JP2019207304A - Laparoscopic surgery training tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a laparoscopic surgery training instrument for practicing surgery under laparoscope in a form close to that of actual surgery. SOLUTION: A sheet-shaped simulated abdominal wall having a flexible material that can be pierced by a needle-shaped member or incised by a blade and has a predetermined area and a simulated abdominal wall are fixed under the laparoscope under the simulated abdominal wall. A laparoscopic surgery training device comprising: a base forming an operation practice space. [Selection diagram] Figure 1

Description

  The present invention relates to a laparoscopic surgical training instrument for training laparoscopic surgery.

  Laparoscopic surgery is an operation method in which an endoscope is inserted into the abdominal cavity from around the umbilicus and an operation is performed in the abdominal cavity based on an image displayed on a television monitor. Specifically, the skin is cut small, and forceps are inserted into the abdominal cavity to perform surgery. Compared with laparotomy, it is less invasive, and the patient's recovery after surgery is faster. However, since it is necessary to operate a plurality of forceps having poor operability in a narrow abdominal cavity while looking at the monitor, the difficulty of the operation itself is higher than that of open surgery.

  Conventionally, a training device that simulates the abdominal cavity has been used for training in laparoscopic surgery (see, for example, Patent Document 1). FIG. 8 is an explanatory diagram of a conventional laparoscopic training instrument 101. A conventional laparoscopic surgical training instrument 101 is composed of a base 115 and a roof portion 105 made of a hard synthetic resin fixed to the base 115, and the roof portion 105 is provided with a plurality of rubber films 120 capable of forming through holes in advance. ing. A person who performs training inserts a grasping forceps 170A and the like through a through hole of a cylindrical instrument 130 inserted into a hole formed in the rubber film 120, and a moving image acquisition device (illustrated) provided in the laparoscopic surgery practice space 110 (Omitted) Practice the surgery while viewing the image acquired on the monitor.

JP-A-2006-148765

  However, in the conventional laparoscopic surgery training instrument, the position of the rubber film into which the forceps and the like are inserted is fixed, and it is not possible to practice the surgery by selecting the optimum position as in an actual medical field. In addition, it is difficult to cope with different drilling positions depending on the department with one training device. In addition, since the roof portion is made of a hard material, the insertion direction of the grasping forceps is limited, and it is difficult to practice, for example, the back of the skin (for example, position O in FIG. 8) as the surgical site.

  The present invention has been made in view of the above problems, and an object of the present invention is to provide a laparoscopic training apparatus for practicing laparoscopic surgery in a manner closer to that of actual surgery than in the past.

  In the present invention, in order to create an environment close to an actual operation, a simulated abdominal wall that can be perforated at a more free position with a needle-like member is provided, and surgery can be practiced at various positions. The simulated abdominal wall was constructed in such a manner that the fabric portion made of a flexible material was held in the frame portion.

  (1) The present invention includes a sheet-like simulated abdominal wall having a predetermined area, which has a flexible material that can be perforated by a needle-like member or can be cut by a blade, and a lower part of the simulated abdominal wall while fixing the simulated abdominal wall. Provided is a laparoscopic training instrument characterized by comprising a base for forming a laparoscopic surgical practice space on the side.

  According to the invention described in (1) above, since the abdominal wall is simulated by a flexible material that can be perforated by a needle-like member or incised by a blade, a person who performs training can perform from any position and in parallel with the simulated abdominal wall. Since the forceps can be inserted into a practice space simulating the intra-abdominal space up to a close angle, and an environment closer to that of actual surgery can be created than before, there is an excellent effect that better surgical training is possible.

  (2) In the present invention, the simulated abdominal wall has a fabric portion made of the flexible material that can be perforated or incised, and the fabric portion is held in a vertical direction, and the abdominal cavity is interposed between the base and the fabric portion. A laparoscopic surgical training instrument described in (1) above, comprising a frame part that forms a surgical operation space under a mirror.

  According to the invention described in (2) above, since the simulated abdominal wall is composed of a fabric portion and a frame portion that holds the fabric portion, a laparoscopic surgical practice space is reliably provided between the base and the fabric portion, It has an excellent effect of being able to practice surgery properly.

  (3) In the present invention (2), an engagement mechanism for detachably engaging the fabric portion and the frame portion is provided between the fabric portion and the frame portion. A laparoscopic surgical training device as described in 1) is provided.

  According to the invention described in (3) above, since the fabric portion is detachably engaged with the frame portion, only the fabric portion can be exchanged. Therefore, a plurality of medical departments have an excellent effect that a single laparoscopic surgical training instrument can be shared by preparing a dedicated fabric. In addition, by properly using a plurality of fabric portions having different thicknesses and rigidity, it is possible to achieve an excellent effect that training for children and adults can be performed with the same laparoscopic training apparatus.

  (4) The present invention provides the laparoscopic surgical training instrument according to (2) or (3) above, wherein the frame portion has at least one opening.

  According to the invention described in (4) above, since the frame portion that holds the fabric portion has at least one opening, the fabric portion facing the opening can be perforated or incised, and the fabric portion The ability to insert forceps or the like into a practice space provided in the lower part of the surgical instrument provides an excellent effect that surgery can be practiced appropriately.

  (5) The laparoscopic surgery training instrument according to any one of (2) to (4), wherein the frame portion is transparent to light in a visible region. provide.

  According to the invention described in (5) above, it is easy to locate the object that simulates the internal organs and the moving image acquisition device that should be placed in the laparoscopic surgical practice space provided below the frame part while checking with the naked eye And the outstanding effect that it can determine appropriately is produced. In addition, since the frame portion 50 is transparent, there is an extremely excellent effect that no light is blocked regardless of the position of the illumination device 45 set.

  (6) The laparoscopic surgical training according to any one of (1) to (5), wherein the present invention includes an illumination device that is sandwiched between the fabric portion and the frame portion. Provide equipment.

  According to the invention described in (6) above, since the lighting device is sandwiched between the fabric portion and the frame portion, a bright surgical field can be secured without sacrificing the practice space, and more appropriate surgical practice is possible. There is an excellent effect of being able to.

  According to the laparoscopic surgical training instrument of claims 1 to 6 of the present invention, it is possible to create an environment close to actual surgery and to achieve an excellent effect that better surgical training is possible.

1 is a perspective view of a laparoscopic surgical training instrument according to a first embodiment of the present invention. (A) It is sectional drawing of a laparoscopic surgery training instrument. (B) It is explanatory drawing which shows the process of releasing engagement of the fabric part and frame part which comprise a simulation abdominal wall. It is a perspective view of a frame part. (A) It is explanatory drawing of the aspect which forms a through-hole in the fabric part of a laparoscopic surgery training instrument with a needle-shaped member. (B) It is explanatory drawing of training operation | movement of the laparoscopic surgery by a laparoscopic surgery training instrument. It is sectional drawing of the laparoscopic surgery training instrument which concerns on 2nd embodiment of this invention. (A) It is sectional drawing of the laparoscopic surgery training instrument which concerns on 3rd embodiment of this invention. (B) It is explanatory drawing of an illuminating device. It is a perspective view of the flame | frame part which comprises the laparoscopic surgery training instrument concerning a modification. It is explanatory drawing explaining the structure of the conventional laparoscopic surgery training instrument.

  Embodiments of the present invention will be described below with reference to the accompanying drawings.

  1 to 7 are examples of embodiments for carrying out the invention, and in the drawings, parts denoted by the same reference numerals represent the same items. In addition, a part of the configuration is omitted as appropriate in each drawing to simplify the drawing. The size, shape, thickness, etc. of the members are exaggerated as appropriate.

  FIG. 1 shows a perspective view of a laparoscopic surgical training instrument 1 according to the first embodiment of the present invention. The laparoscopic surgical training instrument 1 includes a flexible material having elasticity and elasticity that can be perforated by a needle-like member or incised by a blade, and has a sheet-like simulated abdominal wall 5 having a predetermined area, and the simulated abdominal wall 5 is fixed. However, the base 15 which forms the laparoscopic surgery practice space 10 under the simulated abdominal wall 5 is provided. The base 15 is preferably made of a material that is firm enough to prevent the entire structure of the laparoscopic training instrument 1 from being distorted during surgical practice, for example, a metal such as aluminum.

  Inside the laparoscopic surgery practice space 10, a simulated internal organ support 20 and a moving image acquisition device support 40 are provided. The simulated internal support 20 and the moving picture acquisition device support 40 are fixed to the base 15. An illuminating device 45 is held on the simulated abdominal wall 5 on the side of the laparoscopic surgery practice space 10 to ensure the brightness inside the laparoscopic surgery practice space 10.

  The simulated internal organ support 20 includes a column portion 25 fixed to the base 15 and a placement portion 30 on which the simulated internal organ 35 is placed. It is preferable that a hinge structure is provided between the mounting part 30 and the column part 25 so that the angle formed by the mounting part 30 and the column part 25 can be freely changed. Moreover, the height of the mounting part 30 can also be changed.

  The simulated internal organ 35 preferably has a flexibility similar to that of a human tissue such as silicone as a material.

  It is preferable that the moving image acquisition device support 40 has a so-called flexible arm structure and can freely change the direction of the moving image acquisition device (not shown).

  FIG. 2A shows a cross-sectional view of the laparoscopic training instrument 1. The simulated abdominal wall 5 forms a laparoscopic surgical practice space 10 between the base 15 and the fabric portion 60 by holding the fabric portion 60 made of a flexible material that can be perforated or incised, and the fabric portion 60 in the vertical direction. And a frame portion 50 to be used. In addition, an engagement mechanism 65 that detachably engages the fabric portion 60 and the frame portion 50 is provided between the fabric portion 60 and the frame portion 50.

  Specifically, the material of the fabric portion 60 is a flexible material that can be incised with a blade that can be pierced by a needle-like member, for example, on both sides of a chloroprene rubber fabric having a thickness of about 5 mm that includes bubbles, such as that used in wet suits. It is preferable to apply a stretch knit fabric made of polyurethane blend or the like. Of course, the material of the rubber is not particularly limited, and silicone rubber or the like may be employed. In addition, a material other than rubber can be selected as long as it has flexibility that allows punching or cutting.

  The frame portion 50 is preferably a colorless and transparent thin plate of PET (Polyethylene terephthalate), for example, formed in a lattice shape. The frame part 50 is fixed to the base 15 with screws or the like.

  The engagement mechanism 65 is, for example, a metal snap button. A frame-side engagement jig 67 (male side of the snap button) is disposed on the frame portion 50, and a fabric-side engagement jig 69 (snap) is disposed on the fabric portion 60. Place the female side of the button. A plurality of engaging mechanisms 65 are preferably provided along the outer peripheral edges of the fabric portion 60 and the frame portion 50.

  A lighting device 45 is sandwiched between the frame portion 50 and the fabric portion 60 to ensure the brightness inside the laparoscopic surgical practice space 10.

  FIG. 2B is an explanatory diagram showing a process of releasing the engagement between the fabric portion 60 and the frame portion 50 constituting the simulated abdominal wall 5. Specifically, the cloth part 60 and the frame part 50 are separated by removing the snap button.

  FIG. 3 is a perspective view of the frame unit 50. The frame portion 50 is made of a relatively flexible synthetic resin such as PET, and preferably has a ladder shape or a lattice shape. Specifically, the frame unit 50 has at least one opening 55. A plurality of frame-side engagement jigs 67 (male side of the snap button) of the engagement mechanism 65 are provided along the outer peripheral edge of the frame portion 50. The frame part 50 is bent in an arch shape, the end part is fixed to the base 15 (see FIG. 2A), and the frame part 50 is covered with the fabric part 60 to form the laparoscopic surgical practice space 10.

  Next, a laparoscopic surgical training operation using the laparoscopic surgical training instrument 1 according to the first embodiment will be described with reference to FIGS. 4 (A) and 4 (B).

  FIG. 4A is an explanatory diagram of a mode in which a through hole is formed in the fabric portion 60 of the laparoscopic surgery training instrument 1 with the needle-like member N. FIG. By pressing the cloth portion 60 made of a flexible material with the sharp tip of the needle-like member N, a through hole is formed. A catheter K serving as a communication path connecting the inside and outside of the body is inserted into the formed through hole to secure an insertion portion. In addition, although the case where a through-hole is formed with the needle-shaped member N is illustrated here, you may cut | disconnect in slit shape with blades, such as a knife and scissors.

  FIG. 4B is an explanatory diagram of a training operation for laparoscopic surgery using the luminoscopic surgery training instrument 1. The grasping forceps 70 and the like are inserted into the through hole of the catheter K placed on the body surface. When practicing the operation of sewing the simulated internal organs 35, for example, a plurality of grasping forceps 70 are used, and stitching is performed inside the laparoscopic surgical practice space 10 with a needle and a surgical thread.

Since the cloth portion 60 is a flexible material having elasticity and elasticity, the forceps can be brought to a position close to parallel to the simulated skin, and the position on the back side of the simulated skin like the grasping forceps 170B as in the actual operation. It has an extremely excellent effect of being able to practice with O as the surgical site.

  According to the laparoscopic surgical training instrument 1 according to the first embodiment, the abdominal wall is simulated by a flexible material that can be perforated or incised by a needle-like member. The forceps can be inserted into the laparoscopic surgery practice space 10 simulating the intra-abdominal space up to an angle close to the parallel angle, and an environment closer to the actual surgery can be created than before, so that better surgical training is possible. Has an effect.

  According to the laparoscopic surgery training instrument 1 according to the first embodiment, the simulated abdominal wall 5 is configured by the fabric portion 60 and the frame portion 50 that holds the fabric portion 60, so that it is ensured between the base 15 and the fabric portion 60. A laparoscopic surgical practice space 10 is provided, which has an excellent effect of enabling appropriate surgical practice.

  According to the laparoscopic surgical training instrument 1 according to the first embodiment, since the fabric portion 60 is detachably engaged with the frame portion 50, only the fabric portion 60 can be replaced. Therefore, an excellent effect that a plurality of medical departments can share a single laparoscopic training instrument 1 can be obtained by preparing a dedicated fabric portion 60. In addition, by properly using a plurality of fabric portions having different thicknesses and rigidity, it is possible to achieve an excellent effect that training for children and adults can be performed with the same laparoscopic training apparatus.

  According to the laparoscopic training instrument 1 according to the first embodiment, since the frame portion 50 that holds the fabric portion 60 has at least one opening portion 55, the fabric portion 60 that faces the opening portion 55 is perforated. It becomes possible, and it becomes possible to insert the grasping forceps 70 and the like into the laparoscopic surgical practice space 10 provided in the lower part of the fabric portion 60, so that the surgical practice can be appropriately performed. Play.

  According to the laparoscopic surgery training instrument 1 according to the first embodiment, since the frame part 50 is transparent, it should be placed in the laparoscopic surgical practice space 10 provided below the frame part 50 while checking with the naked eye. There is an excellent effect that the position of the object that simulates the internal organs and the position of the moving image acquisition apparatus can be determined easily and appropriately. In addition, since the frame portion 50 is transparent, there is an extremely excellent effect that no light is blocked regardless of the position of the illumination device 45 set.

  FIG. 5 is a cross-sectional view of the laparoscopic surgical training instrument 1 according to the second embodiment of the present invention. In the present embodiment, the operated portion 80 is disposed on the surface of the fabric portion 60 on the side of the laparoscopic surgical practice space 10. At this time, the operated portion 80 is preferably provided at a position where it does not interfere with the frame portion 50. Since other features are the same as those of the first embodiment described above, description thereof is omitted.

  For example, the grasping forceps 70 </ b> A is inserted into the laparoscopic surgical practice space 10 from the fabric part 60 through the frame opening 55, and practiced for suturing and peeling the operated part 80. An excellent effect that it is possible to practice the operation of applying the counter traction for performing the operation on the operated portion 80 inside the abdominal wall while pressing the abdominal wall with the finger H from outside the body, as performed in actual surgery, for example, the operation of scar hernia. Can be played.

  FIG. 6A is a cross-sectional view of a laparoscopic training instrument 1 according to the third embodiment of the present invention. An illuminating device 45 is sandwiched between the frame portion 50 and the fabric portion 60 constituting the simulated abdominal wall 5 of the laparoscopic surgical training instrument 1. Since other features are the same as those of the first embodiment, description thereof is omitted. Light L is emitted from the illumination device 45 to the laparoscopic surgical practice space 10. According to the laparoscopic surgery training instrument 1 according to the third embodiment, since the illumination device 45 is sandwiched between the fabric portion 60 and the frame portion 50, the illumination portion 45 protrudes into the laparoscopic surgery practice space 10. Therefore, a bright operative field can be secured without sacrificing the practice space, and an excellent effect can be achieved in that surgery can be practiced more appropriately.

  FIG. 6B is an explanatory diagram of the lighting device 45. In the lighting device 45, at least one, preferably a plurality of LEDs 49, are disposed on a flexible thin plate-like substrate 46, and emits light when energized through the illumination power supply line 47. Since it is thin and lightweight, it can be easily sandwiched between the frame portion 50 and the fabric portion 60, and the place where it is disposed can be easily changed.

  In addition, the laparoscopic surgery training instrument of the present invention is not limited to the above-described embodiment, and it is needless to say that various modifications can be made without departing from the gist of the present invention.

  For example, as a modified embodiment of the present invention, it is also conceivable to change the shape of the frame portion 50 constituting the simulated abdominal wall 5 (see FIG. 2) of the laparoscopic surgical training instrument 1. FIG. 7 is a perspective view of the frame portion 50 constituting the laparoscopic surgical training instrument 1 according to a modified embodiment. In this modified embodiment, the frame portion 50 has a ladder shape and has a large strip-like opening 55. By having such a large opening, the portion that can be perforated is increased, and the insertion of forceps and the like into the laparoscopic surgery practice space 10 can be practiced in an environment closer to the actual surgery. Can be played.

DESCRIPTION OF SYMBOLS 1 Laparoscopic surgery training instrument 5 Simulated abdominal wall 10 Laparoscopic operation practice space 15 Base 20 Simulated internal organ support base 25 Column part 30 Mounting part 35 Simulated internal organ 40 Moving image acquisition apparatus support base 45 Illumination device 46 Base material 47 Illumination power line 49 LED
DESCRIPTION OF SYMBOLS 50 Frame part 55 Frame opening part 60 Material | dough part 65 Engagement mechanism 67 Frame side engagement jig | tool 69 Material | dough engagement jig 70 Gripping forceps 80 Operated part 101 Conventional laparoscopic surgery training instrument 105 Roof part 110 Laparoscopic under Surgery practice space 115 Base 120 Rubber film 130 Tubular instrument 170 Gripping forceps

Claims (6)

A sheet-like simulated abdominal wall having a predetermined area, having a flexible material that can be perforated by a needle-like member or incised by a blade,
While fixing the simulated abdominal wall, a base that forms a laparoscopic surgical practice space under the simulated abdominal wall;
A laparoscopic surgical training device comprising: The simulated abdominal wall is
A fabric portion made of the flexible material that can be punched or cut;
Holding the fabric portion in the vertical direction, and forming a laparoscopic surgical practice space between the base and the fabric portion;
The laparoscopic surgical training instrument according to claim 1, wherein:   The laparoscopic surgical training instrument according to claim 2, wherein an engagement mechanism for detachably engaging the fabric portion and the frame portion is provided between the fabric portion and the frame portion. .   The laparoscopic surgical training apparatus according to claim 2, wherein the frame portion has at least one opening.   The laparoscopic surgery training instrument according to any one of claims 2 to 4, wherein the frame portion is transparent to light in a visible region.   The laparoscopic surgery training instrument according to any one of claims 1 to 5, further comprising an illumination device that is sandwiched between the fabric portion and the frame portion.

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