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WO2022059717A1 - Dispositif de formation pour techniques orthopédiques et modèle de squelette - Google Patents

Dispositif de formation pour techniques orthopédiques et modèle de squelette Download PDF

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Publication number
WO2022059717A1
WO2022059717A1 PCT/JP2021/033976 JP2021033976W WO2022059717A1 WO 2022059717 A1 WO2022059717 A1 WO 2022059717A1 JP 2021033976 W JP2021033976 W JP 2021033976W WO 2022059717 A1 WO2022059717 A1 WO 2022059717A1
Authority
WO
WIPO (PCT)
Prior art keywords
water tank
endoscope
training device
model
cover member
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/JP2021/033976
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English (en)
Japanese (ja)
Inventor
明 出沢
克也 宮川
美沙 松本
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.)
Nipro Corp
Original Assignee
Nipro 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 Nipro Corp filed Critical Nipro Corp
Priority to JP2022550591A priority Critical patent/JP7745833B2/ja
Publication of WO2022059717A1 publication Critical patent/WO2022059717A1/fr
Anticipated expiration legal-status Critical
Priority to JP2025153885A priority patent/JP2025170163A/ja
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
    • 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
    • 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
    • G09B9/00—Simulators for teaching or training purposes

Definitions

  • the present invention relates to a training device for training an orthopedic procedure performed endoscopically for a disease related to bones such as the lumbar spine and joints.
  • the present invention also includes an invention relating to a skeletal model used in a plastic surgery training device.
  • Patent Document 1 proposes a surgical practice model for endoscopic surgery for lumbar spine disease in International Publication No. 2019/107441 (Patent Document 1).
  • the circumference of the lumbar spine simulation part simulating the lumbar spine that has developed lumbar spine disease is covered with a muscle tissue simulation part made of an elastomer or a gel-like resin.
  • An object of the present invention is to provide an orthopedic surgery training device and a skeletal model having a novel structure capable of training a procedure in endoscopic orthopedic surgery in an environment closer to the actual operation state. ..
  • the skeleton model is fixed, a water tank in which a transparent liquid surrounding the skeleton model is housed, and a tip portion thereof is inserted into the water tank, and the transparent liquid is sucked from the water tank.
  • a shaping technique training device including a suction port and an endoscope having at least one of a discharge port for discharging the transparent liquid into the water tank at the tip portion thereof.
  • the endoscope used in the training device of this embodiment is not limited, and for example, the endoscope used in surgery can be used as it is. Further, since the training procedure is performed in a transparent liquid such as water, the training can be performed in an environment closer to the actual treatment state.
  • the second aspect is that in the orthopedic technique training device according to the first aspect, the filtering device for filtering the transparent liquid sucked from the water tank and the transparent liquid filtered by the filtering device are discharged to the water tank. It is provided with a circulation device for circulating the transparent liquid.
  • the orthopedic surgery training device of this embodiment it is sufficient to inject a transparent liquid such as water into the water tank at the time of use, and since it is lightweight and has excellent portability, it is easy for the user to use it at home or the like. , It will be easier to secure time for training in orthopedic surgery procedures.
  • the third aspect is that in the orthopedic technique training device according to the first or second aspect, both the suction port and the discharge port are provided at the tip portion of the endoscope.
  • the suction port and the discharge port can be positioned near the skeleton model, the cutting powder is sucked and the cutting powder is washed away by the transparent liquid under the endoscope. The visibility can be secured more efficiently and stably.
  • the endoscope generally used in in-hospital surgery has both suction and discharge functions, it is possible to perform training in an environment closer to the actual operation state.
  • a fourth aspect is the orthopedic technique training device according to any one of the first to third aspects, wherein the water tank has a peripheral wall having at least a transparent portion.
  • the state of the skeletal model and the procedure of the orthopedic surgery can be visually recognized from the outside such as the side, which cannot normally be seen, through the transparent part in the peripheral wall.
  • natural light can be taken in from the lateral direction (side), and the field of view can be brightened.
  • a fifth aspect is the orthopedic technique training device according to any one of the first to fourth aspects, wherein a cover member that covers the skeleton model from above is attached to the water tank, and the cover member is attached to the cover member. Is provided with an insertion hole into which the endoscope is inserted, and the endoscope is inserted into the water tank through the insertion hole.
  • the cover member can prevent unintentional happenings such as scattering of transparent liquid and mixing of foreign matter into the water tank. Further, since the cover member is provided with an insertion hole into which the endoscope is inserted, it is possible to provide functions such as specifying the insertion position of the endoscope and guiding the endoscope.
  • the sixth aspect is a water tank in which the skeleton model is fixed and a transparent liquid surrounding the skeleton model is housed, and the skeleton model is assembled to the water tank to cover the skeleton model from above and in the horizontal direction.
  • a cover member having an inclined portion and having a first insertion hole penetrating in the thickness direction in the inclined portion, and a tip portion can be inserted into the water tank through the first insertion hole. It is a shaping technique training device equipped with an endoscope.
  • the endoscope since the endoscope is inserted through the first insertion hole provided in the inclined portion of the cover member, the endoscope is inserted from the direction inclined with respect to the horizontal direction.
  • the training of the procedure to access the treatment site can be performed with a feeling close to the actual treatment state.
  • a seventh aspect is that in the orthopedic technique training device according to the sixth aspect, the skeleton model is detachably fixed to the water tank, and the cover member covers the skeleton model from above. The position can be switched between the position and the open position where the skeleton model can be removed from the water tank.
  • the shaping technique training device of this embodiment by switching the cover member from the closed position to the open position, operations such as attaching / detaching or replacing the skeleton model and replenishing the transparent liquid can be performed without completely removing the cover member from the water tank. It can be carried out.
  • the eighth aspect is in the orthopedic technique training device according to the sixth or seventh aspect, in which a first valve body made of an elastic material is attached to the first insertion hole, and the first valve body is equipped with the first valve body. Is provided with a first insertion hole through which the endoscope is inserted.
  • the orthopedic procedure training device of this embodiment by adopting the first valve body at the insertion site of the endoscope, for example, a relatively hard cover member is adopted to secure the strength of the endoscope. It is possible to bring the feeling of operation when inserting and moving or tilting closer to the actual treatment state.
  • a ninth aspect is that in the orthopedic technique training device according to the eighth aspect, the first valve body has a slit extending from the first insertion hole in at least one of the vertical directions in the inclined direction of the inclined portion. It is provided.
  • the endoscope inserted through the first insertion hole can be moved or tilted in the tilting direction along the slit. At that time, by expanding the slit and moving the endoscope, it is possible to realize an operation feeling close to the stretching of the skin in the actual treatment state based on the elasticity and frictional resistance of the first valve body. It will be possible.
  • a tenth aspect is the orthopedic technique training device according to any one of the sixth to ninth aspects, wherein the cover member has a flat portion extending in the horizontal direction, and the flat portion has an elastic material.
  • a second insertion hole is provided in which a second valve body is provided, and the second valve body is provided with a second insertion hole through which the tip portion of the endoscope is inserted. Is.
  • the flat portion and the inclined portion of the cover member are provided with insertion holes having a valve body through which an endoscope can be inserted, so that, for example, a skeletal model or training to be used can be used.
  • the insertion direction and insertion position of the endoscope can be selected with a greater degree of freedom according to the procedure to be performed.
  • the eleventh aspect is the orthopedic technique training device according to any one of the sixth to tenth aspects, comprising a cover member fixing mechanism for selectively assembling the cover member to a plurality of positions in the aquarium. be.
  • the assembly position of the cover member with respect to the water tank can be selected according to, for example, the skeleton model to be used and the procedure for training. This makes it possible to increase the selection range of the insertion direction and the insertion position of the endoscope.
  • the skeleton model is fixed, a water tank in which a transparent liquid surrounding the skeleton model is housed, an endoscope whose tip portion is inserted into the water tank, and the skeleton model are described. It is provided with a model fixing mechanism for selectively fixing to a plurality of positions in the water tank.
  • the skeleton model when accessing one side of the skeleton model from diagonally above with an endoscope, the skeleton model is positioned close to one side in the water tank. It is also possible to avoid the interference of the endoscope with the peripheral wall.
  • the compact aquarium causes the endoscope to interfere with the peripheral wall of the aquarium. It is also possible to make the target training feasible while avoiding problems such as.
  • a thirteenth aspect is the orthopedic technique training device according to the twelfth aspect, in which a cover member for covering the skeleton model from above is attached to the water tank, and the endoscope is attached to the cover member.
  • An insertion hole is provided for insertion, and the cover member is selectively placed at a plurality of positions with respect to the water tank in the same direction as the direction in which the fixed position of the skeleton model with respect to the water tank can be selected by the model fixing mechanism. It is equipped with a cover member fixing mechanism to be assembled to.
  • the endoscope can be used through an insertion hole provided in the cover member. Access to the skeletal model can be stably realized in the skeletal model fixed at any position.
  • the fourteenth aspect is that in the orthopedic technique training device according to the thirteenth aspect, the skeleton model can be fixed even in a state of being rotated around the vertical axis of the water tank.
  • the orthopedic technique training device of this embodiment for example, by fixing the skeleton model closer to one end side of the water tank, a wide area is secured on the other end side of the water tank and access from the side of the endoscope is easy.
  • the access direction of the skeleton model by the endoscope can be substantially changed. Therefore, while making the size of the aquarium compact, it is possible to realize endoscopic access to the skeletal model from multiple directions in a situation close to the actual treatment state.
  • a fifteenth aspect is the orthopedic technique training device according to the fourteenth aspect, wherein the cover member is inclined with respect to the horizontal direction on both sides in a selectable direction of a fixed position with respect to the water tank by the cover member fixing mechanism.
  • the inclined portion is provided, and the insertion hole is provided in each of the inclined portions.
  • the cover member can be installed corresponding to the fixed position of the skeleton model, and both sides of the skeleton model are slanted through the insertion holes provided in the inclined portions on both sides of the cover member. It is also possible to access the endoscope from above.
  • the skeleton model is fixed, a water tank in which a transparent liquid surrounding the skeleton model is housed, an endoscope whose tip portion is inserted into the water tank, and the endoscope. It is a shaping technique training device provided separately and provided with a lighting device for illuminating the skeleton model.
  • the shaping technique training device of this embodiment since the lighting device is provided separately from the endoscope, the shaping technique training device is provided while ensuring the brightness of the viewing area by the camera provided in the endoscope.
  • the endoscope used in the above a simple type endoscope such as one equipped with a lighting device having a low illuminance or one not equipped with a lighting device can also be adopted.
  • the skeleton model is fixed, a water tank in which a transparent liquid surrounding the skeleton model is housed, an endoscope whose tip portion is inserted into the water tank, and the skeleton model in the water tank. It is a shaping technique training device equipped with a model fixing mechanism that is detachably fixed to the wall portion of the skeleton.
  • the skeleton model is stably positioned and supported by fixing the skeleton model to the wall of the water tank which does not easily move due to the weight of the transparent liquid. Can be done.
  • the skeletal model can be exchanged as appropriate, and a common aquarium can be used when performing multiple trainings.
  • the eighteenth aspect is that in the orthopedic technique training device according to the seventeenth aspect, the skeleton model is provided with a bracket, and the bracket can be attached to and detached from the wall portion of the aquarium by the model fixing mechanism. It is what has been done.
  • the skeleton model is fixed to the water tank via the bracket, the skeleton model is moved to the water tank while avoiding the influence of the shape, size, material, strength, etc. of the skeleton model. It is also possible to fix it firmly and stably.
  • a nineteenth aspect is a skeletal model used in a shaping technique training device including a water tank in which a transparent liquid is housed and an endoscope in which a tip portion is inserted into the water tank, and a plurality of models having different hardnesses from each other. It is composed of a multi-layer structure composed of layers, and the outermost layer is harder than the inner layer.
  • a sensation such as a resistance force close to that of an actual bone is expressed even when cutting or the like, and a skeleton model suitable for a shaping technique training device can be provided.
  • a twentieth aspect is a skeletal model used in a shaping technique training device including a water tank in which a transparent liquid is housed and an endoscope in which a tip portion is inserted into the water tank, and a fibrous interior object in a gap. It has.
  • a fibrous interior material such as cotton or wool felt instead of the conventionally known soft foamed resin, for example, a body such as a nucleus pulposus protruding as a hernia. It is possible to develop a situation closer to that of a procedure for removing tissue with forceps or the like, and a skeletal model suitable for an orthopedic technique training device can be provided.
  • the orthopedic procedure training device and the skeletal model according to the present invention it is possible to train the procedure in endoscopic orthopedic surgery in an environment closer to the actual operation state.
  • a perspective view showing a plastic surgery training device as one embodiment of the present invention A plan view showing a water tank constituting the orthopedic technique training device shown in FIG. 1 with the skeleton model fixed and the cover member in the closed position.
  • Perspective view of the aquarium shown in FIG. A perspective view showing the water tank shown in FIG. 3 in a state where the cover member is in the open position.
  • FIG. 13 is a perspective view showing a second fixed portion constituting the plastic surgery training device shown in FIG. 13, wherein (a) is a locked state and (b) is an unlocked state.
  • FIG. 1 shows a plastic surgery training device 10 as an embodiment of the present invention.
  • This orthopedic procedure training device 10 is intended to improve the technical proficiency of the user in orthopedic surgery using an endoscope, and is capable of training the procedure at the user's home or the like, for example. Is.
  • the orthopedic technique training device 10 includes a skeletal model 12 that imitates a lesion site, a water tank 14 in which the skeletal model 12 is fixed and housed, and an endoscope 15 in which a tip portion is inserted into the water tank 14.
  • the water tank 14 contains water 16 which is a transparent liquid, and the periphery of the skeleton model 12 is covered with water 16.
  • the transparent liquid contained in the water tank 14 is not limited to the water 16, and may be colored, for example. However, the transparent liquid has, for example, a visible light transmittance of 80% or more so that the image obtained by the endoscope 15 can be confirmed on the monitor 164 described later.
  • the water tank 14 has an upper opening 18 that opens upward. That is, the water tank 14 includes a rectangular flat plate-shaped bottom wall 20 and a peripheral wall 22 protruding upward from the outer peripheral edges on all four sides of the bottom wall 20, and the wall of the water tank 14 is formed by the bottom wall 20 and the peripheral wall 22. The part is composed.
  • the vertical direction is a vertical direction and is a direction orthogonal to the paper surface in FIG.
  • the front-back direction means the front-back direction in FIG. 2, which is the direction in which the skeleton model 12 extends in the water tank 14.
  • the front refers to the front in FIG.
  • the left-right direction means the left-right direction in FIG.
  • the water tank 14 of the present embodiment has a plurality of fixed positions of the skeleton model 12, and in FIGS. 2 to 5, the skeleton model 12 is the fixed position of the skeleton model 12 shown in FIG. It is fixed to the left of. Further, as will be described later, the skeleton model 12 of the present embodiment can be fixed to the water tank 14 even in a state of being rotated around a vertical axis and inverted back and forth, and in FIGS. 2 to 5, the skeleton model 12 can be fixed. Is fixed to the water tank 14 in a state of being inverted in the front-rear direction with respect to the skeleton model 12 shown in FIG. For the sake of clarity, the skeleton model 12 is shown by a two-dot chain line in FIG.
  • the peripheral wall 22 of the water tank 14 is provided with a transparent portion 24 made of a transparent material at least in a part thereof, and in the present embodiment, substantially the entire peripheral wall 22 is a transparent portion 24.
  • the transparent portion 24 may be colorless and transparent, or may be colored and transparent, and has, for example, a visible light transmittance of 80% or more.
  • screw holes 26 that open inward in the facing direction (front-back direction) are formed on the wall portions on both sides in the front-rear direction. In the present embodiment, four screw holes 26 are formed in each of the wall portions on both sides in the front-rear direction of the peripheral wall 22, and are provided apart from each other in the left-right direction.
  • FIG. 6 shows a water tank 14 in a single item state before the second fixing portion 40 is assembled, and the first fixing portion 30 and the second fixing portion 40 can be moved to the bottom wall 20 of the water tank 14.
  • a boss portion 32 to be fixed to the boss portion 32 is integrally provided. The first fixed portion 30 and the boss portion 32 are separated from each other with a certain distance in the front-rear direction.
  • the first fixing portion 30 has a certain degree of left-right direction dimension, and a first fixing groove 34 that opens rearward and extends in the left-right direction is formed at the lower portion of the rear end surface of the first fixing portion 30. .. Further, the boss portion 32 is formed with a screw hole 36 that opens upward. Then, the first fixing portion 30 and the boss portion 32, which are formed separately from the main body portion of the water tank 14, are post-fixed to the upper surface of the bottom wall 20, so that the first fixing portion 30 is attached to the water tank 14. And the boss portion 32 are integrally provided.
  • the pair of first fixing portions 30, 30 and the pair of boss portions 32, 32 are provided so as to be separated from each other in the left-right direction, respectively, and the first fixing portion 30 and the boss portion on the left side are provided, respectively.
  • the 32 is opposed to each other in the front-rear direction, and the first fixed portion 30 and the boss portion 32 on the right side are opposed to each other in the front-rear direction, respectively.
  • the pair of first fixing portions 30, 30 and the pair of boss portions 32, 32 are provided unevenly to the right in the water tank 14, and the water tank 14 is provided in the left side. It has a portion where the first fixing portion 30 and the boss portion 32 are not provided.
  • bottomed guide grooves 38, 38 extending in the front-rear direction are provided on both left and right sides of each boss portion 32 in the left-right direction.
  • the second fixing portion 40 mounted on the boss portion 32 faces the first fixing portion 30 in the front-rear direction.
  • the second fixing portion 40 has a substantially hexagonal flat plate shape as a whole, and a guide hole 42 penetrating in the plate thickness direction is formed in the central portion as an oval shape long in the front-rear direction. It is formed.
  • the second fixing portion 40 has a certain degree of left-right direction dimension, and a second fixing groove 44 that opens forward and extends in the left-right direction is formed at the lower portion of the front end surface of the second fixing portion 40. ..
  • guide protrusions 46, 46 extending in the front-rear direction are provided on both sides of the guide hole 42 in the left-right direction. The length dimension of the guide protrusion 46 is shorter than the length dimension of the guide groove 38.
  • the second fixing portion 40 becomes the boss portion 32. It is attached to.
  • the protrusion dimension of the water tank 14 from the bottom wall 20 of the boss portion 32 is slightly larger than the thickness dimension of the second fixing portion 40, and the second fixing portion 40 is attached to the boss portion 32.
  • the boss portion 32 is movable in the guide hole 42. That is, the second fixed portion 40 can move in the front-rear direction with respect to the boss portion 32.
  • the guide protrusions 46, 46 of the second fixing portion 40 are inserted into the guide grooves 38, 38 of the bottom wall 20, and the second fixing portion 40 is front and rear. You can move without tilting in the direction.
  • a storage recess 52 extending forward from the guide hole 42 is formed in the lower part of the guide hole 42.
  • a coil spring 54 extending in the front-rear direction is housed in the housing recess 52 and the guide hole 42, and the front end of the coil spring 54 is fixed to the front inner surface of the housing recess 52 and is rear of the coil spring 54. The end is fixed to the outer peripheral surface of the boss portion 32 inserted into the guide hole 42.
  • the coil spring 54 urges the second fixing portion 40 forward with respect to the boss portion 32. Further, by applying a rearward external force to the second fixing portion 40, the second fixing portion 40 can move backward against the urging force of the coil spring 54.
  • a cover member 56 is attached to the upper opening 18 of the water tank 14.
  • the cover member 56 is a substantially arch-shaped member as a whole, and is formed of, for example, a hard synthetic resin or the like.
  • inclined portions 58, 58 that are inclined with respect to the horizontal direction are provided in a state where the cover member 56 shown in FIGS.
  • a flat portion 60 extending in the horizontal direction is provided in the intermediate portion.
  • the cover member 56 has a pair of cover frames 62, 62 on both sides in the front-rear direction. These cover frames 62, 62 are connected by a rod frame 64 extending in the front-rear direction at both left and right end portions and a connecting portion between the inclined portion 58 and the flat portion 60. Further, as shown in FIG. 4, substantially tubular leg portions 66 protruding from both sides in the front-rear direction are provided at both left-right end portions of the cover frames 62 and 62.
  • the cover side walls 68 and 68 are provided on the inclined portions 58 and 58 on both sides in the left-right direction, respectively, and the flat portion 60 in the middle portion in the left-right direction. Is provided with a cover top wall 70.
  • the cover side walls 68 and 68 and the cover top wall 70 each have a substantially rectangular flat plate shape, and when the cover member 56 shown in FIGS. 2 and 3 is in the closed position, the cover side walls 68 and 68 are in the horizontal direction.
  • the cover top wall 70 is arranged so as to spread in the horizontal direction while being arranged so as to be inclined.
  • cover side walls 68 and 68 and the cover top wall 70 is made of a transparent material, and in the present embodiment, both the cover side walls 68 and 68 and the cover top wall 70 are transparent. It is made of material.
  • the cover side walls 68 and 68 and the cover top wall 70 may be colorless and transparent, or may be colored and transparent, and for example, the visible light transmittance is preferably 80% or more.
  • the cover side walls 68 and 68 are provided with a first insertion hole 74 as an insertion hole penetrating in the plate thickness direction
  • the cover top wall 70 is provided with a first insertion hole as an insertion hole penetrating in the plate thickness direction.
  • 2 Insertion holes 76 are provided.
  • two first insertion holes 74 having a substantially oval shape are formed so as to be separated from each other in the front-rear direction.
  • six second insertion holes 76 having a substantially perfect circular shape are formed so as to be separated from each other in the front-rear direction and the left-right direction.
  • a first valve body 78 made of an elastic material such as rubber is attached to the first insertion hole 74 in the cover side wall 68.
  • the first valve body 78 has an oval shape having an outer diameter larger than that of the first insertion hole 74, and the outer diameter of the intermediate portion in the thickness direction is reduced. Then, the inner peripheral edge portion of the first insertion hole 74 is fitted into the portion having a small diameter in the first valve body 78, so that the first valve body 78 is attached to the first insertion hole 74. That is, in the closed position shown in FIGS. 2 and 3, the first valve body 78 is arranged so as to be inclined with respect to the horizontal direction.
  • a first insertion hole 80 penetrating in the plate thickness direction is formed in the upper portion in the inclined direction. Further, a slit 82 extends downward from the first insertion hole 80 in the inclined direction.
  • the inner diameter of the first insertion hole 80 is not limited, but it is preferably smaller than the outer diameter of the endoscope 15, for example.
  • the first insertion hole may be provided in the middle portion or the lower portion in the inclined direction in the first valve body, and the slit extending from the first insertion hole is provided in both the upper direction and the vertical direction in the inclined direction. It may be extended.
  • a second valve body 84 made of an elastic material such as rubber is attached to the second insertion hole 76 in the cover top wall 70.
  • the second valve body 84 has an oval shape having an outer diameter larger than that of the second insertion hole 76, and the outer diameter of the intermediate portion in the thickness direction is reduced. Then, the inner peripheral edge portion of the second insertion hole 76 is fitted into the portion having a small diameter in the second valve body 84, so that the second valve body 84 is attached to the second insertion hole 76. That is, in the closed position shown in FIGS. 2 and 3, the second valve body 84 is arranged so as to spread in the horizontal direction. A second insertion hole 86 penetrating in the plate thickness direction is formed in the central portion of the second valve body 84.
  • a slit 87 extends from the second insertion hole 86 toward both the front-rear direction and the left-right direction.
  • the inner diameter of the second insertion hole 86 is not limited, but it is preferably smaller than the outer diameter of the endoscope 15, for example.
  • the cover member 56 as described above is supported by the cover support member 88 provided on the inner surface of the peripheral wall 22 of the water tank 14, and is assembled to the water tank 14.
  • the cover support member 88 includes a first support member 88a that is rotatable with respect to the peripheral wall 22 and a second support member 88b that is non-rotatable with respect to the peripheral wall 22.
  • Both the first support member 88a and the second support member 88b have a structure like a tubular body in which a part of the peripheral wall is cut out, and the central axial direction of the tubular body is the thickness of the peripheral wall 22. It extends in the vertical direction.
  • the first support member 88a and the second support member 88b are attached to the water tank 14 by superimposing one end surface (outer end surface in the front-rear direction) on the inner surface of the peripheral wall 22 in the central axis direction.
  • the first support member 88a is composed of an inner peripheral portion 90a and an outer peripheral portion 90b, both of which have a substantially cylindrical shape, and a part of the peripheral wall 92 of the outer peripheral portion 90b is cut out.
  • the outer peripheral portion 90b is assembled so as to be displaceable in the circumferential direction with respect to the inner peripheral portion 90a.
  • a projecting piece-shaped picking piece 100 projecting toward the outer peripheral side is provided at one end of the peripheral wall 92 in the circumferential direction of the outer peripheral portion 90b.
  • the inner peripheral portion 90a of the first support member 88a is fixed to the screw hole 26 on the inner surface of the peripheral wall 22 so as not to rotate in the circumferential direction, for example, by a screw or a pin. Then, by picking the picking piece 100 and displacing the outer peripheral portion 90b in the circumferential direction with respect to the inner peripheral portion 90a, the outer peripheral portion 90b of the first support member 88a can rotate with respect to the peripheral wall 22 of the water tank 14. Has been done. By such rotation of the outer peripheral portion 90b, the circumferential position of the notch 102 on the peripheral wall 92 can be displaced.
  • the notch 102 is formed, for example, with a circumferential dimension of about 1/3 circumference.
  • the second support member 88b has a substantially bottomed cylindrical shape, and a part of the peripheral wall 104 is cut out.
  • the second support member 88b is fixed to the screw hole 26 on the inner surface of the peripheral wall 22 so as not to rotate in the circumferential direction, for example, by a screw or a pin.
  • the notch 106 is formed in the peripheral wall 104 of the second support member 88b with a circumferential dimension of about 1/3 in the upper right.
  • the four screw holes 26 are provided on the wall portions on both sides in the front-rear direction of the peripheral wall 22 of the water tank 14, four covers are provided on the wall portions on both sides in the front-rear direction on the peripheral wall 22.
  • a support member 88 is attached.
  • the two cover support members 88 on the left side are the first support members 88a and the two cover support members 88 on the right side are the second support members on the wall portions on both sides in the front-rear direction of the peripheral wall 22. It is said to be a member 88b.
  • the cover member 56 When the cover member 56 is attached to the water tank 14 via the cover support member 88 (first support member 88a, second support member 88b) as described above, for example, as shown in FIGS.
  • the leg portion 66 of the cover member 56 is inserted into the support member 88a and the second support member 88b on the left side.
  • the leg 66 at the right end of the cover member 56 is inserted into the peripheral wall 104 from the upper right through the notch 106 in the second support member 88b.
  • the cover member 56 can be rotated around the leg portion 66 inserted in the peripheral wall 104, as shown in FIGS. 2 and 3.
  • the leg portion 66 at the left end of the cover member 56 is inserted into the peripheral wall 92 through the notch 102 in the first support member 88a.
  • the circumferential position of the notch 102 in the first support member 88a can be set above the leg portion 66, for example, by pinching the picking piece 100 and rotating the first support member 88a. ..
  • the leg portion 66 is prevented from falling off from the peripheral wall 92 by pinching the picking piece 100 and rotating the first support member 88a. More specifically, by changing the position of the notch 102 in the peripheral wall 92 and covering the upper right side of the first support member 88a with the peripheral wall 92, the cover member 56 is tentatively legged from the second support member 88b. Even if an external force acts on the upper right side, which is the direction in which the portion 66 falls off, the cover member 56 is fixed to the water tank 14 because the leg portion 66 is prevented from falling off from the first support member 88a. ..
  • the cover member fixing mechanism 112 is configured to include a plurality of cover support members 88.
  • the cover member 56 when the notch 102 in the first support member 88a is located above, the cover member 56 is rotated around the leg portion 66 inserted into the second support member 88b to rotate the cover member 56. 56 can be switched from the closed position shown in FIGS. 2 and 3 to the open position shown in FIG. This makes it possible to replace the skeleton model 12 without removing the cover member 56 from the water tank 14.
  • the cover member 56 can be removed from the water tank 14 by exerting an external force upward to the right on the cover member 56 from the state where the cover member 56 is in the open position, and the cover member 56 can be removed from the water tank 14. After removal, the skeletal model 12 may be replaced.
  • the first support member 88a and the second support member 88b on the left side are selected as the cover support member 88 into which the leg portion 66 of the cover member 56 is inserted, and the cover member 56 is assembled.
  • the cover member 56 can be assembled at the assembly position shown in FIGS. 2 to 4 and at the assembly position on the right side of that shown in FIG.
  • the cover member 56 can be assembled to a plurality of positions in the water tank 14 by the cover member fixing mechanism 112 (a plurality of cover support members 88). You can select and assemble one place from the positions.
  • the selectable direction of the assembly position of the cover member 56 (left-right direction in the present embodiment) is the same as the selectable direction of the fixed position of the skeleton model 12 by the model fixing mechanism 130, for example, as will be described later.
  • the assembly position of the cover member 56 can be selected according to the position of the skeleton model 12 fixed by the model fixing mechanism 130.
  • the skeleton model can be changed according to the training procedure, but as shown in FIGS. 8 and 9, the skeleton model 12 of the present embodiment is fixed to the bracket 126 described later.
  • the skeletal model 12 of the present embodiment employs the skeletal model of the lumbar spine as training for surgery for herniated disc.
  • the whole lumbar spine (1st to 5th lumbar vertebrae) may be imitated, but a part of the lumbar vertebra may be imitated.
  • the skeletal model 12 includes an anterior portion of the 3rd lumbar vertebra L3, the 4th lumbar vertebra L4 and the 5th lumbar vertebra L5, an intervertebral disc 114 between the 3rd lumbar vertebra L3 and the 4th lumbar vertebra L4, and the 4th lumbar vertebra L4 and the 5th lumbar vertebra L5. It is equipped with an intervertebral disc 116 between and.
  • FIG. 1 since the skeleton model 12 is fixed to the water tank 14 with the left side in FIG. 8 facing forward, in the following description, the left side in FIG. 8 which is the neck side in the skeleton model 12 The right side in FIG. 8 which is the front side and the leg side is described as the rear side, the upper side in FIG. 8 which is the back side is described as the upper side, and the lower side in FIG. 8 which is the ventral side is described as the lower side.
  • a nerve model 120 that imitates a nerve is inserted into the gap 118 inside the skeleton model 12.
  • the nerve model 120 has a portion 120a imitating a cauda equina nerve extending in the anterior-posterior direction and a portion 120b imitating a nerve root extending laterally from the cauda equina nerve.
  • the skeleton model 12 has a fibrous interior body 122 that imitates a hernia in the internal gap 118.
  • the fibrous interior material 122 for example, cotton, wool felt, or the like can be preferably adopted.
  • the skeleton model 12 can be formed of a hard resin such as an epoxy resin or an acrylic resin, and is formed of foamed polyurethane in the present embodiment. Further, in the present embodiment, the skeleton model 12 has a multi-layer structure composed of a plurality of layers having different hardnesses from each other.
  • the outermost layer is a coating layer 124 made of a synthetic resin that is harder than the inner layer.
  • the outer layer for example, a material different from that of the inner layer may be adopted, but the hardness may be adjusted by changing the foaming rate with respect to the inner layer.
  • the nerve model 120 may be formed of an elastomer such as silicone.
  • the bracket 126 has a substantially rectangular flat plate shape as a whole, and can be formed of, for example, a hard synthetic resin.
  • the bracket 126 is fixed to the lower surface of the skeleton model 12.
  • the fixing structure between the bracket 126 and the skeleton model 12 is not limited, and may be, for example, adhesive.
  • the pin hole 127 is provided in the central portion on the upper surface of the bracket 126.
  • the bracket 126 and the skeleton model 12 are fixed by press-fitting a pin (not shown) protruding downward from the skeleton model 12.
  • the skeleton model 12 and the bracket 126 may be adhered to each other with the pin of the skeleton model 12 inserted into the pin hole 127 of the bracket 126. Further, in the lower portion of the bracket 126, engaging protrusions 128 and 128 protruding on both sides in the front-rear direction are provided.
  • the front-rear dimension of the bracket 126 including these engaging protrusions 128 and 128 is the front-rear direction between the second fixing portion 40 and the first fixing portion 30 in a state of being urged by the coil spring 54 and positioned at the frontmost position. It is made larger than the facing distance in. Then, by applying a rearward external force to the second fixed portion 40 to increase the facing distance between the first fixed portion 30 and the second fixed portion 40, the first fixed portion 30 and the second fixed portion 40 are combined with each other.
  • the bracket 126 can be arranged between them.
  • the second fixing portion 40 is displaced forward according to the urging force of the coil spring 54, and the engaging protrusions 128 on both sides in the front-rear direction of the bracket 126, 128 engages the first fixing groove 34 in the first fixing portion 30 and the second fixing groove 44 in the second fixing portion 40.
  • the skeleton model 12 extends and is fixed in the front-rear direction at the bottom of the water tank 14. That is, in the present embodiment, the model fixing mechanism 130 for fixing the skeleton model 12 to the water tank 14 is configured to include the first fixing portion 30 and the second fixing portion 40.
  • the cover member 56 When removing the skeleton model 12 from the water tank 14, for example, the cover member 56 is rotationally displaced to the open position shown in FIG. 4, and the skeleton model 12 and the bracket 126 are gripped and pushed backward. 2
  • the fixed portion 40 is displaced rearward against the urging force of the coil spring 54, and the facing distance between the first fixed portion 30 and the second fixed portion 40 becomes large. Therefore, the first fixed portion 30 and the second fixed portion 30 and the second fixed portion 40 are fixed.
  • the skeleton model 12 can be removed from between the portions 40. Therefore, in the present embodiment, the skeleton model 12 is detachably fixed to the water tank 14, and more specifically, the bracket 126 is the bottom wall 20 as the wall portion of the water tank 14 by the model fixing mechanism 130. It is fixed so that it can be attached and detached.
  • the pair of first fixing portions 30, 30 and the pair of second fixing portions 40, 40 are provided apart from each other in the left-right direction, and in FIGS.
  • the bracket 126 is fixed by selecting the 1 fixing portion 30 and the second fixing portion 40, but as shown in FIG. 1, the first fixing portion 30 and the second fixing portion 40 on the right side are selected, respectively. It is also possible to fix the bracket 126. That is, the bracket 126 can be fixed at the fixed position shown in FIGS. 2 and 3 and at the fixed position on the right side of that shown in FIG.
  • the skeleton model 12 can be selectively fixed to a plurality of fixed positions in the water tank 14 by the model fixing mechanism 130.
  • the assembly position of the cover member 56 can be selected by the cover member fixing mechanism 112, and the cover member 56 can be set in the plurality of assembly positions according to the position of the skeleton model 12 fixed by the model fixing mechanism 130. You can select and assemble one place from.
  • the skeleton model 12 is shown in FIGS. It can be assembled to the water tank 14 even in the state shown in FIG. 1 by rotating it in the vertical axis direction and reversing it in the front-rear direction, for example.
  • the tip portion of the endoscope 15 is inserted from above into the water tank 14 to which the skeleton model 12 is fixed.
  • the cover member 56 is assembled so as to cover the upper part of the skeleton model 12, and the tip portion of the endoscope 15 is provided with the first insertion hole 74 or the second insertion hole 76 in the cover member 56. It is inserted through.
  • the tip portion of the endoscope 15 is the first. And it is inserted through the first and second insertion holes 80 and 86 in the second valve bodies 78 and 84.
  • the structure of the endoscope used in the orthopedic procedure training device 10 is not limited, and for example, an endoscope generally used in surgery may be used, but in the present embodiment, FIG.
  • the endoscope 15 is a simple endoscope. That is, in the endoscope 15 of the present embodiment, the main body portion 136 is formed of metal. Three lumens, a first lumen 138, a second lumen 140, and a third lumen 142, are formed in the main body 136 of the endoscope 15, and these first to third lumens 138, 140, and 142 are formed, respectively. It is formed so as to extend in the length direction of the main body portion 136.
  • the first lumen 138 has a larger diameter than the second and third lumens 140 and 142, and is a lumen for sucking water 16 housed in the water tank 14 and for inserting an instrument (not shown). be. Further, the second lumen 140 is for inserting the cable 162 described later, and the third lumen 142 is a lumen for discharging water 16 to the water tank 14.
  • the length direction of the main body 136 means the left-right direction in FIG. 10, the tip side means the left side in FIG. 10, and the base end side means the right side in FIG. say.
  • the upper part of the main body 136 means the upper part in FIG. 10
  • the lower part means the lower part in FIG.
  • the lower portion of the main body portion 136 protrudes toward the tip side from the upper portion, and the first lumen 138 is provided on the upper portion of the main body portion 136 and the lower side of the main body portion 136.
  • a second lumen 140 is provided in the portion.
  • the third lumen 142 is provided at a position where the first lumen 138 and the second lumen 140 are laterally separated from each other.
  • the endoscope 15 of the present embodiment has a suction port 144 as an opening of a first lumen 138 which is a lumen for sucking water 16 and a third lumen which is a lumen for discharging water 16 at the tip portion. It is provided with both a discharge port 146 as an opening of 142.
  • a camera 148 is provided in the opening portion of the second lumen 140. That is, the camera 148 is provided on the tip side of the suction port 144 and the discharge port 146, and can take a picture of the instrument inserted through the first lumen 138 (suction port 144).
  • the base end portion of the first lumen 138 is closed by a valve 152 having a slit 150, and in front of the valve 152, a suction tube 154 communicating with the first lumen 138 and extending laterally is provided. It is connected. Further, a discharge tube 156 extending laterally is connected to the base end portion of the third lumen 142.
  • the suction tube 154 and the discharge tube 156 are connected to the pump 158, which is a circulation device, and the filter 160, which is a filtration device, via an appropriate connector or the like outside the water tank 14. Therefore, the shaping procedure training device 10 of the present embodiment includes a pump 158 and a filter 160.
  • the water 16 sucked from the suction port 144 is filtered by the filter 160, and the water 16 filtered by the filter 160 is circulated by the pump 158 and discharged from the discharge port 146 to the water tank 14. It is supposed to be done.
  • the filter 160 is shown by a two-dot chain line in FIG. 1, but the arrangement position of the filter 160 is not particularly limited as long as it is provided on the circulation path of the water 16 from the suction port 144 to the discharge port 146. do not have.
  • a light 166 as a lighting device for illuminating the skeleton model 12 is provided outside the water tank 14 as a separate body from the endoscope 15.
  • the orthopedic procedure training device 10 may be configured to include a light 166.
  • the specific structure of the light 166 is not limited, for example, it is a light with a clip, and the clip is fixed by sandwiching the peripheral wall 22 of the water tank 14, so that the skeleton model 12 is illuminated from above.
  • the LED light may be fixed to the outside of the peripheral wall 22 to illuminate the skeleton model 12 through the transparent portion 24 of the peripheral wall 22. Further, in FIG. 2, the light 166 is fixed to the front side of the peripheral wall 22, but the position where the light 166 is provided is not limited.
  • the tip portion of the endoscope 15 by inserting the tip portion of the endoscope 15 through the cover member 56, it is possible to perform procedure training in orthopedic surgery. That is, with the tip of the endoscope 15 close to the skeleton model 12, an instrument such as a drill or forceps (not shown) is inserted through the valve 152 provided at the base end of the first lumen 138. It is projected from the tip of the endoscope 15. Then, while checking the image displayed on the monitor 164, the instrument is operated to crush or cut the bone (skeleton model 12), remove the hernia (interior object 122), and the like.
  • an instrument such as a drill or forceps (not shown) is inserted through the valve 152 provided at the base end of the first lumen 138. It is projected from the tip of the endoscope 15. Then, while checking the image displayed on the monitor 164, the instrument is operated to crush or cut the bone (skeleton model 12), remove the hernia (interior object 122), and the like.
  • the interlaminated method shown in FIG. 12 (a) and the transforaminal method shown in FIG. 12 (b) are mentioned, and the size of the hernia, the site of occurrence, etc.
  • the intervertebral method or the transforaminal method is selected. That is, in the method shown in FIG. 12 (a), the endoscope 15 is inserted vertically (from above in FIG. 12 (a)) from the back side of the patient, whereas in FIG. 12 (b). In the method shown, the endoscope 15 is inserted from the outside (from the direction inclined upward in FIG. 12 (b)).
  • the cover member 56 of the present embodiment includes a flat portion 60 and an inclined portion 58, and the endoscope 15 can be inserted from either the flat portion 60 or the inclined portion 58. Both transforaminal methods can be trained.
  • the skeleton model 12 is a water tank as shown in FIG. It may be fixed at the fixed position on the right side of the water tank 14, or may be fixed at the fixed position at the substantially center of the water tank 14, as shown in FIGS. 2 to 4. In addition, when the endoscope 15 is not moved significantly in the vertical direction during the training of the transforaminal method, the skeleton model 12 is substantially centered in the water tank 14 as shown in FIGS. 2 to 4. It is preferable to be fixed in the fixed position of.
  • the endoscope 15 can be viewed from either one of the left-right directions through the inclined portions 58 and 58 of the cover member 56 with respect to the skeleton model 12. Is inserted, the peripheral wall 22 of the water tank 14 is prevented from interfering with the endoscope 15.
  • the skeletal model 12 is subjected to an operation of greatly moving the endoscope 15 in the vertical direction.
  • the water tank 14 is fixed at a fixed position on the right side.
  • a sufficient space can be secured on the left side of the skeleton model 12, so that the endoscope 15 is inserted from the left side through the inclined portion 58 of the cover member 56 with respect to the skeleton model 12, and further up and down.
  • Even when moving significantly in the direction it is possible to prevent the peripheral wall 22 of the water tank 14 from interfering with the endoscope 15.
  • the skeleton model 12 When the endoscope 15 is inserted into the skeleton model 12 from the right side, the skeleton model 12 is fixed in a state of being inverted with respect to the fixed position on the right side of the water tank 14. As a result, sufficient space can be secured on the right side of the skeleton model 12 (the right side when the neck side (left side in FIG. 8) of the skeleton model 12 is the front). As a result, even when the endoscope 15 is inserted into the skeleton model 12 from the right side and is largely moved in the vertical direction, the peripheral wall 22 of the water tank 14 may interfere with the endoscope 15. Be avoided.
  • the endoscope 15 has a suction port 144 for sucking the water 16 of the water tank 14 at the tip portion, and discharges the water 16 to the water tank 14. Since it is provided with a discharge port 146 for this purpose, for example, an instrument such as a drill is inserted through the first lumen 138, and the cutting powder of the skeleton model 12 cut by the instrument is sucked together with the water 16 through the suction port 144. , It may be washed away by the water 16 discharged from the discharge port 146.
  • the water 16 sucked together with the cutting powder of the skeleton model 12 is circulated by the pump 158, which is a circulation device, while the cutting powder of the skeleton model 12 is removed by the filter 160, which is a filtration device, and the discharge port 146. Is discharged to the water tank 14.
  • the pump 158 which is a circulation device
  • the filter 160 which is a filtration device
  • the discharge port 146 Is discharged to the water tank 14.
  • the orthopedic technique training device 10 can be used. As a result, the orthopedic procedure training device 10 can be used, for example, at home, and it becomes easy to secure time for training, so that it is possible to improve the proficiency level of the procedure by the user.
  • both the suction port 144 and the discharge port 146 are provided at the tip of the endoscope 15, the suction port 144 sucks the cutting powder of the skeleton model 12 and the discharge port 146 at the treatment site. Both with the flushing of the cutting powder of the skeleton model 12 of the above can be realized more reliably.
  • the inside can be visually recognized from the outside of the water tank 14, for example, the instructor's technique can be observed from the outside, or one's own technique can be photographed from the outside. It is possible to further improve the proficiency level of the procedure in the user.
  • a cover member 56 that covers the skeleton model 12 from above is attached to the water tank 14. This can prevent the water 16 from scattering when the endoscope 15 is inserted into the water tank 14, the skeleton model 12 is cut, and the water 16 is sucked and discharged. Since the cover member 56 is provided with an inclined portion 58 and a flat portion 60, the endoscope 15 can be inserted into the skeleton model 12 from the left-right direction, or the endoscope 15 can be inserted from above. Is possible. Thereby, it is possible to select the insertion position of the endoscope 15 according to the type of the skeletal model 12, the position and size of the lesion site, and the like, and it is possible to perform training of a plurality of different procedures.
  • the inclined portion 58 of the cover member 56 is provided with the first insertion hole 74, and the flat portion 60 of the cover member 56 is provided with the second insertion hole 76.
  • the first valve body 78 is attached to the first insertion hole 74, the first insertion hole 80 is formed in the first valve body 78, and the second valve is formed in the second insertion hole 76.
  • a body 84 is attached, and a second insertion hole 86 is formed in the second valve body 84.
  • the cover member 56 can be switched between a closed position that covers the upper part of the skeleton model 12 and an open position where the skeleton model 12 can be removed from the water tank 14, the cover member 56 can be switched to the water tank. It is possible to remove the skeleton model 12 from the aquarium 14 without completely removing it from 14.
  • the shaping technique training device 10 of the present embodiment has a model fixing mechanism 130 for fixing the skeleton model 12 to the wall portion of the water tank 14, and the model fixing mechanism 130 allows the skeleton model 12 to be moved to the water tank 14. It can be selectively fixed to multiple positions.
  • the cover member 56 of the present embodiment has inclined portions 58 and 58 on both sides in the left-right direction, and by inserting the endoscope 15 from the side of the skeleton model 12, the endoscope 15 and the water tank 14 can be inserted. Although it is easy to interfere with the peripheral wall 22, such interference can be avoided by changing the fixed position of the skeleton model 12 by the model fixing mechanism 130.
  • the skeleton model 12 is inserted into the water tank 14. Since it can be fixed even when it is inverted in the front-rear direction, it is not necessary to provide a large space on both sides of the skeleton model 12 in the left-right direction. good. As a result, the water tank 14 can be made compact, and the space required for storage can be reduced even when the water tank 14 is used at home or the like.
  • the shaping technique training device 10 of the present embodiment has a cover member fixing mechanism 112 for assembling the cover member 56 to the water tank 14, and the cover member 56 is placed in the water tank 14 by the cover member fixing mechanism 112. It can be selectively assembled to multiple positions.
  • the direction of the fixed position of the skeleton model 12 selectable by the model fixing mechanism 130 and the direction of the assembly position of the cover member 56 selectable by the cover member fixing mechanism 112 are the same, and the model.
  • the assembly position of the cover member 56 to be assembled by the cover member fixing mechanism 112 can be selected according to the fixing position of the skeleton model 12 fixed by the fixing mechanism 130. As a result, even when the fixed position of the skeleton model 12 in the water tank 14 is changed, the upper part of the skeleton model 12 can be covered more stably by the cover member 56.
  • the skeleton model 12 is fixed to the bracket 126, and the bracket 126 is detachably fixed to the wall portion of the water tank 14 by the model fixing mechanism 130. Therefore, it is possible to replace the skeletal model 12 after training, and it is possible to use the common water tank 14 even when the training is performed a plurality of times. As a result, even when the orthopedic technique training device 10 is used at home or the like, it is possible to reduce the space for storage and the labor for management without storing a plurality of water tanks 14. Further, even if the skeleton model 12 has a complicated shape, since the bracket 126 is fixed to the model fixing mechanism 130, the fixing region between the skeleton model 12 and the water tank 14 can be stably secured.
  • the light 166 which is a lighting device for illuminating the skeleton model 12
  • the endoscope 15 is used in the orthopedic procedure training device 10.
  • a simpler endoscope than the endoscope actually used for surgery can be adopted.
  • the skeleton model 12 of the present embodiment has a multi-layer structure, and the coating layer 124, which is the outermost layer, is made harder than the inner layer. This makes it possible to provide a skeleton model 12 that is close to the actual feeling of bone when performing training such as cutting.
  • the gap 118 inside the skeleton model 12 has a fibrous interior body 122 that imitates a hernia (nucleus nucleus). This makes it possible to provide a skeletal model 12 that is close to the actual feeling of hernia when training a technique for removing a hernia with forceps or the like in an operation such as a herniated disc.
  • the cover member 56 can be removed from the water tank 14, but it may be made non-removable and the closed position and the open position may be simply switchable.
  • the mode in which the cover member can be switched to the open position is not essential, and the cover member may be detachably assembled in the water tank in the closed position at all times.
  • the switching between the closed position and the open position may be not limited to the displacement due to rotation as in the above embodiment, but may be, for example, a slide displacement in the left-right direction.
  • the structure of the cover member is not limited, and may be composed of only inclined portions on one side or both sides, may be composed only of flat portions, and the inclined portions may have a curved shape or the like. ..
  • the cover member is not indispensable in the orthopedic technique training device according to the present invention.
  • both the suction port 144 and the discharge port 146 are provided at the tip portion of the endoscope 15, but at least one of the suction port and the discharge port is provided at the tip portion of the endoscope.
  • the discharge port for discharging the transparent liquid (for example, water) to the water tank may be provided, for example, on the peripheral wall or the bottom wall of the water tank.
  • the suction port for sucking the transparent liquid from the water tank may be provided, for example, on the peripheral wall or the bottom wall of the water tank.
  • the cutting powder is sucked together with the transparent liquid by the suction port or the discharge port provided at the tip of the endoscope, or is swept away by the transparent liquid discharged from the discharge port.
  • Good visibility is exhibited even under a mirror.
  • the suction port and the discharge port provided at the tip of the endoscope do not have to be open to the tip surface of the endoscope, and may be opened to the outer peripheral surface near the tip.
  • neither the suction port nor the discharge port need to be provided in the endoscope.
  • a suction port is provided on the peripheral wall or the bottom wall of the water tank, and the suction port is transparent.
  • the liquid is discharged to the outside of the water tank, and a discharge port connected to a water source separately provided outside the water tank is provided on the peripheral wall and the bottom wall of the water tank so that the transparent liquid flowing out from the water source is discharged to the water tank.
  • a discharge port connected to a water source separately provided outside the water tank is provided on the peripheral wall and the bottom wall of the water tank so that the transparent liquid flowing out from the water source is discharged to the water tank.
  • the skeleton model 12 can be fixed to two places in the water tank 14, but it may be one place or three or more places.
  • the cover member 56 can be fixed to two places in the water tank 14, but it may be one place or three or more places.
  • the cover member is preferably assembled at a position that covers the upper part of the skeleton model according to the position of the skeleton model in the water tank.
  • the skeleton model 12 is fixed to the bracket 126, and the first and second fixing portions 30, 40 constituting the model fixing mechanism 130 are provided on the bottom wall 20 of the water tank 14, and the bracket is provided.
  • the 126 was fixed to the bottom wall 20 by the model fixing mechanism 130, but is not limited to this embodiment. That is, these brackets and the first and second fixing portions are not indispensable.
  • irregularities such as mutual fitting and locking are provided between the skeleton model and the bottom wall of the water tank, and these irregularities are press-fitted.
  • the skeletal model may be fixed to the bottom of the aquarium by fitting or locking and fixing.
  • the model fixing mechanism does not need to be provided on the bottom wall of the water tank, and may be provided on the peripheral wall of the water tank, or the skeleton model may be fixed across both the bottom wall and the peripheral wall.
  • the cover support member 88 constituting the cover member fixing mechanism 112 is provided on the peripheral wall 22 of the water tank 14, but for example, a cover support member protruding upward from the bottom wall of the water tank is provided. The cover member may be supported by the cover support member.
  • the orthopedic training device 10 of the above-described embodiment training for surgery for intervertebral disc hernia is assumed, and the skeletal model 12 imitates the lumbar spine, but the present invention is not limited to this. That is, the orthopedic training device according to the present invention can be applied to training of bone-related diseases in various parts of the human body or animals, and is a skeleton corresponding to desired training such as treatment of diseases of joint parts including tendons and the like.
  • the model can be adopted as appropriate.
  • the skeleton model may be able to be fixedly supported in a state of being rotated in an arbitrary direction in addition to the front-back inversion as in the above-described embodiment.
  • model fixing mechanism 172 for fixing the skeletal model (12) carelessly engages with the bracket 126, as in the shaping technique training device 170 in another aspect of the present invention shown in FIGS. 13 and 14.
  • a lock portion 174 may be provided as a lock mechanism for preventing the skeleton model (12) from unintentionally falling out of the water tank 14 due to disengagement.
  • the lock portion 174 is provided in the second fixing portion 176 constituting the model fixing mechanism 172.
  • the members and parts substantially the same as those of the first embodiment are designated by the same reference numerals as those of the first embodiment in the drawings, whereby detailed description thereof will be omitted. ..
  • the lock portion 174 is rotatably assembled to the rear end portion of the second fixed portion 176. That is, the rear end portion of the second fixing portion 176 is provided with a rotation shaft 178 protruding outward in the left-right direction, and the front end portion of the lock portion 174 sandwiches and supports the rotation shaft 178. A support portion 180 is provided. Then, by sandwiching the rotation shaft 178 in the support portion 180, the lock portion 174 is assembled to the second fixing portion 176, and the lock portion 174 is centered on the rotation shaft 178 with respect to the second fixing portion 176. It is said to be rotatable.
  • the basic structure of the second fixing portion 176 is the same as that of the second fixing portion 40 in the first embodiment, and the central portion is provided with a guide hole 42 extending in the front-rear direction and the front end.
  • the portion is provided with a second fixing groove 44 extending in the left-right direction.
  • the second fixing portion 176 of the present embodiment is provided with a plurality of bottomed lightening holes 182 that penetrate in the vertical direction.
  • the lock portion 174 has a substantially rectangular shape in a plan view, and an operation hole 184 penetrating in the thickness direction is formed in the central portion in the left-right direction.
  • the lock portion 174 is shown in FIG. 15 (a) at the fixed position of the left skeleton model (12) in FIG. 13 in which the bracket 126 is provided. As you can see, it is in a locked state. That is, the lock portion 174 is operated by pressing the peripheral edge of the operation hole 184 with a finger or the like so that the second fixing portion 176 and the lock portion 174 expand in the front-rear direction. As a result, the rearward movement of the lock portion 174 and the second fixing portion 176 can be prevented, and the skeleton model (12) can be prevented from being unintentionally dropped from the water tank 14. In this embodiment, as shown in FIG. 14, the rear end portion of the lock portion 174 is in contact with the rear wall portion of the peripheral wall 22 of the water tank 14 to maintain the locked state.
  • the lock portion 174 is in the unlocked state as shown in FIG. 15 (b). That is, by operating the lock portion 174 upward by hooking a finger on the operation hole 184 or the like, a gap is created between the rear end portion of the lock portion 174 and the rear wall portion of the peripheral wall 22 of the water tank 14. It is supposed to occur. As a result, the lock portion 174 and the second fixing portion 176 are allowed to move backward, and the skeleton model (12) can be attached to and detached from the water tank 14.
  • the model fixing mechanism may be provided with a lock mechanism for switching between a state in which the skeleton model can be attached to and detached from the water tank and a state in which the skeleton model cannot be attached to and detached from the water tank.
  • a lock mechanism for switching between a state in which the skeleton model can be attached to and detached from the water tank and a state in which the skeleton model cannot be attached to and detached from the water tank.
  • it may be provided in a second fixing portion constituting the model fixing mechanism.
  • the rear end portion and the rear wall portion of the peripheral wall 22 of the water tank 14 face each other in the front-rear direction with a gap such that the bracket 126 does not fall off from the model fixing mechanism 172 even if the second fixing portion 176 moves rearward. You may be. Further, a spring member or the like that holds the lock portion 174 at the lock position with a sense of moderation may be provided.

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Abstract

L'invention concerne un dispositif de formation pour techniques orthopédiques qui présente une construction nouvelle et avec lequel il est possible de pratiquer des techniques de chirurgie orthopédique sous un endoscope dans un environnement plus près d'un état d'opération réel.　Ce dispositif de formation 10 pour techniques orthopédiques comprend : un réservoir d'eau 14 dans lequel un modèle de squelette 12 est fixé en place et dans lequel un liquide transparent 16 recouvrant la périphérie du modèle de squelette 12 est reçu ; et un endoscope 15 dont la partie de pointe est insérée dans le réservoir d'eau 14 et qui comporte, dans la partie de pointe, une ouverture d'aspiration 144 servant à aspirer le liquide transparent 16 du réservoir d'eau 14 et/ou une ouverture de décharge 146 servant à décharger le liquide transparent 16 vers le réservoir d'eau 14.
PCT/JP2021/033976 2020-09-18 2021-09-15 Dispositif de formation pour techniques orthopédiques et modèle de squelette Ceased WO2022059717A1 (fr)

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