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WO2009060099A2 - Dispositif d'entraînement et substrat de test pour des opérations résectoscopiques - Google Patents

Dispositif d'entraînement et substrat de test pour des opérations résectoscopiques Download PDF

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Publication number
WO2009060099A2
WO2009060099A2 PCT/EP2008/065244 EP2008065244W WO2009060099A2 WO 2009060099 A2 WO2009060099 A2 WO 2009060099A2 EP 2008065244 W EP2008065244 W EP 2008065244W WO 2009060099 A2 WO2009060099 A2 WO 2009060099A2
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WO
WIPO (PCT)
Prior art keywords
clamping
training device
opening
cheek
test substrate
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP2008/065244
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German (de)
English (en)
Other versions
WO2009060099A3 (fr
WO2009060099A8 (fr
Inventor
Klaus Forke
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
SAMED GMCH MOBILE UROLOGIE
Original Assignee
SAMED GMCH MOBILE UROLOGIE
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by SAMED GMCH MOBILE UROLOGIE filed Critical SAMED GMCH MOBILE UROLOGIE
Priority to EP08847976A priority Critical patent/EP2212876A2/fr
Publication of WO2009060099A2 publication Critical patent/WO2009060099A2/fr
Publication of WO2009060099A3 publication Critical patent/WO2009060099A3/fr
Publication of WO2009060099A8 publication Critical patent/WO2009060099A8/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
    • G09B23/285—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine for injections, endoscopy, bronchoscopy, sigmoidscopy, insertion of contraceptive devices or enemas

Definitions

  • the invention relates to a training device for resectoscopic operations with a hollow substrate receiving a test substrate, which has an opening for insertion of a resectoscope.
  • the invention also relates to a test substrate for resectoscopic surgery.
  • resektoskopische Ope ⁇ rations are performed. It involves manipulation into existing body orifices, such as the urethra or vagina, for example for the purpose of transurethral Prostatare ⁇ section or transvaginal Hysteroscopy using a resectoscope.
  • the invention is based on the object of specifying a training ⁇ device and test substrate for resectoscopic surgery, with which the surgical techniques can be practiced under realistic conditions and cost-effective use of materials.
  • the hollow body is designed as a container with a bottom and a wall extending from the bottom up wall, the bottom and wall include a wasserbembombombo interior.
  • the opening is arranged in the wall.
  • a tubular instrument receptacle which can be pivoted to the opening is arranged with a receiving opening aligned with the opening in an alignment axis in the middle position of the instrument receptacle.
  • a clamping device is arranged in the interior space, which encloses a clamping space receiving a test substrate and which has a first passage opening located on the side facing the opening on the alignment axis.
  • the clamping device can now be simulated tissue of meat-like consistency, such as animal meat, as a test substrate or a test substrate according to the invention.
  • This represents a low-cost simulation tissue and comes very close to the material properties of human tissue, so that good training conditions are created.
  • the use of real tissue, for example in the form of animal meat is, on the other hand possible in that the chip space, in which the meat is clamped, located in the interior of the container filled with water ⁇ the can, which at least drying of Simulation tissue prevented and thus the good training conditions ⁇ can be maintained over long periods. The water then also absorbs escaping blood.
  • the instrument receiving a resectoscope may then be ⁇ inserted, wherein the instrument holder serves as a guide and, so to speak, imitating the urethra. This is made ⁇ light that the instrument holder is designed to swivel, so that the movements, as they are also made possible by the Membrum virile with the inserted resectoscope may also be performed.
  • the resectoscope can now be inserted through the opening and through the passage opening in the test substrate.
  • a prostate resection can then be simulated. Is the so-simulated operation is completed, it is easy to then take out the test substrate to cut at the Operati ⁇ onsstelle and so to take the operation result in eye ⁇ translucent.
  • a visible trainer consisting of a solid body can be used as the test substrate, which is provided with a longitudinally extending urethra cavity simulating the urethra and aligned with the first passage opening.
  • This classifying trainer is intended for learning instrument operation and assessing or evaluating the field of view.
  • the resectoscope is inserted into the sight trainer clamped in the clamping space.
  • the urethra cavity can be formed as a urethra hole.
  • a urethra hole has a very clear and well-known inner appearance, the image of which can then be compared very well with reality.
  • Visual training can be improved by providing the urethra cavity with markings distributed over the circumference.
  • the trainee can accurately test the Wirkun ⁇ gen of adjustments on the resectoscope and its representation.
  • the markings can be designed as radially encircling degree lines and / or as rulers extending in the longitudinal direction.
  • test substrate consists of a body with a simulation opening simulating the interior of the urethra or the prostate, which is provided with anatomically relevant points, in particular for the visualization thereof. This allows the exerciser to experience the presentation of the real medical or a pathological situation.
  • test substrate is a simulation fabric consisting of a mass of a mixture heated at a core temperature of 68 ° C.
  • Such a simulation fabric comes very close to human tissue for this simulation and is compatible with conventional technologies, e.g. Making sausage production in a simple manner, so that even with frequent exercise no significant costs.
  • the simulation fabric can also be packaged very well in that the test substrate consists of a simulation fabric enveloped by an outer metal sheath exposed to the opening (6).
  • the packaging may even remain in the training device during use. It is thus very easy to use and also removable.
  • the test substrate can also be used to simulate work in different tissue structures.
  • the prostate is surrounded by an external closing prostatic capsule provided.
  • the prostatic capsule is not visible but only with great attention felt.
  • the test substrate is a toward the opening open hollow body made of flexible material, the hollow space is filled with a Simulationsge ⁇ weave. The inside then simulates the protatic capsule.
  • this hollow body can be part of a test substrate with metal sheath by being enveloped with an open to the opening outer metal sheath.
  • the metal shell is hollow cylindrical.
  • an application of a known per se in the form of a so-called tin can also be considered, so that the manufacturing cost can be further reduced by using other conventional technologies.
  • the clamping device on a first side of the clamping space a first clamping cheek and on a first side opposite the second side of the clamping space has a second clamping cheek, both clamping cheeks to each other have a first distance and are designed to be movable relative to each other ,
  • the tensioning device forms a kind of vise.
  • the test substrate can be clamped, with the relati ve ⁇ mobility of the two clamping cheeks can be exploited for the tensioning operation.
  • the first distance can be varied. This allows various ⁇ the large pieces of simulation tissue, for example pieces of meat, the size of the simulated organ size is used to ⁇ .
  • both clamping cheeks are biased with a mutually acting clamping force.
  • the two clamping cheeks can also be arranged in separate clamping parts, which means that the clamping device has a first clamping cheek, which is provided with the passage opening containing the first clamping part and a second clamping cheek second clamping part and the first clamping part with a first part of Wall and the second clamping part is connected to a first part of the wall opposite the second part of the wall. If the connection with the wall designed detachable, both clamping parts can be removed from the container in a simple manner. This improves the
  • the first clamping part has a connectable with the wall Spann ⁇ plate to which the first clamping beam is arranged in parallel to extend retaining bolt between the clamping plate and clamping cheek, on which the first clamping cheek is slidably mounted, and between the clamping plate and the clamping cheek a tension spring is tensioned.
  • the tension springs press the first clamping cheek in Rich ⁇ tion to the second clamping cheek and thus a test substrate is clamped spring loaded.
  • the tension springs are arranged so that zwi ⁇ 's clamping plate and the first clamping cheek each one a retaining pin surrounding rubber spring, consisting of an elastic tension material, is stretched.
  • This train material is very easy to clean and replace in case of consumption.
  • a higher clamping force than with a rubber spring can be achieved by tensioning a coil spring surrounding a retaining bolt between the clamping plate and the first clamping cheek.
  • test substrate in particular of meat-like consistency, for example, from animal meat
  • the test substrate is clamped by the arrangement according to the invention, which takes place by a pure traction.
  • the mechanical stability is increased when the pure frictional connection is supplemented by a form fit, by on the first side of the clamping space facing side of the first clamping cheek and / or on the second side of the clamping space facing side of the second clamping cheek are each arranged perpendicular to the respective side retaining mandrels.
  • a test substrate which is provided with a metal jacket
  • the cylindri ⁇ cal metal shell after removal of the lid and / or Bodenseiti- gene closure in a simple manner can be used in the training device and keeps it safe.
  • annular grooves are arranged as a form-fitting rings into which the cylindrical shell can be inserted.
  • the resectoscope forms an electrode which is biased against a second (large-area) electrode fixed to the patient, it is provided that an electrode is arranged within the form-fitting ring .
  • the simulation tissue can be exposed to the counterpotential to the resectoscope, whereby the electrical resection is made possible.
  • the electrode is formed as a circular disk ⁇ shaped surface electrode. After removal of the bottom-side closure, the test substrate can then be used and contacted over a large area and thus securely.
  • the form-fitting elements are on an auxiliary clamping device, namely a first and a second auxiliary clamping cheek, which clamp the test substrate, angeord ⁇ net and the test substrate is then used with this auxiliary sspannvorrich- processing in the chip space.
  • the vesica urinary is simulated by the exercise device DA is configured by that the second clamping cheek is arranged with a two ⁇ th distance to the wall and the second clamping part comprises spacer elements which extend between the second clamping cheek and the wall.
  • the distance variation can be realized by using different spacer elements of different sizes.
  • a second passage opening is placed, which lies on the alignment axis.
  • Clamping housing with its own clamping housing wall, consisting of a front wall facing the opening, a rear wall facing away from the opening and extending between the front and rear wall side walls, which include the clamping space has up.
  • This clamping housing takes on a first clamping cheek leg ⁇ holding first clamping part and the second clamping cheek.
  • the first clamping part has an elastic element, via which the first clamping cheek is connected to the clamping housing wall in such a way that the first clamping cheek can be tensioned against the second clamping cheek in a clamping direction running longitudinally between the front wall and the rear wall.
  • Such a separate clamping housing makes it possible to clamp outside the container, the test substrate and then insert together with the clamping jaws in the container.
  • Clamping cheek is provided with first lugs, which pass through slots in the side walls of the clamping housing wall, which extend parallel to the clamping direction, pass through.
  • the clamping space facing away from the outside of the clamping housing wall is provided with second lugs. It is between the first noses and corresponding second lugs at least one spring each ge ⁇ clamped on each side wall. With this design, the springs are completely out of the area used for testing.
  • the spring can also be used as an easy to clean and easy to replace rubber spring made of an elastic tensile material.
  • the first clamping cheek can be manufactured very simply by the fact that the first clamping cheek is designed as a clamping rod running transversely to the clamping direction, which passes through the longitudinal holes in the form of the first lugs. This rod can ge ⁇ schrangn at the same time that the resectoscope is free to extend through the first clamping beam, without a passage opening is to be introduced.
  • organs other than the prostate can be included in the simulation, e.g. the Vesica urinaria.
  • the second clamping cheek is connected at a second distance from the rear wall with the clamping housing wall and has a passage opening which lies on the alignment axis.
  • the use of a test substrate according to the invention with a metal shell can be assisted by the fact that on the first side of the clamping space facing side of the first clamping cheek and / or on the second side of the Spannrau- mes facing side of the second clamping cheek are each arranged with the zy ⁇ - cylindrical shell form-fitting rings.
  • the cylindrical metal shell can be used after removal of the lid and / or bottom-side closure in a simple manner in the training device and keeps it safe.
  • the form-fitting rings can be realized in a simple manner in that ring-shaped grooves are arranged as form-fitting rings into which the cylindrical shell can be inserted. These grooves can also be made in this embodiment by simple milling.
  • the form-locking rings can be provided for testing a monopolar electroresection in which the resectoscope forms an electrode which is biased against a patient attached to the second (large-area) electrode, that within the form-fitting ring an electrode is ⁇ arranged.
  • the electrode is formed as a circular disk ⁇ shaped surface electrode. After removal of the bottom-side closure, the test substrate can then be used and contacted over a large area and thus securely.
  • the mobility of the instrument holder is fully guaranteed and, on the other hand, water is prevented from escaping by sealing the outside of the instrument holder against the outside of the wall with an elastic sleeve.
  • the cuff can be meaningfully used to pivot the instrument holder in the elastic sleeve.
  • the pivoting of the instrument holder can also be realized in that with the outside of the wall an elas ⁇ table movable disc is connected spaced and the Instru ⁇ mentenfact is flanged by means of a Flanschfußes to the movable Schei ⁇ be.
  • the authenticity of the simulation can also be increased by that the instrument holder consists of a flexible flexible tube or a tube, which is much closer to the characteristics of the spam virile.
  • Cap is closable. This makes it possible, at a working ⁇ break, in which the resectoscope is not used in the instrument holder to leave the water in the container to continue in due course with the work or at a later time to control the simulation result. Also, it is quite possible to use a liquid other than water, which is better suited for certain simulations, but possibly much more expensive. Due to the closure option, this fluid can also be left in the training device for several resectoscopic simulations.
  • the container is provided with a Wasserablauf ⁇ réelle.
  • a removal of the water can be made without removing the training device from its position and turn over for the purpose of emptying.
  • This may prove particularly useful ⁇ default when various peripheral devices, such as external monitoring equipment correspond to the training device.
  • This also makes it easier to use the training device in teaching, for example, and to use the training device
  • the container is provided with a water inlet opening.
  • the container and / or the clamping parts are made of transparent plastic.
  • the container can be closed in a pressure-tight manner and has a control opening. This makes it possible to simulate gynecological resectoscopic surgery or resectoscopic surgery in the bladder area. Both operations are usually carried out with a slight overpressure. Due to the design of a pressure vessel such slight overpressure conditions may set ⁇ to, thereby extending the scope of the training device is also possible in these operations also in the simulation.
  • a simple way of realizing a pressure vessel is because ⁇ possible that the container with a lid pressure-tight manner is closed, since the container is already made so tight as a result of waterproofness.
  • control opening is arranged in the cover.
  • the execution of the control port may also be further developed in that the inspection opening is provided with a hose connector piece ⁇ .
  • the inspection opening can be closed with an elastic closure.
  • test substrate for use in a training device in which a test substrate can be inserted in a cylindrical metal sheath.
  • a cylindrical metal shell each having a bottom-side and a lid-side closure, of which a simulation fabric consisting of a mass of a heated at a core temperature of 68 0 C mixture of 45-55% by weight minced muscle meat with a fat content of 60 to 80% by mass of stored fat, 18 to 22% by weight of animal fat, 22.5 to 27.5% by weight of water and
  • such a test substrate offers optimum conditions for simulation, since it is a material that comes very close to the real patient tissue in terms of its properties and thus the trainee finds a tissue situation in which he can practice almost under real conditions.
  • such a test substrate can be offered ready-made and it has a long shelf life.
  • a commercially available cylindrical tin can be used.
  • the testsub ⁇ strat on the one hand to store very well and to handle.
  • the test substrate also has a shape that allows easy insertion of the test substrate into the training device.
  • both the bottom-side and the cover-side closure are each provided with a tear tab and can be removed by tearing by means of a predetermined breaking line.
  • the can packaging can be easily opened and possibly the test substrate can be easily inserted into the training device even in the thus opened packaging.
  • the test substrate can also be designed such that a lid-side closure is arranged to toward ge ⁇ preopened hollow body of flexible material within half of the metal shell, the cavity of which is filled with the simulation tissue.
  • the hollow body consists of silicone.
  • PDD poly (ophenylenediamine) or poly (m-phenylenediamine)
  • FIG. 1 is a partially sectioned plan view of a training device according to the invention in a first embodiment
  • Fig. 2 is a plan view of an instrument holder of the first imple mentation form
  • FIG. 3 is a plan view partially in section of a training device according to the invention in a second embodiment
  • FIG. 4 is a first perspective view of a erfindungsge ⁇ MAESSEN training device in the second embodiment
  • FIG. 5 shows a second perspective view of a training device according to the invention in the second embodiment
  • Fig. 6 is a plan view of a third embodiment with a clamping housing
  • Fig. 8 is a plan view of a chip housing of the third exporting ⁇ approximate shape without test substrate
  • Fig. 9 is a side view of the clamping housing from the third ⁇ guide die without test substrate
  • Fig. 11 is a plan view of the clamping housing with clamped test substrate
  • Fig. 12 is a side view of the clamping housing with clamped test substrate
  • Fig. 15 is a perspective view of a punching tool for the urethra channel
  • FIG. 16 is a perspective view of a training device with a pressure-tight container with inserted Resek- toskop,
  • 19 is a perspective view of the training device with pressure-tight container and inserted round substrate
  • FIG. 20 shows a prefabricated test substrate with a metal jacket .
  • FIG. 21 shows a prefabricated test substrate in one with homoge ⁇ ner filling of the metal shell along the sectional plane AA in Fig. 20
  • FIG. 22 shows a prefabricated test substrate with a simulated test substrate.
  • FIG. 23 shows a prefabricated test substrate in an additional substrate holder.
  • a training device 1 for resectoscopic surgery comprises a container 2 with a bottom 3 and a wall 4 extending upwardly from the bottom 3.
  • Floor 3 and wall 4 include a water-fillable interior 5 a.
  • an opening 6 is arranged in the wall 4.
  • tubular instrument receptacle 8 is arranged with an aligned in the middle position of the instrument holder 8 with the opening 6 in an alignment axis 9 receiving opening 10.
  • a clamping device 11 is arranged in the interior 5, which includes a test substrate 12 receiving a clamping space 13 and which has a on the opening 6 facing side on the alignment axis 9 lying first passage opening 14.
  • simulation fabric such as animal meat, eg
  • Pork, beef or poultry meat or meat-containing material such as Leberkarse or the like can be clamped as a test substrate.
  • a resectoscope (not shown) can be inserted, the instrument receptacle 8 serving as a guide.
  • the instrument receptacle 8 is made pivotable in such a way that an elastically movable disc 15 is connected in a spaced manner to the outside 7 of the wall 4, and the instrument receptacle 8 is connected by means of a flange foot 16, as shown in FIG movable disk 15 is flanged by means of a mating flange 17.
  • the mobility of the instrument receptacle 8 is ensured on the one hand and water is prevented from escaping to the outside by the outside 7 of the instrument receptacle 8 being sealed with an elastic sleeve 18 in the region of the opening 6 is, in which the instru ⁇ ment holder 8 is pivotally mounted.
  • the clamping device 11 itself is provided with a first clamping cheek 19 on a first side of the clamping space, in which the passage opening 14 is introduced.
  • a second Clamping 20 On one of the first side opposite the second side of the clamping space 13 is a second Clamping 20 arranged. Both clamping cheeks 19 and 20 have a first distance 21 to each other, so that between the two clamping cheeks 19 and 20, the test substrate 12 can be clamped.
  • the two clamping cheeks are arranged in separate clamping parts 22 and 23, one of the first clamping cheek 19-containing first clamping member 22 and the second clamping cheek 20-containing second clamping member 23 which are detachably connected and opposite each other with the wall 4.
  • the first clamping part 22 has a connectable to the wall 4 clamping plate 24, to which the first clamping cheek 19 is arranged in parallel ⁇ , with 19 clamping pins between clamping plate 24 and clamping cheek 25 extend, on which the first clamping cheek 19 is slidably mounted.
  • These retaining bolts 25 are located on the outside and indeed at the corners of the clamping plate 24 and the first Spannwan- 19 arranged, since they are rectangular.
  • 19 clamping springs in the form of coil springs 26 are tensioned between the clamping plate 24 and the first clamping cheek. The coil springs 26 surround the retaining bolts 25, whereby they are guided.
  • the coil springs 26 press the first clamping cheek 19 in the direction of the second clamping cheek 20 and thus the test substrate 12 is spring-loaded clamped, which is done by a pure adhesion.
  • the mechanical stability is increased by holding mandrels 27, which are arranged on the clamping space 13 facing side of the first clamping cheek 19 and / or on the clamping space facing side of the second clamping cheek 20 each perpendicular to the other side.
  • the second clamping cheek 20 is arranged at a second distance 28 to the wall 4.
  • the second clamping part comprises 23 Dis ⁇ dance elements 29 which extend between the second clamping cheek 20 and the wall 4.
  • a second passage opening 30 is introduced, which lies on the alignment axis 9.
  • the spacers 29 are stored in a different size and used depending on the purpose. This makes it possible for the first distance 21 to be variable by setting the second distance 28. To ensure that no water enters the container 2 to the outside when no resectoscope turned ⁇ leads into the instrument holder 8, it is provided that the tool holder 8 can be closed with a cap 31st
  • the clamping device 11 is provided with a clamping housing 33 with its own clamping housing wall 34.
  • the tensioning housing wall 34 consists of a front wall 35 facing the opening 6, a rear wall 36 facing away from the opening 6, and side walls 37 extending between the front and rear walls 35 and 36.
  • the tensioning housing wall 34 encloses the tensioning space 13.
  • This clamping housing 33 receives a first clamping cheek 19 bein ⁇ holding first clamping member 22 and the second clamping cheek 20.
  • the first clamping part 22 has an elastic element 38, via which the first clamping cheek 19 is connected to the clamping housing wall 34 such that the first clamping cheek 19 against the second clamping cheek 20 in a longitudinal direction between the front wall 35 and rear wall 36 extending clamping direction can be tensioned.
  • Such a separate clamping housing 33 makes it possible to clamp the test substrate 12 outside the container 2 and then to insert it into the container 2 together with the clamping jaws 19 and 20.
  • the first clamping cheek 19 is formed by two clamping bars 39 arranged transversely to the clamping direction and arranged one above the other.
  • the chip bars 39 engage as first lugs 40 through slots 41 in the side walls 37 of the clamping housing wall 34, which extend parallel to the clamping direction through.
  • the clamping space 13 facing away from the outside of the clamping housing wall 34 is provided with second lugs 42.
  • At least one spring 38 is clamped on each side wall 37 between the first lugs 40 and corresponding second lugs 42. With this design, the springs 38 are completely out of the range used for testing.
  • the clamping Rods 39 are arranged at such a distance from each other and below and above the opening 6 that the resectoscope can pass unhindered through the first clamping cheek 19 without having to introduce a passage opening.
  • organs other than the prostate can be included in the simulation, e.g. the Vesica urinaria.
  • the second clamping cheek 20 is connected at a second distance 28 from the rear wall 36 with the clamping housing wall 34 and has a second passage opening 30 which lies on the alignment axis.
  • the training device has essentially three objectives,
  • a visual trainer 44 consisting of a solid body can be used as the test substrate 12, as shown in FIG. 14 and which is equipped with a urethra simulating and with the first passage opening. tion 14 aligned longitudinally extended urethra bore 45 is provided.
  • Such urethra-bore 46 has a very clear and be ⁇ kanntes inner appearance, its image can then be compared very well with reality.
  • the urethra is provided with bore 45 on the peripheral surface as a radially distributed markings umlau ⁇ Fende longitude lines 46 and / or extending in the longitudinal extension rulers 47th
  • the degree lines 46 or the rulers 47 can be used to display angular displacements or the penetration depth of the resectoscope.
  • the manner of the display by the resectoscope can be tested in the case of a completely neutral test substrate 12 in the form of the sight trainer 44 and with known viewing conditions.
  • To facilitate insertion of the classifying trainer 44 is provided on its side, which is to be facing the second clamping cheek 20, with recesses 48 which correspond to the holding mandrels 27.
  • at least one groove 49 is introduced, in which a tension rod 39 can engage.
  • the training device according to the invention can also be used for the training of resection by means of bipolar or monopolar RF electro-resection or resection by means of laser vaporization or laser enucleation.
  • FIG. 7 shows an embodiment for the bipolar RF electro-resection, in which the second clamping cheek 20 on the substrate side is provided with an electrode 50. This electrode 50 is connected to a pole of the resectoscope. The other pole is the resectoscope.
  • a punching tool 51 as shown in Fig. 15 is used.
  • This punching tool consists of a shaft 52 and a punched ⁇ part 53. It is introduced in particular with removed clamping housing 33 with its stamped part 53 through the first passage opening 14 in the test substrate 12. In this case, the stamped part 53 cuts out of the test substrate 12 a core, so that one of the Urethra corresponding opening remains.
  • FIG. 16 and Fig. 17 another embodiment is shown, in which the container 2 is designed pressure-tight. This is described at this point as a separate embodiment, although it is possible to design all embodiments discussed so far also in this way.
  • the wall 4 is provided on its upper side with a circumferential seal 54.
  • the cover plate 55 is placed with a sealing surface.
  • the floor 3 is designed so that it projects laterally beyond the side walls 37. From the over ⁇ standing part of the bottom 3 clamping bolts 56 extend to the cover plate 55, penetrate this and are clamped on the top of the cover plate with clamping nuts 57 so that a clamping force acts on the seal 54. If the cover plate 55 tightly rests on the Obersei ⁇ te the wall 4, then the container 2 is pressure-tight, since the container 2 in itself is already made tight due to the waterproofness.
  • liquid 2 can be supplied to the container 2, which liquid can flow off again via the water outlet opening 32.
  • the container 2 may be properly rinsed during the simulated operation.
  • an overpressure can be adjusted via inflow and outflow in the container 2.
  • About the control opening 58 and the pressure can be controlled. This is important in this case, as it can also train the observance of the pressure during the simulation. Thus, a resection in the area of the uterus with detergent is carried out under light pressure. However, this pressure must not exceed a certain level, since otherwise the rinsing agent is undesirably pressed into a tuba uterina or into the abdomen.
  • a control opening 58 may be arranged in the cover plate 55 or in a side wall 37. The execution of the inspection opening can be further developed in that the inspection opening is provided with a hose connecting piece 59.
  • this inspection opening can also be designed differently and arranged in the cover plate 55 and then conveniently closed with a membrane made of elastic material.
  • a suprapubic derivative of the Vesica urinaria can be simulated.
  • rinsing agent usually passes through the resectoscope 60, which is discharged to the outside via an artificial opening in the vesica urinaria. This can be simulated so that the Memb is ⁇ ran pierced with a needle, much as is done in the manufacture of a suprapubic drainage.
  • Resectoscope 60 and any test substrate 12 which may be formed by a, for example, square-cast substrate 61, as shown in Fig. 17 and Fig. 18.
  • This substrate 61 consists of a body with a simulation opening 62 simulating the interior of the urethra or the prostate, which is provided with anatomically relevant points, in particular for the visualization thereof.
  • the substrate 61 is designed in two parts and has an upper mold 63 and a lower mold 64, in each of which a part a and b of the simulation opening 62 is introduced. This bie ⁇ tet to one the advantage of ease of manufacture. On the other hand, single anatomically interesting points can be demonstrated before a simulation.
  • the simulation opening with an organic material, to assemble it and to punch a channel by means of the punching tool 51. Subsequently, a removal of the organic material in the training device can take place. To assess the result, the substrate 61 can then be removed from the training device, split and the simulation opening 62 can be shown in the open state.
  • FIG. 19 shows the use of a cylindrical substrate 12.
  • This cylindrical test substrate 12 can on the one hand be replaced by a cylindrical substrate 12 Visual Trainer 44 are formed, as shown in Fig. 14.
  • the cylindrical substrate 12 may also be formed by a test ⁇ substrate 65 and in pre-assembled form, as shown in Fig. 20 to Fig. 22.
  • This test substrate has a cylindrical metal shell 66, which is provided with a respective bottom-side and a cover-side closure 67. Both sides are provided with a tear tab 68 and corresponding desired ⁇ breaking points, so that the fasteners may be removed prior to use 67, wherein the metal jacket 66 and remain wrapped around the simulation tissue 69th
  • the clamping housing 33 is designed so that the test substrate 65 can be used after removing the closures 67 by means of the respective tear tab 68 directly into the clamping space 13.
  • the urethra channel is then punched out with the punching tool 51 shown in FIG. 15 and the simulation can be started.
  • the simulation fabric 69 consists of a mass of a heated at a core temperature of 68 0 C mixture of 45 - 55% by weight minced muscle meat with a fat content of 60 to 80% by mass of stored fat,
  • test substrate 65 offers optimal conditions for simulation, since it is a material that comes very close to the real patient tissue in terms of its properties and thus the trainee finds a tissue situation in which he can practice almost under real conditions.
  • test substrate can be offered ready-made and it has a long shelf life. Achieving a shelf life of at least 6 months is not a problem.
  • the simulation tissue 69 is very similar to the adenoma tissue.
  • test substrate 65 can be realized in two embodiments, which are illustrated in FIGS. 21 and 22.
  • the test substrate of FIG. 21 is a non-specific ⁇ Trainingssub strat, which means that the metal casing is completely filled with tissue simulation 69 66, can be trained in the different ⁇ Resekti onstechniken.
  • the test substrate 65 as shown in Fig. 22 includes a replica 70 of the prostatic capsule made of a flexible material, the cavity of which is filled with the simulation tissue. This makes it possible to use the test substrate 65 in addition to practicing the use of a resectoscope in the pure organic material as the embodiment of FIG. 21 also to simulate the work in different tissue structures with the prostatic capsule, which is not visible in a prostate resection but only with great attention is noticeable.
  • the hollow body consists of silicone. This is a particularly easy-to-manufacture version.
  • FIG. 23 shows a prefabricated test substrate 65 for the purpose of simulating an electrical resection in an additional substrate holder 72.
  • the opened test substrate 65 can be inserted into this additional substrate holder 72.
  • the simulation fabric 69 is contacted on the side facing away from the observer with a surface electrode 50.
  • the substrate holder 72 equipped in this way can then be inserted directly into the clamping space 13 or instead of the clamping housing 33.
  • the connection line 73 serves to produce a corresponding electrical connection of the surface electrode 50 with the opposite pole of the resectoscope. Training device and test substrate for resectoscopic surgery

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Abstract

L'invention concerne un dispositif d'entraînement pour des opérations résectoscopiques, comportant un corps creux logeant un substrat de test, présentant une ouverture pour l'introduction d'un résectoscope. L'invention vise à permettre un entraînement aux techniques d'opération dans des conditions proches de la réalité, avec des investissements matériels économiques. A cet effet, le corps creux est conçu en tant que contenant présentant un espace intérieur pouvant être rempli d'eau, dont la paroi présente l'ouverture. Le côté extérieur de la paroi comporte un logement d'instrument tubulaire, pivotant par rapport à l'ouverture, présentant une ouverture de logement alignée avec l'ouverture dans un axe d'alignement, dans une position centrale du logement d'instrument. L'espace intérieur comporte également un dispositif de serrage renfermant un espace de serrage logeant le substrat de test, présentant une première ouverture de passage sur un côté orienté vers l'ouverture, située sur l'axe d'alignement.
PCT/EP2008/065244 2007-11-10 2008-11-10 Dispositif d'entraînement et substrat de test pour des opérations résectoscopiques Ceased WO2009060099A2 (fr)

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EP08847976A EP2212876A2 (fr) 2007-11-10 2008-11-10 Dispositif d'entraînement et substrat de test pour des opérations résectoscopiques

Applications Claiming Priority (4)

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DE102007054116 2007-11-10
DE102007054116.5 2007-11-10
DE102008016580.8 2008-03-31
DE102008016580 2008-03-31

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WO2009060099A2 true WO2009060099A2 (fr) 2009-05-14
WO2009060099A3 WO2009060099A3 (fr) 2009-11-12
WO2009060099A8 WO2009060099A8 (fr) 2010-01-14

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111383508A (zh) * 2020-04-27 2020-07-07 广西医科大学第二附属医院(广西医科大学第二临床医学院) 一种医学人体模型的教学展示架
CN120071733A (zh) * 2025-04-28 2025-05-30 长治医学院附属和平医院 一种耳鼻喉手术演示装置

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102014005325A1 (de) 2014-04-11 2015-10-15 Samed GmbH Dresden Verfahren zur Unterstützung von Lernvorgängen bei Simulationsgeräten für minimalinvasive Operationen

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19716341C2 (de) 1997-03-19 2000-09-21 Erbe Elektromedizin Trainingsmodell, insbesondere Torso

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2817548A1 (de) * 1978-04-21 1979-10-25 Storz Karl Vorrichtung fuer die medizinische ausbildung
US5149270A (en) * 1990-10-29 1992-09-22 Mckeown M J Apparatus for practicing surgical procedures
GB2340811A (en) * 1998-08-25 2000-03-01 Barry Andrew Ward Multiple cans
US6488507B1 (en) * 1999-11-29 2002-12-03 Ethicon, Inc. Portable surgical trainer
FR2873661A1 (fr) * 2004-07-29 2006-02-03 Patrice Chaumeron Boite de conserve egouttoir
DE202004014838U1 (de) * 2004-09-23 2004-11-18 Herzog-Brumbauer, Ralph Konservendose mit zwei Abzugsdeckeln
US7866983B2 (en) * 2006-01-13 2011-01-11 East Tennessee State University Research Foundation Surgical simulator system

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19716341C2 (de) 1997-03-19 2000-09-21 Erbe Elektromedizin Trainingsmodell, insbesondere Torso

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111383508A (zh) * 2020-04-27 2020-07-07 广西医科大学第二附属医院(广西医科大学第二临床医学院) 一种医学人体模型的教学展示架
CN120071733A (zh) * 2025-04-28 2025-05-30 长治医学院附属和平医院 一种耳鼻喉手术演示装置

Also Published As

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DE102008056550A1 (de) 2009-05-20
WO2009060099A3 (fr) 2009-11-12
EP2212876A2 (fr) 2010-08-04
WO2009060099A8 (fr) 2010-01-14

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