Catheter Simulator and Organ Model

Abstract

To provide a catheter simulator capable of improving catheterization techniques for gastrointestinal organs such as the liver and pancreas in a simple configuration.SOLUTION: A catheter simulator 1 comprises a container 10 capable of storing liquid, a bile duct model 100 held in the container with liquid stored therein, a holding projection 22 provided in the container, holding the bile duct model and including an insertion path for guiding a catheter to the inside of the held bile duct model, a connecting part 160 provided in the bile duct model 100, removably connected to the holding projection and in which the catheter can be inserted, and a catheter introduction part 25 integrated with the holding projection, projecting to the outside of a lateral wall 12 and capable of introducing the catheter. The holding projection 22 and the connecting part 160 have a rotational structure for holding the organ model 100 rotatably centered on the axial direction of the insertion path, the organ model held in the container 10 with the liquid stored therein.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The present invention relates to a catheter simulator used to improve the technique when performing catheter treatment on organs of the digestive system such as the liver and pancreas, and an organ model that can be installed in such a catheter simulator.

Background Art

[0002] In recent years, diagnosis and treatment using a catheter have been performed on the bile duct and pancreatic duct. In such diagnosis and treatment, endoscopic retrograde cholangiopancreatography (ERCP) in which a contrast agent is injected into the bile duct and pancreatic duct using an endoscope is used. In ERCP, an endoscope (camera) is inserted through the mouth and reaches the duodenal papilla, which is the outlet of the bile duct and pancreatic duct into the duodenum. There, a contrast agent is injected through a catheter from the tip of the endoscope, and the bile duct and pancreatic duct are X-rayed. Such an examination method can directly examine the bile duct and pancreatic duct, and can also collect tissue from the lesion for pathological examination or actually perform treatment. Therefore, improvement of the technique is important.

[0003] By the way, regarding catheter techniques, various catheter simulators (hereinafter also referred to as simulators) have been proposed in order to acquire and improve the operation technique. For example, Patent Document 1 discloses a simulator in which a blood vessel model to be treated is installed in a human mannequin body and a catheter can be introduced into this blood vessel model. With this simulator, it is possible to install a stent for blood vessel dilation or practice techniques related to packing a coil for occlusion to prevent rupture of an aneurysm.

[0004] However, the simulator disclosed in Patent Document 1 described above is inconvenient to handle and cannot be easily practiced. For this reason, Patent Document 2 discloses a simulator in which a portable container is filled with a liquid (water), and various heart models to be treated are placed in a floating state therein, and catheter operations are practiced. In this simulator, an inlet through which the liquid flows in from a pump and an outlet through which the liquid in the container is discharged toward the pump are formed on the side wall of the container, and the liquid is circulated in the floating heart model. The pump is configured such that its output can be adjusted, and by adjusting the output of the pump, the heart model is caused to pulsate (periodic contraction movement), and catheter techniques for the heart model can be practiced in a more realistic state.

Prior Art Documents

Patent Documents

[0005]

Patent Document 1

Patent Document 2

Summary of the Invention

Problems to be Solved by the Invention

[0006] The simulator disclosed in Patent Document 2 described above has a structure suitable for organs of the circulatory system. When water is stored in a container and an organ model is floated, a pump is connected externally to circulate the water so that practice equivalent to that of an actual human body can be performed. That is, for the heart model and blood vessel model that are floated and held in the container, a pulsatile flow similar to blood flow is generated via the pump, and catheter operations can be practiced under such circumstances.

[0007] By the way, in diagnosis and treatment using a catheter, it is also performed on organs other than the cardiovascular system. For example, it is performed to examine whether there are stones (bile duct stones, pancreatic stones) or tumors in organs of the digestive system such as the liver and pancreas, or to perform treatment. When a malignant tumor is suspected by this examination, tissue is collected by catheter operation, or a thin tube with an ultrasonic diagnostic device attached to the tip is inserted into the bile duct or pancreatic duct for a precise examination by ultrasound. Also, if there are stones in the bile duct or pancreatic duct, they are removed, or if there is stenosis, a stent is inserted to restore the flow of digestive fluid and other treatments are performed.

[0008] As described above, in organs of the digestive system, since it is not necessary to consider blood flow, there is no need to use a pump for its simulator, and in a simulator such as Patent Document 2, it is not possible to practice catheter operation. Also, in the treatment of organs of the cardiovascular system, general anesthesia is performed, while in organs of the digestive system, local anesthesia is often used. For this reason, during actual examinations and treatments, the patient is prompted to rotate the body, and an X-ray image is obtained while rotating the organ within a predetermined range. The simulator of Patent Document 2 does not consider at all the structure for rotating such an organ model. That is, when practicing catheter techniques for examinations and treatments related to organs of the digestive system (especially the liver and pancreas), the simulator disclosed in Patent Document 2 does not have an appropriate structure.

[0009] The present invention has been made paying attention to the above-described actual situation, and an object thereof is to provide a catheter simulator that can improve catheter techniques for organs of the digestive system such as the liver and pancreas with a simple configuration, and an organ model used therefor.

Means for Solving the Problem

[0010] In order to achieve the above object, the catheter simulator according to the present invention includes a container in which a liquid can be stored, surrounded by a side wall and a bottom, an organ model of the digestive system held in a state where the liquid is stored in the container, provided in the container, and holding the organ model. And a holding projection having an insertion passage for guiding a catheter into the held organ model, a connecting portion provided on the organ model, detachably connectable to the holding projection and through which the catheter can be inserted, and integrated with the holding projection, A catheter introduction portion protruding outside the side wall to enable introduction of a catheter, and the holding projection and the connecting portion have a rotation structure for rotatably holding the organ model held in a state where the liquid is stored in the container around the axial direction of the insertion passage. It is characterized by that.

[0011] The above-described catheter simulator creates an organ model of the digestive system having the same size as an actual human body, installs it in a container, and holds it in a state filled with a liquid. By inserting a catheter through the catheter introduction portion into the organ model installed in this way, catheter procedures can be practiced with a simple configuration. In addition, since it is an organ model of the digestive system, there is no need to install a pump for reproducing blood flow, and by rotatably holding the organ model, it becomes possible to easily reproduce a situation where the orientation of the human body is changed during catheter operation.

[0012] Further, in order to achieve the above object, the present invention is an organ model having a bile duct held in a floating state in a container in which a liquid is stored and used when practicing a catheter procedure, and a catheter can be inserted therethrough. A connecting portion formed in a cylindrical shape, and a rotation structure provided on the connecting portion for rotatably holding the organ model.

[0013] According to such an organ model held rotatably, it becomes possible to easily practice catheter procedures for bile ducts and pancreatic ducts, which are organs of the digestive system.

Effect of the Invention

[0014] According to the present invention, it is possible to improve catheter techniques for digestive organs such as the liver and pancreas with a simple configuration.

Brief Description of the Drawings

[0015]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Mode for Carrying Out the Invention

[0016] Hereinafter, embodiments of a catheter simulator and an organ model according to the present invention will be described with reference to the drawings. Note that the organ model in the present invention corresponds to a digestive organ in which no blood flow occurs, unlike the circulatory system in which blood flow occurs, and the organ model of the present embodiment is configured as a bile duct model. That is, in the present embodiment, it is configured as a catheter simulator that can practice examinations, treatments, etc. for the bile ducts of the liver.

[0017] FIG. 1 is a diagram showing the overall configuration of the catheter simulator according to the present embodiment, FIG. 2 is a schematic diagram showing the liver and pancreas regions of an actual human body, and FIG. 3 is an organ model (bile duct model) installed in the container of the catheter simulator shown in FIG. It is a figure which shows one structural example. The catheter simulator 1 according to this embodiment includes a container 10 that suspends and holds an organ model (hereinafter referred to as a bile duct model) 100 to be simulated in a state filled with a liquid W such as water.

[0018] The container 10 is configured as a substantially rectangular parallelepiped box having four side walls 11 to 14 and a bottom 15. The upper surface is open, and the liquid W is accommodated in the accommodation portion 10A surrounded by the side walls 11 to 14 and the bottom 15 through the opening on the upper surface, and the bile duct model 100 is removably held.

[0019] The side walls 11 to 14 and the bottom 15 are made of a material having a strength capable of stably accommodating and holding the liquid W and the bile duct model 100, and have transparency and are lightweight and strong so that the behavior of a catheter or the like inserted from the outside of the bile duct model or the container can be visually observed during the simulation. It is preferably formed of a material (for example, acrylic, polycarbonate, PET, polystyrene, etc.).

[0020] Note that the container 10 may be formed of an opaque material so that the inside cannot be visually recognized. Thus, even in the case of a container whose inside cannot be visually recognized, it is also possible to perform a simulation to grasp the behavior of the catheter only on a monitor by taking a picture with a camera and displaying it on a monitor or the like, or by performing fluoroscopy with X-rays and displaying it on a monitor or the like. That is, the container 10 may be configured to be able to select the use of visual recognition, monitor display confirmation, and X-ray imaging according to the training stage and content (even if it is a transparent material, it may be covered and simulated). Further, as the contrast agent (injectant injected from the tip of the catheter by a syringe at hand) used in X-ray imaging, a liquid containing iodine ions of an easily visible color (reddish brown), for example, povidone iodine solution, can be used. In this case, as the liquid W, a colorless and transparent dissolved water such as hypoalcohol containing water and thiosulfate can be used. That is, since the povidone iodine solution injected from the catheter chemically reacts with hypoalcohol and changes to colorless and transparent in a short time after injection, the injectant does not remain even when the trainer continuously uses the injectant a plurality of times.

[0021] Regarding the shape and size of the container 10, as long as a model that is substantially the same as the bile duct part of the actual human body can be stably held, the shape and size thereof are not limited. As described above, the element accommodated in the container 10 is a bile duct model 100 having approximately the same size as the bile duct part of the actual human body, and since it only needs to be held in a size that can stably hold it, the container 10 can be miniaturized. Specifically, if the long side L1 of the rectangle is about 16 to 19 cm, the short side W1 is about 13 to 16 cm, and the height H1 is about 20 to 25 cm, effective simulation can be performed, there is no waste in the space of the simulation implementation location, and the storage and transportability of the catheter simulator 1 can be improved. Further, although the upper part of the container 10 is open, a lid that can be opened and closed or removed may be provided here. Thereby, while preventing a decrease in visibility due to fluctuations and reflections of the water surface, when performing operations such as preparing the training and cleaning up, such as the operation of storing liquid in the storage part 10A and the operation of holding the bile duct model 100 in the container, it is possible to work efficiently through the opening on the upper surface of the container.

[0022] On the side wall, the bile duct model 100 is held in a floating state (a state not in contact with the bottom 15) when the storage part 10A is filled with liquid. In the actual human body, as shown in FIG. 2, the passage of bile from the liver 130 to the duodenum 140 is called the biliary tract (common bile duct; hereinafter referred to as the bile duct 110), and this bile duct is divided into the intrahepatic bile duct 111, the extrahepatic bile duct 112, the gallbladder 120, and the duodenal papilla 121. The intrahepatic bile duct 111 is divided into the left bile duct 111a and the right bile duct 111b. Further, the extrahepatic bile duct 112 is divided into the hilar region bile duct 112a close to the liver and the distal bile duct 112b close to the pancreas 150. And the bile, which is a digestive juice produced in the liver 130, is carried to the gallbladder 120 through the intrahepatic bile duct 111 and the extrahepatic bile duct 112, concentrated here, and then poured into the duodenum 140.

[0023] The bile duct model 100 of this embodiment is formed as shown in FIG. 3 and is formed in a form imitating the bile duct 110 shown in FIG. 2. Such a bile duct model 100 can be produced from image data (3D image data) of the liver region of an actual patient using a 3D printer or the like. Note that although the organ model in FIG. 3 is composed only of the bile duct, such an organ model may be only a pancreatic duct model or may be a model in which the bile duct and the pancreatic duct are integrally formed. Regarding the bile duct model 100 installed in the container shown in FIG. 3, the same reference numerals are given to the same parts as those of the actual human body shown in FIG. 2.

[0024] As described above, the catheter simulator of this embodiment is used to improve the technique of endoscopic retrograde cholangiopancreatography (ERCP) in which a contrast agent is injected into the bile duct and pancreatic duct using an endoscope. Specifically, in ERCP, an endoscope is inserted through the mouth and reaches the major duodenal papilla 121, which is the exit of the bile duct 110 and the pancreatic duct into the duodenum. Then, a contrast agent is injected through a catheter 200 from the tip of the endoscope, and the bile duct and pancreatic duct are X-rayed to examine various abnormalities (such as the presence of stones and whether there is a malignant tumor). In the catheter simulator of this embodiment, such an examination can be simulated, and furthermore, various treatments for the bile duct part can be simulated.

[0025] For example, the treatment of bile duct stones applies the technique of the ERCP examination, performs cholangiography to confirm the shape of the bile duct, the size and number of stones, etc. Then, in order to facilitate the removal of the stones, an incision of the major duodenal papilla (a surgical procedure in which a knife is inserted into the major duodenal papilla, which is the exit of the bile duct, and the sphincter of Oddi is incised by high frequency), balloon dilation (a surgical procedure in which a balloon is inserted into the major duodenal papilla and the balloon is inflated to widen the inlet) are performed. After performing the above-described procedures, the stones are crushed with a lithotripter or with a basket.

[0026] Also, even in cases where there is a stricture in the bile duct, such as bile duct cancer, it is possible to apply the technique of ERCP examination. That is, in endoscopic surgery by ERCP, a metal stent is inserted and implanted into the bile duct to restore the flow of digestive fluid (bile). The stent is formed of a shape memory alloy and, after being implanted at a predetermined position in the bile duct, functions to expand the bile duct, ensuring the flow of bile over a long period.

[0027] As described above, ERCP can also collect tissue from the lesion for pathological examination or actually perform treatment. Therefore, it is necessary to practice thoroughly the techniques of approaching the catheter to a predetermined position and imaging the bile duct. By using the catheter simulator 1 of the present embodiment, it is possible to improve such techniques.

[0028] In general, when examining and treating organs of the circulatory system (blood vessels, heart, etc.), the organs are imaged from various angles by moving the X-ray. However, in the case of organs of the digestive system, the X-ray is fixed while the patient moves (such as turning a supine patient sideways) to change the imaging angle. For this reason, in the present embodiment, as will be described later, a rotation structure is provided for rotatably holding the bile duct model 100 at the portion connecting and holding the container 10 and the bile duct model 100. That is, in the actual catheter technique for the bile duct of the human body, a catheter is inserted, the syringe at hand is operated, X-ray imaging is performed while flowing a contrast agent from the tip of the catheter, and a still image or a moving image is cut out to create a roadmap of the bile duct to be examined and treated. This roadmap is taken in multiple patterns at different angles by shifting the human body. The actual catheter operation is performed while looking at the roadmap for each pattern displayed on the monitor. Therefore, when practicing with the simulator, the bile duct model 100 held in the container 10 is rotatably held by the following rotation structure so that X-ray imaging can be performed at such different angles.

[0029] Also, when operating the catheter, considering its slipperiness and shape retention, the bile duct model 100 is preferably integrally formed of a hard and transparent resin material (for example, polyurethane, epoxy resin, acrylic resin, polycarbonate resin, unsaturated polyester, vinyl chloride resin, polyethylene terephthalate, etc.). By forming the bile duct model with a hard material in this way, it becomes possible to stably maintain the fixed state in the container containing the liquid, and a simulation can be performed in accordance with the actual catheter operation without the bile duct model moving unnaturally.

[0030] The above-described bile duct model 100 preferably has no seams and is integrally formed. However, parts such as lesions and stenosis parts may be made into parts so that they can be partially attached and detached to and from the intrahepatic bile duct 111 and the extrahepatic bile duct 112. Such parts are not limited in terms of materials such as soft resin materials. For example, it is possible to separately create parts having lesion parts similar to actual human body lesions, such as stone parts or stenosis parts, and make this part detachable. That is, by making a part of the bile duct separable, there is no need to remove the main body itself from the container 10, and it is also possible to install the lesion part to be practiced and perform an appropriate simulation.

[0031] Next, the holding structure (rotating structure) of the above-described container 10 and the bile duct model 100, and the structure of the catheter introduction part will be described together with FIGS. 4 to 6.

[0032] On the side wall 12 of the container 10, there is provided a holding projection 22 that holds the bile duct model 100 and has an insertion passage 22a for guiding a catheter into the held bile duct model 100. This holding projection 22 is integrally formed with a cylindrical base member 20 that is press-fitted into the side wall 12 and fixed by a screw 21 from the outside. The holding projection 22 is formed in a cylindrical shape, integrally formed with the base member from a hard material, and protrudes toward the accommodating portion 10A.

[0033] The bile duct model 100 is provided with a connecting portion 160 that can be detachably connected to the holding projection 22 and through which a catheter can be inserted. This connecting portion 160 is integrally formed at the portion of the duodenal papilla 121 described above, that is, at the site (the end of the bile duct) where bile is injected into the duodenum 140 of the actual human body, and has a cylindrical (circular cylindrical) shape so as to be connected to the holding projection 22. The connecting portion 160 is rotatably connected to the holding projection 22 about the axial direction of the insertion passage 22a and communicates with the insertion passage 22a of the holding projection 22. For this reason, the catheter inserted through the insertion passage 22a directly enters the bile duct model 100.

[0034] Regarding the connection between the connecting portion 160 and the holding projection 22, it is conceivable to adopt a press-fitting structure or a connection structure using screws to rotatably hold the bile duct model 100. However, in the connection between hard members, wear or looseness (vibration) may occur. In addition, in the screw engagement structure, in addition to wear, loosening occurs and the stability of the bile duct model 100 is lost. Therefore, in the present embodiment, by adopting a rotation structure as described below (particularly, a rotation structure with a soft member interposed), the bile duct model 100 is stably rotated.

[0035] In addition, a catheter introduction portion 25 that is integrated with the holding projection 22 and protrudes outside the side wall 12 of the container 10 to enable the introduction of a catheter is provided on the side wall 12 of the container 10. This catheter introduction portion 25 functions as an introduction portion (catheter introduction port) for introducing a catheter from the outside of the container 10 into the bile duct model 100. For this reason, a through hole is formed in the base member 20, and a cylindrical introduction connector 26 that protrudes from the side wall 12 to the outside coaxially is provided in this through hole. A catheter introduction tube 28 is connected to this introduction connector 26, and the catheter is introduced from its opening 28a.

[0036] The inlet connector 26 has a connection mechanism that can be operated outside the container 10. This connection mechanism is structured such that, for example, when the catheter introduction tube 28 is inserted and the operating member (nut) 26a is rotated, the catheter introduction tube 28 can be fixed and released, enabling easy attachment and detachment of the catheter introduction tube 28. When the catheter introduction tube 28 is not inserted (not used), its opening may be closed by a plug member.

[0037] As described above, the holding projection 22 on the container side and the connecting portion 160 on the bile duct model side have a rotation structure that rotatably holds the bile duct model 100 held in a state where the container contains liquid around the axial direction of the insertion passage 22a of the holding projection 22.

[0038] As shown in FIGS. 4 and 6, the rotation structure of the present embodiment includes an adapter 50 formed in a cylindrical shape from a soft resin interposed between the holding projection 22 and the connecting portion 160. As shown in FIG. 5, annular protrusions 22b and 22c are formed at a plurality of locations (two locations in the present embodiment) at predetermined intervals in the axial direction on the outer peripheral surface of the holding projection 22. Also, as shown in FIG. 5, annular protrusions 160a and 160b are formed at a plurality of locations (two locations in the present embodiment) at predetermined intervals in the axial direction on the outer peripheral surface of the connecting portion 160.

[0039] The adapter 50 is configured such that the holding projection 22 and the connecting portion 160 are fitted from both sides in the axial direction. Annular recesses 50a and 50b are formed on one end side of the inner peripheral surface thereof so as to fit with the ring-shaped protrusions 22b and 22c of the holding projection 22, and annular recesses 50c and 50d are formed on the other end side so as to fit with the ring-shaped protrusions 160a and 160b of the connecting portion 160.

[0040] When the bile duct model 100 is held by the holding projection 22 of the container 10 via the adapter 50 formed of such a soft material, the connecting portion 160 of the bile duct model and the holding projection 22 do not wear, and the bile duct model 100 can be rotated to an arbitrary position in a stable state. That is, by interposing the soft adapter 50 between the rigid members, the installation angle of the bile duct model 100 can be changed and X-ray imaging can be performed in the same manner as when changing the actual body's supine state without the bile duct model 100 wobbling or being displaced, and it becomes possible to create a roadmap necessary for the simulation.

[0041] Note that the simulation regarding the actual catheter procedure can be performed while looking at the roadmap displayed on a monitor or the like. For example, the catheter can be advanced from the duodenal papilla 121 to the lesion, and various catheter operations such as occluding or dilating the lesion can be trained.

[0042] Also, in the present embodiment, since the bile duct model 100 is held in a state of not contacting the container 10 by the connection of the connecting portion 160 and the holding projection 22, the installation of the bile duct model can be easily performed, and the configuration of the catheter simulator can be simplified. In this case, the bile duct model may be configured to be held on all of the inner surfaces of the respective side walls 11 to 14 of the container 10, and the introduction portion for introducing the catheter may be provided at a position different from the holding projection or may be provided at a plurality of locations.

[0043] As described above, an example of an embodiment of the catheter simulator and the bile duct model according to the present invention has been shown. However, the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the spirit of the present invention. For example, the organ model can be applied not only to the bile duct model but also to organs of the digestive system where no blood flow occurs. Further, as long as the practice of the catheter insertion operation can be performed while being held in the container 10 filled with liquid, the holding mode (fixing method) of the organ model is not limited.

Explanation of Reference Numerals

[0044] 1 Catheter simulator 10 Container 20 Base member 22 Holding projection 50 Adapter 100 Bile duct model (organ model) 160 Connecting part

Claims

1. A container having a receiving portion surrounded by side walls and a bottom, in which a liquid can be received, An organ model of the digestive system held in a state where a liquid is contained in the container, A holding projection provided on the container, holding the organ model and having an insertion passage for guiding a catheter into the held organ model, A connecting portion provided on the organ model, detachably connectable to the holding projection and through which the catheter can be inserted, A catheter introduction portion integrated with the holding projection and protruding outside the side wall to enable introduction of the catheter, characterized by comprising: The holding projection and the connecting portion have a rotation structure for rotatably holding the organ model held in a state where a liquid is contained in the container about the axial direction of the insertion passage, The organ model is formed of a rigid resin, The rotation structure has a soft adapter interposed between the holding projection and the connecting portion of the organ model, the catheter simulator being characterized thereby.

2. The organ model imitates the bile duct and / or pancreatic duct of the human body, The catheter simulator according to claim 1, characterized in that the connecting portion of the organ model is formed in a tubular shape.

3. Annular protrusions are respectively formed on the outer surface of the connecting portion of the organ model formed in a tubular shape and on the outer surface of the holding projection, The soft adapter is formed in a tubular shape into which the connecting portion of the organ model and the holding projection can be inserted from both sides, The catheter simulator according to claim 2, characterized in that annular recesses for fitting the annular protrusions formed on the outer surface of the connecting portion and the outer surface of the holding projection are respectively formed on the inner surfaces of both sides of the soft adapter.

4. The catheter simulator according to any one of claims 1 to 3, characterized in that the organ model is held in a state where it does not contact the container.

5. An organ model having a bile duct held in a floating state in a container containing a liquid and used when practicing catheter techniques, A connecting portion formed in a tubular shape through which a catheter can be inserted, A rotation structure provided on the connecting portion for rotatably holding the organ model, characterized by comprising: The organ model is formed of a rigid resin, The rotation structure has a soft adapter interposed between the holding projection of the container and the connecting portion of the organ model, the organ model being characterized thereby.

6. The organ model according to claim 5, wherein the connecting portion is formed at an end of the bile duct.

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