The present invention relates to an instrument for attaching an organ model to a thoracic cavity simulator for the training or learning of thoracoscopic surgery.
In recent years, simulators have been developed that can reproduce the human body shape and texture and simulate the surgical environment for the human body for the training and learning of thoracoscopic surgery (for example, refer to Patent Document 1).
The thoracic cavity simulator disclosed in Patent Document 1 is a device including at least a human skeleton model simulating ribs and a casing for accommodating the human skeleton model. A rib part of the casing is provided with an opening, and a diaphragm part of the casing can be opened and closed, and an organ model can be stored inside the ribs of the human skeleton model. According to this device, it is possible to effectively train the procedure of thoracoscopic surgery.
Then, as a method of attaching the organ model to the simulator of Patent Document 1, for example, a gripping member provided with an engaging portion is used.
Since the thoracic cavity simulator disclosed in Patent Document 1 is premised on training in the supine position, sufficient disclosure has not been made in a case in which the thoracic cavity simulator is fixed in a state of being tilted to the left or right. However, depending on the target site and surgical procedure of the operation, the operation may be performed in the lateral decubitus position. Therefore, if the operation is performed in the lateral decubitus position, an instrument capable of fixing the organ model at an appropriate angle is desired.
As a technique in which an organ model can be installed in a tilted state, a training organ installation device is known. The device has a net attached to a hook provided in the device body, and a tubular organ is inserted into the net and is fixed by sewing with a suture thread. In such a training organ installation device, a polygonal leg portion is provided for enabling the device body to rotate, and the angle of the device can be changed during training. In the training organ installation device disclosed in Patent Document 2, there is an advantage that the morphology of a tubular organ curved vertically and horizontally can be accurately reproduced. However, for accurate installation, it is necessary not only to insert the tubular organ into the net but also to perform suturing work, which causes a problem that the installation work is complicated.
There is also a problem that the training organ installation device disclosed in Patent Document 2 cannot be used for an organ model such as a lung.
In view of such a situation, it is an object of the present invention to provide an organ model fixing tool that easily enables stable fixing, attachment/detachment, and positional adjustment of an organ model in a state where a thoracic cavity simulator is tilted. [Means to Solve the Objects]
In order to solve the above problem, the organ model fixing tool of the present invention is provided for fixing the posture of an organ model with respect to a thoracic cavity simulator having a human body skeleton model imitating at least the backbones (spine), the breast bones, and the ribs. The fixing tool is provided with: a base that can be housed inside the rib part of the thoracic cavity simulator; a backbone engaging mechanism that is provided at the backside of the base, and that is to be engaged with a projected part of the backbone part of the thoracic cavity simulator so as to be attached in a slidable manner in the longitudinal direction of the backbone part; a longitudinal partition that is provided at the surface of the base so as to partition the base left and right, wherein the organ model can be placed on both the left and right surfaces of the longitudinal partition, and the length of the longitudinal partition in the longitudinal direction of the backbone part is roughly equal to the length in the longitudinal direction of the breast bone part.
By providing the backbone engaging mechanism on the back surface of the base, the organ model fixing tool can be firmly fixed to the thoracic cavity simulator.
By providing the longitudinal partition, the organ model can be stably installed even when the thoracic cavity simulator is used in a tilted state. In addition, since both the left and right sides can be used for organ model installation, various variations of procedure training are possible.
In the longitudinal partition, the longitudinal length of the backbone is approximately the same as the longitudinal length of the breast bone part, so that the organ model installed in the thoracic cavity simulator can be firmly supported.
In the organ model fixing tool for the thoracic cavity simulator of the present invention, the base may further provide a slide mechanism capable of sliding the longitudinal partition between the left end and the right end of the surface.
In case of reproducing a state close to actual surgery, it is preferable that the space for arranging the organ model can be adjusted. By providing the above slide mechanism, the position of the longitudinal partition can be adjusted to the left and right to adjust the space for arranging the organ model. This enables realistic procedure training that is closer to actual surgery.
In case of the base of the organ model fixing tool for the thoracic cavity simulator of the present invention further provides the slide mechanism capable of sliding the longitudinal partition, the slide mechanism preferably provides an arm portion that connects to the longitudinal partition, an arm drive portion that rotates the end portion of the arm portion on the surface of the base, and a guide portion that defines the movement direction and movement range of the longitudinal partition. Here, the guide portion is composed of a shaft member provided on the surface of the base and a shaft stopper for holding both ends of the shaft member, and the shaft member is inserted into a through hole provided in the longitudinal partition.
Since the slide mechanism provides the arm portion and the arm drive portion, the position of the longitudinal partition can be adjusted with a simple operation. A known worm gear is preferably used as the structure of the arm portion and the arm drive portion. That is, one end of the arm portion is connected to the longitudinal partition, and the other end is provided with a worm wheel. Further, a cylindrical worm is provided in the arm driving portion, and a knob for user operation is provided at the end of the worm. By rotating the knob, the user can rotate the end of the arm portion on the surface of the base. By using the worm gear, even if pressure is applied to the surface of the longitudinal partition, the knob does not rotate easily, so it is possible to fix the position of the longitudinal partition simply by releasing the hand that operates the knob.
Further, by providing the guide portion, the moving direction and the moving range of the longitudinal partition can be defined. Specifically, it is preferable that the longitudinal partition has a structure capable of parallel translating between the left end and the right end of the surface of the base. By configuring the shaft member to be inserted through a through hole provided in the longitudinal partition, the moving direction of the longitudinal partition can be defined with a simple structure. It is preferable that two shaft members are provided. Since both ends of the shaft member are held by the shaft stoppers, the moving range of the longitudinal partition can be easily defined. By the guide portion the movement of the end portion of the arm portion rotating on the surface of the pedestal converts into a left-right parallel movement.
In this way, the arm portion, the arm drive unit, and the guide portion function as one, so that the rotational movement of the knob can be converted into the parallel movement of the longitudinal partition with a relatively simple structure. So, the position of the longitudinal partition can be easily adjusted and fixed.
In the organ model fixing tool for the thoracic cavity simulator of the present invention, the base may further provide an attachment mechanism capable of detachably attaching the longitudinal partition to the left end or the right end of the surface.
By providing the above attachment mechanism, the space for arranging the organ model can be adjusted with a simple structure and operation. As the attachment mechanism, it is preferable to use a mechanism in which one member is locked to the other member and fixed by a rotating claw, and a mechanism in which one member is fitted to the other member and fixed by a claw portion. The structure is not limited to this, and only any of the above mechanisms may be used, or for example, a mechanism for fixing with a fastener such as a screw may be used.
In the organ model fixing tool for the thoracic cavity simulator of the present invention, it is preferable that hook-and-loop fasteners are formed on both the left and right surfaces of the longitudinal partition.
Some of the surface materials of the organ model perform the same function as the loop portion of the hook-and-loop fastener. By forming the hooks of hook-and-loop fastener on the left and right surfaces of the longitudinal partition, the surface of the organ model can be brought into contact with the hooks to firmly fix the organ model, and the organ model can be easily removed and adjusted in position.
By providing hook-and-loop fasteners on both the left and right surfaces of the longitudinal partition, the organ model can be stably installed regardless of whether the thoracic cavity simulator is in the right lateral decubitus position or the left lateral decubitus position. Here, the right lateral decubitus position is a posture in which the right side is down, and the left lateral decubitus position is a posture in which the left side is down.
Further, fixing mechanisms other than the hook-and-loop fastener may be provided on the left and right surfaces of the longitudinal partition, for example, by providing a suction cup or applying an adhesive.
It is preferably that the organ model fixing tool for the thoracic cavity simulator of the present invention loads the organ model on the right side of the longitudinal partition in case of the posture of the thoracic cavity simulator is in the left lateral decubitus position, and the organ model fixing tool loads the organ model on the left side of the longitudinal partition in case of the posture of the thoracic cavity simulator is in the right lateral decubitus position.
Here, the left and right sides of the longitudinal partition surface are along the left and right sides of the structure of the human body, and the right-hand side is the right side and the left-hand side is the left side with the fixing tool in the attached state to the thoracic cavity simulator.
In the organ model fixing tool for the thoracic cavity simulator of the present invention, the organ model is preferably a biological texture organ model of the lung that at least reproduces the shape and texture of the lung.
The shape and texture of the lung include the shape and texture of blood vessels in the hilum and inside the lung. In addition, it is preferable that the trachea, membrane, lymph, pleura, and pulmonary ligament are also reproduced in the biological texture organ model of the lung.
In the organ model fixing tool for the thoracic cavity simulator of the present invention, the backbone attachment mechanism may be provided with a concave portion or a convex portion that can adjust the attachment position on the backbone portion in a stepwise manner.
By providing the backbone attachment mechanism with a concave portion or a convex portion, it is possible to adjust the attachment position of the fixing tool in a stepwise manner. Further, by providing the shape of the concave portion or the convex portion to be small, the fixing tool may be fixed at an arbitrary position substantially steplessly.
In the organ model fixing tool for the thoracic cavity simulator of the present invention, the base, the backbone engagement mechanism, and the longitudinal partition may be integrally molded with resin. By being integrally molded with resin, the organ model can be firmly fixed to the fixing tool and easy to handle.
According to the organ model fixing tool for the thoracic cavity simulator of the present invention, the organ model enables stably fixing in a state where the thoracic cavity simulator is tilted, and there is an effect that attachment/detachment and position adjustment enables easily performing.
Embodiments of the present invention will be described in detail below with reference to the drawings. The present invention is not limited to the following embodiment and examples of shown in the figure, and the present invention can be variously changed in design.
First, the structure of the thoracic cavity simulator to which the organ model fixing tool is attached will be described.
In case of performing lung surgery, surgery is often performed in the lateral decubitus position, and depending on the surgical procedure, it is necessary to install the thoracic cavity simulator 9 so that the right side part 9a and the left side part 9b shown in
However, as shown in
In the thoracic cavity simulator 9, the right side part 9a and the left side part 9b are used, but the left and right sides are assumed to be along the left and right sides in the structure of the human body. That is, the right hand side is the right side part 9a, and the left hand side is the left side part 9b.
Next, the structure of the lung model fixing tool will be described.
As shown in
The recess 21 for attaching to the thoracic cavity simulator 9, the non-slip mechanisms (22a, 22b) shown in
The recess 21 is provided for attaching the lung model fixing tool 1 to the thoracic cavity simulator 9, and has the structure in which the backbone portion 94 of the thoracic cavity simulator 9 is fitted into the recess 21.
The non-slip mechanisms (22a, 22b) are for facilitating the grip of the lung model fixing tool 1 in case of attaching or detaching. That is, since the lung model fixing tool 1 is provided with the longitudinal partition 3 substantially perpendicular to the base 2, it has the structure that is difficult to grasp with one hand. Therefore, non-slip mechanisms (22a, 22b) are provided so that any finger of the operator can easily get caught in the non-slip mechanisms (22a, 22b), which facilitates attachment/detachment.
The concave engaging parts (23a, 23b) and the convex engaging parts (24a, 24b) are provided for positioning and fixing. The structure is such that the convex engaging part (not shown) provided on the backbone portion 94 of the thoracic cavity simulator 9 and the concave engaging parts (23a, 23b) are engaged, and the concave engaging part (not shown) provided on the backbone portion 94 of the thoracic cavity simulator 9 and the convex engaging parts (24a, 24b) are engaged.
The female screw part 25 is provided to fix the lung model fixing tool 1 and the backbone portion 94 using the screw (not shown) after the backbone portion 94 of the thoracic cavity simulator 9 and the lung model fixing tool 1 are engaged with each other.
As shown in
A hook-and-loop fastener 3a is provided on the right surface of the longitudinal partition 3, and the hook-and-loop fastener 3b is provided on the left surface. Here, too, the left and right sides are along the left and right sides in the structure of the human body as same in the right side part 9a and the left side part 9b in the thoracic cavity simulator 9. So, the left side surface of the longitudinal partition 3 in
The hook-and-loop fasteners (3a, 3b) are both formed by hook portions of the hook-and-loop fastener. Since the surface of the lung model 4 described later can play the same role as the loop portion of the hook-and-loop fastener in terms of material, the mounting position of the lung model 4 can be freely adjusted on the hook-and-loop fasteners (3a, 3b).
The surface material of the lung model 4b functions in the same manner as the loop portion of the hook-and-loop fastener. So, since the surface of the lung model 4b comes into contact with the hook-and-loop fastener 3b provided in the longitudinal partition 3, the loop portion and the hook portion of the hook-and-loop fastener 3b are engaged and firmly fixed. Further, since the longitudinal partition 3 is integrally molded with the base 2, for example, even if the lung model 4b is pressed from above by forceps or the like, the three-dimensional position of the lung model 4b is anatomically accurate and the lung model 4b can be supported in accurate place.
Although the lung model is not shown in
The lung model may be fixed to the lung model fixing tool 1 after the lung model fixing tool 1 is attached to the thoracic cavity simulator 9. Further, the fixed position of the lung model can be adjusted with the lung model fixing tool 1 in state of attached to the thoracic cavity simulator 9, or the lung model fixing tool 1 may be removed from the thoracic cavity simulator 9 for adjustment and then be reattached.
As shown in
In case of training in the lateral decubitus position using the lung model 4a of the right lung, the lung model 4a of the right lung is attached to the lung model fixing tool 1 as shown in
Similarly, in case of training in the lateral decubitus position using the left lung model 4b, the left lung model 4b is attached to the lung model fixing tool 1 for training as shown in
In this way, it is possible to train on both the left and right lung. Further, as described above, since the fixed position of the lung models (4a, 4b) can be finely adjusted, more realistic training assuming actual surgery is possible.
Inside the skeleton of the human body, the lungs are located in the generally fixed position, but the position and size may differ slightly from person to person. Even in such the case, it is desirable to be able to perform the procedure training based on the positional relationship between the skeleton and the lungs according to the actual situation.
Although not shown, the base 20 is provided with the mechanism capable of fixing the lung model fixing tool 10 at the arbitrary position on the backbone portion 94. Therefore, as shown in
This makes it possible to more flexibly adjust the fixed position of the lung model.
In case of the lung model fixing tool is fixed upward, as shown in
As shown in
The base 5 is provided with the non-slip mechanisms (59a, 59b) shown in
The recess 53 is provided for attaching the lung model fixing tool 11 to the thoracic cavity simulator 9, and has the structure in which the backbone portion 94 of the thoracic cavity simulator 9 is fitted into the recess 53. The non-slip mechanisms (59a, 59b) is for facilitating the grasp of the lung model fixing tool 11 during attachment or detachment.
The concave engaging parts (55a, 55b) and the convex engaging parts (54a, 54b) are provided for positioning and fixing. The convex engaging part (not shown) provided on the backbone portion 94 of the thoracic cavity simulator 9 and the concave engaging parts (55a, 55b) are engaged, and the concave engaging part (not shown) provided on the backbone portion 94 of the thoracic cavity simulator 9 and the convex engaging parts (54a, 54b) are engaged. Here, the structure of the thoracic cavity simulator 9 is the same as that described in Embodiment 1.
The base 5 is provided with a slide mechanism, and the longitudinal partition 6 is slid by using the slide mechanism.
As shown in
Although not shown in
That is, when the knob 71 is turned counterclockwise in the state shown in
As shown in
In this way, it is possible to attach the lung model after adjusting the height of the longitudinal partition 6 by turning the knob 71. As shown in
Here, a method of using the lung model fixing tool of Embodiment 3 will be described.
As shown in
Then, as shown in
In the examples shown in
On the other hand, in the example shown in
The through hole 96 is formed in the thoracic cavity simulator 9, and the arm drive unit 7 is provided on the lower end 92 side of the thoracic cavity simulator 9 in case of the lung model fixing tool 11 is attached to the thoracic cavity simulator 9. Therefore, even after the lung model fixing tool 11 is attached to the thoracic cavity simulator 9, the position of the longitudinal partition 6 can be adjusted by turning the knob 71. Since it can be adjusted not only before attachment to the thoracic cavity simulator 9 but also after attachment, the surgeon or assistant inserts the hand through the through hole 96 to fine-tune the position of the longitudinal partition 6 during the procedure training. So, it is possible to reproduce the environment in the body cavity that is close to the actual surgery.
As shown in
As shown in
The fastener 56a has the structure in which the rotating claw 30a is provided on the shaft 29a, and the rotating claw 30a is rotated and fixed around the shaft 29a. In case of attaching the longitudinal partition 60, the direction of the rotating claw 30a is adjusted according to the shape of the through hole 63 formed in the longitudinal partition 60, and then the rotating claw 30a and the through hole 63 are fitted. After that, the direction of the rotating claw 30a is adjusted to the position deviated from the shape of the through hole 63. Next, the concave fitting part 57a provided on the base 50 and the convex fitting part 62 provided on the longitudinal partition 60 are fitted each other. In case of the concave fitting part 57a and the convex fitting part 62 are fitted, the claw part 28 provided in the convex fitting part 62 is caught to the window part 27a provided in the concave fitting part 57a and fixed.
In case of releasing the fixed state, the claw part 28 is pressed from the window part 27a, and the convex fitting part 62 is pulled out from the concave fitting part 57a. Further, with respect to the fastener 56a, the longitudinal partition 60 can be easily pulled out from the fastener 56a by adjusting the direction of the rotary claw 30a according to the shape of the through hole 63.
In this embodiment, as shown in
As shown in
Here, how to use the lung model fixing tool of Embodiment 4 will be described.
Next, the lung model (not shown) is fixed to the lung model fixing tool 12 (step S22). Although not shown here, hook portions of the hook-and-loop fastener can be provided on the right surface 60a and the left surface 60b of the longitudinal partition 60 as in the Embodiment 1. By providing the hook portion of the hook-and-loop fastener, the attachment position of the lung model can be arranged at the appropriate position on the right surface 60a or the left surface 60b.
After fixing the lung model to the lung model fixing tool 12, the lung model fixing tool 12 is attached to the thoracic cavity simulator 9 (step S23). The structure of the thoracic cavity simulator 9 is the same as that described in Embodiment 1.
The base 50 has, for attaching to the thoracic cavity simulator 9, the recess 29 and the non-slip mechanism (59a, 59b) shown in
The recess 29 is provided for attaching the lung model fixing tool 12 to the thoracic cavity simulator 9, and has the structure in which the backbone portion 94 of the thoracic cavity simulator 9 is fitted into the recess 29. The non-slip mechanisms (59a, 59b) is for facilitating the grasp of the lung model fixing tool 12 during attachment or detachment. The concave engaging parts (58a, 58b) are provided for positioning and fixing, and have the structure in which the convex engaging parts (not shown) provided on the backbone portion 94 of the thoracic cavity simulator 9 and the concave engaging parts (58a, 58b) are engaged with each other. The female screw part 26 is provided to fix the lung model fixing tool 12 and the backbone portion 94 using the screw (not shown) after the backbone portion 94 of the thoracic cavity simulator 9 and the lung model fixing tool 12 are engaged with each other.
The lung model may be fixed to the lung model fixing tool 12 (step S22) after the lung model fixing tool 12 is attached to the thoracic cavity simulator 9 (step S23). Further, the fixed position of the lung model can be adjusted with the lung model fixing tool 12 attached to the thoracic cavity simulator 9, or the lung model fixing tool 12 may be once removed from the thoracic cavity simulator 9 for adjustment and reattach itself.
The base 50 of the lung model fixing tool 11 of Embodiment 3 may be provided with a mechanism capable of fixing the lung model fixing tool 11 at an arbitrary position on the backbone portion 94. Further, the base 50 of the lung model fixing tool 12 of Embodiment 4 may be provided with a mechanism capable of fixing the lung model fixing tool 12 at an arbitrary position on the backbone portion 94.
The present invention is useful for training and learning of thoracoscopic surgery, and can be used as an organ fixing tool in a surgery support device and a surgery simulation device.
Number | Date | Country | Kind |
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PCT/JP2018/038385 | Oct 2018 | JP | national |
Filing Document | Filing Date | Country | Kind |
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PCT/JP2019/040346 | 10/13/2019 | WO |