Transparent ventricle model

Abstract

To provide a cerebrum model and a training device thereof that are intended for training of endoscope surgeries for treating diseases of the ventricular system.SOLUTION: A human cerebrum model is formed of transparent synthetic resin, and is substantially spherical. In the human cerebrum model, the substantially spherical center part is provided with spaces corresponding to left and right lateral ventricles, the interventricular foramen (the foramen of Monro), the third ventricle, the cerebral aqueduct, and the fourth ventricle, in the human ventricular system.SELECTED DRAWING: Figure 4

Description

[Technical Field]

[0001] The present invention relates to a transparent ventricle model and a training device for use in training in endoscopic surgery for treating ventricular diseases. [Background technology]

[0002] The ventricles (also called the ventricular system) are complex-shaped cavities in the center of the cerebrum that are filled with cerebrospinal fluid. CSF is produced in a tissue called the choroid plexus, which is believed to be located in the left and right lateral ventricles, the third ventricle, and the fourth ventricle that make up the ventricular system. Most of the choroid plexus is located in the left and right lateral ventricles, and the CSF produced mainly travels from the third ventricle through the cerebral aqueduct to the fourth ventricle. It then flows into the subarachnoid space through the median and lateral foramina in the fourth ventricle. CSF that flows into the subarachnoid space is absorbed by arachnoid granulations in the arachnoid membrane and enters the venous system. The amount of CSF in the ventricles and subarachnoid space is estimated to be approximately 150 ml in adults, and the amount produced by humans per day is approximately 500 ml.

[0003] When stenosis or blockage occurs in the third ventricle, cerebral aqueduct, fourth ventricle, or the median or lateral foramen of the fourth ventricle, the ventricular system before cerebrospinal fluid expands into the ventricles upstream of the blockage. The main causes of blockage include intraventricular tumors, pineal tumors, posterior fossa tumors, and intracerebral hemorrhage. When these conditions occur, intraventricular pressure rises, causing symptoms such as headache, nausea, vomiting, papilledema, optic atrophy, and loss of consciousness, leading to a diagnosis of hydrocephalus.

[0004] Endoscopes are used in the surgical treatment of intraventricular diseases such as hydrocephalus. Because the ventricles have a complex structure, determining which part of the ventricular system the tip of the endoscope is touching and whether it is reaching the correct area while avoiding areas that should not be touched often depends on the skill of the surgeon.

[0005] Endoscopic treatments became widespread from the 1980s to the 1990s. However, there were no suitable models of complex organs for endoscopic practice. Until the mid-1990s, cadavers were often used for endoscopic training. For example, in training using a ventriculoscope, an endoscope was inserted into the head of a cadaver, and after training, the brain was divided to verify how the endoscope moved inside the brain. Later, with the development of synthetic resin processing technology, medical models that mimicked the brain also became available, but there was no model that could provide a bird's-eye view of how the endoscope actually moved.

[0006] For example, Patent Document 1 describes a transparent brain model. Although it has a hollow structure, it is a model for calibrating a tomographic imaging device, and is not designed to resemble the hardness or structure of a human body for surgical training.

[0007] Furthermore, medical models of the ventricular system, in particular, must realize a complex hollow structure within the brain, a tissue so soft that it would collapse under its own weight. Therefore, when attempting to closely resemble the actual shape, there are models created with the hollow portion removed, as in Non-Patent Document 1, but there have been no medical models that mimic the actual human ventricular system and allow for a bird's-eye view of the surgical procedure from the outside. [Prior art documents] [Patent documents]

[0008] [Patent Document 1] Japanese Patent Application Laid-Open No. 2008-132022 [Non-patent literature]

[0009] [Non-Patent Document 1] https: / / www.3bs.jp / manual-download / VH410.pdf Summary of the Invention [Problem to be solved by the invention]

[0010] As described above, there has not been a surgical training model that closely resembles the texture of the actual human cerebrum and faithfully reproduces the ventricular system, while allowing the movement of instruments such as endoscopes to be visually observed from the outside. [Means for solving the problem]

[0011] As a result of intensive research into the above-mentioned problems, the inventors discovered that a human cerebral model, which is made by using a 3D printer to produce a mold with a hollow structure of the human ventricular system and then pouring a specific transparent resin into it and solidifying it, allows surgical instruments such as endoscopes to be easily viewed from the outside, and is therefore useful for surgical practice, the development of new surgical methods, and obtaining informed consent from patients, and thus completed the present invention.

[0012] Therefore, the present invention provides the following in summary.

[0013] One embodiment of the present invention is [1] a human cerebral model formed from a transparent synthetic resin and having an approximately spherical shape, in the center of the approximately spherical shape, spaces corresponding to the left and right lateral ventricles, the interventricular foramen (foramen of Monro), the third ventricle, the cerebral aqueduct, and the fourth ventricle in the human ventricular system.

[0014] Another embodiment of the present invention is the human cerebrum model described above, wherein [2] the human cerebrum model is divided at predetermined positions.

[0015] Another embodiment of the present invention is [3] the human cerebrum model described above, wherein the human cerebrum model is divided into two halves, upper and lower, at the level of the posterior horn of the lateral ventricle.

[0016] In another embodiment of the present invention, [4] any one or all of the lateral ventricle, the third ventricle, and the fourth ventricle further comprises a region simulating a choroid plexus, This is the human cerebral model described above.

[0017] Another embodiment of the present invention is the human cerebral model described above, [5] which has an approximately spherical region corresponding to the pineal gland located below the third ventricle and slightly above the inferior horn of the lateral ventricle.

[0018] Another embodiment of the present invention is the human cerebrum model described above, wherein the bisected human cerebrum model is fixed.

[0019] Another embodiment of the present invention is [7] a ventricular system endoscopic training device comprising a human cerebral model formed from a transparent synthetic resin and having an approximately spherical shape, in the center of which are provided spaces corresponding to the left and right lateral ventricles, the interventricular foramen (foramen of Monro), the third ventricle, the cerebral aqueduct, and the fourth ventricle of the human ventricular system, and a partially open transparent container.

[0020]

[0023] Another embodiment of the present invention is the above-described ventricular endoscopy training device, wherein the container is provided with a fixture for fixing the human cerebrum model.

[0021] Another embodiment of the present invention is [9] the above-described ventricular system endoscopic training device, in which the human cerebrum model is divided into two halves, upper and lower, at the height of the posterior horn of the lateral ventricle, the two halves of the human cerebrum model are fixed with a rod passing through them, and the fixing device has a structure for locking the end of the passing rod.

[0022]

[0023] Also, another embodiment of the present invention is

[10] the above-described ventricular system endoscopy training device, wherein the container is filled with a transparent liquid.

[0023] Another embodiment of the present invention is

[11] the above-described ventricular system endoscopic training device, further comprising a sheath having a portion that is visible from the outside when passed through the human cerebrum model in the container.

[0024] Another embodiment of the present invention is

[12] the human cerebrum model described above, wherein the movement target of the endoscope or the area to be avoided by contact or invasion of the endoscope is color-coded. [Effects of the Invention]

[0025] According to the present invention, the movement of an endoscope inside the brain can be observed from the outside during brain surgery. Therefore, it is suitable for training students and doctors in ventricular surgery by using multiple people for observation and recording. Furthermore, since the brain can be viewed in its entirety and in detail from the outside and various insertion patterns of surgical instruments can be considered, it is useful for research and development of approaches to treatment sites. Furthermore, since the movement of surgical instruments can be viewed from the outside, it is also useful for validation of endoscopes and other devices. Furthermore, it can be used by doctors to explain surgical schemes and treatments to patients. [Brief explanation of the drawings]

[0026] [Figure 1] This is a diagram of the human ventricular system as seen from the left side of the head. [Figure 2] FIG. 1 shows a parietal view of the human ventricular system. [Figure 3] FIG. 1 is a schematic diagram of the human cerebral model described herein. [Figure 4] FIG. 1 shows a schematic diagram of the internal structure of the human cerebral model described herein. [Figure 5] FIG. 1 illustrates one embodiment of a container in an exercise device described herein. [Figure 6] FIG. 1 illustrates one embodiment of the use of the training device described herein. [Figure 7] FIG. 1 illustrates one embodiment of the use of the training device described herein. [Figure 8] FIG. 1 illustrates one embodiment of the use of the training device described herein. DETAILED DESCRIPTION OF THE INVENTION

[0027] The ventricle model and ventricular system endoscopy training device described in this specification will be described in more detail below with reference to the drawings, although the ventricle model and ventricular system endoscopy training device described in this specification are not intended to be limiting in any way.

[0028] First, we will provide an overview of the human ventricular system with reference to Figures 1 and 2. The ventricular system, which is the area through which cerebrospinal fluid flows within the brain, consists of the anterior horns (A) of the left and right lateral ventricles, the lateral ventricles (B), the interventricular foramen (J), the third ventricle (E), the cerebral aqueduct (H), and the fourth ventricle (F). The left and right lateral ventricles (B) are located within the cerebrum. The lateral ventricles are part of the ventricular system and are responsible for the production of cerebrospinal fluid. The left and right lateral ventricles (B) are located within the cerebrum. The interventricular foramen (J) (also known as the foramen of Monro) is a passageway connecting the left and right lateral ventricles (B) with the third ventricle (E). CSF produced in the lateral ventricle (B) flows into the third ventricle (E) through the interventricular foramen (J). The third ventricle (E) then receives CSF from the lateral ventricle (B) through the interventricular foramen (J). This area is located between the thalamus and hypothalamus. The cerebral aqueduct (H) is a long, narrow passageway that connects the third ventricle (E) with the fourth ventricle (F) and runs vertically through the brainstem. CSF flows through this aqueduct into the fourth ventricle F. Next, the fourth ventricle F is located between the cerebellum and the brainstem, and CSF flows into it through the cerebral aqueduct. From the fourth ventricle F, CSF flows out of the brain, filling the subarachnoid space, and also flows into the spinal cord via the central canal G.

[0029] The choroid plexus, which is responsible for producing cerebrospinal fluid, is located throughout the left and right lateral ventricles B, the third ventricle E, and the fourth ventricle F (not shown in Figures 1 and 2). The choroid plexus is generally irregularly shaped and has numerous hair-like protrusions. These protrusions are composed of blood vessels and epithelial cells, and the cells are tightly connected to the surrounding capillaries. CSF secreted from the choroid plexus physically protects the brain and spinal cord, maintains the balance of nutrients and chemicals in the brain, and flows to various parts of the brain through the ventricular system. Note that Figures 1 and 2 are intended to explain the ventricular system. In the human cerebral model of the present invention, this ventricular system is molded as a hollow structure within an approximately spherical shape made of transparent synthetic resin.

[0030] The transparent ventricle model of the present invention uses a transparent synthetic resin to model the ventricles, which play such a complex and important role, making it possible to visually understand their complex internal structure. It is particularly important to understand structures such as the ventricular system and choroid plexus in three dimensions, but it is difficult to directly visualize these three-dimensional structures using conventional MRI or CT scans.

[0031] Next, the human cerebrum model 1 in this specification will be described with reference to Figure 3. Figure 3 is a view of the human cerebrum as seen from the front and slightly below. In Figure 3, the outline of the part corresponding to the ventricular system is indicated by a dotted line. The human cerebrum model in this invention is composed of a base material 3 made of a transparent synthetic resin, and as shown in Figure 1, the shape corresponding to the ventricular system part has a hollow structure.

[0032] The transparent synthetic resin used in the transparent ventricle model of the present invention should be capable of reproducing the flexibility of the human cerebrum to a certain extent, should not be partially deformed or destroyed by its own weight, and should be transparent enough to allow its internal structure to be visible from the outside. Furthermore, since the model is used by fixing it in a container filled with a transparent liquid, as described below, it is preferable that the resin has resistance to elution by various liquids. Furthermore, it is preferable that the resin can maintain its shape even when a rod or the like is inserted into the model to fix it to a fixing tool, and that the resin can maintain the above-mentioned preferable properties even when the rod used for fixation is inserted in a different position multiple times.

[0033] Such resins are not particularly limited as long as they are synthetic resins whose transparency and elasticity can be adjusted to a certain extent by additives or crosslinking. Specific examples include ABS resin, polyethylene, polystyrene, epoxy resin, acrylic resin, phenolic resin, polyamide, polybutylene, polycarbonate, polyester, polyurethane, polyvinyl chloride, silicone rubber, etc. From the viewpoint of realizing a texture of the brain, polyurethane and silicone rubber are preferred, with polyurethane being particularly preferred.

[0034] Polyurethane is a general term for polymers having urethane bonds, and is usually produced by polyaddition of compounds having isocyanate groups and hydroxyl groups. The polyurethane used in the present invention is preferably a non-foaming elastomer material.

[0035] Polyurethane is highly suitable for the human cerebral model of the present invention due to its excellent properties, including transparency, flexibility, heat resistance, and chemical resistance. Furthermore, polyurethane retains its properties over a long period of time, making it possible to create highly detailed models. The flexibility of polyurethane is particularly advantageous when creating models with complex shapes, such as the brain. This is particularly suitable for situations where a realistic feel is important, such as surgical practice or preoperative planning. Polyurethane has flexibility that mimics the flexibility of the human cerebrum, allowing for the insertion of surgical instruments, such as sheaths and endoscopes, to be performed with ease similar to that of actual surgery. Furthermore, the resin's transparency allows the movement of surgical instruments within the brain to be observed from the outside. This is particularly useful for surgical practice and preoperative planning.

[0036] As shown in FIG. 4 , the human cerebrum model in this specification is a cerebrum molded from a transparent synthetic resin, which is horizontally divided into two halves, upper and lower, at the position of the posterior horn C of the lateral ventricle of the ventricular system formed therein. In this embodiment, the upper hemisphere is referred to as the upper hemisphere 6 and the lower hemisphere as the lower hemisphere 7. This configuration allows for the explanation of ventricular system procedures and the confirmation of which part of the ventricular system the endoscope is in contact with after training in a procedure while confirming the division of the ventricular system. In the present invention, the division position of the human cerebrum model can be appropriately changed depending on the intended use. Furthermore, since the divided human cerebrum model in this invention is held in a transparent container described below, it is preferably fixed by a suitable means. In the embodiment described in this disclosure, the model is fixed by penetrating a rod, but it may also be fixed by frictional force on the resin surface, or by tape or another fastening device.

[0037] As shown in FIG. 4, the human cerebral model in this specification further includes regions simulating choroid plexus 8 in any or all of the lateral ventricles through the third and fourth ventricles. While the cerebral model of the present invention is made of transparent synthetic resin, these regions may be colored. Alternatively, a pre-colored separate member may be placed in the lateral, third, and fourth ventricles as the choroid plexus. When the choroid plexus 8 is a separate member, it is preferable that it be made of a water-resistant member, since the training device of the present invention will be operated in a transparent liquid such as water, as will be described later.

[0038] With this configuration, during training on surgical tools such as endoscopes, it is possible to confirm from the outside whether choroid plexus cauterization (CPC) or choroid plexus resection (CPR) is being performed accurately while checking the operation of the surgical tool.

[0039] Furthermore, the human cerebral model in this specification can further have a roughly spherical area 4 (Fig. 3) corresponding to the pineal gland located below the third ventricle and slightly above the inferior horn of the lateral ventricle.

[0040] That is, in the ventricular system model of the present invention, contact areas or areas to avoid invasion during surgery may be color-coded. Furthermore, for endoscopic training, it is also effective to color the areas and routes that serve as the movement targets of the endoscope. The colored areas may be colored after molding the cerebral model, or separate parts colored for each area may be attached after molding. By using separate materials for the areas to avoid invasion, their positions can be recognized from the outside during surgical tool training, and they can also be confirmed by touch using an endoscope, etc.

[0041] Next, with reference to FIG. 5, an intraventricular endoscopic training device according to the present invention will be described. This specification provides an endoscopic training device comprising the aforementioned cerebral model and a partially open transparent container. An example of such a transparent container is a so-called cubic transparent container. Furthermore, because the cerebral model of the present invention is approximately spherical, it is necessary to fix the cerebral model during endoscopic training, for example. Preferably, the head is aligned with the direction of actual surgery. Therefore, the human cerebral model 1 of the present invention can be used for endoscopic training by fixing it to a support base 12 in a transparent container 10 shown in FIG. 5. By placing it in the transparent container 10 and fixing it to the support base 12, surgical training can be performed with the head fixed in a direction simulating actual surgery. In the embodiment shown in FIG. 5, the support base 12 is configured with a hook portion 12b with a bent tip attached to the upper part of a roughly U-shaped base 12a with an inclined surface. However, it is not intended that the support base of the present invention be limited to this shape, and the shape of the support base can be modified as appropriate.

[0042] Next, referring to Figure 6, we will explain an embodiment in which the human cerebrum model of this specification is placed in a transparent container 10. When using such a container, it is preferable to fill the container with water 15 or the like so that the cerebrum model is submerged. In the present invention, the liquid filling the transparent container may be a transparent liquid other than water, and can be appropriately selected taking into account factors such as elution properties and the refractive index of light, as well as compatibility with the resin used in the cerebrum model. This configuration can mimic the state of a brain suspended in cerebrospinal fluid. Furthermore, by using polyurethane, which has a refractive index very close to that of water, the transparency of the cerebrum model appears to increase when placed in water. Therefore, the present invention is particularly suitable for surgical tool training and for confirming the movement of surgical tools.

[0043] Furthermore, in FIG. 6, a bisected human cerebrum model can be fixed with a fixture 13. In the embodiment of FIG. 6, the fixture is a rod-shaped fixture 13. Holes 9 for passing the rod-shaped fixture 13 through may be pre-formed in the human cerebrum model as shown in FIG. 4, or, since the cerebrum model itself is made of a flexible material that mimics the tissue of the cerebral cortex, the model may be fixed by inserting a rod into the desired position. In view of the objectives of the present invention, the rod-shaped fixture 13 and transparent container 10 used to fix the cerebrum model are preferably made of a hard material made of a transparent resin. Examples of such resins include, but are not limited to, acrylic resin, polycarbonate resin, polyester resin, polypropylene resin, polystyrene resin, polyurethane resin, and polyvinyl chloride resin.

[0044] The support stand 12 is composed of a base 12a that is inclined and can be placed inside the transparent container 10, and a hook portion 12b for fixing the human cerebrum model 1, which is fixed to the base 12a with a plurality of rod-shaped fixing devices 13. By adjusting the inclination angle of the base 12a, the head position during training can also be changed.

[0045] 7, the intraventricular system endoscopy training device of the present invention also includes a sheath 16 with a colored tip, for example, for endoscopic training. By using such a sheath, the approach of surgical tools to the ventricular system can be confirmed from the outside.

[0046] Next, with reference to Figure 8, an embodiment of the intraventricular endoscopy training device according to the present invention will be described in which an endoscope is inserted. As shown in Figure 8, the sheath 16 is inserted into the desired position, and the endoscope is inserted using this as a guide. In this embodiment, the position of the tip of the endoscope and how it is moving can be confirmed from the outside. Specifically, if the insertion angle or operation of the endoscope (not shown) is changed roughly, it is possible to observe not only the tip of the endoscope but also the endoscope body moving in a wavy manner while pushing against normal structures.

[0047] The human cerebrum model of the present invention can be molded by pouring the aforementioned suitable resin as a molten resin into a mold. While methods for manufacturing such molds are within the knowledge of those skilled in the art, in the present invention, the mold can be designed and manufactured using 3D CAD based on image data of the human cerebrum captured by MRI or CT. When the cerebrum model is divided into upper and lower halves at the level of the posterior horn of the lateral ventricle, manufacturing is facilitated by using a roughly hemispherical injection molding mold with a recess corresponding to the ventricular system. [Industrial Applicability]

[0048] The human cerebral model and intraventricular endoscopic training device using the same of the present invention allow for easy confirmation of the position and movement of surgical instruments within the brain. Therefore, from an educational perspective, it is useful for medical students and healthcare professionals to visually understand the internal structure of the brain while undergoing surgical training. From a diagnostic and treatment planning perspective, it is also useful for understanding specific brain diseases and disorders and formulating treatment plans for them. It can also be used as a reference model for preoperative planning and during surgery. It is also useful for physicians to explain the nature and location of diseases, affected brain regions, and treatment methods to patients and their families. [Explanation of symbols]

[0049] A: Anterior horn of the lateral ventricle B: Lateral ventricle C: Posterior horn of the lateral ventricle D: Inferior angle of the lateral ventricle E: Third ventricle F: fourth ventricle G: central canal H: Cerebral aqueduct I: Interthalamic bridge J: interventricular hole 1: Human cerebral model 3: Base material 4: Pigmented area corresponding to the pineal gland 5: Cavity corresponding to the ventricular system 6: Upper hemisphere 7: lower hemisphere 8: Choroid plexus model 9: Hole 12: Support stand 12a: Base 12b: Hook 13: Rod-shaped fixture 15:Water 16: Sheath 18: Endoscopy

Claims

1. In a roughly spherical human cerebral model made of transparent synthetic resin, spaces corresponding to the left and right lateral ventricles, the interventricular foramen (foramen of Monro), the third ventricle, the cerebral aqueduct, and the fourth ventricle in the human ventricular system are provided in the central portion of the approximately spherical shape, The position and movement of the inserted surgical tool are configured to be visible from outside the human cerebral model. Model of the human brain.

2. 2. The human cerebrum model according to claim 1, wherein the human cerebrum model is divided at predetermined positions.

3. The human cerebral model is divided into two equal parts, upper and lower, at the height of the posterior horn of the lateral ventricle. The human cerebral model according to claim 2.

4. Further provided with a region simulating a choroid plexus in any or all of the lateral ventricle, the third ventricle, or the fourth ventricle; The human cerebral model according to claim 1.

5. 2. The human cerebrum model according to claim 1, wherein a substantially spherical region corresponding to the pineal gland is provided below the third ventricle and slightly above the inferior horn of the lateral ventricle.

6. 4. The human cerebrum model according to claim 2 or 3, wherein the two halves of the human cerebrum model are fixed into a substantially spherical shape using a rod that penetrates a transparent resin.

7. In a roughly spherical human cerebral model made of transparent synthetic resin, a human cerebral model having spaces corresponding to the left and right lateral ventricles, the interventricular foramen (foramen of Monro), the third ventricle, the cerebral aqueduct, and the fourth ventricle in the human ventricular system in the central part of the approximately spherical shape; a partially open transparent container; the human cerebrum model is configured so that the position and movement of an inserted surgical tool can be visually confirmed from outside the human cerebrum model; The human cerebrum model is placed in the transparent container filled with a transparent liquid. Ventricular endoscopy training device.

8. 8. The ventricular endoscopy training device according to claim 7, wherein the transparent container is provided with a fixture for fixing the human cerebrum model.

9. The human cerebrum model is divided into two equal parts, upper and lower, at the height of the posterior horn of the lateral ventricle; The bisected human cerebrum model is fixed with a rod passing through it, The fixture has a structure for locking the end of the rod that passes through it.

9. The ventricular endoscopy training device according to claim 8.

10. 8. The ventricular system endoscopy training device according to claim 7, further comprising a sheath having a portion that can be seen from the outside when passed through the human cerebrum model in the transparent container.

11. 8. A ventricular system endoscopy training device according to claim 7, wherein in the human cerebral model, movement targets for the endoscope or areas to be avoided from contact or invasion by the endoscope are color-coded.

12. Further provided with a region simulating a choroid plexus in any or all of the lateral ventricle, the third ventricle, or the fourth ventricle; The ventricular endoscopy training device according to claim 7.

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