JP3162161U

JP3162161U - Endoscopic surgery / inspection training organ placement device and pulsation device

Info

Publication number: JP3162161U
Application number: JP2009008898U
Authority: JP
Inventors: 芳朗伊藤
Original assignee: 株式会社ワインレッド
Priority date: 2009-11-26
Filing date: 2009-11-26
Publication date: 2010-08-26
Anticipated expiration: 2019-11-26

Abstract

【課題】内視鏡手術・検査の術技の修得をするため生体より切除された管状臓器を設置して実際の手術と同じ環境を体験できるトレーニング用臓器設置装置を提供する。【解決手段】天板部下面１に、オーバーチューブホルダー４の伸縮性面ファスナーで固定されたオーバーチューブ１５の尖端へ、上下２層に張られた樹脂網のうち、Ｕ字状に張られた下層樹脂網１７に設置された直腸１８を結紮する。管状臓器を上層樹脂網を部分切断した穴に挿入貫通し１９、Ｓ状結腸を形成しながら上層樹脂網上に出し２０、糸付縫合針で管状臓器を縫い、縫合糸を網目に縛り付け固定２１する。そこから頭部に向いながら再度樹脂網を部分切断し２２下層樹脂網（背側）へ挿入貫通の後２３、再度上層樹脂網上に出て左結腸曲２４を形成し、横行結腸の形成２５を経て下層樹脂網に入りながら右結腸曲２６を形成して盲腸部２７に至る実際の大腸の状態に設置することができる。【選択図】図２Provided is a training organ placement device in which a tubular organ excised from a living body can be placed to experience the same environment as an actual surgery in order to acquire techniques for endoscopic surgery / examination. SOLUTION: A top of a top plate portion 1 is stretched in a U-shape from a resin net stretched in two layers on the top and bottom of an overtube 15 fixed with an elastic surface fastener of an overtube holder 4. The rectum 18 installed in the lower layer resin net 17 is ligated. The tubular organ is inserted and penetrated through a hole in which the upper layer resin net is partially cut 19 and put out on the upper layer resin net 20 while forming the sigmoid colon. To do. From there, the resin net is partially cut again while facing the head, inserted into the lower 22 resin net (back side) 23, and then exited again on the upper resin net to form the left colonic curve 24, forming the transverse colon 25 The right colon curve 26 can be formed while entering the lower layer resin network via the, and can be placed in the actual state of the large intestine reaching the cecum part 27. [Selection] Figure 2

Description

本考案は内視鏡手術・検査トレーニング用臓器設置システム及び拍動装置に関する。The present invention relates to an organ placement system and a pulsation device for endoscopic surgery / examination training.

従来の内視鏡操作トレーニング装置は内視鏡手術・検査の手技の向上に役立つ。A conventional endoscope operation training device is useful for improving the procedure of endoscopic surgery / inspection.

特願２００４−２６６２７８（Ｐ２００４−２６６２７８）Japanese Patent Application No. 2004-266278 (P2004-266278)

従来の内視鏡操作トレーニング装置を使用しての管状臓器の設置と、実際の管状臓器の環境とに大きな違いがある。実際の管状臓器は直線だけではなく上下左右へ彎曲する形態なので、今迄の内視鏡操作トレーニング装置では正確に再現できない欠点がある。食道管内においては、発生した疾患部を検査または治療する際に、術者より見て、食道左側にある心臓の拍動が食道を圧迫し食道管内壁を変型させるので実際の術技は難しく、その環境を再現できないため実際の管状臓器の状態での内視鏡手術・検査トレーニングができない。また、図２に示すように、大腸においては直腸から一旦Ｓ状に回旋しながら上層樹脂網に出た後、頭方に進みつつ背中側に沈み込み、再度腹部側に戻り左結腸曲を形成する。その後に横行結腸形成を経て、再々度背面側に沈み右結腸曲を形成し下層樹脂網に沈み込み盲腸に至るという複雑な形態を持つため、従来の内視鏡操作トレーニング装置での両端で支える方法では再現できない。There is a great difference between the installation of a tubular organ using a conventional endoscope operation training apparatus and the environment of an actual tubular organ. Since an actual tubular organ is bent not only in a straight line but also vertically and horizontally, there is a drawback that it cannot be accurately reproduced with conventional endoscope operation training apparatuses. In the esophageal canal, when examining or treating the diseased area, the surgeon sees the heart beat on the left side of the esophagus to compress the esophagus and deform the inner wall of the esophageal canal, so the actual technique is difficult, Because the environment cannot be reproduced, endoscopic surgery and inspection training in the state of an actual tubular organ cannot be performed. In addition, as shown in FIG. 2, in the large intestine, after rotating from the rectum to the upper resin net while turning into an S shape, it sinks to the back side while proceeding to the head, and returns to the abdomen side to form a left colonic curve. To do. Later, after the formation of the transverse colon, it has a complicated form that sinks to the back side again, forms a right colon curve, sinks into the lower resin network, and reaches the cecum, so it is supported at both ends with a conventional endoscopic operation training device It cannot be reproduced by the method.

本考案は、従来の内視鏡操作トレーニング装置では再現できなかったため正確な状況での術技練習ができない欠点を、内視鏡手術・検査トレーニング用臓器設置システムと、食道管内内視鏡下での環境との違いを是正できる拍動装置を提供する事により解決する。The present invention has the disadvantage that it cannot be practiced in a precise situation because it could not be reproduced with a conventional endoscopic operation training device, and the organ placement system for endoscopic surgery / examination training and esophageal endoscopy It is solved by providing a pulsation device that can correct the difference with the environment.

本考案は、実際の管状臓器の形態を正確に再現したい場合に、内視鏡手術トレーニング用臓器設置システムを使う事で可能になる。心臓の拍動が食道管を圧迫し、食道管内壁を変型させる手術環境を再現したい場合は拍動装置を使用することで可能になる。The present invention can be realized by using an endoscopic surgical training organ placement system when it is desired to accurately reproduce the shape of an actual tubular organ. If you want to reproduce the surgical environment in which the heart beats the esophageal canal and deforms the inner wall of the esophageal canal, you can use the pulsating device.

上下する管状臓器の設置をする場合には樹脂網を上下２層にし、上層樹脂網を平行に張り、下層樹脂網をＵ字状に緩く張る事で上下の樹脂網の間に空間を造る。上層樹脂網を部分切断して管状臓器を上層樹脂網から下層樹脂網に挿入し上層樹脂網と下層樹脂網の間に造られた空間に管状臓器を設置することで上下する管状臓器が再現設置できる。When installing a tubular organ that moves up and down, the resin mesh is made up of two layers, the upper resin mesh is stretched in parallel, and the lower resin mesh is loosely stretched in a U shape to create a space between the upper and lower resin meshes. Partially cut the upper resin mesh, insert the tubular organ from the upper resin mesh into the lower resin mesh, and place the tubular organ in the space created between the upper resin mesh and the lower resin mesh, so that the tubular organ that goes up and down is reproduced and installed it can.

彎曲する管状臓器環境の設置は、針付縫合糸で管状臓器を縫合し、縫合糸で樹脂網に縛り付けることで可能となり、より高度で、実際の管状臓器環境での内視鏡手術・検査の手技修練ができる。A curved tubular organ environment can be installed by suturing the tubular organ with a needle-attached suture and tying it to a resin net with a suture. Skill training is possible.

本考案に係る内視鏡手術・検査トレーニング用臓器設置システムを使用した管状臓器再現概観図であるIt is a tubular organ reproduction overview using the endoscopic surgery / inspection training organ placement system according to the present invention. 本考案に係る内視鏡手術・検査トレーニング用臓器設置システムを使用した大腸再現概観図であるFIG. 3 is an overview view of a large intestine reproduction using the endoscopic surgery / test training organ placement system according to the present invention. 本考案に係る内視鏡手術・検査トレーニング用臓器設置システムの２層式樹脂網を使用し大腸再現概観図の左側面図であるFIG. 4 is a left side view of an overview view of a large intestine using a two-layer resin network of an endoscopic operation / test training organ setting system according to the present invention. 本考案に係る拍動装置の概観図であるIt is a general-view figure of the pulsation device concerning the present invention.

本考案の内視鏡手術・検査トレーニング用臓器設置システム本体は、図１に示すように、オ−バ−チュ−ブホルダー、臓器結紮フック、樹脂網を止める網架けフックが設けられている。As shown in FIG. 1, the endoscopic surgery / inspection training organ placement system main body of the present invention is provided with an overtube holder, an organ ligation hook, and a netting hook for stopping a resin net.

図２、図３に示すように、樹脂網を２層にして用いる事もできる。As shown in FIGS. 2 and 3, the resin net can be used in two layers.

本考案の拍動装置は図４に示すように駆動部の回転を伸展装置伸展受部に伝導し前後運動をする。As shown in FIG. 4, the pulsation device of the present invention conducts the back-and-forth motion by transmitting the rotation of the drive unit to the extension device extension receiving unit.

本考案の内視鏡手術・検査トレーニング用臓器設置システムは、図１に示すようにオーバーチューブホルダーに固定されたオーバーチューブと臓器結紮フックに管状臓器両端をつなぎ、網を引っ張りることで角度・高さ等を微調整し、網架けフックに止めて、実際の管状臓器の状態に設定することができる。The organ placement system for endoscopic surgery / inspection training of the present invention is shown in FIG. 1 by connecting both ends of a tubular organ to an overtube fixed to an overtube holder and an organ ligation hook, and pulling a net. Fine adjustment of the height, etc., can be stopped by a mesh hook and set to an actual tubular organ state.

本考案の、内視鏡手術・検査トレーニング用臓器設置システムは、図２に示すように、樹脂網を部分的に切断し挿入（１９、２２、２４、２６）させることができる。The organ placement system for endoscopic surgery / inspection training according to the present invention can partially cut and insert (19, 22, 24, 26) a resin net as shown in FIG.

本考案の内視鏡手術・検査トレーニング用臓器設置システムは、図２に示すようにオーバーチューブホルダーのマジックテープを天板部を貫通させ下面まで通すことで、オーバーチューブの下部への設置が可能になり違う角度への設定が可能になった。The organ installation system for endoscopic surgery / inspection training of the present invention can be installed in the lower part of the overtube by passing the magic tape of the overtube holder through the top plate to the bottom as shown in Fig. 2. It became possible to set to a different angle.

本考案の内視鏡手術・検査トレーニング用臓器設置システムは、生体から切除された上下左右に彎曲する大腸のような管状臓器を実際の状態に設置することができる。図２、図３に示すように天板部下面（１）に、オーバーチューブホルダー（４）の伸縮性マジックテープ（２９）で固定されたオーバーチューブ（１５）の尖端へ、上下２層に張られた樹脂網のうち、Ｕ字状に張られた下層樹脂網（１７）に設置された直腸（１８）を結紮する。管状臓器を上層樹脂網を部分切断した穴に挿入貫通し（１９）、Ｓ状結腸を形成しながら上層樹脂網上に出し（２０）、糸付縫合針で管状臓器を縫い、縫合糸を網目に縛り付け固定（２１）する。そこから頭部に向いながら再度樹脂網を部分切断し（２２）下層樹脂網（背側）へ挿入貫通の後（２３）、再度上層樹脂網上に出て左結腸曲（２４）を形成し、横行結腸の形成（２５）を経て下層樹脂網に入りながら右結腸曲（２６）を形成して盲腸部（２７）に至る実際の大腸の状態に設置することができる。なお、各、形状形成箇所は糸付縫合針で縫い、縫合糸を網目に結わえ付け固定設置するが設置の状況により縛り付けを省いてもよい。The endoscopic surgery / inspection training organ placement system according to the present invention can place a tubular organ, such as a large intestine that is excised from a living body and that bends vertically and horizontally, in an actual state. As shown in FIG. 2 and FIG. 3, the top plate bottom surface (1) is stretched in two layers on the top and bottom of the overtube (15) fixed with the elastic magic tape (29) of the overtube holder (4). The rectum (18) installed in the lower layer resin net (17) stretched in a U-shape is ligated among the formed resin nets. The tubular organ is inserted and penetrated into a hole in which the upper resin mesh is partially cut (19), and is formed on the upper resin mesh while forming the sigmoid colon (20). The tubular organ is sewn with a suture needle with thread, and the suture is meshed. Tie to (21). From there, partly cut the resin net again while facing the head (22) After insertion through the lower resin net (back side) (23), it came out again on the upper resin net to form the left colonic curve (24) It can be placed in the actual state of the large intestine reaching the cecum (27) by forming the right colon curve (26) through the formation of the transverse colon (25) and entering the lower resin network. Each shape forming portion is sewn with a suture needle with a thread, and the suture is tied to a mesh and fixed and installed, but the binding may be omitted depending on the installation situation.

本考案の内視鏡手術・検査トレーニング用臓器設置システムは、図１に示すようにオーバーチューブホルダーに伸縮性マジックテープを使用することにより、従来の様な固定部品を使わないために取り付け取替えが容易にでき、使用するオーバーチューブを規定せず、より固定度の強い設置が容易になった。The organ placement system for endoscopic surgery / inspection training of the present invention uses an elastic velcro tape on the overtube holder as shown in FIG. Easy to install, no over-tube to be used is specified, and installation with a higher degree of fixation is easier.

本考案の内視鏡手術・検査トレーニング用臓器設置システム本体は、硬質発泡スチロール製を多用することで、従来のアクリル製より軽く取扱が簡易で、壊れにくく使用後の洗浄が容易になり、搬送による破損もすくなくできた。The main body of the organ placement system for endoscopic surgery / inspection training of the present invention is made of hard polystyrene, making it lighter and easier to handle than acrylic and easy to clean after use. There was no damage.

本考案の拍動装置は、角丸三角回転カムの回転力を伸展棒に縦の運動に替えることで管状臓器（食道）に拍動と同じ運動を起こす事ができる。The pulsating device of the present invention can cause the same movement as the pulsation in the tubular organ (esophagus) by changing the rotational force of the round-cornered triangular rotating cam to the vertical movement with the extension rod.

本考案の拍動装置の角丸三角回転カムの先端部を大きい丸い形状にすることで、伸展部への運動力を滑らかにし、心臓の拍動と同じ動きをつくりだすことが可能になった。By making the tip of the rounded triangular rotating cam of the pulsating device of the present invention into a large round shape, it is possible to smooth the exercise force to the extension part and create the same movement as the pulsation of the heart.

本考案の拍動装置の臓器ストッパーは、伸展部の押す力でおこる食道管の移動を防ぐ。The organ stopper of the pulsating device of the present invention prevents the movement of the esophageal canal caused by the pushing force of the extension part.

本考案の拍動装置の固定用蝶ネジにより、臓器ストッパーの伸展深度の調整・固定ができる。The extension depth of the organ stopper can be adjusted and fixed by the fixing thumbscrew of the pulsating device of the present invention.

本考案の拍動装置は、患者の拍動数は身体的状態によって異なるので、様々な状態の患者にも対応できるよう修練するために回転変速機ダイアルで拍動数を７５から４０回程度まで変えることができる。In the pulsating device of the present invention, since the number of pulsations of the patient varies depending on the physical condition, the number of pulsations is increased from 75 to 40 times with a rotary transmission dial in order to train the patient to cope with various patients. Can be changed.

１内視鏡手術・検査トレーニング用臓器設置システム本体天板部
２内視鏡手術・検査トレーニング用臓器設置システム本体底板部
３本体、天板部と底板部を支える脚部
４オーバーチューブホルダー
５オーバーチューブ固定用伸縮性マジックテープ
６オーバーチューブ
７生体管状臓器
８縫合糸によるオーバーチューブと生体管状臓器食道の先端結紮部
９縫合糸によるオーバーチューブと生体管状臓器食道の末端結紮部
１０樹脂網架けフック
１１臓器結紮フック
１２内視鏡
１３疾患部位
１４樹脂網
１５直腸肛門部へ縫合糸で固定されたオーバーチューブ
１６上層に設置された樹脂網
１７下層に設置された樹脂網
１８結紮された直腸
１９部分切断された樹脂網を貫通する管状臓器
２０Ｓ状結腸の再現
２１管状臓器の形状を整え再現する為に、縫合糸で樹脂網に結紮された管状臓器
２２部分切除された樹脂網から下層樹脂網に入り込む管状臓器
２３ニ層樹脂網に設置された管状臓器
２４下層樹脂網から上層樹脂網に出され、左結腸曲が再現される
２５上層樹脂網に再現される横行結腸
２６上層樹脂網から下層樹脂網に入り込み、右結腸曲が再現される
２７結腸盲腸側
２８下層樹脂網から上層樹脂網に出るＳ状結腸を再現
２９天板部下面にオーバーチューブを固定する伸縮性マジックテープ
３０拍動装置／本体駆動部
３１拍動装置／角丸三角回転カム
３２拍動装置／臓器止めホルダー固定用蝶ネジ
３３拍動装置／臓器止めホルダー
３４拍動装置／回転変速機本体
３５拍動装置／電源スイッチ
３６拍動装置／回転変速機調節ダイアル
３７拍動装置／ＡＣアダプター
３８拍動装置／ＡＣコード
３９伸展装置／伸展棒受部
４０伸展装置／伸展棒
４１伸展装置／伸展棒柱
４２伸展装置／伸展棒戻しゴム
４３伸展装置／伸展棒先端部1 Endoscopic system organ placement system top plate part for endoscopic surgery / inspection training 2 Endoscopic surgery / inspection training organ placement system body bottom plate part 3 Main body, legs supporting the top plate part and bottom plate part 4 Overtube holder 5 Over Elastic Velcro Tape 6 for Tube Fixation Overtube 7 Biological Tubular Organ 8 Overtube by Suture and End Ligature 9 of Biological Tubular Organ Esophageum Overtube by Suture and End Ligature 10 of Biological Tubular Organ Esophageal Resin Hook 11 Organ ligation hook 12 Endoscope 13 Disease site 14 Resin mesh 15 Overtube fixed to the rectal anus with suture thread 16 Resin mesh 17 installed on the upper layer 18 Resin mesh 18 installed on the lower layer Ligated rectum 19 Partial cut Reproduction of sigmoid colon 21 Reconstructing the shape of tubular organ 20 For this purpose, the tubular organ 22 ligated to the resin net with suture thread The tubular organ 23 that enters the lower resin net from the partially excised resin net 23 The tubular organ 24 that is installed in the two-layer resin net and emerges from the lower resin net to the upper resin net The left colon curve is reproduced 25 The transverse colon 26 reproduced in the upper resin network 26 The upper resin network enters the lower resin network, and the right colon curve is reproduced 27 The colon cecum side 28 From the lower resin network to the upper resin network Reproduce the sigmoid colon 29 Stretchable magic tape that fixes the overtube to the lower surface of the top plate 30 Pulsating device / main body drive unit 31 Pulsating device / rounded triangular rotation cam 32 Pulsating device / butterfly for organ holding holder fixation Screw 33 Pulsation device / Organ stop holder 34 Pulsation device / Rotary transmission main body 35 Pulsation device / Power switch 36 Pulsation device / Rotary transmission adjustment dial 37 Pulsation device / AC adapter 38 Pulsing device / AC cord 39 Extension device / extension rod receiving portion 40 Extension device / extension rod 41 Extension device / extension rod column 42 Extension device / extension rod return rubber 43 Extension device / extension rod tip

Claims

底板と、中央に空間の有る天板を支える４脚からなる本体の天板上に、生体から切除された管状臓器の先端を取り付けるオーバーチューブを伸縮性マジックテープで固定するオーバーチューブホルダーと、管状臓器末端を結紮する臓器結紮フック、管状臓器設置の角度・高さを調整し管状臓器を支える２層樹脂網システム、樹脂網を架ける網架けフックを有する内視鏡手術・検査トレーニング用臓器設置システム。An overtube holder for fixing an overtube for attaching a distal end of a tubular organ excised from a living body with a stretchable magic tape on a top plate of a main body comprising four legs supporting a top plate having a space in the center and a tubular shape; Organ ligation hook for ligating the end of the organ, two-layer resin net system that supports the tubular organ by adjusting the angle and height of the tubular organ installation, organ installation system for endoscopic surgery and inspection training that has a net hook that hangs the resin net .

本体および、オーバーチューブホルダーが硬質発泡スチロールである請求項１に記載の、内視鏡手術・検査トレーニング用臓器設置システム。The organ placement system for endoscopic surgery / inspection training according to claim 1, wherein the main body and the overtube holder are rigid polystyrene.

オーバーチューブを固定する為の、伸縮性マジックテープを本体天板部下面まで貫通加工してある、オーバーチューブホルダー。An overtube holder with a stretchable magic tape penetrating to the bottom of the top plate to secure the overtube.

本体駆動部、角丸三角回転カム、臓器止めホルダー固定用蝶ネジ、臓器止めホルダー、回転変速機本体、電源スイッチ、回転変速機調整ダイアル、伸展装置を有する拍動装置。A pulsating device having a main body drive unit, a rounded triangular rotation cam, a thumbscrew for fixing an organ stopper holder, an organ stopper holder, a rotary transmission main body, a power switch, a rotary transmission adjustment dial, and an extension device.

拍動機の回転運動を縦の運動に変える、伸展受部・伸展棒を有する伸展装置。An extension device with an extension receiver and extension rod that changes the rotational motion of the pulsator into a vertical motion.

回転数を変えられる拍動機の回転変速機。A pulsator rotary transmission with variable speed.

先端部を丸くした拍動機の角丸三角回転カム。A rounded triangular rotating cam with a rounded tip.

拍動機の両端に取り付けられた２本のＬ字型臓器止めホルダーシステム。Two L-shaped organ stop holder systems attached to both ends of the pulsator.