Orthopedic technique training device and skeleton model

Abstract

To provide an orthopedic technique training device with a novel structure, capable of training techniques in endoscopic orthopedic surgical procedures in an environment closer to an actual surgical condition.SOLUTION: An orthopedic technique training device 10 comprises: a water tank 14 in which a skeletal model 12 is fixed and which contains a transparent liquid 16 that surrounds the skeletal model 12; and an endoscope 15 whose tip portion is inserted into the water tank 14, and which has at the tip portion at least one of a suction port 144 for suctioning the transparent liquid 16 from the water tank 14 and a discharge port 146 for discharging the transparent liquid 16 into the water tank 14.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to a training device for training orthopedic surgical procedures performed under an endoscope for bone-related diseases such as those of the lumbar vertebrae and joints. The present invention also includes an invention relating to a skeletal model used in the orthopedic procedure training device. [Background technology]

[0002] Minimally invasive surgery using endoscopes has been performed for lumbar spine disorders such as herniated discs and spinal stenosis. However, because such endoscopic surgery requires special skills, it takes time to master the technique, and there has been a demand for a training device aimed at improving the technical proficiency of surgeons.

[0003] Therefore, the present applicant has proposed a surgical training model for endoscopic surgery for lumbar spinal diseases in International Publication No. 2019 / 107441 (Patent Document 1). In this surgical training model, a lumbar spine simulation part that simulates a lumbar spine with lumbar spinal disease is covered with a muscle tissue simulation part made of elastomer or gel resin. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] International Publication No. 2019 / 107441 Summary of the Invention [Problem to be solved by the invention]

[0005] However, when training using the surgical practice model described in Patent Document 1, it is still sometimes difficult to fully reproduce the actual surgical conditions, making it difficult to conduct efficient training.

[0006] The problem to be solved by the present invention is to provide an orthopedic procedure training device and skeletal model with a novel structure that enables training in endoscopic orthopedic surgery procedures in an environment that more closely resembles the actual surgical conditions. [Means for solving the problem]

[0007] The following describes preferred embodiments for understanding the present invention, but the embodiments described below are merely examples and may be appropriately combined with one another. Multiple components described in each embodiment may be recognized and employed independently to the greatest extent possible, and may also be appropriately combined with any of the components described in other embodiments. Accordingly, the present invention is not limited to the embodiments described below, and various other embodiments may be realized.

[0008] The first aspect is an orthopedic technique training device that includes a water tank in which a skeletal model is fixed and which contains a transparent liquid that surrounds the skeletal model, and an endoscope whose tip is inserted into the water tank and has at its tip at least one of a suction port for sucking the transparent liquid from the water tank and a discharge port for discharging the transparent liquid into the water tank.

[0009] In endoscopic surgery for herniated discs, spinal stenosis, and other conditions, bone removal may involve scraping. With this orthopedic training device, the skeletal model is covered with a transparent liquid, preventing cuttings from adhering to the device or becoming airborne, as occurs in training in the atmosphere using air blowing. This simplifies cleanup after training and allows for multiple, repeated use. In particular, by providing at least one of a suction port and a discharge port for the transparent liquid at the distal end of the endoscope, cuttings can be quickly removed from the field of view at the distal end of the endoscope, maintaining endoscopic visibility.

[0010] Furthermore, the endoscope used in this training device is not limited, and for example, an endoscope used in surgery can be used as is. Furthermore, since the training procedures are performed in a transparent liquid such as water, training can be performed in an environment that is closer to the actual surgical conditions.

[0011] In a second aspect, the orthopedic technique training device according to the first aspect is provided with a filtration device that filters the transparent liquid sucked from the water tank, and a circulation device that circulates the transparent liquid by discharging the transparent liquid filtered by the filtration device into the water tank.

[0012] According to this orthopedic surgical technique training device, when using it, all that is required is to pour a transparent liquid such as water into the tank. Because it is lightweight and highly portable, it is easy for users to use at home, etc., and it is also easier to find time to train in orthopedic surgical techniques.

[0013] In a third aspect, 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.

[0014] According to the orthopedic procedure training device of this embodiment, the suction port and discharge port can be positioned near the skeletal model, so that the endoscopic field of view can be more efficiently and stably secured by suctioning the cuttings and washing them away with a transparent liquid. In addition, since endoscopes commonly used in hospital surgeries have both suction and discharge functions, training can be conducted in an environment that more closely resembles the actual surgical conditions.

[0015] In a fourth aspect, in the orthopedic technique training device according to any one of the first to third aspects, the water tank has a peripheral wall at least part of which is transparent.

[0016] According to the orthopedic surgical technique training device of this embodiment, the condition of the skeletal model and the orthopedic surgical technique can be visually confirmed from the side or other direction that is normally not visible through the transparent portion of the peripheral wall. In addition, natural light can be taken in from the side (lateral direction), brightening the field of view.

[0017] In a fifth aspect, in an orthopedic technique training device according to any one of the first to fourth aspects, a cover member that covers the skeletal model from above is attached to the water tank, and the cover member is provided with an insertion hole through which the endoscope is inserted, and the endoscope is inserted into the water tank through the insertion hole.

[0018] According to the orthopedic technique training device of this aspect, the cover member can prevent unintended accidents such as the splashing of the transparent liquid or the intrusion of foreign matter into the water tank. In addition, the cover member is provided with an insertion hole through which an endoscope can be inserted, so it can also have functions such as identifying the insertion position of the endoscope and guiding it.

[0019] The sixth aspect is an orthopedic procedure training device comprising: a water tank in which a skeletal model is fixed and which contains a transparent liquid that covers the skeletal model; a cover member that is attached to the water tank and covers the skeletal model from above, and has an inclined portion that is inclined relative to the horizontal direction, with a first insertion hole that penetrates the inclined portion in the thickness direction; and an endoscope whose tip portion can be inserted into the water tank through the first insertion hole.

[0020] According to the orthopedic procedure training device of this embodiment, an endoscope is inserted through the first insertion hole provided in the inclined portion of the cover member, so that training in the procedure of inserting an endoscope from a direction inclined relative to the horizontal direction to access the treatment site can be performed with a feeling close to that of an actual surgical procedure.

[0021] In a seventh aspect, in the orthopedic technique training device according to the sixth aspect, the skeletal model is removably fixed to the water tank, and the cover member is switchable between a closed position in which the skeletal model is covered from above and an open position in which the skeletal model can be removed from the water tank.

[0022] According to this orthopedic technique training device, by switching the cover member from the closed position to the open position, tasks such as attaching, detaching, or replacing the skeletal model and refilling the transparent liquid can be performed without completely removing the cover member from the water tank.

[0023] In an eighth aspect, in the orthopedic technique training device according to the sixth or seventh aspect, a first valve body made of an elastic material is attached to the first insertion hole, and the first valve body is provided with a first insertion hole through which the endoscope is inserted.

[0024] According to this orthopedic procedure training device, by employing a first valve body at the insertion site of the endoscope, it is possible to ensure strength by employing, for example, a relatively hard cover member, while making the operating feel when inserting and moving or tilting the endoscope closer to the actual surgical condition.

[0025] In a ninth aspect, in the orthopedic technique training device according to the eighth aspect, the first valve body is provided with a slit extending from the first insertion hole in at least one of the upward and downward directions in the inclined direction of the inclined portion.

[0026] According to the orthopedic procedure training device of this aspect, the endoscope inserted into the first insertion hole can be moved or tilted in an inclined direction along the slit. In this case, by pushing the slit open to move the endoscope, it is possible to realize an operation feeling similar to the stretching of the skin in an actual surgical situation, based on the elasticity and frictional resistance of the first valve body.

[0027] In a tenth aspect, in the orthopedic technique training device according to any one of the sixth to ninth aspects, the cover member has a flat portion extending horizontally, and the flat portion is provided with a second insertion hole into which a second valve body made of an elastic material is attached, and the second valve body is provided with a second insertion hole through which the tip portion of the endoscope is inserted.

[0028] According to the orthopedic procedure training device of this embodiment, an insertion hole equipped with a valve body through which an endoscope can be inserted is provided in each of the flat and inclined portions of the cover member, thereby allowing greater freedom in selecting the insertion direction and insertion position of the endoscope depending on, for example, the skeletal model being used and the procedure being trained.

[0029] In an eleventh aspect, the orthopedic technique training device according to any one of the sixth to tenth aspects further comprises a cover member fixing mechanism that selectively assembles the cover member at a plurality of positions in the water tank.

[0030] According to the orthopedic procedure training device of this aspect, the mounting position of the cover member relative to the water tank can be selected depending on, for example, the skeletal model to be used, the procedure to be trained, etc. This also widens the range of options for the insertion direction and insertion position of the endoscope.

[0031] The twelfth aspect comprises a water tank in which a skeletal model is fixed and which contains a transparent liquid that surrounds the skeletal model, an endoscope whose tip is inserted into the water tank, and a model fixing mechanism that selectively fixes the skeletal model to multiple positions in the water tank.

[0032] According to the orthopedic procedure training device of this aspect, for example, when accessing one side of a skeletal model from diagonally above with an endoscope, it is possible to avoid interference of the endoscope with the surrounding walls of the tank by positioning the skeletal model to one side in the tank. Furthermore, by appropriately selecting and determining the fixing position of the skeletal model in the tank depending on, for example, the skeletal model to be used and the procedure to be trained, it is possible to achieve the desired training in a compact tank while avoiding problems such as interference of the endoscope with the surrounding walls of the tank.

[0033] In a thirteenth aspect, in the orthopedic technique training device according to the twelfth aspect, a cover member that covers the skeletal model from above is attached to the water tank, and the cover member has an insertion hole through which the endoscope is inserted, and is equipped with a cover member fixing mechanism that selectively assembles the cover member to a plurality of positions relative to the water tank in the same direction as the selectable direction by the model fixing mechanism for fixing the skeletal model to the water tank.

[0034] According to the orthopedic procedure training device of this embodiment, the fixing position of the cover member can be changed in accordance with the fixing position of the skeletal model, and therefore, stable access to the skeletal model from the endoscope through the insertion hole provided in the cover member can be achieved regardless of the position at which the skeletal model is fixed.

[0035] A fourteenth aspect is the orthopedic technique training device according to the thirteenth aspect, wherein the skeletal model can be fixed even when rotated around the vertical axis of the water tank.

[0036] According to the orthopedic procedure training device of this aspect, for example, by fixing the skeletal model near one end of the water tank, a large area can be secured at the other end of the water tank, facilitating lateral access with an endoscope, and then the skeletal model can be rotated about a vertical axis to substantially change the direction of endoscopic access to the skeletal model. Therefore, it is possible to achieve endoscopic access to the skeletal model from multiple directions under conditions similar to those in actual surgical procedures, while keeping the size of the water tank compact.

[0037] In a fifteenth aspect, in the orthopedic technique training device according to the fourteenth aspect, the cover member is provided with inclined portions inclined relative to the horizontal direction on both sides of the selectable direction of the fixing position relative to the water tank by the cover member fixing mechanism, and each of the inclined portions is provided with the insertion hole.

[0038] According to this orthopedic technique training device, a cover member can be installed corresponding to the fixed position of the skeletal model, and an endoscope can be accessed from diagonally above on both sides of the skeletal model through insertion holes provided in the inclined portions on both sides of the cover member.

[0039] The sixteenth aspect is an orthopedic procedure training device comprising a water tank in which a skeletal model is fixed and which contains a transparent liquid that covers the skeletal model, an endoscope whose tip is inserted into the water tank, and an illumination device that is provided separately from the endoscope and that illuminates the skeletal model.

[0040] According to the orthopedic procedure training device of this embodiment, the lighting device is provided separately from the endoscope, so that the brightness of the field of view of the camera provided on the endoscope is ensured, while simple endoscopes such as those equipped with low-intensity lighting devices or those without lighting devices can be used as endoscopes for the orthopedic procedure training device.

[0041] The seventeenth aspect is an orthopedic procedure training device comprising a water tank in which a skeletal model is fixed and which contains a transparent liquid that surrounds the skeletal model, an endoscope whose tip is inserted into the water tank, and a model fixing mechanism that detachably fixes the skeletal model to the wall of the water tank.

[0042] According to the orthopedic technique training device of this aspect, the skeletal model can be stably positioned and supported by fixing the skeletal model to the wall of the water tank, which does not move easily due to the weight of the transparent liquid. In addition, the skeletal model can be replaced as needed, and a common water tank can be used for multiple training sessions.

[0043] In an 18th aspect, in the orthopedic technique training device according to the 17th aspect, a bracket is provided on the skeletal model, and the bracket can be attached and detached to the wall of the tank by the model fixing mechanism.

[0044] According to this orthopedic technique training device, the skeletal model is fixed to the water tank via a bracket, which makes it possible to avoid the influence of the shape, size, material, strength, etc. of the skeletal model and to firmly and stably fix the skeletal model to the water tank.

[0045] The 19th aspect is a skeletal model used in an orthopedic technique training device that includes a water tank containing a transparent liquid and an endoscope whose tip is inserted into the water tank, and is composed of a multi-layer structure consisting of multiple layers with different hardness, with the outermost layer being harder than the inner layers.

[0046] According to the skeletal model of this embodiment, when performing cutting or the like, a sense of resistance and the like similar to that of actual bones is expressed, and a skeletal model suitable for orthopedic technique training devices can be provided.

[0047] The 20th aspect is a skeletal model used in an orthopedic procedure training device that includes a water tank containing a transparent liquid and an endoscope whose tip is inserted into the water tank, and has fibrous interior materials in the gaps.

[0048] According to the skeletal model of this embodiment, by using a fibrous interior material such as cotton or wool felt instead of the conventionally known soft foam resin, it is possible to create a situation that is closer to a procedure in which body tissue such as the nucleus pulposus that has protruded as a hernia is removed using forceps, etc., and a skeletal model suitable for orthopedic technique training equipment can be provided. [Effects of the Invention]

[0049] The orthopedic procedure training device and skeletal model according to the present invention make it possible to train procedures for endoscopic orthopedic surgery in an environment that more closely resembles the actual surgical conditions. [Brief explanation of the drawings]

[0050] [Figure 1] 1 is a perspective view showing an orthopedic technique training device according to one embodiment of the present invention; [Figure 2] FIG. 2 is a plan view showing the water tank constituting the orthopedic technique training apparatus shown in FIG. 1, with a skeletal model fixed thereto and a cover member in a closed position; [Figure 3] A perspective view of the tank shown in FIG. [Figure 4] FIG. 4 is a perspective view of the water tank shown in FIG. 3 with the cover member in an open position; [Figure 5] A vertical cross-sectional view of the tank showing an enlarged VV cross section in Figure 2. [Figure 6] FIG. 3 is a perspective view showing the water tank shown in FIG. 2 in a separate state. [Figure 7] FIG. 3 is a perspective view showing a second fixing portion constituting the water tank shown in FIG. 2 from the bottom side; [Figure 8] FIG. 2 is a front view showing a specific example of a skeletal model used in the orthopedic technique training device shown in FIG. 1, in a state where the skeletal model is fixed to a bracket. [Figure 9] IX-IX cross section in Figure 8 [Figure 10] FIG. 2 is a right side view schematically showing a specific example of an endoscope used in the orthopedic technique training device shown in FIG. 1. [Figure 11] A front view of the endoscope shown in FIG. [Figure 12] 1A and 1B are explanatory diagrams for explaining surgical methods for herniated discs, in which (a) is an explanatory diagram for the interlaminar method, and (b) is an explanatory diagram for the transforaminal method. [Figure 13] FIG. 1 is a perspective view showing an orthopedic technique training device according to another embodiment of the present invention. [Figure 14] 14 is a longitudinal sectional view of the orthopedic technique training apparatus shown in FIG. 13, which corresponds to FIG. 5. [Figure 15] 14A and 14B are perspective views showing a second fixing part constituting the orthopedic technique training apparatus shown in FIG. 13, in which (a) shows a locked state and (b) shows an unlocked state. DETAILED DESCRIPTION OF THE INVENTION

[0051] In order to clarify the present invention more specifically, embodiments of the present invention will be described in detail below with reference to the drawings.

[0052] 1 shows an orthopedic procedure training device 10 according to one embodiment of the present invention. This orthopedic procedure training device 10 is intended to improve the technical proficiency of users in orthopedic surgery using an endoscope, and allows users to train in procedures at home, for example.

[0053] More specifically, the orthopedic technique training device 10 includes a skeletal model 12 that simulates a lesion site, a water tank 14 in which the skeletal model 12 is fixed and housed, and an endoscope 15 whose tip is inserted into the water tank 14. The water tank 14 contains water 16, which is a transparent liquid, and the periphery of the skeletal model 12 is covered with the water 16. Note that the transparent liquid contained in the water tank 14 is not limited to water 16 and may be, for example, colored. However, the transparent liquid has a visible light transmittance of, for example, 80% or more so that the image captured by the endoscope 15 can be viewed on a monitor 164, which will be described later.

[0054] As shown in Figures 2 to 6, the water tank 14 has an upper opening 18 that opens upward. That is, the water tank 14 has a rectangular, flat bottom wall 20 and peripheral walls 22 that protrude upward from the four outer peripheral edges of the bottom wall 20, and the bottom wall 20 and peripheral walls 22 form the wall portion of the water tank 14. In the following description, the up-down direction is the vertical direction, which is the direction perpendicular to the plane of the paper in Figure 2. Furthermore, the front-to-rear direction refers to the front-to-rear direction in Figure 2, which is the direction in which the skeleton model 12 extends in the water tank 14. In particular, the front refers to the front side in Figure 2, which is the side of the water tank 14 where a first fixing part 30 (described later) is located, and the rear refers to the rear side in Figure 2, which is the side of the water tank 14 where a second fixing part 40 (described later) is located. Furthermore, the left-to-right direction refers to the left-to-right direction in Figure 2.

[0055] As will be described later, the water tank 14 of this embodiment has a plurality of fixing positions for the skeletal model 12, and in Figs. 2 to 5, the skeletal model 12 is fixed to the left of the fixing position of the skeletal model 12 shown in Fig. 1. As will be described later, the skeletal model 12 of this embodiment can be fixed to the water tank 14 even in a state in which it is rotated around a vertical axis and turned upside down, and in Figs. 2 to 5, the skeletal model 12 is fixed to the water tank 14 in a state in which it is turned upside down in the front-to-back direction relative to the skeletal model 12 shown in Fig. 1. For ease of viewing, the skeletal model 12 is indicated by a two-dot chain line in Fig. 5.

[0056] Preferably, at least a portion of the peripheral wall 22 of the aquarium 14 is provided with a transparent portion 24 made of a transparent material, and in this embodiment, substantially the entire peripheral wall 22 is made of the transparent portion 24. This allows the interior of the aquarium 14 to be seen from the outside through the transparent portion 24. The transparent portion 24 may be colorless and transparent or colored and may have a visible light transmittance of 80% or more, for example. Furthermore, screw holes 26 that open inward in opposing directions (front-to-back directions) are formed in the wall portions of the peripheral wall 22 on both sides in the front-to-back direction. In this embodiment, four screw holes 26 are formed in each wall portion of the peripheral wall 22 on both sides in the front-to-back direction, and are spaced apart from each other in the left-to-right direction.

[0057] Additionally, a first fixing portion 30 for fixing the skeleton model 12 and a second fixing portion 40 (described later) are provided on the bottom wall 20 of the water tank 14. Fig. 6 shows the water tank 14 in a standalone state before the second fixing portion 40 is attached, and the first fixing portion 30 and a boss portion 32 for movably fixing the second fixing portion 40 are integrally provided on the bottom wall 20 of the water tank 14. The first fixing portion 30 and the boss portion 32 are spaced apart from each other by a certain distance in the front-to-rear direction.

[0058] The first fixing part 30 has a certain degree of dimension in the left-right direction, and a first fixing groove 34 that opens rearward and extends left-right is formed in the lower part of the rear end face of the first fixing part 30. The boss part 32 also has a screw hole 36 that opens upward. The first fixing part 30 and boss part 32 are formed separately from the main body of the water tub 14, but are later fixed to the upper surface of the bottom wall 20, so that the first fixing part 30 and boss part 32 are provided integrally with the water tub 14.

[0059] In this embodiment, the pair of first fixing portions 30, 30 and the pair of boss portions 32, 32 are spaced apart from each other in the left-right direction, with the left first fixing portion 30 and boss portion 32 facing each other in the front-rear direction, and the right first fixing portion 30 and boss portion 32 facing each other in the front-rear direction. In particular, in this embodiment, the pair of first fixing portions 30, 30 and the pair of boss portions 32, 32 are biased to the right of the water tub 14, and the water tub 14 has a portion on the left side where the first fixing portion 30 and boss portion 32 are not provided. In addition, bottomed guide grooves 38, 38 extending in the front-rear direction are provided on both left-right sides of each boss portion 32.

[0060] Furthermore, the second fixing portion 40 attached to the boss portion 32 faces the first fixing portion 30 in the front-rear direction. As shown in FIG. 7 , the second fixing portion 40 has a generally hexagonal flat plate shape overall, and a guide hole 42 penetrating the plate thickness direction is formed in the center portion as an ellipse elongated in the front-rear direction. The second fixing portion 40 has a certain left-right dimension, and a second fixing groove 44 that opens forward and extends left-right is formed in the lower part of the front end surface of the second fixing portion 40. Furthermore, guide protrusions 46, 46 extending in the front-rear direction are provided on both left and right sides of the guide hole 42. The length of the guide protrusions 46 is shorter than the length of the guide groove 38.

[0061] The second fixing part 40 is attached to the boss part 32 by inserting the boss part 32 into the guide hole 42 of the second fixing part 40 and threading a screw 50 through a washer 48 into the threaded hole 36 of the boss part 32. The boss part 32 protrudes slightly from the bottom wall 20 of the water tub 14 larger than the thickness of the second fixing part 40, allowing the boss part 32 to move within the guide hole 42 when the second fixing part 40 is attached to the boss part 32. In other words, the second fixing part 40 can move in the front-rear direction relative to the boss part 32. When the second fixing part 40 is attached, the guide protrusions 46 of the second fixing part 40 are inserted into the guide grooves 38 of the bottom wall 20, allowing the second fixing part 40 to move in the front-rear direction without tilting.

[0062] In this embodiment, an accommodation recess 52 extending forward from the guide hole 42 is formed below the guide hole 42. A coil spring 54 extending in the front-to-rear direction is accommodated in this accommodation recess 52 and the guide hole 42, with the front end of the coil spring 54 fixed to the front inner surface of the accommodation recess 52 and the rear end of the coil spring 54 fixed to the outer circumferential surface of the boss portion 32 inserted into the guide hole 42. The second fixed portion 40 is biased forward relative to the boss portion 32 by the coil spring 54. In addition, by applying a rearward external force to the second fixed portion 40, the second fixed portion 40 can be moved rearward against the biasing force of the coil spring 54.

[0063] Furthermore, a cover member 56 is attached to the upper opening 18 of the water tub 14. The cover member 56 is a generally arch-shaped member made of, for example, a hard synthetic resin. On both left and right sides of the cover member 56, inclined portions 58, 58 are provided that are inclined relative to the horizontal when the cover member 56 is in the closed position shown in Figures 2 and 3, and a flat portion 60 that extends horizontally is provided in the middle portion in the left and right direction.

[0064] Specifically, the cover member 56 has a pair of cover frames 62, 62 on both front and rear sides. These cover frames 62, 62 are connected by rod frames 64 extending in the front and rear direction at both left and right end portions and at the connection portion between the inclined portion 58 and the flat portion 60. In addition, as shown in Fig. 4, substantially cylindrical leg portions 66 that protrude in the front and rear directions are provided on both left and right end portions of the cover frames 62, 62.

[0065] Between a pair of cover frames 62, 62 facing each other in the front-rear direction, cover side walls 68, 68 are provided on the inclined portions 58, 58 on both left and right sides, and a cover top wall 70 is provided on the flat portion 60 in the middle in the left-right direction. These cover side walls 68, 68 and cover top wall 70 each have a substantially rectangular flat plate shape, and when the cover member 56 is in the closed position shown in Figures 2 and 3, the cover side walls 68, 68 are arranged at an angle relative to the horizontal direction, and the cover top wall 70 is arranged to extend horizontally.

[0066] At least one of the cover side walls 68, 68 and the cover top wall 70 is preferably formed from a transparent material, and in this embodiment, all of the cover side walls 68, 68 and the cover top wall 70 are formed from a transparent material. The cover side walls 68, 68 and the cover top wall 70 may be colorless and transparent or colored and transparent, and preferably have a visible light transmittance of 80% or more, for example.

[0067] The cover side walls 68, 68 are provided with first insertion holes 74 as insertion holes penetrating in the plate thickness direction, and the cover top wall 70 is provided with second insertion holes 76 as insertion holes penetrating in the plate thickness direction. In this embodiment, the cover side wall 68 has two substantially oval first insertion holes 74 formed spaced apart from each other in the front-to-rear direction. The cover top wall 70 has six substantially circular second insertion holes 76 formed spaced apart from each other in the front-to-rear and left-to-right directions.

[0068] Furthermore, 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 with an outer diameter larger than that of the first insertion hole 74, with the outer diameter of the first valve body 78 being smaller at an intermediate portion in the thickness direction. The inner peripheral edge of the first insertion hole 74 is fitted into the small-diameter portion of the first valve body 78, thereby attaching the first valve body 78 to the first insertion hole 74. That is, in the closed position shown in FIGS. 2 and 3 , the first valve body 78 is disposed at an angle relative to the horizontal. A first insertion hole 80 penetrating the first valve body 78 in the plate thickness direction is formed in an upper portion in the angled direction. A slit 82 extends downward in the angled direction from the first insertion hole 80. The inner diameter of the first insertion hole 80 is not limited, but is preferably smaller than the outer diameter of the endoscope 15, for example. In addition, the first insertion hole may be provided in the middle or lower part of the first valve body in the tilt direction, and the slit extending from the first insertion hole may extend upward in the tilt direction or in both the up and down directions.

[0069] Furthermore, 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 with an outer diameter larger than that of the second insertion hole 76, with the outer diameter of the second valve body 84 being smaller at a middle portion in the thickness direction. The inner peripheral edge of the second insertion hole 76 is fitted into the small-diameter portion of the second valve body 84, thereby attaching the second valve body 84 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 to extend horizontally. A second insertion hole 86 is formed in the center of the second valve body 84, penetrating it in the plate thickness direction. Slits 87 extend from the second insertion hole 86 in both the front-rear and left-right directions. The inner diameter of the second insertion hole 86 is not limited, but is preferably smaller than the outer diameter of the endoscope 15, for example.

[0070] The cover member 56 described above is supported by a cover support member 88 provided on the inner surface of the peripheral wall 22 of the water tub 14 and is attached to the water tub 14. In this embodiment, the cover support member 88 is configured to include a first support member 88a that is rotatable relative to the peripheral wall 22 and a second support member 88b that is not rotatable relative to the peripheral wall 22. The first support member 88a and the second support member 88b each have a cylindrical structure with a portion of the peripheral wall cut out, and the central axis of the cylindrical body extends in the thickness direction of the peripheral wall 22. The first support member 88a and the second support member 88b are attached to the water tub 14 with one end face in the central axis direction (the outer end face in the front-to-rear direction) overlapping the inner surface of the peripheral wall 22.

[0071] The first support member 88a is composed of an inner circumferential portion 90a and an outer circumferential portion 90b, both of which are generally cylindrical, with a portion of a peripheral wall 92 of the outer circumferential portion 90b cut out. The outer circumferential portion 90b is assembled to the inner circumferential portion 90a so as to be displaceable in the circumferential direction. Furthermore, a tab 100 in the form of a protruding piece that protrudes outward is provided at one circumferential end of the peripheral wall 92 of the outer circumferential portion 90b.

[0072] The inner peripheral portion 90a of the first support member 88a is fixed by, for example, a screw or a pin to the threaded hole 26 on the inner surface of the peripheral wall 22 so as not to rotate in the circumferential direction. By gripping the tab 100 and displacing the outer peripheral portion 90b in the circumferential direction relative to the inner peripheral portion 90a, the outer peripheral portion 90b of the first support member 88a can be rotated relative to the peripheral wall 22 of the water tub 14. Such rotation of the outer peripheral portion 90b allows the circumferential position of a notch 102 in the peripheral wall 92 to be displaced. The notch 102 is formed with a circumferential dimension of, for example, about 1 / 3 of the circumference.

[0073] The second support member 88b has a generally cylindrical shape with a bottom, and a portion of the peripheral wall 104 is cut out. The second support member 88b is fixed by, for example, a screw or a pin so as not to be rotatable in the circumferential direction relative to the threaded hole 26 on the inner surface of the peripheral wall 22. As a result, in this embodiment, a notch 106 is formed in the upper right corner of the peripheral wall 104 of the second support member 88b, with a circumferential dimension of approximately one-third of the circumference.

[0074] In this embodiment, four screw holes 26 are provided in each of the wall portions on both front and rear sides of the peripheral wall 22 of the water tub 14, and four cover support members 88 are attached to each of the wall portions on both front and rear sides of the peripheral wall 22. In particular, in this embodiment, on both front and rear side walls of the peripheral wall 22, the two cover support members 88 on the left side are first support members 88a, and the two cover support members 88 on the right side are second support members 88b.

[0075] When attaching the cover member 56 to the water tub 14 via these cover support members 88 (first support member 88a, second support member 88b), for example, as shown in FIGS. 2 to 4, the leg 66 of the cover member 56 is inserted into the left-side first support member 88a and the left-side second support member 88b. Specifically, as shown in FIG. 4, the leg 66 on 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. Thereafter, by rotating the leg 66 within the peripheral wall 104, the cover member 56 can be rotated about the leg 66 inserted into the peripheral wall 104, and as shown in FIGS. 2 and 3, the leg 66 on 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, for example, to an upper position where the leg portion 66 can be inserted by pinching the tab 100 and rotating the first support member 88a.

[0076] After inserting the legs 66 into the first support member 88a, the tab 100 is gripped and the first support member 88a is rotated, thereby preventing the legs 66 from falling off the peripheral wall 92. More specifically, by changing the position of the notch 102 in the peripheral wall 92 and covering the upper right of the first support member 88a with the peripheral wall 92, even if an external force acts on the cover member 56 in the upper right direction, which would cause the legs 66 to fall off the second support member 88b, the legs 66 are prevented from falling off the first support member 88a, and the cover member 56 is fixed to the water tank 14. As a result, the cover member 56 is held in a closed position covering the top of the skeletal model 12, as shown in FIGS. 2 and 3 . Therefore, in this embodiment, the cover member fixing mechanism 112 is configured to include multiple cover support members 88.

[0077] Furthermore, for example, when the notch 102 in the first support member 88a is positioned upward, the cover member 56 can be switched from the closed position shown in Figures 2 and 3 to the open position shown in Figure 4 by rotating the cover member 56 about the leg 66 inserted into the second support member 88b. This makes it possible to replace the skeleton model 12 without removing the cover member 56 from the water tank 14. Alternatively, the cover member 56 can be removed from the water tank 14 by applying an external force to the cover member 56 in an upper right direction when the cover member 56 is in the open position. The skeleton model 12 may then be replaced after removing the cover member 56 from the water tank 14.

[0078] 2 to 4, the cover member 56 is assembled by selecting the first support member 88a and the second support member 88b on the left side as the cover support members 88 into which the legs 66 of the cover member 56 are inserted. However, as shown in FIG. 1, the cover member 56 can also be assembled by selecting the first support member 88a and the second support member 88b on the right side. That is, the cover member 56 can be assembled in the assembly position shown in FIGS. 2 to 4 and in an assembly position further to the right than that shown in FIG. 1. In short, in the orthopedic procedure training device 10 of this embodiment, the cover member fixing mechanism 112 (plurality of cover support members 88) allows the cover member 56 to be assembled at multiple positions in the water tank 14, and one of the multiple positions can be selected for assembly. The selectable direction of the assembly position of the cover member 56 (the left-right direction in this embodiment) is the same as the selectable direction of the fixing position of the skeletal model 12 by the model fixing mechanism 130, as described below, for example. In this embodiment, the mounting 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.

[0079] The skeletal model can be changed depending on the procedure to be performed in training, but as shown in Figures 8 and 9, the skeletal model 12 of this embodiment is fixed to a bracket 126, which will be described later. Furthermore, the skeletal model 12 of this embodiment is a lumbar skeletal model used for training in surgery for herniated discs. When a lumbar skeletal model is used, it may be one that simulates the entire lumbar vertebrae (first to fifth lumbar vertebrae), or it may be one that simulates only a portion of the lumbar vertebrae. The skeletal model 12 of this embodiment includes an anterior portion of the third lumbar vertebra L3, the fourth lumbar vertebra L4, and the fifth lumbar vertebra L5, an intervertebral disc 114 between the third lumbar vertebra L3 and the fourth lumbar vertebra L4, and an intervertebral disc 116 between the fourth lumbar vertebra L4 and the fifth lumbar vertebra L5. In Figure 1, the skeletal model 12 is fixed to the water tank 14 with the left side in Figure 8 facing forward, so in the following explanation, the left side in Figure 8, which corresponds to the neck side of the skeletal model 12, will be referred to as the front, the right side in Figure 8, which corresponds to the leg side, will be referred to as the rear, the upper side in Figure 8, which corresponds to the back side, will be referred to as the upside, and the lower side in Figure 8, which corresponds to the belly side, will be referred to as the downside.

[0080] Furthermore, a nerve model 120 simulating a nerve is inserted into a gap 118 inside the skeletal model 12. The nerve model 120 has a portion 120a simulating the cauda equina nerve extending in the front-to-back direction and a portion 120b simulating a nerve root extending laterally from the cauda equina nerve. The skeletal model 12 has a fibrous interior material 122 simulating a hernia in the internal gap 118. For example, cotton or wool felt can be suitably used as the fibrous interior material 122.

[0081] The skeletal model 12 may be formed from a hard resin such as epoxy resin or acrylic resin, and in this embodiment, it is formed from foamed polyurethane. Furthermore, in this embodiment, the skeletal model 12 has a multilayer structure consisting of multiple layers with different hardnesses. The outermost layer is a covering layer 124 made of a synthetic resin that is harder than the inner layers. The outer layer (covering layer 124) may be made of a different material from the inner layers, for example, or its hardness may be adjusted by changing the foaming ratio relative to the inner layers. The nerve model 120 may be formed from an elastomer such as silicone.

[0082] Furthermore, the bracket 126 has a generally rectangular flat plate shape overall and may be formed of, for example, a hard synthetic resin. The bracket 126 is fixed to the underside of the skeletal model 12. The fixing structure between the bracket 126 and the skeletal model 12 is not limited and may be, for example, adhesive bonding. However, in this embodiment, a pin hole 127 is provided in the center of the upper surface of the bracket 126, and a pin (not shown) protruding downward from the skeletal model 12 is press-fitted into the pin hole 127 to fix the bracket 126 to the skeletal model 12. By adopting such a fixing structure, it is possible to replace only the skeletal model 12 while the bracket 126 is attached to, for example, a model fixing mechanism 130 (first and second fixing parts 30, 40) described below. Alternatively, the skeletal model 12 and the bracket 126 may be bonded together with the pin of the skeletal model 12 inserted into the pin hole 127 of the bracket 126. Furthermore, the lower part of the bracket 126 is provided with engaging protrusions 128, 128 protruding on both sides in the front-rear direction.

[0083] The front-rear dimension of the bracket 126, including these engaging protrusions 128, 128, is larger than the opposing distance in the front-rear direction between the first fixing part 30 and the second fixing part 40 when the bracket 126 is biased by the coil spring 54 and positioned at its forwardmost position. By applying a rearward external force to the second fixing part 40 to increase the opposing distance between the first fixing part 30 and the second fixing part 40, the bracket 126 can be positioned between the first fixing part 30 and the second fixing part 40. Furthermore, by releasing the rearward external force on the second fixing part 40, the second fixing part 40 is displaced forward in accordance with the biasing force of the coil spring 54, and the engaging protrusions 128, 128 on both front-rear sides of the bracket 126 engage with the first fixing groove 34 of the first fixing part 30 and the second fixing groove 44 of the second fixing part 40. This allows the skeleton model 12 to be fixed to the bottom of the aquarium 14, extending in the front-rear direction. That is, in this embodiment, the model fixing mechanism 130 that fixes the skeleton model 12 to the water tank 14 includes a first fixing part 30 and a second fixing part 40.

[0084] When removing the skeletal model 12 from the water tank 14, for example, the cover member 56 is rotated to the open position shown in Fig. 4, and the skeletal model 12 and the bracket 126 are grasped and pushed rearward, whereby the second fixing part 40 is displaced rearward against the biasing force of the coil spring 54, increasing the opposing distance between the first fixing part 30 and the second fixing part 40, and the skeletal model 12 can be removed from between the first fixing part 30 and the second fixing part 40. Therefore, in this embodiment, the skeletal model 12 is removably fixed to the water tank 14, and more specifically, the bracket 126 is removably fixed to the bottom wall 20, which serves as a wall part of the water tank 14, by the model fixing mechanism 130.

[0085] In this embodiment, a pair of first fixing portions 30, 30 and a pair of second fixing portions 40, 40 are provided spaced apart in the left-right direction. In FIGS. 2 to 4, the bracket 126 is fixed by selecting the first fixing portion 30 and the second fixing portion 40 on the left side, respectively. However, as shown in FIG. 1, it is also possible to fix the bracket 126 by selecting the first fixing portion 30 and the second fixing portion 40 on the right side, respectively. That is, the bracket 126 can be fixed to the fixing position shown in FIGS. 2 and 3 and to a fixing position further to the right than that shown in FIG. 1. In short, in the orthopedic procedure training device 10 of this embodiment, the model fixing mechanism 130 can selectively fix the skeletal model 12 to multiple fixing positions in the water tank 14. Furthermore, the cover member fixing mechanism 112 can select an assembly position for the cover member 56, and the cover member 56 can be assembled at one of multiple assembly positions selected depending on the position of the skeletal model 12 fixed by the model fixing mechanism 130. Furthermore, in this embodiment, since the skeleton model 12 is provided with the first and second fixing portions 30, 40 and the engaging protrusions 128, 128 on both the front and rear sides, the skeleton model 12 can be rotated in the vertical axis direction relative to the state shown in Figures 2 and 3, for example, flipped in the front and rear direction, and assembled to the water tank 14 in the state shown in Figure 1.

[0086] Then, the tip portion of the endoscope 15 is inserted from above into the water tank 14 to which the skeletal model 12 is fixed. In this embodiment, a cover member 56 is attached so as to cover the skeletal model 12 from above, and the tip portion of the endoscope 15 is inserted through the first insertion hole 74 or the second insertion hole 76 provided in the cover member 56. In particular, in this embodiment, first and second valve bodies 78, 84 are provided in the first insertion hole 74 and the second insertion hole 76, respectively, so that the tip portion of the endoscope 15 can be inserted through the first and second insertion holes 80, 86 in the first and second valve bodies 78, 84.

[0087] The structure of the endoscope used in the orthopedic technique training device 10 according to the present invention is not limited, and for example, an endoscope generally used in surgical procedures may be used. However, in this embodiment, as shown in Figures 10 and 11, the endoscope 15 is a simple endoscope. That is, the endoscope 15 of this embodiment has a main body 136 formed of metal. The main body 136 of the endoscope 15 is formed with three lumens: a first lumen 138, a second lumen 140, and a third lumen 142. These first to third lumens 138, 140, and 142 extend in the longitudinal direction of the main body 136. In this embodiment, the first lumen 138 has a larger diameter than the second and third lumens 140 and 142, and is a lumen for suctioning water 16 contained in the water tank 14 and for inserting an instrument (not shown). The second lumen 140 is for inserting a cable 162 (described later), and the third lumen 142 is a discharge lumen for discharging the water 16 into the water tank 14.

[0088] In the following description, the longitudinal direction of the main body portion 136 refers to the left-right direction in Fig. 10, the distal end side refers to the left side in Fig. 10, and the proximal end side refers to the right side in Fig. 10. Furthermore, the upper side of the main body portion 136 refers to the upper side in Fig. 10, and the lower side refers to the lower side in Fig. 10. In this embodiment, the lower portion of the main body portion 136 protrudes more toward the distal end than the upper portion, and a first lumen 138 is provided in the upper portion of the main body portion 136, and a second lumen 140 is provided in the lower portion of the main body portion 136. Furthermore, a third lumen 142 is provided in the main body portion 136 at a position laterally spaced apart from the first lumen 138 and the second lumen 140.

[0089] These first to third lumens 138, 140, 142 each open at the distal end of the endoscope 15. That is, the endoscope 15 of this embodiment is provided at its distal end with both a suction port 144 as the opening of the first lumen 138, which is a lumen for sucking in the water 16, and a discharge port 146 as the opening of the third lumen 142, which is a lumen for discharging the water 16. Also, a camera 148 is provided at the opening of the second lumen 140. That is, the camera 148 is provided closer to the distal end than the suction port 144 and the discharge port 146, and is capable of capturing an image of an instrument inserted through the first lumen 138 (suction port 144).

[0090] The proximal end portion of the first lumen 138 is closed by a valve 152 having a slit 150, and a suction tube 154 that communicates with the first lumen 138 and extends laterally is connected forward of the valve 152. Furthermore, a discharge tube 156 that extends laterally is connected to the proximal end portion of the third lumen 142. The suction tube 154 and the discharge tube 156 are connected to a pump 158, which is a circulation device, and a filter 160, which is a filtration device, via appropriate connectors or the like, outside the water tank 14. Therefore, the orthopedic technique training device 10 of this embodiment is configured to include the pump 158 and the filter 160. That is, in this embodiment, water 16 sucked through 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 into the water tank 14. Although the filter 160 is indicated by a two-dot chain line in FIG. 1, the location 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.

[0091] Furthermore, a cable 162 connected to the camera 148 is drawn out to the outside of the endoscope 15 through the second lumen 140 and is connected to a monitor 164 via a connector 163 outside the water tank 14. In this embodiment, as shown by the two-dot chain line in FIG. 2 , a light 166 serving as an illumination device for illuminating the skeletal model 12 may be provided outside the water tank 14 as a separate unit from the endoscope 15, and the orthopedic technique training device 10 may be configured to include the light 166. Note that the specific structure of the light 166 is not limited. For example, the light 166 may be a light with a clip that is fixed by clamping the peripheral wall 22 of the water tank 14 to illuminate the skeletal model 12 from above, or an LED light may be fixed to the outside of the peripheral wall 22 to illuminate the skeletal model 12 through the transparent portion 24 of the peripheral wall 22. In addition, although the light 166 is fixed to the front side of the peripheral wall 22 in FIG. 2 , the location where the light 166 is provided is not limited.

[0092] In this orthopedic procedure training device 10, orthopedic surgical procedure training can be performed by inserting the tip portion of the endoscope 15 through the cover member 56. That is, with the tip portion of the endoscope 15 close to the skeletal 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 and protruded 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 bone (skeletal model 12), remove hernia (internal structure 122), etc.

[0093] Surgical methods for herniated discs generally include the interlaminar method shown in Figure 12(a) and the transforaminal method shown in Figure 12(b). The interlaminar method or the transforaminal method is selected depending on the size and location of the herniation. In other words, in the method shown in Figure 12(a), the endoscope 15 is inserted vertically from the patient's back (from above in Figure 12(a)), whereas in the method shown in Figure 12(b), the endoscope 15 is inserted from the outside (from a direction inclined relative to the top in Figure 12(b)). The cover member 56 of this embodiment has a flat portion 60 and an inclined portion 58. The endoscope 15 can be inserted from either the flat portion 60 or the inclined portion 58, allowing training in both the interlaminar method and the transforaminal method.

[0094] Note that, for example, when training using the interlaminar method, the endoscope 15 is inserted through the flat portion 60 of the cover member 56, and therefore the skeletal model 12 may be fixed to a fixed position on the right side of the water tank 14 as shown in FIG. 1, or may be fixed to a fixed position approximately in the center of the water tank 14 as shown in FIGS. 2 to 4. Furthermore, when training using the transforaminal method, if the endoscope 15 is not to be moved significantly up and down, it is preferable that the skeletal model 12 be fixed to a fixed position approximately in the center of the water tank 14 as shown in FIGS. 2 to 4. This ensures sufficient space on both the left and right sides of the skeletal model 12, and therefore, even when the endoscope 15 is inserted into the skeletal model 12 from either the left or right direction through the inclined portions 58, 58 of the cover member 56, interference between the endoscope 15 and the peripheral wall 22 of the water tank 14 is avoided.

[0095] Furthermore, when performing training using the transforaminal method, if the endoscope 15 is moved significantly up and down as indicated by the white arrow in FIG. 12(b), it is preferable to fix the skeletal model 12 to a fixing position on the right side of the water tank 14, as shown in FIG. 1. This ensures sufficient space to the left of the skeletal model 12, and therefore prevents the peripheral wall 22 of the water tank 14 from interfering with the endoscope 15 even when the endoscope 15 is inserted into the skeletal model 12 from the left through the inclined portion 58 of the cover member 56 and then moved significantly up and down. Note that when the endoscope 15 is inserted into the skeletal model 12 from the right, the skeletal model 12 is fixed in a state inverted front to back relative to the fixing position on the right side of the water tank 14. This ensures sufficient space to the right of the skeletal model 12 (to the right when the neck side of the skeletal model 12 (the left side in FIG. 8) is considered to be the front). As a result, even when the endoscope 15 is inserted into the skeletal model 12 from the right and moved significantly up and down, the endoscope 15 is prevented from interfering with the peripheral wall 22 of the water tank 14.

[0096] In the orthopedic procedure training device 10 of this embodiment having the above-described structure, the endoscope 15 is provided at its tip with a suction port 144 for sucking in the water 16 from the water tank 14 and a discharge port 146 for discharging the water 16 into the water tank 14. For example, an instrument such as a drill is inserted through the first lumen 138, and cuttings from the skeletal model 12 are sucked in together with the water 16 through the suction port 144 or swept away by the water 16 discharged from the discharge port 146. The water 16 sucked in together with the cuttings from the skeletal model 12 is then removed by a filter 160, which is a filtering device, and the water 16 is circulated by a pump 158, which is a circulation device, and discharged from the discharge port 146 into the water tank 14. As a result, deterioration of the visibility of the treatment area due to cuttings from the skeletal model 12 is avoided, and training in orthopedic surgical procedures can be performed efficiently.

[0097] Furthermore, because water 16 sucked in through suction port 144 is circulated by pump 158 and discharged from discharge port 146 into water tank 14, water sucked in through the suction port is not discharged out of the water tank through the discharge port, and once a predetermined amount of water 16 is ready, orthopedic technique training device 10 can be used. This allows orthopedic technique training device 10 to be used at home, for example, making it easier to find time for training, and improving the user's proficiency in technique.

[0098] In particular, since both the suction port 144 and the discharge port 146 are provided at the tip portion of the endoscope 15, it is possible to more reliably achieve both the suction of cutting powder from the skeletal model 12 through the suction port 144 and the washing away of cutting powder from the skeletal model 12 through the discharge port 146 at the treatment site.

[0099] Furthermore, since the aquarium 14 has a transparent section 24, it is possible to see the inside of the aquarium 14 from the outside, and for example, it is possible to observe the instructor's techniques from the outside or to photograph one's own techniques from the outside, which further improves the user's proficiency in techniques.

[0100] Furthermore, a cover member 56 that covers the skeletal model 12 from above is attached to the water tank 14. This prevents the water 16 from splashing when the endoscope 15 is inserted into the water tank 14, when the skeletal model 12 is cut, or when the water 16 is sucked in and discharged. This cover member 56 is provided with an inclined portion 58 and a flat portion 60, so that the endoscope 15 can be inserted into the skeletal model 12 from the left or right, or from above. This makes it possible to select the insertion position of the endoscope 15 depending on the type of skeletal model 12 and the position and size of the lesion, etc., and allows training in a number of different procedures.

[0101] Furthermore, a first insertion hole 74 is provided in the inclined portion 58 of the cover member 56, and a second insertion hole 76 is provided in the flat portion 60 of the cover member 56. This makes it easy to insert the endoscope 15 into the water tub 14. In particular, a first valve body 78 is attached to the first insertion hole 74, and a first insertion hole 80 is formed in the first valve body 78, and a second valve body 84 is attached to the second insertion hole 76, and a second insertion hole 86 is formed in the second valve body 84. By setting the inner diameter of these first and second insertion holes 80, 86 to be smaller than the outer diameter of the endoscope 15, a certain degree of resistance is felt when inserting and withdrawing the endoscope 15 into the first and second insertion holes 80, 86. Furthermore, since the slits 82, 87 are provided continuously in the first and second insertion holes 80, 86, a certain degree of resistance can be felt when moving the endoscope 15 inserted into the first and second insertion holes 80, 86 in the up-down or left-right directions. This allows training to be performed with a feeling close to that of an actual surgical procedure.

[0102] Furthermore, in this embodiment, the cover member 56 can be switched between a closed position that covers the top of the skeletal model 12 and an open position that allows the skeletal model 12 to be removed from the water tank 14, so that the skeletal model 12 can be removed from the water tank 14 without completely removing the cover member 56 from the water tank 14.

[0103] Furthermore, the orthopedic procedure training device 10 of this embodiment has a model fixing mechanism 130 that fixes the skeletal model 12 to the wall of the water tank 14, and this model fixing mechanism 130 allows the skeletal model 12 to be selectively fixed to multiple positions in the water tank 14. In particular, the cover member 56 of this embodiment has inclined portions 58, 58 on both the left and right sides. Inserting the endoscope 15 from the side of the skeletal model 12 tends to cause interference between the endoscope 15 and the peripheral wall 22 of the water tank 14. However, by changing the fixing position of the skeletal model 12 using the model fixing mechanism 130, such interference can be avoided. Furthermore, even if a large space is required in the water tank 14 when inserting the endoscope 15 into the skeletal model 12 from the side, in this embodiment, the skeletal model 12 can be fixed in the water tank 14 even when inverted in the front-to-back direction. Therefore, there is no need to provide a large space on both the left and right sides of the skeletal model 12. It is sufficient to provide a fixing position for the skeletal model 12 on either the left or right side of the water tank 14. This allows the water tank 14 to be made compact, and the space required for storage can be reduced when used at home, etc.

[0104] Furthermore, the orthopedic technique training device 10 of this embodiment has a cover member fixing mechanism 112 that assembles the cover member 56 to the water tank 14, and this cover member fixing mechanism 112 allows the cover member 56 to be selectively assembled to a plurality of positions in the water tank 14. In particular, in this embodiment, the direction of the fixing position of the skeletal model 12 that can be selected by the model fixing mechanism 130 is the same as the direction of the assembly position of the cover member 56 that can be selected by the cover member fixing mechanism 112, and the assembly position of the cover member 56 assembled by the cover member fixing mechanism 112 can be selected depending on the fixing position of the skeletal model 12 fixed by the model fixing mechanism 130. This allows the cover member 56 to more stably cover the top of the skeletal model 12 even when the fixing position of the skeletal model 12 in the water tank 14 is changed.

[0105] Furthermore, the skeletal model 12 is fixed to a bracket 126, and this bracket 126 is removably fixed to the wall of the water tank 14 by a model fixing mechanism 130. Therefore, the skeletal model 12 can be replaced after training, and a common water tank 14 can be used even when training is performed multiple times. This eliminates the need to store multiple water tanks 14 when using the orthopedic procedure training device 10 at home, etc., thereby reducing storage space and management efforts. Furthermore, even if the skeletal model 12 has a complex shape, since the bracket 126 is fixed to the model fixing mechanism 130, a stable fixing area between the skeletal model 12 and the water tank 14 can be ensured.

[0106] Furthermore, in this embodiment, the light 166, which is an illumination device that illuminates the skeletal model 12, is provided separately from the endoscope 15, so that the endoscope 15 used in the orthopedic technique training device 10 can be simpler than the endoscope actually used in surgery.

[0107] Furthermore, the skeletal model 12 of this embodiment has a multi-layer structure, with the outermost layer, the covering layer 124, being harder than the inner layers. This allows the skeletal model 12 to provide a sensation similar to that of actual bones when performing training such as cutting.

[0108] Furthermore, a fibrous interior material 122 that simulates a hernia (nucleus pulposus) is provided in the gap 118 inside the skeleton model 12. This makes it possible to provide a skeleton model 12 that is close to the sensation of an actual hernia when training the technique of removing a hernia with forceps or the like in surgery for a herniated disc or the like.

[0109] Although the embodiments of the present invention have been described above, the present invention should not be construed as being limited by the specific descriptions in such embodiments, and can be implemented in various forms with various changes, modifications, improvements, etc. made based on the knowledge of those skilled in the art.

[0110] For example, in the above embodiment, the cover member 56 was removable from the water tub 14. However, it may be non-removable and simply switchable between a closed position and an open position. Alternatively, the cover member need not necessarily be switchable to the open position; it may be removably attached to the water tub in a permanently closed position. Switching between the closed and open positions may be achieved not only by pivoting as in the above embodiment, but also by sliding left and right, for example. Furthermore, the structure of the cover member is not limited to a specific configuration, and it may be configured with only an inclined portion on one or both sides, or may be configured with only a flat portion, or the inclined portion may be curved. However, the cover member is not essential to the orthopedic technique training device of the present invention.

[0111] Furthermore, in the above embodiment, both the suction port 144 and the discharge port 146 are provided at the tip of the endoscope 15. However, it is sufficient that the tip of the endoscope has at least one of a suction port and a discharge port. That is, for example, when a suction port is provided at the tip of the endoscope, the discharge port for discharging a transparent liquid (e.g., water) into the water tank may be provided, for example, in the peripheral wall or bottom wall of the water tank. Furthermore, when a discharge port is provided at the tip of the endoscope, the suction port for sucking the transparent liquid from the water tank may be provided, for example, in the peripheral wall or bottom wall of the water tank. Even in such cases, cutting powder is sucked in along with the transparent liquid by the suction port or discharge port provided at the tip of the endoscope, or is swept away by the transparent liquid discharged from the discharge port, thereby achieving good visibility even under the endoscope. Note that the suction port or discharge port provided at the tip of the endoscope does not need to open on the distal surface of the endoscope, but may open on the outer circumferential surface near the tip. However, in certain aspects of the present invention, neither a suction port nor a discharge port may be provided in the endoscope, and for example, a suction port may be provided in the peripheral wall or bottom wall of the water tank so that transparent liquid sucked in through the suction port is discharged outside the water tank, and a discharge port connected to a water source separately provided outside the water tank may be provided in the peripheral wall or bottom wall of the water tank so that transparent liquid flowing out from the water source is discharged into the water tank. Alternatively, for example, in cases where the amount of transparent liquid in the water tank does not change significantly when transparent liquid is sucked in through the suction port or discharged from the discharge port, an aspect in which only one of a suction port and a discharge port is provided may be employed.

[0112] Furthermore, in the above embodiment, the skeleton model 12 can be fixed to two locations on the water tank 14, but it may be fixed to one location or three or more locations. Similarly, in the above embodiment, the cover member 56 can be fixed to two locations on the water tank 14, but it may be fixed to one location or three or more locations. Note that it is preferable that the cover member be assembled in a position that covers the top of the skeleton model, depending on the position of the skeleton model in the water tank.

[0113] Furthermore, in the above embodiment, the skeleton model 12 is fixed to the bracket 126, and the first and second fixing members 30, 40 constituting the model fixing mechanism 130 are provided on the bottom wall 20 of the water tank 14, and the bracket 126 is fixed to the bottom wall 20 by the model fixing mechanism 130. However, this is not limited to this configuration. That is, the bracket and the first and second fixing members are not essential. For example, the skeleton model and the bottom wall of the water tank may be provided with recesses and protrusions that fit or lock with each other, and the skeleton model may be fixed to the bottom of the water tank by press-fitting or locking these recesses and protrusions. Note that the model fixing mechanism does not have to be provided on the bottom wall of the water tank, but 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. Similarly, in the above embodiment, the cover support member 88 constituting the cover member fixing mechanism 112 was provided on the peripheral wall 22 of the water tank 14, but it is also possible to provide a cover support member that protrudes upward from the bottom wall of the water tank, and to have the cover member supported by the cover support member.

[0114] Furthermore, while the orthopedic procedure training device 10 of the above embodiment is intended for training in surgery for herniated discs and the skeletal model 12 simulates lumbar vertebrae, this is not limited thereto. That is, the orthopedic procedure training device of the present invention can be applied to training for bone-related disorders in various parts of the human or animal body, and a skeletal model corresponding to the desired training, such as treatment for disorders of joints including tendons, can be appropriately adopted. Furthermore, depending on the type of skeletal model and the procedure, the skeletal model may be fixedly supported in a rotated state in any direction, in addition to being inverted front-to-back as in the above embodiment. In particular, by being rotatable around a vertical line, it becomes easy to change the horizontal direction of the skeletal model while aligning the vertical direction of the bones in the actual procedure with the vertical direction of the skeletal model, making it even more suitable for orthopedic procedure training.

[0115] Furthermore, as in an orthopedic technique training device 170 according to another aspect of the present invention shown in FIGS. 13 and 14 , a model fixing mechanism 172 that fixes a skeletal model (12) may be provided with a locking unit 174 as a locking mechanism that prevents the skeletal model (12) from unintentionally falling off the water tank 14 due to inadvertent disengagement from the bracket 126. As shown in FIGS. 15( a) and 15(b), this locking unit 174 is provided on a second fixing unit 176 that constitutes the model fixing mechanism 172. Note that in the following description, components and parts that are substantially the same as those in the first embodiment are denoted by the same reference numerals as in the first embodiment, and detailed description thereof will be omitted. Furthermore, since the following description will focus on the locking unit 174, the endoscope (15) and the pump (158) and filter (160) connected to the endoscope (15), which constitute the orthopedic technique training device 170, are not shown in FIG. 13 , and the cover member 56 is not shown in FIG. 14 .

[0116] More specifically, the locking portion 174 is rotatably assembled to the rear end of the second fixing portion 176. That is, a rotation shaft 178 that protrudes outward in the left-right direction is provided at the rear end of the second fixing portion 176, and a support portion 180 that sandwiches and supports the rotation shaft 178 is provided at the front end of the locking portion 174. The rotation shaft 178 is sandwiched between the support portion 180, whereby the locking portion 174 is assembled to the second fixing portion 176 and is rotatable about the rotation shaft 178 relative to the second fixing portion 176.

[0117] The basic structure of the second fixing portion 176 is the same as that of the second fixing portion 40 in the first embodiment, with a guide hole 42 extending in the front-rear direction provided in the central portion and a second fixing groove 44 extending in the left-right direction provided in the front end portion. The second fixing portion 176 of this embodiment is also provided with a plurality of lightening holes 182 that penetrate in the up-down direction or have a bottom. Furthermore, the locking portion 174 is generally rectangular in plan view, and an operation hole 184 that penetrates in the thickness direction is formed in the central portion in the left-right direction.

[0118] In the orthopedic technique training device 170 of this embodiment as described above, the locking portion 174 is in a locked state as shown in FIG. 15(a) at the fixed position of the skeletal model (12) on the left side of FIG. 13 where the bracket 126 is provided. That is, the locking portion 174 is operated by, for example, pressing the periphery of the operation hole 184 with a finger, so that the second fixing portion 176 and the locking portion 174 are spread in the front-to-rear direction. This prevents the locking portion 174 and the second fixing portion 176 from moving rearward, thereby preventing the skeletal model (12) from unintentionally falling off the water tank 14. Note that in this embodiment, the locked state is maintained by the rear end of the locking portion 174 contacting the rear wall portion of the peripheral wall 22 of the water tank 14, as shown in FIG. 14.

[0119] On the other hand, at the fixed position of the skeleton model (12) on the right side in Fig. 13, the locking part 174 is in an unlocked state as shown in Fig. 15(b). That is, by operating the locking part 174 so as to lift it upward by hooking a finger into the operation hole 184, for example, a gap is created between the rear end of the locking part 174 and the rear wall part of the peripheral wall 22 of the water tank 14. This allows the locking part 174 and the second fixing part 176 to move rearward, making it possible to attach and detach the skeleton model (12) to and from the water tank 14.

[0120] Therefore, as in this embodiment, the model fixing mechanism may be provided with a locking mechanism that switches 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. Such a locking mechanism may be provided, for example, in the second fixing portion that constitutes the model fixing mechanism. Note that when the locking portion 174 shown in FIG. 15(a) is in the locked state, the rear end of the locking portion 174 does not need to contact the rear wall portion of the peripheral wall 22 of the water tank 14. For example, the rear end of the locking portion 174 and the rear wall portion of the peripheral wall 22 of the water tank 14 may face each other in the front-to-rear direction with a gap large enough to prevent the bracket 126 from falling off the model fixing mechanism 172 even if the second fixing portion 176 moves rearward. Also, a spring member or the like may be provided that holds the locking portion 174 in the locked position with a sense of restraint. [Explanation of symbols]

[0121] 10 Orthopedic technique training device 12 Skeletal Models 14 Aquarium 15 Endoscopy 16 Water (transparent liquid) 18 Upper opening 20 Bottom Wall 22 Peripheral wall 24 Transparent part 26 screw holes 30 1st fixed part 32 Boss section 34 1st fixing groove 36 screw holes 38 Guide groove 40 Second fixed part 42 Guide hole 44 Second fixing groove 46 Guide protrusion 48 Washer 50 screws 52 Recessed storage area 54 coil spring 56 Cover member 58 Slope section 60 flat area 62 Cover Frame 64 Rod Frame 66 Legs 68 Cover side wall 70 Cover top wall 74 First insertion hole (insertion hole) 76 Second insertion hole (insertion hole) 78 First valve body 80 First insertion hole 82 Slit 84 Second valve body 86 Second insertion hole 87 Slit 88 Cover support member 88a first support member 88b Second support member 90a inner circumference 90b outer periphery 92 Peripheral wall 100 knobs 102 Notch 104 Peripheral wall 106 Notch 112 Cover member fixing mechanism 114,116 intervertebral disc 118 Gap 120 Neural Model 120a Cauda equina imitation part 120b Nerve root imitation 122 Fibrous interior materials 124 Covering layer 126 Bracket 127 pin holes 128 Engagement protrusion 130 Model Fixing Mechanism 136 Main body 138 1st lumen 140 second lumen 142 third lumen 144 Suction port 146 Discharge port 148 Cameras 150 slits 152 Valve 154 Suction tube 156 Discharge tube 158 Pump (circulation device) 160 Filter (filtration device) 162 Cable 163 Connector 164 monitors 166 Light (lighting equipment) 170 Orthopedic Technique Training Device 172 Model Fixing Mechanism 174 Rock Club 176 Second fixed part 178 Rotating shaft 180 Support part 182 Hole 184 Operation hole L3 3rd lumbar vertebra L4 4th lumbar vertebra L5 5th lumbar vertebra

Claims

1. a water tank in which a skeleton model is fixed and which contains a transparent liquid that covers the skeleton model; an endoscope whose tip portion is inserted into the water tank and has at least one of a suction port for sucking the transparent liquid from the water tank and a discharge port for discharging the transparent liquid into the water tank at the tip portion; It is equipped with An orthopedic technique training device used for training in techniques in which cutting powder is produced from the skeletal model by crushing or cutting the skeletal model.

2. a filtering device that filters the transparent liquid sucked from the water tank; The orthopedic technique training device according to claim 1, further comprising a circulation device that circulates the transparent liquid by discharging the transparent liquid filtered by the filtration device into the water tank.

3. 3. The orthopedic technique training device according to claim 1, wherein both the suction port and the discharge port are provided at the tip portion of the endoscope.

4. 4. The orthopedic technique training device according to claim 1, wherein the water tank has a peripheral wall at least part of which is transparent.

5. a cover member that covers the skeleton model from above is attached to the water tank; 5. The orthopedic technique training device according to claim 1, wherein the cover member has an insertion hole through which the endoscope is inserted, and the endoscope is inserted into the water tank through the insertion hole.

6. a water tank in which a skeleton model is fixed and which contains a transparent liquid that covers the skeleton model; an endoscope whose tip portion is inserted into the water tank; a model fixing mechanism that directly and detachably fixes the lower side of the skeleton model to the bottom wall of the water tank; It is equipped with An orthopedic technique training device used for training techniques that directly apply external forces to the skeletal model.

7. a bracket is provided on the skeletal model; 7. An orthopedic technique training device according to claim 6, wherein the bracket is detachably attached to the bottom wall of the water tank by the model fixing mechanism.

8. A skeletal model for use in an orthopedic technique training device, comprising a water tank containing a transparent liquid and an endoscope whose tip is inserted into the water tank, It is made up of a multi-layer structure consisting of multiple layers with different hardness. The outermost layer is harder than the inner layer, a bracket that is detachably fixed to a wall of the aquarium, the bracket being formed as a separate member from the outermost layer and attached to the outermost layer in an overlapping state; The bracket allows the skeleton model to be selectively positioned and fixed at different positions around a vertical axis within the water tank.

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