JP5947112B2 - Endoscopy training system - Google Patents

Description

  The present invention relates to an endoscope training system for training endoscopic surgery.

  Currently, in the field of medical technology, there is a global trend to minimize pain and injury after surgery. As a technique along such a flow, there is an endoscopic operation which is one of minimally invasive operations.

  The flow to endoscopic surgery is further increasing due to medical economic factors such as less burden on the patient's body and the need for early rehabilitation and hospitalization. However, since endoscopic surgery is an operation while viewing a monitor image acquired by an endoscope, the surgical field is narrow and the degree of freedom of operation of the surgical instrument is low, so unlike conventional laparotomy, More specialized and advanced technology is required. For this reason, in endoscopic surgery, in some cases, there are concerns about the occurrence of damage to living tissues and complications during and after surgery due to immature techniques.

  One type of endoscopic surgery is arthroscopic surgery performed in the orthopedic field. Arthroscopic surgery is a surgery performed by opening a small hole in the body and inserting an arthroscope or surgical instrument for observing the state of the joint through the hole. Arthroscopic surgery is very useful because it causes less pain and bleeding and can be discharged early. For this reason, arthroscopic surgery has made rapid progress centering on the knee joint since the 1980s, and now the applicable range of shoulder joints, wrist joints, hip joints, etc. has expanded. Arthroscopic surgery techniques are now considered basic and indispensable for orthopedic surgeons.

  Such arthroscopic surgery is a difficult operation that requires a specific advanced technique called psychomotor skill. Psychomotor skill is a technology that can accurately grasp the three-dimensional body space from the arthroscopic video, which is a two-dimensional image displayed on the monitor, and accurately operate the arthroscope and the surgical instrument with both hands. .

  In such arthroscopic surgery, which requires advanced technology, if there is insufficient training for the surgeon, tissue damage in the body due to erroneous operation of surgical instruments, complications during and after surgery, etc. may occur. It becomes easy. Therefore, in order to train excellent surgeons who can cope with arthroscopic surgery, it is important to give doctors sufficient opportunities for surgical training.

  The current educational system for arthroscopic technology in Japan only provides guidance during the operation by the instructor and sporadic education and training seminars, and there is an absolute lack of training opportunities for doctors. Is a problem. In addition, there are the following problems in the guidance and education of these arthroscopic techniques.

  Regarding the guidance during the operation by the instructor, the burden on the instructor is large because the number of instructors is small for the trainees and the instruction content is relatively advanced technology. As for education and training seminars, it is a situation where training starts with simple models due to the absolute shortage of fresh frozen enclosures in Japan. To receive training using enclosures, go to overseas seminars. May be forced to participate. For this reason, it is difficult to acquire efficient technology in some education / training seminars. In addition, there are various problems associated with training using a rod, such as complicated handling of the fresh frozen rod itself, an expensive fresh frozen rod, and the possibility of infection with a viral disease or the like. It has been pointed out.

  As described above, the environment for training of advanced arthroscopic techniques is insufficient. For this reason, it is desired to provide an environment that enables more efficient arthroscopic training.

  Thus, for example, there are techniques disclosed in Patent Documents 1 and 2. Patent Documents 1 and 2 both relate to a training apparatus for endoscopic technology. The training device of Patent Document 1 includes a configuration that supports a tubular organ that is excised from a living body and a configuration that supports an endoscope that is inserted into the tubular organ, and uses the tubular organ that is actually excised from the living body. It is for training.

  In addition, the training device of Patent Document 2 uses a box having an object that simulates an affected part inside, and displays a captured image on the screen while inserting a surgical instrument in the box, A predetermined operation is performed on an object. And skill evaluation is performed by the time etc. which perform the predetermined training task defined by operation etc. with respect to the target object in a box.

JP 2006-81568 A JP 2009-236963 A

  According to the technique of Patent Literature 1, it is considered that the operation technique of the endoscope can be acquired while obtaining a feeling close to an actual clinical state by using a tubular organ excised from a living body. However, the technique of Patent Document 1 is for performing training only for the operation of an endoscope, and is an advanced endoscope such as a psychomotor skill for operating an arthroscope and a surgical instrument with both hands as described above. Cannot support technical training. Moreover, since the technique of patent document 1 becomes the object of training for the tubular organ excised from the living body, an application range is limited to an esophagus, a stomach, etc. Moreover, since it is a technique using an actual organ, there is a concern about the possibility of infection with the diseases described above.

  Although the technique of patent document 2 can perform training of operation with both hands by inserting a plurality of surgical instruments in the box, a camera that captures the inside of the box corresponding to the endoscope is not the target of the operation. Absent. That is, in the technique of Patent Document 2, the camera that captures the inside of the box is not operated by the trainee during training, but captures a fixed position within the box. For this reason, the technique of Patent Document 2 does not target the operation of the endoscope as a training target. Moreover, although the technique of patent document 2 performs skill evaluation about a predetermined training task, the evaluation index is about operation of a general surgical instrument assumed in endoscopic surgery, for example, It is difficult to say that effective training can be performed for a specific endoscopic technique such as a psychomotor skill including the operation of an endoscope used in arthroscopic surgery as described above.

  On the other hand, there is a VR training device using VR (virtual reality) as a training device for endoscopic technology. Some VR training devices are equipped with a function that improves the training effect by making full use of the latest CG (computer graphics) technology and transmitting haptic information to a trainee. However, the VR training device may be shortly developed, and the price range is very high. For this reason, the VR training apparatus is only introduced on a trial basis at a core training base in a large city in Japan, and has not been sufficiently spread. In addition, the high price is an obstacle when considering expansion into other countries such as the Asian region.

  As described above, for advanced endoscopic techniques such as arthroscopic techniques, there are no quantitative and objective evaluation indexes and evaluation systems, and the environment for efficient training is insufficient. The current situation is that we can't say that.

  In order to realize an environment for efficient training for advanced endoscopic technology, the trainer's confidence should be able to perform appropriate training independently, even in situations where there is no supervising doctor Is preferred. However, it is difficult for an inexperienced doctor or the like to judge by himself the skills that are lacking or what training is appropriate for him. In this respect, if an endoscopic technique can be quantitatively and objectively evaluated, even an inexperienced doctor or the like can perform efficient training himself.

  Therefore, the present invention provides an endoscope training system capable of performing quantitative and objective evaluation and efficient training for advanced endoscope technology such as arthroscopic technology. For the purpose.

  The endoscope training system of the present invention is an endoscope training system that performs endoscopic surgery training, and has an operation target that receives an operation corresponding to the training content, and is prepared for each training content. A plurality of task boxes, and an insertion slot into which the task box is inserted, and the task box inserted from the insertion slot is held so that a side on which the operation target is operated faces an opening side of the insertion slot A task box holding unit that covers the insertion port, penetrates a surgical instrument used for the operation of the endoscope and the operation target, and allows the operation of the operation target with the endoscope and the surgical instrument to be permitted , Identifying the training content corresponding to the task box inserted in the task box holding unit, A trainer that includes the control unit that outputs control information according to the training content, and the display unit that displays the video according to the training content based on the control information output from the control unit, and performs the training Performs an operation on the operation target while viewing an endoscope image projected by the endoscope, and the training content is set according to the type of the endoscope. It has a correlation with the instruction items.

  Further, in the endoscope training system of the present invention, the training content includes a time required to achieve the training content by an operation on the operation target, a degree of achievement and a failure of the training content by the operation on the operation target. The skill evaluation item includes at least one of numbers, and the skill evaluation item has a correlation with the plurality of instruction items.

  In the endoscope training system of the present invention, the endoscope is an arthroscope, and the plurality of instruction items include a mirror technique using the arthroscope, both hands operating the arthroscope and the surgical instrument. Coordinated operations, avoidance of damage and complications associated with surgery, acquisition of information from the video of the arthroscope, and surgery time.

In the endoscope training system of the present invention, the plurality of task boxes include the following nine task boxes.
A first task box in which the operation of the arthroscope for the operation target is the training content and the skill evaluation item is the required time.
A second task box in which the operation of the arthroscope with respect to the operation target and the contact operation with the surgical instrument are the training contents, and the skill evaluation items are the required time, the achievement level of the training contents, and the number of failures.
A third task box in which the operation of the arthroscope and the grasping operation by the surgical instrument with respect to the operation target are the training contents, and the skill evaluation item is the required time.
The size determination by the image of the arthroscope with respect to the operation target and the contact operation by the surgical instrument are the training contents, and the skill evaluation items are the required time, the achievement degree of the training contents, and the number of failures. Task box.
A fifth task box in which the operation of the arthroscope with respect to the operation target and the cutting operation by the surgical instrument are the training contents, and the skill evaluation items are the required time, the achievement level of the training contents, and the number of failures.
A sixth task box in which the operation of the arthroscope with respect to the operation target and the extraction / insertion operation with the surgical instrument are the training contents, and the skill evaluation items are the required time, the achievement level of the training contents, and the number of failures.
A seventh task box in which the operation of the arthroscope with respect to the operation target and the trace operation by the surgical instrument are the training contents, and the skill evaluation items are the required time, the achievement level of the training contents, and the number of failures.
The operation contents of the arthroscope and the extraction operation by the surgical instrument with respect to the operation object in at least two angle states are the training contents, and the skill evaluation items are the required time, the achievement level of the training contents, and the number of failures. 8 task boxes.
The operation object of the eighth task box as the operation object is symmetrical with respect to the operation object, and the training content includes the operation of the arthroscope and the extraction operation by the surgical instrument with respect to the operation object in at least two angle states. And a ninth task box in which the skill evaluation items are the required time, the achievement level of the training content, and the number of failures.

  In the endoscope training system of the present invention, the task box holding unit is connected to the control unit at a position facing the insertion port, and the control unit receives a signal for identifying the training content. The task box has a second connector connected to the first connector by an insertion operation of the task box into the insertion port on a surface on the insertion side with respect to the insertion port. Have.

  According to the present invention, it is possible to perform a quantitative and objective evaluation of an advanced endoscopic technique such as an arthroscopic technique, and to perform efficient training.

The conceptual diagram of the endoscope training system which concerns on this invention. The figure which shows the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows the use condition of the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows the system main body of the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows the structure of the support mechanism of the task box slot of the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows the task box of the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows the structure of the task box of the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows the structure of the cover body of the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows the structure of the cover body of the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows the structure of the task box slot of the arthroscopic training system which concerns on one Embodiment of this invention. Explanatory drawing about the training content by the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows an example of the arthroscopic image in the arthroscopic training system which concerns on one Embodiment of this invention. Explanatory drawing about the training content by the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows an example of the arthroscopic image in the arthroscopic training system which concerns on one Embodiment of this invention. Explanatory drawing about the training content by the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows an example of the arthroscopic image in the arthroscopic training system which concerns on one Embodiment of this invention. Explanatory drawing about the training content by the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows an example of the arthroscopic image in the arthroscopic training system which concerns on one Embodiment of this invention. Explanatory drawing about the training content by the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows an example of the arthroscopic image in the arthroscopic training system which concerns on one Embodiment of this invention. Explanatory drawing about the training content by the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows an example of the arthroscopic image in the arthroscopic training system which concerns on one Embodiment of this invention. Explanatory drawing about the training content by the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows an example of the arthroscopic image in the arthroscopic training system which concerns on one Embodiment of this invention. Explanatory drawing about the training content by the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows an example of the arthroscopic image in the arthroscopic training system which concerns on one Embodiment of this invention. Explanatory drawing about the training content by the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows an example of the arthroscopic image in the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows the construction image of the biological model which comprises the operation target of the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows an example of the display screen in the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows the set operation | movement of the task box in the arthroscopic training system which concerns on one Embodiment of this invention. Explanatory drawing about the relationship of the instruction | indication item and task box in the arthroscopic training system which concerns on one Embodiment of this invention. The figure which shows the table | surface about the relevance of the instruction | indication item and skill evaluation item in the arthroscopic training system which concerns on one Embodiment of this invention. The perspective view which shows the main body of the arthroscopic training system which concerns on other embodiment of this invention. The figure which shows a part of main body of the arthroscopic training system which concerns on other embodiment of this invention.

[Outline of the present invention]
The present invention relates to an endoscopic training system that performs endoscopic surgery training, and includes a plurality of task boxes for performing training of different contents for each skill required as endoscopic technology. It is prepared in relation to the guidance items in.

  Specifically, according to the guidance items in endoscopic surgery, the technology necessary for endoscopic surgery is divided into multiple training contents in a factorial manner, and a task box is prepared for each divided training content. The evaluation index of the training content performed by the task box is related to each instruction item. As a result, the present invention enables quantitative and objective skill evaluation for advanced endoscopic techniques, so that advanced techniques such as psychomotor skills can be acquired without relying on a supervisor. It is possible to perform efficient training.

[Concept of endoscope training system according to the present invention]
FIG. 1 shows a conceptual diagram of an endoscope training system according to the present invention. As shown in FIG. 1, an endoscope training system 100 according to the present invention performs training for endoscopic surgery, divides a technique required for endoscopic surgery into a plurality of training contents, A plurality of task boxes 200 are prepared for each training content.

  Each task box 200 has an operation target for receiving an operation corresponding to the training content. The operation target included in the task box 200 is, for example, a biological model that simulates an affected part in which endoscopic surgery is performed. The task box 200 has an opening 200a on one side, and an operation to an operation target in the task box 200 is performed from the opening 200a. The task box 200 is inserted and held in a task box slot 300 as a task box holding unit provided in the endoscope training system 100.

  The task box slot 300 has an insertion slot 300a into which the task box 200 is inserted, and holds one task box 200 inserted from the insertion slot 300a. The task box slot 300 holds the task box 200 inserted from the insertion port 300a so that the operation target in the task box 200 receives the operation (opening 200a side) faces the opening side of the insertion port 300a.

  That is, in a state where the task box 200 is held in the task box slot 300, the insertion port 300a of the task box slot 300 and the opening 200a of the task box 200 face the same side. A person who trains (hereinafter, referred to as “trainer”) is positioned so as to face the insertion port 300a of the task box slot 300, and as a training, the person who performs the training with respect to the operation target of the task box 200 set in the task box slot 300 The operation is performed from the opening 200a side.

  The trainee performs an operation on the operation target of the task box 200 using an endoscope and a surgical instrument such as a forceps or a probe. For example, the trainee displays an arbitrary place to be operated of the task box 200 with an endoscope, and performs an operation with a surgical instrument such as a forceps while viewing an image displayed on the monitor.

  An operation target of the task box 200 that receives an operation by the trainee is covered and hidden by a lid portion attached to the insertion port 300a of the task box slot 300. That is, the trainee confirms the state inside the task box 200 with an image by an endoscope through the lid in a state where the operation target of the task box 200 is hidden by the lid attached to the insertion port 300a. While performing the operation. For this reason, the lid is provided with a hole that allows the endoscope and the surgical instrument to penetrate and allows the trainee to operate the operation target.

  As described above, the lid that is attached to the insertion port 300a of the task box slot 300 and hides the operation target of the task box 200 covers the insertion port 300a of the task box slot 300 and is used for the operation of the endoscope and the operation target. The instrument is pierced, and an operation with respect to the operation target by the endoscope and the surgical instrument is allowed.

  As shown in FIG. 1, the endoscope training system 100 includes a touch panel 400 as a display unit. The touch panel 400 displays an image corresponding to the training content of the task box 200 set in the task box slot 300. The touch panel 400 is arranged at a position that can be operated by a trainee who performs training.

  The touch panel 400 displays a display for executing the start / progress / end of the training, a result of the training contents, and the like. The trainee touches the screen according to the display content of the touch panel 400 and proceeds with training as appropriate. Thus, the touch panel 400 as a display unit also functions as an operation unit operated by a trainee in order to advance training.

  The content displayed on the touch panel 400 is controlled by a control unit provided in the endoscope training system 100. The control unit identifies the training content corresponding to the task box 200 inserted and set in the task box slot 300, and outputs control information corresponding to the identified training content.

  And the touch panel 400 displays the image | video according to the training content based on the control information output from the control part. The training content of the task box 200 set in the task box slot 300 is recognized by the control unit by connecting predetermined connectors of the task box 200 and the task box slot 300 to each other.

  In the endoscope training system 100 having the above-described configuration, each training content that is different for each task box 200 includes, for example, a plurality of times required to achieve preset training content, a degree of achievement of the training content, and the like. Skill evaluation items. In other words, each training content is related to the training performed by the trainer, and the time required to achieve the training content as an evaluation index for quantitatively and objectively expressing the skill of the trainer with respect to the training content. A plurality of skill evaluation items such as

  And the training content by each task box 200 has a correlation with respect to the some guidance item about training of endoscopic surgery set according to the kind of endoscope. There are various types of endoscopes such as an arthroscope, a laparoscope, a thoracoscope, a laryngoscope, a small intestine endoscope, a large intestine endoscope, and a capsule endoscope. Skills required as an endoscopic technique in surgery using each endoscope vary depending on the type of endoscope. Therefore, there are guidance items for training of endoscopic surgery for each type of endoscope. The guidance item is an item that is pointed out and instructed to the trainee by a specialist who is a supervising physician or the like in the training for endoscopic surgery.

  In this way, each training content has a correlation with a plurality of instruction items, so that the trainer can perform efficient training. In addition, for each training content, for example, by using an evaluation result based on an evaluation index such as the time required to achieve the training content, the objective is that the skills for the instruction items highly relevant to the training content with low evaluation are immature Evaluation is possible. Further, it is possible to quantitatively evaluate the training content by referring to values such as the time required to achieve the training content, which is an evaluation index of the training content.

  As described above, according to the endoscope training system 100 according to the present embodiment, it is possible to perform a quantitative and objective evaluation on an advanced endoscope technique such as an arthroscopic technique, and to perform efficient training. It can be performed.

  Moreover, it is preferable that not only each training content but the skill evaluation item of each training content has a correlation with respect to the some guidance item about training of endoscopic surgery. In this way, the skill evaluation items of each training content have a correlation with multiple instruction items, so that more quantitative and objective evaluation can be performed for endoscopic surgery, and more efficient training can be performed. It can be carried out.

  Specifically, the trainee uses a plurality of task boxes 200 to perform an operation on the operation target according to the training content of each task box 200. Thereby, the evaluation result about each skill evaluation item of the training content for every task box 200 is obtained.

  As described above, each skill evaluation item of the training content is related to and has a correlation with a plurality of instruction items. Here, the skill evaluation item of the training content has relevance to the instruction item. An improvement in the evaluation of a certain skill evaluation item is equivalent to an improvement in the technology of the corresponding instruction item. There is sex. Examples of the improvement of the skill evaluation item include that the required time is shortened when the skill evaluation item is the required time.

  From the evaluation result of each skill evaluation item of the training content for each task box 200, the trainer has his / her own skill for each instruction item, such as which instruction item is insufficient among a plurality of instruction items. Can be grasped quantitatively and objectively. Therefore, the trainer sets the task box 200 so that the training contents having the skill evaluation items corresponding to the guidance items for which the skills are insufficient, for example, are focused and focused according to the state of his / her skills. Select and train. By performing such training, efficient self-training without waste can be performed without depending on the instructor.

  Hereinafter, the endoscope training system according to the present invention will be described more specifically using embodiments. In the embodiment described below, an arthroscope used in an orthopedic region is taken as an example of the endoscope according to the present invention. That is, in the embodiment described below, an arthroscopic training system which is an example of an endoscope training system according to the present invention will be described.

[Configuration of arthroscopic training system]
The configuration of the arthroscopic training system 1 according to the present embodiment will be described with reference to FIGS. The arthroscopic training system 1 performs training for arthroscopic surgery. Arthroscopic surgery is performed using an arthroscope and a surgical instrument such as forceps.

  Therefore, as shown in FIG. 3, the trainer 50 who uses the arthroscopic training system 1 performs training on the operation techniques of the arthroscope 51 and the surgical instrument 52 as the arthroscopic technique used in the arthroscopic surgery. FIG. 3 shows an example in which the trainee 50 operates the arthroscope 51 with the left hand and operates the forceps as an example of the surgical instrument 52 with the right hand.

  The arthroscopic training system 1 according to this embodiment includes a system main body 2, a plurality of task boxes 3, and a touch panel 4. The arthroscopic training system 1 includes a plurality of task boxes 3 for dividing a technique required for arthroscopic surgery into a plurality of training contents and training each content. Therefore, a plurality of task boxes 3 are prepared for each training content.

  As shown in FIG. 3, a trainee 50 who uses the arthroscopic training system 1 is positioned so as to face the system body 2 and performs training. In the following description, the left-right direction and the up-down direction viewed from the trainer 50 positioned so as to face the system body 2 are the left-right direction and the up-down direction in the system body 2 of the arthroscopic training system 1, respectively.

  The system body 2 includes a control box 5 as a control unit and a task box slot 6 as a task box holding unit. The control box 5 has a substantially box-shaped outer shape in which a pair of surface portions located on opposite sides are formed as curved surfaces protruding outward. The task box slot 6 has substantially the same outer shape as the control box 5, and has an outer size that is slightly smaller than that of the control box 5 as a whole. Both the control box 5 and the task box slot 6 are arranged such that a pair of surface portions formed as curved surfaces protruding outward as described above are located on both the left and right sides as viewed from the trainee 50 who performs training.

  The task box slot 6 is provided above the control box 5. The system main body 2 is used while being placed on a predetermined placement surface 53 such as a desk or a table. The system body 2 is placed on the placement surface 53 with the control box 5 placed on the placement surface 53.

  The task box slot 6 is provided via a support mechanism 10 provided on the upper surface 5 a of the control box 5. The support mechanism 10 has a support plate 11 provided in a state of standing on the upper surface 5 a of the control box 5. The support plate 11 is a member having a rectangular plate shape, and is provided such that its longitudinal direction is the vertical direction. The task box slot 6 is supported on the support plate 11.

  A detailed configuration of the support mechanism 10 will be described with reference to FIG. The support mechanism 10 supports the task box slot 6 so as to be movable up and down and rotatable. As shown in FIG. 5, the support mechanism 10 has the support plate 11 provided on the upper surface 5a as described above.

  The support plate 11 has an edge portion 11a that is bent at a substantially right angle from the rectangular plate portion to the rear side at the periphery of the rectangular plate shape. That is, the rear side of the support plate 11 is surrounded by the edge 11a from both the upper and lower sides and the left and right sides. The lower edge part 11b along the lower side part of the support plate 11 among the edge parts 11a is fixed to the upper surface 5a of the control box 5 by a fixing tool 12 such as a screw, so that the support plate 11 is attached to the upper surface 5a. Fixed.

  The support plate 11 has a long hole 11 c along the longitudinal direction of the support plate 11. The long hole 11 c is formed over substantially the entire vertical direction of the support plate 11 at a substantially central position in the left-right direction on the support plate 11 provided on the control box 5. The task box slot 6 is supported by the support plate 11 with its back surface 6b facing the front surface 11d (see FIG. 4) side of the support plate 11.

  The support mechanism 10 includes a support 13 that penetrates the support plate 11 through the long hole 11 c and is connected to the back surface 6 b of the task box slot 6. The support 13 has a disk-like outer shape, and has an outer diameter larger than the width dimension of the long hole 11c. The support body 13 is provided with the support plate 11 sandwiched between the task box slot 6 and the back surface 6b side in a posture in which the central axis direction of the disk-shaped outer shape is the front-rear direction. The task box slot 6 is supported by the support plate 11 by sandwiching the support plate 11 between the task box slot 6 and the support body 13.

  A state where the support plate 11 is clamped by the task box slot 6 and the support 13 and a state where the support plate 11 is released are switched by the operation of the operation lever 14. The operation lever 14 is provided so that the position of the rotation axis coincides with the position of the center axis of the disk-like support 13 (see arrow A1). The operation lever 14 has a shape in which the rotation base is positioned on the support 13 and extends in the radial direction of the support 13.

  As the operation lever 14 is operated, the support box 11 is released from being held between the task box slot 6 and the support 13, so that the task box slot 6 is allowed to move up and down and rotate. The task box slot 6 moves up and down within a predetermined range by moving up and down along the long hole 11c together with the support 13 and the operation lever 14 (see arrow A2). Further, the task box slot 6 rotates by rotating around the rotation axis at the same position as the rotation axis of the operation lever 14 (see arrow A3). The task box slot 6 is fixed and supported by the support plate 11 by sandwiching the support plate 11 together with the support 13 at any position in the vertical direction and the rotation direction by operating the operation lever 14.

  Further, the support mechanism 10 includes a reel mechanism 15 for supporting the lifting operation of the task box slot 6. The reel mechanism 15 is provided on the back side of the support plate 11 similarly to the support 13, and supports the task box slot 6 by a plate spring 16 via the support 13 that moves up and down integrally with the task box slot 6.

  The reel mechanism 15 includes a leaf spring 16, a rotating reel 17 around which the leaf spring 16 is wound, and a support stay 18 that rotatably supports the rotating reel 17. The support stay 18 is a plate-like member having a gate-like shape, and is fixed to the lower side with respect to the upper edge portion 11 e along the upper side portion of the support plate 11 among the edge portions 11 a of the support plate 11. The The support stay 18 is fixed by, for example, a fixture 18a such as a screw that penetrates the upper edge portion 11e of the edge portion 11a in the vertical direction.

  The rotary reel 17 is supported on the inner side of the gate-like support stay 18 by the support stay 18 with the left-right direction as the rotation axis direction. The leaf spring 16 wound around the rotary reel 17 is, for example, a metal band-shaped member, and is connected to the support body 13 positioned below the reel mechanism 15. The leaf spring 16 is connected to the support 13 by fixing a tip portion extending downward from the rotary reel 17 to the upper end of the support 13 by a fixing member 16 a such as a pin.

  When the task box slot 6 is lowered by the reel mechanism 15 having such a configuration, the leaf spring 16 is pulled out with the rotation of the rotary reel 17, and the task box slot 6 is raised, so that the leaf spring 16 Due to the elasticity, the leaf spring 16 is wound with the rotation of the rotary reel 17. As described above, the reel mechanism 15 that supports the task box slot 6 prevents the task box slot 6 from being suddenly dropped when the support plate 11 is released by the operation of the operation lever 14. Therefore, the reel mechanism 15 supports the task box slot 6 by the leaf spring 16 with such a force that the task box slot 6 does not fall under its own weight.

  By the support mechanism 10 having the above-described configuration, the task box slot 6 is supported in a state where it can be moved up and down and rotated.

  The control box 5 incorporates a control configuration for performing predetermined control in training by the arthroscopic training system 1. The control box 5 controls the arthroscopic training system 1 by executing a predetermined process according to a control program stored in advance. The control box 5 has various functional parts such as a CPU, a memory, and a plurality of input / output interfaces connected by a data communication bus and the like, and transmits and receives various information via the bus and the like.

  As shown in FIG. 4, the task box slot 6 has an insertion slot 6a into which the task box 3 is inserted, and holds one task box 3 inserted from the insertion slot 6a. The task box slot 6 has a substantially box-shaped outer shape as described above, and is formed in a hollow shape. The insertion space 6a provided on one surface side of the task box slot 6 opens the internal space to the outside. The task box slot 6 allows one task box 3 to be inserted into the internal space, and holds the task box 3 facing the outside through the insertion slot 6a.

  The task box 3 is configured as a cartridge with respect to the task box slot 6. As shown in FIGS. 6A and 6B, the task box 3 has a substantially rectangular parallelepiped outer shape, and has an operation target 20 that receives an operation corresponding to the training content. The task box 3 has an opening 3a on one surface side in the substantially rectangular parallelepiped outer shape. The task box 3 has a storage space for the operation target 20 opened to the outside through the opening 3a, and the operation target 20 is provided inside the storage space. The operation target 20 receives an operation from the opening 3a side. 6A is a perspective view of the task box 3 as seen from the front side (opening 3a side), and FIG. 6B is a perspective view of the task box 3 as seen from the back side.

  The opening 3 a of the task box 3 defines the operating range of the arthroscope 51 and the surgical instrument 52 by the trainee 50. That is, the operation range of the arthroscope 51 and the surgical instrument 52 with respect to the operation target 20 in the task box 3 by the trainee 50 is defined by the size of the opening 3a.

  The range in which the arthroscope 51 and the surgical instrument 52 are moved is typically a range of 80 to 120 mm in width, 30 to 70 mm in height, and 40 to 80 mm in depth. For this reason, by setting the width, height, and depth dimensions of the opening 3a of the task box 3 to values within the above ranges, a good operational feeling can be obtained as training for arthroscopic surgery. . In particular, in arthroscopic training, it is preferable to set the width, height, and depth dimensions of the opening 3a of the task box 3 to 85 mm × 40 mm × 70 mm, respectively, in order to obtain an optimal operational feeling.

  The operation target 20 included in the task box 3 is, for example, a living model imitating an affected part where arthroscopic surgery is performed. FIG. 6A shows a structure including a knee joint model in which arthroscopic surgery is performed as an example of the operation target 20.

  Further, as shown in FIG. 7, the task box 3 has a gripping body 31 for being pulled out from the state inserted in the insertion slot 6 a of the task box slot 6. The grip body 31 is provided on the bottom surface 3 c side of the substantially rectangular parallelepiped outer shape of the task box 3.

  The grip body 31 is a substantially rectangular plate-like member, and is provided so as to be movable in the front-rear direction (vertical direction in FIG. 7) along the bottom surface 3c of the task box 3 when the opening 3a side is the front side ( (See FIG. 7, arrow B1). The grip body 31 has a grip portion 31a along the front side portion. The holding part 31a is formed with a rectangular opening 31b that penetrates the holding body 31 that is a plate-like member.

  The grip body 31 is supported by the two locking portions 32 and the two fastening portions 33 so as to be movable in the front-rear direction along the bottom surface 3 c of the task box 3. The locking portions 32 are provided so as to be positioned on both the left and right sides of the gripping body 31 at the front end (opening 3 a side) of the bottom surface 3 c of the task box 3.

  The locking portion 32 is configured by fixing a plate-shaped locking member 32a to the bottom surface 3c by a fixing tool 32b such as a screw. The locking member 32a constituting the locking portion 32 forms a fixed portion 32c fixed to the bottom surface 3c by a fixing tool 32b, and a surface facing the bottom surface 3c with a predetermined distance therebetween, and the bottom surface 3c. A support portion 32d for supporting the grip body 31 is provided therebetween.

  The fastening portion 33 includes a fastener 33 a that penetrates the plate-shaped gripping body 31 and is fixed to the bottom surface 3 c of the task box 3. The two fastening portions 33 are provided at the intermediate portions in the front-rear direction of the grip body 31 at positions spaced apart from each other in the left-right direction. The fastener 33a penetrates the long hole 31c formed in the holding body 31, and is fixed to the bottom surface 3c. The long hole 31c sets the moving direction of the gripping body 31 as the longitudinal direction, allows the gripping body 31 to move, and restricts the moving direction of the gripping body 31. The movement of the grip body 31 along the long hole 31 c is guided by the locking portion 32.

  Thus, the gripping body 31 supported so as to be movable in the front-rear direction is used, and the task box 3 inserted into the insertion slot 6a of the task box slot 6 is pulled out from the insertion slot 6a. The holding body 31 is pulled out from the state where the entire holding body 31 is stored so as to overlap the bottom surface 3c of the task box 3 until the holding portion 31a protrudes toward the opening 3a (see the two-dot chain line in FIG. 7). . The grip portion 31a protruding toward the opening 3a is gripped, and the task box 3 inserted into the insertion port 6a is pulled out. The task box 3 having the above configuration is inserted and held in the task box slot 6.

  The task box slot 6 holds the task box 3 inserted from the insertion slot 6a so that the operation target 20 in the task box 3 receives the operation (opening 3a side) faces the opening side of the insertion slot 6a. That is, in a state where the task box 3 is held in the task box slot 6, the insertion slot 6a of the task box slot 6 and the opening 3a of the task box 3 face the same side. In other words, the task box 3 having a substantially rectangular parallelepiped outer shape is inserted into the insertion port 6a from the back side opposite to the front side when the opening 3a side is the front side. The insertion opening 6 a has a substantially rectangular opening shape corresponding to the outer shape of the task box 3.

  The trainer 50 is positioned so as to face the insertion opening 6a of the task box slot 6, and as an exercise, the trainer 50 performs an operation on the operation target 20 of the task box 3 inserted and set in the task box slot 6 from the opening 3a side. Do. In the following description, in the system main body 2, the side on which the insertion port 6a of the task box slot 6 is opened is the front side, and the opposite side is the back side.

  As shown in FIG. 3, the trainee 50 performs an operation on the operation target 20 (see FIG. 4) of the task box 3 using an arthroscope 51 and a surgical instrument 52 such as a forceps or a probe. That is, the trainer 50 who performs the arthroscopic surgery training performs an operation on the operation target 20 of the task box 3 while viewing the arthroscopic video (endoscopic video) displayed by the arthroscope 51. As shown in FIG. 3, the video acquired by the arthroscope 51 is displayed on a predetermined monitor 54. The monitor 54 is disposed at a position that can be visually recognized by a trainee 50 who performs training. The trainer 50 performs an operation with the surgical instrument 52 such as a forceps while viewing an arbitrary position of the operation target 20 of the task box 3 with the arthroscope 51 and viewing the arthroscopic image 54a displayed with the monitor 54.

  The operation target 20 of the task box 3 that receives an operation by the trainee 50 is covered and hidden by the lid 40 attached to the insertion slot 6a of the task box slot 6. In other words, the trainee 50 shows the state inside the task box 3 through the lid 40 in a state where the operation target 20 of the task box 3 is covered with the lid 40 attached to the insertion slot 6a. The operation is performed while confirming with the arthroscopic image 54a of the monitor 54 by 51.

  As shown in FIG. 8, the lid 40 is a substantially rectangular plate-like member that covers the insertion port 6 a that opens to the front side of the task box slot 6, and is attached to the front side of the task box slot 6. For this reason, the cover body 40 has an outer dimension larger than at least the opening area of the insertion port 6a. 2 and 3 show a state where the lid 40 is attached to the task box slot 6, and FIG. 4 shows a state where the lid 40 is removed from the task box slot 6. . Further, FIG. 8 shows the state of the process of attaching or removing the lid 40 to / from the task box slot 6.

  As shown in FIG. 9A, a hole for allowing the articulator 51 and the surgical instrument 52 operated by the trainee 50 to pass through the lid 40 and allowing the trainer 50 to operate the operation target 20. A portion 41 is provided. In the present embodiment, the lid body 40 has two hole portions 41. The two holes 41 are provided at the same height in a state of being attached to the task box slot 6 and are provided at a predetermined interval in the left-right direction. Of the two holes 41, one hole 41 penetrates the arthroscope 51, and the other hole 41 penetrates a surgical instrument 52 such as forceps.

  As shown in FIG. 9A, the hole 41 forms a strip-shaped opening 42 whose longitudinal direction is the vertical direction with the lid 40 attached to the task box slot 6. The opening 42 is closed by a closing panel 43 made of an elastic material such as rubber. The closing panel 43 is formed with a cut 43 a for allowing the arthroscope 51 or the surgical instrument 52 to pass therethrough.

  The cut 43 a is formed in a straight line along the longitudinal direction of the opening 42 at the center of the opening 42. The arthroscope 51 or the surgical instrument 52 penetrates the hole 41 by passing through the cut 43 a of the closing panel 43 that closes the opening 42. The occlusion panel 43 gives a sense of resistance due to the operation of the arthroscope 51 or the surgical instrument 52 to the trainee 50 who operates the arthroscope 51 and the surgical instrument 52 penetrating the hole 41 by the notch 43a. For this reason, the notch 43a of the obstruction panel 43 is formed so that the resistance accompanying the movement by the operation of the trainee 50 caused by the contact of the obstruction panel 43 with the arthroscope 51 or the surgical instrument 52 to be penetrated is formed. The

  As shown in FIGS. 9A and 9B, the closing panel 43 is attached to the back surface 40 a of the lid body 40 and covers the opening 42 from the back side of the lid body 40. FIG. 9B is a cross-sectional view taken along the line XX in FIG. In the present embodiment, the openings 42 of the two hole portions 41 are covered with a single rectangular blocking panel 43. For this reason, the obstruction | occlusion panel 43 has a magnitude | size which can cover the range in which the opening 42 of the at least 2 hole 41 is provided. However, the closing panel 43 may be provided for each hole 41.

  The obstruction panel 43 that closes the opening 42 in the hole 41 is a member for obtaining a feeling close to that of actual arthroscopic surgery. In the present embodiment, as shown in FIG. 9B, the closing panel 43 includes a front side layer 43b made of a general synthetic rubber and a back side layer 43c made of a sponge-like foamed rubber containing many bubbles. It has a layer structure. The back layer 43c is a soft tissue that is relatively soft with respect to the front layer 43b. The closing panel 43 is affixed to the back surface 40a of the lid 40 with the front side layer 43b facing the opening 42 on the front side of the lid 40 (left side in FIG. 9B).

  Thus, the obstruction panel 43 simulates the skin part of the human body by the front side layer 43b and the tissue such as dermis and fat under the epidermis part by the back side layer 43c. As a result, the trainee 50 can obtain a sense of resistance similar to that of actual arthroscopic surgery with respect to the resistance feeling associated with the operation of the arthroscope 51 and the surgical instrument 52 inserted into the notch 43a of the closure panel 43 in the hole 41. it can.

  The lid 40 is attached to the task box slot 6 by being attracted by the magnetic force of the magnet. Specifically, as shown in FIG. 9B, the substantially rectangular plate-shaped lid body 40 has a bent portion 40b bent at a substantially right angle toward the back surface 40a side on the upper side portion. The lid body 40 has a substantially L-shaped side surface by including the bent portion 40b (see FIG. 9B).

  In the lid body 40 having such a shape, the first magnet 44a is provided on the back surface 40a of the main body portion, and the second magnet 44b is provided on the lower surface 40c of the bent portion 40b. The first magnet 44a has a belt-like shape, and is attached to the back surface 40a in a range covering substantially the entire left and right direction of the lid body 40 so that the longitudinal direction is the left and right direction of the lid body 40 and along the lower side of the lid body 40. Attached. Similar to the first magnet 44a, the second magnet 44b has a belt-like shape / dimension over substantially the entire lateral direction of the lid 40, and is attached to the lower surface 40c of the bent portion 40b.

  As shown in FIG. 9B, the lid 40 attracts the first magnet 44a provided on the back surface 40a to the front surface 6c of the task box slot 6 and causes the second magnet 44b provided on the bottom surface 40c to adhere to the task box slot 6. It is attached to the task box slot 6 by being adsorbed on the upper surface 6d of the. The arrangement and shape of the magnet for attracting the lid 40 to the task box slot 6 are not limited to this embodiment, and the lid 40 can be attracted to the task box slot 6 with a desired adsorption force. Appropriate arrangement and shape can be adopted.

  As described above, by adopting a configuration in which the lid 40 is attached to the task box slot 6 by the magnetic force, the attachment position of the lid 40 with respect to the task box slot 6 can be easily shifted. Fine adjustment of the position can be easily performed. Thereby, from the viewpoint of the position of the hole 41 of the lid body 40, the operation situation that varies depending on the trainer 50, such as the insertion position of the arthroscope and the surgical instrument in the arthroscopic surgery, and the sense of distance to the affected part, is more faithfully reproduced. It becomes possible to do.

  With the lid 40 having the above-described configuration, the operation target 20 of the task box 3 set in the task box slot 6 is covered with the trainee 50. As described above, in the present embodiment, the lid body 40 covers the insertion port 6a of the task box slot 6 and allows the surgical instrument 52 used for the operation of the arthroscope 51 and the operation target 20 to pass therethrough. It functions as a lid that allows the instrument 52 to operate the operation target 20. The trainer 50 operates the arthroscope 51 and the surgical instrument 52 via the lid 40 within the range defined by the size of the opening 3a of the task box 3 as described above, and performs training by the operation target 20. Do.

  The touch panel 4 functions as a display unit that displays an image corresponding to the training content of the task box 3 set in the task box slot 6. The touch panel 4 is disposed at a position where the trainer 50 who performs the training can operate. For example, the touch panel 4 is disposed in front of the system main body 2 on the placement surface 53 as shown in FIG.

  The touch panel 4 displays a display for executing the start / progress / end of the training, a result of the training contents, and the like. The trainer 50 touches the screen according to the display content of the touch panel 4 and proceeds with training as appropriate. As described above, the touch panel 4 as a display unit also functions as an operation unit operated by the trainee 50 in order to advance training.

  The content displayed on the touch panel 4 is controlled by a control box 5 as a control unit provided in the arthroscopic training system 1. For this reason, the touch panel 4 is connected to the control box 5 by the cable 4a. The control box 5 identifies the training content corresponding to the task box 3 inserted and set in the task box slot 6 and outputs control information corresponding to the identified training content.

  And the touch panel 4 displays the image | video according to the training content based on the control information output from the control box 5. FIG. The training contents of the task box 3 set in the task box slot 6 are recognized by the control box 5 by connecting predetermined connectors of the task box 3 and the task box slot 6 to each other.

  Specifically, as shown in FIGS. 6B and 7, in the task box 3, a connector (hereinafter referred to as “box-side connector”) 22 is provided on the back surface 3 d of the substantially rectangular parallelepiped outer shape. . The back surface 3d is a surface on the opposite side to the surface where the opening 3a opens in the task box 3. The box-side connector 22 is configured to protrude from the back surface 3d of the task box 3 while having a substantially rectangular plate shape.

  The box-side connector 22 exposes the connection terminal 22a at the tip in the protruding direction from the back surface 3d of the task box 3. Therefore, the box-side connector 22 has a protruding direction from the back surface 3d of the task box 3 as a connection direction to a connector 21 on the task box slot 6 side (hereinafter referred to as “slot-side connector”) 21 to be connected.

  As shown in FIG. 10, the slot-side connector 21 is provided so as to face the internal space of the task box slot 6. The slot-side connector 21 is connected by a cable 23 to a control configuration built in the control box 5. The cable 23 extends from the back side of the control box 5, passes through the task box slot 6 from the back surface 6 b (see FIG. 5) side, and positions the slot-side connector 21 inside the task box slot 6.

  As shown in FIG. 10, the slot-side connector 21 has a substantially rectangular shape, similar to the box-side connector 22, from the back side surface 6 e that is the surface opposite to the back surface 6 b of the task box slot 6. It is configured to protrude while having a plate-like outer shape. Therefore, the slot-side connector 21 is provided at a position facing the insertion slot 6 a of the task box slot 6. The slot-side connector 21 exposes the connection terminal 21 a at the tip portion in the protruding direction from the back side surface 6 e of the task box slot 6.

  As described above, in the configuration in which the connectors 22 and 21 are provided in the task box 3 and the task box slot 6, respectively, the box side connector 22 is inserted into the slot side connector 21 by the insertion operation of the task box 3 into the insertion port 6a of the task box slot 6. Connected to. That is, in the process of inserting the task box 3 with the opening 3a from the front side through the insertion port 6a of the task box slot 6, the box side connector 22 and the slot side connector 21 face each other, and the task box 3 Is pushed into the insertion opening 6a so that the box-side connector 22 and the slot-side connector 21 are fitted, and the connection terminals 22a and 21a of the connectors 22 and 21 are connected to each other.

  As described above, in the present embodiment, the task box slot 6 is connected to the control box 5 at a position facing the insertion slot 6a, and the slot side connector 21 that receives a signal for the control box 5 to identify the training content is provided. Have. The task box 3 has a box side connector connected to the slot side connector 21 by an insertion operation into the insertion port 6a of the task box 3 on the back surface 3d which is a surface on the insertion side with respect to the insertion port 6a of the task box slot 6. 22. In the present embodiment, the slot-side connector 21 included in the task box slot 6 corresponds to a first connector, and the box-side connector 22 included in the task box 3 corresponds to a second connector.

  By adopting a configuration in which the slot side connector 21 and the box side connector 22 are automatically connected by the insertion operation of the task box 3 into the task box slot 6 as in the arthroscopic training system 1 of the present embodiment, The task box 3 can be easily replaced. Thereby, in the training performed by using a plurality of task boxes 3, labor can be omitted, and the efficiency of training can be improved.

  As shown in FIG. 10, a guide mechanism 24 for guiding the operation of inserting the task box 3 into the task box slot 6 is provided in the task box slot 6. The guide mechanism 24 enables the connection between the slot-side connector 21 and the box-side connector 22 accompanying the insertion operation of the task box 3 into the task box slot 6 as described above. Slide to guide.

  The guide mechanism 24 includes a pair of left and right guide plates 25 and a plurality of guide rollers 26. The pair of guide plates 25 are provided in a standing state in the vertical direction so as to face each other in the horizontal direction. The pair of guide plates 25 has a guide surface 25a as surfaces facing each other in the left-right direction.

  The pair of guide plates 25 guide the task box 3 by bringing the guide surface 25a into contact with the task box 3 inserted from the insertion port 6a of the task box slot 6 from both the left and right sides. Further, the pair of guide plates 25 has an introduction plate portion 25 b that extends in the left-right direction toward the front side at the end portion on the near side in the insertion direction of the task box 3. The guide mechanism 24 receives the task box 3 inserted from the insertion port 6 a of the task box slot 6 by the introduction plate portion 25 b of the pair of guide plates 25.

  The plurality of guide rollers 26 are rotatably provided with the left-right direction as the rotation axis direction. The plurality of guide rollers 26 guide the task box 3 by contacting the bottom surface 3c (see FIG. 7) of the task box 3 inserted from the insertion port 6a of the task box slot 6.

  The plurality of guide rollers 26 are supported by a support plate 27 provided in a standing state in the vertical direction. In the present embodiment, a total of eight guide rollers 26 are provided on each of the left and right sides, four on each side so as to correspond to the left and right ends of the task box 3 inserted from the insertion opening 6 a of the task box slot 6.

  By the guide mechanism 24 having such a configuration, the task box 3 inserted from the insertion port 6a of the task box slot 6 so that the position of the box-side connector 22 in the left-right direction and the vertical direction coincide with the slot-side connector 21. Is guided. In addition, the structure of the guide mechanism 24 which guides the task box 3 inserted from the insertion port 6a is not limited to this embodiment. The guide mechanism 24 only needs to have a configuration that guides the task box 3 so that the box-side connector 22 is connected to the slot-side connector 21 by inserting the task box 3 into the task box slot 6.

  In this way, the task box 3 is inserted into the task box slot 6, and the training content of the inserted task box 3 is recognized by the control box 5 by connecting the box side connector 22 and the slot side connector 21. The For this reason, by connecting the box side connector 22 and the slot side connector 21 to each task box 3, the training contents are identified by the control configuration built in the control box 5 via the connection terminals 22a and 21a. An identification circuit is incorporated.

  For example, the control box 5 identifies the training contents of the task box 3 inserted into the insertion slot 6a and connected to the slot-side connector 21 with the box-side connector 22 by identifying a number assigned to each training content. . The control box 5 outputs a display about the identified training content to the touch panel 4. The display content of the touch panel 4 will be described later. In the description of the present embodiment, inserting the task box 3 into the insertion slot 6a of the task box slot 6 and connecting the box-side connector 22 to the slot-side connector 21 is referred to as “setting” for the task box 3.

  As shown in FIG. 2, the arthroscopic training system 1 according to this embodiment includes a foot switch 7, a speaker 8, and a probe 9 used as a surgical instrument 52 in addition to the above-described configuration.

  The foot switch 7 is used, for example, as a switch for causing the control box 5 to recognize the progress of training while the trainee 50 is operating the arthroscope 51 and the surgical instrument 52 with both hands during training. It is done. Further, the operation of the foot switch 7 may be used instead of the touch operation on the touch panel 4. In this way, the foot switch 7 functions as an operation unit operated by a trainee in order to advance training. The foot switch 7 is connected to the control box 5 by a cable 7a.

  The speaker 8 emits a sound related to training to the trainee 50. Specifically, from the speaker 8, a sound for informing the start / end of training, a sound interlocked with a touch operation on the touch panel 4, a sound interlocked with an operation of the foot switch 7, an operation target 20 by the surgical instrument 52. A sound or the like that is linked to an operation on is generated.

  The probe 9 simulates a probe instrument used as a surgical instrument in actual arthroscopic surgery, and is used as a surgical instrument 52 together with the arthroscope 51 by a trainee 50. The probe 9 is configured as an electronic probe, and detects contact with the operation target 20 of the task box 3 in training with predetermined training contents. For example, in the training content using the probe 9 as the surgical instrument 52, when the probe 9 performs an operation of contacting a predetermined location of the operation target 20, the contact of the probe 9 with respect to the predetermined position is detected as a detection signal by the probe 9. Are input to the control box 5 via the touch panel 4. For this reason, the probe 9 is connected to the touch panel 4.

  In the arthroscopic training system 1 having the above-described configuration, each training content that is different for each task box 3 includes the time required to achieve the training content set in advance by the operation on the operation target 20, and the operation target 20 Has skill evaluation items including at least one of the achievement level of training content and the number of failures by the operation for. In other words, each training content is related to the training performed by the trainer, and the time required to achieve the training content as an evaluation index for quantitatively and objectively expressing the skill of the trainer with respect to the training content. A plurality of skill evaluation items such as

[Instruction items in arthroscopic surgery training]
The plurality of skill evaluation items included in each training content correspond to at least one of a plurality of instruction items regarding training for arthroscopic surgery. Guidance items for training in arthroscopic surgery are items that a specialist who becomes a supervising doctor or the like in training for arthroscopic surgery points out and provides guidance to the trainee.

  The guidance items in the arthroscopic surgery training are: (a) Arthroscopic spectroscopic skills (Inspection), (b) Cooperative movement of both hands operating the arthroscope and surgical instruments (Bi-hand (Bilateral) coordination), (c) Injury and complications associated with surgery (Complications), (d) Information gathering from arthroscopic images, and (e) Surgery time (Time).

  (A) Arthroscopic mirror technique (Inspection) is a technique for obtaining an image of a desired location in an affected area using an arthroscope. In the training by the arthroscopic training system 1 of the present embodiment, this corresponds to the skill of obtaining and visually confirming an image of an arbitrary place of the operation target 20 by the arthroscope 51.

  (B) Bi-hand (Bilateral) coordination, which is a technique for operating an arthroscope and a surgical instrument, is a skill for performing operations while coordinating both hands operating an arthroscope and a surgical instrument such as a forceps. . In the training by the arthroscopic training system 1 of the present embodiment, this corresponds to the skill of performing a predetermined operation with the surgical instrument 52 while obtaining and viewing an image of an arbitrary place of the operation target 20 with the arthroscope 51.

  (C) To avoid damages and complications associated with surgery (Complications), during surgery, excessive force is applied to living tissue with arthroscopes or surgical instruments, or as the arthroscope or surgical instruments move, It is a skill that does not perform operations that induce injuries or complications during or after surgery, such as inadvertently bringing a surgical instrument into contact with a living tissue. In the training by the arthroscopic training system 1 of the present embodiment, this corresponds to the skill of pinching or extracting a predetermined place in the operation target 20 with an appropriate force.

  (D) Information gathering from the image of the arthroscope is a skill of acquiring a necessary image in the affected area by the arthroscope. In the training by the arthroscopic training system 1 of the present embodiment, since an image of an arbitrary place of the operation target 20 is acquired by the arthroscope 51, it corresponds to a comprehensive skill for the operation of the arthroscope 51.

  (E) The operation time (Time) corresponds to a skill for shortening the operation time for a predetermined operation in an arthroscopic operation using an arthroscope and a surgical instrument. In the training by the arthroscopic training system 1 of the present embodiment, the predetermined training content using the arthroscope 51 and the surgical instrument 52 corresponds to the skill of shortening the time until a predetermined operation is completed.

[Training contents of task box]
The training contents of each task box 3 included in the arthroscopic training system 1 of the present embodiment will be described together with the configuration of the operation target 20 included in each task box 3. The arthroscopic training system 1 according to the present embodiment has nine types of task boxes 3 as first to ninth task boxes as task boxes 3 depending on the contents of training. Nine kinds of training contents are prepared from training contents for training simple mirror operations and operation of surgical instruments such as forceps and scissors to training contents for which anatomical position information needs to be grasped.

  In the following description, nine types of task boxes 3 are respectively represented as a first task box 3A, a second task box 3B, a third task box 3C, a fourth task box 3D, a fifth task box 3E, a sixth task box 3F, The seventh task box 3G, the eighth task box 3H, and the ninth task box 3I are used.

(1) Training content of the first task box 3A The training content of the first task box 3A is referred to as “Inspection”, and aims to improve the art of endoscopic viewing with an arthroscope. The training content in the first task box 3A is used to evaluate whether or not normal arthroscopic viewing is possible. In the training content of the first task box 3A, the arthroscopic mirroring focuses on the operation capability of the arthroscope.

  FIG. 11 shows a first operation target 20A that is the operation target 20 of the first task box 3A. As shown in FIG. 11, the first operation target 20 </ b> A has a knee joint model 111. In the knee joint, the ends of the femur and tibia face each other. Therefore, the knee joint model 111 includes a femur portion 112 that simulates an end portion of the femur and a tibia portion 113 that simulates an end portion of the tibia. The femur portion 112 is provided so as to protrude from the upper surface in the substantially rectangular parallelepiped internal space of the first task box 3A, and the tibial portion 113 is also provided so as to protrude from the lower surface in the internal space. Thereby, the femur part 112 and the tibia part 113 oppose each other in the vertical direction.

  A plurality of check points 114 on which predetermined numbers are written are provided on the surfaces of the femur 112 and the tibia 113 constituting the knee joint model 111. In the present embodiment, ten check points 114 each having numbers 1 to 10 are provided. Since the check point 114 is also provided on the back side of the knee joint model 111 and the like, only some of the numbers 1 to 10 appear in FIG. The number of numbers is not particularly limited.

  The content of training by the first task box 3A is to find and catch ten check points 104 provided on the surface of the knee joint model 111 with the arthroscope 51 in numerical order. Specifically, the trainee 50 operates the arthroscope 51 to display ten check points 114 on the monitor 54 in order from the first as an arthroscope image 54a and confirm. When the trainee 50 can grasp one check point 114 at the center of the screen of the arthroscopic image 54a on the monitor 54, the trainer 50 presses the foot switch 7 with the foot each time and starts searching for the next check point 114. To do.

  FIG. 12 shows an example of an arthroscopic image 54a projected by the arthroscope 51 for the first operation target 20A in the first task box 3A. In the example illustrated in FIG. 12, a state in which the number “6” provided in the femur 112 among the plurality of check points 114 is captured by the arthroscope 51 in the arthroscopic image 54 a is illustrated. The trainee 50 performs an operation on the first operation target 20A as described above while viewing the arthroscopic image 54a. As shown in FIG. 12, in the arthroscopic image 54a, since the imaging target is reflected in a distorted state unlike the naked eye, it is difficult to operate while viewing the arthroscopic image 54a.

  In the training by the first task box 3A, the control box 5 detects that the trainer 50 has confirmed the check point 114 by the arthroscope 51 by operating the foot switch 7 by the trainee 50, and the display content of the touch panel 4 is detected. To reflect. Here, for example, whenever the control box 5 detects the operation of the foot switch 7 by the trainee 50, the control box 5 generates a notification sound from the speaker 8. When the search (confirmation) of the tenth check point 114 is completed, the training content in the first task box 3A is cleared.

  The skill evaluation item of the training content by the first task box 3A is a time required until the training content is achieved by the operation of the arthroscope 51 with respect to the first operation target 20A. That is, the time required to complete the search for all the first to tenth check points 114 by operating the arthroscope 51 by the trainer 50 is a skill evaluation item of this training content.

  As described above, the first task box 3A uses the operation of the arthroscope 51 with respect to the first operation target 20A as the training content, and the skill evaluation item achieves the training content by the operation of the arthroscope 51 with respect to the first operation target 20A. Time required until According to the training content by the first task box 3A, the operability of the arthroscope 51 can be improved.

(2) Training content of the second task box 3B The training content of the second task box 3B is referred to as “Inspection & Touching”. The purpose is to improve the technology of cooperative operation of appliances. The content of training by the second task box 3B is used to evaluate whether or not the cooperative operation of both hands for operating the arthroscope and the surgical instrument for contact is possible. In the training contents of the second task box 3B, the arthroscopic view places emphasis on the ability to grasp the sense of depth by the arthroscope. The training content by the second task box 3B can be said to be an advanced type of training content by the first task box 3A.

  FIG. 13 shows a second operation target 20B that is the operation target 20 of the second task box 3B. As shown in FIG. 13, the second operation target 20B includes a femur 212 that simulates the end of the femur and a tibia 213 that simulates the end of the tibia, like the first operation 20A. A knee joint model 211 is included.

  A plurality of contact terminals 214 are provided on the surfaces of the femur 212 and the tibia 213 constituting the knee joint model 211. The contact terminal 214 is a metal disk that slightly protrudes from the surface of the knee joint model 211 and has a circular contact surface. The contact terminal 214 is connected to the connection terminal 22a of the box side connector 22 of the second task box 3B by a predetermined wiring.

  In the present embodiment, ten contact terminals 214 are provided, and any number from 1 to 10 is written in the vicinity of each contact terminal 214 on the surface of the knee joint model 211. In addition, since the contact terminal 214 is provided also in the back side etc. of the knee joint model 211, in FIG. 13, only the contact terminal 214 corresponding to some numbers 1-10 appears. The number of numbers is not particularly limited.

  The training content by the second task box 3B is that the ten contact terminals 214 provided on the surface of the knee joint model 211 are touched with the probe 9 as the surgical instrument 52 while grasping with the arthroscope 51 in numerical order. It is to go. That is, the training by the second task box 3B is the same as the first task box 3A until the numbers are sequentially captured by the arthroscope 51, and further touches the contact terminal 214 installed near the number with the probe 9 from there. It is the addition of training to do.

  Specifically, the trainee 50 operates the arthroscope 51 and displays ten numbers in order from 1 on the monitor 54 as an arthroscope image 54a and confirms the probe on the contact terminal 214 existing near the number. The tip of 9 is brought into contact. Search (confirmation) and touch of the contact terminals 214 in the order of numbers 1 to 10 are prompted by display on the touch panel 4. For example, the number of the contact terminal 214 in the order to be searched is displayed on the touch panel 4, and when the contact terminal 214 is searched and touched, the next number is displayed on the touch panel 4.

  FIG. 14 shows an example of an arthroscopic image 54a projected by the arthroscope 51 for the second operation target 20B in the second task box 3B. In the example shown in FIG. 14, in the arthroscopic image 54 a, a state in which the contact terminal 214 corresponding to the number “1” provided on the femoral portion 112 among the plurality of contact terminals 214 is captured by the arthroscope 51. It is shown. The trainee 50 performs an operation on the second operation target 20B as described above while viewing the arthroscopic image 54a.

  In the training by the second task box 3B, the control box 5 causes the trainer 50 to grasp the contact terminal 214 by the arthroscope 51 and touch the contact terminal 214 by the probe 9 when the trainer 50 touches the contact terminal 214 of the probe 9. The contact is detected and reflected in the display content of the touch panel 4. Here, for example, the control box 5 generates a notification sound from the speaker 8 every time the trainer 50 detects a touch on the contact terminal 214 of the probe 9.

  The contact of the probe 9 with the contact terminal 214 means that an electrical signal obtained by the contact of the probe 9 with the contact terminal 214 is a contact signal to the contact terminal 214 of the probe 9 from the contact terminal 214 to a predetermined wiring and box. It is detected by being input to the control box 5 through the side connector 22 and the slot side connector 21. When the search and touch of the first to tenth contact terminals 214 are completed, the training content by the second task box 3B is cleared.

  The skill evaluation items of the training contents in the second task box 3B are the time required to achieve the training contents by operating the arthroscope 51 and the probe 9 as the surgical instrument 52 for the second operation target 20B, and the degree of achievement of the training contents And the number of failures. The time required to achieve the training content is the time required for the trainee 50 to complete the search and touch of all the first to tenth contact terminals 214 by operating the arthroscope 51 and the probe 9. .

  The achievement level of the training content is the number of contact terminals 214 that can be searched and touched within a predetermined time limit, and is expressed as a score. In addition, the number of failures (number of errors) in the training contents was touched on the contact terminal 214 in the wrong order from the first to the tenth, or the operation was mistakenly touched on the contact terminal 214 of a number different from the order. It is a count and is counted as an error. In addition, when the control box 5 generates a notification sound from the speaker 8 as a result of the touch on the contact terminal 214 as described above, when the touch on the contact terminal 214 counted as an error is detected, the correct contact in the order is performed. An error sound different from the notification sound when a touch on the terminal 214 is detected may be generated.

  As described above, in the second task box 3B, the operation content of the arthroscope 51 with respect to the second operation target 20B and the contact operation with the probe 9 as the surgical instrument 52 are set as training contents, and the skill evaluation item is the joint with respect to the second operation target 20B. The time required to achieve the training content by operating the mirror 51 and the probe 9 and the achievement level and the number of failures of the training content are defined. According to the contents of training by the second task box 3B, it is possible to improve the technique of accurately operating not only the arthroscope 51 but also the contact surgical instrument 52 at the same time.

(3) Training content of the third task box 3C The training content of the third task box 3C is called “Removing loose body”, and is performed with an arthroscope and a surgical instrument, that is, with an arthroscope and forceps The purpose is to improve the technology of cooperative operation of surgical instruments for medical use. The training content in the third task box 3C is used to evaluate whether or not the cooperative operation of both hands for operating the arthroscope and the grasping surgical instrument is possible. In other words, the training by the third task box 3C performs the training of the gripping operation by the surgical instrument 52 for gripping in addition to the cooperative operation of both hands trained by the second task box 3B. In the training content of the third task box 3C, the arthroscopic mirror focuses on the ability to grasp the sense of depth by the arthroscope.

  FIG. 15 shows a third operation target 20C that is the operation target 20 of the third task box 3C. As illustrated in FIG. 15, the third operation target 20 </ b> C includes a femur portion 312 that simulates an end portion of the femur constituting the knee joint. The femur 312 is provided so as to protrude from the lower surface in the substantially rectangular parallelepiped internal space of the third task box 3C, and occupies most of the internal space of the third task box 3C. A patella portion 313 simulating a patella is provided above the femur portion 312. The patella 313 is provided so as to slightly protrude from the upper surface of the internal space of the third task box 3C, and faces the femur 312.

  A plurality of free body portions 314 are provided on the surface of the femur portion 312. The free body part 314 is a small object that is sufficiently small with respect to the femur 312, for example, a spherical shape. The free body portion 314 is a separate body from the femur portion 312 and is held in a detachable state with respect to the femur portion 312. In the present embodiment, the free body part 314 has a needle-like protrusion 314 a protruding from the surface thereof, and is held on the surface of the femur part 312 by inserting the protrusion 314 a into the femur part 312. The free body portion 314 is made of, for example, polystyrene foam. Further, the protrusion 314a of the free body portion 314 has flexibility by being made of a material such as a polyamide resin.

  The free body portion 314 simulates a piece of bone or cartilage generated in the knee joint, which is called a free body. The loose body needs to be removed because it can cause pain if it remains or gets caught in the knee joint. In the third task box 3C, about 5 to 10 free body portions 314 are provided, for example, but in this embodiment, 6 free body portions 314 are provided. In addition, since the free body part 314 is provided also in the back side etc. of the femur part 312, only a part of the free body part 314 appears in FIG. Moreover, the number of the free body parts 314 is not specifically limited.

  The training content in the third task box 3C is that the six free body parts 314 provided on the surface of the femur 312 are removed by the surgical instrument 52 while being caught by the arthroscope 51. Specifically, the trainee 50 operates the arthroscope 51 and grasps the six free body parts 314 with the surgical instrument 52 for grasping such as forceps while confirming and displaying the six free body parts 314 on the monitor 54 as an arthroscopic image 54a. To remove it. The order of removing the six free parts 314 is arbitrary for the trainee 50. When the trainee 50 can remove one free body part 314, the trainer 50 pushes the foot switch 7 with his / her foot each time and starts searching for and removing the next free body part 314.

  FIG. 16 shows an example of an arthroscopic image 54a projected by the arthroscope 51 for the third operation target 20C in the third task box 3C. In the example shown in FIG. 16, in the arthroscopic image 54a, a state in which one free body portion 314 provided on the femur 312 among the plurality of free body portions 314 is grasped by the forceps is shown. The trainee 50 performs an operation on the third operation target 20C as described above while viewing the arthroscopic image 54a.

  In the training by the third task box 3C, the control box 5 detects that the trainee 50 has removed the free body part 314 by the arthroscope 51 and the surgical instrument 52 by the operation of the foot switch 7 by the trainee 50, This is reflected in the display content of the touch panel 4. Here, for example, whenever the control box 5 detects the operation of the foot switch 7 by the trainee 50, the control box 5 generates a notification sound from the speaker 8. When the removal of all six free body parts 314 is completed, the training content by the third task box 3C is cleared.

  The skill evaluation item of the training content in the third task box 3C is the time required to achieve the training content by operating the arthroscope 51 and the grasping surgical instrument 52 such as forceps with respect to the third operation target 20C. That is, the time required until the trainee 50 operates the arthroscope 51 and the surgical instrument 52 to complete the removal of all six free body parts 314 is a skill evaluation item of the training content.

  In the third operation target 20C, the configuration for holding the free body part 314 on the surface of the femur 312 is not limited to the present embodiment, and for example, a magnet or an adhesive may be used. However, from the viewpoint of durability and operational feeling when removing the free body portion 314, the free body portion 314 is held by piercing the femoral portion 312 with the protrusion 314a as in this embodiment. In addition, the protrusion 314a is more preferably made of a soft resin compared to metal or the like.

  As described above, in the third task box 3C, the training content includes the operation of the arthroscope 51 with respect to the third operation target 20C and the gripping operation with the surgical instrument 52, and the skill evaluation items are the arthroscope 51 and the surgery with respect to the third operation target 20C. The time required to achieve the training content by operating the instrument 52 is taken. According to the contents of training by the third task box 3C, it is possible to improve the technique of accurately operating not only the arthroscope 51 but also the grasping surgical instrument 52 at the same time.

(4) Training content of the fourth task box 3D The training content of the fourth task box 3D is referred to as “Size estimation”, and the operation using the arthroscope and the surgical instrument, that is, the arthroscope and the surgical instrument for contact The purpose is to improve the technology of cooperative operation. The content of training by the fourth task box 3D is used to determine the size of the endoscope image and to evaluate whether or not the cooperative operation of both hands operating the surgical instrument for contact with the arthroscope is possible. In the training contents of the fourth task box 3D, the arthroscopic mirror focuses on the ability of size determination by the arthroscope.

  FIG. 17 shows a fourth operation target 20D that is the operation target 20 of the fourth task box 3D. As illustrated in FIG. 17, the fourth operation target 20D includes a plurality of objects 411 having the same shape and different sizes. The object 411 functions as a contact terminal. The plurality of objects 411 are arranged at different positions in the internal space of the fourth task box 3D and are provided in various directions. The object 411 is connected to the connection terminal 22a of the box-side connector 22 of the fourth task box 3D by a predetermined wiring.

  In the present embodiment, the fourth operation target 20D has five objects 411 having a cylindrical outer shape. The five objects 411 are provided so as to protrude from the respective wall surfaces forming the internal space of the fourth task box 3D. However, the shape and the number of the objects 411 are not particularly limited.

  The training content by the fourth task box 3D is that the five objects 411 are touched with the probe 9 while being captured by the arthroscope 51 in order from the smallest size. Specifically, the trainee 50 operates the arthroscope 51 and touches the object 411 with the tip of the probe 9 while displaying and confirming the five objects 411 in ascending order as the arthroscopic image 54a on the monitor 54. I will let you.

  FIG. 18 shows an example of an arthroscopic image 54a projected by the arthroscope 51 for the fourth operation target 20D in the fourth task box 3D. In the example shown in FIG. 18, a state in which four of the five objects 411 are shown in the arthroscopic image 54 a is shown. The trainee 50 performs an operation on the fourth operation target 20D as described above while viewing the arthroscopic image 54a.

  In the training by the fourth task box 3D, the control box 5 detects the relative size of the object 411 by the arthroscope 51 when the trainer 50 touches the object 411 of the probe 9 and the probe 9 The contact with the object 411 is detected and reflected on the display content of the touch panel 4. Here, for example, the control box 5 generates a notification sound from the speaker 8 every time the trainer 50 detects a touch of the probe 9 on the object 411.

  The contact of the probe 9 with the object 411 indicates that an electrical signal obtained when the probe 9 comes into contact with the object 411 is transmitted as a contact signal of the probe 9 to the object 411 from the object 411 and a predetermined wiring and the box side connector 22 and It is detected by being input to the control box 5 via the slot side connector 21 or the like. By completing the search and touching of the five objects 411 in the order of the sizes, the training content by the fourth task box 3D is cleared.

  The skill evaluation items of the training contents in the fourth task box 3D are the time required to achieve the training contents by operating the arthroscope 51 and the probe 9 as the surgical instrument 52 for the fourth operation target 20D, and the degree of achievement of the training contents And the number of failures. The time required to achieve the training content is the time required for the trainer 50 to complete the search and touch of all the five objects 411 by operating the arthroscope 51 and the probe 9.

  The achievement level of the training content is the number of objects 411 that can be searched and touched within a predetermined time limit, and is expressed as a score. In addition, the number of failures (number of errors) in the training content is the number of times that the object 411 is touched with the wrong size order, or the operation 411 is touched with an object 411 of a size different from the order. Is counted as When the control box 5 generates a notification sound from the speaker 8 when the object 411 is touched as described above, when the touch to the object 411 counted as an error is detected, the correct object 411 is returned in order. An error sound different from the notification sound when the touch is detected may be generated.

  As described above, the fourth task box 3D has the training content including the determination of the size of the arthroscope 51 with respect to the fourth operation target 20D by the arthroscopic image 54a and the contact operation by the probe 9 as the surgical instrument 52. Is the time required to achieve the training content by operating the arthroscope 51 and the probe 9 on the fourth operation target 20D, and the achievement level and the number of failures of the training content. According to the training content by the fourth task box 3D, the size of the object can be accurately grasped even under the condition through the arthroscope.

  Specifically, as shown in FIG. 17, when the fourth operation target 20D of the fourth task box 3D is viewed with the naked eye, the difference in size of the plurality of objects 411 is clear and can be easily grasped. Can do. However, since the image obtained by the arthroscope 51 is a two-dimensional image, it is difficult to grasp the relative size difference from the arthroscopic image 54a as shown in FIG. Therefore, by performing the training content by the fourth task box 3D, it is possible to eliminate the perspective from the arthroscopic video as a two-dimensional video and to distinguish the size of the object.

(5) Training content of the fifth task box 3E The training content of the fifth task box 3E is referred to as “Cutting”, and includes an arthroscopic and a surgical instrument cutting operation, that is, an arthroscope and scissors (scissors), etc. The purpose is to improve the technique of cooperative operation of surgical instruments for cutting. The training content in the fifth task box 3E is used to evaluate whether or not the cooperative operation of both hands for operating the arthroscope and the surgical instrument for cutting is possible. That is, the training by the fifth task box 3E performs training of cutting operation by the surgical instrument 52 for cutting in addition to the cooperative operation of both hands trained by the second task box 3B. In the training contents in the fifth task box 3E, the arthroscopic mirror focuses on the ability to grasp the sense of depth by the arthroscope.

  FIG. 19 shows a fifth operation target 20E that is the operation target 20 of the fifth task box 3E. As illustrated in FIG. 19, the fifth operation target 20 </ b> E includes a plurality of rubber bands 511 provided in a state of being hooked at a predetermined position. The rubber band 511 is hooked while straddling the microswitch 512. The micro switch 512 is closed due to the elasticity of the hooked rubber band 511. Specifically, it is as follows.

  As shown in FIG. 19, the micro switch 512 includes a substantially rectangular parallelepiped main body 512a and a lever 512b as an actuator provided on one surface of the main body 512a. The lever 512b is pressed against the surface of the main body 512a where the lever 512b is provided, so that the microswitch 512 is closed. The micro switch 512 has a plurality of terminals on the surface of the main body 512a opposite to the lever 512b, and these terminals are connected to the connection terminals 22a of the box-side connector 22 of the fifth task box 3E and predetermined wiring. Connected by

  The micro switch 512 is installed on the surface forming the internal space of the fifth task box 3E, and the lever 512b side is on the upper side with respect to each surface, that is, the surface on the opposite side to the side where the lever 512b of the main body 512a is provided. However, it is provided so that it may become the surface side which forms the internal space. In the present embodiment, microswitches 512 are provided on the lower surface and the left and right side surfaces of the internal space of the fifth task box 3E.

  The rubber band 511 is hooked while straddling the micro switch 512 from above the lever 512b, and presses the lever 512b by elasticity. In order to hook the rubber band 511 in such a state, each micro switch 512 is provided with a pair of locking projections 513 for locking the rubber band 511 on the same surface as the surface on which the micro switch 512 is provided.

  The pair of locking protrusions 513 are provided at positions facing each other across the microswitch 512 on the surface where the corresponding microswitch 512 is provided. The pair of locking protrusions 513 are locked and held while the rubber band 511 is pulled from both sides so that the lever 512b is pressed by the rubber band 511 straddling the micro switch 512 and the micro switch 512 is closed. The locking protrusion 513 has a hook-like shape that locks the rubber band 511 that straddles the microswitch 512 together with the locking protrusion 513 that forms a pair.

  In this embodiment, ten combinations of the rubber band 511, the micro switch 512, and the pair of locking projections 513 are provided, and each of the micro switches 512 on the surface on which each micro switch 512 is provided has 1 in the vicinity thereof. Any number from 10 to 10 is described. The number and arrangement of the rubber bands 511 and the configuration for locking the rubber bands 511 are not particularly limited.

  The training content of the fifth task box 3E is scissors as a surgical instrument 52 while grasping the rubber bands 511 that are hooked on the locking projections 513 across the microswitch 512 in the numerical order with the arthroscope 51. It is to cut.

  Specifically, the trainee 50 operates the arthroscope 51 and cuts the ten rubber bands 511 with scissors as the surgical instrument 52 while displaying and confirming the ten rubber bands 511 on the monitor 54 as an arthroscopic image 54a. Go. Cutting the rubber bands 511 in the order of numbers 1 to 10 is prompted by display on the touch panel 4. For example, the number of the rubber band 511 in the order to be cut is displayed on the touch panel 4, and when the rubber band 511 is cut, the next number is displayed on the touch panel 4.

  FIG. 20 shows an example of an arthroscopic image 54a projected by the arthroscope 51 for the fourth operation target 20D in the fourth task box 3D. In the example shown in FIG. 20, in the arthroscopic image 54a, a state in which 9 out of 10 sets are shown for the combination of the rubber band 511, the micro switch 512, and the pair of locking projections 513 is shown. The trainee 50 performs an operation on the fifth operation target 20E as described above while viewing the arthroscopic image 54a.

  In training by the fifth task box 3E, the control box 5 detects that the trainee 50 has grasped the rubber band 511 by the arthroscope 51 and has cut by the surgical instrument 52 by cutting the rubber band 511 by the trainee 50, and the touch panel. 4 is reflected in the displayed content. Here, for example, whenever the control box 5 detects the cutting of the rubber band 511 by the trainee 50, the control box 5 generates a notification sound from the speaker 8.

  The cut of the rubber band 511 is detected by the control box 5 by the opening / closing operation of the micro switch 512. Specifically, from the state where the lever 512b is pressed by the rubber band 511 and the micro switch 512 is closed as described above, the rubber band 511 is cut, whereby the lever 512b is released and the micro switch 512 is opened. . A signal for opening the micro switch 512 is detected by the control box 5 as a signal for cutting the rubber band 511 from a terminal of the micro switch 512 via a predetermined wiring, the box side connector 22 and the slot side connector 21 and the like. . By completing the cutting of the first to tenth rubber bands 511, the training content by the fifth task box 3E is cleared.

  The skill evaluation items of the training content in the fifth task box 3E include the time required to achieve the training content by operating the arthroscope 51 and the surgical instrument 52 for cutting such as scissors on the fifth operation target 20E, and the training content Achievement level and number of failures. The time required to achieve the training content is the time required for the trainer 50 to complete the cutting of all the first to tenth rubber bands 511 by operating the arthroscope 51 and the surgical instrument 52.

  The achievement level of the training content is the number of rubber bands 511 that can be cut within a predetermined time limit, and is expressed as a score. The number of failures (number of errors) in the training content is the number of times the rubber bands 511 were cut in the order from the first to the tenth, or the rubber bands 511 having numbers different from the order were cut by mistake. Yes, it counts as an error. When the control box 5 generates a notification sound from the speaker 8 when the rubber band 511 is cut as described above, when the cut of the rubber band 511 counted as an error is detected, the correct cut of the rubber band 511 is performed in order. An error sound different from the notification sound at the time of detection may be generated.

  As described above, in the fifth task box 3E, the operation contents of the arthroscope 51 with respect to the fifth operation target 20E and the cutting operation with the surgical instrument 52 are set as training contents, and the skill evaluation items are the arthroscope 51 and the surgery with respect to the fifth operation target 20E. The time required to achieve the training content by the operation of the instrument 52, and the achievement level and the number of failures of the training content. According to the training content of the fifth task box 3E, not only the arthroscope 51 but also the surgical instrument 52 for cutting can be accurately operated simultaneously, and the technique for accurately excising the tissue in the body can be improved.

(6) Training content of the sixth task box 3F The training content of the sixth task box 3F is called “Pinch & Connection”, and is performed with an arthroscope and a surgical instrument, that is, gripping an arthroscope and forceps, etc. The purpose is to improve the technology of cooperative operation of surgical instruments for medical use. The training content in the sixth task box 3F is used to evaluate whether or not the cooperative operation of both hands for operating the arthroscope and the grasping surgical instrument is possible. That is, in the training by the sixth task box 3F, in addition to the operation to be trained by the third task box 3C, the training of the two-step operation (extraction and insertion operation) by the grasping surgical instrument 52 is performed. In the training contents of the sixth task box 3F, the arthroscopic mirror focuses on the ability to grasp the sense of depth by the arthroscope.

  FIG. 21 shows a sixth operation target 20F that is the operation target 20 of the sixth task box 3F. As illustrated in FIG. 21, the sixth operation target 20 </ b> F includes a plurality of pins 611 provided in a state of being inserted into a predetermined position. The pin 611 functions as a plug and is inserted into a hole 612 that functions as a jack.

  The pin 611 is provided at the tip of the wiring 611a extending from the surface where the corresponding hole 612 is provided. The wiring 611a and the hole 612 are connected to the connection terminal 22a of the box side connector 22 of the sixth task box 3F by a predetermined wiring. Further, in the vicinity of the hole 612 into which the pin 611 is inserted, a hole (similar to the hole 612 is formed with a predetermined distance from the hole 612 on the surface where the hole 612 is provided). Hereafter referred to as “adjacent hole”) 613.

  In the present embodiment, a total of five combinations of the pin 611, the hole 612, and the adjacent hole 613 are provided on the upper surface and the lower surface of the internal space of the sixth task box 3F, and in the vicinity of the hole 612. Each of the numbers 1 to 5 is described. The number and arrangement of the pins 611 are not particularly limited.

  The training content in the sixth task box 3F is that the pin 611 inserted into the hole portion 612 is first pulled out by the surgical instrument 52 while being caught by the arthroscope 51 and replaced with the adjacent hole portion 613 in numerical order. Is to go.

  Specifically, the trainee 50 operates the arthroscope 51 and grasps the pin 611 on the monitor 54 as an arthroscope image 54a and confirms it while grasping it with the surgical instrument 52 for grasping, such as forceps, from the hole 612. Withdrawing, the pin 611 is inserted again into the adjacent hole 613 adjacent to the hole 612. The replacement of the pins 611 is performed in the order of numbers 1 to 5. Replacement (extraction / insertion) of the pins 611 in the order of numbers 1 to 5 is prompted by a display on the touch panel 4. For example, the number of the pin 611 in the order to be replaced is displayed on the touch panel 4, and when the pin 611 is replaced, the next number is displayed on the touch panel 4.

  FIG. 22 shows an example of an arthroscopic image 54a projected by the arthroscope 51 for the sixth operation target 20F in the sixth task box 3F. In the example shown in FIG. 22, in the arthroscopic image 54a, a state where the pin 611 corresponding to the number “3” is pulled out from the hole 612 by the forceps is shown. The trainee 50 performs an operation on the sixth operation target 20F as described above while viewing the arthroscopic image 54a.

  In the training by the sixth task box 3F, the control box 5 detects that the trainer 50 grasps the pin 611 by the arthroscope 51 and replaces the pin 611 by the surgical instrument 52 by replacing the pin 611 by the trainee 50. And reflected on the display content of the touch panel 4. Here, for example, whenever the control box 5 detects the replacement of the pin 611 by the trainee 50, the control box 5 generates a notification sound from the speaker 8.

  The replacement of the pin 611 is detected by the control box 5 by the replacement operation itself from the hole 612 of the pin 611 to the adjacent hole 613. Specifically, when the pin 611 is replaced, the connection circuit configured by inserting the pin 611 as a plug into the hole 612 as a jack or the adjacent hole 613 is switched. The switching of the connection circuit accompanying the replacement of the pin 611 is controlled as a replacement signal of the pin 611 from the hole 612 and the adjacent hole 613 via a predetermined wiring, the box side connector 22 and the slot side connector 21 and the like. Detected by box 5. When the replacement of the first to fifth pins 611 is completed, the training content by the sixth task box 3F is cleared.

  The skill evaluation items of the training contents in the sixth task box 3F include the time required to achieve the training contents by operating the arthroscope 51 and the grasping surgical instrument 52 such as forceps with respect to the sixth operation target 20F, and the training contents Achievement level and number of failures. The time required to achieve the training content is the time required until the trainee 50 completes the replacement of all the first to fifth pins 611 by operating the arthroscope 51 and the surgical instrument 52.

  The achievement level of the training content is the number of pins 611 that can be replaced within a predetermined time limit, and is expressed as a score. In addition, the number of failures (number of errors) in the training content is the wrong order from the first to the fifth, the pin 611 is replaced, the pin 611 having a number different from the order is accidentally pulled out, It is the number of insertions into the adjacent hole 613 of the number, and is counted as an error. When the control box 5 generates a notification sound from the speaker 8 when the pin 611 is replaced as described above, when the operation of the pin 611 counted as an error is detected, the correct replacement of the pin 611 is performed in order. An error sound different from the notification sound at the time of detection may be generated.

  As described above, in the sixth task box 3F, the operation content of the arthroscope 51 with respect to the sixth operation target 20F and the extraction / insertion operation with the surgical instrument 52 are set as training contents, and the skill evaluation item is the arthroscope 51 with respect to the sixth operation target 20F. And the time required to achieve the training content by operating the surgical instrument 52, and the achievement level and the number of failures of the training content. According to the training contents by the sixth task box 3F, it is possible to improve not only the arthroscope 51 but also the grasping surgical instrument 52 at the same time and improve the technique of grasping the body tissue from an appropriate angle.

(7) Training contents of the seventh task box 3G The training contents of the seventh task box 3G are referred to as “Going over the line (Tracing)”. The purpose is to improve the technology of cooperative operation of surgical instruments for contact. The training content in the seventh task box 3G is used to evaluate whether or not the cooperative operation of both hands for operating the arthroscope and the surgical instrument for contact is possible. That is, the training by the seventh task box 3G is a training for advanced operations such as a tracing operation by the contact surgical instrument 52 in addition to the operations trained by the second task box 3B. In the training contents of the seventh task box 3G, the arthroscopic mirror focuses on the ability to grasp the sense of depth by the arthroscope.

  FIG. 23 shows a seventh operation target 20G that is the operation target 20 of the seventh task box 3G. As shown in FIG. 23, the seventh operation target 20G includes a plurality of metal lines 711 made of wires or the like arranged at predetermined positions, a start-side contact terminal 712 provided near both ends of the metal line 711, and a terminal end. Side contact terminals 713. Each of the contact terminals 712 and 713 is a metal disc that slightly protrudes from a surface that forms a substantially rectangular parallelepiped internal space of the seventh task box 3G, and has a circular contact surface. The metal line 711 and the contact terminals 712 and 713 are connected to the connection terminal 22a of the box side connector 22 of the seventh task box 3G by a predetermined wiring.

  In the present embodiment, the seventh operation target 20G has three types of metal lines 711 including a curved metal line 711a, a straight metal line 711b, and an inter-surface metal line 711c as the metal line 711. The curved metal line 711a is arranged in a substantially arc shape along a predetermined surface in the internal space of the seventh task box 3G. The straight metal line 711b is arranged in a straight line along a predetermined surface in the same manner as the curved metal line 711a. The inter-surface metal line 711c is arranged in a state where different surfaces are bridged in the internal space of the seventh task box 3G. These metal lines 711a, 711b, and 711c were created in consideration of the shape of the meniscus in the joint of the knee joint, the presence of the anterior cruciate ligament, and the presence of the posterior cruciate ligament, and clinical palpation training It is arranged assuming that.

  In the present embodiment, on the lower surface of the internal space of the seventh task box 3G, a combination of the curved metal line 711a and the pair of contact terminals 712 and 713, and a combination of the straight metal line 711b and the pair of contact terminals 712 and 713, Two sets are provided. These two combinations are arranged substantially symmetrically on the lower surface of the internal space of the seventh task box 3G.

  In the present embodiment, the inter-surface metal line 711c is arranged in a state of being bridged between the upper surface and the lower surface of the internal space of the seventh task box 3G. Accordingly, one of the contact terminals 712 and 713 provided near both ends of the inter-surface metal line 711c is provided on the upper surface, and the other is provided on the lower surface. In the present embodiment, two sets of combinations of inter-face metal lines 711c and contact terminals 712 and 713 provided near both ends of the inter-face metal lines 711c are provided. The two sets including the inter-surface metal line 711c are arranged in a substantially central portion in the left-right direction between the configurations including the curved metal line 711a and the straight metal line 711b arranged substantially symmetrically as described above. Provided.

  Thus, in this embodiment, a total of six combinations of the metal line 711 and the contact terminals 712 and 713 are provided, and the start-end contact terminal 712 on the surface where the start-end contact terminal 712 is provided in each combination. Any number from 1 to 6 is written in the vicinity. In addition, the wiring shape of the metal line 711, the number of wirings, etc. are not specifically limited.

  The training contents by the seventh task box 3G are obtained by using the probe 9 as the surgical instrument 52 while capturing the combination of the six metal lines 711 and the contact terminals 712 and 713 in the numerical order in the arthroscope 51. Touching the side contact terminal 712, tracing operation on the metal line 711, and touching the terminal side contact terminal 713 are performed in this order.

  Specifically, the trainee 50 operates the arthroscope 51, and displays each part of the metal line 711 and the contact terminals 712 and 713 on the monitor 54 as an arthroscope image 54a, and a number is written in the vicinity. Touch the start-side contact terminal 712 with the probe 9, move the probe 9 along the metal line 711 corresponding to the start-side contact terminal 712, and touch the end-side contact terminal 713 corresponding to the metal line 711. To do. A series of such traces are performed in the order of numbers 1-6. Traces by the probes 9 in the order of numbers 1 to 6 are prompted by display on the touch panel 4. For example, the touch panel 4 displays the number of the combination of the metal lines 711 and the contact terminals 712 and 713 in the current order to be traced, and when the trace of the combination is performed, the touch panel 4 displays Is displayed.

  FIG. 24 shows an example of an arthroscopic image 54a projected by the arthroscope 51 for the seventh operation target 20G in the seventh task box 3G. In the example shown in FIG. 24, the arthroscopic image 54a shows a state in which the probe 9 is in contact with the metal line 711 corresponding to the number “6”. The trainee 50 performs an operation on the seventh operation target 20G as described above while viewing the arthroscopic image 54a.

  In the training by the seventh task box 3G, the control box 5 causes the trainer 50 to connect the metal line with the arthroscope 51 by a series of traces of the start-side contact terminal 712, the metal line 711, and the end-side contact terminal 713. 711 and the contact terminals 712 and 713 are captured, and the probe 9 detects that each part has been touched, and reflects it in the display content of the touch panel 4. Here, for example, the control box 5 generates a notification sound from the speaker 8 every time a series of traces by the trainee 50 is detected.

  The probe 9 contacts each part of the metal line 711 and the contact terminals 712 and 713 and a series of traces are performed. The probe 9 contacts the start-side contact terminal 712, the metal line 711, and the end-side contact terminal 713 in this order. The electric signal obtained by this is a series of trace signals from the probe 9, and the control box 5 via a predetermined wiring from each part of the metal line 711 and the contact terminals 712 and 713, the box side connector 22, the slot side connector 21 and the like. Detected by being input to. When the first to sixth traces are completed, the training content by the seventh task box 3G is cleared.

  The skill evaluation items of the training content in the seventh task box 3G are the time required to achieve the training content by operating the arthroscope 51 and the probe 9 as the surgical instrument 52 on the seventh operation target 20G, and the achievement level of the training content And the number of failures. The time required to achieve the training content is the time required for the trainer 50 to complete all the first to sixth traces by operating the arthroscope 51 and the probe 9.

  The achievement level of the training content is the number of configurations that can be traced within a predetermined time limit, and is expressed as a score. In addition, the number of failures (number of errors) in the training content is traced in the wrong order from the first to the sixth, the probe 9 is brought into contact with a configuration different from the order by mistake, or the metal line 711. This is the number of times the probe 9 is detached from the position and is counted as an error. When the control box 5 generates a notification sound from the speaker 8 with the trace for each configuration as described above, the correct trace is detected in the order when the contact of the probe 9 with the configuration counted as an error is detected. An error sound different from the notification sound at the time may be generated.

  As described above, the seventh task box 3G has the training contents including the operation of the arthroscope 51 for the seventh operation target 20G and the trace operation by the probe 9 as the surgical instrument 52, and the skill evaluation item is the joint for the seventh operation target 20G. The time required to achieve the training content by operating the mirror 51 and the probe 9 and the achievement level and the number of failures of the training content are defined. According to the training content of the seventh task box 3G, not only the arthroscope 51 but also the surgical instrument 52 for contact is accurately operated simultaneously and moved along the line, so that the meniscus and cross existing in the knee joint Techniques for tracing ligaments and the like can be improved.

(8) Training contents of the eighth task box 3H The training contents of the eighth task box 3H are referred to as “Pinch & Pulling”. The purpose is to improve the technology of cooperative operation of surgical instruments for medical use. Training content in the 8th task box 3H corresponds to changes in the positional relationship between the arthroscopic image and the 8th task box 3H, in addition to whether or not the joint operation of both hands operating the surgical instrument for contact with the arthroscope is possible Used to evaluate if possible. In other words, training by the eighth task box 3H is for gripping when the positional relationship between the arthroscopic image and the eighth task box 3H changes up and down / left and right in addition to the operation trained by the third task box 3C. Training for an appropriate extraction operation by the surgical instrument 52 is performed. In the training content of the eighth task box 3H, the arthroscopic mirroring focuses on improving the sense of up / down / left / right by the arthroscope.

  FIG. 25 shows an eighth operation target 20H that is the operation target 20 of the eighth task box 3H. As shown in FIG. 25, the eighth operation target 20H has a plurality of pins 811 provided in a state of being inserted into a predetermined position. The pin 811 functions as a plug and is inserted into the hole 812 functioning as a jack. The pin 811 has a substantially cylindrical outer shape on the side inserted into the hole 812, and has a gripping portion 811a formed in a substantially plate shape at the end opposite to the side inserted into the hole 812.

  The hole 812 into which the pin 811 is inserted is connected to the connection terminal 22a of the box-side connector 22 of the eighth task box 3H by a predetermined wiring. In the internal space of the eighth task box 3H, a column portion 813 provided in a state of being bridged between the upper surface and the lower surface is provided. The column portion 813 is provided in a state of standing in the vertical direction at a substantially central position in the internal space, and becomes an obstacle for an operation on the pin 811 by the trainee 50.

  In the present embodiment, a total of 10 combinations of the pins 811 and the holes 812 are provided on the left and right sides and the back side of the inner space of the eighth task box 3H, and in the vicinity of the holes 812. , Any number from 1 to 10 is described. Note that the number and arrangement of the pins 811 and the holes 812 are not particularly limited.

  The training content in the eighth task box 3H is that the pins 811 inserted in the holes 812 are pulled out by the surgical instrument 52 while being caught by the arthroscope 51 in the numerical order. However, the extraction of the sixth to tenth pins 811 is performed with the eighth task box 3H rotated 90 °. The eighth task box 3H is rotated by rotating the task box slot 6 by the support mechanism 10 provided in the arthroscopic training system 1 (see FIG. 5).

  Specifically, the trainee 50 operates the arthroscope 51 and projects and confirms the pin 811 on the monitor 54 as an arthroscopic image 54 a while grasping the surgical instrument 52 for grasping forceps and the like through the hole 812. Pull out. The pins 811 are pulled out in the order of numbers from the first to the fifth. Next, the eighth task box 3H is rotated 90 ° rightward or leftward by the support mechanism 10, and the remaining sixth to tenth pins 811 are pulled out in the order of the numbers. Pulling out the pins 811 in the order of numbers 1 to 5 and 6 to 10 is prompted by a display on the touch panel 4. For example, on the touch panel 4, the number of the pin 811 in the order to be pulled out is displayed, and when the pin 811 is pulled out, the next number is displayed on the touch panel 4.

  In the present embodiment, the eighth task box 3H is used as two angle states, that is, a normal state as shown in FIG. 25 and a state rotated by 90 °. The number is not particularly limited. For example, the eighth task box 3H may be used as three angular states: a normal state, a state rotated by 45 °, and a state rotated by 90 °. Further, the assignment of the number of pins 811 to be pulled out in each angle state of the eighth task box 3H is also set as appropriate. That is, in the training content by the eighth task box 3H, the eighth task box 3H may be set to different angle states, and an operation on the eighth operation target 20H in at least two angle states may be performed.

  FIG. 26 shows an example of an arthroscopic image 54a projected by the arthroscope 51 for the eighth operation target 20H in the eighth task box 3H. In the example shown in FIG. 26, the arthroscopic image 54a shows a state where the pin 811 corresponding to the number “6” is about to be grasped by the forceps in a normal state (a state where the articulating image is not rotated by 90 °). . The trainee 50 performs an operation on the eighth operation target 20H as described above while viewing the arthroscopic image 54a.

  In the training by the eighth task box 3H, the control box 5 detects that the trainer 50 has grasped the pin 811 by the arthroscope 51 and has pulled the pin 811 by the surgical instrument 52 by pulling the pin 811 by the trainee 50. And reflected on the display content of the touch panel 4. Here, for example, the control box 5 generates a notification sound from the speaker 8 every time it detects that the trainee 50 has pulled the pin 811.

  The pulling out of the pin 811 is detected by the control box 5 by the pulling operation itself from the hole 812 of the pin 811. Specifically, when the pin 811 is pulled out, the connection circuit including the hole 812 is switched. The switching of the connection circuit accompanying the pulling of the pin 811 is detected by the control box 5 as a pulling signal of the pin 811 from the hole 812 through the predetermined wiring, the box side connector 22 and the slot side connector 21 and the like. The When the replacement of the first to tenth pins 811 is completed, the training content by the eighth task box 3H is cleared.

  The skill evaluation items of the training content in the eighth task box 3H include the time required to achieve the training content by operating the arthroscope 51 and the grasping surgical instrument 52 such as forceps with respect to the eighth operation target 20H, and the training content. Achievement level and number of failures. The time required to achieve the training content is the time required until the trainee 50 completes the extraction of all the first to tenth pins 811 by operating the arthroscope 51 and the probe 9.

  The achievement level of the training content is the number of pins 811 that can be pulled out within a predetermined time limit, and is expressed as a score. In addition, the number of failures in training content (number of errors) is the number of times that the order from the first to the tenth is wrong and the pin 811 is pulled out, or the number of pins 811 that are different from the order is accidentally pulled out, Counted as an error. When the control box 5 generates a notification sound from the speaker 8 when the pin 811 is pulled out as described above, when the pulling of the pin 811 counted as an error is detected, the correct pin 811 is pulled out in order. An error sound different from the notification sound at the time of detection may be generated.

  As described above, in the eighth task box 3H, the training content includes the operation of the arthroscope 51 and the extraction operation by the surgical instrument 52 for the eighth operation target 20H in at least two angular states, and the skill evaluation item is the eighth operation target 20H. The time required to achieve the training content by operating the arthroscope 51 and the surgical instrument 52, and the achievement level and the number of failures of the training content. According to the training content in the eighth task box 3H, not only the arthroscope 51 but also the grasping surgical instrument 52 can be accurately operated simultaneously to develop psychomotor skills.

  Specifically, by rotating the eighth task box 3H by 90 °, for example, an image in which an object falls in the left-right direction is shown in the arthroscopic image 54a of the monitor 54. As described above, when the positional relationship between the arthroscopic image 54a of the monitor 54 and the eighth task box 3H changes vertically and horizontally, it is difficult to accurately operate the arthroscope 51 and the surgical instrument 52. Therefore, by performing training using the eighth task box 3H, the user can operate the arthroscope and the surgical instrument while accurately grasping the correspondence between the video displayed on the monitor as the arthroscopic video and the surgical target in the actual body space. It is possible to improve the technology capable of performing the above.

(9) Training content in the ninth task box 3I The training content in the ninth task box 3I is the same as the training content in the eighth task box 3H, but the ninth operation target that is the operation target 20 in the ninth task box 3I. The structure of 20I has a symmetrical (mirror image) relationship with the eighth operation target 20H. The eighth task box 3H and the ninth task box 3I are images of the joints of the left foot and the right foot, respectively. That is, when the operation target 20 of one task box 3 of the eighth task box 3H and the ninth task box 3I is configured assuming the knee joint of the left foot, the operation target 20 of the other task box 3 is the right foot It is configured assuming a knee joint.

  FIG. 27 shows a ninth operation target 20I that is the operation target 20 of the ninth task box 3I. As shown in FIG. 27, the ninth operation target 20I is bilaterally symmetrical with the eighth operation target 20H shown in FIG. 25, and is provided with ten pins 911 having a grip portion 911a provided in a state of being inserted into the hole portion 912. And a column part 913 provided in the center part. Further, in the ninth operation target 20I, the numbers 1 to 10 written in the vicinity of the hole 912 are in the opposite order to the eighth operation target 20H shown in FIG.

  FIG. 28 shows an example of an arthroscopic image 54a projected by the arthroscope 51 for the ninth operation target 20I in the ninth task box 3I. In the example shown in FIG. 28, the arthroscopic image 54a shows a state in which the pin 911 corresponding to the number “7” is gripped by forceps in a normal state (a state where the arthroscope image 54a is not rotated by 90 °). The trainee 50 performs an operation on the ninth operation target 20I as described above while viewing the arthroscopic image 54a.

  The method of training by the ninth task box 3I, the training content, the skill evaluation items of the training content, and the like are the same as those of the eighth task box 3H, and thus description thereof is omitted.

  As described above, the ninth task box 3I has the ninth operation target 20I that is symmetrical to the eighth operation target 20H included in the eighth task box 3H as the operation target 20. The ninth task box 3I sets the skill evaluation items as the time required to achieve the training content by operating the arthroscope 51 and the surgical instrument 52 on the ninth operation target 20I, and the achievement level and the number of failures of the training content. . According to the contents of training by the ninth task box 3I, similarly to the eighth task box 3H, not only the arthroscope 51 but also the grasping surgical instrument 52 can be simultaneously operated accurately, and psychomotor skills can be cultivated.

[Features of task box]
The characteristics of the structure of each task box 3 described above will be described. Of the nine types of task boxes 3 described above, regarding the tasks of the first to third task boxes 3, it is important to improve the skill of “mirror viewing” using an arthroscope. For this reason, for each operation target 20 of the first to third task boxes 3, a “biological model” that faithfully reproduces the inside of the living joint is introduced.

  Specifically, in the first task box 3A and the second task box 3B, the operation objects 20A and 20B have femoral portions 112 and 212 and tibia portions 113 and 213 as parts of a biological model. In the third task box 3C, the operation target 20C includes a femur portion 312 and a patella portion 313 as a living body model portion.

  As described above, the biological model that the first to third task boxes 3 have as the operation target 20 can be processed and manufactured by raising the mold. However, this method is not preferable because it takes much time and cost. . Therefore, it is preferable that the biological model constituting the operation target 20 in each task box 3 is manufactured by the following method.

  As shown in FIG. 29, first, a plurality of cross-sectional image data 71 is acquired for a living joint by MRI (Magnetic Resonance Imaging) or CT (Computerized Tomography), and the outline of the living joint is extracted. Three-dimensional CAD (computer aided manufacturing) data 72 is constructed from the cross-sectional image data 71 group, and the living body shape is reproduced.

  In addition, when biomaterial characteristics such as tactile sensation are required in the biomodel, the biomodel is reproduced by applying animatronics technology and applying a material such as special foam urethane. By using such a manufacturing method, when manufacturing the living body model that constitutes the operation target 20 of the task box 3, the labor and cost are greatly reduced in comparison with the case where the mold is raised and processed and manufactured. be able to.

  In addition, the biological model constituting the operation target 20 is more preferably manufactured by the following method. Performs integral molding that links 3D CAD and RP (Rapid Prototyping). Specifically, first, as shown in FIG. 29, a plurality of cross-sectional image data 71 is acquired by MRI or CT for a living joint, and this is captured on a three-dimensional CAD. The cross-sectional image data 71 captured on the three-dimensional CAD is integrally formed on the three-dimensional CAD by integrating it with all the components such as the component parts of the box housing the operation target 20 in the task box 3. As the RP, for example, a powder forming system RP is used. RP can manufacture plastic molded parts for each order without manufacturing and using a mold, and is optimal for small-volume production like this system.

  For example, in the case where it is necessary to provide the contact terminal 214 on the living body model as in the second operation target 20B of the second task box 3B, installation of the surface of the living body model for installing the contact terminal 214 and the contact terminal 214 is performed. Wiring paths connected to the holes and contact terminals 214 are created in advance on the three-dimensional CAD. By using such a manufacturing method, for example, the installation work and wiring work of electrical terminals such as the contact terminal 214 can be simplified, and a simple and precise assembly work can be realized. Can be reduced.

  On the other hand, among the nine types of task boxes 3 described above, the simple tasks are used for the tasks of the fourth to ninth task boxes 3 without reproducing a real “biological model” in the operation target 20. doing. This means that for the basic skills to be improved by training through the task boxes 3 from the fourth to the ninth, it is efficient to make the operation object 20 simple and to clarify the tasks to be performed as training. It is based on the viewpoint that it is preferable for training.

[Training procedure]
A procedure of training by the arthroscopic training system 1 of the present embodiment will be described together with the display contents of the touch panel 4. Basically, the training is performed according to the instruction of the control box 5 displayed on the touch panel 4, so that an evaluation based on a predetermined skill evaluation item for each training content is displayed on the touch panel 4 as an objective index. It is a mechanism.

  First, in the arthroscopic training system 1, when the system main body 2 is turned on, the system main body 2 and the touch panel 4 are activated, and an application is activated by the control box 5. The operation of turning on the power of the system main body 2 is normally performed in a state where the task box 3 is not set in the task box slot 6.

  When the activation of the application of the system main body 2 is completed, an opening screen 60 as shown in FIG. When the task box 3 is set in the task box slot 6 in a state where the opening screen 60 is displayed, a task box set screen 61 as shown in FIG. Here, it is assumed that a second task box 3B for performing training content called “Inspection & touching” is set as the task box 3.

  As shown in FIG. 31, the task box 3 is set in the task box slot 6 with the lid 40 removed from the insertion slot 6a of the task box slot 6 from the side opposite to the opening 3a. This is done by inserting it into the insertion slot 6a. Here, the task box 3 is pushed into the task box slot 6 until the box side connector 22 is inserted into the slot side connector 21 and connected to each other. After the task box 3 is set in the task box slot 6, the lid 40 is attached to the insertion slot 6a (see FIG. 8).

  As shown in FIG. 30 (b), the task box set screen 61 displays the number of the set task box 3 and the training content (for example, “Inspection & Touching”) of the task box 3 of that number. The The task box set screen 61 includes an image image display unit 61a, a training introduction operation display unit 61b, and a training content display unit 61c. The image image display unit 61a displays an image image reminiscent of training content, such as an enlarged image of the operation target 20 of the set task box 3.

  The training introduction operation display unit 61b has a button function for introducing the trainer 50 into actual training. That is, when the trainee 50 touches the training introduction operation display unit 61b, the display screen of the touch panel 4 is switched to the training screen 62 as shown in FIG. In the example shown in FIG. 30B, the letters “Training” are displayed on the training introduction operation display unit 61b. The training content display unit 61c displays instructions for preparation necessary for training, explanation of the training content, a message prompting the operation of the training introduction operation display unit 61b, and the like.

  As illustrated in FIG. 30C, the training screen 62 includes a training start operation display unit 62a, a number display unit 62b, and an evaluation item display unit 62c. The training start operation display unit 62a has a button function for starting training. That is, the training is started when the trainee 50 touches the training start operation display unit 62a. In the example shown in FIG. 30C, the letters “Start” are displayed on the training start operation display section 62a.

  In the number display part 62b, the number of the next target in the operation target 20 is displayed. For example, in the case of training content by the second task box 3B, each time the trainee 50 touches the contact terminal 214 with the probe 9, the number on the number display unit 62b increases by one.

  The evaluation item display unit 62c displays a training content score (achievement level), the number of errors (number of failures), and the elapsed time (required time). In the example shown in FIG. 30 (c), the evaluation item display unit 62c displays “Clearing” as the score, “Miss” as the number of errors, and “Elapsed time” as the elapsed time. It is displayed.

  In the evaluation item display part 62c, for example, in the case of training contents by the second task box 3B, the following display is performed. The score displayed on the evaluation item display unit 62c is added each time the trainee 50 touches the contact terminal 214 with the probe 9. The number of errors displayed on the evaluation item display unit 62c indicates that the trainee 50 touches the contact terminal 214 in the wrong order from the first to the tenth, or touches the contact terminal 214 with a number that is different from the order by mistake. It is added every time you touch. The elapsed time displayed on the evaluation item display unit 62c is the time elapsed since the training start operation display unit 62a was pressed, and is displayed with characters (seconds) and a bar. The training screen 62 displays the number of the set task box 3 and the training content (for example, “Inspection & Touching”) of the task box 3 of that number.

  The training ends when the trainee 50 clears the preset training content or when a predetermined time limit set in advance elapses. The time limit is visually recognized by the trainee 50 by, for example, a bar display in the evaluation item display unit 62c. When the training is finished, as shown in FIG. 30 (d), a character notifying the end is displayed on the number display portion 62 b of the training screen 62. In the example shown in FIG. 30D, the characters “End” are displayed on the number display portion 62b. In addition, the display on the evaluation item display unit 62c at the time when the training is completed becomes the evaluation result for the training content. Thus, for example, in the case of the second task box 3B, the score (achievement level), the number of errors (number of failures), and the elapsed time (required time) obtained as the evaluation results for the training contents are objective indicators.

  For the screen display by the touch panel 4 as shown in FIG. 20, it is possible to perform training with more visual and sensory operation by adopting a GUI (Graphical User Interface). The result of the training is output by, for example, a printer connected to the control box 5. As the training result, the number of the task box 3, the score, the number of errors, and the elapsed time are output.

  When training for another task box 3 is performed, the task box 3 is pulled out from the task box slot 6 and another task box 3 is set in the task box slot 6. Here, when the task box 3 is pulled out from the task box slot 6, the screen display of the touch panel 4 returns to the opening screen 60 shown in FIG. Further, when pulling out the task box 3 from the task box slot 6, the gripping body 31 provided on the bottom surface 3c side of the task box 3 is used (see FIG. 7). Training by the first to ninth task boxes 3 is performed by the procedure as described above.

[Relationship between teaching items and task boxes]
The relationship between the instruction items in the arthroscopic surgery training and the training contents of each task box 3 will be described. FIG. 32 shows the relationship between the instruction items and the task box 3 in the arthroscopic training system.

  In FIG. 32, the left frame shows the guidance items in the arthroscopic surgery training. From the top, “mirror” is changed to “(a) arthroscopic mirror (Inspection)” and “two-handed cooperative operation”. "(B) Bi-hand (Bilateral) coordination for operating both arthroscopes and surgical instruments" and "Injury / complications" are "(c) Injuries / complications associated with surgery" “Information acquisition” is “information acquisition from (d) arthroscopic video”, and “time” is “(e) surgery time (Time)”. Correspond. Further, in FIG. 32, the inside of the right frame indicates the number of task box 3 that exists in nine types as described above (hereinafter referred to as “box number”). The eighth task box 3H and the ninth task box 3I have the same type of task box 3 in order to share the training contents.

  In FIG. 32, the relationship between the instruction item and the box number is indicated by an arrow from each instruction item to each box number. In FIG. 32, regarding the relevance between the instruction item and the box number, there is an arrow from each instruction item to the top 1 to 3 box numbers where the instruction item has a relatively high relevance compared to other box numbers. It is shown.

  As shown in FIG. 32, the arrows 81a and 81b from the instruction item “mirror view” go to box numbers “6” and “8 & 9”. That is, the instruction item “mirror view” has a relatively high relevance to the training contents in the sixth task box 3F, the eighth task box 3H, and the ninth task box 3I. Therefore, if the skill of the instruction item “mirror viewing” is immature or if you want to improve this skill, training by the 6th, 8th and 9th task boxes 3F, 3H, 3I will be focused and focused. By doing, effective training can be performed.

  Similarly, the arrows 82a and 82b from the instruction item “Both-hands cooperative operation” go to box numbers “1” and “6”. That is, the instruction item “Both-hands cooperative operation” has a relatively high relevance to the training content in the first task box 3A and the sixth task box 3F. Therefore, if the skill of the instruction item “Both-hands coordinated action” is immature or if you want to improve this skill, training by the 1st and 6th task boxes 3A, 3F will be effective. Training.

  In addition, the arrows 83a and 83b from the instruction item “damage / complication” go to the box numbers “6” and “8 & 9”. That is, the instruction item “injury / complication” has a relatively high relevance to the training contents of the sixth task box 3F, the eighth task box 3H, and the ninth task box 3I. Therefore, if the skill of the instruction item “injury / complication” is immature or if you want to improve this skill, training by the 6th, 8th and 9th task boxes 3F, 3H, 3I will be focused and concentrated. Effective training can be performed.

  The arrow 84a from the instruction item “acquire information” is directed to the box number “1”. That is, the instruction item “information acquisition” has a relatively high relevance to the training content by the first task box 3A. Therefore, if the skill of the guidance item “information acquisition” is inexperienced or if you want to improve this skill, the training by the first task box 3A should be focused and concentrated to perform effective training. Can do.

  In addition, the arrows 85a, 85b, and 85c from the instruction item “time” go to the box numbers “2”, “6”, and “8 & 9”. That is, the instruction item “time” has a relatively high relevance to the training contents of the second task box 3B, the sixth task box 3F, the eighth task box 3H, and the ninth task box 3I. Therefore, when the skill of the instruction item “time” is immature or when it is desired to improve this skill, training by the second, sixth, eighth, and ninth task boxes 3B, 3F, 3H, and 3I is emphasized.・ By performing intensively, effective training can be practiced.

  As described above, the training content in each task box 3 has a correlation with the five instruction items in the arthroscopic surgery training. Thus, the training person 50 can perform efficient training because each training content has a correlation with a plurality of instruction items. In addition, for each training content, for example, by using an evaluation result based on an evaluation index such as a score (achievement degree), an objective evaluation that the skill about the training item that is highly related to the training content with low evaluation is immature is performed. Can be done. Further, by referring to values such as a score (achievement level) that is an evaluation index of training content, it is possible to perform quantitative evaluation of the training content.

  As described above, according to the arthroscopic training system 1 according to the present embodiment, quantitative and objective evaluation can be performed for relatively advanced arthroscopic techniques among endoscopic techniques, and efficient training can be performed. It can be performed.

[Relationship between instruction items and skill evaluation items]
Subsequently, the relationship between the instruction items in the arthroscopic surgery training and the skill evaluation items included in the training contents of each task box 3 will be described. Each training content has skill evaluation items as described above, and has a correlation subdivided with respect to instruction items by each skill evaluation item. FIG. 33 shows an example of the relationship between instruction items in the arthroscopic training system and skill evaluation items of each training content.

  In the table shown in FIG. 33, “Parameter of arthroscopic surgical skills” corresponds to a guidance item in arthroscopic surgical training. “Task No.-parameter” corresponds to the box number and the skill evaluation item of the training content of the box number. For example, “No. 6-time” is the time required for the training content of the sixth task box 3F, and “No. 8-score” is the score (achievement level) of the training content of the eighth task box 3H. “No.2-error” is the number of errors (number of failures) in the training content of the second task box 3B. “Correlation coefficient” is a correlation coefficient between the instruction item and the skill evaluation item. As the value of the correlation coefficient is larger, the instruction item and the skill evaluation item are more highly related. “P-value” is a probability-value, which is also called a significance probability, and is a value indicating the significance of the test.

  In the table shown in FIG. 33, regarding the relevance between the instruction item, the box number, and the skill evaluation item, the top 1 to 4 boxes in which the instruction item has a relatively high relevance compared to other box numbers and skill evaluation items. Numbers and skill evaluation items are shown.

  As shown in FIG. 33, the instruction item “mirror view” has a relatively high relevance to the “required time” of the box number “6” and the “score” and “required time” of the box number “8 (9)”. Have. Therefore, when the skill of the instruction item “mirror viewing” is immature or when it is desired to improve the skill, the “required time” of the box number “6”, the “score” and the “score” of the box number “8 (9)” Effective training can be performed by performing training so that the evaluation result of “time required” is improved (in the case of time required, the required time is shortened).

  Similarly, the instruction item “two-handed coordinated action” is relatively “required time” of box number “1”, “required time” of box number “6”, and “required time” of box number “8 (9)”. Highly relevant. Therefore, when the skill of the instruction item “Both-hands cooperative action” is immature or to improve this skill, the “required time” of the box number “1”, the “required time” of the box number “6”, and the box number Effective training can be performed by performing training so as to improve the evaluation result for the “required time” of “8 (9)”.

  The instruction item “damage / complication” includes “number of errors” in box number “2”, “number of errors” in box number “6” and “required time”, and “error in box number“ 8 (9) ”. It has a relatively high relationship with "number". Accordingly, when the skill of the instruction item “damage / complication” is immature or when it is desired to improve the skill, the “number of errors” in the box number “2”, the “number of errors” in the box number “6”, and “ Effective training can be performed by performing training so as to improve the evaluation result for the “required time” and the “number of errors” of the box number “8 (9)”.

  In addition, the instruction item “information acquisition” has a relatively high relationship with the “required time” of the box number “1”. Therefore, if the skill of the guidance item "information acquisition" is immature or if you want to improve this skill, by training to improve the evaluation result for "time required" of box number "1" Effective training can be performed.

  The instruction item “time” has a relatively high relationship with the “required time” of the box number “6”. Therefore, if the skill of the instruction item “time” is immature or if it is desired to improve this skill, training is performed so that the evaluation result for “time required” of box number “6” is improved. Training.

  As described above, the skill evaluation items of each training content have a correlation with the five instruction items in the arthroscopic surgery training. In this way, skill evaluation items of each training content have a correlation with multiple instruction items, so that more quantitative and objective evaluation can be performed for relatively advanced arthroscopic techniques among endoscope techniques. Can train more efficiently.

  Specifically, it is as follows. An example of the relevance between the instruction items shown in FIG. 33 and the skill evaluation items of each training content is as follows. The relationship between the teaching items and skill evaluation items of each training content is clarified.

  A resident doctor performs arthroscopic surgery in front of a specialist, and receives an indication from the specialist corresponding to the guidance items in arthroscopic surgery training. Regarding the instruction item “mirror viewing”, it is pointed out that mirroring skills are immature. Regarding the guidance item “two-handed cooperative action”, it is pointed out that the two-handed cooperative action is immature. The guidance item “damage / complication” is pointed out as to the risk of damage / complication, such as excessive use of force on living tissue. Regarding the guidance item “information acquisition”, it is pointed out that the comprehensive ability of arthroscopic technology is lacking. Regarding the guidance item “time”, it is pointed out that it takes too much surgery time.

  As shown in FIG. 33, regarding the instruction items corresponding to the indications received by the resident doctor from the specialist, the relevance of the training contents to the skill evaluation items clearly appears. For example, a resident doctor who has been evaluated by a specialist as having low mirror skills takes time for training for box number “6”, and the training score for box number “8 (9)” is low and takes time.

  In addition, a resident doctor who has been evaluated by a specialist as having a low skill in a two-handed cooperative operation takes time to train the box numbers “1”, “6”, and “8”. In addition, the resident doctor evaluated by the specialist as being likely to cause complications has a large number of training errors for the box numbers “2”, “6”, and “8”, and the training for the box number “6” takes time.

  As described above, in the arthroscopic training system 1 of the present embodiment, the basic technical elements necessary for arthroscopic surgery have a correlation with a plurality of instruction items in arthroscopic surgery training, and a plurality of task boxes. The content of training by 3 is divided into necessary and sufficient basic tasks. Each training content is divided into prime factors as skill evaluation items having a correlation with a plurality of instruction items.

  The correlation between the guidance items pointed out and taught by a specialist at a normal training seminar or the like and the skill evaluation items of the training content in each task box 3 is clear. In other words, each skill evaluation item such as a score and required time for the training content by each task box 3 is closely linked to a guidance item taught by a resident doctor from a specialist. These correlations indicate that the specialist can evaluate the skills of the doctors receiving the training and point out skills that he is not good at, so that focused and intensive training by the optimal task box 3 becomes possible.

  Specifically, the trainer 50 determines the instruction item such as which instruction item is insufficient among a plurality of instruction items from the evaluation result of each skill evaluation item of the training content for each task box 3. You can grasp the situation of your skills quantitatively and objectively. Therefore, the trainer 50 performs task box 3 so that training content having skill evaluation items corresponding to instruction items for which skills are insufficient, for example, is focused and concentrated according to the state of his / her skills. Select and perform training. By performing such training, efficient self-training without waste can be performed without depending on the instructor.

  As described above, according to the arthroscopic training system 1 of the present embodiment, it is possible to repeatedly train basic skills necessary for arthroscopic surgery, and to quantitatively and objectively evaluate basic skills. The essential training for becomes clear. For this reason, even if there are no or few specialists as supervising physicians, it is possible to efficiently train while reducing the burden on the supervising physicians. An environment capable of training "can be provided.

  The arthroscopic training system 1 of this embodiment has a significantly lower price range than the VR training device. Moreover, for example, by using many existing general-purpose parts in the system configuration, the cost can be easily reduced. For this reason, the arthroscopic training system 1 of this embodiment is easy to introduce into a medical field and is advantageous when considering expansion to other countries such as the Asian region.

[Another embodiment of the arthroscopic training system]
Another embodiment of the arthroscopic training system will be described. The arthroscopic training system of the present embodiment has the same functions as the functions of the arthroscopic training system 1 of the above-described embodiment. For this reason, the description about the overlapping content is abbreviate | omitted suitably using the same name about a common structure.

  As shown in FIG. 34, the arthroscopic training system of this embodiment includes an integral housing 1300 in the system main body 1002. The housing 1300 includes a control box portion 1310 that incorporates a control configuration for performing predetermined control in training by the arthroscopic training system, and a slot support portion 1320 that supports the task box slot 1006.

  In the housing 1300, the control box portion 1310 constitutes a lower portion of the housing 1300, and the slot support portion 1320 constitutes an upper portion of the housing 1300. That is, in the housing 1300, the control configuration is accommodated in the lower internal space, and the task box slot 1006 is supported in the upper portion. The control box portion 1310 and the slot support portion 1320 form an integral and continuous shape with respect to the outer shape of the housing 1300. Specifically, it is as follows.

  As shown in FIG. 34, the housing 1300 has a substantially rectangular parallelepiped outer shape at the base portion which is the lower (mounting surface side) portion, and goes from the base portion to the upper side, that is, the slot support portion 1320 side. Accordingly, it has a shape in which the dimension in the front-rear direction is gradually reduced. Specifically, the back side of the housing 1300 is formed so as to be substantially along the vertical direction with respect to the base portion having a substantially rectangular parallelepiped shape, and the front side of the housing 1300 is formed with respect to the base portion having a substantially rectangular parallelepiped shape. A gently curved surface is formed so as to approach the back side toward the upper side. Accordingly, the housing 1300 has such a shape that the dimension (thickness) in the front-rear direction gradually decreases (thinner) from the front side from the lower side to the upper side.

  In the housing 1300 having such a shape, the left and right side surfaces 1301 have a substantially right triangular shape in which the angled portion formed by the bottom surface side and the back surface side of the housing 1300 is a right angle portion and the front side which is the hypotenuse side is curved. . In addition, the housing 1300 includes a front surface 1302 of a substantially rectangular parallelepiped base portion on the front surface side, and a front surface 1303 that is an upper portion of the front surface 1302 and is formed in a gentle curved surface as described above.

  Inside the control box portion 1310 of the housing 1300, a control configuration for performing predetermined control as described above is incorporated, and a touch panel 1004 is accommodated. The touch panel 1004 is provided so that the display screen can be exposed to the outside through an opening 1304 provided to open to the front surface 1303 in the housing 1300. The touch panel 1004 is provided such that its display screen is along the front surface 1303 of the housing 1300.

  As described above, the task box slot 1006 supported by the slot support portion 1320 is supported by the support mechanism 1010 provided in the slot support portion 1320 in the tunnel portion 1330 provided in the housing 1300.

  The tunnel portion 1330 is a portion that is provided at a substantially central portion in the left-right direction of the slot support portion 1320 and forms a hole that penetrates the upper portion of the housing 1300 in the front-rear direction. The tunnel portion 1330 has a long hole shape or an elliptical shape with the vertical direction as the longitudinal direction in the front view of the housing 1300. The tunnel portion 1330 changes the dimension in the front-rear direction of the inner peripheral surface 1331 of the hole portion, that is, the dimension in the left-right direction in a side view, corresponding to the outer shape of the housing 1300 as described above. Therefore, the dimension of the inner peripheral surface 1331 in the front-rear direction gradually decreases from the lower side to the upper side.

  The support mechanism 1010 that supports the task box slot 1006 has a support shaft 1011 that is provided along the vertical direction at a substantially central position on the left and right sides of the housing 1300. The support shaft 1011 penetrates the upper portion of the slot support portion 1320 forming the tunnel portion 1330, that is, the upper end portion of the housing 1300 in the vertical direction, and opens from the hole opened in the lower surface portion of the inner peripheral surface 1331 to the inside of the housing 1300. Inserted in the tunnel portion 1330 and provided in a manner erected in the vertical direction. A threaded surface is formed on substantially the entire portion of the support shaft 1011 that spans the tunnel portion 1330.

  The task box slot 1006 is supported on the support shaft 1011 via a support member such as a stay (not shown). The task box slot 1006 is supported in a state where it can be moved up and down and rotated.

  Regarding the raising / lowering of the task box slot 1006, the position of the task box slot 1006 in the vertical direction, that is, the axial direction of the support shaft 1011 is changed by the screw action of the screw surface formed on the outer peripheral surface of the support shaft 1011. The support mechanism 1010 is configured such that the vertical position of the task box slot 1006 changes as the support shaft 1011 rotates. Therefore, a grip portion 1012 for rotating the support shaft 1011 is provided on the upper end side of the support shaft 1011. The grip portion 1012 is provided on the upper side of the upper end surface of the housing 1300 and has a disk-shaped outer shape coaxial with the support shaft 1011. By rotating the grip 1012, the vertical position of the task box slot 1006 is adjusted.

  The task box slot 1006 is provided to be rotatable with respect to the support shaft 1011 with the front-rear direction as the rotation axis direction. The task box slot 1006 has the same outer shape as the task box slot 6 included in the arthroscopic training system 1 of the above-described embodiment, and has a pair of side surface portions 1006a formed as curved surfaces protruding outward on the left and right sides. .

  As shown in FIG. 35 (a), the task box slot 1006 is normally used in a posture in which the side surface portion 1006a that protrudes outward is directed to the left and right sides. Then, as shown in FIG. 35 (b), the task box slot 1006 is rotated so that, for example, the side surface portions 1006a on both sides are vertically oriented. The mode shown in FIG. 35B is used when the task box 3 is rotated by 90 ° in the training using the eighth task box 3H and the ninth task box 3I as described above.

  In order to perform such a rotation operation of the task box slot 1006, a grip portion 1013 is provided on the upper and lower surfaces formed in a planar shape in the task box slot 1006. The grip portion 1013 is a plate-like portion that is arched when viewed from the front. A trainee or the like grips the upper and lower grips 1013 and rotates the task box slot 1006.

  As shown in FIGS. 35A and 35B, the arch-shaped gripping portions 1013 provided on the upper and lower surfaces of the task box slot 1006 have a common circumference together with the side surface portion 1006a of the task box slot 1006 in a front view. It has a shape along. That is, when viewed from the front, a circular shape is formed by the side surface portions 1006 a on both sides of the task box slot 1006 and the outer peripheral surfaces of the upper and lower grip portions 1013. By adopting such a shape, the design appearance is improved.

  Further, in the task box slot 1006, an insertion port into which the task box 3 as described above is inserted opens on the front side, and this insertion port is covered with a lid 1040. The lid body 1040 has the same configuration as the lid body 40 in the arthroscopic training system 1 described above.

  In the arthroscopic training system of the present embodiment, a speaker that emits training-related sounds to the trainee is built in the housing 1300. A connection pin 1014 to which a foot switch (see FIG. 2, foot switch 7) and a probe (see FIG. 2, probe 9) are connected is provided below the right side surface 1301 of the housing 1300.

  Further, the arthroscopic training system of the present embodiment includes a printing unit that prints an evaluation result for each skill evaluation item of the training content for each task box 200 as described above. The printing unit is connected to a control configuration for performing predetermined control during training, and is built in the control box unit 1310 of the housing 1300. A discharge port 1015 for discharging the paper 1016 on which the evaluation result of each skill evaluation item is printed by the printing unit is provided on the front surface 1302 of the housing 1300.

  According to the printing unit included in the arthroscopic training system according to the present embodiment, for example, the display at the end of training in the evaluation item display unit 62c of the training screen 62 as described above (see FIG. 30D) is the evaluation result. Are printed on the paper 1016 and printed out from the paper discharge outlet 1015. The evaluation results printed out for the training by each task box 200 are as follows.

  For the first task box 3A, the result of the time required to achieve the training content by operating the arthroscope 51 on the first operation target 20A is printed out as an evaluation result. For the second task box 3B, the time required to achieve the training content by operating the arthroscope 51 and the probe 9 on the second operation target 20B, the achievement level (score) of the training content, and the number of failures (number of errors) ) Is printed out as an evaluation result.

  For the third task box 3C, the result of the time required to achieve the training content by operating the arthroscope 51 and the surgical instrument 52 on the third operation target 20C is printed out as an evaluation result. For the fourth task box 3D, the time required to achieve the training content by operating the arthroscope 51 and the probe 9 on the fourth operation target 20D, the achievement level (score) of the training content, and the number of failures (number of errors) ) Is printed out as an evaluation result.

  For the fifth task box 3E, the time required to achieve the training content by operating the arthroscope 51 and the surgical instrument 52 on the fifth operation target 20E, the achievement level (score) of the training content, and the number of failures (errors) The result of (number) is printed out as an evaluation result. For the sixth task box 3F, the time required to achieve the training content by operating the arthroscope 51 and the surgical instrument 52 on the sixth operation target 20F, the achievement level (score) of the training content, and the number of failures (errors) The result of (number) is printed out as an evaluation result.

  For the seventh task box 3G, the time required to achieve the training content by operating the arthroscope 51 and the probe 9 on the seventh operation target 20G, the achievement level (score) of the training content, and the number of failures (number of errors) ) Is printed out as an evaluation result. Further, for the eighth task box 3H and the ninth task box 3I, the time required to achieve the training content by the operation of the arthroscope 51 and the surgical instrument 52 with respect to the eighth operation object 20H or the ninth operation object 20I, respectively. The results of the achievement level (score) and the number of failures (number of errors) of the training content are printed out as evaluation results.

  For example, the printout from the paper discharge port 1015 by the printing unit is automatically performed when the training content in each task box 200 is completed. As another example, an operation button (for example, a character display section such as “print”) for printing out the evaluation result is displayed on the training screen 62 (see FIG. 30D) on the touch panel 1004. A configuration in which printing out is performed by a screen operation of an operation button by a trainee or the like.

  In this way, by adopting a configuration that includes a printing unit and prints out the evaluation results for each training content, the training evaluation results are output in paper media, so trainers can evaluate their own training. Results can be stored and managed easily. This facilitates, for example, observing changes in long-term evaluation results, and is useful in seeing quantitative and objective improvements in endoscope technology. In addition, the trainer can easily present his or her own evaluation result on a paper medium to another person such as a supervising doctor.

  According to the arthroscopic training system of the present embodiment as described above, the following effects can be obtained in addition to the same effects as the arthroscopic training system 1 of the above-described embodiment. That is, the arthroscopic training system of the present embodiment includes the housing 1300 having an integral and continuous shape as a configuration that accommodates the control configuration and supports the task box slot 1006, so that the system body 1002 has a sense of unity. A stable shape is realized, and high design is obtained.

  In the embodiment of the present invention described above, an arthroscopic training system which is an example of an endoscope training system has been described. However, the present invention is not limited to an arthroscope, but a laparoscope, a thoracoscope, a laryngoscope, and a small intestine. The present invention can be applied to endoscope training in which various types such as an endoscope, a colonoscope, and a capsule endoscope exist.

  Specifically, a plurality of training contents correlated with a plurality of instruction items for training for endoscopic surgery, which are set according to the type of endoscope, the techniques required for endoscopic surgery And further divided into factor evaluation items for skill evaluation items for each training content having a correlation with the instruction item. Then, a plurality of task boxes are prepared so that an evaluation result of a predetermined skill evaluation item can be obtained for each training content. This makes it possible to repeatedly train basic skills necessary for a predetermined type of endoscopic surgery such as laparoscopes, and to quantitatively and objectively evaluate basic skills. Mandatory training becomes clear.

1 Arthroscopic Training System 2 System Body 3 Task Box 3d Rear (Insertion Side)
3A 1st task box 3B 2nd task box 3C 3rd task box 3D 4th task box 3E 5th task box 3F 6th task box 3G 7th task box 3H 8th task box 3I 9th task box 4 Touch panel (display part) )
5 Control box (control unit)
6 Task box slot (task box holding part)
6a Insertion port 20 Operation target 21 Slot side connector (first connector)
22 Box side connector (second connector)
51 Arthroscope (endoscope)
52 Surgical instruments 54a Arthroscopic images (endoscopic images)
40 Lid (lid)
100 Endoscope Training System 200 Task Box 200a Opening 300 Task Box Slot (Task Box Holding Unit)
300a Insertion slot 400 Touch panel (display unit)

Claims (5)

An endoscope training system for training endoscopic surgery,
A plurality of task boxes prepared for each training content, and having an operation target for receiving an operation corresponding to the training content;
A task box holding unit for holding the task box inserted from the insertion port such that the task box has an insertion port to be inserted, and the side on which the operation target is operated faces the opening side of the insertion port;
A lid that covers the insertion port, penetrates the surgical instrument used for the operation of the endoscope and the operation target, and allows the operation of the operation target by the endoscope and the surgical instrument;
A control unit for identifying the training content corresponding to the task box inserted in the task box holding unit, and outputting control information corresponding to the identified training content;
Based on the control information output from the control unit, a display unit that displays a video according to the training content,
The trainer performing the training performs an operation on the operation target while viewing an endoscope image projected by the endoscope,
The training content is set according to the type of endoscope, and has a correlation with a plurality of instruction items for the training,
Endoscopy training system. The training content has a skill evaluation item including at least one of a time required until the training content is achieved by an operation on the operation target, a degree of achievement of the training content by the operation on the operation target, and the number of failures. ,
The skill evaluation item has a correlation with the plurality of instruction items.
The endoscope training system according to claim 1. The endoscope is an arthroscope;
The plurality of instructional items include: arthroscopic speculum skills, cooperative operation of both hands for operating the arthroscope and the surgical instrument, avoidance of damage and complications associated with surgery, acquisition of information from the video of the arthroscope, Including surgery time,
The endoscope training system according to claim 1 or 2. The plurality of task boxes are:
A first task box in which the operation of the arthroscope with respect to the operation target is the training content, and the skill evaluation item is the required time;
A second task box in which the operation of the arthroscope with respect to the operation target and the contact operation with the surgical instrument are the training contents, the skill evaluation items are the required time, and the achievement level and the number of failures of the training contents;
A third task box in which the operation of the arthroscope with respect to the operation target and a grasping operation by the surgical instrument are the training contents, and the skill evaluation item is the required time;
The size determination by the image of the arthroscope with respect to the operation target and the contact operation by the surgical instrument are the training contents, and the skill evaluation items are the required time, the achievement degree of the training contents, and the number of failures. A task box and
A fifth task box in which the operation of the arthroscope and the cutting operation by the surgical instrument with respect to the operation target are the training contents, the skill evaluation items are the required time, and the achievement level and the number of failures of the training contents;
A sixth task box in which the operation of the arthroscope with respect to the operation target and the extraction / insertion operation with the surgical instrument are the training contents, and the skill evaluation items are the required time, the achievement level of the training contents, and the number of failures. ,
A seventh task box in which the operation of the arthroscope with respect to the operation target and the trace operation by the surgical instrument are the training contents, the skill evaluation items are the required time, and the achievement level and the number of failures of the training contents;
The operation contents of the arthroscope and the extraction operation by the surgical instrument with respect to the operation object in at least two angle states are the training contents, and the skill evaluation items are the required time, the achievement level of the training contents, and the number of failures. 8 task boxes,
The operation object of the eighth task box as the operation object is symmetrical with respect to the operation object, and the training content includes the operation of the arthroscope and the extraction operation by the surgical instrument with respect to the operation object in at least two angle states. And a ninth task box in which the skill evaluation items are the required time, and the achievement level and the number of failures of the training content,
including,
The endoscope training system according to claim 2 or claim 3. The task box holding unit is connected to the control unit at a position facing the insertion port, and the control unit has a first connector that receives a signal for identifying the training content,
The task box has a second connector connected to the first connector by an insertion operation of the task box into the insertion port on a surface on the insertion side with respect to the insertion port.
The endoscope training system according to any one of claims 1 to 4.