Organ models, endoscopy training devices

Abstract

To provide an organ model or the like capable of obtaining hand feeling close to that of inserting into an actual organ, when inserting an endoscope.SOLUTION: A large intestine model for endoscopic examination training includes a tube 11. The tube 11 includes a first layer formed of an elastic material, and a second layer formed of an elongation control material. In the tube 11, a cross-sectional shape in the natural state forms an oval shape crushed by its own weight.SELECTED DRAWING: Figure 6

Description

[Technical field]

[0001] The present invention relates to an organ model having a lumen configured to allow an insertion portion of an endoscope to be inserted therethrough, and an endoscopic examination training device including an organ model having a lumen. [Background technology]

[0002] Among organs, the large intestine, which has a lumen, has a complex shape compared to some other organs. Therefore, advanced technology is required to insert an endoscope into the large intestine. Therefore, a large intestine model has been proposed for training in colon examinations using an endoscope.

[0003] For example, Japanese Patent Application Laid-Open Publication No. 58-192522 describes a large intestine model in which liquid rubber is applied to both sides of a braided body made of elastic threads. Because the large intestine model has a braided body, it has the strength to prevent breakage even if the tube wall is made thin so that it can expand and contract in response to air supply and suction, and also has the elasticity to maintain the tubular shape without the lumen collapsing even in its natural state.

[0004] Also, a large intestine model made of a rubber tube without a braided elastic thread has been proposed. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Japanese Patent Application Publication No. 58-192522 Summary of the Invention [Problem to be solved by the invention]

[0006] The conventional colon model is molded to maintain a luminal shape in its natural state. Therefore, even when the endoscope is inserted into the colon model, the surgeon does not feel any resistance to insertion until the endoscope comes into contact with the inner wall of the colon model. Once the endoscope comes into contact with the inner wall of the colon model, the tip and sides of the endoscope stretch the colon model, and the surgeon suddenly feels a large resistance to insertion.

[0007] In the case of an actual large intestine in a living body, the lumen is almost completely collapsed if there is no content. Therefore, when an endoscope is inserted into the actual large intestine, the endoscope is constantly in contact with the intestinal tract as soon as the insertion begins. The surgeon will always feel the insertion resistance at his / her hand as the endoscope advances while in contact with the mucous membrane of the intestinal tract. Furthermore, when the endoscope is pushed into the actual large intestine, at the point where the insertion part of the endoscope stretches the large intestine, the insertion resistance felt by the surgeon at his / her hand increases dramatically compared to before.

[0008] Thus, with conventional organ models having a lumen, such as the large intestine model, the tactile sensation that an operator feels when inserting an endoscope differs from the tactile sensation that an operator feels when inserting an endoscope into an actual organ such as the large intestine, making it difficult to fully master the techniques necessary to examine an actual subject.

[0009] The present invention has been made in consideration of the above circumstances, and aims to provide an organ model that provides a tactile sensation similar to that obtained when inserting an endoscope into an actual organ, and an endoscopic examination training device equipped with the organ model. [Means for solving the problem]

[0010] An organ model according to one aspect of the present invention is an organ model for endoscopic examination training, comprising a tube and configured so that an insertion portion of an endoscope is inserted in the direction of a longitudinal axis of a hollow space of the tube, the tube being formed by laminating a plurality of layers in a wall thickness direction, the layers including a first layer formed of an elastic material and a second layer formed of an elongation-regulating material that regulates the elongation of the first layer; In front of the tube Longitudinal axis Focus on the direction Force direction and intersection When the endoscope is inserted into the tube, the endoscope is automatically inserted into the tube. In its natural state, the cross-sectional shape of the tube in a direction intersecting the longitudinal axis is an oval shape that is crushed under its own weight.

[0011] An endoscopy training device according to one aspect of the present invention comprises the organ model. Effect of the Invention

[0012] According to the organ model and endoscopic examination training device of the present invention, when an endoscope is inserted, a tactile sensation similar to that obtained when the endoscope is inserted into an actual organ can be obtained. [Brief description of the drawings]

[0013] [Figure 1] 1 is a perspective view showing the appearance of an endoscopic examination training device in a first embodiment of the present invention. FIG. [Diagram 2] FIG. 11 is a plan view showing an example of organ models arranged in a torso model, which can be seen when an abdominal cover is opened in the first embodiment. [Diagram 3] FIG. 2 is a perspective view showing the appearance of a part of the large intestine model in the first embodiment. [Figure 4] FIG. 3 is a cross-sectional view showing a configuration in a wall thickness direction of a tube included in the large intestine model in the first embodiment. [Diagram 5] FIG. 3 is a diagram showing an example of a warp knitted fabric as a network structure used in a second layer in the first embodiment. [Figure 6] 13 is a diagram showing examples of cross-sectional shapes of tubes included in the large intestine model in a direction intersecting with a longitudinal axis in a natural state in the first embodiment. [Figure 7] 11 is a table for explaining an effect according to an insertion depth when an insertion part of an endoscope is inserted into a large intestine model in the first embodiment, in comparison with a conventional large intestine model. [Figure 8] 13 is a graph showing an example in which a reaction force received by an insertion section of an endoscope from a large intestine model is compared with a reaction force received from a conventional large intestine model in the first embodiment. [Figure 9] 13 is a chart showing an example in which the network structure constituting the second layer changes in response to stretching of the large intestine model in the first embodiment. [Figure 10] FIG. 2 is a cross-sectional view of a portion of the large intestine model including a fold-forming member in the first embodiment, taken in a direction intersecting with the longitudinal axis. [Figure 11] In the first embodiment, panel A is a front view of the pleat forming member, and panel B is a 10B-10B cross-sectional view of panel A. [Figure 12] FIG. 4 is a cross-sectional view showing a modified example of the large intestine model in the first embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0014] Hereinafter, an embodiment of the present invention will be described with reference to the drawings. However, the present invention is not limited to the embodiment described below.

[0015] In the drawings, the same or corresponding elements are appropriately labeled with the same reference numerals. In addition, in the drawings used in the following description, the scale of each element may be different so that each element is large enough to be recognized on the drawing. The present invention is not limited only to the quantity of elements, the shape of elements, the size ratio of elements, and the relative positional relationship of elements depicted in each drawing. [First embodiment]

[0016] 1 to 12 show a first embodiment of the present invention, and FIG. 1 is a perspective view showing the appearance of an endoscopic examination training device 1. FIG.

[0017] The endoscopic examination training device 1 includes one or more organ models having a lumen. In this embodiment, a large intestine model 5 for endoscopic examination training, which will be described below, is taken as an example of an organ model having a lumen, but the configuration of this embodiment may be applied to models of organs other than the large intestine.

[0018] As shown in Fig. 1, the endoscopic examination training device 1 is equipped with a torso model 2 which models the torso part of a human body. Note that in the torso model 2 shown in Fig. 1, the upper left side of Fig. 1 corresponds to the upper side of the human body, and the lower right side of Fig. 1 corresponds to the lower side of the human body.

[0019] An abdominal cover 3 is provided on the upper surface of the torso model 2 so as to be able to be opened and closed freely. An anus model 4 is provided on one end surface 2a of the torso model 2 corresponding to the lower side of the human body. The anus model 4 is an opening that serves as an entrance when an endoscope 80 (see FIG. 7, etc.) is inserted into the large intestine model 5. A specific example of the endoscope 80 here is a large intestine endoscope.

[0020] FIG. 2 is a plan view showing an example of organ models arranged in the torso model 2, which can be seen when the abdominal cover 3 is opened.

[0021] As shown in Fig. 2, a large intestine model 5 is disposed as an organ model inside the torso model 2. One end of the large intestine model 5 is the above-mentioned anus model 4, and the other end is a terminal part 6 sealed by a removable plug. In Fig. 2, the large intestine model 5, the anus model 4, and the terminal part 6 are hatched to make them easier to distinguish from the other organ models.

[0022] Furthermore, in order to approximate the internal organ arrangement of an actual human body, a stomach model 7, a small intestine model 8, a pancreas model 9, etc. are arranged inside the torso model 2. The stomach model 7, the small intestine model 8, and the pancreas model 9 are each formed, for example, from an elastic material, and are arranged so as to press a part of the large intestine model 5, just like in an actual human body.

[0023] Furthermore, the abdominal cover 3 attached to the torso model 2 so as to be freely opened and closed is also formed of, for example, an elastic material. When the abdominal cover 3 is closed on the torso model 2, the abdominal cover 3 is structured to press a part of the large intestine model 5, similar to an actual human body. Note that, in this embodiment, other organ models and the abdominal cover 3 are arranged, but the present invention is not limited to this embodiment, and only the large intestine model 5 may be arranged on the torso model 2 for use.

[0024] FIG. 3 is a perspective view showing the appearance of the large intestine model 5 with some parts omitted.

[0025] As described above, the large intestine model 5 includes the anus model 4 and the end portion 6, with the anus model 4 provided on one end side and the end portion 6 provided on the other end side.

[0026] The large intestine model 5 includes a tube 11, which is an intestinal model (an intestinal tube simulating the intestinal tract). The tube 11 has a hollow space therein, and is configured so that an insertion portion 81 (see FIG. 7, etc.) of an endoscope 80 is inserted in the direction of the longitudinal axis of the hollow space.

[0027] FIG. 4 is a cross-sectional view showing the configuration in the thickness direction of the tube 11 included in the large intestine model 5. As shown in FIG.

[0028] The tube 11 is constructed by laminating multiple layers in the thickness direction, including a first layer 15 formed of an elastic material and a second layer 16 formed of an elongation-regulating material that regulates the elongation of the first layer 15.

[0029] In the example shown in Fig. 4, the first layer 15 includes two layers, a first layer 15a provided on one surface of the second layer 16 and a first layer 15b provided on the other surface of the second layer 16. However, a configuration in which only one first layer 15 is provided may be used, or the tube 11 may further include layers other than the first layer 15 and the second layer 16. Note that in Fig. 4 and drawings other than Fig. 10 described later, illustration of the tube 11 being configured by laminating the first layer 15a, the second layer 16, and the first layer 15b in the wall thickness direction is omitted.

[0030] The elastic material forming the first layer 15 is an elastic material having a small bending rigidity, for example, a material having a value of 10 or less (so-called Shore hardness A10 degrees) measured by a type A durometer conforming to JIS K 6253.

[0031] A specific example of the elastic material is a silicone resin, which is a synthetic polymer compound having a main skeleton formed by siloxane bonds. However, it is not limited to silicone resin, and elastic materials such as rubber, urethane, and fluororesin may also be used.

[0032] The elongation-regulating material forming the second layer 16 has low bending rigidity, and is preferably a material that has anisotropic elongation.

[0033] The stretch-regulating material can be suitably a mesh structure such as a yarn mesh sheet (see FIG. 8) made by weaving yarn.

[0034] The network structure is made of, for example, fiber fabric. Fiber fabric is mainly classified into woven fabric, knitted fabric, and nonwoven fabric. Woven fabric is basically formed by warp threads and weft threads crossing at right angles to form a structure. Knitted fabric forms a structure by looping threads continuously. In contrast to woven fabric and knitted fabric that use twisted fiber threads, nonwoven fabric is made by intertwining untwisted fiber threads into a sheet shape.

[0035] Woven fabrics basically have relatively small stretchability in the longitudinal and transverse directions. Knitted fabrics generally have stretchability in the longitudinal and transverse directions compared to woven fabrics. Nonwoven fabrics have no directionality in strength and stretchability when fibers are randomly bonded, and have low strength compared to woven fabrics and knitted fabrics. For this reason, it is preferable to use knitted fabrics as the network structure used in the stretch-regulated material.

[0036] Knitting is classified into warp knitting, in which the yarn is advanced vertically to create continuous loops, and weft knitting, in which the yarn is advanced horizontally to create continuous loops.

[0037] Among warp knitting methods, raschel knitting, tricot knitting, etc. are examples of knitting methods that have elasticity and anisotropy of elasticity and have little unevenness when formed into a sheet. Figure 5 is a diagram showing an example of a warp knitted fabric as a net-like structure used in the second layer 16. Warp knitting is formed by weaving together a plurality of warp threads 17, and in Figure 5, one warp thread 17 is hatched to make the mesh easier to understand.

[0038] Among weft knitting methods, there is elasticity and anisotropy of elasticity, and examples of knitting methods that have little unevenness when formed into a sheet include flat knitting, rib knitting, etc. In this embodiment, the anisotropy of elasticity is achieved by arranging the network structure in a direction that makes it difficult to stretch in the longitudinal axis direction and easy to stretch in the radial direction.

[0039] As a suitable example, the network structure of the present embodiment is configured as a knitted fabric made by raschel knitting yarns formed from a material obtained by synthesizing or blending PET (polyethylene terephthalate) and polyurethane. By adding polyurethane to the material forming the yarns, a highly elastic knitted fabric can be configured.

[0040] In addition, as the net-like structure, any knitted fabric, including the above-mentioned examples, may be used, whether warp knitted or weft knitted. Furthermore, for example, by using elastic yarns in which the elasticity of the warp yarns and the elasticity of the weft yarns are different, a woven fabric may be used as the net-like structure. In addition, some nonwoven fabrics are made of ultrafine fibers to achieve high elasticity and are used as base fabrics for first aid bandages, medical tapes, etc. Considering these points, any appropriately constructed nonwoven fabric may be used as the net-like structure.

[0041] When the network structure is made of threads (or fibers), any of natural threads (natural fibers), synthetic threads (synthetic fibers), metal threads (metal fibers), and the like may be used.

[0042] The second layer 16 has anisotropy in which it is more easily stretched in a second direction intersecting the first direction than in the first direction. When the stretch-regulating material is a network structure, it is configured as a knitted fabric that is more easily stretched in the second direction than in the first direction, for example.

[0043] In this embodiment, as an example of an arrangement close to the properties of an actual large intestine, the second layer 16 is configured by arranging the network structure so that the first direction coincides with the direction of the longitudinal axis of the hollow space of the tube 11 and the second direction coincides with the direction intersecting the longitudinal axis.

[0044] In this manner, the large intestine model 5 made of an elastic material, a network structure, and the like, is capable of deforming according to the insertion state of the insertion portion 81 of the endoscope 80.

[0045] FIG. 6 is a diagram showing an example of a cross-sectional shape of the tube 11 included in the large intestine model 5 in a natural state, the cross-sectional shape being taken in a direction intersecting with the longitudinal axis.

[0046] The tube 11 is formed so that in a natural state when the direction of the longitudinal axis intersects with the direction of gravity G, the cross-sectional shape in the direction intersecting with the longitudinal axis is an oval shape that is crushed by its own weight. Here, the oval shape broadly includes various shapes that are deformations of a perfect circle. Examples of oval shapes include an ellipse, an oval (a shape in which both ends of a pair of parallel line segments are connected by a semicircle), a rugby ball shape, an egg shape, a gourd shape, etc., and also includes cases where these shapes are crushed to a nearly flat shape by their own weight, and cases where these shapes have folds or wrinkles.

[0047] Column A in Fig. 6 shows an example of a tube 11 formed from a soft material with low bending rigidity. The top and bottom of the insertion section 81 of the endoscope 80 inserted into the tube 11 are in contact with the inner wall of the tube 11. Furthermore, in the portion where the insertion section 81 is not inserted, the tube 11 is crushed to a nearly flat shape by its own weight. Although not shown, in the state where the insertion section 81 is not inserted, the tube 11 is crushed to a nearly flat shape by its own weight. Therefore, the top and bottom of the inner wall of the tube 11 are in contact at one or more points.

[0048] 6, panels B1 and B2 show examples of the tube 11 made of a material with low bending rigidity (although the bending rigidity is somewhat higher than that of panel A). Panel B1 shows the tube 11 with the insertion part 81 inserted, and panel B2 shows the tube 11 with the insertion part 81 not inserted.

[0049] In the state where the insertion portion 81 is inserted, the cross section of the tube 11 has a substantially elliptical shape with the part where the insertion portion 81 is in contact being the minor axis, as shown in section B1.

[0050] On the other hand, when the insertion part 81 is not inserted, the cross section of the tube 11 has the center of the tube wall sagging due to its own weight, and the top and bottom of the inner wall are in contact at the center, as shown in section B2. Also, because a force acts on the left and right sides of the inner wall of the tube 11 against the reduction in the radius of curvature, the radius of curvature is prevented from decreasing below a certain value, and the left and right sides form an arc shape with a radius of curvature close to that shown in section B1.

[0051] Column C of Fig. 6 shows an example of a tube 11 with pleats. The pleats cause the cross-sectional shape of the tube 11 to have irregularities, but in the natural state of the tube 11, parts of the inner walls facing each other across the longitudinal axis are in contact with each other at multiple points due to their own weight.

[0052] The tube 11 shown in column C of Fig. 6 is provided with a pleat-forming member 12, which will be described later, so that pleats are formed in a natural state. However, the tube 11 may be molded so that pleats are formed in a natural state without providing the pleat-forming member 12. Alternatively, when setting the large intestine model 5 on the endoscopy examination training apparatus 1, the user or manufacturer may set the large intestine model 5 so that pleats are formed.

[0053] However, as shown in lines A, B1, and B2 of FIG. 6, the tube 11 does not have to be provided with pleats.

[0054] In this way, since the tube 11 is made of a material with low bending rigidity, the tube 11 is in a collapsed state due to its own weight in a natural state. This coincides with the collapsed state of the large intestine of the human body in a natural state without air being supplied. Therefore, the large intestine model 5 formed using the tube 11 has a configuration that is highly similar to the actual large intestine.

[0055] Furthermore, when the insertion portion 81 of the endoscope 80 is inserted into the large intestine model 5, the inner wall of the tube 11 always comes into contact with the insertion portion 81. This contact state is also highly similar to that of the actual large intestine.

[0056] Next, FIG. 7 is a chart for explaining the effect according to the insertion depth when the insertion portion 81 of the endoscope 80 is inserted into the large intestine model 5, in comparison with a conventional large intestine model 91. In FIG.

[0057] Column 3 of FIG. 7 shows an example of a state in which the insertion portion 81 of the endoscope 80 is inserted into the large intestine model 5.

[0058] In each of columns 1 to 3 of Figure 7, column A shows the state when the tip 81a of the insertion portion 81 has not yet reached the bent portion 5a of the large intestine model 5 (see column 3A), column B shows the state when the tip 81a of the insertion portion 81 has reached and passed through the bent portion 5a of the large intestine model 5 (see column 3B), and column C shows the state when the bent portion 5a is being pressed by the insertion portion 81 as it passes through the bent portion 5a of the large intestine model 5 (see column 3C).

[0059] Column 1 of FIG. 7 shows the effect according to the insertion depth when the insertion portion 81 of the endoscope 80 is inserted into the conventional large intestine model 91.

[0060] A conventional large intestine model 91 is configured, for example, as a rubber tube that maintains a luminal shape in which the cross section perpendicular to the longitudinal axis is substantially circular in its natural state. In this case, even if the insertion portion 81 is inserted into the large intestine model 91, when the insertion portion 81 is not in contact with the inner wall of the large intestine model 91 as shown in section 1A, the user cannot feel that the insertion portion 81 is inserted into the large intestine model 91.

[0061] Thereafter, as shown in column 1B, when the insertion portion 81 is being inserted into the large intestine model 91, at the point when the insertion portion 81 comes into contact with the inner wall of the large intestine model 91, the insertion portion 81 receives a reaction force due to the contact with the large intestine model 91.

[0062] When the insertion portion 81 is further pushed into the large intestine model 91, the large intestine model 91 stretches in a direction intersecting the longitudinal axis (e.g., in the radial direction) according to the amount of insertion, and the insertion portion 81 receives a reaction force according to the length of stretching (see the dashed line in the graph shown in Figure 8).

[0063] Column 2 of Fig. 7 shows the action according to the insertion depth when the insertion part 81 of the endoscope 80 is inserted into the large intestine model 5 of this embodiment. Note that column 2 of Fig. 7 shows an example in which the large intestine model 5 is the type shown in column A of Fig. 6.

[0064] As described above, the large intestine model 5 of this embodiment has a collapsed luminal shape in its natural state, so that, as shown in section 2A, the insertion portion 81 abuts against the inner wall of the large intestine model 5 from the moment insertion begins and receives a reaction force P from the large intestine model 5.

[0065] Therefore, in the large intestine model 5 of this embodiment, from the moment the insertion part 81 is inserted, a tactile sensation of insertion into the intestinal tract is obtained. This tactile sensation is highly similar to that obtained when the insertion part is inserted into the intestinal tract of a living organism (e.g., a human body). In this way, it is possible to eliminate the discomfort felt in the conventional large intestine model 91 shown in column 1A of Fig. 7, that is, the discomfort of not getting a tactile sensation of insertion even after starting to insert the insertion part 81.

[0066] Thereafter, as shown in section 2B, the insertion portion 81 reaches the bent portion 5a of the large intestine model 5 and presses the bent portion 5a so as to lift it up. Then, as shown from the left to the right diagram in section 1B, the wall of the large intestine model 5 that had been crushed horizontally gradually shifts to a state in which it sags in the direction of gravity G.

[0067] When the insertion portion 81 is further pushed into the large intestine model 5, as shown in section 2C, the insertion portion 81 stretches the curved portion 5a radially, and the reaction force P that the insertion portion 81 receives changes from before it was stretched radially.

[0068] Fig. 8 is a graph showing an example in which the reaction force P that the insertion section 81 of the endoscope 80 receives from the large intestine model 5 is compared with the reaction force that the insertion section 81 receives from a conventional large intestine model 91. Fig. 9 is a chart showing an example in which the network structure constituting the second layer 16 changes in response to the elongation of the large intestine model 5.

[0069] As shown in column A of Figure 9, when force is applied to the second layer 16 formed of a network structure in a tensile direction from its natural state, the closed mesh gradually opens, allowing it to be stretched with a small amount of force (a specified amount or less).

[0070] When the second layer 16 is stretched to a certain amount (certain ratio), the mesh of the network structure becomes fully opened, as shown in column B of Figure 9, and if it is pulled further, the threads that make up the network structure themselves will transition to a state in which they are stretched, and the amount of force required for pulling will suddenly increase.

[0071] When the insertion portion 81 of the endoscope 80 is inserted into a large intestine model 5 formed using such a mesh-like structure, the reaction force P that the insertion portion 81 receives from the large intestine model 5 is, for example, as shown by the solid line in Figure 8.

[0072] First, from the start of insertion of the insertion portion 81 until the radial stretch amount L of the large intestine model 5 reaches a predetermined threshold value L1, the increase rate of the reaction force P with respect to the stretch amount L is relatively low (P1 / L1).

[0073] Thereafter, when the stretch amount L reaches a predetermined threshold value L1, the large intestine model 5 transitions from the state shown in section 2B of Fig. 7 to the state shown in section 2C of Fig. 7. Then, the mesh of the network structure constituting the second layer 16 widens as shown in section B of Fig. 9, providing a large resistance to further stretching. As a result, the rate of increase of the reaction force P relative to the stretch amount L becomes a rate of increase [(P2-P1) / (L2-L1)], which is higher than the above-mentioned rate of increase (P1 / L1).

[0074] Thus, when tube 11 stretches in a direction intersecting the longitudinal axis (e.g., radially), the rate of increase in the reaction force generated by tube 11 against the stretch is greater when the length of tube 11 in the direction intersecting the longitudinal axis is equal to or greater than a predetermined threshold value L1 ((P2-P1) / (L2-L1)) than when the length of tube 11 in the direction intersecting the longitudinal axis is less than a predetermined threshold value L1 (P1 / L1).

[0075] When applying force to an actual large intestine to stretch it in the radial direction, a small amount of force is required up to a certain amount of stretching, but once the amount of stretching exceeds the certain amount, a large amount of force is suddenly required. Therefore, the large intestine model 5 of this embodiment is highly similar to an actual large intestine.

[0076] Because the reaction force P received by the endoscope 80 changes suddenly around a predetermined threshold L1 in the amount of extension, the surgeon can sense that the amount by which the endoscope 80 is pushed is about to exceed the appropriate range.

[0077] Moreover, the dashed dotted line in FIG. 8 indicates an example of a reaction force P when the insertion portion 81 is inserted into the conventional large intestine model 91.

[0078] As described above, the conventional large intestine model 91 maintains a lumen shape with a substantially circular cross section in a natural state, so that even when the insertion portion 81 is inserted, no reaction force P is generated until the insertion portion 81 comes into contact with the inner wall of the large intestine model 91. For this reason, the hand feels unnatural compared to the large intestine of an actual human body.

[0079] Then, after the insertion portion 81 is inserted into the large intestine model 91, a reaction force P is suddenly generated at the point when the insertion portion 81 comes into contact with the inner wall of the large intestine model 91. After the contact, a reaction force P proportional to the radial extension amount L of the large intestine model 91 is generated as shown by the dashed line in Figure 8. If the reaction force P is proportional to the pushing amount, it is not possible to sense the appropriate limit of the pushing amount, and it is difficult to determine how far the endoscope 80 can be pushed in.

[0080] The dashed-dotted line in FIG. 8 shows an example of the reaction force P generated in the large intestine model 91, which has a thick tube wall for durability. In this case, the rate of increase in reaction force P relative to the amount of stretch L is relatively large. Therefore, when the surgeon inserts the endoscope 80 into the conventional large intestine model 91, the surgeon feels that the model is much harder to the touch than the intestinal tract of the human body. However, if the tube wall of the large intestine model 91 is made thinner, the rate of increase in reaction force P relative to the amount of stretch L becomes smaller, and the model can feel softer to the touch. In both the large intestine model 5 of this embodiment and the conventional large intestine model 91, the hardness / softness can be adjusted by changing the thickness and material of the tube wall.

[0081] The conventional large intestine model 91 is configured as a rubber tube, and does not have a second layer 16 formed of an elongation-restricting material. For this reason, the large intestine model 91 can be stretched even beyond the elongation amount L2 of the large intestine model 5 of this embodiment. For example, the large intestine model 91 stretches to an elongation amount L3 (L3>L2) that is impossible in an actual case, and applies a reaction force P3 to the insertion portion 81. At this time, the surgeon feels a tactile sensation that is significantly different from that when the endoscope 80 is inserted into the large intestine of an actual human body.

[0082] The large intestine model 5 of this embodiment may further include a fold-forming member 12, as shown in Fig. 3. The fold-forming member 12 is provided to form folds in the tube 11, simulating the folds in the large intestine of the human body.

[0083] The pleat-forming member 12 is, for example, a pleat-forming ring having an annular (torus-like) shape. The length of the pleat-forming member 12 along the annular shape is configured to be shorter than the length around the longitudinal axis of the surface of the tube 11. Therefore, when the pleat-forming member 12 and the tube 11 are brought into a state in which the cross section is circular, the ring diameter of the pleat-forming member 12 is smaller than the tube diameter of the tube 11.

[0084] The amount of pleats provided in tube 11 can be adjusted by changing the ring diameter of pleat-forming member 12. For example, to reduce the number of pleats, the ring diameter of pleat-forming member 12 can be made closer to the tube diameter of tube 11. On the other hand, to increase the number of pleats, the ring diameter of pleat-forming member 12 can be made significantly shorter than the tube diameter of tube 11.

[0085] The pleat-forming member 12, like the tube 11, is formed from an elastic material having a value of 10 or less (so-called Shore hardness A10 degrees) when measured with a type A durometer conforming to JIS K 6253. The pleat-forming member 12 may be formed from the same Shore hardness and the same elastic material (silicone resin, rubber, urethane, fluororesin, etc.) as the tube 11, but the Shore hardness may be different, or the pleat-forming member 12 may be formed from a different elastic material.

[0086] The fold-forming member 12 is fixed to the surface (inner surface or outer surface) of the tube 11 so that the annular central axis is aligned with the longitudinal axis of the tube 11. However, if the fold-forming member 12 is fixed to the inner surface of the tube 11, the insertion portion 81 of the endoscope 80 will come into contact with the fold-forming member 12 when passing through the hollow space of the tube 11, giving an unnatural feeling in the hand, such as a feeling of being caught.

[0087] For this reason, it is preferable to fix the pleat forming member 12 to the outer surface of the tube 11. In this case, the length of the pleat forming member 12 along the annular shape is shorter than the length of the outer surface of the tube 11 around the longitudinal axis.

[0088] The large intestine model 5 is molded to a length that matches the large intestine of an actual human body. For this purpose, a plurality of pleat-forming members 12 are provided, for example, at predetermined intervals along the longitudinal axis of the tube 11, so that pleats are formed throughout the large intestine model.

[0089] Fig. 10 is a cross-sectional view of a portion of the large intestine model 5 including the fold-forming member 12, cut in a direction intersecting with the longitudinal axis. In Fig. 11, panel A is a front view of the fold-forming member 12, and panel B is a 10B-10B cross-sectional view of panel A. Note that in Figs. 10 and 11, the cross-sectional shape is made circular for ease of viewing, but in the natural state, it has a collapsed luminal shape as described above. Also, illustration of folds is omitted in Figs. 10 and 11.

[0090] 10, the pleat-forming member 12 is adhered to the outer peripheral surface of the tube 11 in a contracted state, for example, by using an adhesive 13. As the adhesive 13, a general adhesive suitable for adhering materials such as resin and rubber to each other can be used.

[0091] 11, the pleat-forming member 12 is molded such that the inner peripheral side of the annular shape has, for example, a linear cross section, that is, when viewed three-dimensionally, a cylindrical surface 12a centered on the central axis of the annular shape. This configuration ensures an adhesive area, and the pleat-forming member 12 can be reliably bonded to the outer peripheral surface of the tube 11. Also, the pleat-forming member 12 is molded such that the outer peripheral side of the annular shape has an arc-shaped cross section, for example a semicircular cross section, in order to reduce the force it receives when it comes into contact with another object.

[0092] When the pleat-forming member 12 is bonded to the inner peripheral surface of the tube 11, the outer peripheral side of the ring may be molded into a cylindrical surface, and the inner peripheral side of the ring may be molded into an arc-shaped cross section.

[0093] However, the pleat forming members 12 may be formed to have other cross-sectional shapes, such as a circle, a square, or the like.

[0094] FIG. 12 is a cross-sectional view showing a modified example of the large intestine model 5. As shown in FIG.

[0095] In the large intestine model 5 of this modified example, a flexible resin coat 18 is provided on at least a portion of the outer surface of the tube 11. The resin coat 18 is provided so that a plurality of projections and recesses are formed on the tube 11 along the longitudinal axis direction. The resin coat 18 is provided, for example, by applying an adhesive that remains flexible even after hardening to the tube 11.

[0096] 12 shows an example in which a plurality of pleat-forming members 12 are provided at predetermined intervals along the longitudinal axis of the tube 11. In this configuration, a resin coating 18 is provided at appropriate locations on the outer surfaces of the tube 11 and the pleat-forming members 12 so that the portions where the pleat-forming members 12 are provided become valleys (concave) 5v and the intermediate portions between two adjacent pleat-forming members 12 become peaks (convex) 5p. The resin coating 18 is provided by applying adhesive to the portions that will become the peaks 5p and hardening the adhesive to form peaks (peak creases) and by applying adhesive to the portions that will become the valleys 5v and hardening the adhesive to form valleys (valley creases).

[0097] The resin coating 18 may be provided on the entire surfaces of the tube 11 and the pleat-forming member 12, with peaks 5p and valleys 5v being formed alternately along the longitudinal axis direction.

[0098] However, in the actual large intestine of a human body, peaks and valleys are not formed regularly at regular intervals, but are irregular. Therefore, it is advisable to provide a resin coat 18 randomly in places on the surfaces of the tube 11 and the pleat-forming member 12 where peaks (convex) 5p and valleys (concave) 5v are to be formed. This allows the peaks 5p and valleys 5v to be formed randomly along the longitudinal axis, making the large intestine model 5 closer to the shape of an actual large intestine.

[0099] When the large intestine model 5 having peaks 5p and valleys 5v formed along the longitudinal axis is sucked by the suction channel provided in the insertion portion 81, the large intestine model 5 contracts like an accordion, and the peaks 5p move in the outer diameter direction. When suction by the suction channel is stopped, the large intestine model 5 expands like an accordion, and the peaks 5p move in the inner diameter direction, returning to its natural state.

[0100] The radial thickness of the portion where the fold-forming member 12 that becomes the valley 5v is provided is the sum of the thickness of the fold-forming member 12 itself and the thickness of the tube 11. In contrast, the radial thickness of the portion where the peak 5p of the large intestine model 5 becomes the thickness of the tube 11. For this reason, the valley 5v is less likely to move in the radial direction than the peak 5p, and the state of the valley 5v can be maintained even when suction / stop of suction is performed.

[0101] However, in order to more reliably maintain the valley 5v state, the bending rigidity of the pleat-forming member 12 may be made greater than the bending rigidity of the tube 11 within the above-mentioned range of Shore hardness A10 degrees.

[0102] Furthermore, when an operation for shortening the length of the large intestine model 5 in the longitudinal axis direction (shortening operation) is performed or the shortening operation is stopped, the large intestine model 5 also expands and contracts like an accordion, similar to suction / stop of suction.

[0103] Incidentally, when using the large intestine model 5, the surgeon or the surgeon's assistant applies a first lubricant to the inner wall of the large intestine model 5 before use, and appropriately applies a second lubricant to the surface of the insertion portion 81 of the endoscope 80 before insertion.

[0104] Conventionally, the first lubricant has been, for example, a mixture of sodium polyacrylate, which is a type of highly water-absorbent polymer, and water.

[0105] In contrast, in this embodiment, a mixture of Endorubri (registered trademark) and glycerin is used as the first lubricant. Endorubri (registered trademark) is a medical lubricant jelly containing about 10% glycerin and other ingredients such as water, propylene glycol, hydroxyethyl cellulose, paraben, and sodium bicarbonate. Therefore, in this embodiment, a first lubricant different from conventional lubricants is used.

[0106] In addition, Endlubri (registered trademark) is used as the second lubricant.

[0107] By applying a first lubricant to the large intestine model 5 and a second lubricant to the insertion portion 81 of the endoscope 80, the large intestine model 5 clings to the insertion portion 81, as shown in column 2 of Figure 7, for example, and a tactile sensation highly similar to that when inserted into an actual large intestine is obtained.

[0108] According to the first embodiment, the tube 11 constituting the large intestine model 5 of the endoscopic examination training device 1 is formed from multiple layers including a first layer 15 formed from an elastic material and a second layer 16 formed from a stretch-regulating material, so that the stretch-regulating material can prevent stretching that would not occur in an actual case.

[0109] Furthermore, because the cross-sectional shape of the tube 11 in its natural state is an oval shape that is crushed by its own weight, when the endoscope 80 is inserted, the large intestine model 5 clings to and comes into contact with the insertion portion 81. This allows the surgeon to constantly feel the resistance from the large intestine model 5 in his hand, providing a tactile sensation highly similar to that experienced when inserting into an actual large intestine.

[0110] Furthermore, by making the second layer 16 anisotropic in terms of stretchability and more easily stretchable in a direction intersecting the longitudinal axis than in the longitudinal axis direction, a large intestine model 5 having stretchability similar to that of an actual large intestine can be obtained.

[0111] Since a network structure having anisotropic stretchability is used as the second layer 16, the large intestine model 5 can be easily manufactured by overlapping a layer of an elastic material on a layer of the network structure.

[0112] The rate of increase in the reaction force generated by the tube 11 against the stretching is set to be greater when the reaction force is equal to or greater than a predetermined threshold value L1 than when the reaction force is less than the predetermined threshold value L1, as shown in Fig. 8. For this reason, when the endoscope 80 is pushed in beyond a certain point, the resistance felt by the surgeon at his / her hand increases suddenly, and the change in the amount of force that would require the surgeon to ease up on the pushing force in an actual case can be appropriately reproduced in the training.

[0113] When the pleat forming member 12 is further fixed to the surface of the tube 11, it is possible to prevent the tube 11 from collapsing too much when air is not being supplied, and also to prevent a specific portion of the tube 11 from expanding too much when air is being supplied.

[0114] In particular, when the fold forming member 12 is fixed to the outer surface of the tube 11, there is an advantage that the insertion portion 81 of the endoscope 80 is less likely to get caught when inserted into the hollow space of the tube 11.

[0115] When the oval shape of the tube 11 is such that, in its natural state, parts of the inner wall facing each other across the longitudinal axis come into contact due to their own weight, the resistance felt by the surgeon from the large intestine model 5 when held in hand becomes more similar to that felt when actually inserting the tube into the large intestine.

[0116] By using a material with low bending rigidity, measured with a Type A durometer conforming to JIS K 6253, of 10 or less as the elastic material forming the first layer 15, the oval shape of the cross section of the tube 11 in its natural state can be appropriately reproduced.

[0117] When a resin coating 18 is provided on at least a portion of the outer surface of the tube 11 and the tube 11 is formed into a shape having a plurality of projections and recesses along the longitudinal axis, the tube 11 can be easily shortened in the axial direction by suction or shortening operations, providing a tactile sensation more similar to that of the actual large intestine.

[0118] At this time, when the fold-forming member 12 is provided, the fold-forming member 12 portion is less likely to be crushed even when suction or shortening operations are performed, so that the fold-forming member 12 portion forms a valley 5v and the portion between two adjacent fold-forming members 12 forms a peak 5p, allowing the large intestine model 5 to expand and contract more like an accordion.

[0119] The present invention is not limited to the above-described embodiment as it is, and in the implementation stage, the components can be modified and embodied without departing from the gist of the invention. In addition, various aspects of the invention can be formed by appropriately combining multiple components disclosed in the above embodiment. For example, some components may be deleted from all the components shown in the embodiment. Furthermore, components from different embodiments may be appropriately combined. In this way, various modifications and applications are possible within the scope of the gist of the invention. [Explanation of symbols]

[0120] 1. Endoscopy training device 2. Torso model 2a…One end face of the fuselage model 3. Abdominal cover 4. Anal model 5. Large intestine model 5a...Bending part 6...End part 7…Stomach model 8. Small intestine model 9. Pancreas model 11. Tube 12...Pleated member 12a...Cylindrical surface 13…Glue 15, 15a, 15b...First layer 16...Second layer 18...Resin coat 80...Endoscope 81…Insertion part 81a…Tip

Claims

1. An organ model for endoscopic examination training, comprising a tube, and configured so that an insertion portion of an endoscope is inserted in a longitudinal direction of a hollow space of the tube, The tube is a first layer formed of an elastomeric material; a second layer formed of a stretch-regulating material that regulates the stretch of the first layer; A plurality of layers including the above are laminated in the thickness direction, When the tube is disposed so that the direction of the longitudinal axis intersects with the direction of gravity, in a natural state in which the endoscope is not inserted into the tube, the cross-sectional shape of the tube in the direction intersecting with the longitudinal axis forms an oval shape that is crushed by its own weight. An organ model characterized by:

2. the second layer has anisotropy such that it is more easily stretched in a second direction intersecting with the first direction than in a first direction; 2. The organ model according to claim 1 .

3. The first direction is a direction of the longitudinal axis, and the second direction is a direction intersecting the longitudinal axis.

3. The organ model according to claim 2 .

4. The second layer is configured by arranging a mesh structure formed as a knitted fabric that is more easily stretched in the second direction than in the first direction such that the first direction coincides with the direction of the longitudinal axis and the second direction coincides with a direction intersecting the longitudinal axis.

4. The organ model according to claim 3.

5. 5. The organ model according to claim 4, wherein the knitting method that is more stretchable in the second direction than in the first direction is raschel knitting.

6. When the tube stretches in a direction perpendicular to the longitudinal axis, an increase rate of a reaction force generated by the tube against the stretch is greater when the length of the tube in the direction perpendicular to the longitudinal axis is equal to or greater than a predetermined threshold value than when the length of the tube in the direction perpendicular to the longitudinal axis is less than the predetermined threshold value.

5. The organ model according to claim 4.

7. a pleat forming member having an annular shape and a length along the annular shape that is less than a length around an axis of the surface of the tube along the longitudinal axis; The pleat forming member is fixed to the surface of the tube such that the annular central axis is aligned with the longitudinal axis.

2. The organ model according to claim 1 .

8. The pleat forming member has a length along the annular direction that is shorter than a length around the longitudinal axis of the outer surface of the tube, and is fixed to the outer surface of the tube.

8. The organ model according to claim 7 .

9. In the natural state, a part of the inner wall of the tube facing each other across the longitudinal axis is in contact with another part of the inner wall due to its own weight.

2. The organ model according to claim 1 .

10. The elastic material forming the first layer is a material having a durometer value of 10 or less as measured by a type A durometer conforming to JIS K 6253.

2. The organ model according to claim 1 .

11. A resin coating is provided on at least a portion of the outer surface of the tube, so that a plurality of projections and recesses are formed on the tube along the longitudinal axis direction.

2. The organ model according to claim 1 .

12. The organ model according to claim 1, An endoscopic examination training device characterized by:

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