WO2020261620A1

WO2020261620A1 - Endoscopic treatment simulation model

Info

Publication number: WO2020261620A1
Application number: PCT/JP2020/001650
Authority: WO
Inventors: 知輝小杉; 裕太中西
Original assignee: 朝日インテック株式会社
Priority date: 2019-06-25
Filing date: 2020-01-20
Publication date: 2020-12-30
Also published as: JP7269803B2; JP2021004915A

Abstract

An endoscopic treatment simulation model comprises: an endoscope model which simulates the tip side of an endoscope and is provided with a device lumen for inserting a medical device and an endoscope tip opening communicating with the device lumen; a liver model which is provided with an intrahepatic bile duct lumen simulating a bile duct inside the liver; and a common bile duct model which is provided with a common bile duct lumen simulating a common bile duct and communicating with the intrahepatic bile duct lumen, said common bile duct model having a common bile duct tip opening which communicates with the common bile duct lumen and into which the tip of the medical device protruding from the endoscope tip opening is inserted.

Description

Endoscopic treatment simulation model

The present invention relates to an endoscopic treatment simulation model.

Endoscopic Retrograde Cholangiopancreatography (ERCP) is known as a method for minimally invasive treatment or examination of the bile duct and pancreatic duct. In ERCP, the endoscope is advanced to the duodenum, and a medical device such as a catheter protruding from the tip of the endoscope is inserted from the papilla into the common bile duct or the like. For example, Patent Document 1 discloses a device having a tubular organ that imitates the large intestine and capable of training an operation or examination using an endoscope. For example, Patent Documents 2 and 3 include a device having a route imitating a coronary artery and capable of training percutaneous coronary angioplasty (PTCA: Percutaneous Transluminal Catheter Angioplasty) using a medical device such as a catheter. It is disclosed.

Japanese Unexamined Patent Publication No. 2016-218415 Japanese Unexamined Patent Publication No. 2001-343891 Japanese Unexamined Patent Publication No. 2008-237304

However, the technique described in Patent Document 1 has a problem that it cannot simulate treatment or examination of the bile duct or pancreatic duct because it only includes a tubular organ that imitates the large intestine. Similarly, the techniques described in Patent Documents 2 and 3 have a problem that they cannot simulate treatment or examination of bile ducts and pancreatic ducts because they only provide a route imitating a coronary artery. Further, the technique described in Patent Document 1 has a problem that it is necessary to separately prepare an endoscope.

The present invention has been made to solve at least a part of the above-mentioned problems, and an object of the present invention is to provide a technique capable of simulating treatment or examination of a bile duct.

The present invention has been made to solve at least a part of the above-mentioned problems, and can be realized as the following forms.

(1) According to one embodiment of the present invention, an endoscopic treatment simulation model is provided. This endoscopic treatment simulation model is an endoscopic model that imitates the tip side of an endoscope, and has a device lumen for inserting a medical device and an endoscope tip opening that communicates with the device lumen. An endoscopic model having, a liver model having an intrahepatic bile duct lumen imitating the bile duct in the liver, and a common bile duct model having a common bile duct lumen imitating the common bile duct communicating with the intrahepatic bile duct lumen. A common bile duct model having a common bile duct tip opening that communicates with the common bile duct lumen and into which the tip of the medical device protruding from the endoscope tip opening is inserted.

According to this configuration, the endoscopic treatment simulation model includes a liver model having an intrahepatic bile duct lumen that imitates the intrahepatic bile duct (intrahepatic bile duct) and a common bile duct that imitates the common bile duct that communicates with the intrahepatic bile duct lumen. A common bile duct model with lumens is provided so that treatment or examination of the bile duct can be simulated. In addition, the endoscopic treatment simulation model further includes an endoscopic model that imitates the tip side of the endoscope. Therefore, even when simulating a procedure using an endoscope such as endoscopic retrograde cholangiopancreatography (ERCP), it is not necessary to prepare an endoscope separately. , You can easily simulate the procedure.

(2) In the endoscopic treatment simulation model of the above-described embodiment, the tip of the endoscopic model is curved in the direction in which the liver model is arranged, and the tip of the endoscope is formed. It may have a tip surface facing the direction in which the liver model is arranged.
According to this configuration, the tip of the endoscope model is curved in the direction in which the liver model is placed, so that the posture of the endoscope inserted up to the duodenal papilla in the actual ERCP is simulated. can do. In addition, since the endoscopic model has a tip surface facing the direction in which the liver model is arranged, the tip surface is used to move a medical device such as a guide wire in the direction in which the liver model is arranged. You can get up towards it. That is, the forceps raising table of the endoscope can be simulated by using the tip surface of the endoscope model.

(3) In the endoscopic treatment simulation model of the above-described embodiment, the endoscopic model and the total are further provided with a predetermined distance between the endoscopic tip opening and the common bile duct tip opening. It may be provided with a retainer that holds the bile duct model.
According to this configuration, since the endoscopic treatment simulation model includes a holding portion, the endoscopic model and the common bile duct model are modeled with a predetermined distance between the tip of the endoscope and the tip of the common bile duct. And can be retained.

(4) In the endoscopic treatment simulation model of the above-described embodiment, the holding portion is in a state where the relative position of the common bile duct tip opening with respect to the endoscopic tip opening is changed, and the endoscopic model and the total It may be possible to hold a bile duct model.
According to this configuration, the holding portion can hold the endoscope model and the common bile duct model in a state where the relative position of the common bile duct tip with respect to the endoscope tip is changed. Therefore, the treatment or examination of the bile duct is simulated with the relative position of the common bile duct tip relative to the endoscopic tip opening changed according to the individual difference in the positional relationship between the duodenal papilla and the common bile duct. be able to.

(5) In the endoscopic treatment simulation model of the above-described form, the liver model communicates with the intrahepatic bile duct lumen, and also communicates with the liver connection port connected to the common bile duct lumen and the intrahepatic bile duct lumen. At the same time, it may have a liver base end port provided on the downstream side of the liver connection port.
According to this configuration, the liver model simulates the configuration of the actual organ that connects the common bile duct to the intrahepatic bile duct because it has a liver connection port that communicates with the intrahepatic bile duct lumen and is connected to the common bile duct lumen. be able to. In addition, since the liver model is provided with a liver proximal opening provided on the downstream side of the liver connecting port, when the intrahepatic bile duct lumen is filled with a liquid simulating bile, the liquid is transferred from the liver proximal opening to the outside. Can be discharged.

(6) In the endoscopic treatment simulation model of the above-described embodiment, the liver model further includes a plurality of end members having substantially the same shape, which are attached to the liver connection port and the liver base end port, respectively. May be good.
According to this configuration, the liver model includes end members attached to the liver connection port and the liver base end port, respectively. By using this end member, it is possible to easily supply the liquid to the intrahepatic bile duct lumen. Further, since the plurality of end members have substantially the same shape, it is possible to easily supply the liquid to the intrahepatic bile duct lumen from any end member.

(7) In the endoscopic treatment simulation model of the above-described embodiment, different identifiers may be displayed on the plurality of end members.
According to this configuration, since different identifiers are displayed on the plurality of end members, the target liver connection port or liver group is used when simulating treatment or examination using the endoscopic treatment simulation model. The end mouth can be easily identified and transmitted.

(8) In the endoscopic treatment simulation model of the above-described embodiment, a plurality of pairs of the endoscopic model, the liver model, and the common bile duct model may be arranged side by side.
According to this configuration, in the endoscopic treatment simulation model, a plurality of pairs of an endoscopic model, a liver model, and a common bile duct model are arranged side by side. Therefore, for example, when the first medical device is inserted into a certain set and the second medical device is inserted into another set, the behavior of the first medical device and the second medical device is changed. Easy to compare.

(9) According to one embodiment of the present invention, an endoscopic treatment simulation model is provided. In this endoscopic treatment simulation model, an endoscopic model that imitates an endoscope inserted up to the papilla of Vater and a medical device that protrudes from the tip of the endoscopic model pass through the common bile duct to the liver. It includes a common bile duct model that imitates the path leading to the common bile duct, and a liver model that mimics the path that the medical device that has passed through the common bile duct model follows the intrahepatic bile duct in the liver.
According to this configuration, the endoscopic treatment simulation model consists of an endoscopic model that imitates an endoscope inserted up to the papilla of Vater and a medical device that protrudes from the tip of the endoscopic model, and the common bile duct. A common bile duct model that mimics the path through the liver to the liver and a liver model that mimics the path through the intrahepatic bile duct in the liver are provided, so that treatment or examination of the bile duct can be simulated.

The present invention can be realized in various aspects, and other organ models (for example, a pancreas model having a pancreatic duct lumen imitating a pancreatic duct, a duodenum model imitating a duodenum, a stomach model imitating a stomach, etc. ) Can be realized in the form of an endoscopic treatment simulation model, a method of manufacturing an endoscopic treatment simulation model, or the like.

It is explanatory drawing which illustrated the structure of the endoscopic treatment simulation model. It is explanatory drawing which illustrated the structure of the endoscope model seen from the 1st direction. It is explanatory drawing which illustrated the structure of the endoscope model seen from the 2nd direction. It is explanatory drawing which illustrated the structure of the liver model. It is explanatory drawing which illustrated the use state of the endoscopic treatment simulation model. It is explanatory drawing which illustrated the structure of the endoscope model of 2nd Embodiment. It is explanatory drawing which illustrated the structure of the endoscope model of 3rd Embodiment. It is explanatory drawing which illustrated the structure of the liver model of 4th Embodiment. It is explanatory drawing which illustrated the structure of the liver model of 5th Embodiment. It is explanatory drawing which illustrated the structure of the liver model of 6th Embodiment.

<First Embodiment>
FIG. 1 is an explanatory diagram illustrating the configuration of the endoscopic treatment simulation model 1. The endoscopic treatment simulation model 1 is a device used to simulate a treatment or examination procedure using an endoscope and a medical device for the bile duct. Hereinafter, endoscopic retrograde cholangiopancreatography (ERCP) will be described as an example of a procedure using an endoscope and a medical device. Generally, in ERCP, the endoscope is advanced to the duodenal papilla, and a medical device protruding from the tip of the endoscope is inserted from the papilla into the common bile duct or the like. The medical device means a device for minimally invasive treatment or examination, such as a catheter or a guide wire.

As shown in FIG. 1, the endoscopic treatment simulation model 1 includes an endoscopic model 10, a liver model 20, a common bile duct model 30, and a holding portion 40. In addition, in FIG. 1 and each subsequent figure, the XYZ axes which are orthogonal to each other are illustrated. The X-axis corresponds to the width direction of the endoscopic treatment simulation model 1. The Y-axis corresponds to the height direction of the endoscopic treatment simulation model 1. The Z-axis corresponds to the depth direction of the endoscopic treatment simulation model 1.

FIG. 2 is an explanatory view illustrating the configuration of the endoscope model 10 as viewed from the first direction. FIG. 3 is an explanatory view illustrating the configuration of the endoscope model 10 as viewed from the second direction. The XYZ axes of FIGS. 2 and 3 correspond to the XYZ axes of FIG. 1, respectively. The endoscope model 10 is a model that reproduces the tip side of the endoscope in a state where it is inserted up to the duodenal papilla. The endoscope model 10 includes a straight portion 110 that imitates the insertion portion of the endoscope, a curved portion 120 that imitates the tip portion of the endoscope, and four pedestals 191 to 194.

The straight portion 110 imitates the posture of the insertion portion of the endoscope in the body, and extends in the Y-axis direction while being gently curved. Inside the straight portion 110, a device lumen 10L extending along the extending direction of the straight portion 110 is formed (FIGS. 1 to 3: broken line). The device lumen 10L of the straight portion 110 has an end portion in the + Y-axis direction communicating with the endoscope base end port 111 and an end portion in the −Y axis direction communicating with the device lumen 10L of the curved portion 120.

The curved portion 120 imitates the posture of the tip portion of the endoscope in the body, and is connected to the straight portion 110 in the + Y-axis direction and the direction of the duodenal papilla in the −Y-axis direction, in other words, the liver. It is curved in the direction in which the model 20 is arranged (in the case of FIG. 1, the + X-axis direction). Inside the curved portion 120, a device lumen 10L extending along the extending direction of the curved portion 120 is formed (FIGS. 1 to 3: broken line). The end of the curved portion 120 in the + Y-axis direction communicates with the device lumen 10L of the straight portion 110, and the end in the −Y-axis direction communicates with the endoscope tip port 154. As shown in FIG. 3, at the end of the curved portion 120 in the −Y axis direction, a tip surface 150 facing the direction in which the liver model 20 is arranged and having the endoscope tip port 154 is formed. There is. In this embodiment, the tip surface 150 is tilted at about 45 degrees with respect to the Y axis. The inclination angle of the tip surface 150 can be arbitrarily determined.

The curved portion 120 may be configured integrally with the straight portion 110, or may be configured to be removable. When it is configured to be removable, for example, it is preferable to prepare a plurality of curved portions 120 having different degrees of curvature and angles of the tip surface 150 in advance. Then, the curved portion 120 having an appropriate degree of curvature or the angle of the tip surface 150 can be selected and used according to the individual difference in the positional relationship between the duodenal papilla and the common bile duct, and more depending on the actual situation. The treatment or examination can be simulated in various aspects. A tube (tubular body) may be inserted into the device lumen 10L of the straight portion 110 and the curved portion 120. In this case, the endoscope model 10 is formed by forming the interpolated tube with the same or similar material as the material of the tube constituting the device lumen in the actual endoscope. Can be more similar.

As shown in FIGS. 2 and 3, the endoscopic treatment simulation model 1 of the present embodiment includes three sets of endoscopic models 10. The three sets of endoscope models 10 are integrally formed, and each includes the straight portion 110, the curved portion 120, and the device lumen 10L (FIGS. 2 and 3: broken lines) described above. In FIGS. 1 to 3, subscripts a, b, and c are added after the reference numerals in order to distinguish the components of each endoscope model 10. For example, the straight portion 110a means the straight portion 110 of the first endoscope model 10, the straight portion 110b means the straight portion 110 of the second endoscope model 10, and the straight portion 110c means the straight portion 110. It means the straight portion 110 of the endoscope model 10 of 3. In the present embodiment, when it is not necessary to distinguish each of them, the subscripts a, b, and c will be omitted.

The four pedestals 191 to 194 are substantially rectangular support members formed at the ends of the straight portion 110c. The pedestals 191 to 194 allow the endoscope model 10 to be placed on a desk in a state where three sets of endoscope models 10 are stacked in the Z-axis direction.

FIG. 4 is an explanatory diagram illustrating the configuration of the liver model 20. The liver model 20 is a model that reproduces the bile duct in the liver (hereinafter, also simply referred to as “intrahepatic bile duct”). Inside the liver model 20, an intrahepatic bile duct lumen 20L simulating the arrangement of the intrahepatic bile duct in the human body is formed (FIG. 4: broken line). In the examples of FIGS. 1 and 4, the intrahepatic bile lumen 20L is provided at four locations: the liver connection port 211, the first liver base end port 221 and the second liver base end port 231 and the third liver base end port 241. Communicating. A common bile duct model 30, which will be described later, is connected to the liver connection port 211. The first to third liver proximal ports 221 to 241 are openings that are open to the outside on the downstream side (meaning the downstream side in the traveling direction of the medical device) from the liver connection port 211. The 1st to 3rd liver base ends 221 to 241 are also collectively referred to as "liver base end mouth".

An end member 210 is attached to the liver connection port 211. Similarly, the first liver base end port 221 has a first end member 220, the second liver base end port 231 has a second end member 230, and the third liver base end port 241 has a third end member 240. , Each is attached. The end member 210 and the first to third end members 220 to 240 are luer lock connectors having substantially the same shape, respectively. In the illustrated example, different identifiers (blanks, 1, 2, 3) are displayed on the end member 210 and the first to third end members 220 to 240, respectively. In the illustrated example, numbers are illustrated as an example of identifiers, but arbitrary identifiers such as characters, symbols, figures, and combinations thereof can be displayed. The end member 210 and the first to third end members 220 to 240 are also collectively referred to as an "end member".

Further, the intrahepatic bile duct lumen 20L has nine ends of the flow path that do not communicate with the outside at the ends 250, 251,252, 253, 254, 255, 256, 257, 259. In the liver model 20 of the present embodiment, the length of each flow path from the liver connection port 211 to the first to third liver base end ports 221 to 241 is the length of each flow path from the liver connection port 211 to the terminal 250 to 259. Longer than the length. For example, as shown in FIG. 4, the length L1 of the flow path from the liver connection port 211 to the second liver base end port 231 (FIG. 4: solid line arrow) is the length of the flow path from the liver connection port 211 to the terminal 259. Is longer than L3 (Fig. 4: dashed arrow). In this way, the liver model 20 can be miniaturized.

The endoscopic treatment simulation model 1 of the present embodiment includes three sets of liver models 20 so as to correspond to the three sets of endoscopic models 10 described with reference to FIGS. 2 and 3, respectively. The three sets of liver models 20 are integrally formed, and each includes the above-mentioned intrahepatic bile duct lumen 20L and end members 210 to 240, and are laminated in the Z-axis direction.

FIG. 5 is an explanatory diagram illustrating a usage state of the endoscopic treatment simulation model 1. In FIG. 5, each component covered by the holding portion 40 is represented by a broken line. As shown in FIG. 5, the common bile duct model 30 is a model that reproduces the common bile duct. As shown in FIG. 5, the common bile duct model 30 includes a tubular portion 310 and a movable member 320.

The tubular portion 310 is a tubular body having a common bile duct lumen 30L formed inside. One end (the end in the + Y-axis direction in the case of FIG. 5) communicates with the bile duct connection port 311 and the other end (the end in the −Y-axis direction in the case of FIG. 5) of the common bile duct lumen 30L of the tubular portion 310. It communicates with the opening 312. The bile duct connection port 311 is connected to the liver connection port 211 of the liver model 20 via the end member 210. The opening 312 is connected to the opening 325 of the movable member 320.

As shown in FIGS. 2 and 3, the movable member 320 includes a prismatic main body portion 321 and a pair of first arm portions 322 and second arm portions 323 formed at both ends of the main body portion 321. .. The main body 321 is formed with a through hole penetrating the lower surface and the upper surface. This through hole communicates with the common bile duct tip opening 324 on the lower surface side (FIG. 2) and communicates with the opening 325 on the upper surface side (FIG. 3). The opening 325 is connected to the opening 312 of the common bile duct model 30 as described above. With such a configuration, the duodenal papilla is simulated by the common bile duct tip opening 324, and the common bile duct extending from the duodenal papilla is simulated by the through hole of the movable member 320 and the common bile duct lumen 30L of the tubular portion 310. be able to. Further, as shown in FIG. 3, the first arm portion 322 and the second arm portion 323 rotate around the rotation axis O (that is, the endoscope tip port 154) in the vicinity of the exit from the tip surface 150 of the endoscope model 10. FIG. 3: One-dot chain line) is rotatably supported by the holding portion 40.

The holding portion 40 is a member that holds the endoscope model 10 and the common bile duct model 30 with a predetermined distance between the endoscope tip opening 154 and the common bile duct tip opening 324. The holding portion 40 includes a pair of a first holding plate 410 and a second holding plate 420. The first holding plate 410 and the second holding plate 420 are plate-shaped members having a substantially semicircular shape. The first holding plate 410 is fixed to the outside of the curved portion 120a (FIG. 3: -Z axis direction), and the second holding plate 420 is fixed to the outside of the curved portion 120c (FIG. 3: + Z axis direction). ing. The first holding plate 410 and the second holding plate 420 are formed with a first rail portion 411 and a second rail portion 421, which are grooves for sliding the movable member 320 around the rotation shaft O, respectively. The user slides the movable member 320 around the rotation axis O, and fixes the movable member 320 to the holding portion 40 at a desired position using a screw 431. As a result, the endoscope model 10 and the common bile duct model 30 can be held in a state where the relative position of the common bile duct tip opening 324 with respect to the endoscope tip opening 154 is changed.

The endoscopic treatment simulation model 1 of the present embodiment has three tubular portions 310 and three through holes so as to correspond to the three sets of endoscopic models 10 described with reference to FIGS. 2 and 3, respectively. It includes a formed movable member 320. In the illustrated example, the movable member 320 has a configuration in which the relative positions of the common bile duct tip ports 324a to c with respect to the endoscope tip ports 154a to c are collectively changed. However, the movable member 320 has a position of the common bile duct tip opening 324a with respect to the endoscope tip opening 154a, a position of the common bile duct tip opening 324b with respect to the endoscope tip opening 154b, and a common bile duct tip opening with respect to the endoscope tip opening 154c. The position of the 324c and the position may be individually changeable.

The endoscopic model 10, the liver model 20, the total bile duct model 30, and the holding portion 40 described above may be made of synthetic resin (for example, ABS resin, PLA resin, polypropylene resin, acrylic resin, PET resin, PVA resin, silicon, etc.). , Rubber, plaster, metal and any other material. The endoscopic model 10, the movable member 320 of the common bile duct model 30, and the holding portion 40 are preferably formed of a transparent or translucent resin (for example, acrylic resin, PET resin, etc.). Then, the state of the medical device passing through the device lumen 10L can be easily observed from the outside. Further, the tubular portion 310 of the liver model 20 and the common bile duct model 30 is preferably formed of a resin (for example, PVA resin, silicone) that is transparent or translucent and has flexibility. By doing so, the state of the medical device passing through the intrahepatic bile duct lumen 20L and the common bile duct lumen 30L can be easily observed from the outside, and the tactile sensation of the liver model 20 and the common bile duct model 30 can be seen in the actual liver. And can resemble the tactile sensation of the common bile duct.

For example, the endoscope model 10, the liver model 20, the movable member 320 of the common bile duct model 30, and the holding portion 40 each input data in which the outer shape, the lumen shape, and the opening shape are input in advance into, for example, a 3D printer. It can be produced by printing. By using a 3D printer, an endoscope model 10, a liver model 20, a movable member 320 of the common bile duct model 30, and a holding portion 40 having a complicated shape can be easily manufactured.

An example of using the endoscopic treatment simulation model 1 will be described with reference to FIG. In the following, the guide wire 2 will be described as an example as a medical device. First, the inside of the intrahepatic bile duct lumen 20L and the common bile duct lumen 30L is filled with a liquid imitating bile. Specifically, a syringe is attached to any one of the end member 210 and the first to third end members 220 to 240 to supply the liquid. The supplied liquid is filled in 20 L of intrahepatic bile duct lumen, and then 30 L of common bile duct lumen communicated with 20 L of intrahepatic bile duct lumen.

For example, when a liquid is supplied from the end member 210, the supplied liquid easily flows into the first to third end members 220 to 240 having low back pressure (pressure applied to the flow path), and thus the intrahepatic bile duct. The air in the lumen 20L can be quickly discharged from the first to third end members 220 to 240. When air (air bubbles) remains in the intrahepatic bile duct lumen 20L, air bubbles can be discharged from the first to third end members 220 to 240 by adding a liquid from the syringe. In this way, the air and air bubbles in the intrahepatic bile duct lumen 20L can be efficiently discharged to the outside by the back pressure difference, so that a pump or the like for circulating the liquid is not required, and the endoscopic treatment simulation model 1 Can be miniaturized.

Next, the guide wire 2 is inserted into the device lumen 10L from the endoscope base end port 111 of the endoscope model 10. The guide wire 2 is pushed through the device lumen 10L to the tip (curved portion 120) of the endoscope model 10, and the tip of the guide wire 2 is projected outward from the endoscope tip port 154.

Next, the tip of the guide wire 2 is inserted into the common bile duct lumen 30L from the common bile duct tip opening 324 simulating the duodenal papilla. This state corresponds to the state in which the guide wire 2 is inserted into the common bile duct from the duodenal papilla in ERCP. At this time, as shown in FIG. 5, the guide wire 2 is gripped at two points, the corner portion 154E (FIG. 5: one-dot chain line circle) and the corner portion 324E (FIG. 5: one-dot chain line circle). In an actual ERCP, the guide wire 2 can be given a steep curve as in the case where the guide wire 2 is raised by the forceps raising table of the endoscope with a steep bend. In other words, the

corners

154E and 324E function similarly to the forceps raising platform of the endoscope. As a result, the tip of the guide wire 2 can be directed toward the common bile duct tip opening 324, which simulates the duodenal papilla. In ERCP, this state corresponds to a state in which the guide wire 2 is projected from the tip of the endoscope advanced to the duodenum and the tip of the guide wire 2 is directed toward the duodenal papilla. Here, the corner portion 154E is a portion formed by the tip surface 150 inclined in the direction in which the liver model 20 is arranged and the endoscope tip opening 154. The corner portion 324E is a portion formed by the lower surface of the main body portion 321 constituting the movable member 320 and the common bile duct tip opening 324. By having the corner portion 154E (FIG. 5: alternate long and short dash line circle) at the endoscope tip port 154, which is the outlet of the guide wire 2, the guide wire 2 is provided regardless of the angle of the movable member 320. (Gripping by the corner portion 154E and the corner portion 324E) can be maintained. As a result, various clinical situations can be simulated.

Next, push the guide wire 2 as it is, and push the tip of the guide wire 2 through the common bile duct lumen 30L to the intrahepatic bile duct lumen 20L. This state corresponds to the state in which the guide wire 2 is inserted into the intrahepatic bile duct in ERCP. After that, the guide wire 2 is pushed forward so that the tip of the guide wire 2 reaches the desired liver proximal port of the first to third liver proximal ports 221 to 241.

As described above, the common bile duct lumen 30L and the intrahepatic bile duct lumen 20L are filled with a liquid imitating bile. Further, the end members (first to third end members 220 to 240) provided at the first to third liver base end ports 221 to 241 are respectively provided so as to project to the outside of the liver model 20. Therefore, it is possible to easily distinguish between the first to third liver base end ports 221-241 that communicate with the outside and the terminals 250 to 259 that do not communicate with the outside.

As described above, according to the endoscopic treatment simulation model 1 of the first embodiment, the liver model 20 having an intrahepatic bile duct lumen 20L that imitates the bile duct (intrahepatic bile duct) in the liver and the intrahepatic bile duct lumen 20L A common bile duct model 30 having a common bile duct lumen 30 L that mimics the common bile duct that communicates with the bile duct is provided, so that treatment or examination of the bile duct can be simulated. Further, the endoscopic treatment simulation model 1 of the first embodiment further includes an endoscopic model 10 that imitates the tip end side of the endoscope. Therefore, even when simulating a procedure using an endoscope, such as endoscopic retrograde cholangiopancreatography (ERCP), there is no need to prepare an endoscope separately, and the procedure is easy. Can be simulated.

Further, according to the endoscopic treatment simulation model 1 of the first embodiment, the curved portion 120 at the tip of the endoscopic model 10 is curved in the direction in which the liver model 20 is arranged. Therefore, it is possible to simulate the posture of the endoscope inserted up to the duodenal papilla in the actual ERCP. Further, since the endoscope model 10 has a tip surface 150 facing the direction in which the liver model 20 is arranged, the liver model 20 arranges a medical device such as a guide wire 2 using the tip surface 150. It can be raised in the direction in which it is being used, and the forceps raising platform of the endoscope can be simulated. Specifically, the liver model 20 is arranged with the guide wire 2 by the corner portion 154E formed on the tip surface 150 and the corner portion 324E formed on the lower surface of the main body portion 321 constituting the movable member 320. It can be raised in the direction, and the forceps raising base of the endoscope can be simulated.

Further, according to the endoscopic treatment simulation model 1 of the first embodiment, since the holding portion 40 is provided, a predetermined distance is opened between the endoscope tip opening 154 and the common bile duct tip opening 324. The endoscopic model 10 and the common bile duct model 30 can be held. Further, the holding portion 40 can hold the endoscope model 10 and the common bile duct model 30 in a state where the relative position of the common bile duct tip opening 324 with respect to the endoscope tip opening 154 is changed. Therefore, treatment or examination of the bile duct is performed with the relative position of the common bile duct tip 324 relative to the endoscope tip 154 changed according to the individual difference in the positional relationship between the duodenal papilla and the common bile duct. Can be simulated. As a result, various clinical situations can be simulated.

Further, according to the endoscopic treatment simulation model 1 of the first embodiment, the liver model 20 includes a liver connection port 211 that communicates with the intrahepatic bile duct lumen 20L and is connected to the common bile duct lumen 30L. It is possible to simulate the actual composition of the organs connected to the intrahepatic bile duct. Further, since the liver model 20 includes the first to third liver proximal ports 221-241 provided on the downstream side of the path of the medical device from the liver connection port 211, bile is simulated in the intrahepatic bile duct lumen 20L. When the liquid is filled, the liquid can be discharged to the outside from the first to third liver base ends 221 to 241.

Further, according to the endoscopic treatment simulation model 1 of the first embodiment, the liver model 20 has an end member 210 and a first end member 210 attached to the liver connection port 211 and the first to third liver base end ports 221-241, respectively. The first to third end members 220 to 240 (end members) are provided. By using the end member 210 and the first to third end members 220 to 240, it is possible to easily supply the fluid to the intrahepatic bile duct lumen 20L. Further, since the end member 210 and the first to third end members 220 to 240 have substantially the same shape, the syringe can be attached from any end member, and the fluid can be supplied to the intrahepatic bile duct lumen 20L. You can do it easily. Further, since different identifiers are displayed on the end member 210 and the first to third end members 220 to 240, when simulating treatment or examination using the endoscopic treatment simulation model 1, the end member 210 and the first to third end members 220 to 240 are displayed. The target liver connection port 211 and the first to third liver base end ports 221 to 241 can be easily identified and transmitted.

Further, in the endoscopic treatment simulation model 1 of the first embodiment, a plurality of pairs of the endoscopic model 10, the liver model 20, and the common bile duct model 30 are arranged side by side. Therefore, for example, when the first medical device is inserted into a certain set and the second medical device is inserted into another set, the behavior of the first medical device and the second medical device is changed. Easy to compare. As described above, the endoscopic treatment simulation model 1 is an endoscopic model 10 that imitates an endoscope inserted up to the papilla of Vater and a medical use that protrudes from a curved portion 120 at the tip of the endoscopic model 10. The device comprises a common bile duct model 30 that mimics the path through the common bile duct to the liver and a liver model 20 that mimics the path through the intrahepatic bile duct in the liver, thus simulating treatment or examination of the bile duct. can do.

<Second Embodiment>
FIG. 6 is an explanatory diagram illustrating the configuration of the endoscope model 10A of the second embodiment. The endoscopic treatment simulation model 1A of the second embodiment includes an endoscopic model 10A instead of the endoscopic model 10. The endoscope model 10A has a configuration in which the relative position of the common bile duct tip 324 with respect to the endoscope tip 154 cannot be changed. The endoscope model 10A includes a holding member 320A instead of the movable member 320, and has a holding portion 40A instead of the holding portion 40.

The holding member 320A has a prismatic main body portion 321A. The main body 321A is formed with a through hole that communicates with the common bile duct tip opening 324 on the lower surface side and communicates with the opening 325 on the upper surface side. The end portion of the main body portion 321A in the −Z axis direction is fixed to the first holding plate 410A of the holding portion 40A by using a screw 431. Similarly, the end portion of the main body portion 321A in the + Z axis direction is fixed to the second holding plate 420A of the holding portion 40A by using a screw. The holding portion 40A includes a first holding plate 410A and a second holding plate 420A, which are substantially semicircular plate-shaped members. The first rail portion 411 and the second rail portion 421 described in the first embodiment are not formed on the first holding plate 410A and the second holding plate 420A.

As described above, the configuration of the endoscope model 10A can be changed in various ways, and by changing the configurations of the holding member 320A and the holding portion 40A, the relative of the common bile duct tip opening 324 to the endoscope tip opening 154. The position may not be changed. Further, in the configuration described with reference to FIG. 6, the holding member 320A and the holding portion 40A may be integrally formed. In such an endoscopic treatment simulation model 1A of the second embodiment, the same effect as that of the first embodiment described above can be obtained.

<Third Embodiment>
FIG. 7 is an explanatory diagram illustrating the configuration of the endoscope model 10B of the third embodiment. The endoscopic treatment simulation model 1B of the third embodiment includes an endoscopic model 10B instead of the endoscopic model 10. In the endoscope model 10B, the tip surface 150B of the end portion of the curved portion 120B in the −Y axis direction does not face the direction in which the liver model 20 is arranged. In other words, the tip surface 150B is formed along the Y axis and is not inclined with respect to the Y axis. As described above, the configuration of the endoscope model 10B can be changed in various ways, and various tip-side shapes in the endoscope may be simulated by changing the configurations of the straight portion 110 and the curved portion 120B. Even in the endoscopic treatment simulation model 1B of the third embodiment, the same effect as that of the first embodiment described above can be obtained.

<Fourth Embodiment>
FIG. 8 is an explanatory diagram illustrating the configuration of the liver model 20C of the fourth embodiment. The endoscopic treatment simulation model 1C of the fourth embodiment includes a liver model 20C instead of the liver model 20. The liver model 20C comprises an end 259C instead of an end 259. The end 259C is the end of a flow path (intrahepatic bile duct lumen 20L) that does not communicate with the outside. In the liver model 20C, the length L1 of the flow path from the liver connection port 211 to the second liver base end port 231 (FIG. 8: solid arrow) is the length L3C of the flow path from the liver connection port 211 to the terminal 259C (FIG. 8). 8: Shorter than the broken line arrow). As described above, the configuration of the liver model 20C can be changed in various ways, and the length of the flow path that does not communicate with the outside may be longer than the length of the flow path that communicates with the outside. Further, the shape of the intrahepatic bile duct lumen 20L in the liver model 20C can be arbitrarily changed, and the arrangement of the intrahepatic bile duct in the human body does not have to be simulated. In such an endoscopic treatment simulation model 1C of the fourth embodiment, the same effect as that of the first embodiment described above can be obtained.

<Fifth Embodiment>
FIG. 9 is an explanatory diagram illustrating the configuration of the liver model 20D of the fifth embodiment. The endoscopic treatment simulation model 1D of the fifth embodiment includes a liver model 20D instead of the liver model 20. The liver model 20D does not include the first to third end members 220 to 240 that are provided at the first to third liver proximal ports 221 to 241 in the first embodiment. As described above, the configuration of the liver model 20D can be changed in various ways, and the end member may be omitted. In the illustrated example, the end members of the first to third liver base end ports 221 to 241 are omitted, while the configuration including the end member 210 of the liver connection port 211 is illustrated, but the end member of the liver connection port 211 is illustrated. Similarly, 210 can be omitted. In such an endoscopic treatment simulation model 1D of the fifth embodiment, the same effect as that of the first embodiment described above can be obtained.

<Sixth Embodiment>
FIG. 10 is an explanatory diagram illustrating the configuration of the liver model 20E of the sixth embodiment. The endoscopic treatment simulation model 1E of the sixth embodiment includes a liver model 20E instead of the liver model 20. The liver model 20E includes end members 210E and first to third end members 220E to 240E in place of the end members 210 and the first to third end members 220 to 240. The end member 210E and the first to third end members 220E to 240E are luer lock connectors having no identifier display. In this way, the configuration of the liver model 20E can be changed in various ways, and in addition to eliminating the display of identifiers in the end members 210E and the first to third end members 220E to 240E, the end members can be made to have an arbitrary size. , Color, shape. For example, the end members 210E and the first to third end members 220E to 240E do not have to be luer lock connectors. Further, the end members 210E and the first to third end members 220E to 240E may be different in at least one of the size, the color, and the shape. In such an endoscopic treatment simulation model 1E of the sixth embodiment, the same effect as that of the first embodiment described above can be obtained.

<Modified example of this embodiment>
The present invention is not limited to the above-described embodiment, and can be implemented in various aspects without departing from the gist thereof. For example, the following modifications are also possible.

[Modification 1]
In the first to sixth embodiments, an example of the configuration of the endoscopic

treatment simulation models

1, 1A to 1E is shown. However, the configuration of the endoscopic treatment simulation model can be changed in various ways. For example, the endoscopic treatment simulation model has a configuration including three sets of endoscopic models stacked in the Z-axis direction, a liver model, and a common bile duct model. However, the endoscopic treatment simulation model may be composed of one set of endoscopic model, liver model, and common bile duct model, and two or more sets of endoscopic model and liver model. , May be constructed with a common bile duct model. Further, the numbers of the endoscopic model, the liver model, and the common bile duct model do not have to be the same, and may be different from each other.

For example, the endoscopic treatment simulation model may include other models not described above (for example, a pancreatic model having a pancreatic duct lumen imitating the pancreatic duct, a duodenum model imitating the duodenum, a stomach model imitating the stomach, etc.). .. For example, an endoscopic treatment simulation model controls at least some of the endoscopic model, liver model, common bile duct model, and other models, or obtains output values from sensors installed in these models. It may be provided with a control device. For example, the endoscopic treatment simulation model may include a pump for circulating fluid in the liver model (intrahepatic bile duct lumen) and the common bile duct model (common bile duct lumen).

[Modification 2]
In the first to sixth embodiments, an example of the configuration of the

endoscope models

10, 10A and 10B is shown. However, the configuration of the endoscope model can be changed in various ways. For example, the pedestal formed on the straight portion may be omitted. For example, the straight portion and the curved portion may be integrally formed and may have a non-removable configuration. For example, the tip surface of the curved portion may be configured so that the angle with respect to the Y axis can be changed.

[Modification 3]
In the above 1st to 6th embodiments, an example of the configuration of the

liver models

20, 20C to 20E is shown. However, the configuration of the liver model can be modified in various ways. For example, a tube (tubular body) may be interpolated into the intrahepatic bile duct lumen. In this case, if the inserted tube is made of PVA resin, the hydrophilicity of the PVA resin allows the intrahepatic bile duct lumen to feel the actual tactile sensation in the intrahepatic bile duct lumen when it is filled with a liquid imitating bile. It is preferable because it can resemble the human body.

[Modification example 4]
In the first to sixth embodiments, an example of the configuration of the common bile duct model 30 is shown. However, the configuration of the common bile duct model can be changed in various ways. For example, a valve made of rubber or a flexible resin material may be provided at the tip of the common bile duct that imitates the papilla of Vater. This is preferable in that the tip of the common bile duct can be made to resemble an actual human body. For example, a tube (tubular body) may be interpolated inside the through hole of the tubular portion or in the lumen of the common bile duct. In this case, it is preferable that the inserted tube is made of PVA resin.

[Modification 5]
Configuration of endoscopic

treatment simulation models

1, 1A to 1E of the first to sixth embodiments, and configuration of endoscopic treatment simulation model, endoscopic model, liver model, and common bile duct model of the above-mentioned modified examples 1 to 4. May be combined as appropriate. For example, the endoscopic treatment simulation model may be constructed by combining the endoscopic model described in the second embodiment or the third embodiment and the liver model described in the fourth to sixth embodiments.

The present embodiment has been described above based on the embodiments and modifications, but the embodiments of the above-described embodiments are for facilitating the understanding of the present embodiment, and do not limit the present embodiment. This aspect may be modified or improved without departing from its spirit and claims, and this aspect includes its equivalents. In addition, if the technical feature is not described as essential in the present specification, it may be deleted as appropriate.

1,1A to 1E ... Endoscopic treatment simulation model 2 ...

Guide wire

10,10A, 10B ...

Endoscopic model

20,20C to 20E ... Liver model 30 ... Common

bile duct model

40,40A ... Holding part 110,110a to 110c ... Straight part 111 ... Endoscope base end port 120, 120B ...

Curved part

150, 150B ... Tip surface 154 ... Endoscope tip port 154E ... Corner 191 ... Pedestal 210 ... End member 211 ... Liver connection port 220 ... First End member 221 ... First liver base end port 230 ... Second end member 231 ... Second liver base end port 240 ... Third end member 241 ... Third liver base end port 250 to 259 ... End 310 ... Tubular part 311 ... Bile duct connection port 312 ... Opening 320 ... Movable member 320A ... Holding

member

321 and 321A ... Main body part 322 ... First arm part 323 ... Second arm part 324 ... Common bile duct tip opening 324E ... Corner part 325 ...

Opening

410, 410A ... No. 1

Holding plate

420, 420A ... 2nd holding plate 411 ... 1st rail part 421 ... 2nd rail part

Claims

It is an endoscopic treatment simulation model
An endoscope model that imitates the tip side of an endoscope and has a device lumen for inserting a medical device and an endoscope tip port communicating with the device lumen.
A liver model with an intrahepatic bile duct lumen that mimics the bile duct in the liver,
A common bile duct model having a common bile duct lumen that imitates the common bile duct that communicates with the intrahepatic bile duct lumen. The tip of the medical device that communicates with the common bile duct lumen and protrudes from the tip of the endoscope A common bile duct model with a common bile duct tip to be inserted,
Endoscopic treatment simulation model equipped with.
The endoscopic treatment simulation model according to claim 1.
The endoscopic model is
The tip is curved in the direction in which the liver model is placed, and
An endoscopic treatment simulation model having a tip surface on which the tip port of the endoscope is formed and facing the direction in which the liver model is arranged.
The endoscopic treatment simulation model according to claim 1 or 2, further comprising:
Endoscopic treatment simulation including a holding portion for holding the endoscopic model and the common bile duct model with a predetermined distance between the endoscopic tip port and the common bile duct tip port. model.
The endoscopic treatment simulation model according to claim 3.
The holding portion is an endoscope capable of holding the endoscope model and the common bile duct model in a state where the relative position of the common bile duct tip mouth with respect to the endoscope tip mouth is changed. Treatment simulation model.
The endoscopic treatment simulation model according to any one of claims 1 to 4.
The liver model is
With the liver connection port connected to the common bile duct lumen while communicating with the intrahepatic bile duct lumen,
An endoscopic treatment simulation model that communicates with the intrahepatic bile duct lumen and has a hepatic proximal end opening provided on the downstream side of the liver connection port.
The endoscopic treatment simulation model according to claim 5.
The liver model is an endoscopic treatment simulation model further comprising a plurality of end members having substantially the same shape attached to the liver connection port and the liver base end port, respectively.
The endoscopic treatment simulation model according to claim 6.
An endoscopic treatment simulation model in which different identifiers are displayed on the plurality of end members.
The endoscopic treatment simulation model according to any one of claims 1 to 7.
An endoscopic treatment simulation model in which a plurality of pairs of the endoscopic model, the liver model, and the common bile duct model are arranged side by side.
It is an endoscopic treatment simulation model
An endoscope model that imitates an endoscope inserted up to the papilla of Vater,
A common bile duct model that mimics the path of a medical device protruding from the tip of the endoscopic model through the common bile duct to the liver.
A liver model that mimics the path of the medical device that has passed through the common bile duct model through the intrahepatic bile duct in the liver.
Endoscopic treatment simulation model equipped with.