JP2017053897A - Simulated blood vessel for training - Google Patents

Abstract

An object of the present invention is to provide a simulated blood vessel for training that can maintain texture similar to that of an actual blood vessel even under the same blood flow and pressure as in a living body. A simulated blood vessel for training (1) formed in a cylindrical shape, comprising an intimal layer (10), a media layer (20) arranged outside the intima layer (10), and a media layer (20) arranged outside the media layer (20). a first mesh layer 40 disposed between the intima layer 10 and the media layer 20; and a second mesh layer disposed between the media layer 20 and the adventitia layer 30. 50 and [Selection drawing] Fig. 2

Description

  The present invention relates to a training simulated blood vessel used for blood vessel incision training or the like.

Conventionally, procedures such as incision of blood vessels, anastomosis of incised portions, and anastomoses between blood vessels have been performed in surgical operations. In addition to blood vessel incision and anastomosis, when extracorporeal circulation using an artificial heart lung machine is performed, a tube called a cannula is temporarily placed inside the blood vessel to construct a flow path for circulating blood outside the body. Things are also done.
Skilled techniques are required for such surgery. Therefore, doctors sometimes perform procedure training using a simulated blood vessel formed of a cylindrical tube, and an anastomosis training simulated blood vessel close to the texture of an actual blood vessel has also been proposed (see, for example, Patent Document 1). .

JP 2012-215818 A

  However, conventional simulated blood vessels do not assume training of procedures in a state in which blood pressure or flow close to that of an actual living body is reproduced inside the blood vessel, and blood flow and pressure similar to those of such living bodies are assumed. There is also a need for a simulated blood vessel for training that can maintain the same texture as an actual blood vessel.

  Therefore, an object of the present invention is to provide a training simulated blood vessel that can maintain the same texture as an actual blood vessel even under the same blood flow and pressure as a living body.

  The present invention is a simulated simulated blood vessel formed in a cylindrical shape, and includes an intima layer, an intima layer disposed outside the intima layer, and an outer membrane disposed outside the intima layer Training comprising a layer, a first mesh layer disposed between the inner film layer and the middle film layer, and a second mesh layer disposed between the middle film layer and the outer film layer Related to simulated blood vessels.

  Moreover, it is preferable that the simulated blood vessel for training further includes a third mesh layer disposed inside the intimal layer.

  The inner film layer, the middle film layer, and the outer film layer are preferably made of an elastic material.

  The rubber hardness of the elastic material is preferably 0 ° to 40 °.

  The intermediate film layer is preferably colored in a different color from the inner film layer and the outer film layer.

  According to the simulated blood vessel for training of the present invention, the same texture as that of an actual blood vessel can be maintained even under the same blood flow and pressure as a living body.

It is a perspective view which shows the simulation blood vessel for training which concerns on one Embodiment of this invention. It is sectional drawing which shows the simulated artery as a simulated blood vessel for training of 1st Embodiment. It is sectional drawing which shows the simulated vein as a training simulated blood vessel of 2nd Embodiment. It is a figure which shows the state of using the simulated blood vessel for training. 2 is a photograph showing the results of Example 1. FIG. It is a photograph which shows the result of a comparative example. It is a photograph which shows the result of a comparative example.

Hereinafter, preferred embodiments of the simulated blood vessel for training of the present invention will be described with reference to the drawings.
The training simulated blood vessel 1 is formed in a cylindrical shape and is used for training of procedures such as incision of blood vessels, anastomosis of incisions, and anastomoses between blood vessels.

  The simulated blood vessel 1 for training in the first embodiment is a simulated artery that simulates the aorta, and as shown in FIGS. 1 and 2, the intima layer 10, the intima layer 20, the adventitia layer 30, 1 mesh layer 40, 2nd mesh layer 50, and 3rd mesh layer 60 are provided.

  The inner membrane layer 10, the middle membrane layer 20, and the outer membrane layer 30 simulate the inner membrane, the middle membrane, and the outer membrane of a blood vessel, respectively. That is, the intima layer 10 is disposed on the innermost side of the training simulated blood vessel 1, and the media layer 20 is disposed on the outside of the intima layer 10. Further, the outer membrane layer 30 is disposed outside the intermediate membrane layer 20. The inner membrane layer 10, the inner membrane layer 20, and the outer membrane layer 30 are made of an elastic material, thereby realizing a texture close to that of an actual blood vessel. Examples of the elastic material used for the inner film layer 10, the inner film layer 20, and the outer film layer 30 include silicone rubber, synthetic rubber, natural rubber, acrylic rubber, olefin rubber, and polyurethane.

  In the first embodiment, the inner film layer 10, the intermediate film layer 20, and the outer film layer 30 are made of silicone rubber. The elastic material used for the intima layer 10, the intima layer 20 and the adventitia layer 30 is measured by a type A durometer from the viewpoint of making the feel at the time of incision and anastomosis of the training simulated blood vessel 1 close to an actual blood vessel. The rubber hardness is preferably 0 ° to 40 °.

In the present embodiment, the intermediate film layer 20 is colored in a different color from the inner film layer 10 and the outer film layer 30. More specifically, the inner membrane layer 10 and the outer membrane layer 30 are colored light pink. The intermediate film layer 20 is colored deeper pink than the inner film layer 10 and the outer film layer 30. As a result, the appearance of the training simulated blood vessel 1 can be made closer to the actual blood vessel.
The thickness of each of the inner membrane layer 10, the middle membrane layer 20, and the outer membrane layer 30 can be set as appropriate according to the blood vessel to be simulated. In the first embodiment, the thickness of each of the inner film layer 10, the middle film layer 20, and the outer film layer 30 is set to 1.5 mm to 2 mm.

  The first mesh layer 40 is disposed between the inner film layer 10 and the middle film layer 20. The second mesh layer 50 is disposed between the intermediate film layer 20 and the outer film layer 30. The third mesh layer 60 is disposed inside the inner membrane layer 10.

  The 1st mesh layer 40, the 2nd mesh layer 50, and the 3rd mesh layer 60 are comprised by the sheet-like member which has the flexibility in which the several through-hole was formed. The 1st mesh layer 40, the 2nd mesh layer 50, and the 3rd mesh layer 60 are 20 micrometers-0.5 mm from a viewpoint which does not deteriorate the touch at the time of an incision or anastomosis, ensuring the intensity | strength of the simulated blood vessel 1 for training. It is preferable that the thickness is configured. From the same viewpoint, the diameter of the plurality of through holes (mesh) is preferably 20 μm to 2 mm. The first mesh layer 40, the second mesh layer 50, and the third mesh layer 60 are made of a synthetic resin such as polyethylene terephthalate, polyurethane, or polypropylene.

  The thickness (outer diameter and inner diameter) of the training simulated blood vessel 1 can be appropriately set according to the type of blood vessel to be simulated. In the first embodiment, the training simulated blood vessel 1 has an outer diameter of 25 mm and an inner diameter of 20 mm.

Next, an aspect of a method for manufacturing the training simulated blood vessel 1 will be described. The training simulated blood vessel 1 of the first embodiment can be manufactured by the following procedure.
(1) The third mesh layer 60 is wound around the surface of a metal rod having a diameter corresponding to the inner diameter of the target training simulated blood vessel 1.
(2) A metal rod around which the third mesh layer 60 is wound is immersed in a tank filled with liquid silicone rubber so that the silicone rubber adheres to the surface of the metal rod (the outer surface of the third mesh layer 60).
(3) Pull up the metal rod to which the silicone rubber is adhered and cure it in air.
(4) The operations (2) and (3) are repeated (for example, about 20 times) to form the inner film layer 10 having a desired thickness.
(5) The first mesh layer 40 is wound around the surface of the formed inner membrane layer 10.
(6) The operations (2) and (3) are repeated again to form the intermediate film layer 20 having a desired thickness outside the first mesh layer 40.
(7) The second mesh layer 50 is wound around the surface of the formed intermediate film layer 20.
(8) The operations (2) and (3) are repeated again to form the outer film layer 30 having a desired thickness outside the second mesh layer 50.
(9) The simulated blood vessel 1 with the outer membrane layer 30 formed is peeled from the metal rod.

  The training simulated blood vessel 1 according to the first embodiment described above has the following effects.

  (1) The training simulated blood vessel 1 includes an inner membrane layer 10, a middle membrane layer 20, an outer membrane layer 30, and a first mesh layer 40 disposed between the inner membrane layer 10 and the middle membrane layer 20. And the second mesh layer 50 disposed between the intermediate film layer 20 and the outer film layer 30. As a result, the training simulated blood vessel 1 can be formed in a three-layer structure in the same way as an actual blood vessel, so that the texture of the training simulated blood vessel 1 can be made closer to the actual blood vessel. In addition, by configuring the training simulated blood vessel 1 including the first mesh layer 40 and the second mesh layer 50 (that is, including a plurality of mesh layers), the strength of the training simulated blood vessel 1 is reduced without impairing the texture. Can be improved. Therefore, the shape of the training simulated blood vessel 1 can be suitably maintained even in a state where the pressure and flow of blood close to an actual living body are reproduced inside the training simulated blood vessel 1. Further, by including the first mesh layer 40 and the second mesh layer 50, when the anastomosis of the training simulated blood vessel 1 is performed, the thread used for the anastomosis is the inner membrane layer 10, the middle membrane layer 20, and the outer membrane layer. It is possible to suitably prevent the inner membrane layer 10, the middle membrane layer 20, and the outer membrane layer 30 from being broken by biting into the 30 anastomosed portions.

  (2) In an actual blood vessel, blood flows through the artery at a pressure higher than that of the vein, so that the artery has a membrane wall thicker than the vein. Therefore, the training simulated blood vessel 1 includes the third mesh layer 60 disposed inside the intima layer 10. As a result, the membrane wall of the training simulated blood vessel 1 that simulates an artery can be formed thicker, and the strength of the training simulated blood vessel 1 can be further improved without impairing the texture of the training simulated blood vessel 1.

  (3) The inner film layer 10, the intermediate film layer 20, and the outer film layer 30 are made of silicone rubber that is an elastic material. As a result, the texture of the training simulated blood vessel 1 can be made closer to an actual blood vessel. Further, since the degree of freedom in coloring the inner membrane layer 10, the inner membrane layer 20, and the outer membrane layer 30 can be increased, the color of the training simulated blood vessel 1 can be made closer to an actual blood vessel.

  (4) The intermediate film layer 20 was colored in a different color from the inner film layer 10 and the outer film layer 30. Thereby, when the training simulated blood vessel 1 is incised, the state of the technique can be grasped not only by tactile sense but also visually. Further, the training simulated blood vessel 1 can be brought closer to an actual blood vessel.

  (5) The rubber hardness of the elastic material was set to 0 ° to 40 °. As a result, the texture of the training simulated blood vessel 1 can be made closer to an actual blood vessel.

Next, a second embodiment of the training simulated blood vessel will be described with reference to FIG. The training simulated blood vessel 1A of the second embodiment is a simulated vein simulating the vena cava, and includes an intima layer 10, an intima layer 20, an outer membrane layer 30, a first mesh layer 40, and a second mesh. A layer 50. That is, the training simulated blood vessel 1A of the second embodiment is different from the first embodiment in that it does not include the third mesh layer.
The training simulated blood vessel 1A of the second embodiment has an outer diameter of 30 mm and an inner diameter of 25 mm. According to the simulated blood vessel for training 1A of the second embodiment, the effects (1) and (3) to (5) described above are exhibited.

  The training simulated blood vessel 1 according to the first embodiment and the training simulated blood vessel 1A according to the second embodiment described above can be used for training a procedure in a state where no liquid is circulated therein by providing the above-described configuration. In addition, as shown in FIG. 4, it can be connected to the extracorporeal circulation training apparatus 100 and used for training of a technique in a state where the pressure and flow of blood close to an actual living body are reproduced.

  More specifically, the extracorporeal circulation training apparatus 100 is a blood-feeding device that is disposed at an artificial cardiopulmonary simulator 110, a blood removal circuit 120, a blood return circuit 130, and a connection portion between the blood removal circuit 120 and the blood return circuit 130. A pump 140 and a blood storage tank 150 disposed in the blood removal circuit 120 are provided. The extracorporeal circulation training apparatus 100 simulates extracorporeal circulation by circulating simulated blood through a circuit constituted by an artificial cardiopulmonary simulator 110, a blood removal circuit 120, a blood storage tank 150, and a blood return circuit 130.

The cardiopulmonary simulator 110 simulates the hemodynamics of the living body by controlling the output of the blood pump 140 or the like.
The blood removal circuit 120 distributes simulated blood derived from the heart-lung machine simulator 110. The upstream side of the blood removal circuit 120 is connected to the oxygenator simulator 110. The blood storage tank 150 stores simulated blood flowing through the blood removal circuit 120.

The blood return circuit 130 connects the blood removal circuit 120 and the cardiopulmonary simulator 110. The blood return circuit 130 returns the simulated blood that has circulated through the blood removal circuit 120 to the oxygenator simulator 110.
The blood feed pump 140 boosts the simulated blood that has circulated through the blood removal circuit 120 and sends it to the blood return circuit 130. The blood pump 140 functions as an artificial heart in the extracorporeal circulation device.

In the extracorporeal circulation training apparatus 100 described above, the training simulated blood vessel 1 of the first embodiment that simulates the aorta constitutes a part of the blood return circuit 130. The training simulated blood vessel 1A of the second embodiment that simulates the vena cava constitutes a part of the blood removal circuit 120.
As a result, the simulated blood boosted by the blood pump 140 circulates in the training simulated blood vessel 1 of the first embodiment, and the blood feeding pump 140 flows in the training simulated blood vessel 1A of the second embodiment. Simulated blood is circulated before being pressurized.

  Next, the present invention will be described in more detail based on examples, but the present invention is not limited thereto.

[Example 1]
After filling the training simulated blood vessel 1 simulating the aorta with tap water and applying a pressure of 100 mmHg, incision and cannulation are performed, and then the inside of the training simulated blood vessel 1 is 5 L / min. The tap water was circulated at a flow rate of. As the simulated blood vessel 1 for training, the following were used.

Outside diameter of simulated blood vessel for training: 25mm
Material of inner membrane layer, middle membrane layer, and outer membrane layer: silicone rubber, hardness 40 °, thickness 2 mm
Material of the first mesh layer, the second mesh layer, and the third mesh layer: polyethylene terephthalate, thickness 0.5 mm, pore diameter 2 mm

  As a result, in the state where pressure was applied, the training simulated blood vessel 1 did not expand, and circulation of tap water after cannulation was possible. FIG. 5 shows a state where tap water is circulated after the incision and cannulation in the first embodiment.

[Example 2]
After filling the simulated blood vessel 1A of the second embodiment simulating the vena cava with tap water and applying a pressure of 20 mmHg, incision and cannulation are performed, and then the inside of the simulated blood vessel 1 for training is 5 L / Tap water was circulated at a flow rate of min. The following were used as the training simulated blood vessel 1A.

Outer diameter of simulated blood vessel for training: 30mm
Material of inner membrane layer, middle membrane layer, and outer membrane layer: silicone rubber, hardness 40 °, thickness 2 mm
Material of the first mesh layer and the second mesh layer: polyethylene terephthalate, thickness 0.5 mm, hole diameter 2 mm

  As a result, in the state where pressure was applied, the training simulated blood vessel 1 did not expand, and circulation of tap water after cannulation was possible.

[Comparative example]
As a training simulated blood vessel 2 of the comparative example, a training simulated blood vessel made of silicone rubber not having the first mesh layer, the second mesh layer, and the third mesh layer (outer diameter 30 mm, silicone rubber layer thickness 2.5 mm) , Hardness 40 °).
When the simulated blood vessel 2 for training in the comparative example was filled with tap water and a pressure of 20 mmHg was applied, the simulated blood vessel 2 for training expanded and the cylindrical shape could not be maintained. The results are shown in FIG.
In addition, when the simulated blood vessel 2 for training in the comparative example was filled with tap water and an incision and anastomosis were performed with a pressure of 20 mmHg applied, the thread dig into the silicone rubber during the anastomosis and the surrounding silicone rubber was torn, The filled tap water leaked outside the simulated blood vessel 2 for training. The results are shown in FIG.

  From the results of the above examples and comparative examples, the inner membrane layer 10, the middle membrane layer 20, the outer membrane layer 30, and the first mesh layer 40 disposed between the inner membrane layer 10 and the middle membrane layer 20. And the second mesh layer 50 disposed between the inner membrane layer 20 and the outer membrane layer 30, and the third simulated mesh blood vessel 1 A disposed further inside the inner membrane layer 10. It has been found that the simulated blood vessel 1 for training can maintain a cylindrical shape even under the same blood flow and pressure as a living body. Further, it was found that the same texture as that of an actual blood vessel can be maintained in training of a technique such as anastomosis as compared with the simulated blood vessel for training in the comparative example.

The preferred embodiments of the simulated blood vessel for training of the present invention have been described above. However, the present invention is not limited to the above-described embodiments, and can be modified as appropriate.
For example, in the present embodiment, the training simulated blood vessel is formed by wrapping a mesh layer around the surface of the metal rod and attaching liquid silicone rubber to the surface of the metal rod, but the present invention is not limited thereto. That is, the simulated blood vessel for training may be formed by laminating a sheet-like silicone rubber and a mesh layer, and bending and bonding the laminated sheet-like silicone rubber and mesh layer laminate to a cylindrical shape.

  In the present embodiment, the training simulated blood vessel is configured using silicone rubber having a rubber hardness of 40 °, but the present invention is not limited thereto. That is, for example, when simulating an arteriosclerotic blood vessel or a calcified blood vessel, a hardened silicone rubber (for example, hardness 100 °) may be used to configure the training simulated blood vessel.

1,1A Training simulated blood vessel 10 Inner membrane layer 20 Middle membrane layer 30 Outer membrane layer 40 First mesh layer 50 Second mesh layer 60 Third mesh layer

Claims (5)

A training simulated blood vessel formed in a cylindrical shape,
An intima layer;
A middle layer disposed outside the inner layer,
An outer membrane layer disposed outside the middle membrane layer;
A first mesh layer disposed between the inner membrane layer and the middle membrane layer;
A training simulated blood vessel comprising: a second mesh layer disposed between the intermediate layer and the outer membrane layer.   The simulated blood vessel for training according to claim 1, further comprising a third mesh layer disposed inside the intima layer.   The simulated blood vessel for training according to claim 1 or 2, wherein the inner membrane layer, the middle membrane layer, and the outer membrane layer are made of an elastic material.   The simulated blood vessel according to claim 3, wherein the elastic material has a rubber hardness of 0 ° to 40 °.   The simulated blood vessel for training according to any one of claims 1 to 4, wherein the middle film layer is colored in a color different from that of the inner film layer and the outer film layer.