JP6756947B2 - Organ fixture for abdominal cavity simulator - Google Patents

Description

The present invention relates to an instrument for fixing a biological texture organ model to a abdominal cavity simulator.

In recent years, laparoscopic surgery is often performed in operations such as digestive organs and urinary organs because the scars are small and the postoperative recovery is quick.
However, laparoscopic surgery has a problem that the difficulty of surgery is high and the skill of the surgeon is likely to differ. Therefore, a technique for effectively performing laparoscopic surgery procedure training is desired.

As a technique for performing laparoscopic surgery technique training, a abdominal cavity simulator having a casing made of a member simulating a human body shape is known (see Patent Document 1).
The abdominal cavity simulator disclosed in Patent Document 1 is provided with a plurality of ports through which surgical instruments can be inserted, and can perform repeated training. In addition, when the biological texture organ model is installed in the simulator, it is configured so that the alignment can be easily performed, which makes the simulator highly convenient.
In order for training using such a peritoneal simulator to be performed effectively, the surgical field obtained by the operator through the endoscope must be close to the actual surgical field, and therefore, the abdominal cavity simulator must be used. The biological texture organ model to be mounted inside needs to be mounted in an anatomically accurate three-dimensional position.
However, in the abdominal cavity simulator disclosed in Patent Document 1, a mechanism for attaching the biological texture organ model to an anatomically accurate three-dimensional position is provided in the model grip portion used for attaching the biological texture organ model. There is not enough disclosure about whether or not it is.

As a technique for providing an anatomically accurate practice model, an anatomical model composed of a plurality of layers is known (see Patent Document 2). This is a technique for a gallbladder model, especially used for training laparoscopic cholecystectomy, which consists of an anatomical part and a removable connectable support.
However, although the anatomical model disclosed in Patent Document 2 is intended to reproduce an organ more accurately, there is a problem that the production cost of the organ model is high.

In addition, a hernia model for training in repair of an inguinal hernia is known (see Patent Document 3). This is a model for practicing transperitoneal preperitoneal (TAPP) and total extraperitoneal (TEP) techniques for laparoscopic hernia repair and is assumed to have an anatomical structure.
However, the hernia model disclosed in Patent Document 3 also has a problem that the production cost of the organ model becomes high as in the anatomical model disclosed in Patent Document 2.

International Pamphlet WO2015 / 151504 Gazette Japanese Patent Application Laid-Open No. 2016-523383 Special Table 2016-518631

In order to perform effective procedure training, it is necessary to accurately reproduce the organs according to the anatomical structure. However, on the other hand, since training is repeated, it is desirable that an organ model be produced at low cost.
In view of such a situation, the present invention can produce a biological texture organ model at a low cost while being arranged at an anatomically accurate three-dimensional position when the biological texture organ model is attached to the abdominal cavity simulator. It is an object of the present invention to provide an organ fixture for an abdominal cavity simulator.

In order to solve the above problems, the organ fixture for a laparoscopic simulator of the present invention is an organ fixture in which an organ model is arranged in a three-dimensional space of the lumen of the laparoscopic simulator for learning a laparoscopic technique. It is composed of at least a pelvic part simulating the above, a back part having left and right lateral abdomen and a bulge of the spine, and an abdomen provided with a plurality of ports through which surgical instruments used under laparoscopic procedures can be inserted. Is at least one of a stomach model fixture, a uterine model fixture, and an inguinal hernia model fixture, all of which are three-dimensionally placed in the laparoscopic simulator lumen of the organ model when the organ model is attached. The surface of the fixture itself is raised, depressed, or curved so that the position is anatomically correct, and the gastric model fixture has at least three levels of elevation difference in the esophagus. A tray on which at least a gastric organ model with a part and duodenum is placed, and a laparoscopic model fixture is a curved inner wall on the back surface of a flexible sheet-like uterine model with uterine, ovarian and bladder organ models. The laparoscopic hernia model fixture can be attached to the inner wall of the pelvic region and can attach the back surface of a flexible sheet-like laparoscopic hernia model having two symmetrical organ models of the hernia phylum. It is a thing.

Attempting to attach an organ model to an abdominal cavity simulator without using an organ fixture requires the organ model itself to be shaped into an anatomically correct shape, but in that case, the parts that are not necessarily important in the procedure training Because it will be reproduced precisely, the manufacturing cost will be high. In addition, there is a limit to accurate reproduction of the positional relationship and fixed state of organs only by devising the material and shape of the organ model.
By using the organ fixture of the present invention, it is possible to design separately on the assumption that the organ model and the organ fixture are combined, and a flexible and high-quality design becomes possible. That is, the organ fixture enables accurate and stable fixation of the organ model, while it is possible to design the organ model in a substantially planar shape, for example, assuming the state after attachment. It becomes.
In addition, important parts of the procedure training can be accurately reproduced with an organ model, and parts that are not necessarily important can be deformed with an organ fixture, so that an organ model can be produced at low cost.

In the organ fixture for the abdominal cavity simulator of the present invention, in the stomach model fixture, the back surface of the tray fits into the spine ridge on the back, the side surface of the tray engages with the left and right lateral abdomen, and the center of the tray surface is the spine ridge. It is curved and raised along the tray, and the left and right sides are plate-shaped with the center of the tray surface in between. The height difference of the tray surface in three stages is the center, the right plate seen from the head side, and the left plate seen from the head side. It is preferable that the height difference is provided in the order of.
With such a configuration, the gastric organ model can be placed so as to be in an anatomically correct position.

In the organ fixture for the abdominal cavity simulator of the present invention, it is preferable that the stomach model fixture is further provided with a means for sandwiching and fixing the esophagus of the stomach organ model on the central head side of the tray surface.
Further, in the organ fixture for the abdominal cavity simulator of the present invention, the gastric model fixture is further provided with a means for fixing the duodenum of the gastric organ model on the pelvic side of the right plate when viewed from the head side of the tray surface. Is preferable.
By providing means for sandwiching and fixing the esophagus of the gastric organ model and means for fixing the duodenum, not only can the three-dimensional placement position of the gastric organ model be stably maintained, but also during procedure training. It is possible to accurately reproduce the elasticity when the stomach organ model is grasped.

In the organ fixture for the abdominal cavity simulator of the present invention, the stomach model fixture is further provided with a second ridge on which the stomach organ model is placed on the ridge along the central spine ridge on the tray surface. It is preferable that
By providing the second ridge, the organ model can be placed at a more accurate position.

In the organ fixture for the abdominal cavity simulator of the present invention, it is preferable that the stomach model fixture is further provided with a recessed portion on which the organ model of the spleen is placed on the head side of the left plate when viewed from the head side of the tray surface. ..
Since the spleen is located in the supine position at a position depressed from the spine, the spleen can be placed in a more accurate position by providing the depressed portion.

In the organ fixture for the abdominal cavity simulator of the present invention, it is preferable that the stomach model fixture is mounted on the sheet-shaped model simulating the omentum mounted on the tray surface.
By placing the gastric organ model on the sheet-shaped model that simulates the omentum, it will be placed at an anatomically accurate position. In addition, it is preferable that the gastric organ model is further provided with the spleen, peripheral blood vessels, lymph nodes, transverse colon, pancreas, and peritoneum. In that case, the transverse colon and pancreas are placed under a sheet-like model that mimics the omentum.

In the organ fixture for the abdominal cavity simulator of the present invention, the uterine model fixture is a member that replaces the pelvis, or a member that can be fitted to the inner wall member or inner wall of the pelvis, and the central back side of the fixture is raised. However, when the back surface of the uterus model was attached to the fixed position, the unevenness of the curved surface of the inner wall was formed so that the three-dimensional placement positions of the uterus, ovaries, and bladder were anatomically correct. Is preferable.
With such a configuration, the uterine model can be attached so as to be in an anatomically correct three-dimensional position.

In the organ fixture for the abdominal cavity simulator of the present invention, the uterus model fixture is provided so that the portion where the uterus is arranged is provided high and the portion where the bladder is arranged becomes low, and the uterus is arranged. It is preferable that the bladder is formed in a substantially truncated cone shape in which the diameter decreases from the location where the bladder is arranged.
With such a configuration, the shape of the pelvis is reproduced more accurately, and the uterine model can be attached so as to have a more anatomically correct three-dimensional position.

In the organ fixture for the abdominal cavity simulator of the present invention, the uterine model attached to the uterine model fixture includes the organ model of the uterus, ovary and bladder, as well as the rectum, adipose tissue, ureter, external iliac artery, and external iliac vein. , It is preferred that at least one organ model selected from the circular ligament is further deployed.
By arranging an organ model such as the rectum, the surgical field, especially when viewed with an endoscope, can be reproduced more accurately, and effective training becomes possible. The organ model such as the rectum is also provided so as to have an accurate three-dimensional arrangement position when attached to the uterine model fixture.

In the organ fixture for the abdominal cavity simulator of the present invention, when the inguinal hernia model is attached, the fixture is applied to the back surfaces of the two hernia portals and the arteries, veins and vas deferens running around them. It is preferable that the shape of the fixture is formed so as not to come into contact with each other.
By forming the fixture so that it does not come into contact with the fixture, it does not interfere with the procedure in the procedure training, and more realistic training becomes possible.

In the organ fixture for the abdominal cavity simulator of the present invention, the inguinal hernia model attached to the inguinal hernia model fixture has a sheet-like surface covered with a gel-like membrane having the texture of an exfoliated layer of the preperitoneal fascia. In addition to one hernia phylum organ model, it is preferred that at least one organ model selected from medial umbilical folds, midline umbilical folds, arteries, veins, bladder, and sperm canal is further deployed.
By arranging an organ model such as the medial umbilical fold, the surgical field, especially when viewed with an endoscope, can be reproduced more accurately, and effective training becomes possible. The organ model such as the medial umbilical fold is also provided so as to have an accurate three-dimensional arrangement position when attached to the inguinal hernia model fixture.

In the organ fixture for the abdominal cavity simulator of the present invention, it is preferable that the gel-like membrane covering the inguinal hernia model attached to the inguinal hernia model fixture can be replaced and reused.
Since the procedure training is generally repeated, it can be replaced and reused, so that the training can be performed at low cost.

It is preferable that a foamy fascia model or a foamy loosely coupled weave model is further provided between the organ models attached to the organ fixture for the abdominal cavity simulator of the present invention.
By providing a foam-like fascia model or a foam-like loosely coupled weave model, not only the surgical field when viewed with an endoscope is reproduced more accurately, but also procedures such as peeling and incision are made more realistic. It can be carried out. The loose connective tissue is also called a loose connective tissue.

According to the organ fixture for the abdominal cavity simulator of the present invention, when the biological texture organ model is attached to the abdominal cavity simulator, it is arranged at an anatomically accurate three-dimensional position, and the biological texture organ model is inexpensive. It has the effect of being able to produce.

Perspective view of the gastric integrated model fixture of Example 1 External view 1 of the gastric integrated model fixture of Example 1 External view 2 of the gastric integrated model fixture of Example 1 External view 3 of the gastric integrated model fixture of Example 1 Explanatory drawing of the tray of the gastric integrated model fixture Top view of gastric integrated model Installation image of the integrated gastric model Peritoneal simulator perspective view Image of attachment of gastric integrated model fixture to abdominal cavity simulator Usage flow chart of the gastric integrated model fixture of Example 1 Perspective view of the uterine model fixture of Example 2 External view 1 of the uterine model fixture of Example 2 External view 2 of the uterine model fixture of Example 2 External view 3 of the uterine model fixture of Example 2 Top view of uterine model Installation explanatory view of the uterus model Installation image of the uterus model Image of attachment of uterine model fixture to abdominal cavity simulator Use flow diagram of the uterine model fixture of Example 2 Perspective view of the inguinal hernia model fixture of Example 3 External view 1 of the inguinal hernia model fixture of Example 3 External view 2 of the inguinal hernia model fixture of Example 3 External view 3 of the inguinal hernia model fixture of Example 3 Top view of inguinal hernia model Installation explanatory view of the inguinal hernia model Installation image of inguinal hernia model Image of attachment of inguinal hernia model fixture to abdominal cavity simulator Usage flow chart of the inguinal hernia model fixture of Example 3

Hereinafter, an example of the embodiment of the present invention will be described in detail with reference to the drawings. The scope of the present invention is not limited to the following examples and illustrated examples, and many modifications and modifications can be made.

FIG. 1 shows a perspective view of the gastric integrated model fixture of Example 1. 2 to 4 are external views of the gastric integrated model fixture of Example 1, FIG. 2 (1) is a front view, FIG. 2 (2) is a rear view, and FIG. 3 (1) is a plan view. 3 (2) is a bottom view, FIG. 4 (1) is a right side view, and FIG. 4 (2) is a left side view.
As shown in FIGS. 3 (1) and 3 (2), the gastric integrated model fixture 1 includes a tray 4 and mounting members (5a, 5b). The tray 4 is a place where a biological texture organ model is placed and fixed, and is composed of trays (4a, 4b). In this embodiment, the configuration in which two trays (4a, 4b) are combined is shown, but the trays (4a, 4b) may be integrally molded.
The attachment members (5a, 5b) serve as an adapter for attaching to the abdominal cavity simulator described later, and are manufactured according to the shape of the abdominal cavity simulator to be attached.
The tray 4a and the mounting members (5a, 5b) are fixed by using two screws 51, respectively. Further, the tray 4b and the mounting members (5a, 5b) are also fixed by using two screws 51, respectively. In this way, since the tray 4 and the mounting members (5a, 5b) are detachable by the screws 51, the mounting members (5a, 5b) can be replaced according to the size of the abdominal cavity simulator to be used. Is. Further, unlike such a configuration, the tray 4 and the mounting members (5a, 5b) can be integrally molded.
As shown in FIGS. 4 (1) and 4 (2), the mounting member 5a is provided with female screw portions (6a, 6b), and the mounting member 5b is provided with female screw portions (6c, 6d). It can be easily attached to the abdominal cavity simulator using the 52.

As shown in FIG. 1, the tray 4 has an uneven shape instead of a flat surface. The reason for this shape will be described with reference to FIG.
FIG. 5 is an explanatory view of a tray of the gastric integrated model fixture, (1) shows a case where a flat tray is used, and (2) shows a case where an uneven tray is used.
As will be described in detail later, the gastric integrated model 10 includes not only the stomach but also models of various organs such as the spleen and the transverse colon. And those organ models originally exist with a height difference inside the human body. However, as shown in FIG. 5 (1), when the gastric integrated model 10 is installed on the tray 400, the height difference cannot be reproduced because the tray 400 has a planar shape. That is, when using a flat tray, it is necessary to provide a height difference in the gastric integrated model 10 itself. However, in order to produce a gastric integrated model that accurately reproduces the height difference, there is a problem that the production cost is high because it is necessary to precisely produce a part that is not necessary for the procedure training.
Therefore, as shown in FIG. 5 (2), by providing a height difference in the tray 4 itself, even when the gastric integrated model 10 produced in a substantially planar shape is installed, an anatomically accurate three-dimensional position is provided. It is possible to place organs in.
That is, when it is desired to arrange the part 10b at a position higher than the part 10a and the part 10c at a position lower than the part (10a, 10b), the upper stage is as shown in the tray 4 shown in FIG. 5 (2). By using a member in which the portion 4c, the lower portion 4d, and the raised portion 4e are formed, the height difference can be produced reliably and easily. For convenience of explanation, the depressed portion 4f is not shown here.

As shown in FIG. 1, the tray 4 is provided with a mechanism for fixing the gastric integrated model 10, specifically, an esophageal fixing mechanism 7a, a duodenum fixing mechanism 7b, and a through hole 7c. .. Two through holes 7c are provided at the top and bottom, and after inserting the end of the duodenum 11b from the top of the tray 4 to the inside of the ridge 4e, it is folded back and further inserted from the inside of the ridge 4e onto the tray 4 to fix the duodenum. The mechanism 7b has a shape that allows the end of the duodenum 11b to be fixed. Unlike this, only one through hole 7c may be provided, the end portion of the duodenum 11b may be fixed by the duodenum fixing mechanism 7b, and the remaining portion may be inserted from the through hole 7c to the inside of the raised portion 4e.

FIG. 6 shows a plan view of the gastric integrated model. The gastric integrated model 10, which is a biological texture organ model, reproduces the stomach and the peripheral part of the stomach in an integrated manner, and makes it possible to train gastric removal and peripheral treatment in a series of steps. Specifically, as shown in FIG. 6, it is composed of a stomach 11, a spleen 12, a peripheral blood vessel 13, a lymph node 14, a transverse colon 15, an omentum 16, a pancreas 17, and a peritoneum 18.
The stomach 11 is provided not only with the stomach but also with the esophagus 11a at the cardia and the duodenum 11b at the pylorus. The stomach 11 has a structure corresponding to a delta anastomosis.
Further, polyvinyl alcohol (PVA) resin is used as the material, and since the polyvinyl alcohol resin contains water, it is possible to use an electric knife or the like.
In the following examples, the organ called "stomach" or the like is not an actual organ but a biological texture organ model.

FIG. 7 shows a mounting image of the integrated gastric model. As shown in FIG. 7, the gastric integrated model 10 is arranged on the tray 4 of the gastric integrated model fixture 1, and the esophagus 11a is sandwiched and fixed by the esophageal fixation mechanism 7a. Further, the duodenum 11b is inserted through the two through holes 7c shown in FIG. 1, and the end portion is fixed by the duodenum fixing mechanism 7b shown in FIG. This makes it possible to reproduce the state in which the duodenum falls under the retroperitoneum and is connected to the small intestine.
The tray 4 is provided with four height differences of an upper portion 4c, a lower portion 4d, a raised portion 4e, and a depressed portion 4f. Therefore, when the gastric integrated model 10 is arranged, for example, the central portion of the stomach 11 has a raised shape and is arranged higher than the stomach 11 arranged in the upper portion 4c near the liver. Blood vessels and bile ducts that connect to the liver run near the liver, but there is no depression. By using the gastric integrated model fixture 1, such a three-dimensional positional relationship can be accurately reproduced. Similarly, with respect to the transverse colon 15, a height difference is provided depending on the locations where the upper part 4c, the raised part 4e, and the lower part 4d are arranged.
Further, since the spleen 12 is arranged in the depressed portion 4f, it is arranged at the lowest position than other organs. This makes it possible to reproduce the appearance of the bottom of the spleen falling substantially to the dorsal side.
In this way, the organ can be arranged at an anatomically accurate three-dimensional position only by appropriately arranging the gastric integrated model 10 on the tray 4.

FIG. 8 is a perspective view of the abdominal cavity simulator, in which (1) shows an assembled state and (2) shows a disassembled state. As shown in FIG. 8 (1), the abdominal cavity simulator 9 is composed of an abdomen 91, a pelvis portion 92 and a back portion 93, and as shown in FIG. 8 (2), the back portion 93 is provided with a lid portion 94. There is.

FIG. 9 is an image diagram of attachment of the gastric integrated model fixture to the abdominal cavity simulator, in which (1) is before attachment and (2) is after attachment.
As shown in FIG. 9 (1), the female screw portions (6a to 6d) provided on the gastric integrated model fixture 1 and the female screw portions (93a to 93d) provided on the back portion 93 of the abdominal cavity simulator 9. Align the positions and fix them with screws 52 as shown in FIG. 9 (2). The raised portion 4e is attached so as to fit into the spine 93h, but also has a function of adjusting the placement position of the gastric integrated model 10 placed on the raised portion 4e.
Here, for convenience of explanation, the gastric integrated model 10 is not fixed to the gastric integrated model fixture 1 and is attached to the back 93 of the abdominal cavity simulator 9, but in reality, the gastric integrated model is first attached. After fixing the gastric integrated model 10 to the fixture 1, it is attached to the back portion 93.
A specific flow of using the gastric integrated model fixture will be described with reference to FIG. FIG. 10 shows a flow chart of use of the gastric integrated model fixture of Example 1.
As shown in FIG. 10, when the gastric integrated model fixture is used, first, the gastric integrated model 10 is arranged on the tray 4 (step S01). Next, the esophagus 11a is fixed using the esophageal fixing mechanism 7a (step S02). The duodenum 11b is fixed using the duodenum fixation mechanism 7b (step S03). The gastric integrated model fixture 1 is attached to the back portion 93 of the abdominal cavity simulator 9 (step S04). Finally, the pneumoperitoneum cover, the abdomen 91, is attached to the back 93 (step S05).

FIG. 11 shows a perspective view of the uterine model fixture of Example 2. 12 to 14 are external views of the uterine model fixture of the second embodiment, FIG. 12 (1) is a front view, FIG. 12 (2) is a rear view, and FIG. 13 (1) is a plan view. 13 (2) is a bottom view, FIG. 14 (1) is a right side view, and FIG. 14 (2) is a left side view.
As shown in FIGS. 13 (1) and 13 (2), the uterine model fixture 2 is composed of five constituent members (2a to 2e), each of which is fixed by a screw 51. Specifically, the constituent member 2a and the constituent member 2b are configured with the constituent member 2d as shown in FIG. 11, and the constituent member 2a and the constituent member (2c, 2e) are configured with the constituent member 2d as shown in FIG. 11 or FIG. 12 (1). As shown in FIG. 14 (1), the member 2e is fixed to the constituent member 2c and the constituent member 2d by a screw 51 as shown in FIG. 14 (2).
Further, as shown in FIG. 13 (1), the uterine model fixture 2 is provided with hook-and-loop fasteners (71a to 71c). The hook-and-loop fasteners (71a to 71c) are formed by hook portions, and the base member 20a of the uterine model 20 described later can play the same role as the loop portion of the hook-and-loop fastener in terms of material, so that the mounting position of the uterine model 20 can be freely adjusted. It is adjustable to.
The uterine model fixture 2 is provided with a head-side opening 8a and a foot-side opening 8b, and the head-side opening 8a is provided wider than the foot-side opening 8b. As shown in FIGS. 12 (2) and 13 (1), the inside of the uterine model fixture 2 has a curved surface shape. Therefore, the inside of the uterine model fixture 2 is provided so as to gradually narrow from the cranial opening 8a to the foot opening 8b. When the uterus model is attached to the uterus model fixture 2, the organ model is attached along the curved surface shape, so that the organ is arranged at an anatomically correct position.
Further, as shown in FIG. 11, the head side opening 8a is provided with a raised portion 2i. As shown in FIG. 14, the raised portion 2i is provided with an inclination so as to gently descend from the head-side opening 8a to the foot-side opening 8b, as shown in FIG. By providing such a height difference, the organ is arranged at an anatomically correct position when the uterine model is attached.

FIG. 15 shows a plan view of the uterus model. As shown in FIG. 15, the uterine model 20 includes a uterus 21, a bladder 22, a rectal 23, an ovary 24, an adipose tissue 25, a ureter 26, an external iliac artery 27a, an external iliac vein 27b, an artery 27c, and a vein 27d. It consists of a circular ligament 28 and a nerve 29.
In addition, although not shown here, the uterine model 20 accurately represents bubble-like fascia and loose connective tissue in which anatomical presence is observed between organs. As a result, training operations such as peeling are visually and textured, and the training effect is increased. The existence of foam-like fascia and loose connective tissue has become clearer with the advent of 3D high-definition cameras.

Looking at the overall shape, the uterus model produced on a flat surface is designed by deforming the internal structure such as blood vessel running, imagining the three-dimensional structure after installation on the uterus model fixture 2. Therefore, in the planar state shown in FIG. 15, the three-dimensional positions of each organ are not anatomically accurate. Therefore, a mechanism in which a three-dimensional position of an organ, which is not accurate in a flat state, is attached to the uterine model fixture 2 to be an accurate position will be described with reference to FIG.

16A and 16B are explanatory views of attachment of the uterus model, in which (1) is in a flat state and (2) is in a state of being attached to a fixture. As described above, the inside of the uterine model fixture 2 has a curved surface shape, and is provided so as to gradually narrow from the cranial opening 8a to the foot opening 8b. Therefore, when the planar uterus model 20 shown in FIG. 16 (1) is attached to the uterus model fixture 2, the left and right upper ends of the uterus model 20 are rounded so as to be narrow as shown in FIG. 16 (2). Will be placed.
Further, since the uterus model fixture 2 is provided with the raised portion 2i, the center of the lower portion of the uterus model 20 is raised and gently descends upward.

FIG. 17 shows a mounting image of the uterus model. As shown in FIG. 17, the uterus model 20 is attached to the uterus model fixture 2.
In FIG. 15, the external iliac artery 27a and the external iliac vein 27b in the uterine model 20 are provided so as to expand toward the left and right upwards, but in FIG. 17, the curved shape provided in the uterine model fixture 2 is provided. Therefore, they are arranged so as to gather toward the center of the foot-side opening 8b.
As described above, unlike the uterus model 20 shown in FIG. 15, it can be seen that the uterus model 20 is arranged at an anatomically correct three-dimensional position.

FIG. 18 shows an image of attaching the uterine model fixture to the abdominal cavity simulator. As shown in FIG. 18 (1), the uterine model fixture 2 and the back portion 93 of the abdominal cavity simulator 9 are provided on the female screw portions (2f to 2h) and the back portion 93 provided on the uterine model fixture 2. The female screw portions (93e to 93 g) are brought into contact with each other, and as shown in FIG. 18 (2), they are fixed by using the screw 52 for attachment. Specifically, the female screw portion 2f and the female screw portion 93e, the female screw portion 2g and the female screw portion 93f, and the female screw portion 2h and the female screw portion 93g are fixed. In this way, it can be easily attached.

FIG. 19 shows a flow chart of use of the uterine model fixture of Example 2. As shown in FIG. 19, when using the uterus model fixture 2, the uterus model 20 is first fixed to the uterus model fixture 2 (step S11), and then the uterus model is attached to the back 93 of the abdominal cavity simulator 9. Fixing tool 2 is attached (step S12). Finally, the pneumoperitoneum cover, the abdomen 91, is attached to the back 93 (step S13).
In FIG. 18, the uterus model 20 is not fixed to the uterus model fixture 2, but is attached to the back portion 93 of the abdominal cavity simulator 9, but the uterus model 20 is fixed by the surface fasteners (71a to 71c). It is also possible to fix the uterus model 20 after attaching the uterus model fixture 2 to the back portion 93 in this way because it is merely removable.

FIG. 20 shows a perspective view of the inguinal hernia model fixture of Example 3. 21 to 23 are external views of the inguinal hernia model fixture of the third embodiment, FIG. 21 (1) is a front view, FIG. 21 (2) is a rear view, and FIG. 22 (1) is a plan view. 22 (2) is a bottom view, FIG. 23 (1) is a right side view, and FIG. 23 (2) is a left side view.
As shown in FIGS. 21 (1) and 21 (2), the inguinal hernia model fixture 3 is composed of three trays (3a to 3c), and the tray 3a and the tray 3b and the tray 3b and the tray 3c are fitted to each other. It is glued.
The trays (3a to 3c) are provided with fixed portions (30a to 30c), and the fixed portions (30a to 30c) are provided with hook-and-loop fasteners (71d to 71f), respectively. The hook-and-loop fasteners (71d to 71f) are formed by hook portions, and the gel film 47 of the inguinal hernia model 40, which will be described later, can play the same role as the loop portion of the hook-and-loop fastener in terms of material. Therefore, the mounting position of the inguinal hernia model 40 Can be adjusted freely.
The trays (3a, 3c) are provided with mounting mechanisms (31, 32), respectively. The mounting mechanism 31 is provided with a female screw portion 31a, and the mounting mechanism 32 is provided with a female screw portion 32a.

FIG. 24 shows a plan view of the inguinal hernia model. As shown in FIG. 24, the inguinal hernia model 40 is a model of an inguinal hernia composed of the peritoneum 40a. The inguinal hernia model 40 is provided with two hernia gates 41, a medial umbilical fold 42, a median umbilical fold 43, an arterial 44a, a vein 44b, a bladder 45 and a vas deferens 46, which are the inguinal hernia model 40. It is covered with a gel film 47 provided on the surface of the.
The gel film 47 is a single layer of gel-like tissue, and reproduces the texture of the exfoliated layer of the preperitoneal fascia. Further, since the gel film 47 can be replaced and reused, the training cost can be reduced.
The arterial part 44a and the venous part 44b become merkmal in training, and it is possible to select and reproduce the biological structures such as the arterial part 44a, the venous part 44b and the muscle.

A method of attaching the inguinal hernia model 40 to the inguinal hernia model fixture 3 will be described with reference to FIG. 25. FIG. 25 is an explanatory view of mounting the inguinal hernia model, in which (1) is before mounting and (2) is after mounting. As shown in FIG. 25 (1), the inguinal hernia model 40 has a substantially planar shape before mounting. As shown in FIG. 22 (2) and the like, the inner surface of the inguinal hernia model fixture 3 has a curved surface shape. Therefore, as shown in FIG. 25 (2), the inguinal hernia model 40 is bent and attached along the curved surface shape of the inner surface of the inguinal hernia model fixture 3.

FIG. 26 shows a mounting image of the inguinal hernia model. As shown in FIG. 26, the inguinal hernia model 40 is attached along the curved surface shape of the inner surface of the inguinal hernia model fixture 3. Therefore, for example, in FIG. 24, the distance between the medial umbilical folds 42 is narrow at the upper part and widens toward the lower part, but in FIG. 26, it is substantially parallel.
In this way, the inguinal hernia model 40 can be integrated with the inguinal hernia model fixture 3 to arrange the organs at anatomically correct three-dimensional positions.

FIG. 27 shows an image of mounting the inguinal hernia model fixture on the abdominal cavity simulator. As shown in FIG. 27, when the inguinal hernia model fixture 3 is attached to the pelvis portion 92 of the abdominal cavity simulator 9, the positioning convex portion 33 and the inside of the pelvis portion 92 provided in the inguinal hernia model fixture 3 are used. The provided recess 34 is fitted. In this state, the female screw portion 32a provided on the inguinal hernia model fixture 3, the female screw portion 92a provided inside the pelvis portion 92, the female screw portion 31a, and the female screw portion 92b are screwed (not shown). Fix it.
Here, the inguinal hernia model fixture 3 is attached to the pelvis portion 92 before connecting the pelvis portion 92 to the back portion 93, but generally, after connecting the pelvis portion 92 to the back portion 93. Attach the inguinal hernia model fixture 3. However, as shown in FIG. 27, the inguinal hernia model fixture 3 may be attached to the pelvis portion 92 first.

FIG. 28 shows a flow chart of using the inguinal hernia model fixture of Example 3. As shown in FIG. 28, when using the inguinal hernia model fixture 3, first, the pelvis portion 92 and the back portion 93 of the abdominal cavity simulator 9 are connected (step S21). Next, the inguinal hernia model fixture 3 is attached to the pelvis portion 92 (step S22). The inguinal hernia model 40 is fixed to the inguinal hernia model fixture 3 (step S23). Finally, the abdomen 91 of the abdominal cavity simulator 9 is attached to the back 93 (step S24).

(Other Examples)
When the rectal model as a biological texture organ model is attached to the abdominal cavity simulator, it may be a fixture that presses and fixes the rectal model from above. This allows the rectal model to be placed and fixed in an anatomically correct three-dimensional position.

The present invention can be used as an organ model fixture for an abdominal cavity simulator.

1 Gastric integrated model fixture 2 Womb model fixture 2a-2e Components 2f-2h, 6a-6d, 31a, 32a, 92a, 92b, 93a-93g Female screw part 2i Raised part 3 Vein hernia model fixture 3a-3c , 4, 4a, 4b, 400 Tray 4c Upper part 4d Lower part 4e Raised part 4f Depressed part 5a, 5b Mounting member 7a Esophageal fixing mechanism 7b Duodenal fixing mechanism 7c Through hole 8a Cranial opening 8b Foot opening 9 Peritoneal simulator 10 Gastric integrated model 11 Gastric 11a Esophagus 11b Duodenal 12 Spleen 13 Peri-stomach blood vessels 14 Lymph nodes 15 Transverse colon 16 Odami 17 Pancreas 18,40a Peritoneum 20 Uterine model 20a Base member 21 Uterine 22,45 Bladder 23 Rectal 24 Ovary Tissue 26 Urinary tract 27a External iliac artery 27b External iliac vein 27c Arterial 27d Vein 28 Circular ligament 29 Nerve 30a-30c Fixation 31, 32 Mounting mechanism 33 Convex 34 Concave 40 Inguinal hernia model 41 Hernia gate 42 Medial umbilical fold 43 Midline umbilical fold 44a Arterial 44b Vein 46 Sperm 47 Gel membrane 51,52 Screws 71a-71f Face fastener 91 Abdomen 92 Stomach 93 Back 93h Stomach 94 Lid

Claims (3)

Laparoscopic simulator for learning laparoscopic techniques In an organ fixture that places an organ model in the three-dimensional space of the lumen
The abdominal cavity simulator is composed of a pelvis that simulates the shape of a human body, a back that has left and right lateral abdomen and a bulge of the spine, and an abdomen that is provided with a plurality of ports through which surgical instruments used under laparoscopic procedures can be inserted. At least configured,
The organ fixture is a uterine model fixture and
The uterine model fixture is
The back surface of a flexible sheet-like uterine model with uterine, ovarian and bladder organ models can be attached to the curved inner wall.
A member that replaces the pelvis, or a member that can be fitted to the inner wall member or inner wall of the pelvis, and the central back side of the fixture is raised.
When the back surface of the uterine model is attached to a fixed position, the unevenness of the curved surface of the inner wall is formed so that the three-dimensional arrangement position of the organ model is anatomically correct. Organ fixture for abdominal simulator. The uterine model fixture is
The place where the uterus is placed is provided high, the place where the bladder is placed is provided so as to be low, and the diameter decreases from the place where the uterus is placed toward the place where the bladder is placed. The organ fixture for a peritoneal simulator according to claim 1 , wherein the organ is formed in a truncated cone shape.
The uterus model attached to the uterus model fixture
In addition to uterine, ovarian and bladder organ models
The abdominal cavity simulator according to claim 1 or 2 , wherein at least one organ model selected from the rectum, adipose tissue, ureter, external iliac artery, external iliac vein, and circular ligament is further arranged. Organ fixture.