WO2023157383A1 - Orthopedic procedure training device - Google Patents

Abstract

Provided is an orthopedic procedure training device with a new, more practical structure that improves or solves at least one of the practical problems in the conventional training device.　An orthopedic procedure training device 10 includes a water tank 14 that contains a training liquid 18, a model supporting part 61 that positions and supports a training framework model 12 inside the water tank 14, an elastic wall member 90 that forms at least a portion of a wall 46 of the water tank 14 and is formed from an elastic material through which an endoscope 16 can be inserted.

Description

Orthopedic training device

The present invention relates to a training device for training orthopedic surgical procedures performed under an endoscope for diseases related to bones such as lumbar vertebrae and joints.

Conventionally, minimally invasive surgery using an endoscope has been performed for diseases of the lumbar spine such as intervertebral disc herniation and spinal canal stenosis. Surgery using such an endoscope requires special techniques, and it takes time to master. had been

Therefore, in International Publication No. 2019/107441 (Patent Document 1), the applicant has proposed a surgical practice model for endoscopic surgery for lumbar spine disease. In this surgical practice model, a lumbar vertebrae simulating portion that simulates a lumbar vertebrae with lumbar vertebrae disease is covered with a muscle tissue simulating portion made of elastomer or gel-like resin.

WO2019/107441

However, when training is performed using the surgical practice model described in Patent Document 1, it may still be difficult to sufficiently reproduce the actual surgical condition, and it may be difficult to perform efficient training. was there. In particular, the human body is filled with liquid, and in order to reproduce that state, it is desirable to store liquid for training in the water tank of the training apparatus. However, the case of inserting an endoscope into a water tank containing a training liquid for training has not been sufficiently studied, and there is a problem to be solved. For example, when it is difficult to achieve a situation similar to the human body, such as ensuring flexibility in selecting the position to insert the endoscope or realizing followability when moving the endoscope up and down while it is inserted. was there. Further, when the inserted endoscope is moved, there is a possibility that the training liquid in the water tank may leak out from the insertion point of the endoscope.

The problem to be solved by the present invention is to improve or solve at least one of the practical problems of conventional training devices, and to provide an orthopedic training device with a novel structure that is more practical.

For example, by making the characteristics of the insertion part of the endoscope closer to the human body, it will be possible to train endoscopic orthopedic surgery procedures in an environment that is closer to actual surgical conditions. Also, by preventing liquid leakage to the outside of the water tank during operation of the endoscope, which is close to actual surgical conditions, it is possible to allow procedures close to actual surgical conditions. The problem to be solved by the present invention also includes providing an orthopedic training device with high training effect.

Hereinafter, preferred embodiments for understanding the present invention will be described. can be recognized and employed as independently as possible, and can also be employed in combination with any of the components described in other aspects as appropriate. Accordingly, the present invention can be implemented in various alternatives without being limited to the embodiments described below.

A first aspect comprises a water tank containing a training liquid, a model supporting section for positioning and supporting a training skeletal model inside the water tank, and at least a part of a wall of the water tank. and an elastic wall member made of an elastic material through which a mirror can be inserted.

According to the orthopedic technique training device of this aspect, since the elastic wall member through which the endoscope can be inserted constitutes at least a part of the wall of the aquarium, for example, a rigid wall member constituting the wall of the aquarium is used. Compared to the case where a through-hole is fixed in a resin member and the endoscope is inserted through the through-hole, the insertion position of the endoscope is allowed by the elastic deformation of the elastic wall member, so that the insertion position does not change. etc. are also allowed, and it is possible to train by bringing the feeling of the procedure closer to the actual human skin. For example, an operation similar to moving the endoscope laterally as the skin stretches is realized, such as a procedure called handdown, in which the endoscope is pushed down while it is inserted from the side. It becomes possible. Therefore, it is possible to train procedures in orthopedic surgery in an environment that is closer to actual surgical conditions.

A second aspect is the orthopedic technique training device according to the first aspect, wherein in the elastic wall member, a hole for inserting the endoscope can be formed by puncturing a perforating member, and the perforating member is removed. The insertion hole is closed based on the elasticity of the elastic wall member itself.

According to the orthopedic technique training device of this aspect, for example, even when the insertion position of the endoscope is located below the liquid level of the training liquid, the elasticity of the elastic wall member allows the insertion hole for the endoscope to be opened. Since it is closable, the insertion hole is closed at the same time as the piercing member is removed. Therefore, it is possible to prevent liquid from leaking through the insertion hole without providing a separate sealing member or the like, thereby simplifying the structure.

A third aspect is the orthopedic surgery training device according to the first or second aspect, wherein the elastic wall member constitutes at least a part of the peripheral wall of the water tank, and the upper side of the elastic wall member A portion is a curved wall portion that curves and extends inwardly to cover the upper opening of the water tank.

According to the orthopedic technique training device of this aspect, for example, when training for a disease of the lumbar spine, the elastic wall member can be regarded as the skin of the curved part of the human body from the flank to the back, and the upper (back) ), it is possible to train the insertion of the endoscope not only from the portion that spreads flat at the outer side, but also from the portion that curves more outwardly. In addition, since the elastic wall member is provided from the upper opening to the peripheral wall portion, it is possible to move the endoscope downward, such as during hand-down training.

A fourth aspect is the orthopedic technique training apparatus according to the third aspect, wherein the peripheral wall portion of the water tank has a rectangular cylindrical shape having four flat vertical wall portions as a whole, and at least one vertical wall portion is The elastic wall member is arranged in the opening provided in the part.

According to the orthopedic technique training device of this aspect, when training is performed for a disease of the lumbar spine, for example, the two right and left vertical wall portions of the rectangular tube can be regarded as the left and right flanks of the human body. By providing an elastic wall member in at least one of the parts, it is possible to train the insertion of the endoscope not only from above (back) but also from the outside.

A fifth aspect is the orthopedic technique training device according to the fourth aspect, wherein the elastic wall member is in the form of a rectangular sheet, and the upper edge and the lower edge of the elastic wall member extend against the water tank. By being fixedly attached, the elastic wall member is attached in a tensioned state in the vertical direction, and in this attached state, both side portions in the width direction of the elastic wall member are on the opening side on both sides in the width direction of the opening portion. It is sealed by being pressed against an edge-like abutting portion that is convex toward the outside.

According to the orthopedic technique training device of this aspect, the rectangular sheet-like elastic wall member is attached while being pulled in the vertical direction so as to cover the opening provided in the vertical wall. The opening is sealed to prevent liquid leakage through the opening. In particular, edge-like contact portions are provided on both sides in the width direction of the opening portion, and are pressed against both width-direction side portions of the elastic wall member. The contact pressure of the elastic wall member is improved, and the sealing performance of the elastic wall member can be improved. In addition, since the elastic wall member is arranged in a stretched state having a tensile stress in the vertical direction, excessive deformation of the elastic wall member is suppressed even when the endoscope is moved downward during handdown training, for example. and improved stability.

A sixth aspect is the orthopedic technique training device according to the fifth aspect, wherein an upper rod is attached to the upper edge of the elastic wall member and a lower rod is attached to the lower edge of the elastic wall member, The upper rod and the lower rod are detachably fixed to the water tank so that the elastic wall member is mounted in a tensioned state in the vertical direction.

According to the orthopedic technique training device of this aspect, the upper rod and the lower rod are fixed to the water tank in a state separated from the natural length of the elastic wall member, so that the elastic wall member is pulled in the vertical direction. It can be easily attached to the water tank in the state.

A seventh aspect is the orthopedic surgery training device according to the fifth or sixth aspect, wherein the opening portion is formed over the entire width direction of one vertical wall portion, and The edge-like abutting portions against which the widthwise side portions of the elastic wall member are pressed are formed by the edge portions of the vertical wall portions located on both sides of the wall portion in the circumferential direction. be.

According to the orthopedic technique training device of this aspect, it is possible to ensure a sufficiently large width dimension of the opening portion, and to construct the edge-shaped abutment portion by skillfully utilizing the edge portions of the vertical wall portions on both sides. Therefore, it is possible to seal the opening by means of the elastic wall member without providing a special edge-like abutting portion.

An eighth aspect is the orthopedic technique training device according to any one of the fourth to seventh aspects, wherein the outer peripheral portion of the elastic wall member is superimposed on the vertical wall portion and sealed in a contact state. A pressing mechanism that presses from the outside is provided in at least a part of the portion that

According to the orthopedic technique training device of this aspect, a pressing mechanism is provided that presses the outer peripheral portion of the elastic wall member from the outside in a contact state in which the outer peripheral portion of the elastic wall member is superimposed on the vertical wall portion. It is possible to further improve the sealing performance of the opening portion by the wall member.

A ninth aspect is the orthopedic training apparatus according to the eighth aspect, wherein a separate receiving tank having an upward opening larger than the circumference of the water tank is disposed below the water tank, and The pressing mechanism for pressing the elastic wall member from the outside is provided between the elastic wall member and the peripheral wall of the receiving tank.

According to the orthopedic training device of this aspect, since a larger receiving tank is provided below the water tank, even if the liquid for training spills from the water tank, it can be received by the receiving tank. Then, the pressing mechanism can be provided by making good use of such a receiving tank.

A tenth aspect is the plastic surgery training device according to the ninth aspect, wherein the pressing mechanism includes a block-shaped pressing member made of an elastic material.

According to the orthopedic technique training device of this aspect, by inserting a block-shaped pressing member between the elastic wall member and the peripheral wall of the receiving tank, a pressing mechanism that presses the elastic wall member from the outside can be configured, Sealing of the opening portion by the elastic wall member can be easily realized.

An eleventh aspect is the orthopedic technique training device according to any one of the first to tenth aspects, wherein a visible position marker indicating a planned insertion position of the endoscope can be displayed on the elastic wall member. It is what is done.

According to the orthopedic technique training device of this aspect, by making the intended insertion position of the endoscope visible, the effects of the training can be more reliably received. The position marker may be displayed on the elastic wall member in advance before use of the training device. Alternatively, when performing training including selection of the insertion position of the endoscope, the operator may be able to write the position marker when using the training device.

A twelfth aspect is the orthopedic technique training apparatus according to any one of the first to eleventh aspects, wherein a prescribed water level necessary for immersing the skeletal model in water is set in the water tank, and In the above, a region extending below the specified water level is composed of the elastic wall member.

According to the orthopedic technique training device of this aspect, since the area extending below the specified water level in the water tank is composed of the elastic wall member, the insertion position of the endoscope provided by the elastic wall member can be assumed. It becomes possible to select in areas extending more laterally or downwardly of the human body to be treated.

A thirteenth aspect is the orthopedic training apparatus according to any one of the first to twelfth aspects, wherein the water tank includes a vertical wall portion forming a peripheral wall portion and an upper wall portion covering an upper opening. The vertical wall portion and the upper wall portion are transparent.

According to the plastic surgery training device of this aspect, the state of training can be visually recognized from the outside, and the effects of training can be easily confirmed.

A fourteenth aspect is the orthopedic training apparatus according to any one of the first to thirteenth aspects, wherein the wall of the water tank is provided with an insertion hole for the endoscope, and the water tank a model position setting mechanism for movably and fixedly setting the skeletal model to a plurality of different positions inside the skeletal model, and the distance from the insertion hole to the skeletal model can be changed by moving the skeletal model It is said that

According to the orthopedic technique training device of this aspect, the model position setting mechanism can move the skeletal model to a plurality of different positions in the water tank, and the distance from the insertion hole to the skeletal model can be appropriately adjusted and set. becomes possible. Therefore, for example, assuming that the distance from the skin to the skeleton differs depending on the body type of the patient, the distance from the insertion hole of the water tank to the skeleton model is appropriately set or different in multiple types. It becomes possible to do

A fifteenth aspect is the orthopedic training apparatus according to the fourteenth aspect, wherein a base member to which the skeletal model is attachable and detachable is arranged inside the water tank, and the base member is moved in the horizontal direction. The model position setting mechanism includes a guide mechanism that guides the model, and a lock mechanism that positions the base member at a plurality of positions in the movement direction of the guide mechanism.

According to the orthopedic technique training device of this aspect, a base member that is moved and positioned by a guide mechanism and a lock mechanism is adopted, and the skeleton model is supported by the base member. As a result, the position of the skeletal model can be easily changed, and there is no need to directly grasp and move the skeletal model, so the risk of damage to the skeletal model can be reduced.

A sixteenth aspect is the orthopedic training device according to the fifteenth aspect, wherein the guide mechanism includes a guide rod and a guide hole provided in the base member and through which the guide rod is inserted. As the guide rod and the guide hole rotate relative to each other around the central axis, the outer peripheral portion of the guide rod and the inner peripheral portion of the guide hole engage with each other. The lock mechanism is configured by preventing the movement of the base member in the axial direction of the guide rod so that it can be fixed.

According to the orthopedic technique training device of this aspect, by a simple operation of relatively rotating the guide rod and the guide hole around the central axis, the guide hole (base member) can be fixed and released from the guide rod, i.e., in the water tank. , the position of the skeleton model can be switched between fixed and movable.

A seventeenth aspect is the orthopedic training device according to the sixteenth aspect, wherein in the locking mechanism, protrusions extending in the circumferential direction are formed on the outer peripheral surface of the guide rod and the inner peripheral surface of the guide hole. By relative rotation of the guide rod and the guide hole about the central axis, the protrusion on the guide rod side and the protrusion on the guide hole side are meshed so as to overlap in the axial direction, thereby causing the biting. It is designed so that a mutual effect can be exhibited.

According to the orthopedic training device of this aspect, the locking mechanism is realized by the engagement action in the axial direction between the convex portion on the guide rod side and the convex portion on the guide hole side. As a result, the positioning of the base member (skeletal model) can be performed more firmly than in the case where only the frictional resistance is used. Even if it is large, it becomes easy to stably position and hold the skeletal model.

An eighteenth aspect comprises a water tank containing a training liquid and capable of placing a training skeletal model immersed in the liquid, and inserting an endoscope from the outside of the water tank into the skeletal model. In the orthopedic technique training device for training the surgical technique of (1), a separate receiving tank is arranged below the water tank, and an upward opening in the receiving tank is made larger than the circumference of the water tank.

According to the orthopedic technique training device of this aspect, since a larger receiving tank is provided below the water tank, even if the liquid for training spills from the water tank, it can be received by the receiving tank, and the liquid for training can be received by the receiving tank. Liquid leakage to the device can be prevented, and the flexibility of the installation location of the device is also increased.

A nineteenth aspect is the orthopedic training device according to the eighteenth aspect, wherein the water tank is detachable with respect to the receiving tank, and positioning is performed by relatively positioning the water tank and the receiving tank in the horizontal direction. A mechanism is provided.

According to the orthopedic technique training device of this aspect, relative displacement in the horizontal direction between the water tank and the receiving tank is prevented. (displacement of treatment position), water leakage, etc. are prevented, and training can be performed more stably or intensively.

A twentieth aspect is the orthopedic training apparatus according to the eighteenth or nineteenth aspect, wherein the volume in which the liquid can be stored in the receiving tank is equal to or greater than a specified volume of liquid to be stored in the water tank during training. It is.

According to the orthopedic technique training device of this aspect, even if the entire amount of the training liquid stored in the water tank leaks from the water tank, the entire amount of the liquid can be received by the receiving tank, and the liquid cannot flow out of the training apparatus. Leakage can be prevented more reliably. Also, for example, by transferring the entire amount of liquid in the water tank to the receiving tank after training, it is possible to carry out wastewater treatment while holding only the receiving tank.

A twenty-first aspect is the orthopedic training apparatus according to any one of the eighteenth to twentieth aspects, wherein the water tank is provided with an openable and closable water tank drainage port, and the water tank drainage port is located in the receiving tank. The opening position is provided, and the receiving tank is also provided with an openable and closable receiving tank drainage port.

According to the orthopedic technique training device of this aspect, for example, by opening the water tank drain port after using the training device, the training liquid in the water tank can be drained to the receiving tank, and the training liquid in the water tank can be discharged. is drained into the receiving tank, the training liquid in the receiving tank can be drained to the outside of the training apparatus by opening the receiving tank drain port. Therefore, when draining water from the water tank or the receiving tank, there is no need to lift the whole of the water tank or the receiving tank, thereby facilitating the operation. Further, by draining a predetermined amount or all of the liquid in the water tank in the receiving tank, it becomes possible to facilitate the carrying of the water tank.

A twenty-second aspect is the orthopedic technique training apparatus according to any one of the eighteenth to twenty-first aspects, wherein the endoscope can be inserted into a vertical wall portion forming a peripheral wall portion of the water tank. be.

According to the orthopedic technique training device of this aspect, if the endoscope is inserted into the vertical wall portion that constitutes the peripheral wall portion of the water tank, and if the endoscope is removed during or after training, there is a risk that liquid will leak out of the water tank. Even if there is, the receiving tank can prevent the liquid from splashing or leaking to the outside.

A twenty-third aspect is the orthopedic training apparatus according to the twenty-second aspect, wherein a position where the endoscope can be inserted in the vertical wall portion of the water tank is located below a prescribed water level for training. It is set.

According to the orthopedic technique training device of this aspect, even if liquid leaks from the water tank to the outside when inserting or removing the endoscope, the liquid is stored in the receiving tank, and the liquid leaks and spreads to the outside from there. Avoided. Therefore, by providing a receiving tank, it is possible to easily select and train in a wide area from the side to the lower side of the human body where the insertion port of the endoscope is assumed, without considering the risk of liquid leakage. It becomes possible. In this aspect, preferably, the elastic wall member according to any one of the first to eleventh aspects can be employed in the water tank. This makes it easy to set the position where the endoscope inserted through the elastic wall member can be inserted below the specified water level. It should be noted that this aspect includes the case where the insertion position of the endoscope is moved below the specified water level due to the elastic deformation of the elastic wall member accompanying the hand-down operation.

A twenty-fourth aspect is the orthopedic training device according to any one of the eighteenth to twenty-third aspects, wherein the separation of the water tank and the receiving tank is restricted, and the receiving tank is held attached to the water tank. A connecting means is provided for

According to the orthopedic training device of this aspect, even if force is exerted on the water tank due to an external force exerted through the endoscope during training, rattling of the water tank can be effectively prevented.

A twenty-fifth aspect is the orthopedic training device according to the twenty-fourth aspect, wherein the connecting means is configured using a permanent magnet.

According to the plastic surgery training device of this aspect, the connecting means can be configured with a simple structure. For example, by arranging the permanent magnets so as to exhibit attractive force in the vertical direction, even if an external force exerted during training exerts a vertically upward force on the water tank, the rattling of the water tank can be effectively suppressed. becomes possible.

According to one aspect of the orthopedic technique training device according to the present invention, it is possible to train the technique in endoscopic orthopedic surgery in an environment that is closer to actual surgical conditions.

For example, according to the orthopedic technique training device according to the present invention, it is easy to realize an environment in which training operations such as hand-down of an endoscope are permitted.

1 is a perspective view showing the orthopedic training device as a first embodiment of the present invention in use; FIG. FIG. 2 is a perspective view showing the orthopedic training device shown in FIG. 1 in an unused state; A plan view of the orthopedic training device shown in FIG. Front view of the orthopedic training device shown in FIG. Left side view of the orthopedic procedure and training device shown in FIG. VI-VI sectional view in FIG. VII-VII cross-sectional view in FIG. Longitudinal cross-sectional view showing the main part in the VIII-VIII cross section of FIG. FIG. 2 is a perspective view showing a single water tank constituting the orthopedic training apparatus shown in FIG. 1; FIG. 2 is a perspective view from the bottom side of a water tank that constitutes the orthopedic training apparatus shown in FIG. 1; FIG. 2 is a perspective view showing a receiving tank that constitutes the orthopedic training apparatus shown in FIG. 1; FIG. 2 is a perspective view showing a pressing mechanism that constitutes the orthopedic training device shown in FIG. 1; FIG. 2 is a front view showing a specific example of a skeletal model used in the orthopedic training device shown in FIG. 1 in a state of being fixed to a bracket; XIV-XIV sectional view in FIG. FIG. 2 is a right side view schematically showing a specific example of an endoscope used in the orthopedic training device shown in FIG. 1; Front view of the endoscope shown in FIG. 15 BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an explanatory drawing for explaining a surgical method for intervertebral disc herniation, wherein (a) is a drawing for explaining an interlaminar method and (b) is a drawing for explaining a transforaminal method; A perspective view showing an orthopedic training device as a second embodiment of the present invention. FIG. 19 is a perspective view showing the orthopedic training device shown in FIG. 18 in a see-through state; 18 is a perspective view showing the orthopedic training device shown in FIG. 18 is a perspective view showing the orthopedic training device shown in FIG. 18 from the bottom side FIG. 19 is a plan view showing a state in which the upper wall portion is removed in the orthopedic training device shown in FIG. 18; Explanatory diagram for explaining a model position setting mechanism that constitutes the plastic surgery training device shown in FIG. FIG. 24 is a vertical cross-sectional view of the model position setting mechanism shown in FIG. 23, which is a cross-sectional view of the front end portion in a state where a bracket is attached to the base member that constitutes the model position setting mechanism; FIG. 24 is a vertical cross-sectional view of the model position setting mechanism shown in FIG. 23, which is a cross-sectional view of the rear end portion in a state where a bracket is attached to the base member that constitutes the model position setting mechanism; FIG. 4 is an explanatory diagram for explaining an unlocked state and a locked state by a lock mechanism, where (a) shows the unlocked state and (b) shows the locked state; FIG. 4 is an explanatory diagram for explaining a state in which the bracket is removable from the base member and a state in which the bracket is fixed, in which (a) is the state in which the bracket is removable, and (b) is the bracket; is fixed FIG. 7 is a longitudinal sectional view showing an orthopedic training device as a third embodiment of the present invention, corresponding to FIG. 6;

Hereinafter, in order to clarify the present invention more specifically, embodiments of the present invention will be described in detail with reference to the drawings.

First, FIG. 1 shows an orthopedic training device 10 as a first embodiment of the present invention. This orthopedic technique training device 10 is intended to improve the technical proficiency of the user in orthopedic surgery using an endoscope, and is designed to allow the user to perform surgical technique training at home, for example. is.

More specifically, the orthopedic technique training device 10 includes a training skeletal model 12 imitating a lesion site, and a water tank 14 in which the skeletal model 12 is fixed and accommodated. A distal end portion of an endoscope 16 is inserted into the water tank 14 from the outside, so that a surgical technique for the skeletal model 12 can be trained. The orthopedic training device 10 may be configured including such an endoscope 16 . Water tank 14 contains water 18, which is a liquid for training.

In the water tank 14, the water 18 is stored at a specified capacity or more, specifically, the water 18 is stored to such an extent that the entire skeletal model 12 is immersed in the water 18. That is, a specified water level required for immersing the skeleton model 12 in the water 18 may be set in the water tank 14. For example, a mark indicating the specified water level is provided in the water tank 14, and the surface of the water 18 reaches the mark. The water 18 may be poured into the water tank 14 until it reaches the end. In this embodiment, no particular water level is set, and the water 18 is simply stored up to the vicinity of the upper end portion of the water tank 14 . Of course, the upper end portion of the water tank 14 may be the specified water level.

The liquid for training is not limited to the water 18, and may be, for example, a colored liquid, but is preferably transparent so that the state of training can be seen. When the training liquid is transparent, the visible light transmittance is, for example, 80% or more so that the image of the endoscope 16 can be checked on a monitor (not shown) connected to the endoscope 16 .

2 to 8 show the device body 20 of the orthopedic training device 10. FIG. The device body 20 includes the water tank 14 described above. The water tank 14 as a whole has a substantially box-like shape that opens upward, and has an upper opening 22 . That is, the water tank 14 includes a rectangular flat bottom wall portion 24 and peripheral wall portions 26 projecting upward from the four outer peripheral edge portions of the bottom wall portion 24 . The peripheral wall portion 26 has a rectangular tubular shape as a whole and has four flat vertical wall portions 28 .

In the following description, the vertical direction is the vertical direction, which is the vertical direction in FIG. Further, the front-rear direction refers to the left-right direction in FIG. In particular, in this embodiment, a skeleton model of the lumbar spine is used as the skeleton model 12, and the front refers to the neck of the skeleton model 12 when the skeleton model 12 is placed in the water tank 14 as shown in FIG. The left side in FIG. 4 is the side, and the rear side is the leg side of the skeleton model 12 in FIG. Furthermore, the left-right direction means the left-right direction in FIG. Although some parts are fixed by bolts or screws in the drawings, the bolts or screws may be omitted for clarity. Also, for ease of viewing, the insides of some members are shown transparently.

The upper opening 22 of the water tank 14 is partially covered by the upper wall portion 30 . The upper wall portion 30 has a substantially rectangular plate shape, and is formed with a through hole 32 passing therethrough in the plate thickness direction (vertical direction). In this embodiment, six through-holes 32 are formed and arranged in line in the front-rear and left-right directions. A valve body 34 made of an elastic material such as rubber or urethane foam is attached to each through hole 32 . Each valve body 34 has a substantially cylindrical shape with an outer diameter larger than the diameter of each through hole 32, and the outer diameter of the intermediate portion in the thickness direction (vertical direction) is reduced. Each valve body 34 is attached to each through hole 32 by fitting the inner peripheral edge portion of each through hole 32 into a portion having a small diameter in the middle portion in the thickness direction of each valve body 34 . there is A central portion of each valve body 34 is provided with a thin portion 36 that is thinner than other portions and into which the endoscope 16 can be punctured and inserted.

As shown in FIGS. 1 and 3, upper wall holders 40 are fixed by bolts or screws to the upper end portions of the vertical wall portions 28a and 28b on both sides in the front-rear direction of the vertical wall portion 28 of the water tank 14. ing. Each upper wall holding portion 40 is provided with a mounting portion 42 protruding inward in the facing direction (front-rear direction), and both front-rear direction ends of the upper wall portion 30 are mounted on each mounting portion 42 . there is Both front and rear ends of the upper wall portion 30 are mounted on the mounting portions 42 of the respective upper wall holding portions 40, and the front and rear ends of the upper wall portion 30 and the mounting portions 42 are connected by a rotary operation knob. The upper wall portion 30 is releasably fixed to the upper opening portion 22 of the water tank 14 by being fixed by a known fixing means such as a locking mechanism, and is detachably attached. A wall portion 46 of the water tank 14 is configured including the upper wall portion 30 and the peripheral wall portion 26 .

The peripheral wall portion 26 (each vertical wall portion 28) and the upper wall portion 30 are preferably made of a transparent resin material, and preferably have a visible light transmittance of 80% or higher. Of course, even if the peripheral wall portion 26 (each of the vertical wall portions 28) and the upper wall portion 30 are transparent, they are not limited to being entirely transparent, and may be partially transparent. good too. In addition, it is preferable that the bottom wall portion 24 is set to have a low visible light transmittance in consideration of ease of attachment of the bracket 152 to the skeletal model 12, which will be described later.

In this embodiment, as also shown in FIG. 9, the right vertical wall portion 28, which is one of the four vertical wall portions 28, is provided with an opening portion 48. The portion 48 extends over the entire width direction (front-rear direction) of the right vertical wall portion 28 and also extends over the entire vertical direction. In short, the opening portion 48 provided in the right vertical wall portion 28 is continuous with the upper opening portion 22 and constitutes one large opening portion 50 that opens rightward and upward. The vertical wall portions 28a and 28b on both the front and rear sides are smoothly curved and continuous from the right side to the upper side, and are formed so as to have no bending points (bending points).

Further, in the present embodiment, edge-like abutment portions convex toward the opening side are provided on the respective end edges of the vertical wall portions 28a and 28b and the bottom wall portion 24 on both front and rear sides that constitute the opening portion 48. A portion 52 is provided. Specifically, the plate thickness dimension is gradually reduced toward the opening side in the vertical wall portions 28a and 28b on both front and rear sides located on both sides in the circumferential direction of the right vertical wall portion 28 and the right end portion of the bottom wall portion 24. As a result, edge-like contact portions 52 are provided on both sides in the width direction (both sides in the front-rear direction) and on the lower side of the opening portion 48 . In this embodiment, the edge-like contact portions 52 of the vertical wall portions 28a and 28b on both the front and rear sides extend not only to the right side of the water tank 14 but also to the upper side (that is, the edge portion of the upper opening 22). is provided.

Furthermore, on the inner surfaces of the vertical wall portions 28a and 28b on both the front and rear sides, an upper fixing member 54 for fixing the upper end side portion of an elastic wall member 90 described later is provided to the right of the fixing portion of the upper wall portion 30. A bolt or It is fixed with screws. The upper fixing member 54 extends in the vertical direction as a whole, and is bifurcated at its upper end, and an upper support recess 56 is provided at the bifurcated portion for hooking an upper rod 98, which will be described later. 19 to 22, which will be described later, each upper fixing member 54 is assembled with a retaining member 57, and when the upper rod 98 is hooked to each upper support recess 56, By covering the openings of the upper support recesses 56 with the retaining members 57, the upper rods 98 are prevented from slipping out of the respective upper support recesses 56. As shown in FIG. A lower fixing member 58 for fixing a lower end side portion of an elastic wall member 90, which will be described later, is fixed to the right end portion of the lower surface of the bottom wall portion 24 by bolts or screws. The lower fixing member 58 extends in the left-right direction as a whole and is bifurcated at the right end, and the bifurcated portion is provided with a lower support recess 60 to which a lower rod 100 described later is hooked.

Furthermore, a model supporting portion 61 for positioning and supporting the skeleton model 12 inside the water tank 14 is provided on the inner surface (upper surface) of the bottom wall portion 24 of the water tank 14 . The model support portion 61 of this embodiment includes a first fixing portion 62 and a second fixing portion 64 for fixing a bracket 152 in the skeletal model 12 to be described later. is fixed to the bottom wall portion 24 of the water tank 14 by bolts or screws. As shown in FIGS. 8 and 10, the first fixing portion 62 and the second fixing portion 64 are separated from each other in the front-rear direction, and the first fixing portion 62 is provided in front of the water tank 14. , a second fixing portion 64 is provided at the rear. The first fixing portion 62 has a certain lateral dimension, and a rearwardly opening first fixing groove 66 is formed in the lower portion of the first fixing portion 62 . In this embodiment, the first fixing groove 66 is formed over the entire length of the first fixing portion 62 in the front-rear direction.

In addition, a tubular portion penetrating in the vertical direction is provided in the central portion of the second fixing portion 64, and the second fixing portion 64 includes a rotating member capable of rotating around the central axis of the tubular portion. 68 is installed. The rotating member 68 is provided with a pressing portion 70 that presses a rear engaging protrusion 156 of a bracket 152, which will be described later, from above. Further, a lever member 74 having a knob portion 72 protruding upward is assembled substantially coaxially with the rotating member 68 . and rotate integrally. The rotating member 68 and the lever member 74 can be integrally fixed by, for example, fastening bolts or screws (not shown). An accommodation groove 76 is formed in the lower surface of the second fixing portion 64 to accommodate the pressing portion 70 when the rotating member 68 is rotated to release the pressing portion 70 from pressing the engaging projection 156 . ing.

Furthermore, water tank legs 78 projecting downward are provided at the four corners of the bottom wall part 24 of the water tank 14 . In this embodiment, each water tank leg 78 is fixed to the bottom wall 24 by bolts or screws. Each water tank leg 78 has a substantially truncated cone shape as a whole, and a positioning recess 80 opening downward is formed in the lower surface of each. Each water tank leg 78 may be made of synthetic resin, but may also be made entirely or partially of metal having ferromagnetism or paramagnetism. If each water tank leg 78 is made of synthetic resin, for example, the permanent magnet 82 may be embedded inside.

Furthermore, in the rear vertical wall portion 28b of the water tank 14, a through-hole 84 is formed in the lower left portion thereof and penetrates in the plate thickness direction (front-to-rear direction). A water tank port member 88 is assembled. The inside and outside of the water tank 14 communicate with each other through the water tank drain port 86 . This water tank drain port 86 is open toward a receiving tank 106 which is positioned below and will be described later. A port 86 ) is located within the reservoir 106 . The tube 89 is provided with a clamp and a valve capable of switching between opening and closing, so that the water tank drain port 86 can be opened and closed.

Here, at least a portion of the wall portion 46 of the water tank 14 is constituted by an elastic wall member 90 made of an elastic material through which the endoscope 16 can be inserted. A portion is constituted by an elastic wall member 90 . Specifically, as described above, the right vertical wall portion 28, which is one of the four vertical wall portions 28, is provided with the opening portion 48, and the elastic wall member is provided so as to cover the opening portion 48. 90 are placed. In particular, in this embodiment, an elastic wall member 90 is provided in place of the right vertical wall portion 28 in the water tank 14, and the front and rear vertical wall portions 28a and 28b, the left vertical wall portion 28c and the elastic wall member 90 are provided. Thus, a substantially box-shaped water tank 14 is constructed. Although the material of the elastic material constituting the elastic wall member 90 is not limited, for example, foamed resin such as closed-cell urethane foam, non-foamed soft synthetic resin, silicone sheet, artificial rubber sheet (foamed or non-foamed) can be used. (including foaming) and composite materials thereof can be used, and foamed urethane is used in this embodiment. Although the hardness of the elastic wall member 90 is not limited, it is preferable to set the Shore C hardness within the range of 20° to 90° so as to achieve elongation characteristics close to those of human skin.

Width direction side portions and lower end portions of the elastic wall member 90 are superimposed and pressed against the respective edge-like contact portions 52 of the vertical wall portions 28a and 28b and the bottom wall portion 24 on both front and rear sides, thereby elastically A wall member 90 seals the opening 48 . In this embodiment, the elastic wall member 90 is in the form of a substantially rectangular sheet, and is flexibly elastically deformable. 1 to 7, the elastic wall member 90 is provided from the right side to the upper side of the opening 50, and covers the right side of the opening 50 (the opening portion 48) and extends substantially flat. A right flat portion 92, an upper flat portion 94 that partially covers the upper part of the opening 50 (upper opening 22) and spreads substantially flat, and the right flat portion 92 and the upper flat portion 94 are connected to form front and rear sides. and a curved wall portion 96 extending along the curved portions of the vertical wall portions 28a and 28b. That is, the upper portion of the elastic wall member 90 is provided with a curved wall portion 96 that curves and extends inward so as to cover the upper opening portion 22 of the water tub 14 . On the other hand, the lower end portion of the elastic wall member 90 (the lower end portion of the right flat portion 92) protrudes below the vertical wall portions 28a, 28b and the bottom wall portion 24 on both front and rear sides. Therefore, in this embodiment, the elastic wall member 90 is provided over a region below the specified water level necessary for immersing the skeleton model 12 . As a result, the position where the endoscope 16 can be inserted in the right vertical wall portion 28 (elastic wall member 90) can be set below the specified water level for training.

It should be noted that the flat portions such as the right flat portion 92 and the upper flat portion 94 of the elastic wall member 90 are not essential. If the elastic wall member 90 is curved without bending, the elastic wall member 90 may be curved along the entire right end surface of the vertical wall portions 28a and 28b.

An upper rod 98 is attached to the upper side of the elastic wall member 90 (the end of the upper flat portion 94 opposite to the curved wall portion 96), and the lower side of the elastic wall member 90 (the right side). A lower rod 100 is attached to the end of the flat portion 92 opposite the curved wall portion 96 . Specifically, an upper rod 98 and a lower rod 100 extend in the width direction (front-rear direction) of the elastic wall member 90 and are inserted through the upper edge portion and the lower edge portion of the elastic wall member 90 , respectively. These upper and lower rods 98 and 100 protrude from the elastic wall member 90 on both sides in the front-rear direction. Fixed.

In addition, mounting recesses 104 that are recessed inward in the length direction of the elastic wall member 90 are provided on both side portions in the width direction (front-rear direction) of the upper end side portion and the lower end side portion of the elastic wall member 90 . The upper rod 98 is partially exposed by the mounting recesses 104 on the upper end side of the elastic wall member 90 , and the lower rod 100 is partially exposed by the mounting recesses 104 on the lower end side of the elastic wall member 90 . Exposed. The upper rods 98 exposed from the mounting recesses 104 at the upper edge of the elastic wall member 90 are hooked on the upper support recesses 56 of the upper fixing members 54 fixed to the vertical walls 28a and 28b on both front and rear sides. , the lower rods 100 exposed from the mounting recesses 104 at the lower end side portions of the elastic wall member 90 are hooked to the lower support recesses 60 of the lower fixing members 58 fixed to the bottom wall portion 24, thereby forming the elastic wall member. 90 is mounted over opening 48 in tub 14 .

In the upper support recess 56 and the lower support recess 60, the separation distance along the right end surfaces of the front and rear vertical wall portions 28a and 28b is larger than the natural length of the elastic wall member 90 in the longitudinal direction. That is, when the upper and lower rods 98, 100 are hooked on the upper and lower support recesses 56, 60, respectively, the elastic wall member 90 is pulled in the longitudinal direction. It is pressed against each edge-like abutting portion 52 which is the end edge of the opening portion 48 with a state. Therefore, when the elastic wall member 90 is attached to the water tank 14, for example, after the lower rod 100 is hooked to the lower support recess 60, the upper rod 98 is pulled into the upper support recess 56 while pulling the elastic wall member 90 in the longitudinal direction. hook to As a result, even after the elastic wall member 90 is released from being pulled, the elastic wall member 90 is attached to the water tank 14 in a state in which the elastic wall member 90 is pulled more vertically than in the natural state. In short, the upper and lower edges of the elastic wall member 90 are fixedly attached to the water tank 14, so that the elastic wall member 90 is attached in a state of tension in the vertical direction.

For example, the elastic wall member 90 is pulled out from the upper support recess 56 while pulling the elastic wall member 90 in the longitudinal direction by gripping both grip portions 102 of the upper rod 98 , and then pulling the upper rod 98 out of the lower support recess 60 . It can be removed from the water tank 14 by withdrawing the lower rod 100 . That is, the upper rod 98 and the lower rod 100 are detachable from the water tank 14 , so that the elastic wall member 90 can be detachably attached to the water tank 14 .

A visible position marker (not shown) indicating the expected insertion position of the endoscope 16 may be displayed on the elastic wall member 90 of the present embodiment. Such position markers may be different depending on the user's proficiency level of the procedure. good. Even in such a case, the position markers printed on the elastic wall member 90, etc., are The position, size, etc. may be different.

Further, for example, in the case of a highly proficient user, a position marker may be written on the elastic wall member 90 with, for example, an oil-based pen. Thereby, the user can perform training including selection of the insertion position of the endoscope 16 . It should be noted that such position markers may be erasable so that the elastic wall member 90 can be used repeatedly and the position markers can be placed in different locations, for example when training different procedures. .

Further, the orthopedic training apparatus 10 of the present embodiment includes a receiving tank 106 larger than the water tank 14 provided below the water tank 14 and an elastic wall member 90 pressed against the edge-like contact portion 52 from the outside. A pressing mechanism 108 for pressing is provided. The pressing mechanism 108 has the elastic wall member 90 outside the elastic wall member 90 in at least a part of the opening portion 48 where the outer peripheral portion of the elastic wall member 90 is overlapped with the vertical wall portions 28a and 28b on both the front and rear sides to be sealed. It is preferable that the elastic wall member 90 is pressed from the front and back sides of the vertical wall portions 28a and 28b, and the bottom wall portion of the elastic wall member 90 by the pressing mechanism 108, as will be described later. 24 edge-like abutment portions 52 are pressed.

As shown in FIG. 11, the receiving tank 106 has a generally box-like shape that opens upward as a whole, and includes a substantially rectangular bottom wall 110 and a peripheral wall 112 that protrudes upward from the outer peripheral edge of the bottom wall 110 . I have. The peripheral wall 112 has a certain amount of vertical dimension, and the volume of liquid that can be stored in the reservoir 106 is set to be equal to or greater than the prescribed volume stored in the water tank 14 during training. Receiving tank legs 114 protruding downward are fixed to the lower surface at the four corners of the bottom wall 110 with bolts or screws. The bottom wall 110 is also provided with a through-hole 116 penetrating in the plate thickness direction (vertical direction). The inside and outside of the receiving tank 106 communicate with each other through the receiving tank drain port 118 . The receiving tank drain port 118 is open to the outside, and a tube 122 or the like is connected to the receiving tank port member 120 as shown in FIG. 1, for example. The tube 122 is provided with a clamp and a valve capable of switching between opening and closing, so that the receiving tank drainage port 118 can be opened and closed. The arrangement positions of the through hole 116 and the receiving tank port member 120 are not limited, and may be provided in the central portion of the bottom wall 110 as shown in FIGS. (eg, left rear of bottom wall 110 as shown in FIGS. 3 and 4).

In addition, the upward opening of the receiving tank 106 is made larger than the circumference of the water tank 14 , so that the water tank 14 can be placed on the bottom wall 110 of the receiving tank 106 . A positioning protrusion 124 projecting upward is fixed by a bolt or screw to the portion of the bottom wall 110 on which the water tank legs 78 of the water tank 14 are overlapped. Each positioning protrusion 124 has a substantially truncated cone shape as a whole and is slightly smaller than the positioning recess 80 in each water tank leg 78 . Each positioning protrusion 124 may be made of synthetic resin, or may be made entirely or partially of metal having ferromagnetism or paramagnetism, for example. When each positioning projection 124 is made of synthetic resin, for example, a permanent magnet 126 may be embedded inside.

Accordingly, when the water tank 14 is placed on the bottom wall 110 of the receiving tank 106 , the positioning protrusions 124 on the bottom wall 110 enter the positioning recesses 80 on the water tank legs 78 . The receiving tank 106 is positioned in the horizontal direction (direction perpendicular to the vertical direction). That is, in the present embodiment, a positioning mechanism 127 that relatively positions the water tank 14 and the receiving tank 106 in the horizontal direction is configured including the positioning concave portion 80 and the positioning convex portion 124 . Since the water tank 14 and the receiving tank 106 are not fixed in the vertical direction, the water tank 14 can be removed from the receiving tank 106 by lifting the water tank 14 from the receiving tank 106 after training.

In particular, when the permanent magnets 82 and 126 are provided in each of the water tank legs 78 and each of the positioning protrusions 124, the mutual attractive forces of these permanent magnets 82 and 126 prevent the water tank 14 from unintentionally detaching from the receiving tank 106. obtain. If one of the water tank legs 78 and the positioning protrusions 124 is wholly or partly made of metal, the permanent magnet is attached to the other of the water tank legs 78 and the positioning protrusions 124. It may be provided only. Alternatively, a permanent magnet 82 or 126 is provided on either one of each water tank leg 78 and each positioning protrusion 124, and between each water tank leg 78 and the other of each positioning protrusion 124 a bolt or screw. Alternatively, the bolts or screws that fix the water tank legs 78 and/or the positioning protrusions 124 may be made of permanent magnets. That is, connecting means 128 that includes at least one of the permanent magnets 82 and 126 to restrict unintentional detachment of the water tank 14 and the receiving tank 106 and hold the water tank 14 and the receiving tank 106 in a mounted state can be configured. .

As also shown in FIG. 12 , the pressing mechanism 108 of this embodiment includes a pressing plate 130 having a screw hole 129 and a knob 134 having a screw 132 screwed into the screw hole 129 . The pressing plate 130 as a whole has a substantially rectangular plate shape with a certain width dimension (front-to-rear dimension). direction dimension). In the orthopedic technique training device 10 of the present embodiment, the pressure plate 130 is assembled so that the plate thickness direction is the left-right direction. One surface in the plate thickness direction (the left surface when assembled to the orthopedic training device 10) is a substantially flat surface, and the other surface in the plate thickness direction is provided with a screw hole 129 so that the knob 134 A screw 132 is screwed thereon.

As a result, by rotating the tightening portion 136 of the knob 134 around the central axis, the screw is tightened to move the knob 134 in the screw feed direction (from right to left), or the screw is loosened to move the knob. It is possible to move 134 in the opposite direction. As a result, the distance (horizontal distance) from one surface of the pressing plate 130 in the plate thickness direction to the end surface of the tightening portion 136 of the knob 134 can be adjusted according to the operation of tightening or loosening the screw.

In the present embodiment, three screw holes 129 are provided on the other surface of the pressing plate 130 in the plate thickness direction and are spaced apart from each other in the front-rear direction. is provided. At the lower end of the pressing plate 130, between the screw holes 129, 129 adjacent in the front-rear direction, a notch-shaped recess 138 opening upward is formed penetrating in the plate thickness direction (horizontal direction). . Each recess 138 is provided at a position corresponding to each mounting recess 104 on the lower end side portion of the elastic wall member 90 .

The pressing mechanism 108 is provided so as to press the elastic wall member 90 from the outside when the water tank 14 is placed on the receiving tank 106 . That is, one surface in the plate thickness direction of the pressing plate 130 which is a substantially flat surface is superimposed on the surface of the elastic wall member 90 opposite to the side superimposed on the opening portion 48 of the water tank 14, and The end surface of the tightening portion 136 of each knob 134 attached to the other surface of the pressing plate 130 in the plate thickness direction abuts against the right inner surface of the peripheral wall 112 of the receiving tank 106 . In particular, as described above, by rotating each knob 134, the horizontal distance from one surface of the pressing plate 130 in the plate thickness direction to the end surface of the tightening portion 136 can be adjusted. 132 is loosened to increase the horizontal distance from one surface of the pressing plate 130 in the plate thickness direction to the end surface of the tightening portion 136 , so that the elastic wall member 90 is pressed by the pressing plate 130 to press the water tank 14 . Between the plate 130 and the elastic wall member 90, the elastic wall member 90 is substantially compressed in the left-right direction.

In the present embodiment, the pressing mechanism 108 (pressing plate 130) is mounted on the bottom wall 110 of the receiving tank 106, and the elastic wall member 90 extends over a certain vertical range from the lower end of the water tank 14. 14. Specifically, the edge-like abutting portions 52 of the bottom wall portion 24 and the lower portions of the vertical wall portions 28a and 28b on both front and rear sides of the water tank 14 (in particular, the portions extending substantially vertically without reaching the curved portion). The elastic wall member 90 is pressed by the pressing mechanism 108 against.

The skeletal model that is attached to the water tank 14 and used for training can be changed according to the training procedure. As shown in FIGS. 152. In addition, the skeletal model 12 of the present embodiment employs a lumbar spine skeletal model as training for intervertebral disc herniation surgery. When adopting the skeleton model of the lumbar vertebrae, the entire lumbar vertebrae (first to fifth lumbar vertebrae) may be modeled, or a part of the lumbar vertebrae may be modeled. The skeletal model 12 includes the front portions of the third lumbar vertebra L3, the fourth lumbar vertebra L4 and the fifth lumbar vertebra L5, the intervertebral disc 140 between the third lumbar vertebra L3 and the fourth lumbar vertebra L4, the fourth lumbar vertebra L4 and the fifth lumbar vertebra L5. and an intervertebral disc 142 between them. 1 to 12 described above, the neck side of the skeletal model 12 is the front side, and the leg side is the rear side, so the left side in FIG. The right side in FIG. 13 will be described as the rear, the upper side in FIG. 13 as the back side will be described as the upper side, and the lower side in FIG.

In addition, a nerve model 146 simulating a nerve is inserted through a gap 144 inside the skeleton model 12 . The nerve model 146 has a portion 146a imitating the cauda equina nerve extending in the front-rear direction and a portion 146b imitating the nerve root extending laterally from the cauda equina nerve. The skeletal model 12 has a fibrous internal material 148 imitating a hernia in an internal gap 144 . As the fibrous interior material 148, for example, cotton, wool felt, or the like can be preferably used.

The skeletal model 12 can be made of hard resin such as epoxy resin or acrylic resin, and is made of foamed polyurethane in this embodiment. Furthermore, in this embodiment, the skeleton model 12 has a multi-layered structure composed of a plurality of layers with different hardnesses. The outermost layer is a covering layer 150 made of a synthetic resin harder than the inner layers. Such an outer layer (coating layer 150) may employ a material different from that of the inner layer, for example, and the hardness may be adjusted by changing the foaming rate of the inner layer. Also, the nerve model 146 may be formed of an elastomer such as silicone, for example.

Furthermore, the bracket 152 has a substantially rectangular flat plate shape as a whole, and can be made of hard synthetic resin, for example. Such a bracket 152 is fixed to the lower surface of the skeletal model 12 . The fixing structure between the bracket 152 and the skeletal model 12 is not limited, and may be, for example, adhesion. The bracket 152 and the skeleton model 12 are fixed by press-fitting a pin (not shown) protruding downward from the skeleton model 12 . By adopting such a fixing structure, for example, it is possible to replace only the skeleton model 12 with the bracket 152 attached to the model support portion 61 (the first and second fixing portions 62 and 64). Alternatively, the skeleton model 12 and the bracket 152 may be bonded together with the pin of the skeleton model 12 inserted into the pin hole 154 of the bracket 152 . In addition, engagement protrusions 156, 156 are provided at the lower portion of the bracket 152 so as to protrude on both sides in the front-rear direction.

The front-to-rear dimension of the bracket 152 including these engaging protrusions 156, 156 is such that the front engaging protrusion 156 is inserted into the first fixing groove 66 of the first fixing portion 62 in the model support portion 61, and the second The holding portion 70 of the rotating member 68 provided on the fixed portion 64 is sized to hold the rear engaging protrusion 156 from above when the holding portion 70 is in the fixed position. Then, by rotating the rotating member 68 to release the pressing of the engaging projection 156 from above by the pressing portion 70 , the skeleton model 12 can be moved from between the first fixing portion 62 and the second fixing portion 64 . The bracket 152 with the is fixed can be taken out.

Then, the distal end portion of the endoscope 16 is inserted from above into the water tank 14 to which the skeletal model 12 is fixed through either the valve bodies 34 provided on the upper wall portion 30 or the elastic wall member 90 . be put in. The structure of the endoscope used in the orthopedic training device 10 according to the present invention is not limited, and for example, an endoscope generally used in surgical operations may be used. As indicated by 16, the endoscope 16 is a simple endoscope. That is, in the endoscope 16 of this embodiment, the body portion 158 is made of metal.

A body portion 158 of the endoscope 16 is formed with three lumens, a first lumen 160, a second lumen 162, and a third lumen 164. These first to third lumens 160, 162, and 164 are respectively It is formed to extend in the length direction of the body portion 158 . In this embodiment, the first lumen 160 has a larger diameter than the second and third lumens 162, 164, and is a lumen for sucking the water 18 contained in the water tank 14 and for inserting an instrument (not shown). be. The second lumen 162 is for inserting a cable 180 to be described later, and the third lumen 164 is a discharge lumen for discharging the water 18 into the water tank 14 .

In the following description, the length direction of the main body 158 refers to the left-right direction in FIG. 15, the distal side refers to the left side in FIG. 15, and the proximal side refers to the right side in FIG. say. Further, the upper side of the body portion 158 means the upper side in FIG. 15, and the lower side means the lower side in FIG. In this embodiment, the lower portion of the main body portion 158 protrudes further toward the distal end than the upper portion, and the upper portion of the main body portion 158 is provided with the first lumen 160. A second lumen 162 is provided in the portion. A third lumen 164 is provided in the body portion 158 at a position laterally deviating from the first lumen 160 and the second lumen 162 .

These first to third lumens 160, 162, 164 are opened at the distal end portion of the endoscope 16, respectively. That is, the endoscope 16 of this embodiment has a suction port 166 as an opening of a first lumen 160 for suctioning the water 18 and a third lumen for discharging the water 18 at the distal end portion. 164 and a discharge port 168 as an opening. A camera 170 is provided at the opening of the second lumen 162 . That is, the camera 170 is provided on the distal side of the suction port 166 and the discharge port 168, and is capable of photographing the instrument inserted through the first lumen 160 (suction port 166).

A proximal end portion of the first lumen 160 is closed by a valve 174 having a slit 172. In front of the valve 174, a suction tube 176 communicates with the first lumen 160 and extends sideways. It is connected. Furthermore, a discharge tube 178 extending laterally is connected to the base end portion of the third lumen 164 . These suction tube 176 and discharge tube 178 may be connected to a pump as a circulation device and a filter as a filtration device (not shown) via appropriate connectors outside the water tank 14 . Therefore, the orthopedic technique training device 10 of the present embodiment may be configured including a pump, a filter, and the like (not shown). In this embodiment, the water 18 sucked from the suction port 166 is filtered by the filter, and the filtered water 18 is circulated by the pump and discharged from the discharge port 168 into the water tank 14. It has become.

Furthermore, a cable 180 connected to the camera 170 is pulled out of the endoscope 16 through the second lumen 162 and connected to a monitor (not shown) outside the water tank 14 via a connector 182 . Further, the plastic surgery training device 10 of the present embodiment may include a light as an illumination device, and a light (not shown) may be provided on the water tank 14 and/or the endoscope 16 .

When the endoscope 16 is inserted through the elastic wall member 90 , the dilator 184 and the sheath 186 as piercing members are pierced through the elastic wall member 90 before the endoscope 16 is inserted. 15, the dilator 184 is inserted into the sheath 186, and the dilator 184 and the sheath 186 are integrally pierced through the elastic wall member 90. As shown in FIG. After that, the sheath 186 is left in the elastic wall member 90 by pulling out the dilator 184 with respect to the sheath 186 . The sheath 186 forms an insertion hole 188 for the endoscope 16 in the elastic wall member 90 , and the endoscope 16 can be inserted through the elastic wall member 90 through the insertion hole 188 . That is, the insertion hole 188 for the endoscope 16 can be formed by puncturing the dilator 184 which is a perforating member.

Further, after training is completed, the insertion hole 188 can be closed based on the elasticity of the elastic wall member 90 itself by removing the sheath 186, which is the perforating member, from the elastic wall member 90. Also when the endoscope 16 is inserted through any one of the valve bodies 34 in the upper wall portion 30 , the dilator 184 and the sheath 186 as the piercing member may be inserted prior to the endoscope 16 . Of course, the dilator 184 and the sheath 186 are not essential, and the endoscope 16 may directly pierce each valve element 34 and elastic wall member 90 . That is, the insertion hole 188 for inserting the endoscope 16 into the water tank 14 can be formed in the peripheral wall portion 26 having the elastic wall member 90 and the upper wall portion 30 having the respective valve bodies 34 . Therefore, the insertion hole 188 is provided in the wall portion 46 of the water tank 14 including the peripheral wall portion 26 and the upper wall portion 30 .

With such an orthopedic surgical training device 10, by inserting the distal end portion of the endoscope 16 through either the valve body 34 or the elastic wall member 90, training of surgical procedures in orthopedic surgery can be performed. That is, with the distal end portion of the endoscope 16 approaching the skeleton model 12, an instrument such as a drill or forceps (not shown) is inserted through the valve 174 provided at the proximal end of the first lumen 160. It is made to protrude from the tip of the endoscope 16 . Then, while confirming an image displayed on a monitor (not shown), the instrument is operated to crush or cut a bone (skeletal model 12), extract a hernia (internal material 148), or the like.

By the way, as a surgical method for intervertebral disc herniation, there are generally an interlaminar method shown in FIG. 17(a) and a transforaminal method shown in FIG. 17(b). Interlaminar or transforaminal methods are selected accordingly. That is, in the method shown in FIG. 17(a), the endoscope 16 is inserted vertically from the back side of the patient (from above in FIG. 17(a)), whereas in the method shown in FIG. In the method shown, the endoscope 16 is inserted from the outer side (from a direction inclined upward in FIG. 17(b)). The orthopedic training device 10 of the present embodiment includes an upper wall portion 30 provided with each valve element 34, and an elastic wall member 90 provided outside the upper wall portion 30. Each valve element 34 Since the endoscope 16 can be inserted through both the elastic wall member 90 and the elastic wall member 90, both the interlaminar method and the transforaminal method can be trained.

In addition, when training the transforaminal method, in FIG. 1, assuming that the treatment is performed from the left side of the patient, The endoscope 16 is inserted through the elastic wall member 90 from the side). For example, by turning the skeleton model 12 back and forth and placing it in the water tank 14, training for inserting the endoscope 16 from the patient's right side is performed. be able to. Moreover, in the transforaminal method, as indicated by the white arrow in FIG. There is As described above, even when the endoscope 16 is moved up and down by a large amount, the elastic wall member 90 covers a wide range from the upper side to the right side of the water tank 14. In contrast, interference with the peripheral wall portion 26 of the water tank 14 is avoided.

Then, after completing the training, the endoscope 16 inserted through the elastic wall member 90 is pulled out. When the endoscope 16 is inserted, if a dilator 184 or a sheath 186 is employed as a perforating member, the insertion area formed on the elastic wall member 90 is removed by withdrawing the sheath 186 after the endoscope 16 is withdrawn. The hole 188 is closed by elastic restoring deformation of the elastic wall member 90 . After that, by opening the clamp or valve of the tube 89 connected to the water tank port member 88 to open the water tank drain port 86, the water 18 in the water tank 14 flows into the receiving tank 106 through the water tank drain port 86. drained. After the water 18 in the water tank 14 is drained, the water tank 14 is removed from the receiving tank 106 . The water 18 stored in the reservoir 106 is drained from a suitable drain, such as the user's home washroom, for example, through a tube 122 connected to the reservoir port member 120 in the reservoir 106 .

In the orthopedic technique training apparatus 10 of the present embodiment having the structure as described above, a part of the wall portion 46 of the water tank 14 is constituted by the elastic wall member 90. An elastic wall member 90 is employed instead of the right vertical wall portion 28 constituting the . Therefore, the endoscope 16 can be inserted over a wider range than when a through hole for inserting the endoscope is provided in the hard vertical wall, and the endoscope 16 can be used during training. Even when moving 16 to a large extent, interference with the hard vertical wall portion is avoided. Furthermore, when a through-hole for insertion is provided in the hard vertical wall portion, the insertion position of the endoscope is limited. is provided, the flexibility of the insertion position of the endoscope 16 is improved. As a result, it is possible to perform training including selection of the insertion position of the endoscope 16, and training can be performed in a state closer to actual surgery.

Furthermore, it is possible to pierce the elastic wall member 90 with a piercing member (the dilator 184 and the sheath 186) prior to the endoscope 16 to form the insertion hole 188 for the endoscope 16. Since such perforating members (dilators, sheaths, etc.) are generally used in actual surgery, training can be performed in a state that is closer to actual surgery. Since the insertion hole 188 is immediately closed due to the elasticity of the elastic wall member 90 as the endoscope 16 and the perforating member (sheath 186) are removed, the water in the water tank 14 is prevented from flowing through the insertion hole 188. 18 leakage can be prevented.

In addition, the elastic wall member 90 of this embodiment not only constitutes a part of the peripheral wall portion 26 of the water tank 14 , but also the upper portion of the elastic wall member 90 is formed as a curved wall portion 96 so as to extend upward from the water tank 14 . It partially covers the opening 22 . As a result, the endoscope 16 can be passed through the curved wall portion 96 of the elastic wall member 90, for example, and the transforaminal training can be performed as shown in FIG. 17(b). In addition, since the elastic wall member 90 covers up to the upper opening 22, leakage of the water 18 from the upper opening 22 can be effectively prevented.

Furthermore, in the present embodiment, the peripheral wall portion 26 of the water tank 14 has a rectangular cylindrical shape composed of four vertical wall portions 28, and instead of one of the vertical wall portions 28 (right vertical wall portion 28) An elastic wall member 90 is arranged. As a result, for example, the elastic wall member 90 can be provided on the side of the skeleton model 12, and training can be performed on the assumption that the patient will be treated while standing on the side. Of course, elastic wall members may be provided anteriorly or posteriorly with respect to the skeletal model, depending on the procedure to be trained. By forming the peripheral wall portion 26 into a rectangular cylindrical shape in this manner, the peripheral wall portion 26 and thus the orthopedic technique training apparatus 10 can be made compact.

Furthermore, in this embodiment, the elastic wall member 90 is attached to the water tank 14 in a state of tension in the length direction (vertical direction), and the attachment position of the elastic wall member 90 in the water tank 14 is in edge-like abutment. A portion 52 is provided. As a result, the opening 48 in the water tank 14 can be effectively sealed by the elastic wall member 90 to prevent leakage of the water 18 through the opening 48 . In particular, the elastic wall member 90 is provided with an upper rod 98 and a lower rod 100 at its upper and lower end portions, respectively. By attaching the elastic wall member 90 to the water tank 14, the elastic wall member 90 can be easily attached.

In addition, in this embodiment, the opening portion 48 is provided over the entire right vertical wall portion 28, and the edge-like abutting portions 52 are formed at the right edge portions of the front and rear vertical wall portions 28a and 28b, respectively. is provided. As a result, a large width dimension of the opening portion 48 can be ensured, and the edge-like abutting portion 52 can be configured by skillfully utilizing the vertical wall portions 28a and 28b on both the front and rear sides. Furthermore, in a state in which the elastic wall member 90 is superimposed on each of the edge-like contact portions 52, a pressing mechanism 108 is provided outside the elastic wall member 90 so that the elastic wall member 90 can be brought into contact with each edge-like contact portion. It is pressed against the portion 52 . Thereby, the sealing performance of the opening portion 48 by the elastic wall member 90 can be further improved.

Furthermore, in the elastic wall member 90 of the present embodiment, a visible position marker indicating the planned insertion position of the endoscope 16 can be displayed. As a result, the endoscope 16 can be inserted from an appropriate position, and the effects of the training can be enjoyed more reliably. In addition, the upper wall portion 30 and the peripheral wall portion 26 (each vertical wall portion 28) of the wall portion 46 of the water tank 14 are both made of a transparent material, so that the operation of the endoscope 16 can be visually recognized from the outside. . As a result, for example, the instructor's operation can be confirmed from the outside, and the own operation can be recorded from the outside, so that the state of the training can be easily confirmed.

Furthermore, a specified water level of the water 18 necessary for immersing the skeletal model 12 in the water tank 14 may be set. 18 is accommodated, and it is also possible to set the upper end portion of the water tank 14 to a specified water level. The elastic wall member 90 is provided below the specified water level (in this embodiment, the upper end portion of the water tank 14), and in this embodiment, it protrudes below the bottom wall portion 24 of the water tank 14. . As a result, the endoscope 16 can be trained assuming that it will be inserted in a wide area extending laterally and downwardly of the human body. Further, when the endoscope 16 is inserted through the elastic wall member 90, the endoscope 16 can be inserted into the water 18 without passing through an air layer, so that training more suitable for actual surgery can be performed. can be done.

Further, according to the plastic surgery training device 10 of the present embodiment, a larger receiving tank 106 is provided below the water tank 14 . As a result, for example, even if the water 18 in the water tank 14 leaks by moving the endoscope 16 greatly during training, the leaked water 18 can be received by the receiving tank 106, and the orthopedic training apparatus 10 can be used. Leakage of the water 18 to the outside can be prevented. Therefore, it is possible to improve the flexibility of the installation location of the orthopedic training device 10 .

Furthermore, in this embodiment, each water tank leg 78 of the water tank 14 is provided with a positioning recess 80, and the bottom wall 110 of the receiving tank 106 is provided with a positioning protrusion 124 that fits into each of the positioning recesses 80. A positioning mechanism 127 for positioning the water tank 14 and the receiving tank 106 in the horizontal direction is constituted by the positioning concave portions 80 and the positioning convex portions 124 . As a result, for example, it is possible to prevent the water tank 14 from being displaced horizontally with respect to the receiving tank 106 during training, so that the training can be performed more concentratedly.

In particular, in the present embodiment, the elastic wall member 90 and the pressing mechanism 108 (the pressing plate 130 and the knobs 134) are sandwiched between the water tank 14 and the right wall portion of the peripheral wall 112 of the receiving tank 106, and the elastic wall member 90 is pressed by the pressing mechanism 108. Since the water tank 14 cannot be displaced in the horizontal direction, the pressing of the elastic wall member 90 against the water tank 14 and the prevention of leakage of the water 18 from the water tank 14 are achieved more reliably. obtain.

Furthermore, in the present embodiment, the volume of liquid that can be stored in the receiving tank 106 is set to be equal to or greater than the specified amount of water stored in the water tank 14 during training. Even if the water flows out, the entire amount of the water can be received by the receiving tank 106, and the leakage of the water 18 to the outside of the plastic surgery training apparatus 10 can be prevented more reliably.

In particular, in this embodiment, the water tank 14 is provided with an openable and closable water tank drain port 86, and the receiving tank 106 is provided with an openable and closable water tank drain port 118. As a result, for example, after training, the water 18 in the water tank 14 can be discharged into the receiving tank 106 by opening the water tank drain port 86 . Since the receiving tank 106 can receive the water 18 in excess of the prescribed amount in the water tank 14, the water 18 in the water tank 14 can be moved to the receiving tank 106 by one time drainage. Therefore, by allowing the water receiving tank 106 to store more than a specified amount of water, it is possible to improve the drainage efficiency after training. Also, after the water 18 is discharged to the receiving tank 106, only the receiving tank 106 can be carried by removing the water tank 14, and the water 18 in the receiving tank 106 can be drained more safely without spilling.

Further, permanent magnets 82 and 126 may be provided on each of the water tank legs 78 of the water tank 14 and on each of the positioning projections 124 of the receiving tank 106, respectively. Such permanent magnets 82 and 126 hold the water tank 14 and the receiving tank 106 in an attached state, thereby preventing the water tank 14 from wobbling or the like during training. Furthermore, even after training, for example, when the water 18 is drained into the water reservoir 106 , the water tank 14 can be prevented from unintentionally floating up from the water reservoir 106 .

Next, FIGS. 18 to 22 show an orthopedic training device 200 as a second embodiment of the present invention. The orthopedic technique training apparatus 200 of this embodiment has a water tank 14 substantially similar to that of the orthopedic technique training apparatus 10 of the first embodiment. The structure of the model supporting portion that positions and supports the inside of the model and the structure of the pressing mechanism that presses the elastic wall member 90 from the outside are different. In the following description, members and parts that are substantially the same as those of the above embodiment are denoted by the same reference numerals as those of the above embodiment, and detailed explanation thereof will be omitted.

More specifically, the plastic surgery training device 200 of this embodiment includes a model position setting mechanism 202 that movably and fixedly sets the skeletal model 12 to a plurality of different positions inside the water tank 14 . By moving the skeleton model 12 by the model position setting mechanism 202, the distance from the endoscope 16 insertion hole 188 provided in the wall portion 46 of the water tank 14 to the skeleton model 12 can be changed.

Particularly in this embodiment, a base member 204 to which the skeletal model 12 can be attached and detached is provided inside the water tank 14. A guide mechanism 206 guides the base member 204 so as to be movable in the horizontal direction. A model position setting mechanism 202 is configured including a lock mechanism 208 for positioning at a plurality of positions in the direction of movement by 206 . Accordingly, in this embodiment, the model support section 210 that positions and supports the skeleton model 12 inside the water tank 14 includes the model position setting mechanism 202 (especially the lock mechanism 208 ) and the base member 204 .

Specifically, as shown in FIG. 23, the base member 204 is a substantially rectangular plate-shaped member as a whole, and is made of synthetic resin. The base member 204 is arranged with the front-rear direction being the longitudinal direction with respect to the bottom wall portion 24, and a mounting portion 212 to which the bracket 152 of the skeleton model 12 is mounted is provided at the middle portion in the front-rear direction. In addition, guide holes 214 penetrating in the left-right direction are provided at both ends in the front-rear direction.

The mounting part 212 is a substantially rectangular recess opening upward and has an opening of a predetermined size. That is, the widthwise (lateral) dimension A (see FIG. 23) of the upper opening 216 of the mounting portion 212 is equal to or slightly larger than the widthwise dimension B of the bracket 152 (see FIG. 14). In addition, the lengthwise (forward and backward) dimension C (see FIG. 23) of the upper opening 216 is equal to or slightly larger than the lengthwise dimension D (see FIG. 13) of the upper portion of the bracket 152. At the same time, it is slightly smaller than the maximum length dimension E of the lower portion of the bracket 152 (maximum front-to-rear dimension at the position where each engaging projection 156 is formed, see FIG. 13). As shown in FIGS. 23 to 25, fixed grooves 218 into which the front-side engagement protrusions 156 of the bracket 152 are fitted are provided in the lower portions of the wall portions 217a and 217b on both sides in the front-rear direction of the mounting portion 212. A fixing groove 220 is provided in which the engaging protrusion 156 on the rear side is fitted. A plurality of drainage holes 222 are provided in the bottom wall of the mounting section 212, so that the water 18 can be easily drained from the mounting section 212 in the orthopedic training apparatus 200 after use. ing. Further, an opening 223 is provided in the left-right central portion of the wall portion 217b on the rear side of the mounting portion 212. As will be described later, a bracket 152 mounted on the mounting portion 212 is provided through the opening 223. A projecting distal end portion 228 of the spring portion 226 can be elastically contacted from behind.

A bracket fixing mechanism 224 for fixing the bracket 152 attached to the mounting portion 212 is provided on the base member 204 behind the mounting portion 212 . The bracket fixing mechanism 224 is provided integrally with the base member 204 and has a spring portion 226 that is elastically deformable in the front-rear direction. A protruding tip 228 is provided that can abut against 156 . A substantially hemispherical rear protrusion 230 that protrudes rearward is provided on the protruding distal end 228 . Further, the bracket fixing mechanism 224 has a fixation switching portion 232 which is slidable in the left-right direction and switches between fixation and release of the bracket 152 . The fixed switching portion 232 includes a knob portion 234 that protrudes upward and can be operated by the user by pinching it, and a knob portion 234 that is integrally provided with the knob portion 234 and is attached to a protruding tip portion 228 of the spring portion 226 from behind. and a contact portion 236 that can be brought into contact.

23 and 25, in a state where the bracket 152 is attached to the attachment portion 212, the contact portion 236 is slid rightward by pinching the knob portion 234 and displacing the contact portion 236. is brought into contact with the protruding distal end portion 228 of the spring portion 226 from behind, so that the front and rear ends of the engaging protrusions 156 fitted in the fixing grooves 218 and 220 are aligned with the inner surfaces of the front fixing grooves 218. The bracket 152 is fixed to the mounting portion 212 by being clamped in the front-rear direction by the projecting tip portion 228 . In particular, the protruding distal end portion 228 is provided with a rear protruding portion 230 that protrudes rearward. A small pressing surface holds the protruding tip 228 in the forward protruding position. As a result, the supporting force of the bracket 152 between the front fixing groove 218 and the projecting tip portion 228, in other words, the fixing force of the bracket 152 to the mounting portion 212 is improved. 25 in the initial state (the state before the contact portion 236 is slid leftward), or the contact portion 236 is slid leftward. By displacing and contacting the protruding tip 228 from behind, the protruding tip 228 may be pushed forward to move to the position shown in FIG. 25 .

Also, as shown in FIGS. 24 and 25, each guide hole 214 provided at both ends in the front-rear direction of the base member 204 extends in a substantially circular shape over the entire length in the length direction. A substantially plate-like projection (guide-hole-side projection) 238 is provided on the inner peripheral surface of each guide hole 214 and protrudes toward the inner peripheral side (inward in the radial direction). The guide hole-side convex portion 238 extends in the circumferential direction in a substantially crescent-shaped plate shape within the guide hole 214 , and the height of the projection in the radial direction is equal to the outer circumference of a guide rod 240 to be inserted into the guide hole 214 , which will be described later. It is said to be at a height that touches the surface or barely reaches. The plate thickness of the guide hole-side protrusion 238 (thickness dimension in the axial direction of the guide hole 214) is such that the tip portion on the tip side in the projection direction (the inner peripheral side of the guide hole 214) is thicker than the base end portion in the projection direction. Smaller is desirable.

At least one such guide hole-side protrusion 238 may be formed in the guide hole 214, but preferably a plurality of such guide hole-side protrusions 238 are formed separated from each other in the length direction (horizontal direction) of the guide hole 214 ( 3 to 10, for example). When a plurality of guide hole-side protrusions 238 are provided, each guide hole-side protrusion 238 is fitted between guide rod-side protrusions 250 formed on the guide rod 240 in the axial direction (recesses 252), as will be described later. The pitch (interval) is set so that they mesh with each other.

On the other hand, a plurality (a pair in this embodiment) of guide rods 240, 240 extending parallel to each other are fixedly attached to the bottom wall portion 24 of the water tub 14. As shown in FIG. Each of these guide rods 240 extends in the left-right direction and faces each other with a predetermined distance therebetween in the front-rear direction. Each guide rod 240 is rotatably supported by fixing members 242 at both ends in the length direction (left and right direction) and fixed in position. The fixing members 242 on both sides in the left-right direction are fixed to the water tank 14 with bolts or the like, so that the guide rods 240 are attached to the water tank 14 via the fixing members 242 . The left end of each guide rod 240 penetrates the left fixing member 242 and protrudes leftward. An operable lever portion 244 is integrally provided. Further, the guide rod 240 of this embodiment has a composite structure in which a synthetic resin layer is fixed around a metal core rod 246 extending over the entire length in a covering state. As a result, the rigidity of each guide rod 240 is improved, and the degree of freedom in setting the shape of the outer peripheral surface is improved.

Each of these guide rods 240 extends straight with a constant substantially circular cross-sectional shape, and has an outer peripheral surface shape that is one size smaller than the inner peripheral surface of each guide hole 214. A flat surface 248 extending in the chord direction is formed at locations (lower portion in FIG. 24 and upper portion in FIG. 25), and such flat surface 248 spreads over the entire length in the axial direction in a chamfered manner. . Further, the outer peripheral surface of the guide rod 240 is provided with a plurality of protrusions (guide rod-side protrusions) 250 that protrude to the outer peripheral side at portions that are circumferentially out of the flat surface 248 . The guide-rod-side projection 250 has a substantially plate-like or flange-like shape and extends in the circumferential direction.

The protrusion height of the guide rod side protrusion 250 is set so that the outer diameter dimension at the formation position of the guide rod side protrusion 250 is the same as or slightly smaller than the inner diameter dimension of the guide hole 214 of the base member 204 . Since the guide-rod-side protrusions 250 extend in the circumferential direction over more than half the circumference with a substantially constant protrusion height (outer diameter dimension), the outer peripheral surfaces of the many guide-rod-side protrusions 250 cooperate with each other. In addition, a guide surface is formed that slides on the inner peripheral surface of the guide hole 214 of the base member 204 and guides the base member 204 so as to be movable in the axial direction.

In addition, the thickness dimension of the guide rod side protrusion 250 is smaller on the protruding distal end side than on the proximal end side, and the thickness dimension is gradually reduced at both ends in the circumferential direction toward the ends in the circumferential direction. . A large number of such guide-rod-side protrusions 250 are formed at regular intervals (pitch) in the longitudinal direction of the guide rod 240 . As a result, a recess 252 that opens toward the outer peripheral surface and extends in the circumferential direction is formed between the guide rod- side protrusions 250 , 250 that are adjacent in the axial direction of the guide rod 240 . In addition, the opening dimension (separation distance between adjacent guide rod side protrusions 250, 250) of each recess 252 is gradually increased toward the outer peripheral side.

Each guide rod 240 as described above is inserted through each guide hole 214 in the base member 204 . When fixing each guide rod 240 and each guide hole 214 (base member 204), as shown in FIGS. to rotate. As a result, each guide hole side protrusion 238 relatively moves in the circumferential direction so as to enter the recess 252 of each guide rod 240, and each guide hole side protrusion 238 is moved between the guide rod side protrusions 250, 250 adjacent in the axial direction. The projections 238 are sandwiched from both sides in the axial direction so as to engage with each other. In such an interlocking state, the guide rod- side protrusions 250 and 250 are axially overlapped with the guide hole-side protrusion 238 and fit together. Movement is blocked and a positioning state is established.

On the other hand, to release the fixation between each guide rod 240 and each guide hole 214 (base member 204), each lever portion 244 is pinched and each guide rod is released, as indicated by the two-dot chain lines in FIGS. 240 is rotated around the central axis to disengage the guide rod-side projections 250 from the guide hole-side projections 238 in the circumferential direction. As a result, the guide hole-side protrusion 238 slips out of the recess 252 of the guide rod 240, and the guide hole-side protrusion 238 and the guide rod-side protrusion 250 are axially positioned by meshing in an overlapping state. is released, allowing each guide hole 214 (base member 204) to move in the longitudinal direction with respect to each guide rod 240. As shown in FIG. In this released state, the flat surface 248 of the guide rod 240 is radially spaced apart from the guide hole-side projection 238 of the guide hole 214 and faces the guide rod of the guide hole-side projection 238 . By avoiding contact with 240, movement of base member 204 along guide rod 240 is realized more smoothly.

As described above, in the present embodiment, the guide mechanism 206 for movably guiding the base member 204 in the horizontal direction (especially the horizontal direction among the directions perpendicular to the vertical direction) includes each guide rod 240 and each guide rod. Each guide hole 214 through which 240 is inserted is included. Each guide rod 240 and each guide hole 214 are fixed by rotating each guide rod 240 around the central axis and engaging the outer peripheral surface of each guide rod 240 with the inner peripheral surface of each guide hole 214 . The locking mechanism 208 that prevents the movement of the base member 204 along each guide rod 240 and makes it possible to fix the base member 204 is constituted by such a meshing action. In particular, each guide hole-side protrusion 238 is provided on the inner peripheral surface of each guide hole 214, and each guide rod-side protrusion 250 (each recess 252) is provided on the outer peripheral surface of each guide rod 240. Each guide hole-side projection 238 enters each recess 252 and meshes with the outer peripheral surface of each guide rod 240, thereby exhibiting the meshing action. Thus, the lock mechanism 208 that positions the base member 204 in the movement direction (horizontal direction) of the guide mechanism 206 can also be configured by the fitting action of the guide hole side protrusions 238 and the recesses 252 .

Furthermore, in the orthopedic technique training device 200 of the present embodiment, the pressing mechanism 254 that presses the elastic wall member 90 from the outside in a state of being pressed against the edge-like contact portion 52 includes the elastic wall member 90 and the peripheral wall of the reservoir 106. 112. As also shown in FIGS. 18 to 22, the pressing mechanism 254 of this embodiment includes a block-shaped pressing member 256 . The pressing member 256 is preferably made of an elastic member, and is made of high-density polyethylene or foamed polyethylene in this embodiment. The pressing member 256 preferably has deformation rigidity greater than that of the elastic wall member 90 . The pressing member 256 has a substantially rectangular or substantially trapezoidal cross section, and has a certain amount of lateral dimension and longitudinal dimension when placed on the water tub 14 . In this embodiment, the front-rear dimension of the pressing member 256 is substantially equal to the front-rear dimension of the elastic wall member 90 . The lateral dimension of the pressing member 256 is approximately equal to or slightly larger than the separation distance between the elastic wall member 90 and the right inner surface of the peripheral wall 112 of the receiving tank 106 .

In this embodiment, the pressing member 256 is inserted between the elastic wall member 90 and the right portion of the peripheral wall 112 in a state where the water tank 14 is placed on the receiving tank 106 . In particular, since the lateral dimension of the pressing member 256 is larger than the separation distance between the elastic wall member 90 and the right inner surface of the peripheral wall 112 , the pressing member 256 is positioned between the elastic wall member 90 and the right portion of the peripheral wall 112 . By being arranged between the elastic wall member 90 and/or the pressing member 256, the elastic wall member 90 and/or the pressing member 256 are compressed in the left-right direction, and the right portion (the right flat portion 92) of the elastic wall member 90 moves between the elastic wall member 90 and the water tank. 14. Thus, the pressing member 256 is provided to press the elastic wall member 90 from the outside.

A specific example of how to use the plastic surgery training device 200 of the present embodiment will be described below with reference to FIGS. That is, FIG. 26(a) shows a state in which the lock mechanism 208 is released in the model position setting mechanism 202 and the base member 204 can move along each guide rod 240, and FIG. ) shows a state in which the base member 204 is positioned with respect to each guide rod 240 by the lock mechanism 208 . 27(a) shows a state in which the bracket fixing mechanism 224 is not operating and the bracket 152 can be removed from the mounting portion 212 of the base member 204, and FIG. , the state in which the bracket 152 is fixed to the mounting portion 212 of the base member 204 by the bracket fixing mechanism 224 is shown.

In the initial state (preparatory state before training), the lock mechanism 208 is released as shown in FIG. In this embodiment, each guide hole-side convex portion 238 and the flat surface 248 face each other in the front-rear direction. This allows the base member 204 to move in the length direction (horizontal direction) of each guide rod 240 .

In this state (or in a state where the locking mechanism 208 is activated as shown in FIG. 26(b)), the bracket 152 is mounted on the mounting portion 212 of the base member 204 as shown in FIG. 27(a). . The front-rear dimension C of the upper opening 216 of the mounting portion 212 is set smaller than the maximum front-rear dimension E of the bracket 152. After fitting the portion 156 into the rear fixing groove 220, the bracket 152 is accommodated in the mounting portion 212 by rotating the entire bracket 152 around the fitting portion and lowering the front, so that the front engaging protrusion is engaged. 156 can be fitted into the front locking groove 218 .

Specifically, at the stage of mounting the bracket 152 to the mounting portion 212, the abutment portion 236 of the fixed switching portion 232 is not positioned behind the protruding tip portion 228 of the spring portion 226, and the protruding tip portion 228 is the spring. It can be displaced in the front-rear direction as the portion 226 is elastically deformed. Therefore, by pushing the bracket 152 rearward with the rear engaging projection 156 fitted in the fixing groove 220, the bracket 152 can be moved rearward by a distance F from the state shown in FIG. Accordingly, the front engaging protrusion 156 can be fitted into the front fixing groove 218 . More specifically, by pushing the bracket 152 rearward (against the urging force of the spring portion 226) with the rear engagement protrusion 156 of the bracket 152 inserted into the rear fixing groove 220, the bracket 152 is , until the upper portion of the bracket 152 and the rear wall portion 217b of the mounting portion 212 come into contact with each other (distance: F). Here, since the engagement depth G (see FIG. 24) of the engagement projection 156 on the front side of the bracket 152 with the fixed groove 218 is set smaller than the movement distance F (G<F), By moving the bracket 152 rearward by a distance F, a gap having a size of FG for fitting the front engaging protrusion 156 into the fixing groove 218 is formed. In a state in which both engaging projections 156 and 156 are fitted into the fixing grooves 218 and 220 on both sides, the rearward movement of the bracket 152 is elastically prevented by the protruding distal end portion 228, The engaged state of the engaging projections 156, 156 is maintained to prevent unintended dropping off.

Thereafter, as shown in FIG. 27(b), the knob portion 234 of the fixed switching portion 232 is pinched to displace the contact portion 236 to the right, so that the contact portion 236 is moved to the projecting tip end portion 228 of the spring portion 226. , the bracket 152 is pushed forward by the projecting tip portion 228 , and the front engaging protrusion 156 of the bracket 152 hits the front inner surface of the fixing groove 218 . As a result, the engaging protrusions 156 on both sides of the bracket 152 are sandwiched between the inner surface of the front fixed groove 218 and the protruding distal end portion 228 in the front-rear direction, thereby preventing the bracket 152 from moving within the mounting portion 212. . In order to remove the bracket 152 from the mounting portion 212, it is sufficient to carry out the operation opposite to the mounting. By releasing the contact, the spring portion 226 (protruding distal end portion 228) can be elastically deformed in the front-rear direction. As a result, the bracket 152 can be displaced rearward, and the front engaging protrusion 156 can be pulled out of the front fixing groove 218 by moving the bracket 152 rearward. In this state, the bracket 152 can be taken out from the mounting portion 212 by, for example, putting a finger on the front end portion of the upper end portion of the bracket 152 and pulling it up.

In this state, after moving the base member 204 to a desired position along each guide rod 240 in the left-right direction, as shown in FIG. By operating the lever portion 244, each guide rod 240 is rotated around the central axis. As a result, the guide hole-side protrusions 238 inside the guide holes 214 enter the recesses 252 of the guide rods 240 and mesh with the outer peripheral surface of the guide rods 240 , thereby fixing the base member 204 to the guide rods 240 . That is, in this embodiment, the base member 204 (skeletal model 12) can be fixed at a plurality of positions along the length of each guide rod 240. The base member 204 can be fixed at any position within the movable range of the member 204 .

In the present embodiment, as described above, each guide hole-side convex portion 238 of each guide hole 214 and each guide rod-side convex portion 238 of each guide rod 240 both protrude toward the distal end side. is tapered so that the 26(a), the lever 244 is oriented straight upward, through a state in which the lever 244 is slanted as shown in FIG. When the portion 244 reaches a horizontal state, even if there is a positional deviation between each guide hole side protrusion 238 and each recess 252, the guiding action of the inclined surfaces of both protrusions 238 and 250 allows each guide hole side to move. The projections 238 are gradually inserted into the respective recesses 252, and in the state shown in FIG. As a result, it engages with the outer peripheral surface of each guide rod 240 .

After fixing the base member 204 with the bracket 152 attached to each guide rod 240 in this way, the skeleton model 12 is fixed to the bracket 152 . Subsequent operations are the same as in the first embodiment, and the endoscope 16 is moved according to, for example, the interlaminar method shown in FIG. be trained in orthopedic techniques used.

In the orthopedic technique training apparatus 200 of the present embodiment having the structure as described above, at least a part of the wall portion 46 of the water tank 14 is composed of the elastic wall member 90 through which the endoscope 16 can be inserted. , effects similar to those of the first embodiment can be exhibited. In particular, in this embodiment, the model position setting mechanism 202 can move the skeletal model 12 to a plurality of positions inside the water tank 14 . The distance and direction (angle) of are changeable. As a result, the distance from the insertion hole 188 to the skeleton model 12 can be changed according to, for example, the body type of a patient expected to undergo surgery, the length of the endoscope expected to be used, and the like. That is, when a large patient or a long endoscope is assumed, the skeleton model 12 is separated from the elastic wall member 90 to increase the distance from the insertion hole 188 to the skeleton model 12. Assuming a short endoscope, the skeleton model 12 can be brought closer to the elastic wall member 90 to reduce the distance from the insertion hole 188 to the skeleton model 12 . As a result, more practical training can be performed according to the body type of each patient and the length of the endoscope to be used.

In this embodiment, the model position setting mechanism 202 includes a guide mechanism 206 that guides the base member 204 so as to be movable in the horizontal direction (particularly in the lateral direction), and a lock that positions the base member 204 at a plurality of positions in the horizontal direction (particularly in the lateral direction). A model position setting mechanism 202 is configured including a mechanism 208 . As a result, when moving the skeleton model 12, it is sufficient to move the base member 204 instead of the skeleton model 12 itself, so that the movement of the skeleton model 12 can be made easier and the risk of damage to the skeleton model 12 can be reduced. .

Further, the guide mechanism 206 includes a pair of guide rods 240, 240 and guide holes 214, 214 through which the guide rods 240 are inserted. The locking mechanism 208 is configured by engaging the outer peripheral surface of the guide rod 240 with the inner peripheral surface of each guide hole 214 . That is, by a simple operation of rotating each guide rod 240 around the central axis, locking and unlocking by the lock mechanism 208 can be easily switched.

In particular, a plurality of guide hole-side protrusions 238 are provided on the inner peripheral surface of each guide hole 214, and a plurality of guide rod-side protrusions 250 (recesses 252) are provided on the outer peripheral surface of each guide rod 240. Each guide hole 214 (base member 204) is positioned with respect to each guide rod 240 by each guide hole side protrusion 238 entering each recess 252 and biting into the outer peripheral surface of each guide rod 240. It has become so. That is, in addition to the action of engagement between the outer peripheral surface of each guide rod 240 and the inner peripheral surface of each guide hole 214 (each guide hole-side protrusion 238), each guide hole-side protrusion 238 enters each recess 252. Since the positioning of each guide rod 240 and each guide hole 214 (base member 204) is achieved also by the above, each guide rod 240 and base member 204 can be fixed more firmly.

Next, FIG. 28 shows an endoscopic orthopedic training device 260 as a third embodiment of the present invention. In the second embodiment, the base member 204 to which the bracket 152 of the skeletal model 12 is attached is slidable in the lateral direction along each guide rod 240 and can be fixed at an arbitrary position. In the present embodiment, the model support portions 61 in the first embodiment are provided at two locations separated from each other in the left-right direction, and the brackets 152 are provided at the first position 262 and the second position separated from each other in the left-right direction. 2 positions 264 can be selectively mounted. That is, in this embodiment, a model is provided in which the skeleton model 12 including both model support portions 61 is movably and fixedly set to a plurality of different positions (the first position 262 and the second position 264) inside the water tank 14. A position setting mechanism 266 is configured. Since the model supporting portion 61 in this embodiment has the same structure as in the first embodiment, the same reference numerals as those in the first embodiment are given in the figure, and detailed description thereof will be omitted.

Also in the orthopedic technique training device 260 of the present embodiment, at least a part of the wall portion 46 of the water tank 14 is composed of the elastic wall member 90 through which the endoscope 16 can be inserted. A similar effect can be exhibited. In addition, the model position setting mechanism 266 of this embodiment can fix the skeleton model 12 at different positions (the first position 262 and the second position 264) in the left-right direction. Since the distance from the common hole 188 to the skeleton model 12 can be changed, the same effect as the second embodiment can be exhibited. In particular, in the third embodiment, a first position 262 and a second position 264 to which the skeletal model 12 can be fixed are set in advance, and the user can select either the first position 262 or the second position 264. , the distance between the insertion hole 188 (elastic wall member 90) and the skeletal model 12 need not be finely set, and the skeletal model 12 can be more easily fixed to the water tank 14. be able to.

Although the embodiments of the present invention have been described above, the present invention is not to be construed as being limited by the specific descriptions in such embodiments, and various changes, modifications, improvements, etc. based on the knowledge of those skilled in the art. It is possible to implement in a mode in which

For example, in the above-described embodiment, the elastic wall member 90 is provided on the right vertical wall portion 28 of the peripheral wall portion 26, but instead of or in addition to the right vertical wall portion, the elastic wall member 90 may A resilient wall member may be provided on the wall. In the above-described embodiment, the elastic wall member 90 is provided on the right vertical wall portion 28, which is one of the four vertical wall portions 28. An elastic wall member may be provided across one or more vertical wall portions. That is, for example, the elastic wall member may be provided over the entire opening 50 (the upper opening 22 and the opening 48) of the water tub 14 in the above embodiment. In this case, the condition of the blinds, in other words, the operation of the endoscope cannot be visually confirmed from above, and the training is conducted only with the images acquired from the endoscope through the monitor. We can provide a training device for people. Furthermore, in the above-described embodiment, the elastic wall member 90 is composed of one member, but may be composed of a plurality of members. and an endoscope may be inserted through the valve body.

In the above-described embodiment, the opening 48 is provided over the entire right vertical wall 28, but the opening covered by the elastic wall member is the peripheral wall (each vertical wall) or the upper wall. may be partially provided in That is, the opening may be provided with a size that does not interfere with the operation of the endoscope by the peripheral edge of the opening when the endoscope is moved by a large amount, such as hand-down. Further, in the case where any of the vertical wall portions has a window-like opening, it is preferable that the opening be widened downward from the upper end of the vertical wall portion. In addition, when the opening is partially provided in one wall, it is preferable that an edge-like abutting portion projecting toward the elastic wall member is provided at the peripheral edge of the opening. By providing such an edge-like contact portion, the sealing effect of the elastic wall member can be stably exhibited.

In the above-described embodiment, the upper rod 98 and the lower rod 100 are inserted through the upper and lower edge portions of the elastic wall member 90, respectively. It may be fixed, or it may be separate from the elastic wall member and fixed to the upper fixing member and the lower fixing member with the upper end side portion and the lower end side portion of the elastic wall member sandwiched. It may be.

The pressing mechanism that presses the elastic wall member from the outside is not limited to the modes described in the first embodiment and the second and third embodiments. As the pressing mechanism, for example, a screw mechanism, a cam mechanism, or the like may be used to continuously exert a pressing force with a simple operation, or a coil spring may be provided between the elastic wall member and the peripheral wall of the receiving tank. Alternatively, the elastic wall member may be pressed against the water tank by an elastic restoring force that accompanies the compressive deformation of the coil spring.

The positioning mechanism for positioning the water tank and the receiving tank in the horizontal direction is not limited to the aspect described in the above embodiment. For example, a substantially rectangular frame-shaped protrusion may be provided that protrudes upward from the bottom wall of the receiving tank and covers each water tank leg of the water tank from the outside. may be provided partially in the circumferential direction.

The connection means for holding the water tank and the receiving tank in an attached state is not limited to those using permanent magnets as described in the above embodiment. For example, as in the above embodiment, unevenness may be provided between the water tank leg and the bottom wall of the receiving tank, and these unevenness may be fitted in a press-fit state, or the claw protruding from the water tank may be the bottom of the receiving tank. It may be adapted to be hooked on a wall or peripheral wall.

Further, in the above-described embodiment, the elastic wall member 90 extends below the water surface of the specified amount of water 18 in the water tank 14, so that when the endoscope 16 is inserted, the endoscope 16 is exposed to the water without passing through an air layer. 18, but it is not limited to this mode. That is, even if the elastic wall member is provided only above the liquid level of the training liquid (water) in the water tank, for example, after inserting an endoscope (or a perforating member) into the elastic wall member, Depressing the scope (or piercing member) downward may allow the tip portion of the endoscope to be inserted into the training fluid.

Furthermore, in the above-described embodiment, the skeletal model 12 is fixed to the bracket 152, and the bracket 152 is fixed to the bottom wall portion 24 of the water tank 14 by the model support portions 61 and 210, but it is limited to this aspect. not a thing That is, the bracket is not essential, and the specific structure of the model support is not limited. The skeletal model may be fixed to the bottom wall of the water tank by providing these protrusions and recesses by press-fitting or engaging and fixing them. Note that the model supporting section does not need to be provided on the bottom wall of the water tank, but may be provided on the peripheral wall of the water tank, and the skeletal model may be fixed across both the bottom wall and the peripheral wall. .

Furthermore, in the second and third embodiments, the model position setting mechanisms 202 and 266 are provided for movably and fixedly setting the skeletal model 12 to a plurality of different positions inside the water tank 14. The method for changing the distance from the insertion hole to the skeleton model is not limited to the above mode. That is, while the position of the skeleton model is fixed, the wall of the water tank in which the endoscope insertion hole is provided may be moved to change the distance from the insertion hole to the skeleton model. In particular, by making it possible to change the position of the insertion hole in combination with the change of the position of the skeleton model, it is possible to adjust the distance from the insertion hole to the skeleton model over a larger distance.

Also, in the second embodiment, the base member 204 is movable in one direction (horizontal direction), but it may be movable in multiple directions. For example, a base plate to which the pair of guide rods 240, 240 in the second embodiment are fixed may be provided, and the base plate may be movably supported with respect to the bottom wall of the water tank by another pair of guide rods or the like. , the base member 204 can be moved in different directions together with the pair of guide rods 240, 240, thereby making it possible to move the base member 204, for example, in horizontal orthogonal two-axis directions (for example, left-right direction and front-back direction). may be

Furthermore, in the second embodiment, the outer peripheral portion of the guide rod 240 (the guide rod-side convex portion 250) and the inner peripheral portion of the guide hole 214 (the guide hole-side convex portion 238) mesh so as to overlap in the axial direction. Although the lock mechanism 208 is configured by the interlocking action, the specific structure of the lock mechanism is not limited. For example, by making the outer peripheral surface of the guide rod and the inner peripheral surface of the guide hole non-circular and substantially similar shapes corresponding to each other, while allowing movement at a specific relative position in the circumferential direction, from there to the guide hole By rotating the guide rods in the circumferential direction, the inner and outer peripheral surfaces may be pressed against each other in the radial direction so that the guide rods are engaged with each other, and a lock mechanism that prevents the movement of the base member by frictional force or the like is constructed. may be

Furthermore, in the second embodiment, the guide rod 240 is rotatable around the central axis. A non-rotatable guide rod may be employed, which also makes it possible to switch between fixing and moving the base member by relative rotation between the guide hole and the guide rod.

Furthermore, in the third embodiment, the skeletal model 12 can be fixed at two positions, the first position 262 and the second position 264, which are separated from each other in the left-right direction. By providing a plurality of supporting portions 61, the skeletal model may be fixed at three or more positions separated from each other in the lateral direction and/or the longitudinal direction in the water tank.

In addition, in the orthopedic technique training devices 10, 200, and 260 of the above embodiments, it is assumed that training for intervertebral disc herniation surgery is performed, and the skeletal model 12 imitates the lumbar vertebrae, but the present invention is not limited to this. That is, the orthopedic training apparatus according to the present invention is applicable to training for diseases related to bones in various parts of the human body or animals. A model can be adopted as appropriate. In addition, depending on the type of skeleton model and the technique, the skeleton model may be fixedly supported while being rotated in an arbitrary direction, in addition to being reversed front to back as in the above embodiment. In particular, by making it possible to rotate around the vertical line, it becomes easy to change the horizontal direction of the skeletal model while aligning the vertical direction of the bones in the actual procedure with the vertical direction of the skeletal model. more suitable.

10 Orthopedic Technique Training Apparatus (First Embodiment)
12 skeletal model 14 water tank 16 endoscope 18 water (liquid for training)
20 Apparatus main body 22 Upper opening 24 Bottom wall 26 Peripheral wall 28, 28a, 28b, 28c Vertical wall 30 Upper wall 32 Through hole 34 Valve body 36 Thin portion 40 Upper wall holding portion 42 Mounting portion 46 Wall 48 Opening portion 50 Opening 52 Edge-shaped abutting portion 54 Upper fixing member 56 Upper supporting recess 57 Retaining member 58 Lower fixing member 60 Lower supporting recess 61 Model supporting portion 62 First fixing portion 64 Second fixing portion 66 First fixing groove 68 Rotating member 70 Pressing portion 72 Knob portion 74 Lever member 76 Accommodating groove 78 Water tank leg portion 80 Positioning concave portion 82 Permanent magnet 84 Through hole 86 Water tank drain port 88 Water tank port member 89 Tube 90 Elastic wall member 92 Right flat portion 94 Above Flat portion 96 Curved wall portion 98 Upper rod 100 Lower rod 102 Grip portion 104 Mounting recess 106 Receiving tank 108 Pressing mechanism 110 Bottom wall 112 Peripheral wall 114 Receiving tank leg 116 Through hole 118 Receiving tank drain port 120 Receiving tank port member 122 Tube 124 Positioning protrusion 126 Permanent magnet 127 Positioning mechanism 128 Connecting means 129 Screw hole 130 Pressing plate 132 Screw 134 Knob 136 Tightening part 138 Concave part 140, 142 Intervertebral disc 144 Gap 146 Nerve model 146a Part 146b imitating cauda equina nerve Part 148 imitating nerve root Internal part Object 150 Coating layer 152 Bracket 154 Pin hole 156 Engagement protrusion 158 Main body 160 First lumen 162 Second lumen 164 Third lumen 166 Suction port 168 Discharge port 170 Camera 172 Slit 174 Valve 176 Suction tube 178 Discharge tube 180 Cable 182 Connector 184 Dilator (perforated member)
186 sheath (piercing member)
188 insertion hole 200 orthopedic training device (second embodiment)
202 model position setting mechanism 204 base member 206 guide mechanism 208 lock mechanism 210 model support portion 212 mounting portion 214 guide hole 216 upper openings 217a, 217b wall portions 218, 220 fixing groove 222 drain hole 223 opening portion 224 bracket fixing mechanism 226 spring Portion 228 Protruding tip portion 230 Rearward protruding portion 232 Fixed switching portion 234 Knob portion 236 Contact portion 238 Guide hole side convex portion (convex portion)
240 Guide rod 242 Fixed member 244 Lever portion 246 Core rod 248 Flat surface 250 Guide rod side convex portion (convex portion)
252 recess 254 pressing mechanism 256 pressing member 260 orthopedic training device (third embodiment)
262 First position 264 Second position 266 Model positioning mechanism L3 Third lumbar L4 Fourth lumbar L5 Fifth lumbar

Claims (25)

1. a water tank containing a training liquid;
   a model support for positioning and supporting a skeletal model for training inside the water tank;
   An orthopedic technique training device, comprising: an elastic wall member that constitutes at least a part of the wall of the water tank and is made of an elastic material through which an endoscope can be inserted.
2. In the elastic wall member,
   2. The piercing member according to claim 1, wherein the piercing member allows the insertion hole for the endoscope to be formed, and the piercing member is pulled out to close the insertion hole based on the elasticity of the elastic wall member itself. Orthopedic training device.
3. The elastic wall member constitutes at least a part of the peripheral wall of the water tank, and
   3. The orthopedic training apparatus according to claim 1, wherein the upper portion of said elastic wall member is a curved wall portion that curves and extends inwardly so as to cover the upper opening of said water tank.
4. 3. The peripheral wall of the water tank has a rectangular cylindrical shape with four flat vertical walls as a whole, and the elastic wall member is arranged in an opening provided in at least one of the vertical walls. 3. The orthopedic training device according to 3.
5. The elastic wall member is in the form of a rectangular sheet, and the upper edge and the lower edge of the elastic wall member are fixedly attached to the water tank so that the elastic wall member is attached in a state of tension in the vertical direction. has been
   In such an attached state, both widthwise side portions of the elastic wall member are pressed against the edge-like abutting portions that are convex toward the opening side on both widthwise side portions of the opening portion to be sealed. Item 5. The orthopedic training device according to item 4.
6. an upper rod is attached to the upper edge of the elastic wall member and a lower rod is attached to the lower edge of the elastic wall member;
   6. The orthopedic training device according to claim 5, wherein the elastic wall member is attached in a vertically tensioned state by detachably fixing the upper rod and the lower rod to the water tank.
7. The opening is formed over the entire width of one vertical wall,
   The edge-like abutment portions against which the widthwise side portions of the elastic wall member are pressed are formed by the edge portions of the vertical wall portions on both sides located on both sides of the one vertical wall portion in the circumferential direction. The plastic surgery training device according to claim 5 or 6.
8. 8. A pressing mechanism is provided for pressing the outer peripheral portion of the elastic wall member from the outside at least a part of the portion that overlaps the vertical wall portion and is sealed in a contact state. The orthopedic procedure training device according to any one of claims 1 to 3.
9. A separate receiving tank having an upward opening larger than the circumference of the outer periphery of the water tank is disposed below the water tank. 9. The orthopedic training device according to claim 8, wherein the pressing mechanism for pressing from is provided.
10. The orthopedic technique training device according to claim 9, wherein the pressing mechanism includes a block-shaped pressing member made of an elastic material.
11. In the elastic wall member,
    The orthopedic surgery training device according to any one of claims 1 to 10, wherein a visible position marker indicating a planned insertion position of the endoscope can be displayed.
12. Claims 1 to 4, wherein a specified water level necessary for immersing the skeleton model in water is set in the water tank, and a region of the water tank below the specified water level is composed of the elastic wall member. 12. The orthopedic training device according to any one of 11.
13. The water tank includes a vertical wall portion forming a peripheral wall portion and an upper wall portion covering an upper opening,
    The orthopedic training device according to any one of claims 1 to 12, wherein the vertical wall portion and the upper wall portion are transparent.
14. The wall portion of the water tank is provided with an insertion hole for the endoscope,
    a model position setting mechanism for movably and fixedly setting the skeletal model to a plurality of different positions inside the water tank;
    The orthopedic surgery training device according to any one of claims 1 to 13, wherein the distance from the insertion hole to the skeletal model can be changed by moving the skeletal model.
15. A base member to which the skeletal model is attachable and detachable is arranged inside the water tank, and
    wherein the model position setting mechanism includes a guide mechanism for horizontally movably guiding the base member, and a lock mechanism for positioning the base member at a plurality of positions in the movement direction of the guide mechanism. Item 15. The orthopedic training device according to Item 14.
16. The guide mechanism includes a guide rod and a guide hole provided in the base member and through which the guide rod is inserted,
    As the guide rod and the guide hole rotate relative to each other around the central axis, the outer peripheral portion of the guide rod and the inner peripheral portion of the guide hole engage with each other. 16. The orthopedic training device according to claim 15, wherein the lock mechanism is configured by preventing the movement of the base member in the axial direction of .
17. In the lock mechanism, protrusions extending in the circumferential direction are formed on the outer peripheral surface of the guide rod and the inner peripheral surface of the guide hole, respectively. 17. The orthopedic procedure according to claim 16, wherein the occlusion action is exerted by engaging the convex portion on the guide rod side and the convex portion on the guide hole side so as to overlap in the axial direction. training device.
18. A water tank is provided in which a training liquid is stored and a skeletal model for training can be placed in the liquid in an immersed state, and an endoscope is inserted from the outside of the water tank to train a treatment procedure for the skeletal model. In the orthopedic training device,
    An orthopedic training device, wherein a separate receiving tank is arranged below the water tank, and an upward opening in the receiving tank is made larger than the circumference of the outer circumference of the water tank.
19. The water tank is detachable from the receiving tank,
    19. The orthopedic training apparatus according to claim 18, further comprising a positioning mechanism for relatively positioning the water tank and the receiving tank in the horizontal direction.
20. The orthopedic surgery training device according to claim 18 or 19, wherein the volume of liquid that can be stored in the receiving tank is equal to or greater than a prescribed volume of liquid that is stored in the water tank during training.
21. The water tank is provided with a water tank drain port that can be opened and closed, and the water tank drain port is positioned as an opening in the receiving tank,
    The orthopedic training apparatus according to any one of claims 18 to 20, wherein the receiving tank is also provided with an openable/closable receiving tank drainage port.
22. The orthopedic technique training device according to any one of claims 18 to 21, wherein the endoscope can be inserted into the vertical wall portion forming the peripheral wall portion of the water tank.
23. The orthopedic technique training apparatus according to claim 22, wherein a position where the endoscope can be inserted in the vertical wall portion of the water tank is set below a prescribed water level for training.
24. The orthopedic technique training apparatus according to any one of claims 18 to 23, further comprising connecting means for restricting detachment of the water tank and the receiving tank and holding the receiving tank in a state of being attached to the water tank. .
25. The orthopedic training device according to claim 24, wherein the connecting means is constructed using a permanent magnet.

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