CN110767058A - Micromanipulation space limiter - Google Patents

Abstract

The invention discloses a micromanipulation space limiter, and belongs to the technical field of medical instruments. A micromanipulation space limiter comprises a base and at least 2 baffles; the base is provided with an operation plane, the operation plane is provided with at least 2 sliding chutes penetrating through the plane of the baffle, and the edge position below the operation plane is fixedly connected with a supporting seat; the baffle has a main part face, and main part face below fixedly connected with at least one connecting rod, the width less than or equal to the width of spout of connecting rod, fastener of below fixed connection of connecting rod, the width of fastener is greater than the width of connecting rod, the height of connecting rod is greater than operating plane's thickness. The invention has the advantages that: simple structure, the baffle can be dismantled, can make up wantonly, can adjust the position, can simulate out operation space of different shapes, size, and help training person promotes the operation level step by step, improves training efficiency, makes the simulation training press close to true operation, lets the doctor improve operation skill safely.

Description

Micromanipulation space limiter

technical field

The invention relates to a micro-operation space limiter, relates to surgical skill training equipment, and belongs to the technical field of medical instruments.

Background technique

Since the 1950s, the rapid development of microsurgery equipment and instruments represented by operating microscopes has promoted the gradual maturity of microsurgery and has become an important milestone in the history of modern surgical development, marking that surgery has entered a new development. stage. Subsequently, microsurgical techniques were widely popularized all over the world. A number of disciplines such as neurosurgery, ophthalmology, otolaryngology, and plastic surgery developed microsurgical techniques, which led to revolutionary changes in the treatment of related diseases and significantly improved prognosis. Complications and mortality were significantly reduced. Compared with the traditional surgical technique under the naked eye, microneurosurgery technology can magnify the surgical field by 5 to 20 times through the microscope, the lesions are clearly displayed, and the operation under the microscope is more precise and accurate. While the lesions are removed to a certain extent, the normal nerve structure is preserved as completely as possible, and the iatrogenic surgical trauma is reduced to a minimum. It can be said that microsurgery has become a technique that surgeons must master.

Microsurgical technology is very important, but it is not easy to master this technology. It requires not only solid anatomical knowledge, but also skilled operating skills under the microscope and good psychological quality. At the current stage of my country's medical education and training model, whether in the postgraduate training stage or in the standardized training stage for resident physicians, medical students have limited exposure to microsurgery, less understanding of microscopic equipment, unfamiliar operations, and lack of coordination. There is a lack of basic understanding of the potential iatrogenic injury that may occur; and newly graduated medical students and even young physicians with limited clinical work experience often lack standardized and systematic training for this skill, which greatly affects their relationship with senior surgeons. It affects the quality and efficiency of the operation, and may even cause serious complications to the patient. It can be seen that the traditional clinical skills teaching methods have been difficult to meet the teaching requirements.

Learning and practicing clinical skills on patients exposes more and more difficulties and drawbacks, and medical simulation teaching plays an increasingly important role in clinical skills training. Microsurgery is a delicate and complex discipline, which is widely used in neurosurgery, ophthalmology, plastic surgery, hand surgery, oral and maxillofacial and other fields. It requires high operating skills. Only through repeated practical training, to truly master this technique. Simulation training has also been paid more and more attention. Major medical units have established microsurgery training laboratories and formulated training plans, so that doctors can receive a lot of training before performing operations, and gradually master microsurgery techniques. Be well prepared for surgery. For example, the simulation training course in neurosurgery includes many contents such as newspaper lettering training under microscope, rubber finger training, silicone tube training, anatomical separation of mouse blood vessels and nerves, and end-to-end anastomosis of mouse abdominal aorta. This simulation teaching method has also achieved good results, and doctors' microsurgery skills have been significantly improved.

However, simulation training also has its limitations. Some doctors perform well in the training process, but still cannot perform micromanipulation proficiently in actual surgery. The important reason is that it is impossible to simulate the whole clinical process in simulation teaching, there is no completely real clinical effect, and it is affected by the quality of training equipment and products, and sometimes the effect of clinical teaching is affected by the designer's ill-conceived consideration. Simulation teaching focuses on training students in standardized operations or the evolution of the disease and its typical treatment procedures. There is a big difference between the operation training of puncture, incision and suture, and rescue on the model and the operation on the human body. In order to improve the effect of simulation training, it is necessary to simulate the actual effect closer to the clinic, such as improving the simulation training equipment and using standardized patients.

The inventor has conducted several trainings on micromanipulation and tested the trainees. Most trainees can meet the training requirements and complete the test. However, according to follow-up reports, many students with excellent tests are still unable to successfully complete microsurgery, especially in deep tissue manipulations. There are many reasons for the analysis: insufficient training time, training methods need to be improved, the simulation effect is far from the actual situation, etc. One of the important reasons is that the training equipment fails to simulate the actual surgical effect. We analyzed the simulation training through the doctor's questionnaire. One of the most frequently reported problems is that the operation space between the simulation training of micro-operation and the actual operation is quite different.

The practical operating space of many microsurgeries is very small. Taking neurotumorectomy as an example, the tumor can grow deep in the brain or spinal cord. After the tumor is exposed, a deep "canyon" is formed by the skin edge, skull edge, meninges and normal nerve tissue, and the tumor grows at the bottom of the valley. Tumor resection has to operate in this small space (Figure 1). Moreover, the outer edge of the tumor is normal nerve tissue, which doctors need to protect as much as possible, which further restricts the operating space. Surgical instruments such as microscissors and micro tweezers need to be lengthened, and the difficulty of the operation can be imagined. However, the operation space of the current micromanipulation simulation training is open without any blockage, and the operator can use microscopic scissors, needle holders, bipolar coagulation and other instruments to operate without restrictions, which results in simulation training and real Surgery makes a huge difference. The doctor completed the training task well during the simulation training, but when it came to the actual operation, he found that the operation he was used to during the practice could not be completed at all, which caused difficulty in completing the operation.

In order to better simulate real surgery, we need to create a small space for real surgery during micromanipulation training. If there is a kind of equipment that can well create a small space for surgical operations and can adjust different levels of difficulty, then the simulation training can be made more realistic and the training efficiency can be greatly improved. Through a literature search, we found no studies in this area. Previous studies have mainly used live animals or human specimens to make simulation training more realistic. Using animal or human specimens for practice can get a more realistic operating experience. However, human specimens and live animals are scarce, expensive, and difficult to store and handle, making it difficult to popularize and use. scientific research. It can be said that there is currently a lack of a simple and effective training equipment that can simulate the operation space close to the real operation.

SUMMARY OF THE INVENTION

The technical problem to be solved by the present invention is to provide a micro-operation space limiter capable of simulating a narrow space of real surgery, so that the training difficulty of the user can be adjusted and the training level of the trainer can be improved.

In order to achieve the above objects, the present invention adopts the following technical solutions.

Micromanipulation space limiter, consisting of a base and at least 2 baffles, the baffles can slide and/or rotate within the chute on the base;

The base has an operating plane, on which there are at least two chutes penetrating the baffle plane, and a support seat is fixedly connected to the lower edge of the operating plane, so that there is a certain height space below the operating platform; the function of the chutes is to So that the baffle can be composed of different spaces;

The baffle has a main body surface, at least one connecting rod is fixedly connected below the main body surface, the width of the connecting rod is less than or equal to the width of the chute, and a clip is fixedly connected below the connecting rod, and the width of the clip is greater than the width of the connecting rod, connecting The height of the rod is greater than the thickness of the operating plane of the base.

The operation plane is a geometric shape, including a regular geometric shape or an irregular geometric shape, and the regular geometric shape includes but is not limited to a rectangle, a circle, an ellipse, a regular polygon, and the like.

The operating plane of the base and the support base may be fixedly connected, such as bonded or integrally formed connection, or may be detachable connection. When the two are detachably connected, the corresponding connection parts of the two are also provided with a structure for detachable connection, including but not limited to a slot, a buckle, an internal threaded hole, an external spiral structure, and the like.

A restraining member is also fixedly connected to the base. The composition and structure of the restraint is the same as that of the animal anatomy board, for example, it includes an animal head fixing column and 4 animal limb fixing posts, and fixing holes are opened on the animal limb fixing posts; the animal limb fixing posts can also be replaced with fixed folder. Constraints belong to the prior art. The invention adds restraint parts on the basic structure, which can be used to fix experimental animals, so that it can be used as a micro-operation dissection table and an operation table, and the scope of application is wider.

The main body surface of the baffle, the connecting rods, and the clips may be fixedly connected, such as bonding or integrally formed connection, or may be detachable connection. When three or two of them are detachable connections, the corresponding connection parts shall be provided with structures for detachable connection, including but not limited to slots and buckles, or nuts and screws, etc. For example, the main body surface and the connecting rod are integrally formed and connected, the lower part of the connecting rod is provided with an external helical structure (similar to a screw), and the clip is provided with a penetrating or non-penetrating internal threaded hole (similar to a nut), which can connect the connecting rod The bottom is screwed and fixed with the clip, and the position can also be adjusted through the thread, and the length of the connecting rod in the chute can be adjusted, so that the baffle is more firmly fixed on the support plane.

Preferably, the main body surface, the connecting rod and the clip of the baffle are integrally formed and connected. This structure is the simplest, easy to process, and easy to use, without losing parts.

The support base is a rectangular parallelepiped and is located at two corresponding edge positions below the operation plane, or at four edge positions below the operation plane. Its function is to make the bottom of the operation plane form a certain distance from the desktop on which the micromanipulation space limiter is placed. move within. Except for the rectangular parallelepiped, any geometrically shaped component that can play a supporting role can be used as a support seat, and its position layout is a conventional position layout, for example, at the four edges of the operation plane, the three parts below the operation plane that can form a virtual triangle position of a vertex.

The height of the support base is 1-5 cm, preferably 1.5 cm.

The chute is a straight line, an arc line, a curved line, and a line formed by intersecting them. There can be multiple different line shapes on an operation plane, they can intersect or not. By combining the baffles with different line shapes and positions, a variety of simulated surgical operation space shapes can be formed.

The width of the chute is 0.5-2 cm, preferably 1.0 cm. The chute is used to accommodate the connecting rod of the baffle, and the preferred width is slightly wider than the connecting rod of the baffle.

The main surface of the baffle is a plane, an arc surface, a curved surface or a surface obtained by any combination thereof. A variety of different faces can be enclosed into simple or complex shapes, which is convenient to increase the difficulty of training from easy to difficult.

The height of the baffle is 2cm-10cm, preferably 4cm, 6cm, 8cm, and the width is 10cm-20cm, preferably 15cm. The higher the height of the baffle, the smaller the inclination angle of the corresponding limiting space, and the more difficult it is for the operator to operate the practical medical device in the space from above. In training, in order to improve the skills of the trainers, training methods that exceed the difficulty of conventional surgery can be used to improve the skills and adaptability of their operations.

The width of the connecting rod is 0.5-1.8 cm, preferably 1.0 cm. The connecting rod should have a certain supporting force, and at the same time form an effective connection with the clip below, so it should not be too thin or too thick.

The clip may be a geometrical structure integrally formed with the connecting rod, such as a cuboid, prism, umbrella, prism, etc., or a connecting nut, butterfly nut, etc., which can be detached from the connecting rod.

The use method of the present invention is as follows: when in use, the baffles are inserted into the chute on the base, and the trainer operates between the baffles. The baffle can slide on the base to simulate different spaces and cause different operation difficulties.

Since the size and shape of the operating space in different clinical operations are different, an ideal space limiter should also be able to simulate spaces of different shapes and sizes, and the space limiter is not easy to have too many parts and is easy to install. The present invention completely solves the problem. this key issue.

In addition, the ideal material for the space limiter should be light, firm, long in service life, easy to manufacture, and inexpensive. The materials that can be selected in the present invention include but are not limited to plastic, bakelite, metal and other materials.

The advantages of the invention are as follows: the micromanipulation space limiter is simple in structure and reasonable in structure, the baffle is detachable, can be combined arbitrarily, and the position can be adjusted, which is convenient for disassembly and installation, and can simulate spaces of different shapes and sizes, and the actual operation is convenient and thus Obtain different limit spaces, so it can adjust the training difficulty of the user, simulate the real surgical space, and help the trainer to improve the operation level step by step. The invention improves the traditional micromanipulation training method for medical students and doctors, improves the training efficiency, and makes the simulation training more close to the real operation, so that the doctor can safely improve the surgical skills, thereby reducing the surgical complications and ultimately benefiting the patients. The invention is suitable for use in all departments, colleges and educational institutions with microscopic training conditions, and has wide application prospects.

Description of drawings

The specific embodiments of the present invention will be described in further detail below with reference to the accompanying drawings.

Fig. 1 shows the microscopic resection of a spinal cord tumor in the prior art. The operation space is narrow, and only extended surgical instruments can be used, which is difficult to operate.

2A is a perspective view of the base of Embodiment 1

FIG. 2B is a top view of the base of Embodiment 1

2C is a bottom view of the base of Embodiment 1

FIG. 3A is a perspective view of the first type of baffle

3B is a perspective view of a second type of baffle

3C is a perspective view of a third type of baffle

Figure 3D is a perspective view of the fourth type of baffle

3E is a perspective view of the fifth baffle

Figure 3F is a perspective view of the sixth type of baffle

FIG. 4 is a reference diagram of the use state of Embodiment 1

5A is a perspective view of the base of Example 2, with restraints for fixing experimental animals

FIG. 5B is a bottom view of the base of Example 2

FIG. 6 is a top view of the base of Embodiment 3, and a base is provided with multiple groups of chutes

The marks in the figure are as follows: 1- base, 11- operation plane, 12- chute, 13- support base, 2- baffle plate, 21- main body surface, 22- connecting rod, 221- external thread, 23- clip, 231-internal thread, 3-animal head fixation post, 31-base of animal head fixation post, 4-animal limb fixation post, 41-fixation hole, 42-base of animal limb fixation post

Detailed ways

Example 1

2A-2C, 3A-3D:

A micromanipulation space limiter, consisting of a base (1) and baffle plates (2) with four specifications;

The base (1) has a rectangular operating plane (11), and four sliding grooves (12) penetrating the operating plane (11) are provided on the operating plane (11), and the bottom of the operating plane (11) is at two opposite side edge positions Each of them is integrally formed and connected with a support seat (13) in the shape of a rectangular parallelepiped. The length of the operation plane is 30cm, the width is 20cm, and the thickness is 1.5cm; the length of the support base is 20cm, the width is 2.0cm, and the height is 1.5cm.

The chute (12) is four symmetrically arranged criss-cross linear chute. Each cross-shaped chute is composed of a long straight line and a short straight line intersecting vertically. The length of the long straight line is 11.1cm and the width is 1.05cm. The length of the short straight line is 6.65cm and the width is 1.05cm. One end outside the position is 1.0cm, and the other end is 9.05cm. The intersecting positions of the four chutes are all located in the middle of the operation plane (11), forming the four end points of a square. The distance between the long sides of the adjacent two groups of chutes is 2.6 cm, and the distance between the short sides is 0.6 cm. cm.

The baffle plate (2) has a main body surface (21), and two parallel connecting rods (22) are fixedly connected under the main body surface (21), and each connecting rod (22) is 1.55 cm in height and 0.9 cm in width, The thickness is 1.0cm, the two link rods are located in the middle of the baffle (2), and the width between them is 2.65cm.

A cuboid-shaped clip (23) is fixedly connected to the lower part of the connecting rod (22). The clip (23) has a width of 2.8 cm, a height of 1.0 cm and a thickness of 1.0 cm. The clip (23) is wider than the connecting rod. The width of (22), the height of the connecting rod (22) is 1.55cm, which is slightly larger than the thickness (1.0cm) of the base operating plane (11). The main body surface (21), the connecting rod (22) and the clip (23) of the baffle are integrally formed and connected. The surface of the main body (21) of the baffle is a flat surface (FIG. 3A-FIG. 3C) or an arc surface (FIG. 3D). The main surface (21) of the baffle plate (2) has different sizes, with a length of 15.5 cm, a width of 1.0 cm, and a height of 4 cm (Fig. 3A), 6 cm (Fig. 3B), and 8 cm (Fig. 3C). Four different shapes and specifications of baffles can realize spaces with different operation difficulties, and can be combined arbitrarily between them. In this embodiment, the number of baffles of each specification can be one or more. In the most simplified case, only two arc baffles as shown in FIG. 3D or one arc baffle and one plane baffle are used. Combined, you can form a closed training space.

In this embodiment, the main body surface (21), the connecting rod (22) and the clip (23) of the baffle are integrally formed and connected; the operating plane (11) of the base (1) is integrally formed and connected to the support seat (13) .

Referring to Fig. 4, when the present invention is in use, two long straight lines or two short straight lines on the same side are selected as slide rails, and 2-4 baffles (21) are selected as required, and the two clamps ( 23) and the connecting rod (22) are inserted downward into the cross position of the chute (12), and move the two connecting rods (22) to the required position in the chute, so that the baffle (2) is perpendicular to the base (1) the operating plane (11). Since there are two connecting rods under each baffle, after the position is fixed, the main body surface is relatively stable, and it is not easy to move back and forth, left and right. After one baffle is installed, other baffles and corresponding slide rails are selected to perform the same operation, so that multiple baffles (21) form or enclose a narrow space required for training. The trainer uses surgical instruments to perform simulated surgical operation training between the spaces enclosed by the baffles (21). By applying external force, the baffle plate (2) can move arbitrarily on the operation plane (11) of the base, simulating operation spaces of different sizes and training difficulties.

Example 2

Referring to Figure 3E and Figure 5A and Figure 5B, the difference from Embodiment 1 is:

A restraint for fixing the experimental animal is added on the base (1). The restraint includes an animal head fixing post (3) and four animal limb fixing posts (4). The animal limb fixing post (4) is provided with a fixing post (4). hole (41). The support seat (13) of the base is four cylinders, which are respectively fixedly connected under the four corners of the operation plane.

The animal head fixing post (3) is fixedly installed at one end of the longer central axis of the operation plane (11), and the animal limb fixing posts (4) are fixedly installed on the outer sides of the four chutes (12) respectively, forming a rectangular four an endpoint. On the operation plane (11), there are corresponding through holes for the animal head fixing column (3) and through holes for the animal limb fixing piles. Below the operation plane (see Fig. 5B ) are correspondingly provided with the animal head fixing holes. The end of the column (3) is detachably connected to the base (31) of the animal head fixing column and the base (42) of the animal limb fixing pile that is detachably and fixedly connected to the end of the animal limb fixing pile (4). The corresponding There may be a screw connection between the base and the end.

The main body surface (21) of the baffle plate (2) is a curved surface, which is a reverse combination of two arc surfaces, which can simulate a more complicated narrow operation space. The baffle plate (2) in the shape of a curved surface can further complicate the limited space and further increase the difficulty of the training of the micromanipulation operation. There is one connecting rod (22) and one clamping piece (23) below the baffle plate (2), and this structure makes it easier to move in the slide rail.

This embodiment can effectively fix the tissue of the experimental animal or living body, prevent the fixed object from sliding and displacement, simulate a more realistic surgical scene, and improve the difficulty of training.

Example 3

Referring to Figure 3F and Figure 6, the difference from Embodiment 1 is:

The operating plane (11) of the base (1) is provided with three groups of runners (12), the upper left runner is the same as that of the first embodiment, and the lower left runners (12) do not intersect, forming a bracket type; The lateral chute is composed of two groups of long straight lines and short straight lines that cross in the middle. There are multiple sets of chutes on the same plane, which can be combined to form a variety of trainings, so that multiple trainings of different difficulty can be carried out simultaneously or continuously on the same operating plane, and the training intensity can be increased.

The main body surface (21) of the baffle plate (2) is in the combined shape of a curved surface and a flat surface, the lower part of the main body surface is a flat surface, and the upper part integrally formed and connected with the flat surface is an arc surface that is curved to one side, which can block the line of sight from above and further increase the Difficulty of surgery. In this embodiment, the connecting rod (22) is cylindrical and is integrally connected with the main body surface (21). The upper part is an external helical structure (221), the clip (23) is a butterfly nut, and the middle is a screw hole (231) with an internal thread.

In this embodiment, the main body surface (21) of the baffle plate is integrally connected with the connecting rod (22), and the clip (23) is detachably connected with the connecting rod. When in use, first remove the butterfly nut, directly insert the connecting rod into the chute at the predetermined position, connect the butterfly nut to the connecting rod under the operating plane, and adjust the position of the nut until it is locked in the operation. Below the plane, it can play a very good fixing effect. In addition, the connecting rod is cylindrical, which can rotate the angle in the chute in the non-clamped state, adjust the direction, and can be directly inserted and unplugged without a butterfly nut during installation and disassembly, without having to move to the cross The position of the cross, so the operation also has certain advantages.

We selected trainees participating in residency training to complete a randomized controlled study to verify the effectiveness of the restrictor. The results of the investigation on the personal feelings of the trainees show that the present invention satisfies the training needs of the users well, and the skills of the users have been significantly improved during the training period.

The series of detailed descriptions listed above are only specific descriptions for the feasible embodiments of the present invention, and they are not used to limit the protection scope of the present invention. Those skilled in the art can design many other modifications and embodiments. , such modifications and implementations will fall within the scope and spirit of the principles disclosed herein. More particularly, various variations and modifications are possible in the component parts and/or arrangements of the subject combination arrangement within the scope of the present disclosure, drawings and claims. In addition to variations and modifications in the component parts and/or arrangements, other uses will also be apparent to those skilled in the art.

Claims (10)

1. A micromanipulation space limiter, comprising: the device comprises a base and at least 2 baffles, wherein the baffles can slide and/or rotate in a sliding groove on the base;

the base is provided with an operation plane, the operation plane is provided with at least 2 sliding chutes penetrating through the operation plane, and a supporting seat is fixedly connected below the operation plane;

the baffle has a main part face, and main part face below fixedly connected with at least one connecting rod, the width less than or equal to the width of spout of connecting rod, fastener of below fixed connection of connecting rod, the width of fastener is greater than the width of connecting rod, the height of connecting rod is greater than base operating plane's thickness.

2. A micromanipulation space limiter according to claim 1, wherein: the operating plane is a geometric shape, including a regular geometric shape or an irregular geometric shape, and the regular geometric shape includes but is not limited to a rectangle, a circle, an ellipse, a regular polygon, and the like.

3. A micromanipulation space limiter according to claim 1, wherein: the operation plane of the base is fixedly connected or detachably connected with the supporting seat, and the operation plane of the base is fixedly connected with the supporting seat by bonding or integral forming; when the two are detachably connected, the corresponding connection part of the two is also provided with a structure for detachable connection, including but not limited to a clamping groove, a buckle, an internal thread hole, an external spiral structure and the like.

4. A micromanipulation space limiter according to claim 1, wherein: and the base is also fixedly connected with a restraint piece.

5. A micromanipulation space limiter according to claim 1, wherein: the main body surface of the baffle, the connecting rod and the clamping piece are fixedly connected or detachably connected, and the fixed connection is bonding or integrally formed connection; when the three or two of them are detachably connected, the corresponding connecting portion should be provided with a structure for detachable connection, including but not limited to a slot and a buckle, or a nut and a screw.

6. A micromanipulation space limiter according to claim 1, wherein: the supporting seat is a cuboid and is positioned at two corresponding edge positions below the operating plane or at four edge positions below the operating plane; besides the cuboid, any geometric component capable of playing a supporting role can be used as a supporting seat, and the position layout of the supporting seat is the conventional position layout, for example, the supporting seat is positioned at four edges of an operation plane and at the position of three vertexes which can form a virtual triangle below the operation plane; the height of the support seat is 1-5cm, preferably 1.5 cm.

7. A micromanipulation space limiter according to claim 1, wherein: the sliding groove is a straight line, an arc line, a curve line and a line shape formed by intersecting the straight line, the arc line and the curve line.

8. A micromanipulation space limiter according to claim 1, wherein: the width of the sliding groove is 0.5-2cm, and preferably 1.0 cm.

9. A micromanipulation space limiter according to claim 1, wherein: the main body surface of the baffle is a plane, an arc surface, a curved surface or a surface obtained by any combination of the planes, the arc surfaces and the curved surfaces.

10. A micromanipulation space limiter according to claim 1, wherein: the height of the baffle is 2cm-10cm, preferably 4cm, 6cm and 8cm, and the width of the baffle is 10cm-20cm, preferably 15 cm;

the width of the connecting rod is 0.5-1.8cm, preferably 1.0 cm;

the fastener can be a structure with the geometry of connecting rod integrated into one piece, for example cuboid, prism, umbrella-type, prism etc. also can be with detachable connecting nut of connecting rod, butterfly nut etc..

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