Hip joint surgery simulation device and method of use

Abstract

To increase a movable range of a femur model.SOLUTION: A hip joint surgical simulation device 100 is provided, comprising a pelvis holder M2 for holding a pelvis model 80, a holding member 30 for holding a femur model 70, and a holding mechanism M1 configured to hold the holding member in such a way that the holding member is rotatable about a first axis AZ, second axis AX, and third axis AY, each passing a reference point R at a predetermined position relative to the holding member 30, where the first axis AZ is perpendicular to the second axis AX and the second axis AX is perpendicular to the third axis AY.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to a hip surgery simulation device and a method for using the same. [Background technology]

[0002] One of the known causes of hip joint pain is femoroacetabular impingement, which occurs when a protruding portion of at least one of the femoral head and the acetabulum collides with the other bone during hip joint movement.

[0003] Hip arthroscopy is a minimally invasive treatment method for femoroacetabular impingement. In hip arthroscopy, the surgeon makes several approximately 2cm incisions in the patient's skin and inserts an arthroscope and surgical instruments into the incisions to remove the protruding deformity. Hip arthroscopy requires more advanced surgical techniques than open surgery, which requires large incisions in the skin, because surgical instruments must be operated within the field of view of the arthroscope. To improve surgical techniques, it is desirable to practice hip arthroscopy on cadavers. However, it is difficult to prepare cadavers for surgical practice.

[0004] Japanese Patent Application Laid-Open Publication No. 2019-28152 describes a hip arthroscopic surgery simulation device for practicing hip arthroscopic surgery using a medical model. In this hip arthroscopic surgery simulation device, one end of a shaft member is fixed to the femoral head, and the shaft member is supported so that it can swing vertically and horizontally around the femoral head and rotate around its axis. This requires the device to be larger by the length of the shaft member. Furthermore, the limited range of motion of the shaft member limits the range in which the femoral head can be rotated. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Japanese Patent Application Publication No. 2019-28152 Summary of the Invention [Problem to be solved by the invention]

[0006] An object of the present invention is to provide a hip joint surgery simulation device that is compact and allows a medical model to have an increased degree of freedom of movement, and a method for using the same. [Means for solving the problem]

[0007] According to one aspect of the present invention, a hip joint surgery simulation device includes a pelvis holding unit that holds a pelvis model, a holding member that holds a femur model, and a holding mechanism that holds the holding member rotatably about a first axis, a second axis, and a third axis that pass through a reference point whose relative position relative to the holding member is predetermined, the first axis and the second axis being orthogonal to each other, and the second axis and the third axis being orthogonal to each other. The holding mechanism includes a first joint rotatable around a first axis, a second joint held by the first joint and rotatable around a second axis, and a rotary holding section held by the second joint and holding the holding member rotatable around a third axis. .

[0008] According to this aspect, the holding member that holds the femur model is held by the holding mechanism so as to be rotatable about a first axis passing through the reference point, a second axis perpendicular to the first axis and passing through the reference point, and a third axis perpendicular to the second axis and passing through the reference point. Therefore, the femur model can be rotated about at least one of the first axis, the second axis, and the third axis about the reference point. This increases the range of motion for rotating the femur model. As a result, it is possible to provide a hip joint surgery simulation device that is compact and has an increased degree of freedom of movement for the medical model.

[0010] Also The first joint rotates around the first axis, the second joint held by the first joint rotates around the second axis, and the holding member rotates around the third axis by the rotary holding part held by the second joint. This simplifies the configuration of the holding mechanism and allows the device to be made smaller. According to another aspect of the present invention, a hip joint surgery simulation device includes a pelvis holding unit that holds a pelvis model, a holding member that holds a femur model, a holding mechanism that holds the holding member rotatably about a first axis, a second axis, and a third axis that pass through a reference point whose relative position relative to the holding member is predetermined, a transparent top plate positioned in an area above the pelvis holding unit and the holding member, and an imaging and display device having a camera and a display unit facing away from the camera, and the imaging and display device is placed on the top plate with the camera facing downward.

[0011] Preferably, the pelvis holding portion includes an adjustment mechanism that can change the relative position between the reference point and the pelvis model.

[0012] According to this aspect, the relative positions of the femur model and the pelvis model can be easily adjusted.

[0013] Preferably, the apparatus further comprises a skin holding member for holding a skin model covering the pelvis model and the femur model, and a reinforcing member attached to the skin holding member for reinforcing the skin model.

[0014] According to this aspect, the skin model is reinforced by the reinforcing member, so that the elasticity of the skin model can be adjusted.

[0015] Preferably, the apparatus further includes a camera positioned so that at least a portion of the pelvic model and at least a portion of the femur model held by the holding member are included in the imaging range, and a display device that displays an image captured by the camera.

[0016] According to this aspect, an image of at least a part of the pelvis model and at least a part of the femur model is displayed, so that an image that simulates an image captured by X-rays in an actual surgery can be displayed.

[0017] According to another aspect of the present invention, a method of using the hip joint surgery simulation device includes a positioning process in which the holding mechanism is operated to rotate the femoral model while referring to an image displayed on the display device in order to determine the relative position between the surgical instrument and the surgical target portion of the pelvic model and / or femoral model; a processing process in which the surgical target portion is processed using the surgical instrument; and a confirmation process in which the holding mechanism is operated to rotate the femoral model while referring to an image displayed on the display device in order to confirm the shape of the surgical target portion.

[0018] According to this aspect, the holding mechanism is operated to rotate the femur model while referring to the image displayed on the display device, the surgical target portion is processed using surgical instruments, and the holding mechanism is operated to rotate the femur model to confirm the shape of the surgical target portion. Therefore, the relative positions of the surgical instruments and the surgical target portion can be determined from the image displayed on the display device, and the shape of the surgical target portion can be confirmed from the image displayed on the display device. As a result, a method of using the hip joint surgery simulation device can be provided that allows practicing hip joint surgery while obtaining information similar to that obtained in actual surgery. According to yet another aspect of the present invention, a method of using a hip joint surgery simulation device includes: a holding mechanism that holds the holding member so as to be rotatable about a first axis, a second axis, and a third axis that pass through a predetermined reference point relative to the holding member; and a transparent top plate that is located above the pelvis holding member and the holding member, the method including the steps of: placing an imaging display device having a camera and a display facing away from the camera on the top plate with the camera facing downward; a positioning process that rotates the femur model by operating the holding mechanism while referring to an image displayed on the display device in order to determine the relative positions of surgical instruments and surgical target portions of the pelvis model and / or femur model; a processing process that processes the surgical target portion using the surgical instruments; and a confirmation process that rotates the femur model by operating the holding mechanism while referring to an image displayed on the display device in order to confirm the shape of the surgical target portion. [Brief explanation of the drawings]

[0019] [Figure 1] 1 is a perspective view of the appearance of a hip joint surgery simulation device according to an embodiment of the present invention. [Figure 2] FIG. 2 is a front view of the hip joint surgery simulation device. [Figure 3] FIG. 2 is a plan view of the hip joint surgery simulation device. [Figure 4] FIG. 1 is a side view of the hip joint surgery simulation device. [Figure 5] 10A and 10B are diagrams for explaining the inward rotation and outward rotation of the holding mechanism. [Figure 6] 10A and 10B are diagrams for explaining bending and extending operations of the holding mechanism. [Figure 7] 10A and 10B are diagrams illustrating the abduction and adduction movements of the holding mechanism. [Figure 8] FIG. 1 is a perspective view of the appearance of a hip joint surgery simulation device during hip joint surgery practice. [Figure 9] FIG. 10 is a diagram showing an example of an image displayed on a display unit of a smartphone. [Figure 10] FIG. 10 is a diagram showing an example of an image obtained by binarizing the image of FIG. 9. [Figure 11] 1 is an explanatory diagram showing the basic steps of hip arthroscopy. [Figure 12]10 is a flowchart showing an example of the flow of a method of using the hip joint surgery simulation device 100. [Figure 13] FIG. 1 is a first view showing an example of a femur model. [Figure 14] FIG. 2 is a second view showing an example of a femur model. DETAILED DESCRIPTION OF THE INVENTION

[0020] A hip joint surgery simulation device according to an embodiment of the present invention will be described with reference to the drawings.

[0021] (1) Configuration of the hip joint surgery simulation device FIG. 1 is a perspective view of the appearance of a hip surgery simulation device according to one embodiment of the present invention. Referring to FIG. 1, in the hip surgery simulation device 100, mutually orthogonal X, Y, and Z directions are defined to clarify the positional relationships. The X and Y directions are orthogonal to each other in a horizontal plane, and the Z direction corresponds to the vertical direction. The hip surgery simulation device 100 simulates the hip joint of a patient lying supine on a bed. Therefore, in the hip surgery simulation device 100, the Z direction indicates the front of the patient, the X direction indicates the right direction of the patient, and the Y direction indicates the upward direction of the patient.

[0022] The holding mechanism M1 and the pelvis holding portion M2 are fixed onto a flat base member 51. A frame 50 that defines a predetermined space above the base member 51 is attached to the base member 51.

[0023] The frame 50 includes front pillars 52A and 52B extending vertically from both front ends (in the positive X-direction) on the top surface of the base member 51, rear pillars 53A and 53B extending vertically from both rear ends (in the negative X-direction), and rail members 54A and 54B whose ends are connected to the front pillars 52A and 52B and the rear pillars 53A and 53A, respectively. The rail members 54A and 54B each have grooves 55A and 55B (see FIG. 4) extending in the X-direction on the opposing surfaces.

[0024] Fig. 2 is a front view of the hip joint surgery simulation device. Fig. 3 is a plan view of the hip joint surgery simulation device. Fig. 4 is a cross-sectional view taken along line AA in Fig. 2. In Figs. 2 to 4, the X, Y, and Z directions are indicated by arrows as appropriate. Also, in Figs. 2 to 4, a portion of the frame 50 is omitted for the sake of explanation.

[0025] The holding mechanism M1 holds a femur model 70 that imitates a part of a human right femur. The pelvis holding part M2 holds a pelvis model 80 that imitates a pelvis including the part around the acetabulum on the right side of a human hipbone.

[0026] The holding mechanism M1 holds the holding member 30, which holds the femur model 70, rotatably about a first axis AZ, a second axis AX, and a third axis AY, each of which passes through a reference point R whose relative position is predetermined relative to the holding member 30. The first axis AZ is perpendicular to the XY plane. The second axis AX is parallel to the XY plane. The first axis AZ and the second axis AX are always perpendicular to each other, and the second axis AX and the third axis AY are always perpendicular to each other.

[0027] The holding mechanism M1 has a first joint 10 that is rotatable around a first axis AZ, a second joint 20 that is held by the first joint 10 and is rotatable around a second axis AX that is perpendicular to the first axis AZ at a reference point R, and a rotary holding portion 24 that is held by the second joint 20 and holds the holding member 30 rotatable around a third axis AY that is perpendicular to the second axis AX at the reference point R.

[0028] A first bearing 56 that supports an axis perpendicular to the XY plane is fixed to the upper surface of the base member 51. The first joint 10 has a first plane 11 and a second plane 12 that perpendicularly intersects with the first plane 11. The first joint 10 has a first rotation shaft 13 that extends perpendicularly from the first plane 11. The first rotation shaft 13 is supported by the first bearing 56 fixed to the upper surface of the base member 51. Therefore, the first rotation shaft 13 is parallel to the Z direction. The center of rotation of the first rotation shaft 13 is the first axis AZ, and the first joint 10 is rotatable around the first axis AZ.

[0029] The first joint 10 also has a second bearing 14 that is fixed to the second plane 12 and supports an axis perpendicular to the second plane 12. The second joint 20 has a third plane 21 and a fourth plane 22 that perpendicularly intersects with the third plane 21. The second joint 20 has a second rotation axis 23 that extends perpendicularly from the third plane 21. The second rotation axis 23 is supported by the second bearing 14 provided in the first joint 10 so as to be parallel to the XY plane.

[0030] The second bearing 14 is fixed to the second plane 12 of the first joint 10 so as to support the second rotating shaft 23 at a position where the center of rotation of the second rotating shaft 23 intersects with the first axis AZ at the reference point R. The center of rotation of the second rotating shaft 23 is the second axis AX, and the second joint 20 is rotatable around the second axis AX.

[0031] The second joint 20 also has a rotation holding part 24 that is fixed to the fourth plane 22 and supports an axis perpendicular to the fourth plane 22. The holding member 30 has a fifth plane 31 and a third rotation axis 33 that extends perpendicularly from the fifth plane 31. The third rotation axis 33 is supported by the rotation holding part 24 provided on the second joint 20. The rotation holding part 24 is fixed to the fourth plane 22 so as to support the third rotation axis 33 at a position where the rotation center of the third rotation axis 33 is perpendicular to the second axis AX at the reference point R. The rotation center of the third rotation axis 33 is the third axis AY, and the holding member 30 is rotatable around the third axis AY.

[0032] The holding member 30 holds the femur model 70 on a sixth plane 32 opposite to the fifth plane 31. The femur model 70 held by the holding member 40 has a femoral head 71, which is the femoral head, a femoral neck 72, and a greater trochanter 73. The holding member 30 holds the femur model 70 so that a predetermined position in the femur model 70 coincides with a reference point R. Here, the holding member 30 holds the femur model 70 so that the center of the femoral head 71 of the femur model 70 coincides with the reference point R. Therefore, the holding mechanism M1 can rotate the femur model 70 about the first axis AZ, the second axis AX, and the third axis AY, each of which is centered on the reference point R.

[0033] The holding mechanism M1 may be provided with a mechanism for adjusting the relative position between the holding member 30 and the femur model 70 in directions parallel to the first axis AZ, the second axis AX, and the third axis AY so that a desired position in the femur model 70 coincides with the reference point R.

[0034] The pelvis holding part M2 holds a pelvis model 80 that imitates a pelvis. The pelvis model 80 has a portion that imitates an acetabulum, and the femoral head 71 of the femur model 70 is configured to be able to fit into the acetabulum portion of the pelvis model 80. The pelvis holding part M2 includes an adjustment mechanism that can change the relative position of the reference point R and the pelvis model 80.

[0035] The pelvis holding unit M2 has a support member 61, a holding base 60 to which a pelvis model 80 is attached, and a connecting member 63 that connects the holding base 60 and the support member 61. The support member 61 has a cylindrical columnar portion 61A and a rectangular parallelepiped fixing portion 61B connected to one end of the cylindrical portion 61A. The fixing portion 61B is inserted into a groove 55A formed in the rail member 54A and fixed to the rail member 54A with a screw. As a result, the support member 61 is fixed to the rail member 54A with the cylindrical portion 61A parallel to the Y direction, and its position in the X direction relative to the rail member 54A is determined.

[0036] The connecting member 63 has a rectangular prism shape, and has a hole formed at one end, the hole having an inner diameter larger than the outer diameter of the cylindrical portion 61A of the support member 61. With the cylindrical portion 61A of the support member 61 passing through the hole in the connecting member 63, the connecting member 63 is fixed to the support member 61 with a screw 63A. The position of the connecting member 63 in the Y direction is determined by adjusting the length by which the cylindrical portion 61A of the support member 61 passes through the connecting member 63. Furthermore, the position of the connecting member 63 in the XZ plane is determined by adjusting the angle around the outer periphery of the connecting member 63.

[0037] The holding base 60 has a hole that engages with the connecting member 63. The other end of the connecting member 63 is inserted into the hole in the holding base 60, and the holding base 60 is fixed to the connecting member 63 with a screw 60A. The position of the holding base 60 in the Z direction is determined by adjusting the length by which the connecting member 63 is inserted into the hole in the holding base 60.

[0038] Alternatively, a ball joint may be used by making the other end of the connecting member 63 spherical and forming a recess in the holding base 60 that makes spherical contact with the other end of the connecting member 63. This allows the holding base 60 to be adjusted to any angle relative to the connecting member 63. In this case, it is preferable to make the length of the connecting member 63 variable in order to adjust the position of the holding base 60 in the Z direction.

[0039] FIG. 5 is a diagram illustrating the internal rotation and external rotation of the holding mechanism. FIG. 5 shows an example in which the holding mechanism M1 holds a femoral model 70 that simulates a right femur. FIG. 5(A) shows an example of the state of the holding mechanism M1 in the reference position. The first joint 10 and the second joint 20 are in the reference position. In the reference position, the first axis AZ, the second axis AX, and the third axis AY are perpendicular to each other. The reference position of the first joint 10 is determined by the position of the first rotation axis 13 relative to the first bearing 56. Here, the second rotation axis 23, which is supported by the second bearing 14, is set to a position parallel to the X direction. The reference position of the second joint 20 is determined by the position of the second rotation axis 23 relative to the second bearing 14. Here, the third rotation axis 33, which is supported by the rotation support unit 24, is set to a position parallel to the Y direction.

[0040] The reference position of the holding member 30 is the position where the mark on the holding member 30 indicates the value 0 on the scale marked on the rotating holding part 24. When the holding member 30 is in the reference position, the femur model 70 is attached to the holding member 30 and the pelvis model 80 is attached to the holding base 60 so that the hips and knees are extended and the toes are facing forward.

[0041] Figure 5(B) shows the femoral model 70 in a state where it has been internally rotated from the reference position. As the mark on the holding member 30 indicates the scale value 2.5 on the rotation holder 24, it is shown that the femoral model 70 has rotated in the positive direction about the AY axis. Figure 5(C) shows the femoral model 70 in an externally rotated state. As the mark on the holding member 30 indicates the scale value -2.5 on the rotation holder 24, it is shown that the femoral model 70 has rotated in the negative direction about the AY axis.

[0042] FIG. 6 is a diagram illustrating the bending and extension operations of the holding mechanism. Similar to FIG. 5(A), FIG. 6(A) shows an example of the state of the holding mechanism M1 in the reference position. FIG. 6(B) shows the state in which the femur model 70 has been bent from the reference position shown in FIG. 6(A). As the mark on the second joint 20 indicates the scale value 3 on the second bearing 14, the femur model 70 is shown rotating in the positive direction about the AX axis. FIG. 6(C) shows the state in which the femur model 70 has been extended. As the mark on the second joint 20 indicates the scale value −3 on the second bearing 14, the femur model 70 is shown rotating in the negative direction about the AX axis.

[0043] Figure 7 is a diagram illustrating the abduction and adduction movements of the holding mechanism. Similar to Figure 5(A), Figure 7(A) shows an example of the state of the holding mechanism M1 in the reference position. Figure 7(B) shows a state in which the femur model 70 has been adducted from the reference position shown in Figure 7(A). This shows that the first joint 10 is rotating clockwise around the AZ axis, as indicated by the arrow. Figure 7(C) shows a state in which the femur model 70 has been abducted. This shows that the first joint 10 is rotating counterclockwise around the AZ axis, as indicated by the arrow.

[0044] In the hip joint surgery simulation device 100 of this embodiment, the holding mechanism M1 can rotate the femur model 70 about each of the AZ axis, AX axis, and AY axis. In this case, the AZ axis, AX axis, and AY axis always pass through the reference point R, so the femur model 70 can be rotated about the reference point R. While the femur model 70 is being rotated, the relative position between the reference point R and the pelvis model 80 does not change, so it is possible to accurately reproduce the change in the relative position between the femur and the acetabulum that occurs during an actual surgery.

[0045] Furthermore, the pair of the first rotating shaft 13 and the first bearing 56 realizes rotation about the AZ axis, the pair of the second rotating shaft 23 and the second bearing 14 realizes rotation about the AX axis, and the pair of the third rotating shaft 33 and the rotation holder 24 realizes rotation about the AY axis. The shafts and bearings may be reversed. The pair of the first rotating shaft 13 and the first bearing 56, the pair of the second rotating shaft 23 and the second bearing 14, and the pair of the third rotating shaft 33 and the rotation holder 24 are independent. Therefore, it is possible to combine two or more of rotation about the AZ axis, rotation about the AX axis, and rotation about the AY axis. For example, the femoral model 70 can be externally or internally rotated while being externally or internally abducted and further flexed or extended.

[0046] Figure 8 is a perspective view of the hip joint surgery simulation device during hip joint surgery practice. Referring to Figure 8, front columns 52A, 52B of frame 50 hold skin model 92. Each of the two front columns 52A, 52B includes an inclined portion that slopes backward at a predetermined height. The distance between the two front columns 52A, 52B is determined in the Y direction so that the hip joints of femur model 70 and pelvis model 80 are positioned between the two front columns 52A, 52B.

[0047] The hook surface (or loop surface) of a hook-and-loop fastener is attached to each of the two front pillars 52A, 52B, and the loop surface (or hook surface) of the hook-and-loop fastener is attached to the back surface of the skin model 92. Note that the skin model 92 may be detachably attached to the two front pillars 52A, 52B by screws, snaps, or the like instead of hook-and-loop fasteners.

[0048] Reinforcing members 91 are attached to the two front pillars 52A, 52B so as to overlap the skin model 92. The material of the reinforcing member 91 may be resin or metal. The reinforcing member 91 has gaps that allow the arthroscope T1 and surgical instrument T2 to pass through. For example, the surgical instrument T2 is an instrument for cutting bone, such as a cutter or reamer. The reinforcing member 91 may have a mesh shape or may have holes formed in some parts. The reinforcing member 91 imparts a predetermined elastic force to the skin model 92 in response to a force applied to the skin model 92 from the front with a scalpel or the like. The user can feel an elastic force similar to that of skin when cutting the skin model 92 from the front with a scalpel or the like.

[0049] The hip surgery simulation device 100 also has a transparent top panel 95 on its upper surface. The top panel 95 includes an upper area that extends vertically from the holding mechanism M1 and the pelvis holding unit M2. The top panel 95 has an area on which the smartphone 200 can be placed. The smartphone 200 has a display unit on its front surface and a camera on its back surface. The smartphone 200 is placed on the top panel 95 with the display unit facing upward and the camera facing downward. Therefore, the imaging area of ​​the camera of the smartphone 200 can include the femur model 70 held by the holding mechanism M1 and the pelvis model 80 held by the pelvis holding unit M2.

[0050] The smartphone 200 is placed on the top board 95 of the hip joint surgery simulation device 100 with the display set to display an image captured by the camera. The angle of view of the camera of the smartphone 200 is set to include at least a portion of each of the femur model 70 and the pelvis model 80. Therefore, images captured from above of the femur model 70 and the pelvis model 80 are displayed on the display of the smartphone 200. Therefore, an image simulating an image captured with X-rays in an actual surgery can be displayed on the display of the smartphone 200. Furthermore, by setting the smartphone 200 to display a binarized image of the image to be displayed, an image similar to an image captured with X-rays can be displayed.

[0051] Two openings 92A, 92B are formed in the skin model 92 with a scalpel, and an arthroscope T1 is inserted into one opening 92B, and a surgical instrument T2 is inserted into the other opening 92A. The user can determine the positions of the arthroscope T1 and the surgical instrument T2 while checking the relative positions of the arthroscope T1 and the surgical instrument T2, respectively, to the femur model 70 and the pelvis model 80, and by referring to the image captured by the arthroscope T1 and the image displayed on the display unit of the smartphone 200.

[0052] 9 is a diagram showing an example of an image displayed on the display unit of the smartphone. Referring to FIG. 9, the image displayed on the display unit of the smartphone includes a femur model 70 and a pelvis model 80.

[0053] Fig. 10 is a diagram showing an example of an image obtained by binarizing the image of Fig. 9. Referring to Fig. 10, the binarized image includes the outline of femur model 70 and the outline of pelvis model 80 from the image shown in Fig. 9. Therefore, although the outline of femur model 70 can be confirmed from the binarized image, it is difficult to confirm the shape in the depth direction, such as undulations within the outline.

[0054] (2) Hip arthroscopy practice An overview of hip arthroscopic surgery will be explained. Figure 11 is an explanatory diagram showing the basic steps of hip arthroscopic surgery. In Figures 11(a) to (f), the right ilium B1 and right femur B2 are shown in solid lines as the lumbar region of the human body and the surrounding skeleton. The skin covering the right ilium B1 and right femur B2 is also shown in dashed lines.

[0055] The initial state is shown in Figure 11(a). In this hip arthroscopic surgery, a portion of the femoral head B21 of the right femur B2 is the surgical target portion B22. First, as shown in Figure 11(b), the femoral head B21 of the right femur B2 is removed (dislocated) from the acetabulum B11 of the right ilium B1. Then, a portion of the skin covering the hip joint is incised, and multiple openings B3 (two in this example) are formed.

[0056] 11(c), an arthroscope T1 is inserted into one opening B3 until the tip of the arthroscope T1 reaches a position near the femoral head B21. A surgical instrument T2 is inserted into the other opening B3 until the tip of the surgical instrument T2 reaches a position near the femoral head B21.

[0057] Next, the joint capsule (not shown) is incised. While referring to the X-ray image and the image captured by the arthroscope T1, the surgeon flexes, extends, abducts, adduces, externally rotates, or internally rotates the right femur B2 so that the tip of the surgical instrument T2 (e.g., a cutter or reamer) and the surgical target B22 are positioned within the field of view of the arthroscope T1. The range of motion of the arthroscope T1 is limited because it passes through one opening B3 and the incision in the joint capsule. Similarly, the range of motion of the surgical instrument T1 is limited because it passes through another opening B3 and the incision in the joint capsule. Therefore, the surgeon flexes, extends, abducts, adduces, externally rotates, or internally rotates the right femur B2 while minimizing movement of the arthroscope T1 and the surgical instrument T1 so that the surgical target B22 is positioned within the field of view of the arthroscope T1. The surgical instrument T2 then grinds and removes the surgical target B22.

[0058] Next, as shown in FIG. 11(d), the right femur B2 is flexed, extended, abducted, adduced, externally rotated, or internally rotated so that the surgical target portion B22 is positioned at the contour of the right femur B2 in the X-ray image. This allows the surgical target portion B22 to be positioned at the contour, allowing the amount of grinding to be confirmed. If grinding of the surgical target portion B22 is insufficient, the right femur B2 is flexed, extended, abducted, adduced, externally rotated, or internally rotated so that the tip of the surgical instrument T2 and the surgical target portion B22 are positioned within the field of view of the arthroscope T1. The surgical target portion B22 is then ground and removed using the surgical instrument T2. The procedures shown in FIGS. 11(c) and 11(d) are repeated until the surgical target portion B22 is completely removed.

[0059] The incision in the joint capsule (not shown) is then sutured, and the femoral head B21 of the right femur B2 is fitted into the acetabulum B11 of the right ilium B1, as shown in Figure 11(e). Finally, the multiple openings B3 are sutured, as shown in Figure 11(f), to complete the hip arthroscopic surgery.

[0060] A user can use the hip surgery simulation device 100 to practice the above-described hip surgery.

[0061] Fig. 12 is a flowchart showing an example of the flow of a method of using hip joint surgery simulation device 100. Referring to Fig. 12, a user of hip joint surgery simulation device 100 first adjusts the distance between femur model 70 and pelvis model 80 to recreate a state in which femur model 70 is dislocated from the acetabulum of pelvis model 80 (step S01). Specifically, the user loosens screws 63A that secure connecting member 63 to support member 61, and moves holding base 60 away from reference point R. After the position of holding base 60 has been adjusted, connecting member 63 is secured to support member 61 with screws 63A.

[0062] Next, the user forms two openings 92A and 92B in the skin model 92 (step S02). The user incises the skin model 92 with a scalpel.

[0063] Next, the user inserts the arthroscope T1 and the surgical instrument T2 into the multiple openings 92A, 92B (step S03). Then, the user confirms the position of the surgical instrument T2 using the image (step S04). The user confirms the position of the surgical instrument T2 by referring to the image captured by the arthroscope T1 and the image displayed on the display unit of the smartphone 200. In particular, since the outline of the femur model 70 is displayed in the image on the smartphone 200, the user can confirm the positions of the surgical target portion 79, the arthroscope T1, and the surgical instrument T2 within the outline.

[0064] Next, the user moves the femur model 70 so that the surgical target portion 79 of the femur model 70 is located within the field of view of the arthroscope T1 and within the range of motion (surgical area) of the surgical instrument T2 (step S05). Specifically, the user operates the holding mechanism M1 to rotate the femur model 70 around at least one of the first axis AZ, the second axis AX, and the third axis AY. As described for the actual surgery using FIG. 11 , the range of motion of the arthroscope T2 and the surgical instrument T2 is limited. For this reason, the user positions the surgical target portion 79 within the surgical area by minimizing movement of the arthroscope T1 and the surgical instrument T1.

[0065] The user then refers to the image captured by the arthroscope T1 and the image displayed on the display unit of the smartphone 200 to determine whether the surgical target area 79 is included in the surgical area (step S06). If the surgical target area 79 is included in the surgical area, the user proceeds to step S07, but if not, the user returns to step S04. That is, the user repeats steps S04 and S05 until the surgical target area 79 is included in the surgical area.

[0066] In step S07, the user cuts the surgical target portion 79 with the surgical instrument T2. In step S08, the user moves the femur model 70. Specifically, the user operates the holding mechanism M1 to rotate the femur model 70 around at least one of the first axis AZ, the second axis AX, and the third axis AY. The user confirms the surgical target portion 79 while referring to the image displayed on the display unit of the smartphone 200 (step S09). The user determines whether the surgical target portion 79 of the femur model 70 is located on the outline of the femur model 70 in the image displayed on the display unit of the smartphone 200 (step S10). If the user determines that the surgical target portion 79 is located on the outline of the femur model 70 in the image displayed on the display unit of the smartphone 200, the process proceeds to step S11; otherwise, the process returns to step S08.

[0067] In steps S08 to S10, the user operates the holding mechanism M1 to rotate the femur model 70 around at least one of the first axis AZ, the second axis AX, and the third axis AY until the surgical target portion 79 of the femur model 70 is positioned on the outline of the femur model 70 in the image displayed on the display unit of the smartphone 200.

[0068] In step S11, the user determines whether grinding is complete. The user checks the amount of cutting of the surgical target portion 79 of the femur model 70 and the shape after cutting by referring to the outline of the femur model 70 in the image displayed on the display unit of the smartphone 200. If the user determines that grinding is complete, the user proceeds to step S12; otherwise, the user returns to step S04.

[0069] The user removes the arthroscope T1 and the surgical instrument T2 from the hip joint surgery simulation device 100 (step S12), and fits the femur model 70 into the pelvis model 80 (step S13). Specifically, the user loosens the screws that secure the connecting member 63 to the support member 61, and moves the holding base 60 so that it approaches the reference point R. After the position of the holding base 60 has been adjusted, the connecting member 63 is secured to the support member 61 with the screws. Finally, the user sutures the two openings 92A and 92B of the skin model 92 (step S14).

[0070] <Example of a femur model> 13 and 14 are diagrams showing an example of a femur model. A femur model 70 is divided into two parts, an upper model 75 and a lower model 78, along the XZ plane. Two convex portions 76A and 77A are formed on a cut surface 75A of the upper model 75. Two concave portions 76B and 77B are formed on a cut surface 78A of the lower model 78.

[0071] The upper model 75 and the lower model 78 are coupled together by engaging the convex portion 76A of the upper model 75 with the concave portion 76B of the lower model 78 and by engaging the convex portion 77A of the upper model 75 with the concave portion 77B of the lower model 78. This prevents the user from making a mistake in the coupling direction when coupling the upper model 75 and the lower model 78. Furthermore, the lower model 78 can be fixed to the holding member 30 of the hip joint surgery simulation device 100, and only the upper model 757 can be replaced.

[0072] Furthermore, only the upper model 75 having the protrusions 76A, 77A whose shapes and positions correspond to the recesses 76B, 77B of the lower model 78 can be coupled to the recesses 76B, 77B of the lower model 78.

[0073] The upper model 75 may be generated by a 3D printer using, for example, a CT scanner or MRI to acquire multiple cross-sectional images of a portion of the body including the hip joint, and using three-dimensional data generated based on the multiple cross-sectional images. In this case, the upper model 75 is generated to accurately mimic the surgical target area 79. Therefore, by matching the shape of the surgical target area 79 to the shape of the actual surgical target area B22 of the patient, a mock surgery can be effectively performed before surgery.

[0074] The hip joint surgery simulation device 100 of this embodiment includes a pelvis holding unit M2 that holds a pelvis model 80, a holding member 30 that holds a femur model 70, and a holding mechanism M1 that holds the holding member 30 rotatably about a first axis AZ, a second axis AX, and a third axis AY that pass through a reference point R whose position relative to the holding member 30 is predetermined. The first axis AZ and the second axis AX are always perpendicular to each other, and the second axis AX and the third axis AY are always perpendicular to each other. Therefore, the holding member 30 is held by the holding mechanism M1 so as to be rotatable about the first axis AZ, the second axis AX, and the third axis AY that pass through the reference point R. Therefore, the femur model 70 can be rotated about at least one of the first axis AZ, the second axis AX, and the third axis AY around the reference point R. This increases the range of motion when rotating the femur model 70. As a result, the hip joint surgery simulation device 100 can be made smaller and the degree of freedom of movement of the medical model consisting of the femur model 70 and the pelvis model 80 can be increased.

[0075] The holding mechanism M1 also includes a first joint 10 rotatable about a first axis AZ, a second joint 20 held by the first joint 10 and rotatable about a second axis AX perpendicular to the first axis AZ at a reference point R, and a rotary holding unit 24 held by the second joint 20 and holding the holding member 30 rotatable about a third axis AY perpendicular to the second axis AX at the reference point R. As a result, the first joint 10 rotates about the first axis AZ, the second joint 20 held by the first joint 10 rotates about the second axis AX, and the rotary holding unit 24 held by the second joint 20 rotates the holding member 30 about the third axis AY. This allows the configuration of the holding mechanism M1 to be compact, thereby enabling the device to be made more compact.

[0076] Furthermore, the pelvis holding part M2 includes a support member 61 and a connecting member 63 as an adjustment mechanism that can change the relative position between the reference point R and the pelvis model 80. Therefore, the relative positions of the femur model 70 and the pelvis model 80 can be easily adjusted.

[0077] Moreover, hip joint surgery simulation device 100 further includes front pillars 52A, 52B as skin holding members that hold skin model 92 covering pelvis model 80 and femur model 70, and reinforcing members 91 that are attached to front pillars 52A, 52B and reinforce skin model 92. Therefore, skin model 92 is reinforced by reinforcing members 91, and the elastic force of skin model 92 can be adjusted.

[0078] The hip joint surgery simulation device 100 further includes a smartphone 200 including a camera arranged so that at least a portion of the pelvis model 80 and at least a portion of the femur model 70 are included in the imaging range, and a display device that displays an image captured by the camera. Therefore, an image captured of at least a portion of the pelvis model 80 and at least a portion of the femur model 70 is displayed on the display unit of the smartphone 200. Therefore, it is possible to display an image that simulates an image captured by X-rays that is displayed in an actual surgery.

[0079] Furthermore, the method for practicing hip joint surgery using the hip joint surgery simulation device 100 described above includes a positioning process in which the user rotates the femur model 70 by operating the holding mechanism M1 while referring to the image displayed on the smartphone 200 in order to determine the relative position of the surgical instrument T2 and the surgical target portion 79 of the pelvis model 80 and / or femur model 70, a processing process in which the user processes the surgical target portion 79 using the surgical instrument T2, and a confirmation process in which the user rotates the femur model 70 by operating the holding mechanism M1 while referring to the image displayed on the smartphone 200 in order to confirm the shape of the surgical target portion 79. For this reason, the user rotates the femur model 70 by operating the holding mechanism M1 while referring to the image displayed on the smartphone 200, processes the surgical target portion 79 using the surgical instrument T2, and then rotates the femur model 70 by operating the holding mechanism M1 in order to confirm the shape of the surgical target portion 79. Therefore, the relative position of the surgical instrument T2 and the surgical target part 79 can be determined from the image displayed on the smartphone 200, and the shape of the surgical target part 79 can be confirmed from the image displayed on the smartphone 200. As a result, it becomes possible to practice hip joint surgery while obtaining information similar to that obtained in an actual surgery.

[0080] The hip joint surgery simulation device 100 can also be used for user education and training. For example, an instructor can point out the surgical target area 79 in the image displayed on the display unit of the smartphone 200, allowing the user to understand the surgical target area 79. Furthermore, by understanding the positions of the femur model 70 before and after rotating the femur model 70 and the image displayed on the display unit of the smartphone 200, the user can learn the direction and amount of rotation of the femur model 70 by looking only at the image displayed on the display unit of the smartphone 200.

[0081] (3) Other Examples of Hip Surgery Simulation Device 100 (a) A joint capsule model that imitates the joint capsule that covers the connecting portion of the femur model 70 that is fitted into the pelvis model 80 may be further attached. Also, a labrum model may be further attached to the pelvis model 80. Also, a cartilage model and a ligament model may be further attached to the femur model 70 and the pelvis model 80. This more accurately reproduces the condition of the acetabulum, femur, and their surrounding areas, making it possible to practice under conditions that are closer to actual hip joint surgery.

[0082] (b) In the above embodiment, femur model 70 represents the right femur of a human body, and pelvis model 80 represents a part of the acetabulum of the right ilium of a human body, but femur model 70 may be formed to represent the left femur of a human body, and pelvis model 80 to represent a part of the acetabulum of the left ilium of a human body. In this case, in hip joint surgery simulation device 100, support member 61 of pelvis holding unit M2 is attached to groove 55B of rail member 54B shown on the right side of Figure 2, and second joint 20 shown in Figure 2 is used in a state where its basic position is a position rotated 180 degrees around second axis AX.

[0083] (c) In this embodiment, an area is provided on the top panel 95 of the hip joint surgery simulation device 100 where a smartphone 200 can be placed. The hip joint surgery simulation device 100 may include a camera and a display device that displays images captured by the camera, instead of the smartphone 200. In this case, the camera is fixed to the top panel 95, and the display device may be separate from or integrated with the hip joint surgery simulation device 100. Furthermore, the top panel 95 does not have to be transparent.

[0084] (d) In this embodiment, the hip joint surgery simulation device 100 has been described using arthroscopic surgery as an example, but the surgeries to which the hip joint surgery simulation device 100 can be applied are not limited to surgeries using an arthroscope T1. The hip joint surgery simulation device 100 can be used to simulate surgeries related to the hip joint. For example, the device can be applied to surgeries for femoral neck fractures, pelvic osteotomy surgeries, artificial hip joint surgeries, etc. [Explanation of symbols]

[0085] 100 Hip joint surgery simulation device, M1 Holding mechanism, M2 Pelvis holding part, R Reference point, AZ First axis, AX Second axis, AY Third axis, T1 Arthroscope, T2 Surgical instrument, 10 First joint, 11 First plane, 12 Second plane, 13 First rotation axis, 14 Second bearing, 20 Second joint, 21 Third plane, 22 Fourth plane, 23 Second rotation axis, 24 Rotation holding part, 30 Holding member, 31 Fifth plane, 32 Sixth plane, 33 Third rotation axis, 40 Holding member, 50 Frame, 51 Base member, 52A, 52B Front column, 53A, 53B Rear column, 54A, 54B Rail member, 55A, 55B Groove, 56 First bearing, 60 Holding base, 60A Screw, 61 Support member, 61A Cylindrical part, 61B Fixation part, 63 connecting member, 63A screw, 70 femoral model, 71 femoral head, 72 femoral neck, 73 greater trochanter, 75 upper model, 78 lower model, 75A, 78A cut surface, 76A, 77A convex part, 76B, 77B concave part, 79 surgical target part, 80 pelvic model, 91 reinforcement member, 92 skin model, 92A, 92B opening, 95 top plate, 200 smartphone.

Claims

1. a pelvis holding part for holding a pelvis model; a holding member for holding a femur model; a holding mechanism that holds the holding member rotatably about a first axis, a second axis, and a third axis, each of which passes through a predetermined reference point and has a relative position relative to the holding member; the first axis and the second axis are perpendicular to each other, and the second axis and the third axis are perpendicular to each other; The holding mechanism includes a first joint rotatable about the first axis; a second joint held by the first joint and rotatable about the second axis; a rotational holding unit that is held by the second joint and holds the holding member rotatably around the third axis.

2. A pelvis holding part for holding a pelvis model; a holding member for holding a femur model; a holding mechanism that holds the holding member rotatably about a first axis, a second axis, and a third axis, each of which passes through a predetermined reference point and has a relative position relative to the holding member; a transparent top plate disposed in an area above the pelvis holding portion and the holding member; an imaging and display device having a camera and a display unit facing away from the camera, The hip joint surgery simulation device, wherein the imaging and display device is placed on the tabletop with the camera facing downward.

3. 3. The hip joint surgery simulation device according to claim 1, wherein the pelvis holding unit includes an adjustment mechanism that can change the relative position between the reference point and the pelvis model.

4. a skin holding member for holding a skin model covering the pelvic model and the femur model; 4. The hip joint surgery simulation device according to claim 1, further comprising a reinforcing member attached to said skin holding member for reinforcing said skin model.

5. a camera disposed so that at least a portion of the pelvis model and at least a portion of the femur model held by the holding member are included in an imaging range; 5. The hip joint surgery simulation device according to claim 1, further comprising a display device that displays an image captured by the camera.

6. A method of using the hip joint surgery simulation device according to claim 5, comprising: a positioning process in which the holding mechanism is operated to rotate the femoral model while referring to the image displayed on the display device in order to determine the relative positions of a surgical instrument and the surgical target portion of the pelvic model and / or the femoral model; a processing step of processing the surgical target portion using the surgical instrument; a confirmation process of operating the holding mechanism to rotate the femur model while referring to the image displayed on the display device in order to confirm the shape of the surgical target part.

7. A method of using a hip joint surgery simulation device, comprising: The hip joint surgery simulation device includes: a pelvis holding part for holding a pelvis model; a holding member for holding a femur model; a holding mechanism that holds the holding member rotatably about a first axis, a second axis, and a third axis, each of which passes through a predetermined reference point and has a relative position relative to the holding member; a transparent top plate disposed in an area above the pelvis holding portion and the holding member, a process of placing an imaging and display device having a camera and a display unit facing away from the camera on the top board with the camera facing downward; a positioning process in which the holding mechanism is operated to rotate the femoral model while referring to the image displayed on the display device in order to determine the relative positions of a surgical instrument and the surgical target portion of the pelvic model and / or the femoral model; a processing step of processing the surgical target portion using the surgical instrument; a confirmation process of operating the holding mechanism to rotate the femur model while referring to the image displayed on the display device in order to confirm the shape of the surgical target part.

Images