen, small intestine, and large intestine, respectively, and at least a part of the side wall is transparent or translucent. , and a container having an opening opening toward the front and accommodating the organ model.

It is equipped with organ models spanning the main organs within the abdominal cavity: liver, spleen, small intestine, and large intestine. Therefore, the present invention is suitable for training various procedures involving multiple organs within the abdominal cavity. Furthermore, at least a portion of the side wall of the container housing the organ model is transparent or translucent. Therefore, it is easy to check the training results from the outside through the side wall of the container. Therefore, a simulator suitable for evaluation of procedures is realized.

Further, in the present invention, it is preferable that at least one of the organ models is made of an elastic material. According to this, since an elastic material is used, it is easy to reproduce the soft touch of an actual organ.

Further, in the present invention, it is preferable that at least one of the organ models is partially fixed to the container. According to this, by being kept partially fixed, it is easier to reproduce the actual mobility of organs within the human body.

Further, in the present invention, in at least one of the organ models, the region fixed to the container is a first region corresponding to a region fixed to another organ in the abdominal cavity in an actual human body, and It is preferable that the second region corresponds to a part of the human body that is not fixed to other organs in the abdominal cavity. According to this, by fixing in the first region, it is easier to reproduce the situation inside the human body, and by fixing in the second region, it is easier to perform fixing in consideration of manufacturing circumstances, usability for training, etc.

Further, the present invention includes a stomach model that is the organ model corresponding to the stomach, and a region corresponding to the back surface of the stomach model is included in the second region, and the stomach model is adjacent to the stomach model. Preferably, the spleen model is supported by said stomach model. According to this, the back of the stomach model, which is a part that is not fixed in the actual human body, is fixed to the container. Therefore, by restricting the mobility of the stomach model, the stomach model and adjacent spleen model are properly supported by the stomach model, thereby maintaining the spleen model in place. Furthermore, since the stomach model is prevented from moving unnecessarily, when the present simulator is used for training that does not involve the stomach model, the stomach model is less likely to interfere with the smooth implementation of the training, improving usability.

Further, in the present invention, a mesenteric model in which the mesentery is reproduced is arranged, and the mesenteric model is fixed to the organ model by a fixing member that removably fixes the mesenteric model to the organ model. It is preferable that According to this, in training, when irreversible processing is performed on the mesenchymal model, it may be necessary to exchange the mesenchymal model. In such a case, since the mesenteric model is removable by the fixing member, it is easy to replace the mesenteric model.

Further, in the present invention, it is preferable that a skin model that partially covers the opening is removably attached to the container. According to this, it is easy to remove the skin model from the container to observe the inside of the simulator and perform maintenance.

The medical procedure training method of the present invention includes a procedure step of performing a procedure on the procedure simulator in a simulated manner through a portion not covered by the skin model in an opening area of the opening; and an observation step of observing at least one of the state of the procedure and its result. According to this, in the procedure process, training is performed through an opening in which the skin model has a limited opening area in accordance with actual clinical practice, and in the observation process, the training situation and its results can be easily observed through the side wall of the container.

In the medical technique training method of the present invention, gauze packing is applied in a simulated manner. According to this, packing training can be performed appropriately.

Further, in the present invention, in the procedure simulator with the gauze packing, the gauze inside can be visually recognized from the front through the opening, and the gauze inside can be visually recognized from the side through the side wall of the container. Preferably, it is recognizable. According to this, training results can be appropriately evaluated by observing the inside of the simulator from both the front and side.

The medical procedure training method of the present invention includes a procedure step of simulating the Pringle method on a procedure simulator, and the procedure simulator includes a blood vessel model in which blood vessels flowing into the liver are reproduced; The mesenteric model is fixed to the blood vessel model by the fixing member, and in the procedure step, a through hole is formed in the mesenteric model. According to this, since the mesenchymal model is removable, the mesenchymal model in which through-holes have been formed during training can be replaced after training, and the simulator can be used for the next training.

Further, in the present invention, it is preferable that the organ protection sheet is placed in a simulated manner through the opening area. According to this, training for temporary abdominal closure by indwelling an organ protection sheet can be appropriately performed.

1 is a front view of a medical procedure simulator according to an embodiment of the present invention. FIG. FIG. 2 is a diagram in which models other than the skeletal model and the abdominal cavity model are removed from the procedure simulator of FIG. 1. FIG. 2 is an enlarged view of the vicinity of the liver model and the reticulum model in FIG. 1. FIG. FIG. 2 is a diagram showing the procedure simulator of FIG. 1 subjected to five-point packing of the abdominal cavity. (a) It is the figure which looked at FIG. 4 from below. (b) A view of FIG. 4 viewed from above. FIG. 2 is a diagram showing the procedure simulator of FIG. 1 subjected to perihepatic packing. FIG. 2 is a diagram showing the procedure simulator of FIG. 1 subjected to the Pringle method. FIG. 2 is a diagram showing the procedure simulator of FIG. 1 subjected to a temporary abdominal closure method.

A medical procedure simulator 1 according to an embodiment of the present invention will be described with reference to the drawings. The procedure simulator 1 includes a model body 100 that imitates each organ in the abdominal cavity of a human body, and a container 200 that includes a portion that imitates the entire abdominal cavity. The procedure simulator 1 is mainly used for training in trauma surgery. As shown in FIG. 1, the procedure simulator 1 assumes upper and lower, left and right, anterior and posterior (or dorsal) positions based on the anatomical orientation.

As shown in FIGS. 1, 2, and 7, the model body 100 includes a liver model 110, a spleen model 120, a stomach model 130, a small intestine model 140, a large intestine model 150 (each of which is an organ model in the present invention), It includes models such as a reticulum model 160, a liver falciform mesenteric model 170, a skeletal model 180, and a skin model 190. The model body 100 is suitably manufactured in the size of an adult, a child, an infant, or an infant for which manual training is to be performed. Furthermore, the model body 100 may be a model with female or male characteristics as necessary.

The liver model 110 is made of urethane resin. The material used in liver model 110 may be any other elastic material that can reproduce the soft feel of a real liver. The liver model 110 is molded by pouring urethane resin into a mold made of silicone resin or the like and hardening the urethane resin. The liver model 110 is colored to resemble the actual liver by mixing a coloring agent into the urethane resin or by coloring the surface of the urethane resin. The outer surface of the liver model 110 is coated with transparent silicon or the like to form a liver coating. Since the liver model 110 has a tactile feel similar to that of an actual liver, it is suitable for training in manual liver compression techniques.

The spleen model 120 is made of urethane resin. The material used in the spleen model 120 may be any other elastic material that can reproduce the soft feel of a real spleen. The spleen model 120 is molded by pouring urethane resin into a mold made of silicone resin or the like and curing the urethane resin. It is colored to match the actual spleen by mixing a coloring agent with the urethane resin or by coloring the surface of the cured urethane resin.

The stomach model 130, the small intestine model 140, and the large intestine model 150 are each made of urethane resin. The material used for each model may be any other elastic material that can reproduce the soft feel of each actual organ. The materials used for each model may be the same or different. Each model is molded by pouring urethane resin into a mold made of paper clay or the like and curing the urethane resin. Each model is colored to match the actual organ, either by mixing a coloring agent into the urethane resin or by coloring the surface of the cured urethane resin.

The reticulum model 160 is formed of a sheet of transparent silicone resin colored in skin color. The omentum model 160 may be formed from a sheet of other materials as long as they are transparent and flexible. A blood vessel model 161 is installed inside the omentum model 160. The blood vessel model 161 imitates the portal vein and the like in the hepatoduodenal ligament region in the reticulum model 160. The blood vessel model 161 is composed of tubular or rod-shaped members. For example, it may be composed of a tubular member such as a straw and a rod-shaped member such as a bamboo skewer inserted into the tubular member. The omentum model 160 covers the blood vessel model 161.

The falciform ligament model 170 is made of a sheet of transparent silicone resin colored orange. The falciform ligament model 170 may be formed from a sheet of other materials as long as they are transparent and flexible. Note that the mesenteric model in the present invention corresponds to the reticulum model 160 and the falciform mesenteric model 170.

As shown in FIG. 2, the skeletal model 180 includes a rib model 181, a pelvis model 182, and a spine model 183. The skeleton models 180 are each made by molding paper clay.

The skin model 190 is formed from a sheet of transparent silicone resin colored in skin color. As shown in FIG. 7, the skin model 190 has an oval opening 195 that is elongated in the vertical direction. The skin model 190 is hung on the container 200 so as to straddle the opening area of an opening 210 (described later) and so that the opening 195 overlaps with the opening area of the opening 210. The trainee can insert his or her hand into the container 200 through the opening 195. The size of the opening 195 is adjusted as appropriate depending on the procedure to be trained. The skin model 190 is attachable to and detachable from the container 200.

The container 200 is a rectangular box-shaped container having an opening 210 as shown in FIGS. 1 and 2. The opening 210 has an opening area that opens toward the front. The inside of the container 200 can be observed from the outside through the opening area of the opening 210. The container 200 has an upper wall 201, a left wall 202, a right wall 203, a lower wall 204, and a back wall 205, and each wall is transparent. The transparency of each wall may be any level as long as the state and result of the training procedure can be confirmed from the outside, and may be, for example, semi-transparent. The size of the container 200 is large enough to accommodate the model body 100. For example, the container 200 may have a vertical size of 53 cm, a horizontal size of 39 cm, and a front-back size of 24.3 cm for an adult human body. When the skin model 190 is attached to the container 200, a part of the opening area of the opening 210 is opened to the outside through the opening 195 of the skin model 190, and the remaining part is covered by the skin model 190. This limits a portion of the opening area.

The container 200 has an abdominal cavity model 300 inside. The abdominal cavity model 300 is a depression formed by injecting transparent silicone resin into the container 200 up to the opening 210 and hardening the transparent silicone resin using a mold that reproduces the surface shape of the abdominal cavity. Thereby, for example, the right paracolic groove, the left paracolic groove, the pelvic cavity, etc. are reproduced in the abdominal cavity model 300. As shown in FIG. 2, the abdominal cavity model 300 is formed by having a skeleton model 180 embedded therein before the transparent silicone resin hardens. The skeletal model 180 is placed at a position corresponding to the actual human body.

The container 200 has grips 220 on the upper wall 201 and the lower wall 204, respectively, as shown in FIG. 5(b). The grip portion 220 is U-shaped, and the container 200 can be carried by gripping it with the left and right hands, respectively.

Inside the container 200, a catheter tube or similar tubes (not shown) that simulates bleeding may be passed from the pelvis model 182 to the dorsal side of the abdominal cavity model 300. By placing one end of this catheter tube in the abdominal cavity model 300 and placing the other end outside, and flowing red liquid into the catheter tube from the other end, bleeding from each organ model in the abdominal cavity model 300 can be expressed. By changing the position of the tip of the catheter tube within the abdominal cavity model 300, models of bleeding from various parts of each organ model can be formed.

A liver model 110, a spleen model 120, a stomach model 130, a small intestine model 140, a large intestine model 150, a reticulum model 160, a falciform ligament model 170, and a skin model 190 are fixed to the container 200 as follows.

Liver model 110 is fixed to abdominal cavity model 300 via transparent silicone. In an actual liver, the transparent silicone is fixed by the connective tissue of the lumbar vertebrae of the diaphragm, the inferior vena caval ligament, the hepatic coronal ligament, the hepatic triangular ligament (other organs referred to in the present invention), and the hepatic falciform ligament. It is applied to a specific region (the first region in the present invention) on the back or top surface of the liver model 110 so as to reproduce the state in which the liver model 110 is in a state where the liver model 110 is in a state where the liver model 110 is in a state where the liver model 110 is in a state in which As a result, the liver model 110 is adjusted to have a mobility similar to the situation in which five-point abdominal packing or packing around the liver is normally performed.

Spleen model 120 is fixed to stomach model 130 via transparent silicone. The actual spleen is located under the left diaphragm by the gastrosplenic ligament, splenic colonic ligament, pancreaticosplenic ligament, and diaphragmatic splenic fold. On the other hand, the spleen model 120 is fixed to the stomach model 130 via transparent silicone between the spleen model 120 and the stomach model 130 so as to reproduce a situation as close as possible to the situation in which five-point abdominal packing is normally performed. has been done.

Stomach model 130 is fixed to abdominal cavity model 300 via transparent silicone. Transparent silicone is applied to a specific region (second region in the present invention) on the back surface of the stomach model 130. The actual stomach is not an organ that is fixed by the retroperitoneum. In contrast, in the present embodiment, the stomach model 130 is fixed as described above so as to be less likely to interfere with smooth training when training for a liver trauma surgery simulation in which the stomach model 130 is not directly involved. Further, by fixing the stomach model 130 in this manner, the spleen model 120 fixed to the stomach model 130 is supported by the stomach model 130.

The small intestine model 140 is fixed to the abdominal cavity model 300 via transparent silicone. Transparent silicone is applied to a specific region (first region in the present invention) on the back surface of the small intestine model 140. This site corresponds to the duodenum in the small intestine model 140. This reproduces the situation in which the duodenum of the small intestine is actually fixed to the dorsal abdominal wall by the retroperitoneum (another organ in the present invention).

The large intestine model 150 is fixed to the abdominal cavity model 300 via transparent silicone. Transparent silicone is applied to a specific region on the back of the large intestine model 150. A part of this region (first region in the present invention) corresponds to the ascending colon and descending colon in the large intestine model 150. This reproduces the actual situation in which each part of the ascending colon and descending colon of the large intestine is fixed to the dorsal abdominal wall by the retroperitoneum (another organ referred to in the present invention). Further, another part of the above-mentioned specific region (second region in the present invention) corresponds to the sigmoid colon. This part is fixed to the abdominal cavity model 300 in order to prevent smooth training.

Blood vessel model 161 is fixed to liver model 110. This reproduces that the blood vessel model 161 is a blood vessel flowing into the liver model 110.

The omentum model 160 is fixed to a blood vessel model 161 with a clip (fixing member referred to in the present invention, not shown). This allows the reticulum model 160 to be removed from the blood vessel model 161 and replaced.

As shown in FIGS. 4 and 7, the falciform ligament model 170 is fixed to the liver model 110 and the skin model 190 via two metal wires 175a and 175b (fixing members in the present invention). has been done. Specifically, one end of each of the wires 175a and 175b is attached to the falciform ligament model 170. The other end of the wire 175a is bent and hooked onto the skin model 190. The other end of the wire 175b is bent and hooked onto the liver model 110. In this way, the hepatic falciform ligament model 170 is fixed between the skin model 190 and the liver model 110 in a hanging pattern. The falciform ligament model 170 can be replaced by removing the wires 175a and 175b from the liver model 110 and the skin model 190.

Skin model 190 is removably secured to opening 210 with a clip (not shown).

An example of how to use the procedure simulator 1 for trauma surgery training will be described below. In this usage example, the procedures performed in a simulated manner using the procedure simulator 1 are five-point abdominal packing, manual compression for the liver, perihepatic packing, Pringle method, and temporary abdominal closure method. In both of these, there is a procedure process in which the trainee performs various procedures on the procedure simulator 1 in a simulated manner, and an observation process in which the evaluator observes the training situation and its results during or after the procedure process. be done. In the procedure process, the trainee inserts his or her hand into the container 200 through the opening 195 of the skin model 190, that is, through the part of the opening area of the opening 210 that is not covered by the skin model 190, and applies a simulated pattern to the model body 100. perform a specific procedure. In the observation process, the training situation and its results are observed from the outside through the transparent upper wall 201, left wall 202, right wall 203, lower wall 204, and back wall 205. Further, if necessary, the fixation of the skin model 190 and the container 200 with the clips is removed to open the opening 210. Then, the training situation or its results are observed through the opening 210. According to this, it is possible not only to train a technique, but also to evaluate the training situation and its results at a glance through each transparent wall and, if necessary, through the opening 210 opened by removing the skin model 190. can.

The procedure simulator 1 is used in training for each procedure as follows.

(5-point abdominal cavity packing: Figure 4)
Five-point abdominal packing is a procedure in which gauze is placed at five points: under the left and right diaphragms, in the left and right paracolic grooves, and in the pelvic cavity. This procedure is performed to detect intra-abdominal bleeding due to trauma, as well as to temporarily stop the bleeding and stabilize the condition.

In the procedure step, first, a state is created in which a catheter tube placed in the abdominal cavity model 300 is simulatively caused to bleed. Next, the trainee simulatively places the gauze 400 through the opening 195 of the skin model 190 at a position corresponding to the upper right side of the container 200 and below the right diaphragm. Next, gauze 400 is placed in the upper left part of container 200 at a position corresponding to the left diaphragm. At this time, as shown in FIG. 5(b), gauze 400 is placed up to the dorsal side of the liver model and spleen model. Next, the gauze 400 is placed in a position corresponding to the right paracolic groove, which is about the middle of the abdominal cavity model 300 in the vertical direction. Next, the gauze 400 is placed in a position corresponding to the left paracolic groove, which is about the middle of the abdominal cavity model 300 in the vertical direction. In the procedure simulator 1, as described above, by fixing the large intestine model 150 and the abdominal cavity model 300, the actual fusion region between the colon and the retroperitoneum is reproduced. Therefore, training for placing gauze in the right paracolic groove and the left paracolic groove can be performed in the same way as in actual clinical practice. Next, as shown in FIG. 5(b), gauze 400 is placed in the lower pelvic cavity.

In the observation step, the evaluator observes the training situation and its results, and evaluates whether the gauze 400 is placed in an appropriate location. In addition, after the status of placement of the gauze 400 is evaluated in the observation process, the gauze 400 may be removed from the procedure simulator 1 by having the trainee search for bleeding points by checking whether the gauze 400 is colored. good.

(Manual compression for the liver)
Manual liver compression is a technique to manually compress the liver for bleeding caused by liver damage. After this temporary hemostasis is achieved, other bleeding detection and necessary treatment can be performed.

In the procedure step, the trainee inserts his hand through the opening 195 of the skin model 190 and compresses the liver model 110 with his hand. The liver model 110 is made of urethane resin, a material that approximates the hardness of an actual liver, and the liver capsule is reproduced with transparent silicone. Therefore, training can be conducted in the same way as in actual clinical practice.

(Perihepatic packing: Figure 6)
Perihepatic packing is a procedure in which gauze is placed around the liver in an attempt to stop bleeding from liver injury, similar to manual liver compression.

In the procedure step, the trainee inserts his hand through the opening 195 of the skin model 190 and places gauze 400 around the liver model 110 including the deep part of the liver model 110. At this time, the gauze 400 is inserted into the procedure simulator 1 so that a compressive force in a vector along a direction that appropriately compresses the liver injury site is applied. In the procedure simulator 1, it is possible to perform training in which the gauze 400 is placed so as to appropriately apply a compressive force in a vector perpendicular to the direction in which the injury spreads, depending on the liver injury site, in the same manner as in actual clinical practice.

In the observation step, similarly to the five-point abdominal cavity packing, the evaluator observes the training situation and its results, and evaluates whether the gauze 400 is placed in an appropriate location.

(Pringle method: Figure 7)
The Pringle method is a procedure that clamps the hepatoduodenal ligament, in other words, temporarily blocks the blood flow in the hepatic artery and portal vein system, in situations where hemostasis due to liver damage is insufficient to stop the bleeding at the site of liver damage. .

In the procedure step, the trainee touches the blood vessel model 161 located on the dorsal side of the region corresponding to the hepatoduodenal ligament in the reticulum model 160 along with the region corresponding to the hepatoduodenal ligament through the opening 195 of the skin model 190. know Next, while the trainee palpates the blood vessel model 161 and confirms its position, the trainee uses a shear blade to pierce the reticulum model 160 near the blood vessel model 161 to make a through hole in the reticulum model 160. Next, as shown in FIG. 7, the trainee passes forceps 450 through the through hole and holds the blood vessel model 161 between the forceps 450 and performs simulated hemostasis. The procedure simulator 1 allows training to be performed in the same manner as in actual clinical practice by reproducing the hepatoduodenal ligament and its surrounding membranous structure.

In the observation step, the evaluator observes the training situation and its results, and evaluates how well the blood vessels (blood vessel model 161) flowing into the liver are appropriately blocked.

(Temporary abdominal closure method: Figure 8)
Temporary abdominal closure is a technique that temporarily closes the abdomen while using an organ protection sheet. This makes it possible to quickly complete the minimum necessary surgery to stop bleeding and avoid contamination, and move on to the next intensive treatment.

In the procedure step, the trainee covers the opening 195 of the skin model 190 with an organ protection sheet 500 that is larger than the opening 195. The organ protection sheet 500 may be an organ protection sheet made of polyurethane that is used in the actual clinical setting of Vacuum Assisted Closure, or other substitutes may be used. Next, the trainee cuts the organ protection sheet 500 into a size slightly larger than the opening 195 using a shear blade. Next, the trainee manually pushes the organ protection sheet 500 into the abdominal cavity model 300 through the opening 195. At this time, if the liver falciform ligament model 170 obstructs the procedure, the liver falciform ligament model 170 is cut off with a shear blade. In the procedure simulator 1, since there is a small intestine model 140 and a large intestine model 150, the trainee can perform training with an awareness of protecting the intestinal tract.

In the observation step, the evaluator observes the training situation and its results, and evaluates whether the organ protection sheet 500 can be placed so as to cover the entire organ.

According to the medical procedure simulator 1 as described above, each organ model is provided for the main organs in the abdominal cavity, such as the liver, spleen, stomach, small intestine, and large intestine. Therefore, the procedure simulator 1 is suitable for training various procedures involving multiple organs within the abdominal cavity. Moreover, the upper wall 201, left wall 202, right wall 203, lower wall 204, and back wall 205 of the container 200 that accommodates each organ model are transparent. Therefore, it is easy to check the training results from the outside through each side wall of the container 200. Therefore, a simulator suitable for evaluation of procedures is realized.

Furthermore, since the organ model uses an elastic material such as urethane resin, it is easy to reproduce the soft feel of an actual organ.

Further, the back surfaces of the liver model 110, spleen model 120, stomach model 130, small intestine model 140, and large intestine model 150 are partially fixed to the abdominal cavity model 300. Being partially fixed makes it easier to reproduce the actual mobility of organs within the human body.

In addition, on the back of the liver model 110, small intestine model 140, and large intestine model 150 (ascending colon and descending colon regions), the regions fixed to the abdominal cavity model 300 with transparent silicone are different from other organs such as the retroperitoneum in the actual human body. This is the area corresponding to the part fixed to . According to this, the fixation makes it easier to reproduce the situation inside the human body.

On the other hand, on the backs of the spleen model 120, stomach model 130, and large intestine model 150 (site of the sigmoid colon), areas fixed to the abdominal cavity model 300 with transparent silicone are fixed to other organs such as the retroperitoneum in the actual human body. This is the area corresponding to the part that is not displayed. According to this, the back surface of the stomach model 130 and the like, which is a part that is not fixed in the actual human body, is fixed to the abdominal cavity model 300. This type of fixation makes it easy to fix the product in consideration of manufacturing circumstances, ease of use for training, and the like. Further, the spleen model 120 adjacent to the stomach model 130 is supported by the stomach model 130. By restricting the mobility of the stomach model 130, the spleen model 120 adjacent to the stomach model 130 is properly supported by the stomach model 130, thereby maintaining the spleen model 120 in place. Further, since the stomach model 130 is prevented from moving unnecessarily, when the procedure simulator 1 is used for training that does not involve the stomach model 130, the stomach model 130 is less likely to interfere with the smooth implementation of the training, improving usability. .

Further, between the liver model 110, the stomach model 130, and the small intestine model 140, a reticulum model 160 in which the mesentery is reproduced is fixed with a clip and removably disposed. Between the liver model 110 and the skin model 190, a hepatic falciform mesenteric model 170 in which the mesentery is reproduced is removably arranged and fixed to wires 175a and 175b. According to these, in training, when irreversible processing is performed on the reticulum model 160 and the hepatic falciform mesenteric model 170, it may be necessary to replace each mesenteric model. In such a case, since each mesenteric model can be removed using a fixing member such as a clip or a wire, each mesenteric model can be easily replaced.

Furthermore, since the skin model 190 that partially covers the opening 210 is removably attached to the container 200, it is easy to remove the skin model 190 from the container 200 to observe the inside of the procedure simulator 1 and perform maintenance. .

In addition, in training using the procedure simulator 1, in the procedure process, the skin model 190 is trained through an opening 210 with a limited opening area in accordance with the actual clinical situation, and in the observation process, the skin model 190 is trained from the container 200. It is easy to observe the training results through the removed and wide open opening 210 and each side wall of the container 200.

Furthermore, during training using the procedure simulator 1, packing with gauze 400 is simulated as shown in FIGS. 4 to 6 during five-point packing of the abdominal cavity and packing around the liver. According to this, packing training can be performed appropriately. Furthermore, in the packed procedure simulator 1, the gauze 400 inside can be visually recognized from the front through the opening 210, and the gauze 400 inside can be visually recognized from the side through each side wall of the container 200. Therefore, the training results can be appropriately evaluated by observing the inside of the procedure simulator 1 from both the front and the side.

Furthermore, when performing the Pringle method during training using the procedure simulator 1, since the reticulum model 160 is removable, the reticulum model 160 in which through holes have been formed during training can be replaced after the training and the 1 can be used for the next training.

Further, in training using the procedure simulator 1, it is possible to appropriately train the temporary abdominal closure method by indwelling the organ protection sheet 500.

<Other variations>
Although the above is a description of the preferred embodiments of the present invention, the present invention is not limited to the above-described embodiments, and various modifications may be made within the scope described in the means for solving the problems. It is possible.

The embodiments described above relate to a human technique simulator and a technique training method. However, the technique simulator and technique training method for other animals may also be used.

In the embodiments described above, each model is created to imitate an actual human body. However, for models that are not directly related to the procedure to be trained, there is little need to make them close to the real thing. For example, such a model may be an object having a simple structure such as a sphere, an ellipse, or a box. For example, the stomach model 130 may be an object with a simple structure as a procedure simulator used in training for liver trauma surgery techniques. Alternatively, the above-mentioned models that are less directly related to the procedure to be trained may not be installed in the procedure simulator.

In the embodiments described above, the skin model 190 has an opening 195. However, the skin model may have an opening that can be opened and closed. Further, the skin model does not need to have an opening, and the trainee may form an opening as appropriate during the training of the procedure.

In the embodiment described above, the procedure simulator 1 includes a liver model 110, a spleen model 120, a stomach model 130, a small intestine model 140, a large intestine model 150, a lesser omentum model 160, a liver falciform ligament model 170, and a skin model 190. There is. However, the procedure simulator may have only models of organs necessary for the planned procedure training. For example, only one of the reticulum model 160 and the falciform mesenteric model 170 may be installed as the mesenteric model, or the mesenteric model may not be installed. Further, other mesenchymal models may also be installed.

In the embodiments described above, the liver model 110, spleen model 120, stomach model 130, small intestine model 140, large intestine model 150, reticulum model 160, falciform ligament model 170, and skin model 190 are similar to the corresponding organs in the human body. Although it is colored, it does not have to be colored. Further, the color may be changed as necessary.

In the embodiment described above, all of the side walls of the container 200 are transparent, but only some of the side walls may be transparent, or only a portion of the side walls may be transparent.

In the embodiment described above, two of the liver model 110, spleen model 120, stomach model 130, small intestine model 140, and large intestine model 150 are fixed to each other or to the abdominal cavity model 300 or the skin model 190. However, depending on the procedure planned for training, the fixation may be removed or fixed at a different location.

Transparent silicone is used to fix the liver model 110, spleen model 120, stomach model 130, small intestine model 140, and large intestine model 150. However, double-sided tape, hook-and-loop fastener, adhesive, etc. may also be used.

In the embodiments described above, the container 200 includes the grip 220, but the grip 220 may be omitted.

1 Procedure simulator 110 Model body 110 Liver model 120 Spleen model 130 Stomach model 140 Small intestine model 150 Large intestine model 160 Lesser omentum model 161 Blood vessel model 170 Hepatic falciform ligament models 175a and 175b Wire 190 Skin model 195 Opening 200 Container 201 Upper wall 202 Left wall 203 Right wall 204 Lower wall 205 Back wall 210 Opening 300 Abdominal cavity model 400 Gauze 500 Organ protection sheet

Claims (12)

A liver model, a spleen model, a small intestine model, and a large intestine model, which are organ models corresponding to the liver, spleen, small intestine, and large intestine, respectively;
A medical procedure simulator comprising: a container in which at least a portion of the side wall is transparent or translucent, has an opening opening toward the front, and accommodates the organ model. The procedure simulator according to claim 1, wherein an elastic material is used for at least one of the organ models. The procedure simulator according to claim 1 or 2, wherein at least one of the organ models is partially fixed to the container. A region fixed to the container in at least one of the organ models includes a first region corresponding to a region fixed to another organ in the abdominal cavity in an actual human body and another region in the abdominal cavity in the actual human body. The procedure simulator according to claim 3, further comprising a second region corresponding to a region not fixed to an organ. It is equipped with a stomach model which is the organ model corresponding to the stomach,
A region corresponding to the back surface of the stomach model is included in the second region,
The procedure simulator according to claim 4, wherein the spleen model adjacent to the stomach model is supported by the stomach model. A mesentery model that reproduces the mesentery is placed,
3. The procedure simulator according to claim 1, wherein the mesenteric model is fixed to the organ model by a fixing member that removably fixes the mesenteric model to the organ model. The procedure simulator according to claim 1 or 2, wherein a skin model that partially covers the opening is removably attached to the container. A procedure step for the procedure simulator according to claim 7, in which a procedure is performed in a simulated manner through a portion of the opening region of the opening that is not covered by the skin model;
A medical technique training method, comprising an observation step of observing at least one of the condition of the technique and its result through the side wall of the container. A medical technique training method, comprising applying gauze packing to the technique simulator according to claim 1 or 2 in a simulated manner. The gauze-packed procedure simulator is characterized in that the gauze inside can be visually recognized from the front through the opening, and the gauze inside can be visually recognized from the side through the side wall of the container. The manual skill training method according to claim 9. It includes a procedure step of simulating the Pringle method on the procedure simulator according to claim 6,
The procedure simulator includes a blood vessel model in which a blood vessel flowing into the liver is reproduced,
the mesenchymal model is fixed to the blood vessel model by the fixing member,
A medical procedure training method, characterized in that in the procedure step, a through hole is formed in the mesenchymal model. 9. The manual training method according to claim 8, wherein in the manual procedure step, an organ protection sheet is placed in a simulated manner through the opening area.