WO2008044649A1 - Auxiliary tool for training surgical operation - Google Patents

Abstract

An auxiliary tool for training surgical operation through which the ability of angiostomy can be enhanced efficiently and effectively before clinical experience is acquired in the manual skill of high difficulty such as coronary arteries bypass operation. The auxiliary tool (1) for training surgical operation is arranged such that two operation object parts (BV1, BV2) can be held freely at an anastomotic position by fixing a pair of first and second holding bodies (111, 121) to a bottom plate (130). Consequently, an environment closer to clinical experience can be reproduced, and the ability of angiostomy can be enhanced efficiently and effectively before clinical experience is acquired in the manual skill of high difficulty such as coronary arteries bypass operation and aortic valve replacement operation.

Description

 Specification

 Surgical training aids

 Technical field

 [0001] The present invention relates to a surgical training aid used for training of various surgical operations including vascular anastomosis.

 Background art

 In recent years, for example, coronary artery bypass surgery has been performed on patients with ischemic heart diseases such as myocardial infarction. This method involves exposing the heart and anastomosing a bypass vessel to deliver blood from other vessels to the stenotic coronary artery that causes ischemia. This method is recognized as a method in which the revascularization effect can be maintained over a long period of time. Also, a surgical operation that removes the leaflet of the affected area and sutures the substitute valve, such as aortic valve replacement surgery for the heart, requires skill, and thus requires training.

 Disclosure of the invention

 Problems to be solved by the invention

 [0003] Conventionally, for example, doctors who have experienced many procedures for stopping the heart, such as coronary artery bypass surgery and aortic valve replacement surgery, have responded by gradually training off-pump coronary artery anastomosis. It was. One of the important issues in such training is the mastery of skillful anastomosing of small blood vessels in an environment where the heart moves and undulates within a limited time. So far, it is difficult to improve the skill of such training more effectively and effectively than actual surgery.

 [0004] The present invention has been made paying attention to the situation in the medical education field. The purpose of the present invention is to gain clinical experience in highly difficult procedures such as coronary artery bypass surgery and aortic valve replacement. Another object of the present invention is to provide an auxiliary tool for external surgery training capable of improving the skill of vascular anastomosis efficiently and effectively.

 Means for solving the problem

[0005] In order to solve the above-mentioned problem, the surgical training aid according to claim 1 includes an anastomosis between the first holding body for holding the first surgical target site and the first surgical target site. Or suture A second holding body for holding the second surgical target site, and a bottom plate for installing the first holding body and the second holding body at predetermined arbitrary positions, respectively, The holding body includes a mounting table for mounting the first surgical target site in a state of being laid down along the axial direction, and a first support column that supports the mounting table. The holding body includes a holding unit that holds the second surgical target site from the axial direction thereof, and a second support that supports the holding unit, and the holding unit forwards the second surgical target site. Move between the anastomosis position where the first surgical target site placed on the table can be anastomosed and the second surgical target site separated from the first surgical target site by a predetermined distance It is possible to do it.

 [0006] According to the surgical training aid described in claim 1, the two surgical target sites are anastomosed by the first and second pair of holding bodies attached to arbitrary predetermined positions of the bottom plate. Because it can be held freely in position, it is possible to reproduce an environment that is closer to the clinical experience, effectively and effectively before gaining clinical experience in highly difficult procedures such as coronary artery bypass surgery. The skill of vascular anastomosis can be improved. In addition, since the anastomosis results can be determined on the spot, there is a great contribution to improving technical capabilities. Furthermore, since the surgical training aid of this configuration is composed of only a pair of holding bodies, the structure is simple and inexpensive.

 [0007] Further, the surgical training aid described in claim 2 is the blood vessel anastomosis training aid described in claim 1, wherein the first holding body and the second support are provided on the upper surface of the bottom plate. A plurality of holding body mounting holes for fixing the holding body are provided, and a male screw projects from the lower ends of the first holding body and the second holding body. The male screw and the holding body mounting hole The first holding body, the second holding body and the bottom plate are fixed by screwing together.

 [0008] According to the surgical training aid described in claim 2, the same operational effects as the surgical training aid described in claim 1 can be obtained, and a plurality of the surgical training aids are provided on the bottom plate. The first holder and the second holder can be screwed together at any position in the holder mounting hole so that the attachment can be ensured and strengthened, and the attachment to the desired position can be facilitated. Therefore, a more stable anastomosis can be performed.

[0009] In addition, the surgical training aid according to claim 3 is an external device according to claim 1. The surgical operation training aid further comprises a square frame-shaped frame, and a frame support having an upper portion fixed to the four corners of the frame and a lower portion fixed to the bottom plate.

 [0010] According to the surgical training aid described in claim 3, the same operational effects as the surgical training aid described in claim 1 can be obtained, and a human thorax can be simulated. Can be used to perform vascular anastomosis training that is very close to the actual situation.

[0011] Further, the surgical training assisting tool described in claim 4 is the external surgical training assisting tool described in claim 1, wherein the first holding body includes the first support column. The mounting table is connected by a joint, and the joint includes (a) a ball joint that fixes the mounting table to the other end, (b) a ball press that holds the ball joint, and (c) the ball joystick. A ball receiver for pivotally supporting the bearing, (d) a column receiver fixed to the first column and engaged with the ball receiver, and (e) an elastic force between the ball receiver and the column receiver. And (f) a housing that covers and connects the above (a) to (e).

 [0012] According to the surgical training aid described in claim 4, the same operational effects as the surgical training aid described in claim 1 can be obtained, and the mounting table can be raised by the joint. It can be moved to any direction and angle with a degree of freedom. In addition, since the ball holder and the pillar holder are inertially engaged by the spring, deterioration, rattling and loosening due to wear of the joint can be prevented, and the orientation and angle of the mounting table can be adjusted smoothly and easily. it can.

 [0013] In addition, the surgical training assisting tool described in claim 5 is the external surgical training assisting tool described in claim 1, wherein the second holding body includes the second support column. A position adjusting unit is further provided between the holding units.

 [0014] According to the surgical training aid according to claim 5, the same operational effects as the external surgery training aid according to claim 1 can be obtained, and the second holding body can be The second surgical site to be held can be easily finely adjusted to an arbitrary position.

[0015] Further, the surgical training aid described in claim 6 is the surgical surgery training aid described in claim 5, wherein the position adjusting unit has balls at both ends of a cylinder. A dumbbell-shaped connector and a cylindrical body in which a ball of the connector is fitted to both ends and the ball is rotatably held are alternately connected to each other.

 [0016] According to the surgical training aid according to claim 6, the same effect as that of the external surgery training aid according to claim 5 can be obtained, and the connector ball within the cylindrical body. Since it can freely rotate, it can be easily bent in a desired direction, and fine adjustment of the position of the second surgical target part held by the second holding body is further facilitated.

 The invention's effect

 [0017] According to the present invention, it is possible to reproduce an environment closer to a clinical experience with a simple configuration, and before gaining clinical experience in highly difficult procedures such as coronary artery bypass surgery and aortic valve replacement surgery. Thus, the skill of vascular anastomosis can be improved efficiently and effectively. Brief Description of Drawings

 FIG. 1 is a perspective view of a surgical training aid according to a first embodiment of the present invention.

 FIG. 2 is a perspective view showing a state where the frame and the support for the surgical training aid of FIG. 1 are removed.

 FIG. 3 is a perspective view showing details of the first and second attachment portions in FIG. 1.

 FIG. 4 shows the frame and frame support of FIG. 1, (a) is a perspective view of the frame, and (b) is a perspective view of the frame support.

 5 shows details of the position adjustment unit in FIG. 1, (a) is a perspective view showing the configuration of the position adjustment unit, (b) is a perspective view showing a cylindrical body of the position adjustment unit, and (c) is a position adjustment. It is a perspective view which shows the connector of a part.

 FIG. 6 is a perspective view showing the appearance of the joint of FIG.

 FIG. 7 is an assembly drawing of the joint of FIG.

 FIG. 8 is a part view (part 1) of the joint of FIG. 1, (a) is a side view and a plan view of the ball joint, (b) is a side view, a sectional view and a top view of the ball retainer, (c) Is a cross-sectional view of the ball receiver.

FIG. 9 is a part view (part 2) of the joint shown in FIG. 1, wherein (a) is a sectional view of the housing and (b) is a sectional view and a side view of the column support. FIG. 10] A perspective view showing a state in which the first surgical site and the second surgical site at the anastomosis position are anastomosed.

Explanation of symbols

101 Surgical training aids

 111 First holder

 112 First strut

 113 First mounting part

 114 fittings

 115 mounting table

 121 Second holder

 122 2nd support

 123 Second mounting part

 124 liiii adjustment section

 125 clips

 126 Shaft member

 130 Bottom plate

 131 frames

 132 Support for frame

 133 Holder mounting hole

 134 Frame support hole

 141, 1322 male thread

 1141 Ball joint

1142 Ball holder

1143 Ball holder

1144 Housing

1145 support

1146 Spring

1241 Cylindrical body 1242 connector

 1243A, 1243B Bonore

 1244 Shaft

 1311 Screw holes

 1321 Female thread

 BV1 First surgical site

 BV2 Second surgical site

 BEST MODE FOR CARRYING OUT THE INVENTION

Hereinafter, embodiments of the surgical training aid according to the present invention will be described with reference to the accompanying drawings.

 [0021] As shown in FIG. 1, the surgical training aid 101 of the present embodiment is a first holding unit for holding a first surgical target site (artificial simulated site or experimental animal site) BV1. A body 111, a second surgical target part (artificial surgical target part, etc.) to be anastomosed or sutured to the first surgical target part BV1, a second holding part 121 holding BV2, and the first holding part 111 And a bottom plate 130 for attaching and fixing the second holding body.

 [0022] As shown in FIG. 2, the first holding body 111 includes a mounting table 115 for mounting the first surgical target site BV1 in a state of being laid down along its axial direction. The first support column 112 that supports the mounting table 115 and the joint 114 that connects the mounting table 115 and the first support column 112 are provided.

 Here, although not shown, the mounting table 115 includes a mounting table main body and a holder that is rotatably mounted on the mounting table main body. An elastic holding member that forms the mounting surface of the mounting table 115 and holds the first surgical target site BV1 is detachably attached in the circular receiving groove! The elastic holding member is provided with pulsating means for pulsating.

 [0024] The first support column 112 is formed of a tubular body formed of a material that can be deformed and can maintain the deformed state. In particular, in the present embodiment, the first support column 112 is formed as a stand tube made elastic by winding a long strip of metal material or plastic material in a spiral shape!

[0025] The first support column 112 is detachably attached to the bottom plate 130 below the first support column 112. A first mounting portion 113 for mounting is provided. The first mounting portion 113 is detachably attached to the bottom plate 130 (for example, by screwing).

[0026] As clearly shown in FIGS. 1 and 2, the second holding body 121 is a second surgical target site.

A holding part 125 that holds the BV2 in its axial direction, and a second column 12 that supports the holding part 125

2 and a position adjusting unit 124 that enables adjustment of the position of the holding unit 125 between the holding unit 125 and the second support column.

[0027] The holding unit 125 has a shaft member that supports the second surgical target site BV2 by being passed through the lumen of the second surgical target site BV2. The holding part 125 is a clip 12 for fixing the second surgical target site BV2 at a predetermined insertion position with respect to the shaft member.

6 is further included.

 [0028] The second support column 122 is made of a tubular body made of a material that can be deformed and maintain the deformed state. Specifically, like the first support column 112, the second support column 122 is formed as a stand tube made elastic by winding a long band of a metal material in a spiral shape.

 In addition, a second attachment portion 123 for detachably attaching the second support column 122 to the bottom plate 130 is provided below the second support column 122. The second mounting portion 123 is detachably attached to the bottom plate 130 (for example, by screwing).

 [0030] Next, a brief description will be given of a case where vascular anastomosis training is performed using the surgical training aid 101 having the above-described configuration.

 First, the first surgical target site BV 1 is fitted into the axial groove of the elastic holding member, and the first surgical target site BV 1 is set on the mounting table 115.

 On the other hand, the second surgical target site BV2 to be anastomosed or sutured to the first surgical target site BV1 is passed through the shaft member of the holding portion 125 of the second holding body 121. At this time, the second surgical target part BV2 is projected from the tip of the shaft member by a predetermined amount, and in this state, the second surgical target part BV2 is sandwiched together with the shaft member by the clip 126, and the second surgical target part is inserted. Fix site BV 2.

[0033] After that, the first and second holding bodies 111 and 121 holding the first and second surgical target parts BV1 and BV2 in this way are placed on the bottom plate 130 at a predetermined interval. of Attach with attachment parts 113 and 123. This is shown in Figure 2. In this attached state, the first or second support pillars 112 and 122 are deformed, or the direction and angle of the joint 114 of the first holding body 111 are adjusted, or the position adjusting section 124 of the second holding body 112 is adjusted. By adjusting the holding portion 125 or the mounting table 115, the anastomosis position where the first surgical target site BV1 and the second surgical target site BV2 can be anastomosed, and the first surgical target site BV1 and the first surgical target site BV2. The force S can be moved between the second surgical target site BV2 and the separated position where it can be separated by a predetermined distance. Therefore, when performing an anastomosis or a suturing operation, the trainer can force S to position these surgical target parts BV1 and BV2 at the anastomosis position (position in FIG. 10). As shown in FIG. The surgical target site BV1 and the second surgical target site BV2 can be anastomosed using the suture thread 70 and the suture needle 72. Further, during this anastomosis operation, fluid is supplied from the fluid supply source to the elastic holding member and pulsated. This pulsation is preferably set so as to correspond to the heartbeat.

Hereinafter, embodiments of the present invention will be described in more detail.

 As shown in FIGS. 1 and 2, in the present embodiment, the first holder 111 and the second holder 121 of the surgical training aid 101 are the first support 112 and the second support 121, respectively. The first mounting portion 113 and the second mounting portion 123 provided at the lower end of the column 122 are fixed to the bottom plate 130.

 FIG. 3 shows details of the mounting portion. As shown in the figure, first and second attachment portions 113 and 123 from which male screws 141 protrude are provided at the lower ends of the first and second support columns 112 and 122. On the upper surface of the bottom plate 130, as shown in FIG. 1 and FIG. 2, a holding body mounting hole 133 in which a female screw is engaged with the male screw 141 is disposed. Since a plurality of holding body attaching holes 133 are arranged on the upper surface of the bottom plate 130, the first and second holding bodies 111 and 121 can be attached at arbitrary positions.

 [0037] Thus, by providing the bottom plate 130 and attaching the first and second attachment portions 113 and 123 thereto, the vascular anastomosis training can be easily performed at an arbitrary position. In particular, the first and second holding bodies 111 and 121 are fixed to the bottom plate 130 by screwing, so that the first and second holding bodies 111 and 121 are securely and firmly fixed without being removed by contact. Is possible.

Next, in this embodiment, as shown in FIG. 1, four frame supports are provided at the four corners of the bottom plate 130. Each of the pillars 132 is attached, and the frame 131 is mounted and fixed on the frame pillar 132. The frame 131 has a frame shape as shown in FIG. 4 (a), and screw holes 1311 are provided at its four corners. Further, as shown in FIG. 4 (b), the frame support column 132 is provided with a male screw 1322 at the bottom. The male screws 1322 are fixed to frame post mounting holes 134 (see FIG. 2) arranged at the four corners of the bottom plate 130. Further, a screw hole in which a female screw 1321 is cut is provided in the upper portion of the frame support column 132, and is fixed to the frame 131 by a screw fixing hole 1311 and a screw (see FIG. 1).

[0039] Here, the width of the frame 131 and the height of the frame support 132 are set to approximately the average width and height of the human thorax in order to simulate an actual vascular anastomosis. This makes it possible to perform vascular anastomosis training that is very close to the actual situation, such as posture, position sense, and force input.

Next, in the present embodiment, in order to enable fine adjustment of the position of the second holding body 121, the position adjusting unit 124 is provided between the second support column 122 and the holding unit 125. FIG. 5 shows details of the position adjustment unit 1 24. As shown in this figure, the position adjusting portion 124 has a ball joint structure in which a cylindrical connector 1242 composed of balls 1 243A and 1243B and a shaft 1244 is strongly fitted to a cylindrical body 1241 so as not to drop off. Since the balls 1243A and 1243B of the connector 1242 can freely rotate in the cylindrical body 1241, the force S can be easily bent in a desired direction. Therefore, the second surgical target site BV2 fixed to the shaft member with the clip 126 can be easily finely adjusted to an arbitrary position.

Next, in the present embodiment, the first support column 112 of the first holding body 111 and the mounting table 115 are connected using the joint 114. Details of the joint 114 are shown in FIGS. As shown in these figures, 'Joint 114 has a bow joint 卜 1141 (Fig. 8 (a)) and a ball retainer 1142 (Fig. 8) for holding the bow joint join 卜 1141 from falling off. (b)], a ball receiver 1143 having a spherical surface for receiving the ball joint 1141 (Fig. 8 (c)), a housing 1144 (Fig. 9 (a)) for covering and connecting the components of the joint 114, the first holding body A support post 1145 (FIG. 9B) for receiving the first support post 112 of 111, and a spring 1146 for inertiaally engaging the support post 1145 and the ball support 1143. The ball joint 1141 can freely rotate on the spherical surface of the ball receiver 114 3. Therefore, the mounting table 115 can be freely oriented with a high degree of freedom. Can be moved to an angle. The load applied from the ball joint 1141 to the ball receiver 1143 is supported by the spring 1146 in inertia. Therefore, deterioration due to wear of the joint 114 is prevented, and the orientation and angle of the mounting table 115 can be adjusted smoothly and easily. With such a configuration, rattling and loosening can be effectively prevented as compared with the case where the mounting table 115 and the first support column 112 are rigidly fixed.

 As described above, the embodiments of the present invention have been described. However, the present invention is not limited to the above-described embodiments, and various modifications can be made based on the gist of the present invention. It ’s not what you want.

 Industrial applicability

[0043] The present invention relates to a surgical training aid used for various surgical training including vascular anastomosis surgery, and has industrial applicability.

Claims

The scope of the claims  [1] a first holding body for holding a first surgical site;  A second holding body for holding a second surgical site to be anastomosed or sutured to the first surgical site;  A bottom plate for installing the first holding body and the second holding body at respective predetermined positions;  With  The first holding body includes a mounting table for mounting the first surgical target site in a state of being laid down along the axial direction, and a first support column that supports the mounting table.  The second holding body has a holding portion that holds the second surgical target site from its axial direction, and a second support column that supports the holding portion,  The holding unit includes an anastomosis position where the second surgical target part can be anastomosed to the first surgical target part placed on the mounting table, and the second surgical target part is the first surgical target part. It can move between the separated positions that are separated from the position by a predetermined distance,  A surgical training aid characterized by that. [2] The upper surface of the bottom plate is provided with a plurality of holding body mounting holes for fixing the first holding body and the second holding body, and is formed at the lower ends of the first holding body and the second holding body. 2. A male screw is provided so as to fix the first holding body, the second holding body and the bottom plate by screwing the male screw and the holding body mounting hole. Surgical training aids described in 1. [3] A rectangular frame-shaped frame;  The upper part is fixed to the four corners of the frame, and the lower part is a frame support fixed to the bottom plate,  The surgical training aid according to claim 1, further comprising: [4] The first support of the first holding body is connected to the mounting table by a joint, and the joint is  (a) a ball joint in which the mounting table is fixed to the other end; (b) a ball presser holding the ball joint; (c) a ball receiver that rotatably supports the ball joint;  (d) a column holder fixed to the first column and engaged with the ball receiver; (e) a spring that inertially engages the ball receiver and the strut receiver;  (f) a housing that covers and connects the above (a) to (e);  The surgical training aid according to claim 1, further comprising: 5. The surgical training aid according to claim 1, further comprising a position adjusting unit between the second support column and the holding unit of the second holding body. [6] The position adjusting unit includes a dumbbell-shaped connector having balls at both ends of a cylinder, and a cylindrical body in which the balls of the connector are fitted at both ends and rotatably hold the balls. 6. The surgical training aid according to claim 5, comprising a structure in which a plurality of each is alternately connected.