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WO2018034074A1 - Simulateur de procédure - Google Patents

Simulateur de procédure Download PDF

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Publication number
WO2018034074A1
WO2018034074A1 PCT/JP2017/024576 JP2017024576W WO2018034074A1 WO 2018034074 A1 WO2018034074 A1 WO 2018034074A1 JP 2017024576 W JP2017024576 W JP 2017024576W WO 2018034074 A1 WO2018034074 A1 WO 2018034074A1
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WO
WIPO (PCT)
Prior art keywords
simulated
blood
subcutaneous tissue
simulator
femoral artery
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/JP2017/024576
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English (en)
Japanese (ja)
Inventor
石森元文
小崎浩司
中村義博
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.)
Terumo Corp
Original Assignee
Terumo Corp
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 Terumo Corp filed Critical Terumo Corp
Priority to JP2018534293A priority Critical patent/JP7005500B2/ja
Publication of WO2018034074A1 publication Critical patent/WO2018034074A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • 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
    • G09B19/00—Teaching not covered by other main groups of this subclass
    • 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
    • G09B23/30—Anatomical models

Definitions

  • the present invention relates to a technique simulator for percutaneously puncturing a medical device into a simulated blood vessel.
  • PCPS Percutaneous cardiopulmonary support
  • a femoral artery and a femoral vein are cannulated.
  • a technique simulator in which a simulated blood vessel is embedded in a gel-like simulated subcutaneous tissue may be used.
  • a procedure simulator uses a gel-like simulated subcutaneous tissue, the simulated subcutaneous tissue may be damaged when the medical device is punctured and removed from the simulated blood vessel.
  • the present invention has been made in view of such problems, and an object of the present invention is to provide a technique simulator capable of suppressing the damage of the simulated subcutaneous tissue when the medical device is punctured and removed from the simulated blood vessel.
  • a procedure simulator includes a container, a gel-like simulated subcutaneous tissue provided in the container, a simulated blood vessel embedded in the simulated subcutaneous tissue, and the simulated subcutaneous tissue. And a fiber layer provided on at least one of the surface layer portion and the simulated blood vessel.
  • the strength of the part of the simulated subcutaneous tissue that contacts the fiber layer can be improved, the damage of the simulated subcutaneous tissue can be suppressed when the medical device is punctured and removed from the simulated blood vessel.
  • a simulated skin covering the surface portion of the simulated subcutaneous tissue may be provided, and the fiber layer may be provided between the simulated blood vessel and the simulated skin.
  • the sensation of puncturing and removing the medical device from the simulated blood vessel can be approximated to an actual procedure.
  • the fiber layer may be embedded in the simulated subcutaneous tissue.
  • the fiber layer can be prevented from shifting with respect to the simulated subcutaneous tissue when the medical device is punctured and removed from the simulated blood vessel.
  • the simulated subcutaneous tissue may be impregnated in the fiber layer.
  • the fiber layer can be firmly bonded to the simulated subcutaneous tissue.
  • the fiber layer may be composed of a fiber having liquid absorbency.
  • the fiber layer can be more firmly bonded to the simulated subcutaneous tissue by absorbing the liquid in the simulated subcutaneous tissue into the fibers of the fiber layer.
  • simulated blood may circulate in the simulated blood vessel, and the fiber layer may be provided on the outer peripheral surface of the simulated blood vessel.
  • the simulated blood vessel may include a simulated femoral artery simulating a human femoral artery and a simulated femoral vein simulating a human femoral vein.
  • the technique simulator includes a blood circuit model through which simulated blood circulates, the blood circuit model including the simulated heart, the simulated femoral artery and the simulated femoral vein, and the simulated blood in the simulated heart.
  • a pump for sending the simulated blood in the simulated heart to the simulated femoral artery may be provided in the first flow path.
  • the first flow path has a simulated aorta imitating a human aorta
  • the third flow path has a simulated inferior vena cava imitating a human inferior vena cava
  • Each of the aorta and the simulated inferior vena cava may be made of a material having flexibility and transparency.
  • the strength of the portion of the simulated subcutaneous tissue that contacts the fiber layer can be improved, it is possible to suppress damage to the simulated subcutaneous tissue when the medical device is punctured and removed from the simulated blood vessel.
  • FIG. 5A is a first manufacturing explanatory diagram of the puncture model
  • FIG. 5B is a second manufacturing explanatory diagram of the puncture model
  • FIG. 6A is a third manufacturing explanatory diagram of the puncture model
  • FIG. 6B is a fourth manufacturing explanatory diagram of the puncture model.
  • FIG. 7A is a cross-sectional explanatory view showing a state where a predilator is inserted into a simulated blood vessel
  • FIG. 7B is a cross-sectional explanatory view showing a state where a cannula is inserted into the simulated blood vessel. It is explanatory drawing of the procedure of PCPS using the said procedure simulator.
  • 9A is a longitudinal sectional view of a puncture model having a fiber layer according to a modification
  • FIG. 9B is a transverse sectional view of the puncture model shown in FIG. 9A.
  • the procedure simulator 10 is used as training for a procedure in which a femoral artery and a femoral vein are cannulated in PCPS.
  • the procedure simulator 10 includes a blood circuit model 14 in which the simulated blood 12 circulates and a puncture model 16 provided in the blood circuit model 14.
  • the simulated blood 12 simulates human blood, and for example, water colored in red can be used.
  • the blood circuit model 14 includes a simulated heart 18, a simulated blood vessel 20, a first channel 22, a second channel 24, a third channel 26, a fourth channel 28, a storage unit 30, and a fifth channel 32. ing.
  • the simulated heart 18 imitates the human heart.
  • the simulated heart 18 is made of a resin material having flexibility and transparency.
  • resin material include elastomeric materials such as silicone rubber (silicone elastomer) and thermosetting polyurethane elastomer, gels such as silicone hydrogel, PVA hydrogel, and gelatin, silicone resin, epoxy resin, polyurethane, Examples thereof include thermosetting resins such as unsaturated polyesters, phenol resins and urea resins, and thermoplastic resins such as polymethyl methacrylate alone or in combination.
  • the simulated blood vessel 20 constitutes a part of the puncture model 16 and includes a simulated femoral artery 34 imitating the human femoral artery and a simulated femoral vein 36 imitating the human femoral vein.
  • the simulated femoral artery 34 and the simulated femoral vein 36 are juxtaposed in a state extending in one direction. Details of the simulated femoral artery 34 and the simulated femoral vein 36 will be described later.
  • the first flow path 22 guides the simulated blood 12 in the simulated heart 18 to the simulated femoral artery 34, and the first tube 38 connected to the simulated heart 18 and one end of the first tube 38 and the simulated femoral artery 34. And a simulated aorta 40 connecting the two.
  • the first tube 38 is provided with a pump 42 for reproducing the pulsation of the simulated heart 18. That is, the pump 42 sends the simulated blood 12 in the simulated heart 18 to the simulated femoral artery 34 via the simulated aorta 40.
  • the first tube 38 is made of a resin material having transparency. The same applies to the second tube 44, the third tube 50, the fourth tube 52, the fifth tube 54, and the sixth tube 58, which will be described later.
  • the simulated aorta 40 imitates the human aorta and is made of a resin material having flexibility and transparency. As such a resin material, for example, the same resin material as that of the simulated heart 18 described above can be used.
  • the simulated aorta 40 includes a simulated aortic arch 40a simulating a human aortic arch and a simulated abdominal aorta 40b simulating a human abdominal aorta.
  • the second flow path 24 is for guiding the simulated blood 12 in the simulated femoral artery 34 to the simulated femoral vein 36, and the second flow path 24 connects the other ends of the simulated femoral artery 34 and the simulated femoral vein 36 to each other. It has a tube 44.
  • the second tube 44 is a bifurcated tube formed in a substantially Y shape.
  • An occlusion member 46 is provided at the end of the second tube 44 opposite to the simulated femoral artery 34 and the simulated femoral vein 36.
  • the third flow path 26 is for guiding the simulated blood 12 in the simulated femoral vein 36 into the simulated heart 18 and has a simulated inferior vena cava 48 simulating the inferior vena cava of the human body.
  • the simulated inferior vena cava 48 is made of a resin material having flexibility and transparency. As such a resin material, for example, the same resin material as that of the simulated heart 18 described above can be used.
  • the fourth flow path 28 includes a third tube 50 that connects the simulated abdominal aorta 40b and the reservoir 30, a fourth tube 52 that connects the simulated aortic arch 40a and the third tube 50, a simulated inferior vena cava 48, and a second tube. And a fifth tube 54 connecting the four tubes 52.
  • a forceps 56 for blocking the flow of the simulated blood 12 is provided on the downstream side of the connection portion with the fourth tube 52 in the third tube 50.
  • the simulated blood 12 is stored in the storage unit 30.
  • the fifth flow path 32 includes a sixth tube 58 that guides the simulated blood 12 in the reservoir 30 to the simulated inferior vena cava 48.
  • the sixth tube 58 is provided with forceps 60 for blocking the circulation of the simulated blood 12.
  • the puncture model 16 includes a container 62, a simulated subcutaneous tissue 64, a simulated bone portion 66, a simulated femoral artery 34, a simulated femoral vein 36, a fiber layer 72, and a simulated skin 74.
  • the container 62 is a substantially rectangular parallelepiped box-shaped container opened on one side, and is made of a resin material such as polypropylene.
  • a plurality of first locking portions 76 for fixing the simulated skin 74 are provided on the outer surface of the container 62 (see FIGS. 4A to 5A).
  • the simulated subcutaneous tissue 64 is a gel-like member that imitates the thigh of a human body, and is filled in the container 62.
  • the simulated subcutaneous tissue 64 is, for example, made into a block shape by adding a hardening agent to a mixed solution of water, acrylamide, aluminum oxide or the like.
  • the simulated subcutaneous tissue 64 configured in this way can obtain a soft tissue feel like the thigh of a human body.
  • an echo image can be displayed on the screen using an ultrasonic inspection apparatus.
  • the simulated bone portion 66 is embedded in the simulated subcutaneous tissue 64, and includes a simulated upper anterior iliac spine 66a that imitates the upper anterior iliac spine of a human body, and a simulated pubic nodule 66b that simulates the pubic nodule of the human body ( (See FIG. 2).
  • the simulated anterior iliac spine 66a and the simulated pubic nodule 66b serve as landmarks for identifying the positions of the simulated femoral artery 34 and the simulated femoral vein 36.
  • Such a simulated bone part 66 can be manufactured using a 3D printer based on human body data, for example, with an epoxy resin or the like.
  • the simulated femoral artery 34 and the simulated femoral vein 36 extend along the longitudinal direction of the container 62 while being adjacent to each other.
  • the simulated femoral artery 34 and the simulated femoral vein 36 penetrate both sides in the longitudinal direction of the container 62 while being embedded in the simulated subcutaneous tissue 64.
  • the simulated femoral artery 34 and the simulated femoral vein 36 are located above the simulated bone portion 66 (on the simulated skin 74 side opposite to the bottom surface of the container 62) (see FIGS. 4A and 4B).
  • the simulated femoral artery 34 is located at a depth of about 150 mm from the outer surface of the simulated skin 74. However, the depth of the simulated femoral artery 34 from the outer surface of the simulated skin 74 can be arbitrarily changed.
  • the simulated femoral artery 34 is located above the simulated femoral vein 36 and on the side where the simulated upper anterior iliac spine 66a is located.
  • the inner diameter of the simulated femoral artery 34 is set smaller than the inner diameter of the simulated femoral vein 36.
  • the inner diameter of the simulated femoral artery 34 is preferably in the range of 6 mm to 8 mm, more preferably 7 mm.
  • the inner diameter of the simulated femoral vein 36 is preferably in the range of 9 mm to 11 mm, and more preferably 10 mm.
  • the simulated femoral artery 34 and the simulated femoral vein 36 can be approximated to the femoral artery and femoral vein of the patient in a cardiac arrested state.
  • the length of the simulated femoral artery 34 is shorter than the length of the simulated femoral vein 36.
  • the length of the simulated femoral artery 34 is preferably in the range of 70 mm to 90 mm, and more preferably 80 mm.
  • the length of the simulated femoral vein 36 is preferably in the range of 110 mm to 130 mm, and more preferably 120 mm. In this case, the simulated femoral artery 34 and the simulated femoral vein 36 can be effectively pulsated (pulsated).
  • the simulated femoral artery 34 and the simulated femoral vein 36 are made of, for example, a resin material such as silicon rubber, polyvinyl alcohol, or natural rubber.
  • the resin material constituting the simulated femoral artery 34 and the simulated femoral vein 36 preferably has a durometer hardness of 30A to 40A measured by type A based on JIS K 6253 standard, and more preferably 35A.
  • the simulated femoral artery 34 and the simulated femoral vein 36 can be suitably pulsated and sensed when a medical device (hereinafter simply referred to as medical device) such as a guide wire, predilator, dilator, and cannula is punctured. Can be approximated to the sense of puncturing the femoral artery and vein of the human body.
  • a medical device such as a guide wire, predilator, dilator, and cannula
  • the fiber layer 72 has an intermediate fiber portion 73 embedded above the simulated blood vessel 20 in the simulated subcutaneous tissue 64. That is, the intermediate fiber portion 73 is provided between the surface layer portion 64 a of the simulated subcutaneous tissue 64 and the simulated blood vessel 20.
  • the intermediate fiber portion 73 is a non-woven fabric composed of fibers having liquid absorbency (water absorption) such as polyester fibers.
  • the intermediate fiber portion 73 is firmly bonded to the simulated subcutaneous tissue 64 by being impregnated (filled) with the simulated subcutaneous tissue 64 therein.
  • the intermediate fiber part 73 may be comprised with the fiber which does not have a liquid absorptivity, and may be a woven fabric instead of a nonwoven fabric.
  • the simulated skin 74 is a sheet member made of, for example, silicon rubber.
  • the simulated skin 74 preferably has a tear strength of 30 kN / m or more as measured based on JIS K 6252 standard. In this case, the simulated skin 74 can be prevented from being torn when the medical device is punctured or removed.
  • a plurality of second locking portions 78 that can be locked to the first locking portions 76 provided on the container 62 are provided on the back surface of the simulated skin 74.
  • locking part 78 are comprised as a hook-and-loop fastener, for example.
  • the simulated skin 74 is in contact (adhesion) with the outer surface of the simulated subcutaneous tissue 64 in a state where a predetermined tension is applied.
  • the simulated skin 74 is preferably colored in a color corresponding to the color of the human skin in order to have reality.
  • the constituent material of the simulated skin 74 is not limited to silicon rubber and can be arbitrarily changed.
  • a simulated bone portion 66 is disposed in the container 62, and the simulated femoral artery 34 and the simulated femoral vein 36 are disposed so as to penetrate both longitudinal side walls of the container 62.
  • a hardening agent is mixed into the subcutaneous tissue molding material 80, and the subcutaneous tissue molding material 80 before being cured is put in a predetermined amount (for example, about 80% of the capacity in the container 62). Inject only (amount).
  • the simulated bone 66, the simulated femoral artery 34, and the simulated femoral vein 36 are completely hidden by the subcutaneous tissue molding material 80, and a predetermined space is formed above the subcutaneous tissue molding material 80 in the container 62. .
  • the fiber layer 72 is disposed in the space above the subcutaneous tissue molding material 80 in the container 62 (see FIG. 6A).
  • the subcutaneous tissue molding material 80 before being hardened to fill the space is further injected into the container 62.
  • the subcutaneous tissue molding material 80 enters the fiber layer 72, and the subcutaneous tissue molding material 80 in the container 62 is cured to form the simulated subcutaneous tissue 64.
  • the fiber layer 72 absorbs moisture in the subcutaneous tissue molding material 80, the fiber layer 72 is firmly bonded to the simulated subcutaneous tissue 64.
  • the simulated skin 74 is covered from above the simulated subcutaneous tissue 64, and the second locking portion 78 of the simulated skin 74 is locked to the first locking of the container 62 in a state where tension is applied to the simulated skin 74. Lock to the part 76. Thereby, the puncture model 16 is manufactured.
  • the pump system 100 used for the PCPS procedure includes a blood removal tube 102, a centrifugal pump 104, a drive motor 106, an artificial lung 108, a blood supply tube 110, and a controller 112.
  • the blood removal tube 102 guides the simulated blood 12 guided from the blood removal cannula 130 to the centrifugal pump 104.
  • the centrifugal pump 104 guides the simulated blood 12 guided from the blood removal tube 102 to the artificial lung 108.
  • the drive motor 106 is a motor for driving the centrifugal pump 104.
  • the artificial lung 108 is a membrane-type artificial lung, and performs gas exchange of the simulated blood 12 guided from the centrifugal pump 104 (excluding carbon dioxide in the simulated blood 12 and taking in oxygen).
  • the blood supply tube 110 guides the simulated blood 12 that has undergone gas exchange and is oxygenated to the blood supply cannula 128.
  • the controller 112 controls driving of the drive motor 106.
  • the pump 42 is driven with the forceps 56 blocking the flow of the simulated blood 12 in the third tube 50 and the forceps 60 blocking the flow of the simulated blood 12 in the sixth tube 58.
  • the simulated blood 12 in the simulated heart 18 circulates to the simulated heart 18 via the first tube 38, the simulated aorta 40, the simulated femoral artery 34, the second tube 44, the simulated femoral vein 36, and the simulated inferior vena cava 48.
  • the simulated blood 12 circulates in the blood circuit model 14, so that the simulated blood vessel 20 pulsates by the simulated blood 12.
  • the forceps 60 are operated to cause the simulated blood 12 in the reservoir 30 to enter the simulated heart 18 via the sixth tube 58. Supply.
  • the user inserts a blood cannula 128 into the simulated femoral artery 34 (cannulate the simulated femoral artery 34).
  • the user confirms the puncture site from the positions of the simulated anterior iliac spine 66a and the simulated pubic nodule 66b by touching the simulated skin 74 with fingers, and makes a small incision on the simulated skin 74 with a scalpel.
  • a guide wire 120 is percutaneously inserted into the simulated femoral artery 34 by the Seldinger method.
  • the pre-dilator 122 is inserted into the simulated femoral artery 34 through the guide wire 120.
  • the positional relationship between the simulated femoral artery 34 and the predilator 122 is confirmed using an echo image of the ultrasonic inspection device 124.
  • the predilator 122 is removed, and a blood cannula 128 into which the dilator 126 has been inserted is inserted into the simulated femoral artery 34 along the guide wire 120 as shown in FIG. 7B.
  • the positional relationship between the simulated femoral artery 34 and the dilator 126 is confirmed using an echo image of the ultrasonic inspection device 124. Thereafter, as shown in FIG. 8, the tip of the blood cannula 128 is placed at a predetermined position of the simulated abdominal aorta 40b, and the guide wire 120 and the dilator 126 are removed.
  • the user inserts a blood removal cannula 130 into the simulated femoral vein 36 (cannulate the simulated femoral vein 36).
  • a blood removal cannula 130 for the simulated femoral vein 36 is the same as the puncture procedure of the blood supply cannula 128 for the simulated femoral artery 34, and thus detailed description thereof is omitted.
  • the tip of the blood removal cannula 130 is placed at a predetermined position of the simulated inferior vena cava 48.
  • the blood pump 110 is connected to the hub 128a of the blood cannula 128 and the blood drain tube 102 is connected to the hub 130a of the blood cannula 130.
  • the centrifugal pump 104 is operated. Drive.
  • oxygen is supplied to the oxygenator 108.
  • the simulated blood 12 guided from the simulated inferior vena cava 48 to the blood removal cannula 130 is guided to the centrifugal pump 104 via the blood removal tube 102.
  • the simulated blood 12 derived from the centrifugal pump 104 is exchanged in the artificial lung 108 and then guided to the simulated abdominal aorta 40b via the blood supply tube 110 and the blood supply cannula 128.
  • the forceps 56 and 60 are operated to adjust the simulated blood 12 in the blood circuit model 14 to an appropriate amount.
  • the driving of the centrifugal pump 104 is stopped, and the supply of oxygen to the oxygenator 108 is stopped.
  • the blood cannula 128 is removed from the simulated femoral artery 34, and the blood removal cannula 130 is removed from the simulated femoral vein 36.
  • the intermediate fiber part 73 is provided between the surface layer part 64a of the simulated subcutaneous tissue 64 and the simulated blood vessel 20, the strength of the part of the simulated subcutaneous tissue 64 that contacts the intermediate fiber part 73 is improved. be able to. Thereby, damage of the simulated subcutaneous tissue 64 can be suppressed when the simulated blood vessel 20 is punctured and removed from the medical device.
  • the medical device when punctured and removed from the simulated blood vessel 20, a part of the simulated subcutaneous tissue 64 may adhere to the medical device.
  • the attached tissue attached to the medical device among the simulated subcutaneous tissue 64 can be peeled off by the intermediate fiber portion 73, the simulated subcutaneous tissue 64 is punctured and removed from the simulated blood vessel 20 by the medical device. Can be effectively suppressed.
  • the puncture model 16 of this embodiment includes the simulated skin 74 that covers the surface layer portion 64a of the simulated subcutaneous tissue 64, the sensation of puncturing and removing the medical device from the simulated blood vessel 20 can be approximated to an actual procedure. .
  • the intermediate fiber portion 73 is embedded in the simulated subcutaneous tissue 64, the intermediate fiber portion 73 can be prevented from shifting with respect to the simulated subcutaneous tissue 64 when the medical device 20 is punctured and removed from the simulated blood vessel 20.
  • the intermediate fiber portion 73 is impregnated with the simulated subcutaneous tissue 64, the intermediate fiber portion 73 can be firmly bonded to the simulated subcutaneous tissue 64. Furthermore, since the intermediate fiber part 73 is comprised with the fiber which has a liquid absorptivity, the liquid in the simulated subcutaneous tissue 64 can be absorbed by the fiber of the intermediate fiber part 73. FIG. Therefore, the intermediate fiber portion 73 can be more firmly bonded to the simulated subcutaneous tissue 64, and the simulated blood 12 can be prevented from leaking onto the simulated skin 74.
  • the simulated blood vessel 20 has the simulated femoral artery 34 and the simulated femoral vein 36, it is possible to experience a simulated experience of puncturing a medical device in the femoral artery and femoral vein of the human body.
  • the blood circuit model 14 includes a simulated heart 18, a first flow path 22, a simulated femoral artery 34, a second flow path 24, a simulated femoral vein 36, and a third flow path 26, and the first flow path.
  • a pump 42 for sending the simulated blood 12 in the simulated heart 18 to the simulated femoral artery 34 is provided.
  • the simulated aorta 40 in the first flow path 22 and the simulated inferior vena cava 48 in the third flow path 26 are made of a transparent resin material.
  • the simulated blood 12 sent from the pump 42 to the simulated aorta 40 may be collided with the simulated blood that looks like oxygenated blood sent from the blood cannula 128 to the simulated aorta 40. it can.
  • the collision between the blood sent to the aorta by self-pulsation and the oxygenated blood sent from the blood cannula to the aorta is reproduced by the blood circuit model 14 and the state can be visually recognized. it can. Therefore, it is possible to learn from the technique simulator 10 the principle of causing a difference in blood collection data of the left and right radial arteries when performing PCPS on the human body.
  • a central venous catheter can be inserted into the simulated inferior vena cava 48, and the distal end thereof can be positioned near the distal end of the blood removal cannula 130.
  • the simulated inferior vena cava 48 is flexible, negative pressure can be applied to the inferior vena cava 48 during PCPS.
  • PCPS computerized tomography
  • negative pressure in the inferior vena cava may cause the inferior vena cava to stick to the blood removal cannula, resulting in poor blood removal that reduces the amount of blood removed by the cannula.
  • the simulated inferior vena cava 48 when performing PCPS, can be set to a negative pressure and the simulated inferior vena cava 48 can be stuck to the cannula 130 for blood removal.
  • the phenomenon that the inferior vena cava sticks to the blood removal cannula during PCPS can be reproduced by the blood circuit model 14 and the state thereof can be visually recognized. Therefore, the principle of blood removal failure when PCPS is performed on the human body can be learned by the procedure simulator 10.
  • each of the simulated aorta 40 and the simulated inferior vena cava 48 is made of a material having flexibility and transparency. It is possible to reproduce various trouble events and visually recognize the phenomenon. Thereby, various trouble events that occur when performing PCPS on the human body can be learned by the procedure simulator 10.
  • the puncture model 16 may have a fiber layer 140 shown in FIGS. 9A and 9B instead of the fiber layer 72.
  • the fiber layer 140 has a first outer peripheral fiber portion 142, a second outer peripheral fiber portion 144, an intermediate fiber portion 73, and a surface fiber portion 148.
  • the first outer peripheral fiber portion 142 is provided so as to cover the entire outer peripheral surface of the portion of the simulated femoral artery 34 embedded in the simulated subcutaneous tissue 64.
  • the first outer peripheral fiber portion 142 is made of, for example, a fiber having liquid absorbency (water absorption) such as polyester fiber, and the simulated subcutaneous tissue 64 is filled in the first outer peripheral fiber portion 142 to the simulated subcutaneous tissue 64. It is tightly coupled.
  • the 1st outer periphery fiber part 142 may be comprised with the fiber which does not have a liquid absorptivity.
  • the first outer peripheral fiber portion 142 is formed by, for example, winding a non-woven fabric or a woven fabric made of the fibers around the outer peripheral surface of the simulated femoral artery 34 and bonding the same with an adhesive.
  • the second outer peripheral fiber portion 144 is provided so as to cover the entire outer peripheral surface of the portion of the simulated femoral vein 36 embedded in the simulated subcutaneous tissue 64. Since the 2nd outer periphery fiber part 144 is comprised similarly to the 1st outer periphery fiber part 142, the detailed description is abbreviate
  • the surface fiber portion 148 is disposed on the outer surface of the simulated subcutaneous tissue 64.
  • the surface fiber portion 148 is, for example, a nonwoven fabric composed of polyester fibers.
  • the surface fiber portion 148 may be composed of fibers other than polyester fibers, or may be a woven fabric instead of a nonwoven fabric.
  • the first outer peripheral fiber portion 142 is provided on the outer peripheral surface of the simulated femoral artery 34, the leakage of the simulated blood 12 between the simulated subcutaneous tissue 64 and the simulated femoral artery 34 is suppressed. Can do. Further, the strength of the portion of the simulated subcutaneous tissue 64 that contacts the first outer peripheral fiber portion 142 can be improved. Further, when the medical device punctures the simulated femoral artery 34, the attached tissue of the medical device can be peeled off by the first outer peripheral fiber portion 142.
  • the second outer peripheral fiber portion 144 is provided on the outer peripheral surface of the simulated femoral vein 36, it is possible to prevent the simulated blood 12 from leaking between the simulated subcutaneous tissue 64 and the simulated femoral vein 36. Moreover, the intensity
  • the surface fiber portion 148 is provided on the surface layer portion 64a of the simulated subcutaneous tissue 64, the strength of the portion of the simulated subcutaneous tissue 64 that is in contact with the surface fiber portion 148 can be improved.
  • the adherent tissue of the medical device can be peeled off by the surface fiber portion 148.
  • the fiber layer 140 is not limited to the configuration described above. In the fiber layer 140, at least one of the first outer peripheral fiber portion 142, the second outer peripheral fiber portion 144, the intermediate fiber portion 73, and the surface fiber portion 148 may be omitted.
  • the fiber layer 140 may include at least one of the first outer peripheral fiber portion 142 and the second outer peripheral fiber portion 144, and the intermediate fiber portion 73 and the surface fiber portion 148 may be omitted.
  • the fiber layer 140 may include at least one of the first outer peripheral fiber portion 142 and the second outer peripheral fiber portion 144 and the intermediate fiber portion 73, and the surface fiber portion 148 may be omitted.
  • the fiber layer 140 includes at least one of the first outer peripheral fiber portion 142 and the second outer peripheral fiber portion 144 and the surface fiber portion 148, and the intermediate fiber portion 73 may be omitted. Furthermore, for example, the fiber layer 140 may have a surface fiber portion 148, and at least one of the first outer peripheral fiber portion 142 and the second outer peripheral fiber portion 144 and the intermediate fiber portion 73 may be omitted.
  • the fiber layer 140 includes the surface fiber portion 148 and the intermediate fiber portion 73, and at least one of the first outer periphery fiber portion 142 and the second outer periphery fiber portion 144 may be omitted.
  • the procedure simulator according to the present invention is not limited to the above-described embodiment, and various configurations can be adopted without departing from the gist of the present invention.

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Abstract

Selon l'invention, un simulateur de procédure (10) est pourvu d'un tissu sous-cutané simulé sous forme de gel (64) qui est disposé à l'intérieur d'un récipient (62), un vaisseau sanguin simulé (20) qui est intégré dans le tissu sous-cutané simulé (64), et une couche fibreuse (72) qui est disposée dans au moins un emplacement parmi la partie de couche de surface (64a) du tissu sous-cutané simulé (64), ou entre la partie de couche de surface (64a) et le vaisseau sanguin simulé (20). La couche fibreuse (72) est disposée entre le vaisseau sanguin simulé (20) et la peau simulée (74).
PCT/JP2017/024576 2016-08-17 2017-07-05 Simulateur de procédure Ceased WO2018034074A1 (fr)

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JP2018534293A JP7005500B2 (ja) 2016-08-17 2017-07-05 手技シミュレータ

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JP2016-159850 2016-08-17
JP2016159850 2016-08-17

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WO2018034074A1 true WO2018034074A1 (fr) 2018-02-22

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WO2020079779A1 (fr) * 2018-10-17 2020-04-23 朝日インテック株式会社 Dispositif de simulation de corps humain, procédé de commande de dispositif de simulation de corps humain et programme informatique
JP7032741B2 (ja) 2019-09-03 2022-03-09 学校法人近畿大学 穿刺練習用模型
JP2021039224A (ja) * 2019-09-03 2021-03-11 学校法人近畿大学 穿刺練習用模型
JP2021060567A (ja) * 2019-10-09 2021-04-15 学校法人自治医科大学 模擬皮膚装置、模擬皮膚装置の使用方法、縫合評価方法および制御装置
JP7370030B2 (ja) 2019-10-09 2023-10-27 学校法人自治医科大学 模擬皮膚装置、模擬皮膚装置の使用方法、縫合評価方法および制御装置

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