CN202694651U - 一种腹腔镜手术穿刺操作训练器 - Google Patents
一种腹腔镜手术穿刺操作训练器 Download PDFInfo
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Abstract
本实用新型涉及医疗技能培训技术领域，是一种应用于临床教学中腹腔镜技术操作训练的腹腔镜手术穿刺操作训练器。由外支撑罩(1)、腹部组织(2)、内脏器官(3)组成。外支撑罩(1)由圆弧形空心外罩(1.1)和长方体底座(1.3)组成，前后封闭，中央区有六个预设穿刺孔，根据训练需要选择使用成三角形分布的任意三个孔，分别置入观察镜(4)和腹腔镜手术器械(5)，一侧底边设有两个活页(1.3)，用以连接底座(1.2)，腹部组织(2)贴附于圆弧形空心外罩(1.1)内表面，由模拟皮肤(2.1)，肌肉(2.2)，腹膜外脂肪(2.3)和腹膜(2.4)组成。内脏器官(3)位于圆弧形空心外罩(1.1)内，置于长方体底座(1.3)上。本实用新型结构简单，操作简便，模拟性强，训练流程简单，成本低，使住院医师或初学腹腔镜医师腹腔镜基础训练规模化，常态化成为可能。
Description
技术领域
本实用新型涉及医疗技能培训技术领域，是一种应用于临床教学中腹腔镜技术操作训练的训练器。
背景技术
1987年法国里昂的Phillip Mouret完成了世界首例腹腔镜胆囊切除术，随即在世界范围内迅速得到推广和普及。腹腔镜作为微创外科技术的巨大进展，它具有美容，术后疼痛轻，手术创伤轻，内环境干扰轻微，住院时间短，极少发生切口疝等优点。如今腹腔镜技术已被广泛应用于临床的各种微创手术，如腹腔脏器活检术，肝脏、肾脏囊肿破顶减压术，胆囊、阑尾切除术等，往往采用腹腔镜技术。腹腔镜技术通常需在腹壁打3～5个直径为5～20mm的孔，在孔内安置套管，套管分别用于置入内窥镜进行观察，置入各种手术器械进行操作。但腹腔镜手术与开腹手术还是有明显差别，它与传统的开放手术完全不同，临床上即使很有经验的手术医师，如果没有经过培训不可能开展这一手术。腹腔镜作为一种新型手术器械，需要术者通过二维监视器而感知三维空间深度及方向感觉，此种操作需通过专门训练而逐步培养。尤其在泌尿外科腹腔镜应用中，有很多与肾脏有关的手术需要建立腹腔镜下腹膜外手术入路，又有许多普外科手术如胆囊切除术等需建立腹腔镜下腹膜内手术入路。在临床实际操作过程中，初学腹腔镜的医生往往在用trocar(套管针)穿刺建立手术入路时由于技术不熟练，用力不均，经验不足，会出现穿到腹膜内或穿到肌肉组织内，伤及腹腔内脏器官，腹腔内血管神经，造成器官损伤，肌肉损伤，大出血等意外情况。为避免出现这种情况或由不当操作引起的其它并发症，国内外医学院校在临床教学中，使用了多种训练模式和模拟训练器，反光镜简易黑箱训练器、腹腔镜 黑箱训练器、计算机仿真训练器以及方位操作训练、综合操作训练、动物实验操作训练等。但这些训练方法主要存在以下两个大问题：一是使用简易训练器和训练方法缺乏对腹部解剖学层次的模拟或模拟程度不精细。腹部解剖学结构层次主要分皮肤，肌肉，腹膜外脂肪和腹膜四层，而大多数简易训练器以一层较厚的软材料代替。二是使用计算机仿真训练器，动物实验操作训练等较高级的训练方法，这类方法主要问题在于训练成本太高，训练设备昂贵且此类设备大多由国外生产，训练过程繁琐在国内医学院校中普及难度较大。且由于住院医师绝大多数是第一次接触腹腔镜手术训练，基础欠缺，开展此类训练适应周期长。目前在国内的住院医师或初学腹腔镜的医师培训中，尚缺乏一种腹部解剖学层次精细模拟，训练方法简便，训练成本低，价格便宜能够普遍应用的腹腔镜穿刺手术操作训练器。
发明内容
本实用新型的目的是提供一种能够较好模拟腹部解剖学层次，训练方法简便，训练成本低，价格便宜且易于推广应用的腹腔镜手术穿刺操作训练器。
本实用新型由外支撑罩、腹部组织、内脏器官组成，外支撑罩由钢化玻璃制成，主要起固定腹部组织，形成腹腔的作用，以免在穿刺腹壁时造成腹部组织向内部塌陷，外支撑罩通过一侧底边上的两个活页与底座连接，可以使外支撑罩打开和关闭，以方便取放里面的物品，外支撑罩上预设六个穿刺孔，根据训练需要选择使用成三角形分布的任意三个孔，腹部组织由四层海绵构成，由外至内依次模拟皮肤层，肌肉层，腹膜外脂肪层和腹膜层，腹部组织与外支撑罩呈相同的弧度并贴附于外支撑罩内表面；内脏器官由软质材料如橡胶软管，气球等组成，意在模拟腹腔内脏器官，置于长方体底座上，与人体器官比例相同，形状相近，模拟性强，底座由厚塑料板制成，与外支撑罩通过活页连接在一起构 成密闭腹腔模型。
使用时在六个预设穿刺孔中选择手术所需的呈三角形分布的任意三个开孔，之后在其中一个开孔上用手术刀依次切开分离皮肤层、肌肉层、腹膜外脂肪层三层组织，然后用套管针小心穿刺腹膜，取出套管内芯，将观察镜沿套管放入腹腔；另外两个穿刺孔在观察镜的监视下进行穿刺操作，套管针穿刺完成后，置入相应腹腔镜手术器械；在套管针穿刺和插入过程中，如伤及内脏及其它组织，可在观察镜下看到或使气球模拟的内脏爆裂，提醒手术产生损伤，达到训练目的。
本实用新型结构简单，操作简便，模拟性强，训练流程简单，成本低，使住院医师或初学腹腔镜医师腹腔镜基础训练规模化，常态化成为可能。
附图说明
图1为本实用新型的内部结构图。
图2为本实用新型的局部视图。
图3为本实用新型的装配图。
图4为本实用新型的结构图。
图5为本实用新型的使用情况模拟图。
图6为本实用新型的俯视图。
图7为本实用新型的A-A剖视图。
具体实施方式
现结合附图和实施例对本实用新型作详细描述。
本实用新型由外支撑罩1、腹部组织2、内脏器官3以及底座4组成。外支撑罩1由圆弧形空心外罩1.1和长方体底座1.3组成，前后封闭，中央预设穿 刺区上有六个开孔，根据训练需要选择使用成三角排列的三个孔，分别置入观察镜4和腹腔镜手术器械5，一侧底边设有两个活页1.3，用以连接底座1.2，腹部组织2贴附于圆弧形空心外罩1.1内表面，由模拟皮肤2.1，肌肉2.2，腹膜外脂肪2.3和腹膜2.4组成。内脏器官3位于圆弧形空心外罩1.1内，置于长方体底座1.3上。
实施例1.一种模拟经人体腹部进行阑尾切除术的腹腔镜穿刺训练器
本实用新型的圆弧形空心外罩1.1由钢化玻璃制成，横切面半圆直径20cm，纵切面长方形长为40cm，宽为10cm，活页1.3为钢制，长5cm，底座1.2由厚塑料板或木板制成，长约45cm，宽约25cm，、通过活页1.3和圆弧形空心外罩1.1相连，腹部组织2为长方形，长40cm，宽为62cm，由密度较小海绵制成的模拟皮肤2.1，腹膜外脂肪2.3，密度较大海绵制成的模拟肌肉2.2，模拟腹膜2.4组成，贴附于圆弧形空心外罩1.1内表面，模拟阑尾和内脏器官，内脏组织3可由橡胶软管，气球，泡沫等制成，位于圆弧形空心外罩1.1内，置于长方体底座1.3上。
本实用新型可根据各医学院校训练实际情况设计成不同规格。
Claims (1)
1.一种腹腔镜手术穿刺操作训练器，其特征在于由外支撑罩(1)、腹部组织(2)、内脏器官(3)组成，外支撑罩(1)由圆弧形空心外罩(1.1)和长方体底座(1.3)组成，前后封闭，中央区有六个预设穿刺孔，根据训练需要选择使用成三角形分布的任意三个孔，分别置入观察镜(4)和腹腔镜手术器械(5)，腹部组织(2)贴附于圆弧形空心外罩(1.1)内表面，由模拟皮肤(2.1)，肌肉(2.2)，腹膜外脂肪(2.3)和腹膜(2.4)组成，可精细模拟人体腹部解剖学层次；内脏器官(3)位于圆弧形空心外罩(1.1)内，置于长方体底座(1.3)上，与人体器官比例相同，形状相近，模拟性强。
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