WO2009116123A1 - Auxiliary device for surgery training - Google Patents

Abstract

An auxiliary device for surgery training that allows to effectively and efficiently attain enhancement of manual skill prior to accumulation of clinical experience in highly difficult surgical operation. The auxiliary device (10) for surgery training is characterized by having first retaining means (11) provided with a suction orifice (116) for retaining a first surgery subject by suction force; suction means (15) for applying suction force to the suction orifice (116) of the first retaining means (11); a frame member (13) constituting an approximately rectangular parallelepiped frame, provided so as to allow placing of the first retaining means (11) at a given location; and a bottom plate (14) disposed at an inferior portion of the approximately rectangular parallelepiped frame of the frame member (13).

Description

Surgical training aids

The present invention relates to a surgical training aid used for various surgical trainings.

In recent years, for example, surgical operations in the field of cardiac surgery, for example, have made remarkable progress due to remarkable technological innovation. Along with this, surgical techniques have become more complex and specialized, and the difficulty level has increased, and the experience and skill of the surgeon have become more demanding than ever.

For example, as an example of a surgical operation in the field of cardiac surgery, there is a coronary artery bypass operation performed on a patient having ischemic heart disease such as myocardial infarction. This exposes the heart and anastomoses a bypass blood vessel for sending blood from other blood vessels to the stenotic coronary artery causing ischemia. This method is recognized as a method that can maintain the revascularization effect over a long period of time. Further, in aortic valve replacement surgery performed on a patient having aortic valve disease such as aortic valve stenosis, the heart is similarly exposed, the valve leaflet of the affected part is removed, and a substitute artificial valve is sutured. These are known as one of relatively difficult surgical operations.

By the way, until now, an apparatus for training surgical suture technique has been disclosed as a surgical suture trainer (see, for example, Patent Document 1).
Japanese Patent Publication No. 60-35150

Until now, doctors who have experienced a lot of surgeries using heart-lung machines that have stopped the heart can perform more difficult off-pumps while the heart is moving. We have raised the level of skill by gaining experience step by step, such as performing surgery. In other words, the skill level in the surgical operation as described above needs to be increased through actual surgery, and it is difficult to improve the skill efficiently and effectively.

Further, in the surgical suturing practice device disclosed in the above-mentioned Patent Document 1, the object of suturing is a cloth, which lacks a sense of reality and realism, and is a practical simulation training for a highly difficult surgical operation. There was a problem of not getting.

The present invention has been made paying attention to the circumstances of the medical education field as described above, and the purpose thereof is to efficiently and effectively before gaining clinical experience in a highly difficult surgical operation. An object of the present invention is to provide a surgical training aid that can improve the skill of a procedure.

In order to solve the above-mentioned problems, the present invention provides a first holding means having a suction port for holding a first surgical object with a suction force, and applying a suction force to the suction port of the first holding means. And a suction member that allows the first holding unit to be installed at a predetermined position, a frame member that forms a substantially rectangular parallelepiped frame, and a bottom plate that is disposed below the substantially rectangular parallelepiped frame made of the frame member; A surgical training aid is provided.

Here, the surgical training aid may further include second holding means for holding a second surgical object to be anastomosed or sutured to the first surgical object. The second holding means can be installed at a predetermined position of the substantially rectangular parallelepiped frame.

In addition, it is preferable that the surgical training assisting tool further includes a mounting means for mounting the first surgical object. This mounting means can be installed at a predetermined position of the substantially rectangular parallelepiped frame.

Note that the first holding means sucks and holds the first surgical object from above. Alternatively, the first surgical object may be sucked and held from the lower part or the side part.

Further, it is preferable that the first holding means is composed of an arm means for holding the suction port and a support column for supporting the arm means. At this time, the arm means is formed of one or a plurality of rod-shaped members that hold the suction port at an arbitrary position. Alternatively, the arm means is formed by a flexible member that holds the suction port at an arbitrary position.

Furthermore, it is preferable that the second holding means is formed of a flexible member that holds the second surgical object at an arbitrary position.

According to the present invention, it is possible to reproduce an environment closer to a clinical experience with a simple configuration. The skill of the technique can be improved effectively.

1 is a perspective view of a surgical training aid according to a first embodiment of the present invention. It is a principal part enlarged view at the time of use of the surgical training auxiliary tool which concerns on the 1st Embodiment of this invention. FIG. 3 is a perspective view showing an example of a structure of a first holding body in the surgical training aid according to the first embodiment of the present invention. FIG. 5 is a perspective view showing an example of a structure of a second holding body in the surgical training aid according to the first embodiment of the present invention. It is a perspective view which shows an example of the structure of a baseplate and a frame in the surgical training auxiliary tool which concerns on the 1st Embodiment of this invention. It is a figure which shows an example of a slide board and the screw for attachment in the surgical training assistance tool which concerns on the 1st Embodiment of this invention. In the surgical training auxiliary tool which concerns on the 1st Embodiment of this invention, it is a figure which shows an example of each structural member of a mounting base. It is a figure which shows a mode that vascular anastomosis training is performed using the auxiliary tool for surgical training which concerns on the 1st Embodiment of this invention. It is a perspective view of the surgical training aid according to the second embodiment of the present invention. It is a principal part enlarged view at the time of use of the surgical training auxiliary tool which concerns on the 2nd Embodiment of this invention. It is a figure which shows a mode that aortic valve replacement training is performed using the surgical training auxiliary tool which concerns on the 2nd Embodiment of this invention.

Explanation of symbols

10, 20 Surgical training aids 11, 21 First holding body 12 Second holding body 13 Frame 14 Bottom plate 15 Suction device 16 Mounting base 17 Mounting base 31, 33 First surgical object 32, 34 Second Surgical target 41, 43 suture thread 42, 44 suture needle 45 suture thread holder 46 valve holder 47 forceps 111 strut 112 arm part 113, 123 attachment part 114 clamp part 115 suction port support part 116, 211 suction port 117, 212 suction device Connection part 118 Connection tube 119A Vertical position adjustment part 119a, 119b Clamp lever 119B Horizontal position adjustment part 121 Flexible arm part 122 Holding part 124 Clip 131 Base frame 131A, 133A Joint 132 Column frame 132A Joint plate 133 Beam frame 134 Rail 135 Slide 135A Screw hole 136 Mounting screw 151 Vacuum cylinder 152 Piston drive unit 153 Pressure gauge 155 Tube 161 Mounting plate fixing member 162A Frame mounting opening 162B Frame mounting notch 163 Long hole 164 First mounting plate 165 Fixing member mounting Hole 166 opening 167 second mounting plate 171 screw hole 331 stitching position

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

[First Embodiment]
In this embodiment, the case where it is used for training of coronary artery bypass surgery is described as an example. Here, FIG. 1 is a perspective view of the surgical training aid according to the first embodiment of the present invention, and FIG. 2 is an enlarged view of a main part when the surgical training aid is used.

As shown in these drawings, the surgical training aid 10 of the present embodiment sucks the first surgical object (artificial pseudo site or experimental animal site: here, the heart of the experimental animal as an example) 31. A first holding body 11 that is held by force and a second operation object 32 that is anastomosed or sutured to the first operation object 31 (artificial operation object site: an artificial blood vessel as an example here) 32 is held. And a plurality of frames 13 (see FIG. 5) in which the first holding body 11 and the second holding body 12 are arranged at arbitrary positions. In order to mount the first surgical object 31, and the bottom plate 14 for installing the foundation part, the suction device 15 connected to the first holding body 11 and applying a suction force to the first holding body The mounting table 16 is configured.

First, the first holding body 11 is configured as shown in FIG. 3, for example. That is, the first holding body 11 includes a support column 111 and an arm portion 112. The column 111 is fixed to the rail of the frame 13 through the mounting base 17. An attachment portion (screw) 113 is engraved on the outer periphery of the lower portion of the column 111, and this attachment portion 113 is screwed into a screw hole 171 formed in the attachment base 17, so that the column 111 is attached to the attachment base 17. It is attached. Further, an arm portion 112 is disposed on the support column 111 so as to be movable along the axial direction of the support column 111 by a clamp unit 114.

The arm portion 112 is provided with a suction port support portion 115 at one end and a suction device connection portion 117 at the other end. The suction port support part 115 supports the suction port 116 for holding the first surgical object 31 with a suction force so as to be swingable. A tube 155 led out from the suction device 15 is connected to the suction device connection portion 117. Further, a connection tube 118 that continues to the suction port 116 is connected to the suction device connection portion 117, and the inside communicates so that the suction force of the suction device 15 acts on the suction port 116 from the tube 155 through the connection tube 118. Yes.

The clamp part 114 fixes the arm part 112 to the arbitrary position of the support | pillar 111 by the vertical position adjustment part 119A. That is, with the clamp lever 119a loosened, the clamp portion 114 is slid to an arbitrary position along the axial direction of the support column 111. After positioning, the clamp lever 119a is tightened and fixed to the support column 111. The clamp portion 114 is also provided with a horizontal position adjusting portion 119B, and the horizontal position adjusting portion 119B holds the arm portion 112 so as to be slidable along the axial direction. Then, similarly to the vertical position adjustment unit 119A, the arm unit 112 is slid to an arbitrary position along the axial direction with the clamp lever 119b loosened. After positioning, the clamp lever 119b is tightened to move the arm unit 112. Fix it.

As described above, the first holding body 11 includes the clamp portion 114 having the position adjustment portions 119A and 119B and the suction port support portion 115 that supports the suction port 116 so as to be swingable. The position, orientation, and angle can be set freely. That is, during surgical training, the first surgical object 31 held by the suction port 116 is set to a position, orientation, and angle at which the user can easily perform training, or a position, orientation, and angle that are close to actual surgery. Is possible. The 1st holding body 11 in this embodiment is suitable especially when it is necessary to hold | maintain the upper part of the 1st surgery object 31, and to perform training.

Here, both the support column 111 and the arm portion 112 are composed of rod-shaped members, and the support member 111 supports the one arm portion 112. However, the first holding body 11 of the present embodiment is For example, the arm portion 112 may be composed of a plurality of rod-shaped members, and may be composed of a flexible member having a material or a structure that can be deformed and can maintain a deformed state, instead of the rod-shaped member. May be.

Next, the second holding body 12 is configured as shown in FIG. 4, for example. That is, the second holding body 12 includes a flexible arm part 121 as a support and a holding part 122 for holding the second surgical object 32. Similarly to the first holding body 11, the second holding body 12 is fixed to the rail of the frame 13 via the mounting base 17. An attachment portion (screw) 123 is provided on the outer periphery of the lower portion of the flexible arm portion 121. The attachment portion 123 is screwed into a screw hole 171 formed in the attachment base 17, so that the second holding body 12 is It is attached to the mounting base 17.

The flexible arm 121 is formed of a material or a structure that can be deformed and can maintain the deformed state. Here, as an example, as shown in FIG. 4, it is assumed to have a structure in which ball joints are continuously provided.

The holding unit 122 is composed of a shaft member that holds the second surgical object 32 by being inserted into the lumen of the second surgical object (here, an artificial blood vessel) 32. In addition, the holding unit 122 further includes a clip 124 for fixing the second surgical object 32 to the shaft member at a predetermined insertion position.

Since it is configured as described above, the second holding body 12 can reliably hold the second surgical object 32 at a free position, orientation, and angle. In the present embodiment, as an example, the shape of the holding portion 122 is configured to include a shaft member in order to hold the artificial blood vessel. However, in the present invention, the shape of the holding portion 122 is not limited to this and is configured according to the object to be held. Can be modified in various ways.

Next, the frame 13 and the bottom plate 14 are configured as shown in FIG. 5, for example. That is, the frame 13 includes a base frame 131 that is fixed along each side of the bottom plate 14, a column frame 132 that is fixed perpendicularly to the base frame 131, and a beam frame 133 that connects the tops of the column frames 132. Consists of Each frame 13 is formed with rails 134 on the four sides of the column. The mounting base 17 can be installed on the rail 134, and a slide plate 135 (see FIG. 6A) which can be inserted into the rail 134 and can be provided with a screw hole 135A at an arbitrary position, and the slide By using a mounting screw 136 (see FIG. 6B) that can be connected to the screw hole 135A provided in the plate 135, the suction device 15 and a mounting plate fixing member to be described later can be freely attached to the frame 13. It is possible to install.

The base frame 131 and the beam frame 133 are provided with joints 131A and 133A for attaching the column frame 132 at predetermined positions. A joint plate 132A that is locked to the joints 131A and 133A is attached to the column frame 132. As shown in FIG. 5, the frame 13 can be easily assembled into a substantially rectangular parallelepiped frame shape by merely locking the joints 131A and 133A and the joint plate 132A.

Here, the width and height of the substantially rectangular parallelepiped formed by the frame 13 are set to the average width and height of the human thorax in order to simulate a surgical operation in an actual human body. As a result, it is possible to carry out training that is very close to the actual situation, such as posture, position sense, and force input.

Next, the suction device 15 uses the vacuum cylinder 151 in this embodiment, but is not limited to this, and any device that can suck and hold the first surgical object with a predetermined pressure may be used. The suction device 15 is attached to an arbitrary position of the frame 13 by the suction device fixing plate 18, the slide plate 135 and the mounting screw 136 described above. The suction device 15 includes a piston drive unit 152 for extracting air from the vacuum cylinder 151, a pressure gauge 153 for confirming leakage, a check valve for preventing a backflow of air, a filter, a leak valve, and the like. Yes. Here, when the piston drive unit 152 is operated to evacuate the vacuum cylinder 151, the first surgical object 31 passes through the suction device connection unit 117 and the connection tube 118 from the tube 155 through the suction port 116 due to the generated negative pressure. Can be sucked and held.

The first surgical object 31 may be held only by the first holding body 11 described above, but a mounting table 16 for the first surgical object 31 may be further provided to assist this. . FIG. 7 shows an example of each constituent member of the mounting table 16. 7A shows a mounting plate fixing member, FIG. 7B shows a first mounting plate, and FIG. 7C shows a second mounting plate.

Here, the mounting plate fixing member 161 shown in FIG. 7A is composed of a flat plate provided with a frame mounting opening 162A, a frame mounting notch 162B, and a long hole 163. The frame mounting opening 162A and the frame mounting notch 162B are for locking to the mounting screw 136 previously installed at an arbitrary position of the frame 13 using the slide plate 135 described above. Thereby, the mounting plate fixing member 161 is disposed at an arbitrary position of the frame 13.

Next, the first mounting plate 164 shown in FIG. 7B is composed of a substantially L-shaped flat plate provided with a fixing member mounting hole 165 and an opening 166. The fixing member mounting hole 165 is a hole for mounting the first mounting plate 164 to the mounting plate fixing member 161, and is aligned with the elongated hole 163 of the mounting plate fixing member 161 and then bolts and nuts. Fixed with etc. At this time, the flat plate side provided with the opening 166 is fixed so as to be substantially horizontal with the bottom plate 14. In addition, since the long hole 163 provided in the mounting plate fixing member 161 side has a long shape in the height direction, the mounting height of the first mounting plate 164 can be freely set. The opening 166 will be described in detail in a second embodiment described later.

Next, the second mounting plate 167 shown in FIG. 7C is formed of a flat plate, and is used by being mounted on the first mounting plate 164 when necessary. Here, the second mounting plate 167 is only configured to be mounted on the first mounting plate 164. However, the second mounting plate 167 is used by being fixed on the first mounting plate 164 with, for example, bolts and nuts. It is good also as a structure. When the first surgical object 31 is held from above by the first holding body 11 as in the present embodiment, the first surgical object is placed on the second placement plate 167 having a large area as shown in FIG. It is desirable to mount 31.

Here, a case where vascular anastomosis training is performed using the surgical training aid 10 having the above-described configuration will be described.

First, the first holding body 11, the second holding body 12, the suction device 15, and the mounting table 16 are respectively installed on the frame 13 at optimal positions. Next, when the first surgical object 31 is placed on the mounting table 16 and set at an appropriate position for training, it is brought into contact with the first holding body 11 and the suction device 15 is operated to perform the first surgery. The object 31 is held by a suction force.

The second surgical object 32 (here, an artificial blood vessel) to be anastomosed with the first surgical object 31 is inserted into the holding part 122 of the second holding body 12. At this time, the second surgical object 32 is fixed by being sandwiched by the clip 124 together with the holding part 122 in a state where the second surgical object 32 protrudes from the tip of the holding part 122 by a predetermined length. And the 2nd operation object 32 is moved to the optimal position for anastomosis with the flexible arm part 121 of the 2nd holding body 12 which deform | transforms freely. As a result, as shown in FIG. 8, the first surgical object 31 and the second surgical object 32 are anastomosed using the suture thread 41 and the suture needle 42.

Because of this configuration, according to the present embodiment, it is possible to reproduce an environment closer to a clinical experience with a simple configuration, and the technique can be efficiently and effectively performed before gaining clinical experience in a highly difficult surgical operation. The skill can be improved. In particular, the present embodiment is suitable for a case where training is performed while holding the upper part of the first surgical target, such as training for coronary artery bypass surgery.

[Second Embodiment]
In this embodiment, the case where it uses for training of aortic valve replacement surgery as an example is described. FIG. 9 is a perspective view of a surgical training aid according to the second embodiment of the present invention, and FIG. 10 is an enlarged view of a main part when the surgical training aid is used. In these drawings, parts having the same configurations as those in FIG. 1 and FIG.

As shown in these drawings, the surgical training aid 20 of this embodiment includes a holder having a funnel-shaped suction port 211 as the first holder 21. The first surgical object 33 is stably held by supporting the first holding body 21 with the opening 166 of the first placement plate 164.

The 1st holding body 21 is comprised from the funnel-shaped suction opening 211 by which the suction device connection part 212 was provided in the lower end, as shown in FIG. A tube 155 led out from the suction device 15 is connected to the suction device connection portion 212. The suction device connecting portion 212 communicates with the inside so that the suction force of the suction device 15 acts on the suction port 211 via the tube 155.

The first holding body 21 is in a state where the first mounting plate 164 is set on the frame by the mounting plate fixing member 161 (a state where the second mounting plate 167 of FIG. 1 is removed). It is installed by inserting a funnel-shaped suction port 211 into the opening 166 of the mounting plate 164. Of course, the diameter of the opening 166 of the first mounting plate 164 is appropriately set so as to be smaller than the maximum diameter of the suction port 211 and to stabilize the first holding body 21.

Here, a case where an aortic valve replacement operation is performed using the surgical training auxiliary tool 20 having the above configuration will be described.

First, the first holding body 21, the suction device 15, and the mounting table 16 (the mounting plate fixing member 161 and the first mounting plate 164) are installed on the frame 13 at optimal positions. The first holding body 21 is set so that the suction port 211 fits into the opening 166 of the mounting table 16. Next, the first surgical object 33 is placed at an appropriate position for training on the suction port 211, the suction device 15 is operated, and the first surgical object 33 is held by the suction force.

Then, as shown in FIG. 11, the suture object 43 and the suture needle 44 are used at the stitching position 331 of the first surgical object (here, the heart of the experimental animal) 33 to use the second surgical object (here, the artificial valve). ) 34 is sutured. In FIG. 11, 45 is a suture holder placed on the frame 13, 46 is a valve holder for holding the artificial valve 34, and 47 is forceps.

In this embodiment, the second holding body 12 in the first embodiment is not used. For example, the holding portion 122 at the tip of the second holding body 12 is replaced with a valve holder for holding the artificial valve 34. The artificial valve 34 may be held at the time of suturing.

Because of this configuration, according to the present embodiment, it is possible to reproduce an environment closer to a clinical experience with a simple configuration, and the technique can be efficiently and effectively performed before gaining clinical experience in a highly difficult surgical operation. The skill can be improved. In particular, this embodiment is suitable for a case where training is performed while holding the lower part of the first surgical target, such as training for aortic valve replacement surgery.

In the first and second embodiments, examples of coronary artery bypass surgery and aortic valve replacement surgery have been described. However, the present invention is not limited to surgery in the field of cardiac surgery, and covers the entire surgical field. Applicable to surgical training.

In the first and second embodiments described above, the example in which the upper part or the lower part of the first operation target is sucked and held has been described. However, other parts (for example, side parts) may be sucked and held. good.

As mentioned above, although embodiment of this invention was described, this invention is not limited to the said embodiment, Based on the meaning of this invention, various deformation | transformation are possible, These are excluded from the scope of the present invention. is not.

The present invention relates to a surgical training aid used for various surgical training and has industrial applicability.

Claims (10)

First holding means having a suction port for holding the first surgical object by suction force;
Suction means for applying a suction force to the suction port of the first holding means;
The first holding means can be installed at a predetermined position, and a frame member that forms a substantially rectangular parallelepiped frame;
A bottom plate disposed at a lower portion of the substantially rectangular parallelepiped frame made of the frame member;
A surgical training aid, comprising: A second holding means for holding a second surgical object to be anastomosed or sutured to the first surgical object;
The surgical training aid according to claim 1, wherein the second holding means can be installed at a predetermined position of the substantially rectangular parallelepiped frame. A placement means for placing the first surgical object;
The surgical training aid according to claim 1 or 2, wherein the placing means can be installed at a predetermined position of the substantially rectangular parallelepiped frame. The surgical training assisting device according to any one of claims 1 to 3, wherein the first holding means sucks and holds the first surgical object from above. The surgical training assisting device according to any one of claims 1 to 3, wherein the first holding means sucks and holds the first surgical object from below. The surgical training aid according to any one of claims 1 to 3, wherein the first holding means sucks and holds the first surgical object from its side. The surgical operation according to any one of claims 4 to 6, wherein the first holding unit includes an arm unit that holds the suction port and a support column that supports the arm unit. Surgical training aids. The surgical training aid according to claim 7, wherein the arm means is formed of one or a plurality of rod-like members that hold the suction port at an arbitrary position. The surgical training aid according to claim 7, wherein the arm means is formed of a flexible member that holds the suction port at an arbitrary position. 3. The surgical training aid according to claim 2, wherein the second holding means is formed of a flexible member that holds the second surgical object in an arbitrary position.

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