JP2024171324A - General-purpose technique training device - Google Patents

Abstract

To provide a general-purpose manipulation training device that is compatible with both endoscopic surgery and robot-assisted surgery, and adaptable to various regions and surgical methods.SOLUTION: A general-purpose manipulation training device includes a thoracic cavity simulator 2 as a simulator that simulates a portion of a human body, a base 3 as a pedestal part, and a lung model fixture 4 as an organ model fixture that fixes an organ model. Training is conducted by mounting the thoracic cavity simulator 2 and the lung model fixture 4 onto the base 3. The base 3 includes a base body 30, a mounting part 31, and an anti-slip material 32. The mounting part 31 functions as a first mounting part and a second mounting part. The thoracic cavity simulator 2 includes a frame part 5, a thoracic cavity part 6, and a fitting part 21. The frame part 5 and the thoracic cavity part 6 function as the simulator body, and the fitting part 21 functions as the first fixing part. The lung model fixture 4 is a fixture capable of holding the organ model that simulates a right lung and includes a mediastinum part, a support part, and a fitting part.SELECTED DRAWING: Figure 1

Description

The present invention relates to a simulator for training and learning about endoscopic surgery.

In recent years, simulators that reproduce the shape and texture of a human body and can simulate a surgical environment for a human body have been developed for the purpose of training and learning in thoracoscopic surgery (see, for example, Patent Document 1).
The thoracic simulator disclosed in the above-mentioned Patent Document 1 is a device consisting of a human skeletal model simulating at least ribs and a casing for housing the human skeletal model, and an opening is provided in the rib part of the casing, the diaphragm part can be opened and closed, and an organ model can be housed inside the ribs of the human skeletal model. This makes it possible to effectively train thoracoscopic surgery techniques. The method of attaching the organ model to the simulator in the above-mentioned Patent Document 1 is, for example, to use a gripping member provided with an engagement part. The simulator in the above-mentioned Patent Document 1 is premised on training in a supine position.

On the other hand, as a technology that enables training in the lateral position, an organ model fixing device is known that can stably fix an organ model with a tilted thoracic simulator and is easy to attach, remove, and adjust the position (see Patent Document 2). This is a fixing device that fixes the posture of an organ model relative to a thoracic simulator that includes a human skeletal model that simulates at least the spine, sternum, and ribs, and it is said that this makes it possible to fix the organ model at an appropriate angle during training in the lateral position.

In the simulator of Patent Document 1, the organ model is attached to the simulator itself using a gripping member provided with an engagement portion. The organ model fixing tool of Patent Document 2 is also attached directly to the thoracic simulator. Therefore, for example, if a specification change occurs in part of the simulator of Patent Document 1, it will be necessary to create a new attachment site for the gripping member. Similarly, for example, if a specification change occurs in part of the thoracic simulator disclosed in Patent Document 2, it will be necessary to create a new attachment site for the organ model fixing tool.

In robot-assisted surgery, which has been widely implemented in recent years, unlike endoscopic surgery performed by humans, forceps and other instruments may be inserted at ports and angles that humans would not operate, so with conventional simulators, the forceps and other instruments interfere with parts of the simulator, making it difficult to provide proper training. In addition, there are multiple types of robots used in robot-assisted surgery, and the position of the ports and the insertion angle of the forceps and other instruments may differ depending on the type of robot. In reality, it is difficult to provide a single simulator that meets all of these diverse needs.
Therefore, in order to provide a simulator that is compatible with robot-assisted surgery using multiple types of robots, it is necessary to provide a simulator that is compatible with the specifications of each robot.
However, if multiple types of simulators are to be created to reproduce conditions closer to those of the human body in order to accommodate multiple types of robots, there is a problem in that the production costs will be too high.

Furthermore, many of the conventional simulators used for surgical training have been limited to specific uses, such as replicating the thoracic cavity or the abdominal cavity.
However, there is a demand for a versatile training device that can be used for a wide range of surgical sites and procedures.

International Publication Pamphlet WO2015/151503 International Publication No. WO2020/080318

In conventional simulators for procedural training, a simulator that precisely replicates the abdominal or thoracic cavity is first created, and then an organ model fixing device is designed to fit the created simulator. Therefore, the organ model fixing device to be attached to the simulator had to be designed within the limitations imposed by the simulator's shape and other specifications. In addition, because the simulator itself needs to be held stably in order to perform training, a separate dedicated fixing device was also required to support the simulator.

However, what is important about a training device is not to base it on the design of a simulator, but to first consider the purpose and content of the training, and then to design a simulator with the most appropriate shape and organ model fixing tool to achieve the purpose of the training. In doing so, it is necessary that 1) it can accommodate a variety of surgical procedures, 2) it can accommodate not only manual training in human surgery but also training in robot-assisted surgery, and 3) it can accommodate a variety of robots for robot-assisted surgery.
As a result of extensive research, the inventors have discovered that by providing a member that stably supports the simulator and organ model fixing device, and attaching and fixing the simulator and organ model fixing device directly to this member, it is possible to accommodate a wide variety of training.
In view of the above circumstances, the present invention aims to provide a general-purpose procedure training device that can be used for both endoscopic surgery and robot-assisted surgery, and can be used for a variety of body parts and surgical procedures.

In order to solve the above problems, the general-purpose procedural training device of the present invention includes a three-dimensional simulator that simulates a part of the body, an organ model fixture for fixing an organ model, and a flat base with an attachment part, the simulator has a simulator body that simulates a part of the body and a first fixing part that fixes it to the base, the organ model fixture has an organ model fixture body to which the organ model is attached and a second fixing part that fixes it to the base, the base has first and second mounting parts for mounting the first and second fixing parts, and when the organ model fixture with the organ model attached and the simulator are fixed to the base, the three-dimensional positional relationship between the part of the body simulated by the simulator body and the organ model is anatomically reproduced.

Generally, when attaching an organ model fixture to a simulator, in order to stably fix the organ model fixture and to make it easy to attach and remove it, it is necessary to devise fixing mechanisms on both the simulator side and the organ model fixture side, which leads to increased manufacturing costs.
Therefore, by attaching the simulator and the organ model fixture to the pedestal, rather than attaching the organ model fixture to the simulator, it becomes unnecessary to provide a fixing mechanism for the simulator and the organ model fixture. In other words, the simulator only needs to have a fixing part that fits the mounting part of the pedestal, and the organ model fixture only needs to have a fixing part that fits the mounting part of the pedestal.

Furthermore, by configuring the simulator and the organ model fixture to be attached separately, the simulator and the organ model fixture can be designed separately, increasing the degree of freedom in design. Therefore, it is possible to prepare multiple types of simulators according to the type of robot, and use one type of organ model fixture. Also, for the simulator and the organ model fixture, it is easy to realistically reproduce only the parts necessary for training, and delete or deform the parts that have little effect on training.
In addition, the "part of the body" simulated by the simulator body refers to the ribs, sternum, thoracic vertebrae, etc. in the case of a thoracic cavity simulator.

The first or second fixing part does not have to be one, and may be two or more. Similarly, the first or second mounting part does not have to be one, and may be two or more. Also, the correspondence of attaching the first fixing part to the first mounting part and the second fixing part to the second mounting part is not essential, and the second fixing part may be attached to the first mounting part and the first fixing part to the second mounting part. Therefore, for example, when two first mounting parts and one second mounting part are provided on the base part, two first fixing parts are provided on the simulator, and one second mounting part is provided on the organ model fixing tool, the first fixing part is attached to the first mounting part and the second fixing part is attached to the second mounting part. In contrast, if the base has two first mounting parts and one second mounting part, the simulator has one first fixing part, and the organ model fixing tool has two second mounting parts, the second fixing part is attached to the first mounting part, and the first fixing part is attached to the second mounting part. In this way, a variety of mounting methods can be used to suit the shapes of the simulator and the organ model fixing tool.

In the general-purpose procedural training device of the present invention, it is preferable that the simulator is a thoracic cavity simulator that simulates either the left or right thoracic cavity, and the organ model fixing device is a lung model fixing device that fixes either the left or right lung model corresponding to the thoracic cavity.
By using a simulator that simulates either the left or right thoracic cavity, rather than the entire thoracic cavity, only the parts required for training can be realistically reproduced, and the manufacturing cost can be reduced. For example, when performing upper lobectomy, middle lobectomy, or lower lobectomy of the right lung, or medial lymph node dissection, training can be performed by attaching a thoracic cavity simulator that simulates the right thoracic cavity and a lung model fixing device that fixes the right lung model to the pedestal. On the other hand, when performing upper lobectomy, lower lobectomy, or medial lymph node dissection of the left lung, training can be performed by attaching a thoracic cavity simulator that simulates the left thoracic cavity and a lung model fixing device that fixes the left lung model to the pedestal.

In the general-purpose procedural training device of the present invention, the simulator body is provided with support parts that support the thoracic cavity, and is preferably provided with a maximum height of the caudal support part that is lower than a maximum height of the ribs supported by the caudal support part. The maximum height of the caudal support part is preferably lower than a maximum height of the ribs supported by the caudal support part.
Because the maximum height of the caudal support part is lower than the maximum height of the rib part that it supports, when forceps or the like are inserted from a low angle on the caudal side during robot-assisted surgery, the forceps or the like do not interfere with the caudal support part, allowing for effective training.

In the general-purpose procedural training device of the present invention, the simulator body is provided with support parts that support the thoracic cavity, and is preferably provided with a maximum height of the head support part that is lower than the maximum height of the rib part supported by the head support part. The simulator body is provided with a thoracic cavity part that comprises a rib part, a sternum part and a thoracic vertebrae part, and that simulates either the left or right thoracic cavity, a head support part and a caudal support part that support part of the rib part, a thoracic vertebrae support part that supports the thoracic vertebrae part, and a sternum support part that supports the sternum part.
Because the maximum height of the head support part is lower than the maximum height of the rib part that it supports, when forceps etc. are inserted from a low angle toward the head during robot-assisted surgery, the forceps etc. do not interfere with the head support part, making it possible to provide effective training.

In the general-purpose procedural training device of the present invention, the first fixing portion is composed of two parts and the second fixing portion is composed of one part, and it is preferable that the first mounting portion is composed of two parts and the second mounting portion is composed of one part, and the first fixing portion is attached to the first mounting portion and the second fixing portion is attached to the second mounting portion. By fixing the thoracic cavity simulator at two points, it can be stably fixed. Furthermore, by fixing the lung model fixing device at one point, it can be easily attached and detached.

In the general-purpose procedural training device of the present invention, the simulator body is provided with a support portion that supports the thoracic cavity, which comprises a rib portion, a sternum portion, and a thoracic vertebrae portion, and which simulates either the left or right side of the thoracic cavity, and which comprises a head support portion and a caudal support portion that support a portion of the rib portion, a thoracic vertebrae support portion that supports the thoracic vertebrae portion, and a sternum support portion that supports the sternum portion, and the caudal support portion comprises a dorsal member connected to the thoracic vertebrae support portion, and a chest side member connected to the sternum support portion, and a portion of the chest side member may be connected to the dorsal member via a hinge portion so as to be openable and closable, or a portion of the chest side member may be connected to the dorsal member so as to be detachable and detachable.
By making a part of the caudal support part openable or closable or attachable/detachable, when forceps or the like are inserted from a low angle on the caudal side in robot-assisted surgery, the forceps or the like do not interfere with the caudal support part, enabling more effective training. The openable or detachable part of the chest side member is preferably engaged with the dorsal side member using a known fastener such as a striker or a screw. The fixing portion of the chest side member and the dorsal side member is preferably structured to be fixed by fitting together in order to improve stability during fixing. When a part of the chest side member is opened or removed, the chest side member may release the support state of a part of the rib that it supports. In such a case, the rib that is released from the support state is preferably the tenth rib. This forms a large space near the tenth rib, improving the degree of freedom of insertion of forceps or the like, and enabling various trainings to be accommodated.

In the general-purpose procedural training device of the present invention, the caudal support section may further include a beam member that connects the thoracic support section or the dorsal member to the thoracic member. By including the beam member, the stability of the dorsal member and the thoracic member is improved and the thoracic cavity can be stably supported even when a part of the thoracic member is in an open or removed state. The beam member is provided at the bottom of the simulator body in a position that does not interfere with the lung model fixing device.

In the general-purpose procedural training device of the present invention, the sternum support part and the chest side member may be connected with a gap provided near the position corresponding to the pith of the thoracic cavity. By providing a gap near the position corresponding to the pith, a part of the body can be reproduced more accurately, and when forceps or the like are inserted from a low angle on the caudal side during robot-assisted surgery, the forceps or the like do not interfere with the caudal support part, allowing for more effective training.

In the general-purpose procedural training device of the present invention, the portion of the chest side member that supports the ribs may be separated as a connecting member and fixed to the ribs, and may be fitted and fixed to a part of the openable chest side member. By separating only the portion of the chest side member that is fixed to the ribs, more space can be provided when the part of the chest side member is opened or removed, making it possible to insert forceps or the like from various angles.

The general-purpose surgical training device of the present invention has the advantage of being able to handle both endoscopic surgery and robot-assisted surgery, and can be used for a variety of body parts and surgical procedures.

FIG. 1 is a perspective view of a general-purpose technique training device according to a first embodiment of the present invention; FIG. 1 is an external view of a general-purpose technique training device according to a first embodiment of the present invention; FIG. 2 is an external view of the general-purpose technique training device according to the first embodiment; FIG. 3 is an external view of the general-purpose technique training device according to the first embodiment; FIG. 1 is a perspective view of a thoracic cavity simulator according to a first embodiment of the present invention; FIG. 1 is an external view of a thoracic cavity simulator according to a first embodiment of the present invention; FIG. 1 is a plan view of a thoracic cavity simulator according to a first embodiment of the present invention; FIG. 1 is a bottom view of the thoracic cavity simulator of the first embodiment. FIG. 2 is an external view of the thoracic cavity simulator according to the first embodiment; FIG. 1 is a perspective view of a lung model fixing tool according to a first embodiment; FIG. 1 is an external view of the lung model fixing tool of Example 1. FIG. 2 is an external view of the lung model fixing tool of Example 1. Oblique view of lung model Flow of use of the general-purpose technique training device of the first embodiment Lung model installation instructions Installation instructions for the lung model fixture Installation instructions for the thoracic simulator Appearance of the general-purpose training device after the lung model is attached (1) Plan view of the general-purpose training device with the lung model attached FIG. 1 is a comparative explanatory diagram of the general-purpose procedure training device of the first embodiment and a thoracic cavity simulator of a comparative example. Image of inserting a medical instrument into the thoracic cavity simulator of Example 1 (1) Image of inserting a medical instrument into the thoracic cavity simulator of Example 1 (2) Image of inserting a medical instrument into a thoracic cavity simulator (comparison example) FIG. 13 is a perspective view of a lung model fixture according to another embodiment. FIG. 13 is a perspective view of the thoracic cavity simulator according to the second embodiment, seen from the head side. FIG. 13 is a perspective view of the thoracic cavity simulator of the second embodiment as viewed from the caudal side. FIG. 1 is a front view and a rear view of a thoracic cavity simulator according to a second embodiment of the present invention; FIG. 11 is a plan view of a thoracic cavity simulator according to a second embodiment of the present invention; FIG. 13 is a bottom view of the thoracic cavity simulator of the second embodiment. FIG. 13 is a right side view and a left side view of a thoracic cavity simulator according to a second embodiment of the present invention; FIG. 11 is a front view showing an open state of the tail support part of the second embodiment. FIG. 13 is a perspective view showing an open state of the tail support part of the second embodiment;

Below, an example of an embodiment of the present invention will be described in detail with reference to the drawings. Note that the scope of the present invention is not limited to the following examples and illustrated examples, and many modifications and variations are possible.

1 to 4 are external views of the general-purpose technique training device of Example 1, with FIG. 1 being a perspective view, FIG. 2 (1) being a front view, FIG. 2 (2) being a rear view, FIG. 3 (1) being a plan view, FIG. 3 (2) being a bottom view, FIG. 4 (1) being a right side view, and FIG. 4 (2) being a left side view.
As shown in FIG. 1, the general-purpose procedural training device 1 is composed of a thoracic cavity simulator 2 as a simulator that simulates a part of the body, a base 3 as a pedestal portion, and a lung model fixing device 4 as an organ model fixing device for fixing an organ model, and training is performed by attaching the thoracic cavity simulator 2 and the lung model fixing device 4 to the base 3.

The base 3 is composed of a base body 30, an attachment portion 31, and an anti-slip member 32. As shown in Figs. 2 (1) and (2), the attachment portion 31 is composed of attachment portions (31a to 31c), and in this embodiment, the attachment portions (31a, 31b) function as the first attachment portion, and the attachment portion 31c functions as the second attachment portion. As shown in Fig. 3 (2), six anti-slip members (32a to 32f) are provided on the back surface of the base body 30 as the anti-slip member 32. The anti-slip members (32a to 32f) are made of a rubber material, and stably support the thoracic simulator 2 and the lung model fixing device 4 during training.

The thoracic cavity simulator 2 is composed of a frame 5 as a support, a thoracic cavity section 6, and a fitting section 21. The frame 5 and the thoracic cavity section 6 function as the simulator body, and the fitting section 21 functions as a first fixing section. The frame 5 is made of nylon material containing carbon powder. The thoracic cavity section 6 is made of urethane. The fitting section 21 is made of nylon material containing carbon powder. Figures 5 to 9 are external views of the thoracic cavity simulator of Example 1, with Figure 5 being a perspective view, Figure 6 (1) being a front view, Figure 6 (2) being a rear view, Figure 7 being a plan view, Figure 8 being a bottom view, Figure 9 (1) being a right side view, and Figure 9 (2) being a left side view.
The frame portion 5 shown in FIG. 1 is composed of a head support portion 51, a tail support portion 52, a thoracic support portion 53, and a sternum support portion 54, as shown in FIGS. 5, 7, and 8, and the head support portion 51 and the thoracic support portion 53, the head support portion 51 and the sternum support portion 54, the tail support portion 52 and the thoracic support portion 53, or the tail support portion 52 and the sternum support portion 54 are connected at each end.
The fitting portion 21 is composed of two fitting portions. That is, as shown in Fig. 8, a fitting portion 21a is provided at the bottom of the thoracic vertebrae support portion 53, and a fitting portion 21b is provided at the bottom of the sternum support portion 54. As shown in Figs. 9(1) and (2), a recess 7b is provided in the fitting portions (21a, 21b), and the structure allows for easy attachment/detachment to and fixation on the base 3.

As shown in Figures 5, 7 and 8, the thoracic cavity 6 shown in Figure 1 comprises a rib portion 60, a thoracic vertebrae portion 61 and a sternum portion 62, and the rib portion 60 comprises a first rib portion 6a, a second rib portion 6b, a third rib portion 6c, a fourth rib portion 6d, a fifth rib portion 6e, a sixth rib portion 6f, a seventh rib portion 6g, an eighth rib portion 6h, a ninth rib portion 6i, a tenth rib portion 6j, an eleventh rib portion 6k and a twelfth rib portion 6l.
7 , one ends of the fourth rib 6d, the fifth rib 6e, the sixth rib 6f, the seventh rib 6g, the eighth rib 6h, the ninth rib 6i, the tenth rib 6j, the eleventh rib 6k, and the twelfth rib 6l are joined to the thoracic vertebrae 61. One ends of the first rib 6a, the second rib 6b, the third rib 6c, the fourth rib 6d, the fifth rib 6e, the sixth rib 6f, the seventh rib 6g, the eighth rib 6h, the ninth rib 6i, and the tenth rib 6j are joined to the sternum 62.

As shown in Fig. 6 (1), the other ends of the tenth rib 6j, the eleventh rib 6k, and the twelfth rib 6l are connected and fixed to the caudal support part 52 at their respective connection parts (52a to 52c) using fasteners 7. As shown in Fig. 6 (1) or Fig. 9 (2), the maximum height _H2 of the caudal support part 52 is set lower than the maximum height _H1 of the tenth rib 6j, the eleventh rib 6k, and the twelfth rib 6l supported by the caudal support part 52. This improves the degree of freedom of the insertion angle when inserting a medical instrument such as forceps from the caudal side.
As shown in Fig. 6 (2), the other end of the first rib portion 6a, the second rib portion 6b, or the third rib portion 6c is connected and fixed to the head side support portion 51 at the respective connection portions (51a to 51c) using fasteners 7. As shown in Fig. 6 (2) or Fig. 9 (1), the maximum height _H4 of the head side support portion 51 is set lower than the maximum height _H3 of the first rib portion 6a, the second rib portion 6b, or the third rib portion 6c supported by the head side support portion 51. This improves the degree of freedom of the insertion angle when inserting a medical instrument such as forceps from the head side.

Figures 10 to 12 are external views of the lung model fixing device of Example 1, with Figure 10 being an oblique view, Figure 11 (1) being a front view, Figure 11 (2) being a bottom view, Figure 12 (1) being a right side view, and Figure 12 (2) being a left side view.
10 is a fixture capable of mounting an organ model simulating a right lung, and is composed of a mediastinum 41, a support part 42, and a fitting part 43. The mediastinum 41 and the support part 42, and the support part 42 and the fitting part 43 are connected and fixed, respectively. The mediastinum 41, the support part 42, and the fitting part 43 are made of nylon material containing carbon powder.
An organ model simulating a right lung can be attached to the mediastinum 41, which has a flat surface. As shown in Figure 11 (1) or (2), the mediastinum 41 is provided wider to the left of the support part 42 or the fitting part 43, in consideration of the anatomical positional relationship between the organ model and the thoracic cavity simulator when the lung model fixing tool 4 is attached to the base 3 after the organ model is fixed.
12(1) or 12(2), the fitting portion 43 is provided with a total of four recesses 7b, and has a structure that allows easy attachment/detachment and fastening to the base 3. The fitting portion 43 functions as a second fastening portion.

Fig. 13 shows a perspective view of the lung model. The lung model 8 shown in Fig. 13 is a lobectomy model simulating the right lung in a lateral position when performing upper lobectomy, middle lobectomy, lower lobectomy, or median lymph node dissection, and is composed of a lobe 81, an upper lobe 82, a middle lobe 83, and a lower lobe 84.
The lobe 81 is a deformed lower part of the right lung during surgery, while the upper lobe 82, middle lobe 83, and lower lobe 84 are more detailed reproductions of the upper part of the right lung during surgery. All of them faithfully reproduce the spongy texture of the lungs, and a series of instrumental operations such as energy devices including electric scalpels and staplers are possible. Although not shown here, the lung model 8 also reproduces the bronchi, veins, arteries, lymph nodes, nerves, and pleura.

Now, a method of using the general-purpose manual training device of Example 1 will be described. FIG. 14 shows a flow of using the general-purpose manual training device of Example 1. As shown in FIG. 14, first, the lung model 8 is attached to the lung model fixing device 4 (step S01). FIG. 15 is an explanatory diagram of the attachment of the lung model, where (1) shows the state before attachment and (2) shows the state after attachment. As shown in FIG. 15 (1), the lung model 8 is attached to the surface of the mediastinum 41 of the lung model fixing device 4. The surface of the mediastinum 41 has an area that can cover the entire bottom surface of the lung model 8, and can stably support the lung model 8.

Next, the lung model fixing device 4 is attached to the base 3 (step S02). FIG. 16 shows an explanatory diagram of the attachment of the lung model fixing device. As shown in FIG. 16, the attachment portion 31c is provided with a plurality of convex portions 7a. Therefore, when attaching the lung model fixing device 4 to the base 3, the fitting portion 43 is fitted into the attachment portion 31c from above, and then it is slid in the direction of the arrow 11a, so that the concave portions 7b (see FIG. 12) engage with the convex portions 7a, and it can be easily fixed. Conversely, when removing the lung model fixing device 4 from the base 3, it is slid in the direction of the arrow 11b, so that the engagement state between the concave portions 7b and the convex portions 7a can be released, and it can be easily removed upward.

After the lung model fixing tool 4 is attached to the base 3, the thoracic simulator 2 is attached to the base 3 (step S03). FIG. 17 is an explanatory diagram of the attachment of the thoracic simulator, (1) shows the state before attachment, and (2) shows the state after attachment. As shown in FIG. 17 (1), when attaching the thoracic simulator 2 to the base 3, the fitting parts (21a, 21b) are fitted to the attachment parts (31a, 31b) from above the base 3 in the direction of the arrow 11c, and then slid in the direction of the arrow 11d, so that the recess 7b (see FIG. 9) of the fitting parts (21a, 21b) engages with the protrusion 7a (see FIG. 16) of the attachment parts (31a, 31b), and the simulator can be easily fixed. Conversely, when removing the thoracic simulator 2 from the base 3, the engagement state between the recess 7b and the protrusion 7a can be released by sliding in the direction of the arrow 11e, and the simulator can be easily removed in the direction of the arrow 11f.

As shown in FIG. 17(2), after attaching the lung model fixing tool 4 and the thoracic simulator 2 to the pedestal 3, forceps or the like are inserted to perform training (step S04). FIG. 18 and FIG. 19 are external views of the general-purpose manual training device after the lung model is attached, with FIG. 18(1) being a front view, FIG. 18(2) being a rear view, and FIG. 19 being a plan view. As shown in FIG. 18 and FIG. 19, when the lung model 8 is attached to the lung model fixing tool 4 and the thoracic simulator 2 and the lung model fixing tool 4 are fixed to the pedestal 3, the three-dimensional positional relationship between the rib portion 60, the thoracic vertebrae portion 61, and the sternum portion 62 simulated in the thoracic simulator 2 and the lung model 8 attached to the lung model fixing tool 4 is anatomically reproduced. In this way, by fixing the thoracic simulator 2 and the lung model fixing tool 4 via the pedestal 3 rather than directly fixing them, the simulator and the fixing tool can be individually designed according to the purpose and content of the training. It is also easy to precisely reproduce the parts of the body that are necessary for the training, and deform or not reproduce parts that are not required.

FIG. 20 is a comparative explanatory diagram of the general-purpose procedural training device of Example 1 and a thoracic cavity simulator of a comparative example, where (1) shows the general-purpose procedural training device of Example 1 and (2) shows the thoracic cavity simulator of the comparative example.
As shown in Fig. 20(2), the thoracic cavity simulator 100 of the comparative example is a simulator that reproduces the entire thoracic cavity, and a lung model fixing tool 400 is attached to the inside of the rib portion 600 for training. In the thoracic cavity simulator 100, both a part _A1 corresponding to the right thoracic cavity and a part _A2 corresponding to the left thoracic cavity are reproduced, so when designing the lung model fixing tool 400, it is necessary to make it conform to the shape and specifications of the thoracic cavity simulator 100. In contrast, as shown in Fig. 20(1), in the general-purpose technique training device 1 of the first embodiment, only the part _A1 corresponding to the right thoracic cavity is reproduced. This is because, for example, when training in lobectomy of the right lung, it is sufficient that the right thoracic cavity is accurately reproduced, and the left thoracic cavity may be significantly deformed or deleted.

20(2) does not show a base or the like, the thoracic simulator 100 requires a dedicated fixture for supporting the head support part 501 and the tail support part 502. When the thoracic simulator 100 is attached to a dedicated fixture, the head support part 501 and the tail support part 502 play the same role as the fitting parts (21a, 21b) in the thoracic simulator 2, so the head support part 501 and the tail support part 502 are required to have a high strength sufficient for stable fixation to the fixture. For this reason, for example, the thickness _T2 of the tail support part 502 of the thoracic simulator 100 is set to be larger than the thickness _T1 of the tail support part 52 of the thoracic simulator 2. However, in robot-assisted surgery, unlike endoscopic surgery performed by human hands, forceps or the like may be inserted at a port or angle that is not operated by a human being. Therefore, if the thickness _T2 of the tail support part 502 is set to be large, there is a problem that the forceps or the like may interfere with the tail support part 502, making it difficult to perform appropriate training.

The following describes the image of inserting a medical instrument into a thoracic simulator, the difference between inserting by human hand and by robot arm, and the difference between inserting into the thoracic simulator of Example 1 and inserting into the thoracic simulator of the comparative example, with reference to Figs. 21 to 23. Figs. 21 and 22 are illustrations of inserting a medical instrument into the thoracic simulator of Example 1, with Fig. 21 showing an oblique view and Fig. 22 showing a left side view. (1) shows an image of inserting a medical instrument by human hand, and (2) shows an image of inserting a medical instrument by a robot arm, respectively. Also, Fig. 23 is an illustration of inserting a medical instrument into the thoracic simulator of the comparative example, with (1) showing an oblique view from the head side and (2) showing a left side view.

In the case of inserting a medical instrument manually, in Fig. 21 (1), the forceps 9a is inserted between the fourth rib 6d and the fifth rib 6e, i.e., at the fourth intercostal position, and the forceps 9b is inserted between the seventh rib 6g and the eighth rib 6h, i.e., at the seventh intercostal position. In addition, the trocar 12a is inserted between the sixth rib 6f and the seventh rib 6g, i.e., at the sixth intercostal position. An endoscope or the like is inserted separately into the trocar 12a.
In the case of inserting a medical instrument by a robot arm, in FIG. 21 (2), a trocar 12b is inserted between the seventh rib 6g and the eighth rib 6h, i.e., at the seventh intercostal position, and a forceps 9c is inserted into the trocar 12b. A trocar 12c is inserted between the eighth rib 6h and the ninth rib 6i, i.e., at the eighth intercostal position. An endoscope or the like is inserted separately into the trocar 12c. A trocar 12d is inserted between the ninth rib 6i and the tenth rib 6j, i.e., at the ninth intercostal position, and a forceps 9d is inserted into the trocar 12d. A trocar 12e is inserted between the tenth rib 6j and the eleventh rib 6k, i.e., at the tenth intercostal position. An endoscope or the like is inserted separately into the trocar 12e.

As shown in FIG. 22(1), when a medical instrument is inserted by hand, forceps or the like is inserted from a relatively vertical direction, as indicated by arrows (11g, 11h), whereas, as shown in FIG. 22(2), when a medical instrument is inserted by a robotic arm, forceps or the like may be inserted from a relatively horizontal direction, as indicated by arrows (11i, 11j).
Therefore, as shown in Figure 23 (1) or (2), when training in robot-assisted surgery is performed using the thoracic cavity simulator 100 of the comparative example, if forceps 9e are inserted between the ninth rib 600i and the tenth rib 600j, i.e., at the ninth intercostal position, the forceps 9e will interfere with the caudal support portion 502 at area _A3 , making it difficult to perform training smoothly.

In contrast, in the thoracic cavity simulator 2 of Example 1, as shown in Fig. 20(1), the thickness _T1 of the caudal support part 52 is small, and as shown in Fig. 6(1) or Fig. 9(2), the maximum height _H2 of the caudal support part 52 is lower than the maximum height _H1 of the tenth rib 6j, the eleventh rib 6k, or the twelfth rib 6l supported by the caudal support part 52, resulting in a structure with a high degree of freedom in the insertion angle and capable of preventing interference of the forceps with the caudal support part 52. In addition, as for the width of the caudal support part, the width _W1 of the caudal support part 52 shown in Fig. 20(1) is narrower than the width _W2 of the caudal support part 502 shown in Fig. 20(2), resulting in a structure with a high degree of freedom in the insertion angle not only in the upward direction but also in the left-right direction.

Figures 25 to 30 are external views of the thoracic cavity simulator of Example 2, with Figure 25 being a perspective view seen from the head side, Figure 26 being a perspective view seen from the tail side, Figure 27(1) being a front view, Figure 27(2) being a rear view, Figure 28 being a plan view, Figure 29 being a bottom view, Figure 30(1) being a right side view, and Figure 30(2) being a left side view. The thoracic cavity simulator 20 of Example 2 can be used as a general-purpose manual technique training device, for example, in place of the thoracic cavity simulator 2 of Example 1, in combination with the base 3 and lung model fixing tool 4 of Example 1.
As shown in Fig. 25, the thoracic cavity simulator 20 is composed of a frame 50 as a support part, a thoracic cavity part 6, and a fitting part 21. The frame 50 and the thoracic cavity part 6 function as the simulator body, and the fitting part 21 functions as a first fixing part. The frame 50 is made of nylon material containing carbon powder. The thoracic cavity part 6 is made of urethane. The fitting part 21 is made of nylon material containing carbon powder.
As shown in FIG. 26 , the frame 50 of the thoracic cavity simulator 20 is composed of a head support section 55, a tail support section 56, a thoracic support section 57, and a sternum support section 58, and the head support section 55 and the thoracic support section 57, the head support section 55 and the sternum support section 58, the tail support section 56 and the thoracic support section 57, or the tail support section 56 and the sternum support section 58 are connected to each other.
The fitting portion 21 is composed of two fitting portions (21a, 21b). That is, as shown in Fig. 29, the fitting portion 21a is provided at the bottom of the thoracic vertebrae support portion 57, and the fitting portion 21b is provided at the bottom of the sternum support portion 58. As shown in Figs. 30 (1) and (2), a recess 7b is provided in the fitting portions (21a, 21b), and the structure allows easy attachment/detachment and fastening to the base 3. In this way, the structure of the fitting portions (21a, 21b) is the same as that of the thoracic cavity simulator 2 of the first embodiment.

The thoracic cavity 6 shown in Fig. 25 is composed of a rib portion 60, a thoracic vertebrae portion 61, and a sternum portion 62, and the rib portion 60 is composed of a first rib portion 6a, a second rib portion 6b, a third rib portion 6c, a fourth rib portion 6d, a fifth rib portion 6e, a sixth rib portion 6f, a seventh rib portion 6g, an eighth rib portion 6h, a ninth rib portion 6i, a tenth rib portion 6j, an eleventh rib portion 6k, and a twelfth rib portion 6l, as shown in Fig. 28. One end of the fourth rib portion 6d, the fifth rib portion 6e, the sixth rib portion 6f, the seventh rib portion 6g, the eighth rib portion 6h, the ninth rib portion 6i, the tenth rib portion 6j, the eleventh rib portion 6k, and the twelfth rib portion 6l are joined to the thoracic vertebrae portion 61. The thoracic portion 61 is connected to the thoracic support portion 57 as shown in FIG.
As shown in Fig. 28, one end of each of the first rib portion 6a, the second rib portion 6b, the third rib portion 6c, the fourth rib portion 6d, the fifth rib portion 6e, the sixth rib portion 6f, the seventh rib portion 6g, the eighth rib portion 6h, the ninth rib portion 6i, and the tenth rib portion 6j is joined to the sternum portion 62. As shown in Fig. 30(1), the sternum portion 62 is connected to a sternum support portion 58.

The connecting member 56e shown in Fig. 27(1) is a member in which a portion supporting the tenth rib 6j is separated from the chest side member and fixed to the tenth rib 6j, and can be fixed by fitting with the chest side member 56b. The other ends of the eleventh rib 6k and the twelfth rib 6l are fixed to the dorsal side member 56a at the connecting portions (52b, 52c) using fasteners 7. As shown in Fig. 27(1) or Fig. 30(2), the maximum height _H6 of the tail side support portion 56 is set lower than the maximum height _H5 of the tenth rib 6j, the eleventh rib 6k, or the twelfth rib 6l supported by the tail side support portion 56. This improves the degree of freedom of the insertion angle when inserting a medical instrument such as forceps from the tail side, even when the chest side member 56b is fixed to the dorsal side member 56a and the connecting member 56e.
The other end of the first rib portion 6a, the second rib portion 6b or the third rib portion 6c shown in Figure 28 is connected and fixed to the head side support portion 55 using fasteners 7 at the connection portions (51a to 51c) shown in Figure 27 (2).

Here, a description will be given of the opening and closing mechanism of the tail support part 56. As shown in Fig. 26, the tail support part 56 of the second embodiment is composed of a back side member 56a, a chest side member (56b, 56c), a beam member 56d, and a connecting member 56e.
30(2), the dorsal member 56a is connected to an end of the thoracic support portion 57 using the fastener 7. As described above, the connecting member 56e is connected to the tenth rib portion 6j.
One end of the chest side member (56b, 56c) shown in Fig. 26 is connected to be rotatable by a hinge part 56f. As shown in Fig. 30(1), the other end of the chest side member 56c is connected so that the lower surface of the sternum support part 58 and the upper surface of the chest side member 56c abut against each other. The caudal support part 52 of the first embodiment shown in Fig. 9(1) is connected to the caudal extension of the part of the sternum support part 54 that supports the sternum part 62 (see Fig. 7), but in this embodiment, the chest side member 56c is fixed to the lower surface of the sternum support part 58 to provide a gap 63b. This allows for greater freedom in the angle at which forceps or the like are inserted during training.
29, the chest side member 56c and the thoracic vertebrae support portion 57 are connected by a beam member 56d, and stability can be ensured even when the caudal support portion 56 is in an open state. The beam member 56d may be structured to connect the chest side member 56c and the dorsal side member 56a.

Fig. 31 is a front view showing the open state of the tail support part of Example 2. Fig. 32 is a perspective view showing the open state of the tail support part of Example 2, (1) showing a perspective view seen from the tail and dorsal side, and (2) showing a perspective view seen from the tail and thoracic side.
As shown in Fig. 27(1), the back side member 56a and the chest side member 56b are each provided with a member constituting a striker 59, realizing a locking mechanism. The tail side support part 56 can be fixed by fitting the chest side member 56b to the back side member 56a and the connecting member 56e and locking the striker 59. On the other hand, as shown in Fig. 31, the striker 59 can be released, and then the chest side member 56b can be rotated using the hinge part 56f to release the engagement between the chest side member 56b and the back side member 56a and the connecting member 56e, thereby opening the tail side support part 56.
By opening the caudal support part 56, as shown in Fig. 31, a gap 63a is formed, which improves the degree of freedom of the angle at which forceps or the like is inserted during training. For example, as shown by the arrows in Fig. 32(1) or (2), training is possible in which forceps or the like is inserted from the vicinity of the pith on the chest side or from the direction of the abdomen. In addition, the chest side member 56c is connected not only to the sternum support part 58 but also to the thoracic vertebrae support part 57 by the beam member 56d, so that the structure ensures stability even when the caudal support part 56 is in the open state.

Other Examples
Fig. 24 shows a perspective view of a lung model fixing tool of another embodiment. As shown in Fig. 24, unlike the lung model fixing tool 4 of the embodiment 1, a hook portion 44 of a hook-and-loop fastener may be provided on the mediastinum 41, as in the lung model fixing tool 4a.

This invention is useful for training in endoscopic surgery and robotic-assisted surgery.

1 General-purpose technique training device 2, 20, 100 Thoracic cavity simulator 3 Base 4, 4a, 400 Lung model fixing tool 5, 50 Frame 6 Thoracic cavity 6a First rib 6b Second rib 6c Third rib 6d Fourth rib 6e Fifth rib 6f Sixth rib 6g Seventh rib 6h Eighth rib 6i, 600i Ninth rib 6j, 600j Tenth rib 6k Eleventh rib 6l Twelfth rib 7 Fastener 7a Convex 7b Concave 8 Lung model 9a to 9e Forceps 11a to 11f Arrows 12a to 12d Trocars 21, 21a, 21b, 43 Fitting 30 Base body 31, 31a to 31c Attachment portion 32, 32a to 32f Anti-slip member 33 Convex portion 41 Mediastinum portion 42 Support portion 44 Hook portion 51, 55, 501 Head side support portion 51a to 51c, 52a to 52c Connection portion 52, 56, 502 Caudal side support portion 53, 57 Thoracic vertebrae support portion 54, 58 Sternum support portion 56a Dorsal side member 56b, 56c Chest side member 56d Beam member 56e Connection member 56f Hinge portion 59 Lung lock 60 Rib portion 61 Thoracic vertebrae portion 62 Sternum portion 63a, 63b Gap 81 Lung lobe portion 82 Upper lobe portion 83 Middle lobe portion 84 Lower lobe portion A ₁ , A ₂ portion H ₁ to _H6 Maximum height _T1 , _T2 Thickness _W1 , _W2 Width

Claims (9)

A three-dimensional simulator that simulates a part of the body,
an organ model fixture for fixing the organ model;
A flat base portion having an attachment portion is provided,
the simulator has a simulator body simulating a part of a body and a first fixing part fixed to the base part,
the organ model fixing tool has an organ model fixing tool main body for attaching the organ model and a second fixing part for fixing the organ model to the base part,
the base portion has first and second mounting portions for mounting the first and second fixing portions,
A general-purpose procedural training device characterized in that, when the organ model fixing tool to which the organ model is attached and the simulator are fixed to the base, the three-dimensional positional relationship between the part of the body simulated by the simulator body and the organ model is anatomically reproduced. The general-purpose procedural training device according to claim 1, characterized in that the simulator is a thoracic cavity simulator that simulates either the left or right thoracic cavity, and the organ model fixing device is a lung model fixing device that fixes either the left or right lung model corresponding to the thoracic cavity. The simulator body includes:
a thoracic cavity portion consisting of a rib portion, a sternum portion, and a thoracic vertebra portion, simulating either the left or right thoracic cavity;
a support section for supporting the thoracic cavity section, the support section comprising a head support section and a tail support section for supporting a part of the rib section, a thoracic support section for supporting the thoracic vertebrae section, and a sternum support section for supporting the sternum section;
Equipped with
3. The general-purpose procedural training device according to claim 2, wherein a maximum height of the caudal support portion is lower than a maximum height of a rib portion supported by the caudal support portion. The simulator body includes:
a thoracic cavity portion consisting of a rib portion, a sternum portion, and a thoracic vertebra portion, simulating either the left or right thoracic cavity;
a support section for supporting the thoracic cavity section, the support section comprising a head support section and a tail support section for supporting a part of the rib section, a thoracic support section for supporting the thoracic vertebrae section, and a sternum support section for supporting the sternum section;
Equipped with
3. The general-purpose manual skill training device according to claim 2, wherein a maximum height of the head side support portion is lower than a maximum height of a rib portion supported by the head side support portion. The first fixing portion is composed of two parts and the second fixing portion is composed of one part,
In addition, the first mounting portion is composed of two parts and the second mounting portion is composed of one part,
3. The general-purpose manual skill training device according to claim 2, wherein a first fixing portion is attached to the first mounting portion, and a second fixing portion is attached to the second mounting portion. The simulator body includes:
a thoracic cavity portion consisting of a rib portion, a sternum portion, and a thoracic vertebra portion, simulating either the left or right thoracic cavity;
a support section for supporting the thoracic cavity section, the support section comprising a head support section and a tail support section for supporting a part of the rib section, a thoracic support section for supporting the thoracic vertebrae section, and a sternum support section for supporting the sternum section;
Equipped with
the caudal support portion comprises a dorsal member connected to the thoracic support portion and a thoracic member connected to the sternum support portion;
The general-purpose procedural training device according to claim 2, characterized in that a part of the chest side member is connected to the back side member via a hinge portion so as to be openable and closable, or a part of the chest side member is connected to the back side member so as to be detachable. The general-purpose technique training device according to claim 6, characterized in that the caudal support section further comprises a beam member connecting the thoracic support section or the dorsal member to the thoracic member. The general-purpose technique training device according to claim 6 or 7, characterized in that the sternum support part and the chest side member are connected with a gap provided near a position corresponding to the pith of the thoracic cavity. 8. The general-purpose procedural training device according to claim 6 or 7, characterized in that a portion of the chest side member that supports the rib portion can be separated as a connecting member and fixed to the rib portion, and can be fixed by engaging with a part of the chest side member that can be opened and closed.