JP7372705B2 - Body cavity model for surgical technique training and its usage method - Google Patents

Description

The present invention relates to an artificial skin model used by doctors and others to train surgical techniques related to wound closure, such as suturing, and a method of using the same.

In medical practice, skin suturing is one of the surgical procedures that is routinely and frequently performed. Physicians are required to treat wounds such as injuries to the forehead, limbs, and lacerations on a daily basis, not only in hospitals but also in clinics. Furthermore, most surgical operations involve skin incisions, and the incisions must be closed afterwards. Since the degree of healing of wounds and surgical scars is significantly influenced by the appropriate selection of techniques such as suturing and the skill of the surgeon, the surgeon must undergo considerable training before performing surgery on the patient. That is required.

Conventional surgical technique training methods for skin include wet labs using naturally derived tissues such as pig skin and dry labs using artificial models and simulators.

Wet labs are performed using thin pig skin on the dorsal side and pig skin containing thick subcutaneous adipose tissue on the ventral side. In this case, the pig skin is often provided in a state where it is fixed with pins on a styrene flat plate about 2 cm thick.

In addition, in the dry lab, models made of multiple layers of soft urethane resin, sponge, and hydrogels such as PVA (polyvinyl alcohol) are fixed to predetermined fixtures and used for training.

Here, human skin has tensile stress, so in order to reproduce this, there is a conventional technique in which a fixed pedestal made of a rigid material in the shape of a "kamaboko" is prepared and a skin model is placed on this.

By the way, with conventional skin models and fixtures, the training target is only the skin model itself, that is, the execution of surgical procedures on the skin, and the training target is only the skin model itself, that is, the execution of surgical procedures on the skin. It is not intended for surgical technique training.

Generally, the purpose of forming an opening through an actual skin incision is to expand the visual field and surgical field, which is directly linked to the ease of performing surgery on the other organs mentioned above. and postoperative closure is required. Furthermore, as described above, the thickness of the skin, the flexibility of the skin, the distance to the bone, etc. vary depending on the surgical site. Training with a uniform artificial skin model may not make sense.

For example, in the case of the skin of the chest, there is a part where the ribs are and an intercostal area, which is the gap between the ribs.A small opening of about 2 cm is made in this intercostal area, and an endoscope or surgical instruments are inserted to perform heart surgery. I do. After surgery, the skin is sutured to close the opening.

On the other hand, conventional techniques do not assume the training of organs such as organs and blood vessels that are located deeper than the skin model, making it difficult to train for minimally invasive surgery using approaches that penetrate the skin. could not.

The present invention was made in view of the above circumstances, and an object thereof is to provide an artificial skin model for surgical technique training that is highly usable and can also be used for training in minimally invasive surgery. It is something.

In order to solve the above problems, the following invention is provided according to a main aspect of the present invention.

(1) An artificial skin model for a surgical training device,
It has a main body made of a flexible flat plate member, and a skin model layer, which is a first artificial organ, fixed to the middle part of the main body in the longitudinal direction excluding both ends,
By bending the midway part of the main body with the side to which the skin model layer is fixed on the outside of the radius of curvature, both ends in the length direction are bent to form a space imitating a body cavity inside the radius of curvature. An artificial skin model characterized in that it can be fixed to a fixing device and is configured so that when removed from the fixing device, it returns to a flat plate shape due to restoring force.

(2) In the artificial skin model described in (1) above,
A through hole communicating from a surface outside the radius of curvature to an inside surface is provided at a predetermined position in the midway portion of the main body to which the skin model layer is attached;
The skin model layer is fixed to a surface on the outside of the radius of curvature in the middle part of the main body so as to cover the through hole,
The artificial skin model, wherein the through hole is located so as to face a second artificial organ for surgical technique training installed on the fixture.

(3) In the artificial skin model described in (1) above,
An artificial skin model, wherein the skin model layer is made of a naturally derived material.

(4) In the artificial skin model described in (1) above,
An artificial skin model, characterized in that the main body is provided with fastener members at both ends in the length direction for detachably fixing the main body to the fixing tool in a bent state.

(5) In the artificial skin model described in (1) above,
A slit is provided at least at both ends in the length direction of the main body, and the main body is divided into two or more panel pieces in the width direction by the slit. An artificial skin model characterized by being configured to be fixed to a fixture.

(6) In the artificial skin model described in (2) above,
The artificial skin model is characterized in that the through-hole is formed in a shape that simulates a space between bones under the skin, depending on the type and site of the surgical technique to be trained.

(7) A method of using an artificial skin model for a surgical training device, comprising:
The artificial skin model is
It has a main body made of a flexible flat plate member, and a skin model layer, which is a first artificial organ, fixed to the middle part of the main body in the longitudinal direction excluding both ends,
The artificial skin model has a length in which a space imitating a body cavity is formed inside the radius of curvature by bending the middle part of the main body with the side to which the skin model layer is fixed on the outside of the radius of curvature. a step of fixing both ends of the direction to a predetermined fixture;
A method for using an artificial skin model, comprising the step of: installing a second artificial organ in a space imitating the body cavity of the fixture.

(8) In the method of using the artificial skin model described in (7) above,
A through hole communicating from a surface outside the radius of curvature to an inside surface is provided at a predetermined position in the midway portion of the main body to which the skin model layer is attached;
The skin model layer is fixed to a surface on the outside of the radius of curvature in the middle part of the main body so as to cover the through hole,
A method of using an artificial skin model, characterized in that the second artificial organ is installed facing the through hole.

(9) In the artificial skin model described in (7) above,
A slit is provided at least at both longitudinal ends of the main body, and the slit divides the main body into two or more panel pieces in the width direction,
A method of using an artificial skin model, wherein the fixing step includes bending the main body while partially overlapping the panel pieces and fixing it to the fixture.

(10) In the method of using the artificial skin model described in (8) above,
A method for using an artificial skin model, characterized in that the through hole is formed in a shape that simulates a space between bones under the skin, depending on the type and site of the surgical technique to be trained.

Features of the present invention other than those described above are shown in the following embodiments and drawings.

This configuration has excellent portability, storability, and portability, can apply any tension to the surface of the skin model to reproduce any part, and is minimally invasive with needle holders, forceps, trocars, etc. Provided are an artificial skin model and a method of using the same that can efficiently and effectively train surgical techniques involving the insertion of surgical instruments.

FIG. 1 is a schematic configuration diagram showing an artificial skin model according to an embodiment of the present invention.

FIG. 2 is a schematic configuration diagram showing the main body of the artificial skin model.

FIG. 3 is a schematic configuration diagram showing the pedestal.

FIG. 4 is a schematic configuration diagram showing the assembled artificial skin model.

FIG. 5 is a schematic diagram showing the assembled state of the artificial skin model.

FIG. 6 is a schematic configuration diagram showing a modified example.

FIG. 7 is a schematic configuration diagram showing a modified example.

FIG. 8 is a schematic configuration diagram showing a modified example.

FIG. 9 is a schematic configuration diagram showing a modified example.

FIG. 10 is a schematic configuration diagram showing a modified example.

FIG. 11 is a schematic configuration diagram showing a modified example.

FIG. 12 is a schematic configuration diagram showing a modified example.

FIG. 13 is a schematic configuration diagram showing a modified example.

FIG. 14 is a schematic configuration diagram showing a modified example.

FIG. 15 is a schematic configuration diagram showing a modified example.

Hereinafter, one embodiment of the present invention will be described with reference to the drawings.

(Artificial skin model device)
What is shown in FIGS. 1(a) and 1(b) is an artificial skin model 1 (first training target organ model) for surgical technique training according to this embodiment.

This artificial skin model 1 has a thin, flat main body 2 made of polypropylene, and a skin model layer 3 fixed at a midway point in the length direction of the main body 2.

Here, the dimensions of the main body 2 are 1 mm in thickness, 100 mm in width, and 250 mm in length, and the dimensions of the skin model are 5 mm in thickness, 70 mm in thickness, and 200 mm in length. Therefore, about 25 mm of each of the lengthwise ends 2a and 2b of the main body is left uncovered by the skin model. It is preferable that these end portions 2a and 2b are not covered by the skin model layer 3 in order to ensure the degree of freedom of deformation of the artificial skin model 1.

In addition, as shown in FIGS. 1(a) and 2, a long hole-shaped penetration with a width of 10 mm and a length of 180 mm is provided at the position where the skin model layer is provided in the middle part in the length direction of the main body 2. Three holes 4a to 4c are provided in parallel. This through hole is created by cutting the main body using, for example, a laser beam machine. Further, the interval between the elongated holes is 5 mm in this embodiment.

Furthermore, plastic snap buttons 5a to 5d are attached at equal intervals along the edge of the main body at both ends 2a and 2b of the main body 2 where the skin model layer 3 is not provided.
On both sides of the main body 2 in the width direction, upright ribs 6a to 6d are provided to restrict deformation of the main body 2. These ribs 6a to 6d are formed by thinning the surface of the main body 2 along the curved line shown in the figure using laser processing or the like to form a hinge, and are configured to be used by bending this portion inward during use. has been done.

(skin model layer)
As the skin model layer 3, it is possible to use either a wet laboratory model using a naturally derived tissue such as pig skin or a dry lab model using an artificial material. For wet lab use, it is desirable to use pig skin that is thin on the dorsal side or pig skin that includes thick subcutaneous adipose tissue on the ventral side. For dry lab use, it is desirable to use a model with multiple layers of soft urethane resin, sponge, and hydrogel such as PVA (polyvinyl alcohol).

This skin model layer 3 has a configuration that simulates actual skin, and is formed by laminating 1 to 3 different layers.

(Pedestal to attach artificial skin model device)
FIG. 3 shows a pedestal 7 on which the artificial skin model 1 is mounted.

This pedestal 7 has a bottom area width of 120 mm and a length of 200 mm, and has connecting parts 7a and 7b connected to both ends 2a and 2b of the main body 2 of the artificial skin model 1 at both longitudinal ends thereof. ing. This pedestal 7 is formed of a rigid body made of aluminum with a thickness of 1.5 mm, and the connecting portions 7a and 7b are formed by bending both ends of the pedestal 7 upward and standing up. The inner surfaces of the connecting parts 7a and 7b have convex snap buttons 8a to 8d connected to the concave snap buttons 5a to 5d provided on both ends 2a and 2b of the main body 2 of the artificial skin model 1, respectively. installed.

(Assembling artificial skin model device)
4 and 5 are schematic diagrams showing how the artificial skin model 1 is used.

When using the artificial skin model 1, the user holds both ends 2a and 2b of the main body 2 of the artificial skin model 1, and bends the body 2 with the side on which the skin model layer 3 is stacked on the outside of the radius of curvature. Then, in this bent state, the concave snap buttons 5a to 5d provided on both ends 2a and 2b of the main body 2 are coupled to the convex snap buttons 8a to 8d provided on the base 7. With this, the artificial skin model 1 can be fixed to the pedestal 7 in the state shown in FIGS. 4 and 5.

Here, the dimensions of the pedestal 7 are preferably designed such that the curvature of the main body 2 is approximately the same as that of the chest. This can be achieved by adjusting the ratio of the lengths of the main body 2 and the pedestal 7. Further, if necessary, the upright ribs 6a to 6d provided on the main body 2 are folded inward to restrict deformation at positions near both ends 2a and 2b.

Thereby, the curvature of the outer surface of the skin model layer 3 and the tensile stress inside the skin model accompanying the curvature can be adjusted as appropriate.

With the artificial skin model 1 assembled in this manner, a space 10 imitating a body cavity is defined between the lower surface of the main body 2 and the upper surface of the pedestal 7. In this embodiment, a blood vessel model 11 is installed in this space 10 as a second training target organ model. As this blood vessel model, a porcine carotid artery or a silicone blood vessel model with an inner diameter of 2 mm and an outer diameter of 3 mm is used.

(how to use)
When performing surgical technique training using this artificial skin model 1, the user, ie, the technique trainee, cuts the central surface of the artificial skin model layer 3 with a surgical instrument such as a scalpel 14, as shown in FIGS. 4 and 5. An incision of about 30 mm is made along the longitudinal direction of the through hole provided in the main body 2.

Then, the trainee inserts the minimally invasive surgical instrument 14 having a shaft length of 300 mm through the incision in the skin model layer 3 made above. At this time, the tip of the minimally invasive surgical instrument 13 extends into the space 10 through the incised portion of the skin model layer 3 and one of the through holes 4a to 4c provided in the main body 2. can be done.

This makes it possible to train the incisional surgical technique of the skin model layer 3, which is the first organ model, using the skin model 1, and also to reduce the amount of stress on the second organ model 11 placed in the space 10. It becomes possible to train in surgical techniques for anastomosis and suturing using invasive surgical instruments. At this time, by bending and installing the artificial skin model 1, desired tension can be applied to the surface of the skin model layer 3, and elasticity can be increased when the skin model layer 3 is pushed downward. can be made to resemble the chest as desired. Furthermore, by using the upright ribs 6a to 6b at this time, it is possible to finely adjust the elasticity and to prevent unnecessary deformation of the main body 2.

After using the artificial skin model 1, by removing it from the pedestal 7, the artificial skin model 1 and the pedestal 7 can be returned to a flat state, making it easy to store and improve portability. It has the effect of being superior.

(Modification 1)
In this example, the through holes 4a to 4c are parallel slits, but they are not limited to this shape and can be designed as appropriate depending on the purpose of surgical technique training.

For example, in the case of incision of skin tissue in head and neck surgery and training of surgical techniques for subcutaneous bone and muscle tissue, at least one circular through hole 4e with a diameter of 30 mm is formed on the main body 2, as shown in FIG. A natural skin model layer 3 derived from a pig's back having a thickness of 10 mm is pasted to cover the through hole 4e, thereby closing the through hole 4e.

In this example, in order to deform the skin model layer 3 not only in the length direction of the main body 2 but also in the width direction, that is, in a three-dimensional direction (deform into a dome shape), By making cuts 13 as shown in the figure in both ends 2a, 2b along the central axis along the central axis, the ends 2a, 2b are divided into four parts in the width direction, and four panel pieces 14a to 14d are provided. There is.

When using such an artificial skin model 1, as shown in FIG. 7, the other ends of the adjacent panel pieces 14a to 14d are overlapped with each other, and in this state, they are connected to a pedestal 7' shown in FIG. 8. The pedestal used in this example is provided with the convex snap buttons 8a to 8d so as to correspond to the dimensions and positions between the concave snap buttons 5a to 5d when the panel pieces 14a to 14d are stacked.

According to such a configuration, when the artificial skin model 1 is attached to the pedestal 7', the skin model layer 3 is pulled in a three-dimensional direction, and can be deformed into a so-called dome shape. This makes it possible to effectively train skin tissue incisions in head and neck surgery, and surgical techniques for subcutaneous bone and muscle tissue, for example.

In this modification, one slit 13 is provided at each end, but the invention is not limited to this. A plurality of slits 13 may be provided as shown by 15 in FIG. It is also possible to divide the panel into panel pieces and provide concave snap buttons 16a to 16f on each panel piece so that it can be deformed into a more complicated shape. In this case, as shown in FIG. 10, it is preferable that the pedestal 7'' is also provided with convex snap buttons 17a to 17f at positions where the panel pieces are desired to be fixed.

(Modification 2)
For example, when reproducing the skin tissue and subcutaneous bone/muscle tissue in the abdomen and performing training in a manual training environment for target organs such as the intestinal tract and digestive organs, an artificial skin model 21 as shown in FIG. 11 may be used. Can be used.

In this example, a main body 22 (600 mm x 600 mm) made of waterproof cardboard with a thickness of 2.0 mm is used, and six circular through holes 23a to 23f with a diameter of 30 mm are provided in the main body 22.

Furthermore, in this modification, Velcro (registered trademark) 24a, 24b are attached to both longitudinal ends 22a, 22b of the main body 22 as fastener members instead of the snap buttons used above.

Then, skin model layers 26a to 26f made of silicone and fiber composite having a thickness of 5 mm were adhered to the upper surface of the main body 22 using an adhesive to construct an artificial skin model 21.

The pedestal used for this artificial skin model 21 is as shown at 27 in FIG. 12, and the rigid pedestal 27 is made of waterproof cardboard with a thickness of 3 mm. (registered trademark) 28a and 28b are attached.

By installing a pig large intestine or a silicone intestinal model 11 with an outer diameter of about 20 mm as a second artificial organ model on the upper surface of the pedestal 27, training similar to that in the above embodiment can be performed.

That is, after bending the artificial skin model 21 and installing it on the pedestal 27, the user makes an incision of about 20 mm on the surface of the skin model layers 23a to 23f, which are the first organ models provided on the upper surface of the main body 22. By inserting a trocar or a minimally invasive surgical device with a shaft length of 300 mm through this incision, anastomosis and suturing surgical techniques can be performed on the intestinal model 11, which is the second organ model.

Note that FIGS. 13 and 14 show a further modification of the second modification, in which a plurality of cuts 29 are made in the main body 22 of the artificial skin model 21, so that both ends 22a and 22b of the main body 22 are It is divided into multiple panel pieces.

In this example, the pedestal 27 is divided into the three pedestal pieces 30 to 32, and the pedestal pieces 30 to 32 are movably connected to each other by hinges 33a and 33b.

According to such a further modification, after the artificial skin model 21 is bent and attached to the pedestal 27, the pedestal 27 side is further bent, thereby deforming the skin model 1 three-dimensionally. It is possible.

Moreover, FIG. 15 shows a further modification of this modification 2.

The artificial organ model 37 of this example is configured to reproduce ribs by arranging elongated through holes 37a and 37b on the left and right sides with oblique angles as in the above embodiment. . The chest can be reproduced by bonding rectangular skin model layers 38a and 38b so as to close the left and right through holes 37a and 37b.

Further, the present invention is not limited to the above-described embodiment and modified examples, but can be modified without changing the gist.

For example, the shapes of the main body, skin model layer, and through holes are not limited to the above shapes. Furthermore, the surgical instruments are not limited to those mentioned above, scalpels, etc.

1... Artificial skin model 2a, 2b... Both ends 3... Skin model layer 4a to 4c... Through hole 4e... Circular through hole 4... Through hole 5a to 5d... Concave side snap button 6a to 6d... Rib 7... Pedestal 8a to 8d ... Convex snap button 10... Space 11... Blood vessel model (second organ model)
13...Scalpel 14...Minimally invasive surgical instruments 14a-14d...Panel pieces 16a-16f...Concave side snap buttons 17a-17f...Convex side snap buttons 21...Artificial skin model 22...Main body 22a, 22b...Both ends 23e...Through hole 23a to 23f...Skin model layer

Claims (5)

A body cavity model for a surgical training device,
It has a main body made of a flexible flat plate member,
By bending the midway part of the main body, both lengthwise ends can be fixed to a predetermined fixture with a space imitating a body cavity formed inside the radius of curvature, and the restoring force is maintained when removed from the fixture. It is configured to return to a flat plate shape by
A slit is provided at least at both longitudinal ends of the main body, and the slit divides the main body into two or more panel pieces in the width direction. A body cavity model characterized by being configured to be fixed to a fixture. The body cavity model according to claim 1,
A body cavity model characterized in that a through hole communicating from a surface outside the radius of curvature to an inside surface is provided at a predetermined position in a midway portion of the body. The body cavity model according to claim 2,
The body cavity model is characterized in that the through hole is formed in a shape that simulates a space between bones under the skin, depending on the type and site of the surgical technique to be trained. The body cavity model according to claim 1,
A body cavity model characterized in that fastener members for removably fixing the main body to the fixing tool in a bent state are provided at both longitudinal ends of the main body. A method of using a body cavity model for a surgical training device, the method comprising:
This body cavity model is
It has a main body made of a flexible flat plate member,
a step of fixing both lengthwise ends to predetermined fixing tools in a state where a space imitating a body cavity is formed inside the radius of curvature by bending the midway part of the main body;
A slit is provided at least at both longitudinal ends of the main body, and the slit divides the main body into two or more panel pieces in the width direction,
The method for using a body cavity model, wherein the fixing step includes bending the main body while partially overlapping the panel pieces and fixing it to the fixture.