Orthopedic procedure training device

Abstract

Provided is an orthopedic procedure training device with a new, more practical structure that improves or solves at least one of the practical problems in the conventional training device.　An orthopedic procedure training device 10 includes a water tank 14 that contains a training liquid 18, a model supporting part 61 that positions and supports a training framework model 12 inside the water tank 14, an elastic wall member 90 that forms at least a portion of a wall 46 of the water tank 14 and is formed from an elastic material through which an endoscope 16 can be inserted.

Description

Orthopedic technique training device

[0001] The present invention relates to a training device for training in orthopedic surgery procedures performed under an endoscope for bone-related diseases such as those of the lumbar vertebrae and joints.

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

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

[0004] International Publication No. 2019 / 107441

[0005] However, when training using the surgical training model described in Patent Document 1, it is sometimes difficult to fully reproduce the actual surgical conditions, making it difficult to conduct efficient training. In particular, since the human body is filled with fluid, it is desirable to fill the training tank of the training device with training fluid to reproduce this condition. However, training by inserting an endoscope into a tank filled with training fluid has not yet been fully explored, leaving problems that need to be addressed. For example, it has been difficult to achieve a condition similar to that of the human body in terms of ensuring freedom of choice in the insertion position of the endoscope and achieving tracking when the endoscope is moved up and down while inserted. Furthermore, there is a risk that the training fluid in the tank may leak out from the insertion point of the endoscope when the inserted endoscope is moved.

[0006] The problem to be solved by the present invention is to improve or solve at least one of the practical problems of conventional training devices, and to provide an orthopedic procedure training device with a new structure that is more practical.

[0007] For example, the present invention aims to provide an orthopedic procedure training device that is more practical and has a high training effect, by making it possible to make the characteristics of the insertion part of the endoscope closer to those of the human body, thereby enabling training in endoscopic orthopedic procedure techniques in an environment closer to actual surgical conditions, or by preventing liquid leakage outside the water tank even when operating the endoscope in a manner similar to actual surgical conditions, thereby allowing procedures closer to actual surgical conditions.

[0008] The following describes preferred embodiments for understanding the present invention, but the embodiments described below are merely examples and may be appropriately combined with one another. Multiple components described in each embodiment may be recognized and employed independently to the greatest extent possible, and may also be appropriately combined with any of the components described in other embodiments. Accordingly, the present invention is not limited to the embodiments described below, and various other embodiments may be realized.

[0009] The first aspect is an orthopedic procedure training device comprising a water tank for containing a training liquid, a model support section for positioning and supporting a training skeletal model inside the water tank, and an elastic wall member made of an elastic material that forms at least a part of the wall section of the water tank and allows an endoscope to be inserted therethrough.

[0010] According to the orthopedic procedure training device of this aspect, the elastic wall member through which the endoscope can be inserted constitutes at least a portion of the wall of the water tank. Therefore, compared to, for example, a case in which a through-hole is fixedly formed in a hard resin member constituting the wall of the water tank and the endoscope is inserted through the through-hole, the insertion position of the endoscope is allowed by elastic deformation of the elastic wall member, and changes in the insertion position are also permitted, making it possible to train procedures that feel closer to actual human skin. For example, it is possible to perform a procedure called hand-down, in which the endoscope is inserted from the side and pushed down, similar to moving the endoscope laterally as the skin stretches. This allows orthopedic surgical procedures to be trained in an environment that more closely resembles the actual surgical conditions.

[0011] In a second aspect, in the orthopedic technique training device according to the first aspect, an insertion hole for the endoscope can be formed in the elastic wall member by puncturing it with a perforating member, and the insertion hole is closed by removing the perforating member based on the elasticity of the elastic wall member itself.

[0012] According to the orthopedic procedure training device of this aspect, even if the insertion position of the endoscope is below the level of the training liquid, the elasticity of the elastic wall member makes it possible to close the insertion hole of the endoscope, so that the insertion hole is closed simultaneously with the removal of the perforating member. Therefore, it is possible to prevent leakage of liquid through the insertion hole without providing a separate sealing member or the like, and the structure can be simplified.

[0013] In a third aspect, in the orthopedic technique training device according to the first or second aspect, the elastic wall member constitutes at least a part of the peripheral wall of the water tank, and the upper part of the elastic wall member forms a curved wall that curves and extends inward to cover the upper opening of the water tank.

[0014] With this orthopedic technique training device, when training for lumbar spine disorders, for example, the elastic wall member can be considered to represent the skin of the curved portion of the human body from the flank to the back, and training can be performed to insert the endoscope not only from the flat, spreading portion at the top (back), but also from the curved portion at the outside. Furthermore, because the elastic wall member is provided from the upper opening to the peripheral wall portion, it is also possible to perform movements such as pushing the endoscope downward, such as hand-down training.

[0015] In a fourth aspect, in the orthopedic technique training device according to the third aspect, the peripheral wall portion of the water tank has a rectangular cylindrical shape having four flat vertical wall portions as a whole, and the elastic wall member is arranged in an opening portion provided in at least one of the vertical wall portions.

[0016] With this orthopedic technique training device, when training for lumbar spine diseases, for example, the two left and right vertical wall portions of the rectangular tube can be considered to represent the left and right flanks of the human body, and by providing an elastic wall member on at least one of the left and right vertical wall portions, it is possible to train the insertion of an endoscope not only from above (the back), but also from the outside.

[0017] In a fifth aspect, in the orthopedic technique training device according to the fourth aspect, the elastic wall member is in the form of a rectangular sheet, and the upper and lower edge portions of the elastic wall member are fixedly attached to the water tank, so that the elastic wall member is attached in a state of tension in the vertical direction, and in this attached state, both widthwise side portions of the elastic wall member are pressed against edge-like abutment portions that are convex toward the opening side on both widthwise sides of the opening portion, thereby forming a seal.

[0018] According to this orthopedic procedure training device, a rectangular sheet-shaped elastic wall member is attached in a vertically tensioned state so as to cover an opening provided in a vertical wall portion, and the elastic wall member seals the opening, preventing liquid leakage through the opening. In particular, edge-like abutment portions are provided on both widthwise sides of the opening and are pressed against both widthwise sides of the elastic wall member, thereby increasing the contact pressure between the widthwise sides of the opening (edge-like abutment portions) and the elastic wall member, thereby improving the sealing performance of the elastic wall member. Furthermore, because the elastic wall member is arranged in a stretched state with tensile stress in the vertical direction, excessive deformation of the elastic wall member is suppressed, improving stability, for example, when the endoscope is moved downward during hand-down training.

[0019] In a sixth aspect, in the orthopedic technique training device according to the fifth aspect, an upper rod is attached to the upper edge of the elastic wall member and a lower rod is attached to the lower edge, and the upper rod and the lower rod are detachably fixed to the water tank, so that the elastic wall member is attached in a state of tension in the vertical direction.

[0020] According to this orthopedic technique training device, by fixing the upper rod and the lower rod to the water tank while they are spaced apart from each other beyond the natural length of the elastic wall member, the elastic wall member can be easily attached to the water tank while being pulled in the vertical direction.

[0021] In a seventh aspect, in the orthopedic technique training device according to the fifth or sixth aspect, the opening portion is formed across the entire width of one of the vertical wall portions, and the edge-shaped abutment portion against which both widthwise portions of the elastic wall member are pressed is formed by the end edges of the vertical wall portions on both sides located circumferentially adjacent to the one vertical wall portion.

[0022] According to the orthopedic technique training device of this embodiment, the width dimension of the opening can be ensured to be sufficiently large, and the edge portions of the vertical wall portions on both sides can be cleverly utilized to form edge-shaped abutment portions, so that the opening can be sealed with an elastic wall member without providing a special edge-shaped abutment portion.

[0023] In an eighth aspect, in the orthopedic technique training device according to any one of the fourth to seventh aspects, a pressing mechanism is provided that presses from the outside the outer peripheral portion of the elastic wall member at least in part of the portion that is overlapped and sealed against the vertical wall portion.

[0024] According to the orthopedic technique training device of this embodiment, a pressing mechanism is provided that presses the outer peripheral portion of the elastic wall member from the outside while it is in contact with the vertical wall portion and overlapped thereon, and this pressing mechanism can further improve the sealing of the opening portion provided by the elastic wall member.

[0025] In a ninth aspect, in the orthopedic technique training device according to the eighth aspect, a separate receiving tank is disposed below the water tank, the upward opening of which is larger than the outer periphery of the water tank, and the pressing mechanism is provided between the elastic wall member and the peripheral wall of the receiving tank to press the elastic wall member from the outside.

[0026] According to the orthopedic technique training device of this aspect, a larger receiving tank is provided below the water tank, so that even if the training liquid spills from the water tank, it can be received in the receiving tank. This receiving tank can then be used effectively to provide a pressing mechanism.

[0027] In a tenth aspect, in the orthopedic technique training device according to the ninth aspect, the pressing mechanism includes a block-shaped pressing member made of an elastic material.

[0028] According to this orthopedic technique training device, by inserting a block-shaped pressing member between the elastic wall member and the peripheral wall of the receiving tank, a pressing mechanism can be constructed that presses the elastic wall member from the outside, making it easy to seal the opening with the elastic wall member.

[0029] In an eleventh aspect, in the orthopedic technique training device according to any one of the first to tenth aspects, a visible position marker indicating the intended insertion position of the endoscope can be displayed on the elastic wall member.

[0030] According to the orthopedic procedure training device of this aspect, the intended insertion position of the endoscope can be visually confirmed, thereby more reliably enjoying the benefits of training. Note that the position marker may be displayed on the elastic wall member before use of the training device, and the intended insertion position of the endoscope may be confirmed for each procedure by, for example, changing the elastic wall member according to the procedure to be mastered. Alternatively, if training is performed that includes selecting the insertion position of the endoscope, the operator may be able to write the position marker when using the training device.

[0031] In a twelfth aspect, in the orthopedic technique training device according to any one of the first to eleventh aspects, a specified water level required to immerse the skeletal model in water is set in the water tank, and the area in the water tank extending below the specified water level is constituted by the elastic wall member.

[0032] According to this orthopedic technique training device, the area in the water tank that extends below the specified water level is made up of an elastic wall member, so that the insertion position of the endoscope provided by the elastic wall member can be selected in an area that extends further to the side or below the expected human body.

[0033] In a thirteenth aspect, in the orthopedic technique training device according to any one of the first to twelfth aspects, the water tank has a vertical wall portion constituting a peripheral wall portion and an upper wall portion covering an upper opening, and the vertical wall portion and the upper wall portion are transparent.

[0034] According to the orthopedic technique training device of this aspect, the state of training can be visually confirmed from the outside, and the effects of training can be easily confirmed.

[0035] In a fourteenth aspect, in the orthopedic technique training device according to any one of the first to thirteenth aspects, an insertion hole for the endoscope is provided in the wall of the water tank, and a model position setting mechanism is provided for setting the skeletal model inside the water tank so that the skeletal model can be moved to a plurality of different positions and fixedly set therein, and the distance from the insertion hole to the skeletal model can be changed by moving the skeletal model.

[0036] According to the orthopedic procedure training device of this aspect, the skeletal model can be moved to multiple different positions in the water tank using the model position setting mechanism, and the distance from the insertion hole to the skeletal model can be adjusted as needed. Therefore, assuming that the distance from the skin to the skeleton varies depending on the patient's body shape, for example, it is possible to appropriately set the distance from the insertion hole of the water tank to the skeletal model or to perform procedure training with multiple different distances.

[0037] In a fifteenth aspect, in the orthopedic technique training device according to the fourteenth aspect, a base member to which the skeletal model can be attached and detached is disposed inside the water tank, and the model position setting mechanism is configured to include a guide mechanism that guides the base member so that it can move horizontally, and a locking mechanism that positions the base member at multiple positions in the direction of movement by the guide mechanism.

[0038] The orthopedic procedure training device of this aspect employs a base member that is moved and positioned by a guide mechanism and a locking mechanism, and the skeletal model is supported by the base member. This allows the position of the skeletal model to be easily changed, and since there is no need to directly grasp and move the skeletal model, the risk of damage to the skeletal model can be reduced.

[0039] In a sixteenth aspect, in the orthopedic technique training device according to the fifteenth aspect, the guide mechanism is configured to include a guide rod and a guide hole provided in the base member and through which the guide rod is inserted, and the outer circumferential portion of the guide rod and the inner circumferential portion of the guide hole are adapted to engage with each other as the guide rod and the guide hole rotate relative to each other about the central axis, and this interlocking action prevents movement of the base member in the axial direction of the guide rod, thereby enabling it to be fixed, thereby configuring the locking mechanism.

[0040] According to this orthopedic technique training device, the guide hole (base member) can be fixed or unlocked relative to the guide rod by simply rotating the guide rod and the guide hole relative to each other around the central axis, i.e., the position of the skeletal model in the water tank can be fixed or moved.

[0041] In a seventeenth aspect, in the orthopedic technique training device according to the sixteenth aspect, in the locking mechanism, a convex portion extending in the circumferential direction is formed on the outer peripheral surface of the guide rod and the inner peripheral surface of the guide hole, respectively, and the convex portion on the guide rod side and the convex portion on the guide hole side engage with each other so as to overlap in the axial direction due to relative rotation between the guide rod and the guide hole about the central axis, thereby exerting the interlocking action.

[0042] According to the orthopedic procedure training device of this aspect, a locking mechanism is realized by the axial engagement between the convex portion on the guide rod and the convex portion on the guide hole, which makes it possible to position the base member (skeletal model) more firmly than when positioning is achieved by friction resistance alone, and makes it easy to stably position and hold the skeletal model even when, for example, surgical instruments such as forceps or drills apply a large pressure to the skeletal model.

[0043] The eighteenth aspect is an orthopedic technique training device that includes a water tank that can hold a training liquid and place a training skeletal model immersed in the liquid, and in which an endoscope is inserted from outside the water tank to train surgical techniques on the skeletal model, and a separate receiving tank is arranged below the water tank, and the upward opening of the receiving tank is larger than the outer periphery of the water tank.

[0044] According to this embodiment of the orthopedic technique training device, an even larger receiving tank is provided below the water tank, so that even if training liquid spills from the water tank, it can be received in the receiving tank, preventing the liquid from leaking outside the training device and increasing the freedom in where the device can be installed.

[0045] In a nineteenth aspect, in the orthopedic technique training device according to the eighteenth aspect, the water tank is detachable from the receiving tank, and a positioning mechanism is provided for positioning the water tank and the receiving tank relative to each other in the horizontal direction.

[0046] According to this orthopedic technique training device, relative horizontal displacement between the water tank and the receiving tank is prevented, thereby preventing, for example, inadvertent operational errors (misalignment of the treatment position) and water leaks during training that may be caused by relative movement between the water tank and the receiving tank, making it possible to perform training more stably and with greater concentration.

[0047] In a twentieth aspect, in the orthopedic technique training device according to the eighteenth or nineteenth aspect, the capacity of the liquid that can be stored in the receiving tank is equal to or greater than the specified liquid volume that can be stored in the water tank during training.

[0048] According to the orthopedic technique training device of this aspect, even if the entire amount of training liquid stored in the water tank leaks from the water tank, the entire amount can be received in the receiving tank, thereby more reliably preventing the liquid from leaking outside the training device. Furthermore, for example, by transferring the entire amount of liquid in the water tank to the receiving tank after training, it becomes possible to drain the liquid by holding only the receiving tank.

[0049] In a 21st aspect, in the orthopedic technique training device according to any one of the 18th to 20th aspects, the water tank is provided with an openable water tank drain outlet, the water tank drain outlet is positioned so as to open within the receiving tank, and the receiving tank is also provided with an openable receiving tank drain outlet.

[0050] According to this orthopedic technique training device, for example, by opening the water tank drain port after use of the training device, the training liquid in the water tank can be drained into the receiving tank, and by opening the receiving tank drain port after draining the training liquid in the water tank into the receiving tank, the training liquid in the receiving tank can be drained outside the training device. Therefore, there is no need to lift the entire water tank or receiving tank when draining the liquid from the water tank or receiving tank, making operation easier. Furthermore, by draining a predetermined amount or all of the liquid from the water tank inside the receiving tank, it becomes easier to carry the water tank.

[0051] In a twenty-second aspect, in the orthopedic technique training device according to any one of the eighteenth to twenty-first aspects, the endoscope can be inserted into a vertical wall portion that forms the peripheral wall portion of the water tank.

[0052] According to this orthopedic technique training device, an endoscope is inserted into the vertical wall that forms the peripheral wall of the water tank, and even if there is a risk of liquid leaking from the water tank when the endoscope is removed during or after training, the receiving tank can prevent the liquid from splashing or leaking to the outside.

[0053] In a 23rd aspect, in the orthopedic technique training device according to the 22nd aspect, the position in the vertical wall portion of the water tank at which the endoscope can be inserted is set to be lower than the specified water level during training.

[0054] According to the orthopedic procedure training device of this aspect, even if liquid leaks from the water tank during the insertion or removal of the endoscope, the liquid is contained in the receiving tank, preventing the liquid from leaking and spreading to the outside. Therefore, the provision of the receiving tank makes it easy to select the endoscope insertion port over a wide area, including the sides and bottom of the human body, for training without considering the risk of liquid leakage. In this aspect, the elastic wall member according to any one of the first to eleventh aspects can be preferably used in the water tank. This makes it easy to set the insertion position of the endoscope inserted through the elastic wall member below the specified water level. This aspect also includes cases where the endoscope insertion position moves below the specified water level due to elastic deformation of the elastic wall member associated with the hand-down operation.

[0055] In a 24th aspect, in the orthopedic technique training device according to any one of the 18th to 23rd aspects, a connecting means is provided that restricts separation between the water tank and the receiving tank and maintains the receiving tank attached to the water tank.

[0056] According to the orthopedic procedure training device of this aspect, even if a force is applied to the water tank due to an external force applied through an endoscope during training, rattle of the water tank can be effectively prevented.

[0057] In a twenty-fifth aspect, in the orthopedic technique training device according to the twenty-fourth aspect, the connecting means is configured using a permanent magnet.

[0058] According to the orthopedic technique training device of this aspect, the connecting means can be constructed with a simple structure. For example, if the permanent magnets are arranged in a manner that exerts an attractive force in the vertical direction, it is possible to effectively suppress rattling of the water tank even when an external force acting vertically upward is applied to the water tank during training.

[0059] According to one aspect of the orthopedic procedure training device of the present invention, it is possible to train procedures for endoscopic orthopedic surgery in an environment that is closer to the actual surgical conditions.

[0060] For example, the orthopedic procedure training device according to the present invention makes it easy to create an environment in which training operations such as handing down an endoscope are permitted.

[0061] 1 is a perspective view showing an orthopedic technique training device according to a first embodiment of the present invention in a used state; 2 is a perspective view showing the orthopedic technique training device shown in FIG. 1 in a non-used state; 3 is a plan view of the orthopedic technique training device shown in FIG. 2; 4 is a front view of the orthopedic technique training device shown in FIG. 2; 5 is a left side view of the orthopedic technique training device shown in FIG. 2; 1. A perspective view showing a water tank constituting the orthopedic training apparatus shown in FIG. 1, from the bottom side. 1. A perspective view showing a receiving tank constituting the orthopedic training apparatus shown in FIG. 1. 1. A perspective view showing a pressing mechanism constituting the orthopedic training apparatus shown in FIG. 1. 2. A front view showing a specific example of a skeletal model used in the orthopedic training apparatus shown in FIG. 1, in a state fixed to a bracket. 3. A cross-sectional view taken along the line XIV-XIV in FIG. 13. 4. A right side view showing a specific example of an endoscope used in the orthopedic training apparatus shown in FIG. 1. 5. A front view of the endoscope shown in FIG. 23 is a longitudinal cross-sectional view of the model position setting mechanism shown in FIG. 23, showing a front end portion in a state where a bracket is attached to a base member constituting the model position setting mechanism; FIG. 23 is a longitudinal cross-sectional view of the model position setting mechanism shown in FIG. 23, showing a rear end portion in a state where a bracket is attached to a base member constituting the model position setting mechanism;6A and 6B are explanatory views for explaining a state in which a bracket is detachable from a base member and a state in which the bracket is fixed, respectively, and FIG. 6A is a longitudinal cross-sectional view showing an orthopedic technique training device according to a third embodiment of the present invention, in which FIG. 6A shows a state in which the bracket is detachable, and FIG. 6B shows a state in which the bracket is fixed.

[0062] In order to clarify the present invention more specifically, embodiments of the present invention will be described in detail below with reference to the drawings.

[0063] 1 shows an orthopedic procedure training device 10 according to a first embodiment of the present invention. This orthopedic procedure training device 10 is intended to improve a user's technical proficiency in orthopedic surgery using an endoscope, and allows the user to train in procedures in their own home, for example.

[0064] More specifically, the orthopedic procedure training device 10 includes a training skeletal model 12 that simulates a lesion site, and a water tank 14 in which the skeletal model 12 is fixed and housed. The tip of an endoscope 16 can be inserted into the water tank 14 from the outside, allowing training in surgical procedures for the skeletal model 12. The orthopedic procedure training device 10 may be configured to include such an endoscope 16. The water tank 14 contains water 18, which is a training liquid.

[0065] The water tank 14 is filled with water 18 to a specified volume or more, specifically, to the extent that the entire skeletal model 12 is immersed in the water 18. That is, a specified water level required to immerse the skeletal model 12 in the water 18 may be set in the water tank 14, or, for example, a mark indicating the specified water level may be provided in the water tank 14 so that the water 18 is poured into the water tank 14 until the water surface reaches the mark. In this embodiment, no specified water level is set, and the water 18 is simply filled up to near the upper end of the water tank 14. However, the upper end of the water tank 14 may also be set as the specified water level.

[0066] The training liquid is not limited to water 18 and may be, for example, a colored liquid, but is preferably transparent so that the training state can be seen. If the training liquid is transparent, it should have a visible light transmittance of, for example, 80% or more so that the image from the endoscope 16 can be confirmed on a monitor (not shown) connected to the endoscope 16.

[0067] 2 to 8 show the device body 20 of the orthopedic technique training device 10. The device body 20 includes the water tank 14. The water tank 14 is generally box-shaped and opens upward as a whole, and has an upper opening 22. That is, the water tank 14 has a rectangular, flat bottom wall 24 and peripheral walls 26 that protrude upward from the four outer peripheral edges of the bottom wall 24. The peripheral wall 26 is generally rectangular and cylindrical, and has four flat vertical walls 28.

[0068] In the following description, the up-down direction refers to the vertical direction, i.e., the up-down direction in FIG. 4 . The front-rear direction refers to the left-right direction in FIG. 4 , which is the direction in which the skeletal model 12 extends in the water tank 14. In particular, in this embodiment, a lumbar skeletal model is used as the skeletal model 12, and the front refers to the left side in FIG. 4 , which is the neck side of the skeletal model 12 when the skeletal model 12 is placed in the water tank 14 as in FIG. 1 . The rear refers to the right side in FIG. 4 , which is the leg side of the skeletal model 12. Furthermore, the left-right direction refers to the left-right direction in FIG. 5 . Note that, although some parts are fixed with bolts or screws in the figures, the bolts or screws may be omitted for clarity. For clarity, some components are shown with their interiors visible through the transparent view.

[0069] The upper opening 22 of the water tub 14 is partially covered by an upper wall 30. The upper wall 30 has a generally rectangular plate shape and is formed with through-holes 32 that penetrate the wall in the thickness direction (vertical direction). In this embodiment, six through-holes 32 are formed and aligned in the front-to-back and left-to-right directions. Each through-hole 32 is fitted with a valve element 34 made of an elastic material such as rubber or urethane foam. Each valve element 34 is generally cylindrical in shape, with an outer diameter larger than that of the corresponding through-hole 32, and the outer diameter is smaller at a middle portion in the thickness direction (vertical direction). The inner periphery of each through-hole 32 is fitted into the smaller-diameter portion at the middle portion in the thickness direction of each valve element 34, thereby fitting each valve element 34 to its corresponding through-hole 32. Each valve element 34 has a central thin-walled portion 36 that is thinner than the remaining portions and allows the endoscope 16 to puncture and pass through.

[0070] As shown in Figures 1 and 3, upper wall holders 40 are fixed by bolts or screws to the upper ends of the vertical wall portions 28a, 28b on both front-to-rear sides of the vertical wall portions 28 of the water tub 14. Each upper wall holder 40 has a mounting portion 42 that protrudes inward in the opposing direction (front-to-rear direction), and both front-to-rear ends of the upper wall portion 30 rest on each mounting portion 42. Both front-to-rear ends of the upper wall portion 30 rest on the mounting portions 42 of each upper wall holder 40, and the both front-to-rear ends of the upper wall portion 30 are fixed to the mounting portions 42 by known fixing means such as a locking mechanism with a rotary operation knob, thereby releasably fixing the upper wall portion 30 to the upper opening 22 of the water tub 14 and detachably attaching it. The wall portion 46 of the water tub 14 is composed of the upper wall portion 30 and the peripheral wall portion 26.

[0071] The peripheral wall portion 26 (each vertical wall portion 28) and the upper wall portion 30 are preferably formed from a transparent resin material, and it is desirable that the visible light transmittance be 80% or more, for example. However, even when the peripheral wall portion 26 (each vertical wall portion 28) and the upper wall portion 30 are transparent, they are not limited to being entirely transparent, and may be partially transparent. Furthermore, it is preferable that the visible light transmittance of the bottom wall portion 24 be set low, taking into consideration the ease of attaching a bracket 152 to the skeleton model 12, which will be described later, and the like.

[0072] 9 , an opening 48 is provided in the right-side vertical wall 28, which is one of the four vertical wall portions 28. In particular, in this embodiment, the opening 48 extends across the entire width (front-rear direction) of the right-side vertical wall 28, as well as the entire up-down direction. In other words, the opening 48 provided in the right-side vertical wall 28 is continuous with the upper opening 22, forming a single large opening 50 that opens to the right and upward. The portions of the front and rear vertical wall portions 28a, 28b from the right to the upward direction are smoothly curved and continuous, and are formed without any bending points (break points).

[0073] In this embodiment, the edges of the front and rear vertical walls 28a, 28b and the bottom wall 24 that constitute the opening 48 are provided with edge-like abutment portions 52 that are convex toward the opening. Specifically, the thicknesses of the front and rear vertical walls 28a, 28b and the right end of the bottom wall 24 located circumferentially adjacent to the right vertical wall 28 are gradually reduced toward the opening, thereby providing edge-like abutment portions 52 on both widthwise sides (front and rear sides) and the lower side of the opening 48. In this embodiment, the edge-like abutment portions 52 on the front and rear vertical walls 28a, 28b are provided not only on the right side of the water tub 14 but also on the upper side (i.e., the edges of the upper opening 22).

[0074] Furthermore, on the inner surfaces of the front and rear vertical walls 28a, 28b, to the right of the fixing portion of the top wall 30, upper fixing members 54 are fixed with bolts or screws to fix the upper edges of the elastic wall members 90 (described later). The upper fixing members 54 extend vertically as a whole and are bifurcated at their upper ends, with upper support recesses 56 on which an upper rod 98 (described later) is hooked. As shown in Figures 19 to 22 (described later), each upper fixing member 54 is fitted with a stopper member 57. When the upper rod 98 is hooked in each upper support recess 56, the stopper member 57 covers the opening of the upper support recess 56, thereby preventing the upper rod 98 from slipping out of the upper support recess 56. A lower fixing member 58 is fixed with a bolt or screw to the right end of the lower surface of the bottom wall 24. The lower fixing member 58 fixes the lower edges of the elastic wall members 90 (described later). The lower fixing member 58 extends in the left-right direction as a whole and branches into two at the right end, with a lower support recess 60 at the branched portion onto which a lower rod 100 (described later) is hooked.

[0075] Furthermore, a model support portion 61 for positioning and supporting the skeleton model 12 within the water tank 14 is provided on the inner surface (upper surface) of the bottom wall portion 24 of the water tank 14. The model support portion 61 in this embodiment includes a first fixing portion 62 and a second fixing portion 64 for fixing a bracket 152 of the skeleton model 12 (described later), and the first fixing portion 62 and the second fixing portion 64 are fixed to the bottom wall portion 24 of the water tank 14 with bolts or screws. As shown in FIGS. 8 and 10 , the first fixing portion 62 and the second fixing portion 64 are spaced apart from each other in the front-to-rear direction, with the first fixing portion 62 provided at the front of the water tank 14 and the second fixing portion 64 provided at the rear. The first fixing portion 62 has a certain degree of dimension in the left-to-right direction, and a first fixing groove 66 opening rearward is formed in the lower portion of the first fixing portion 62. In this embodiment, the first fixing groove 66 is formed over the entire length of the first fixing portion 62 in the front-to-rear direction.

[0076] The second fixing part 64 has a central cylindrical portion extending vertically therethrough, and a rotating member 68 rotatable about the central axis of the cylindrical portion is attached to the second fixing part 64. The rotating member 68 is provided with a retaining portion 70 that presses from above against a rear engagement protrusion 156 of a bracket 152 (described later). A lever member 74 having an upwardly protruding knob 72 is attached to the rotating member 68 approximately coaxially, and the rotating member 68 and the lever member 74 rotate integrally with respect to the second fixing part 64. The rotating member 68 and the lever member 74 can be fixed integrally by fastening, for example, bolts or screws (not shown). The underside of the second fixing part 64 is formed with a receiving groove 76 that receives the retaining portion 70 when the rotating member 68 is rotated to release the retaining portion 70 from pressing against the engagement protrusion 156.

[0077] Furthermore, water tank legs 78 protruding downward are provided at the four corners of the bottom wall 24 of the water tank 14. In this embodiment, each water tank leg 78 is fixed to the bottom wall 24 with bolts or screws. Each water tank leg 78 has a generally truncated cone shape, and a positioning recess 80 that opens downward is formed on the underside of each water tank leg 78. Each water tank leg 78 may be made of synthetic resin, but may also be made entirely or partially of a ferromagnetic or paramagnetic metal, for example. If each water tank leg 78 is made of synthetic resin, a permanent magnet 82 may be embedded therein, for example.

[0078] Furthermore, a through-hole 84 is formed in the lower left of the rear vertical wall portion 28b of the water tub 14, penetrating in the thickness direction (front-to-back direction). A water tank port member 88 having a water tank drain port 86 is attached to the through-hole 84. The water tank drain port 86 connects the inside and outside of the water tub 14. The water tank drain port 86 opens toward a receiving tank 106 (described below) located below. For example, a tube 89 (see FIG. 1) or the like is connected to the water tank port member 88, with the opening of the tube 89 (water tank drain port 86) located within the receiving tank 106. The tube 89 is provided with a clamp or a valve that can be switched between open and closed positions, allowing the water tank drain port 86 to be opened and closed.

[0079] Here, at least a portion of the wall 46 of the water tub 14 is formed of an elastic wall member 90 made of an elastic material through which the endoscope 16 can be inserted, and in this embodiment, at least a portion of the peripheral wall 26 is formed of the elastic wall member 90. Specifically, as described above, an opening 48 is provided in the right-side vertical wall 28, which is one of the four vertical walls 28, and the elastic wall member 90 is arranged to cover this opening 48. In particular, in this embodiment, the elastic wall member 90 is provided in place of the right-side vertical wall 28 of the water tub 14, and the approximately box-shaped water tub 14 is formed by the front and rear vertical walls 28a, 28b, the left-side vertical wall 28c, and the elastic wall member 90. The elastic material constituting the elastic wall member 90 is not limited, but may be, for example, foamed resin such as closed-cell urethane foam, non-foamed soft synthetic resin, silicone sheet, artificial rubber sheet (whether foamed or non-foamed), or a composite of these, and in this embodiment, foamed urethane is used. The hardness of the elastic wall member 90 is not limited, but it is preferable that the Shore C hardness be set within the range of 20° to 90° so as to achieve elongation characteristics similar to those of human skin.

[0080] The opening 48 is sealed by the elastic wall member 90 as both widthwise side portions and the lower end portion of the elastic wall member 90 overlap and are pressed against the edge-like contact portions 52 of the front and rear vertical wall portions 28a, 28b and the bottom wall portion 24. In this embodiment, the elastic wall member 90 is in the form of a substantially rectangular sheet and is flexible and elastically deformable. As shown in FIGS. 1 to 7 , the elastic wall member 90 is provided from the right to the upper portion of the opening 50 and includes a right flat portion 92 that extends substantially flat and covers the right side of the opening 50 (opening portion 48), an upper flat portion 94 that extends substantially flat and partially covers the upper portion of the opening 50 (upper opening 22), and a curved wall portion 96 that connects the right flat portion 92 and the upper flat portion 94 and extends along the curved portions of the front and rear vertical wall portions 28a, 28b. That is, the upper portion of the elastic wall member 90 is provided with a curved wall portion 96 that curves and extends inward so as to cover the upper opening 22 of the water tub 14. Meanwhile, the lower end portion of the elastic wall member 90 (the lower end portion of the right flat portion 92) protrudes downward beyond the front and rear vertical wall portions 28a, 28b and the bottom wall portion 24. Therefore, in this embodiment, the elastic wall member 90 is provided over an area that extends below the specified water level required to immerse the skeletal model 12. This makes it possible to set the position on the right vertical wall portion 28 (elastic wall member 90) at which the endoscope 16 can be inserted to a position below the specified water level for training.

[0081] In addition, flat, expanding portions such as the right flat portion 92 and the upper flat portion 94 are not essential for the elastic wall member 90. For example, if the right end faces of the front and rear vertical wall portions 28a, 28b are curved without having any flat portions, the elastic wall member 90 may be curved along the entire right end faces of such vertical wall portions 28a, 28b.

[0082] An upper rod 98 is attached to the upper edge of the elastic wall member 90 (the end of the upper flat portion 94 opposite the curved wall portion 96), and a lower rod 100 is attached to the lower edge of the elastic wall member 90 (the end of the right flat portion 92 opposite the curved wall portion 96). Specifically, the upper rod 98 and the lower rod 100 are inserted through the upper and lower edges of the elastic wall member 90, respectively, extending in the width direction (front-to-back direction) of the elastic wall member 90. These upper and lower rods 98, 100 protrude from the elastic wall member 90 on both sides in the front-to-back direction, and grips 102 are fixed to both ends of the upper and lower rods 98, 100 protruding from the elastic wall member 90.

[0083] Furthermore, mounting recesses 104 recessed inward in the length direction of the elastic wall member 90 are provided on both sides in the width direction (front-to-back direction) of the upper and lower edge portions of the elastic wall member 90. The upper rod 98 is partially exposed by each mounting recess 104 on the upper edge portion of the elastic wall member 90, and the lower rod 100 is partially exposed by each mounting recess 104 on the lower edge portion of the elastic wall member 90. The upper rods 98 exposed from each mounting recess 104 at the upper edge of the elastic wall member 90 are hooked onto the upper support recesses 56 of each upper fixing member 54 fixed to the vertical wall portions 28a, 28b on both the front and rear sides, and the lower rods 100 exposed from each mounting recess 104 at the lower edge of the elastic wall member 90 are hooked onto the lower support recesses 60 of each lower fixing member 58 fixed to the bottom wall portion 24, so that the elastic wall member 90 is attached to cover the opening portion 48 in the water tank 14.

[0084] The separation distance between the upper support recess 56 and the lower support recess 60 along the right end surfaces of the front and rear vertical walls 28a, 28b is greater than the natural length of the elastic wall member 90 in the longitudinal direction. That is, when the upper and lower rods 98, 100 are hooked onto the upper and lower support recesses 56, 60, respectively, the elastic wall member 90 is pulled in the longitudinal direction, and in this tensioned state, the elastic wall member 90 is pressed against the edge-like abutment portions 52, which are the edges of the opening 48. Therefore, when attaching the elastic wall member 90 to the water tub 14, for example, the lower rod 100 is hooked onto the lower support recess 60, and then the upper rod 98 is hooked onto the upper support recess 56 while pulling the elastic wall member 90 in the longitudinal direction. As a result, even after the tension on the elastic wall member 90 is released, the elastic wall member 90 remains attached to the water tub 14 in a state where it is pulled vertically more than its natural state. In short, the upper and lower edge portions of the elastic wall member 90 are fixedly attached to the water tub 14, so that the elastic wall member 90 is mounted in a state of tension in the vertical direction.

[0085] The elastic wall member 90 can be removed from the water tub 14, for example, by grasping both gripping portions 102 of the upper rod 98 and pulling the elastic wall member 90 in the lengthwise direction while removing the upper rod 98 from the upper support recess 56, and then removing the lower rod 100 from the lower support recess 60. In other words, the upper rod 98 and the lower rod 100 are detachable from the water tub 14, and this allows the elastic wall member 90 to be detachably attached to the water tub 14.

[0086] The elastic wall member 90 of this embodiment may be capable of displaying a visible position marker (not shown) that indicates the planned insertion position of the endoscope 16. Such a position marker may vary depending on the user's level of proficiency in the procedure, and for example, in the case of a user with low proficiency, the position marker may be printed in advance on the elastic wall member 90. Even in such a case, the position, size, etc. of the position marker printed on the elastic wall member 90 may vary depending on the skeletal model 12 used, such as when the skeletal model 12 is a lumbar vertebrae skeletal model described below or when using another skeletal model.

[0087] Furthermore, for example, in the case of a highly skilled user, the elastic wall member 90 may be configured so that a position marker can be written on it with, for example, an oil-based pen, allowing the user to perform training that includes selecting the insertion position of the endoscope 16. Note that such a position marker may be erasable, allowing the elastic wall member 90 to be used repeatedly and allowing the position marker to be written in a different position when, for example, training in a different procedure is performed.

[0088] Furthermore, the orthopedic technique training device 10 of this embodiment is equipped with a receiving tank 106 larger than the water tank 14 and provided below the water tank 14, and a pressing mechanism 108 that presses the elastic wall member 90 from the outside while pressing it against the edge-like abutment portions 52. It is preferable that the pressing mechanism 108 presses the elastic wall member 90 from the outside at least in part of the portion of the opening portion 48 where the outer periphery of the elastic wall member 90 is overlapped and sealed with the front and rear vertical wall portions 28a, 28b, but in this embodiment, as will be described later, the pressing mechanism 108 presses the elastic wall member 90 against the lower portions of the front and rear vertical wall portions 28a, 28b and the edge-like abutment portions 52 of the bottom wall portion 24.

[0089] As shown in FIG. 11 , the receiving tank 106 is generally box-shaped and opens upward. It includes a generally rectangular bottom wall 110 and a peripheral wall 112 that protrudes upward from the outer periphery of the bottom wall 110. The peripheral wall 112 has a certain vertical dimension, and the volume of liquid that can be stored in the receiving tank 106 is equal to or greater than the specified capacity of the aquarium 14 during training. Receiving tank legs 114 that protrude downward are fixed to the underside of the four corners of the bottom wall 110 with bolts or screws. The bottom wall 110 also has a through-hole 116 that penetrates the plate thickness (vertical direction), and a receiving tank port member 120 having a receiving tank drain port 118 is attached to the through-hole 116. The receiving tank drain port 118 connects the interior and exterior of the receiving tank 106 to each other. The receiving tank drain port 118 opens to the outside, and as shown in Figure 1, for example, a tube 122 or the like is connected to the receiving tank port member 120. The tube 122 is provided with a clamp or a valve that can be switched between open and closed, allowing the receiving tank drain port 118 to be opened and closed. The positions of the through-hole 116 and the receiving tank port member 120 are not limited, and they may be provided in the center of the bottom wall 110 as shown in Figures 6, 7, and 11, or in a corner of the bottom wall 110 (for example, the left rear part of the bottom wall 110 as shown in Figures 3 and 4).

[0090] The upward opening of the receiving tank 106 is larger than the outer circumference of the water tank 14, allowing the water tank 14 to be placed on the bottom wall 110 of the receiving tank 106. An upwardly protruding positioning protrusion 124 is fixed to the bottom wall 110 with a bolt or screw at the portion where the water tank leg 78 of the water tank 14 overlaps. Each positioning protrusion 124 has a generally truncated cone shape and is slightly smaller than the positioning recess 80 of each water tank leg 78. Each positioning protrusion 124 may be made of synthetic resin, but may also be made entirely or partially of a ferromagnetic or paramagnetic metal, for example. If each positioning protrusion 124 is made of synthetic resin, a permanent magnet 126 may be embedded therein, for example.

[0091] As a result, when the aquarium 14 is placed on the bottom wall 110 of the receiving tank 106, the positioning protrusions 124 on the bottom wall 110 fit into the positioning recesses 80 on each aquarium leg 78, positioning the aquarium 14 and the receiving tank 106 in the horizontal direction (a direction perpendicular to the up-down direction). That is, in this embodiment, the positioning recesses 80 and the positioning protrusions 124 constitute a positioning mechanism 127 that positions the aquarium 14 and the receiving tank 106 relative to each other in the horizontal direction. Note that, because the aquarium 14 and the receiving tank 106 are not fixed in the up-down direction, the aquarium 14 can be removed from the receiving tank 106 after training is completed by lifting it off the receiving tank 106.

[0092] In particular, if permanent magnets 82, 126 are provided in each water tank leg 78 or each positioning protrusion 124, the attractive force between these permanent magnets 82, 126 can prevent the water tank 14 from unintentionally detaching from the receiving tank 106. Note that if either one of the water tank legs 78 or each positioning protrusion 124 is made entirely or partially of metal, a permanent magnet may be provided only on the other of the water tank legs 78 and each positioning protrusion 124. Alternatively, the permanent magnets 82, 126 may be provided on either one of the water tank legs 78 or each positioning protrusion 124, and attractive force may act between the permanent magnets 82, 126 and the bolts or screws securing the water tank legs 78 and / or each positioning protrusion 124. In other words, a connecting means 128 can be configured that includes at least one of the permanent magnets 82, 126 to restrict unintentional separation of the water tank 14 and the receiving tank 106, thereby maintaining the water tank 14 and the receiving tank 106 in an attached state.

[0093] 12 , the pressing mechanism 108 of this embodiment includes a pressing plate 130 having a threaded hole 129 and a knob 134 having a screw 132 that threads into the threaded hole 129. The pressing plate 130 is a generally rectangular plate having a certain widthwise dimension (front-to-back dimension) overall, and in this embodiment, the widthwise dimension of the pressing plate 130 is generally equal to the widthwise dimension (front-to-back dimension) of the elastic wall member 90. In the orthopedic technique training device 10 of this embodiment, the pressing plate 130 is assembled so that its thickness direction is the left-to-right direction. One surface in the thickness direction (the left surface when assembled to the orthopedic technique training device 10) is generally flat, and a threaded hole 129 is provided on the other surface in the thickness direction, into which the screw 132 of the knob 134 is threaded.

[0094] As a result, by rotating the tightening portion 136 of the knob 134 around the central axis, it is possible to tighten the screw and move the knob 134 in the screw feed direction (from right to left), or to loosen the screw and move the knob 134 in the opposite direction. As a result, the distance (left-right distance) from one surface in the plate thickness direction of the pressure plate 130 to the end face of the tightening portion 136 of the knob 134 can be adjusted depending on the operation of tightening or loosening the screw.

[0095] In this embodiment, three screw holes 129 are provided on the other surface of the pressure plate 130 in the plate thickness direction, spaced apart from one another in the front-to-rear direction, and three knobs 134 are provided to screw into the screw holes 129. At the lower end of the pressure plate 130, notched recesses 138 that open upward are formed between adjacent screw holes 129 in the front-to-rear direction, penetrating the plate thickness direction (left-to-right direction). Each of these recesses 138 is provided at a position corresponding to each mounting recess 104 on the lower edge of the elastic wall member 90.

[0096] This pressing mechanism 108 is provided to press outward against the elastic wall member 90 when the water tub 14 is placed on the receiving tub 106. That is, one surface in the thickness direction of the pressing plate 130, which is made substantially flat, is placed against the surface of the elastic wall member 90 opposite the side that is placed against the opening 48 of the water tub 14, and the end faces of the tightening portions 136 of the knobs 134 attached to the other surface in the thickness direction of the pressing plate 130 abut against the right inner surface of the peripheral wall 112 of the receiving tub 106. In particular, as mentioned above, the left-right distance from one surface in the thickness direction of the pressure plate 130 to the end face of the clamping portion 136 can be adjusted by rotating each knob 134, and therefore, by loosening the screws 132 of each knob 134 and increasing the left-right distance from one surface in the thickness direction of the pressure plate 130 to the end face of the clamping portion 136, the elastic wall member 90 is pressed by the pressure plate 130, and the elastic wall member 90 is placed in an approximately compressed state in the left-right direction between the water tank 14 and the pressure plate 130.

[0097] In this embodiment, the pressing mechanism 108 (pressing plate 130) is placed on the bottom wall 110 of the receiving tub 106 and presses the elastic wall member 90 against the water tub 14 over a certain range in the vertical direction from the bottom end of the water tub 14. Specifically, the pressing mechanism 108 presses the elastic wall member 90 against each edge-like abutment portion 52 of the bottom wall portion 24 of the water tub 14 and the lower portions of the front and rear vertical wall portions 28a, 28b (particularly, the portions that do not reach the curved portions and extend generally in the vertical direction).

[0098] The skeletal model attached to the water tank 14 for training can be changed depending on the training procedure, but as shown in Figures 13 and 14, the skeletal model 12 of this embodiment is fixed to a bracket 152, which will be described later. Furthermore, the skeletal model 12 of this embodiment is a lumbar skeletal model used for training in surgery for herniated discs. When a lumbar skeletal model is used, it may simulate the entire lumbar vertebrae (first to fifth lumbar vertebrae) or a portion of the lumbar vertebrae. The skeletal model 12 of this embodiment includes an anterior portion of the third lumbar vertebra L3, the fourth lumbar vertebra L4, and the fifth lumbar vertebra L5, an intervertebral disc 140 between the third lumbar vertebra L3 and the fourth lumbar vertebra L4, and an intervertebral disc 142 between the fourth lumbar vertebra L4 and the fifth lumbar vertebra L5. 1 to 12, the neck side of the skeletal model 12 is described as the front and the leg side as the rear. Therefore, the left side in FIG. 13, which corresponds to the neck side of the skeletal model 12, will be described as the front, the right side in FIG. 13, which corresponds to the leg side, will be described as the rear, the upper side in FIG. 13, which corresponds to the back side, will be described as the upper side, and the lower side in FIG. 13, which corresponds to the abdominal side, will be described as the lower side.

[0099] Furthermore, a nerve model 146 simulating a nerve is inserted into a gap 144 inside the skeletal model 12. The nerve model 146 has a portion 146a simulating the cauda equina nerve extending in the front-to-back direction and a portion 146b simulating a nerve root extending laterally from the cauda equina nerve. The skeletal model 12 also has a fibrous interior material 148 simulating a hernia in the internal gap 144. For example, cotton or wool felt can be suitably used as the fibrous interior material 148.

[0100] The skeletal model 12 may be formed from a hard resin such as epoxy resin or acrylic resin, and in this embodiment, it is formed from foamed polyurethane. Furthermore, in this embodiment, the skeletal model 12 has a multilayer structure consisting of multiple layers with different hardnesses. The outermost layer is a covering layer 150 made of a synthetic resin that is harder than the inner layers. This outer layer (covering layer 150) may be made of a different material from the inner layers, for example, or its hardness may be adjusted by changing the foaming ratio relative to the inner layers. Furthermore, the nerve model 146 may be formed from an elastomer such as silicone.

[0101] Furthermore, the bracket 152 has a generally rectangular flat plate shape overall and may be formed of, for example, a hard synthetic resin. The bracket 152 is fixed to the underside of the skeleton model 12. The fixing structure between the bracket 152 and the skeleton model 12 is not limited and may be, for example, adhesive bonding. However, in this embodiment, a pin hole 154 is provided in the center of the upper surface of the bracket 152, and a pin (not shown) protruding downward from the skeleton model 12 is press-fitted into the pin hole 154 to fix the bracket 152 to the skeleton model 12. By adopting such a fixing structure, for example, it is possible to replace only the skeleton model 12 while the bracket 152 is attached to the model support part 61 (first and second fixing parts 62, 64). Alternatively, the skeleton model 12 and the bracket 152 may be bonded together with the pin of the skeleton model 12 inserted into the pin hole 154 of the bracket 152. Furthermore, the lower part of the bracket 152 is provided with engaging protrusions 156, 156 protruding on both sides in the front-rear direction.

[0102] The front-to-rear dimension of the bracket 152, including these engaging protrusions 156, 156, is set to a size such that when the front engaging protrusion 156 is inserted into the first fixing groove 66 of the first fixing portion 62 of the model support part 61 and the pressing portion 70 of the rotating member 68 provided on the second fixing portion 64 is in a fixed position, the rear engaging protrusion 156 is pressed from above by the pressing portion 70. Then, by rotating the rotating member 68 to release the pressing portion 70 from above on the engaging protrusion 156, the bracket 152 with the skeleton model 12 fixed thereto can be removed from between the first fixing portion 62 and the second fixing portion 64.

[0103] The distal end of the endoscope 16 is inserted from above into the water tank 14 to which the skeletal model 12 is fixed, via either one of the valve bodies 34 and the elastic wall member 90 provided on the upper wall portion 30. The structure of the endoscope used in the orthopedic technique training device 10 according to the present invention is not limited, and an endoscope generally used in surgical operations may be used, for example. However, in this embodiment, the endoscope 16 is a simple endoscope, as shown in Figures 15 and 16. That is, the endoscope 16 of this embodiment has a main body 158 made of metal.

[0104] The main body 158 of the endoscope 16 is formed with three lumens: a first lumen 160, a second lumen 162, and a third lumen 164. These first to third lumens 160, 162, and 164 extend in the longitudinal direction of the main body 158. In this embodiment, the first lumen 160 has a larger diameter than the second and third lumens 162 and 164, and is a lumen for suctioning water 18 contained in the water tub 14 and for inserting an instrument (not shown). The second lumen 162 is for inserting a cable 180 (described later), and the third lumen 164 is a lumen for discharging water 18 into the water tub 14.

[0105] In the following description, the longitudinal direction of the main body 158 refers to the left-right direction in Fig. 15, the distal end side refers to the left side in Fig. 15, and the proximal end side refers to the right side in Fig. 15. Furthermore, the upper side of the main body 158 refers to the upper side in Fig. 15, and the lower side refers to the lower side in Fig. 15. In this embodiment, the lower portion of the main body 158 protrudes more distally than the upper portion, and a first lumen 160 is provided in the upper portion of the main body 158, and a second lumen 162 is provided in the lower portion of the main body 158. Furthermore, a third lumen 164 is provided in the main body 158 at a position laterally spaced apart from the first lumen 160 and the second lumen 162.

[0106] These first to third lumens 160, 162, 164 each open at the distal end of the endoscope 16. That is, the endoscope 16 of this embodiment is provided at its distal end with both a suction port 166 as the opening of the first lumen 160, which is a lumen for sucking in water 18, and a discharge port 168 as the opening of the third lumen 164, which is a lumen for discharging water 18. In addition, a camera 170 is provided at the opening of the second lumen 162. That is, the camera 170 is provided closer to the distal end than the suction port 166 and the discharge port 168, and is capable of capturing images of an instrument inserted through the first lumen 160 (suction port 166).

[0107] The proximal end of the first lumen 160 is closed by a valve 174 having a slit 172, and a suction tube 176 that communicates with the first lumen 160 and extends laterally is connected forward of the valve 174. Furthermore, a discharge tube 178 that extends laterally is connected to the proximal end of the third lumen 164. The suction tube 176 and the discharge tube 178 may be connected to a pump (a circulation device) or a filter (a filtration device) (not shown) via an appropriate connector or the like outside the water tank 14. Therefore, the orthopedic technique training device 10 of this embodiment may be configured to include a pump, a filter, or the like (not shown). In this embodiment, water 18 sucked through the suction port 166 is filtered by the filter, and the filtered water 18 is circulated by the pump and discharged from the discharge port 168 into the water tank 14.

[0108] Furthermore, a cable 180 connected to the camera 170 is drawn out to the outside of the endoscope 16 through the second lumen 162 and is connected to a monitor (not shown) outside the water tank 14 via a connector 182. The orthopedic technique training device 10 of this embodiment may also include a light as an illumination device, and a light (not shown) may be provided in the water tank 14 and / or the endoscope 16.

[0109] When the endoscope 16 is inserted through the elastic wall member 90, a dilator 184 and a sheath 186 serving as a punching member are pierced through the elastic wall member 90 before the endoscope 16 is inserted. As shown by the two-dot chain line in Fig. 15 , the dilator 184 is inserted into the sheath 186, and the dilator 184 and the sheath 186 are pierced together through the elastic wall member 90. Thereafter, the dilator 184 is pulled out relative to the sheath 186, thereby leaving the sheath 186 in the elastic wall member 90. The sheath 186 forms an insertion hole 188 for the endoscope 16 in the elastic wall member 90, and the endoscope 16 can be inserted through the insertion hole 188 into the elastic wall member 90. That is, the insertion hole 188 for the endoscope 16 can be formed by puncturing the elastic wall member 90 with the dilator 184 serving as a punching member.

[0110] Furthermore, after training is completed, the sheath 186, which serves as a piercing member, can be removed from the elastic wall member 90, thereby closing the insertion hole 188 based on the elasticity of the elastic wall member 90 itself. Even when the endoscope 16 is inserted through one of the valve bodies 34 in the upper wall portion 30, the dilator 184 and sheath 186, which serve as piercing members, may be inserted before the endoscope 16. However, the dilator 184 and sheath 186 are not essential, and the endoscope 16 may be inserted directly through one of the valve bodies 34 and the elastic wall member 90. In other words, the insertion hole 188 for inserting the endoscope 16 into the water tub 14 may be formed in the peripheral wall portion 26, which has the elastic wall member 90, and in the upper wall portion 30, which has the valve bodies 34. Therefore, the insertion hole 188 is provided in the wall portion 46 of the water tub 14, including the peripheral wall portion 26 and the upper wall portion 30.

[0111] With this orthopedic procedure training device 10, orthopedic surgical procedure training can be performed by inserting the distal end of the endoscope 16 through either one of the valve bodies 34 or the elastic wall member 90. That is, with the distal end of the endoscope 16 brought close to the skeletal model 12, an instrument such as a drill or forceps (not shown) is inserted through the valve 174 provided at the proximal end of the first lumen 160 and protruded from the distal end of the endoscope 16. Then, while checking the image displayed on the monitor (not shown), the instrument is operated to crush or cut bone (skeletal model 12), remove hernia (internal structure 148), or the like.

[0112] Surgical methods for herniated discs generally include the interlaminar approach shown in Figure 17(a) and the transforaminal approach shown in Figure 17(b). The interlaminar approach or the transforaminal approach is selected depending on the size and location of the herniation. In other words, in the approach shown in Figure 17(a), the endoscope 16 is inserted vertically from the patient's back (from above in Figure 17(a)), whereas in the approach shown in Figure 17(b), the endoscope 16 is inserted from the outside (from a direction inclined relative to the top in Figure 17(b)). The orthopedic technique training device 10 of this embodiment includes an upper wall portion 30 on which each valve body 34 is provided and an elastic wall member 90 provided outside the upper wall portion 30. Since the endoscope 16 can be inserted from either the valve body 34 or the elastic wall member 90, training in both the interlaminar approach and the transforaminal approach is possible.

[0113] In training for the transforaminal technique, the endoscope 16 is inserted through the elastic wall member 90 from the left side of the skeletal model 12 (the left side when the skeletal model 12 is positioned at the center and the patient's neck is positioned forward) in Figure 1, assuming that treatment will be performed from the patient's left side. However, by flipping the skeletal model 12 front to back and placing it in the water bath 14, training can be performed for inserting the endoscope 16 from the patient's right side. Furthermore, the transforaminal technique may involve significant downward movement (hand down) or upward movement of the endoscope 16, as indicated by the white arrows in Figure 17(b). Even when significant vertical movement of the endoscope 16 is required, the elastic wall member 90 covers a wide area of ​​the water bath 14 from the top to the right, preventing interference with the peripheral wall 26 of the water bath 14 during the movement of the endoscope 16.

[0114] After the training session is completed, the endoscope 16 inserted through the elastic wall member 90 is removed. If a dilator 184 or sheath 186 is used as a perforating member when inserting the endoscope 16, the sheath 186 is removed after the endoscope 16 is removed, and the insertion hole 188 formed in the elastic wall member 90 is closed by the elastic restoration deformation of the elastic wall member 90. The clamp or valve of the tube 89 connected to the water tank port member 88 is then released to open the water tank drain port 86, allowing the water 18 in the water tank 14 to drain through the water tank drain port 86 into the receiving tank 106. After the water 18 in the water tank 14 has been drained, the water tank 14 is removed from the receiving tank 106. The water 18 stored in the receiving tank 106 is drained through a suitable drain, for example, through a tube 122 connected to the receiving tank port member 120 of the receiving tank 106, to an appropriate drain, such as a bathroom in the user's home.

[0115] In the orthopedic procedure training device 10 of this embodiment, which is configured as described above, a portion of the wall 46 of the water tub 14 is formed of an elastic wall member 90. In particular, in this embodiment, the elastic wall member 90 is used in place of the right-side vertical wall 28 constituting the peripheral wall 26 of the water tub 14. Therefore, compared to, for example, a case in which a through-hole for endoscope insertion is provided in a rigid vertical wall, the endoscope 16 can be inserted over a wider range, and interference from the rigid vertical wall is avoided even when the endoscope 16 is moved significantly during training. Furthermore, whereas providing a through-hole for endoscope insertion in a rigid vertical wall limits the insertion position of the endoscope, providing the elastic wall member 90 over a wider range as in this embodiment improves the flexibility of the insertion position of the endoscope 16. As a result, training can be performed that includes the selection of the insertion position of the endoscope 16, allowing training to be performed under conditions that are closer to actual surgery.

[0116] Furthermore, a perforating member (dilator 184 and sheath 186) can be inserted into the elastic wall member 90 prior to the insertion of the endoscope 16 to form an insertion hole 188 for the endoscope 16. Since such perforating members (dilators, sheaths, etc.) are generally used in actual surgeries, training can be performed under conditions that are closer to actual surgery. When the endoscope 16 and perforating member (sheath 186) are removed, the insertion hole 188 is immediately closed due to the elasticity of the elastic wall member 90, thereby preventing leakage of the water 18 in the water tank 14 through the insertion hole 188.

[0117] Furthermore, the elastic wall member 90 of this embodiment not only constitutes part of the peripheral wall 26 of the water tub 14, but also has an upper portion that forms a curved wall 96, partially covering the upper opening 22 of the water tub 14. This allows the endoscope 16 to be inserted through the curved wall 96 of the elastic wall member 90, making it possible to perform transforaminal training, as shown in Figure 17(b) above. Furthermore, since the elastic wall member 90 covers the upper opening 22, leakage of water 18 from the upper opening 22 can be effectively prevented.

[0118] Furthermore, in this embodiment, the peripheral wall 26 of the water tank 14 has a rectangular cylindrical shape composed of four vertical walls 28, and an elastic wall member 90 is provided in place of one of the vertical walls 28 (the right-side vertical wall 28). This allows the elastic wall member 90 to be provided on the side of the skeletal model 12, for example, allowing training to be performed while standing to the side of a patient. However, the elastic wall member may be provided in front of or behind the skeletal model depending on the technique to be trained. By providing the peripheral wall 26 with a rectangular cylindrical shape, the peripheral wall 26 and, ultimately, the orthopedic technique training device 10 can be made more compact.

[0119] Furthermore, in this embodiment, the elastic wall member 90 is attached to the water tub 14 under tension in the lengthwise direction (vertical direction), and an edge-like abutment portion 52 is provided at the attachment position of the elastic wall member 90 on the water tub 14. This allows the opening 48 in the water tub 14 to be effectively sealed by the elastic wall member 90, preventing leakage of water 18 through the opening 48. In particular, the elastic wall member 90 is provided with upper rods 98 and lower rods 100 on its upper and lower edges, respectively, and by attaching the elastic wall member 90 to the water tub 14 under tension using these upper and lower rods 98, 100, the elastic wall member 90 can be easily attached to the water tub 14.

[0120] In this embodiment, the opening 48 is provided over the entire right vertical wall 28, and edge-like contact portions 52 are provided at the right edge portions of the front and rear vertical wall portions 28a, 28b. This allows a large width dimension for the opening 48 and allows the front and rear vertical wall portions 28a, 28b to be used effectively to form the edge-like contact portions 52. Furthermore, when the elastic wall member 90 is overlapped with each of the edge-like contact portions 52, a pressing mechanism 108 is provided on the outside of the elastic wall member 90, pressing the elastic wall member 90 against each edge-like contact portion 52. This further improves the sealing ability of the opening 48 provided by the elastic wall member 90.

[0121] Furthermore, the elastic wall member 90 of this embodiment can display a visible position marker that indicates the intended insertion position of the endoscope 16. This allows the endoscope 16 to be inserted from the appropriate position, making it possible to more reliably enjoy the benefits of training. In addition, the upper wall portion 30 and the peripheral wall portion 26 (each vertical wall portion 28) of the wall portion 46 of the water tank 14 are both made of a transparent material, so that the operation of the endoscope 16 can be visually confirmed from the outside. This allows, for example, the instructor's operation to be confirmed from the outside, or the trainer's own operation to be recorded from the outside, making it easy to check the progress of training, etc.

[0122] Furthermore, a predetermined water level of the water 18 required to immerse the skeletal model 12 in the water tank 14 may be set. In this embodiment, no specific predetermined water level is set. However, the water 18 may be filled up to near the top of the water tank 14, and the top of the water tank 14 may be set as the predetermined water level. The elastic wall member 90 is also provided below this predetermined water level (the top of the water tank 14 in this embodiment) and protrudes below the bottom wall 24 of the water tank 14 in this embodiment. This allows training to be conducted while simulating the insertion of the endoscope 16 over a wide area extending to the sides and bottom of the human body. Furthermore, since the endoscope 16 can be inserted into the water 18 without an air layer when the endoscope 16 is inserted through the elastic wall member 90, training can be conducted that is more in line with actual surgery.

[0123] Furthermore, according to the orthopedic technique training device 10 of this embodiment, a larger receiving tank 106 is provided below the water tank 14. As a result, even if the water 18 in the water tank 14 leaks due to large movements of the endoscope 16 during training, the leaked water 18 can be received in the receiving tank 106, preventing the water 18 from leaking outside the orthopedic technique training device 10. This also improves the flexibility of the installation location of the orthopedic technique training device 10.

[0124] Furthermore, in this embodiment, each of the tank legs 78 of the tank 14 is provided with a positioning recess 80, and the bottom wall 110 of the receiving tank 106 is provided with a positioning protrusion 124 that fits into each of the positioning recesses 80. These positioning recesses 80 and positioning protrusions 124 form a positioning mechanism 127 that horizontally positions the tank 14 and the receiving tank 106. This prevents the tank 14 from unintentionally shifting horizontally relative to the receiving tank 106 during training, for example, allowing the user to concentrate more on their training.

[0125] In particular, in this embodiment, the elastic wall member 90 and the pressing mechanism 108 (pressing plate 130 and each knob 134) are sandwiched between the water tank 14 and the right wall portion of the peripheral wall 112 of the receiving tank 106, thereby enabling the pressing mechanism 108 to press the elastic wall member 90.Since the water tank 14 cannot be displaced horizontally, the pressing of the elastic wall member 90 against the water tank 14 and the prevention of water 18 leaking from the water tank 14 can be more reliably achieved.

[0126] Furthermore, in this embodiment, the volume of liquid that can be stored in the receiving tank 106 is equal to or greater than the specified amount of water that can be stored in the water tank 14 during training. Therefore, even if water 18 in the water tank 14 spills out during training, the entire amount can be received in the receiving tank 106, and leakage of water 18 to the outside of the orthopedic technique training device 10 can be more reliably prevented.

[0127] In particular, in this embodiment, the water tub 14 is provided with an openable water tub drain outlet 86, and the receiving tub 106 is provided with an openable receiving tub drain outlet 118. As a result, for example, after training is completed, the water 18 in the water tub 14 can be drained into the receiving tub 106 by opening the water tub drain outlet 86. Furthermore, since the receiving tub 106 can receive more water 18 than the specified amount for the water tub 14, the water 18 in the water tub 14 can be transferred to the receiving tub 106 in a single drain. Therefore, since the receiving tub 106 can store more than the specified amount of water, drainage efficiency after training is also improved. Furthermore, after draining the water 18 into the receiving tub 106, the water tub 14 can be removed and the receiving tub 106 can be carried alone, allowing the water 18 in the receiving tub 106 to be drained more safely without spilling.

[0128] Furthermore, each of the tank legs 78 of the tank 14 and each of the positioning projections 124 of the receiving tank 106 may be provided with a permanent magnet 82, 126. Such permanent magnets 82, 126 keep the tank 14 and the receiving tank 106 attached to each other, preventing the tank 14 from wobbling during training. Furthermore, even after training, for example, when the water 18 is drained into the receiving tank 106, the tank 14 can be prevented from unintentionally floating up from the receiving tank 106.

[0129] 18 to 22 show an orthopedic technique training device 200 as a second embodiment of the present invention. The orthopedic technique training device 200 of this embodiment has a water tank 14 that is substantially similar to the orthopedic technique training device 10 of the first embodiment, but differs from the first embodiment in the structure of the model support section that positions and supports the skeletal model 12 inside the water tank 14 and the structure of the pressing mechanism that presses the elastic wall member 90 from the outside. In the following description, members and parts that are substantially the same as those of the previous embodiment are designated by the same reference numerals in the drawings, and detailed description thereof will be omitted.

[0130] More specifically, the orthopedic technique training device 200 of this embodiment is equipped with a model position setting mechanism 202 that moves and fixes the skeletal model 12 to a plurality of different positions inside the water tank 14. By moving the skeletal model 12 using this model position setting mechanism 202, the distance from the insertion hole 188 for the endoscope 16, which is provided in the wall portion 46 of the water tank 14, to the skeletal model 12 can be changed.

[0131] In particular, in this embodiment, a base member 204 to which the skeletal model 12 can be detachably attached is provided inside the water tank 14, and the model positioning mechanism 202 is configured to include a guide mechanism 206 that guides the base member 204 so that it can move horizontally, and a locking mechanism 208 that positions the base member 204 at multiple positions in the direction of movement by the guide mechanism 206. Therefore, in this embodiment, a model support unit 210 that supports and positions the skeletal model 12 inside the water tank 14 is configured to include the model positioning mechanism 202 (particularly the locking mechanism 208) and the base member 204.

[0132] 23, the base member 204 is a generally rectangular plate-shaped member made of synthetic resin. The base member 204 is oriented with its longitudinal direction in the front-to-rear direction relative to the bottom wall 24. A mounting portion 212 for mounting the bracket 152 of the skeleton model 12 is provided in the middle portion in the front-to-rear direction, and guide holes 214 that penetrate in the left-to-right direction are provided at both ends in the front-to-rear direction.

[0133] The mounting portion 212 is a generally rectangular recess that opens upward and has an opening of a predetermined size. That is, the widthwise (left-right) dimension A (see FIG. 23) of an upper opening 216 in the mounting portion 212 is equal to or slightly larger than the widthwise dimension B (see FIG. 14) of the bracket 152. Furthermore, the lengthwise (front-rear) dimension C (see FIG. 23) of the upper opening 216 is equal to or slightly larger than the lengthwise dimension D (see FIG. 13) of the upper portion of the bracket 152, and is slightly smaller than the maximum length dimension E of the lower portion of the bracket 152 (the maximum front-rear dimension at the position where each engaging protrusion 156 is formed; see FIG. 13). 23 to 25 , a fixing groove 218 into which the front engaging protrusion 156 of the bracket 152 is fitted and a fixing groove 220 into which the rear engaging protrusion 156 is fitted are provided in the lower portions of the wall portions 217a, 217b on both front and rear sides of the mounting portion 212. A plurality of drain holes 222 are provided in the bottom wall of the mounting portion 212, allowing water 18 to be easily drained from the mounting portion 212 after use of the orthopedic technique training device 200. Furthermore, an opening 223 is provided in the center portion of the rear wall portion 217b of the mounting portion 212 in the left-right direction, and a protruding tip portion 228 of the spring portion 226 can elastically abut against the bracket 152 attached to the mounting portion 212 from behind through the opening 223, as will be described later.

[0134] Furthermore, a bracket fixing mechanism 224 that fixes the bracket 152 attached to the attachment portion 212 is provided on the base member 204 behind the attachment portion 212. The bracket fixing mechanism 224 includes a spring portion 226 that is integrally provided on the base member 204 and is elastically deformable in the front-to-rear direction, and a protruding tip portion of the spring portion 226 is provided with a protruding tip portion 228 that can come into contact with the rear engaging protrusion 156 of the bracket 152. The protruding tip portion 228 is provided with a substantially hemispherical rearward protruding portion 230 that protrudes rearward. Furthermore, the bracket fixing mechanism 224 has a fixation switching portion 232 that is slidable in the left-right direction and switches between fixing and releasing the bracket 152. The fixed switching portion 232 has a knob portion 234 that protrudes upward and can be gripped and operated by the user, and an abutment portion 236 that is integrally formed with the knob portion 234 and can abut against the protruding tip portion 228 of the spring portion 226 from behind.

[0135] 23 and 25 , with the bracket 152 attached to the attachment portion 212, by pinching the knob portion 234 and sliding the abutment portion 236 to the right so that the abutment portion 236 abuts against the protruding tip portion 228 of the spring portion 226 from behind, both front-to-rear end portions of each engaging protrusion 156 fitted into each fixing groove 218, 220 are clamped in the front-to-rear direction by the inner surface of the front fixing groove 218 and the protruding tip portion 228, thereby fixing the bracket 152 to the attachment portion 212. In particular, the protruding tip portion 228 is provided with a rearward protruding portion 230 that protrudes rearward, and when the protruding tip portion 228 abuts against the abutment portion 236 at the rearward protruding portion 230, the abutment portion 236 holds the protruding tip portion 228 in a forward protruding position with a small pressing surface. This improves the support force of the bracket 152 between the front fixing groove 218 and the protruding tip 228, in other words, the fixing force of the bracket 152 to the mounting part 212. Note that the protruding tip 228 may be in the position shown in Fig. 25 in its initial state (the state before the abutting part 236 is slid and displaced to the left), or the abutting part 236 may be slid and displaced to the left so that it abuts against the protruding tip 228 from behind, causing the protruding tip 228 to be pushed forward and move to the position shown in Fig. 25.

[0136] 24 and 25 , each guide hole 214 provided at each end of the base member 204 in the front-rear direction extends in a substantially circular shape over its entire length. The inner circumferential surface of each guide hole 214 is provided with a substantially plate-shaped convex portion (guide hole convex portion) 238 that protrudes inward (radially inward). This guide hole convex portion 238 extends circumferentially within the guide hole 214 in a substantially crescent-moon-shaped plate shape, with a radial protrusion height that is just short of contacting the outer circumferential surface of a guide rod 240 (described below) inserted into the guide hole 214. It is desirable that the plate thickness of the guide hole convex portion 238 (thickness dimension in the axial direction of the guide hole 214) be smaller at the tip end (inner circumferential side of the guide hole 214) than at the base end (protrusion).

[0137] At least one such guide hole side protrusion 238 needs to be formed in the guide hole 214, but preferably a plurality (e.g., 3 to 10) are formed spaced apart from one another in the longitudinal direction (left-right direction) of the guide hole 214. When a plurality of guide hole side protrusions 238 are provided, the pitch (spacing) is set so that the guide hole side protrusions 238 fit into and engage with the axial spaces (recesses 252) of the guide rod side protrusions 250 formed on the guide rod 240, as will be described later.

[0138] Meanwhile, multiple guide rods 240 (a pair in this embodiment) extending parallel to each other are fixedly attached to the bottom wall 24 of the water tub 14. Each guide rod 240 extends in the left-right direction and faces each other at a predetermined distance in the front-to-rear direction. Both longitudinal (left-right) ends of each guide rod 240 are supported by fixing members 242 so that they can rotate around a central axis and are fixed in position. Each fixing member 242 on both left and right sides is fixed to the water tub 14 with bolts or the like, thereby attaching each guide rod 240 to the water tub 14 via each fixing member 242. The left end of each guide rod 240 protrudes leftward through the left fixing member 242, and a lever 244 is integrally formed at the left end of each guide rod 240, allowing the guide rod 240 to be manually rotated around its central axis. Furthermore, the guide rods 240 of this embodiment have a composite structure in which a synthetic resin layer is fixed and coated around a metal core rod 246 that extends the entire length of the guide rod 240. This improves the rigidity of each guide rod 240 and also improves the degree of freedom in designing the shape of the outer circumferential surface.

[0139] Each guide rod 240 extends straight with a constant, approximately circular cross-section, and its outer circumferential surface is slightly smaller than the inner circumferential surface of each guide hole 214. A flat surface 248 extending in the chord direction is formed at one circumferential location on the outer circumferential surface (the lower portion in FIG. 24 and the upper portion in FIG. 25 ), and this flat surface 248 is chamfered and spreads over the entire axial length. Furthermore, the outer circumferential surface of the guide rod 240 is provided with a plurality of convex portions (guide rod convex portions) 250 that protrude outward in portions circumferentially outside the flat surface 248. These guide rod convex portions 250 are approximately plate-shaped or flange-shaped and extend in the circumferential direction, with the protruding height at both circumferential ends gradually decreasing as they approach the flat surface 248.

[0140] The protruding height of the guide rod side convex portion 250 is set so that the outer diameter dimension at the formation position of the guide rod side convex portion 250 is the same as or slightly smaller than the inner diameter dimension of the guide hole 214 of the base member 204. Furthermore, since the guide rod side convex portion 250 extends in the circumferential direction over more than half the circumference with a substantially constant protruding height (outer diameter dimension), the outer peripheral surfaces of the many guide rod side convex portions 250 cooperate to form a guide surface that slides against the inner peripheral surface of the guide hole 214 of the base member 204 and guides the base member 204 so that it can move in the axial direction.

[0141] The thickness of the guide rod side protrusions 250 is smaller at the protruding tip end than at the base end, and the thickness at both circumferential end portions gradually decreases toward the circumferential ends. A large number of such guide rod side protrusions 250 are formed at a constant interval (pitch) along the length of the guide rod 240. As a result, recesses 252 that open toward the outer circumferential surface and extend in the circumferential direction are formed between adjacent guide rod side protrusions 250 in the axial direction of the guide rod 240. The opening dimension of each recess 252 (the distance between adjacent guide rod side protrusions 250) gradually increases toward the outer periphery.

[0142] Each guide rod 240 is inserted through a corresponding guide hole 214 in the base member 204. To secure each guide rod 240 to each guide hole 214 (base member 204), as shown in FIGS. 24 and 25 , the levers 244 are grasped and each guide rod 240 is rotated about its central axis. This causes each guide hole protrusion 238 to move circumferentially relative to the guide rod 240, entering the corresponding recess 252. This causes each guide hole protrusion 238 to be sandwiched between axially adjacent guide rod protrusions 250, 250, thereby engaging with each other in the axial direction. In this engaged state, the guide rod protrusions 250, 250 axially overlap and fit with the guide hole protrusions 238, thereby preventing axial movement of the guide hole 214 (base member 204) relative to the guide rod 240 and positioning the guide rod 240.

[0143] On the other hand, when releasing the fixation between each guide rod 240 and each guide hole 214 (base member 204), as shown by the two-dot chain lines in Figures 24 and 25, each lever portion 244 is pinched and each guide rod 240 is rotated about its central axis, causing each guide rod convex portion 250 to disengage circumferentially from the guide hole convex portion 238. This causes the guide hole convex portion 238 to come out of the recess 252 of the guide rod 240, releasing the axial positioning established by the engagement between the guide hole convex portion 238 and the guide rod convex portion 250 in an overlapping state in the axial direction, and allowing each guide hole 214 (base member 204) to move longitudinally relative to each guide rod 240. In addition, in this released state, the flat surface 248 of the guide rod 240 is positioned radially opposite the guide hole side protrusion 238 of the guide hole 214, and contact between the guide hole side protrusion 238 and the guide rod 240 is avoided, thereby enabling the base member 204 to move more smoothly along the guide rod 240.

[0144] As described above, in this embodiment, the guide mechanism 206 that guides the base member 204 to be movable in the horizontal direction (particularly the left-right direction among directions perpendicular to the up-down direction) is configured to include each guide rod 240 and each guide hole 214 through which each guide rod 240 is inserted. Also, each guide rod 240 is rotated about its central axis to engage the outer circumferential surface of each guide rod 240 with the inner circumferential surface of each guide hole 214, thereby fixing each guide rod 240 to each guide hole 214, and this interlocking action forms the lock mechanism 208 that prevents movement of the base member 204 along each guide rod 240 and enables fixing. In particular, guide hole convexities 238 are provided on the inner peripheral surface of each guide hole 214, and guide rod convexities 250 (respective recesses 252) are provided on the outer peripheral surface of each guide rod 240, and the interlocking action is exerted by each guide hole convexity 238 entering each recess 252 and interlocking with the outer peripheral surface of each guide rod 240. As a result, the locking mechanism 208 that positions the base member 204 in the direction of movement (left-right direction) by the guide mechanism 206 can also be configured by the fitting action of each guide hole convexity 238 and each recess 252.

[0145] Furthermore, in the orthopedic technique training device 200 of this embodiment, a pressing mechanism 254 that presses the elastic wall member 90 from the outside while pressing it against the edge-shaped abutment portion 52 is provided between the elastic wall member 90 and the peripheral wall 112 of the receiving tub 106. As also shown in FIGS. 18 to 22 , the pressing mechanism 254 of this embodiment includes a block-shaped pressing member 256. The pressing member 256 is preferably formed of an elastic material, and in this embodiment, it is formed of high-density polyethylene or foamed polyethylene. It is preferable that the pressing member 256 has greater deformation rigidity than the elastic wall member 90. This pressing member 256 has a substantially rectangular or trapezoidal cross section and has certain left-right and front-to-back dimensions when placed on the water tub 14. In this embodiment, the front-to-back dimension of the pressing member 256 is approximately equal to the front-to-back dimension of the elastic wall member 90. The left-right dimension of the pressing member 256 is approximately equal to or slightly larger than the distance between the elastic wall member 90 and the right inner surface of the peripheral wall 112 of the receiving tub 106 .

[0146] In this embodiment, when the water tub 14 is placed on the receiving tub 106, the pressing member 256 is inserted and positioned between the elastic wall member 90 and the right portion of the peripheral wall 112. In particular, the left-right dimension of the pressing member 256 is greater than the distance between the elastic wall member 90 and the right inner surface of the peripheral wall 112. Therefore, by positioning the pressing member 256 between the elastic wall member 90 and the right portion of the peripheral wall 112, the elastic wall member 90 and / or the pressing member 256 are compressed in the left-right direction, and the right portion of the elastic wall member 90 (right flat portion 92) is sandwiched between the elastic wall member 90 and the water tub 14. In this way, the pressing member 256 is configured to press the elastic wall member 90 from the outside.

[0147] A specific example of a method of using the orthopedic technique training device 200 of this embodiment will be described below with reference to Figures 26 and 27. That is, Figure 26(a) shows a state in which the locking mechanism 208 in the model positioning mechanism 202 is released and the base member 204 is movable along each guide rod 240, while Figure 26(b) shows a state in which the locking mechanism 208 has positioned the base member 204 relative to each guide rod 240. Also, Figure 27(a) shows a state in which the bracket fixing mechanism 224 is not activated and the bracket 152 is removable from the mounting portion 212 of the base member 204, while Figure 27(b) shows a state in which the bracket 152 is fixed to the mounting portion 212 of the base member 204 by the bracket fixing mechanism 224.

[0148] 26(a), the locking mechanism 208 is released, i.e., the guide hole protrusions 238 of the guide holes 214 and the flat surfaces 248 of the guide rods 240 are aligned in the circumferential direction, and in this embodiment, the guide hole protrusions 238 and the flat surfaces 248 face each other in the front-to-rear direction. This allows the base member 204 to move in the length direction (left-right direction) of the guide rods 240.

[0149] In this state (or in a state in which the locking mechanism 208 is activated as shown in FIG. 26( b)), the bracket 152 is attached to the attachment portion 212 of the base member 204 as shown in FIG. 27( a). Note that the front-to-rear dimension C of the upper opening 216 in the attachment portion 212 is smaller than the maximum front-to-rear dimension E of the bracket 152. However, by tilting the bracket 152 in the front-to-rear direction to fit the rear engagement protrusion 156 of the bracket 152 into the rear fixing groove 220, and then rotating the entire bracket 152 around the fitting portion to lower the front, the bracket 152 can be accommodated in the attachment portion 212 and the front engagement protrusion 156 can be fitted into the front fixing groove 218.

[0150] Specifically, at the stage of attaching the bracket 152 to the attachment portion 212, the abutment portion 236 of the fixation switching portion 232 is not located rearward of the protruding tip 228 of the spring portion 226, and the protruding tip 228 can be displaced in the front-to-rear direction in accordance with the elastic deformation of the spring portion 226. Therefore, by pushing the bracket 152 rearward with the rear engaging protrusion 156 fitted into the fixing groove 220, the bracket 152 can be moved rearward by a distance F from the state shown in FIG. More specifically, by pushing bracket 152 rearward (against the biasing force of spring portion 226) with rear engagement protrusion 156 of bracket 152 inserted into rear fixing groove 220, bracket 152 moves rearward (by distance F) until the upper portion of bracket 152 abuts against rear wall portion 217b of mounting portion 212. Here, because the engagement depth G (see FIG. 24 ) of engagement protrusion 156 on the front side of bracket 152 into fixing groove 218 is smaller than the movement distance F (G<F), moving bracket 152 rearward by distance F forms a gap F-G in size for fitting front engagement protrusion 156 into fixing groove 218. Furthermore, when both engaging protrusions 156, 156 are fitted into the fixing grooves 218, 220 on both sides, the bracket 152 is elastically prevented from moving rearward by the protruding tip 228, thereby maintaining the engaged state of the engaging protrusions 156, 156 and preventing unintended detachment.

[0151] 27(b), the knob 234 of the fixing switching part 232 is pinched to displace the abutment part 236 to the right, and the abutment part 236 is brought into contact with the protruding tip 228 of the spring part 226 from behind, whereby the bracket 152 is pushed forward by the protruding tip 228 and the front engaging protrusion 156 of the bracket 152 hits the front inner surface of the fixing groove 218. As a result, the engaging protrusions 156 on both sides of the bracket 152 are sandwiched between the inner surface of the front fixing groove 218 and the protruding tip 228 in the front-to-rear direction, preventing the bracket 152 from moving within the mounting part 212. Note that removing the bracket 152 from the mounting portion 212 can be achieved by performing the reverse operation of the mounting operation: gripping the knob portion 234 and displacing the abutment portion 236 leftward, releasing it from contact with the protruding tip portion 228, and allowing the spring portion 226 (protruding tip portion 228) to elastically deform in the front-to-rear direction. This allows the bracket 152 to be displaced rearward, and the rearward movement of the bracket 152 allows the front engaging protrusion 156 to be released from the front fixing groove 218. In this state, the bracket 152 can be removed from the mounting portion 212, for example, by hooking the front end of the upper end portion of the bracket 152 with one's fingers and lifting it up.

[0152] In this state, the base member 204 is moved left and right along each guide rod 240 to a desired position, and then, as shown in FIG. 26( b), each lever 244 provided at the left end of each guide rod 240 is operated to rotate each guide rod 240 about its central axis. As a result, each guide hole side protrusion 238 inside each guide hole 214 enters into each recess 252 of each guide rod 240 and engages with the outer peripheral surface, thereby fixing the base member 204 to each guide rod 240. That is, in this embodiment, the base member 204 (skeleton model 12) can be fixed at multiple positions in the length direction of each guide rod 240, and particularly in this embodiment, the base member 204 can be fixed at any position within the range in which the base member 204 can move relative to each guide rod 240.

[0153] In this embodiment, as described above, the guide hole convexities 238 of the guide holes 214 and the guide rod convexities 238 of the guide rods 240 are both tapered so that their thickness decreases toward the protruding tip. As a result, even if there is a misalignment between the guide hole convexities 238 and the recesses 252 when the lever portion 244 changes from a state in which it faces straight upward as shown in Fig. 26(a) to a state in which it is inclined as shown in Fig. 25 to a state in which it is horizontal as shown in Fig. 26(b), the guide hole convexities 238 gradually enter the recesses 252 due to the guiding action of the inclined surfaces of the convexities 238, 250. In this state in Fig. 26(b) where the lever portion 244 is in the horizontal position, the guide hole convexities 238 are reliably positioned within the recesses 252 and engage with the outer peripheral surfaces of the guide rods 240.

[0154] After the base member 204 with the brackets 152 attached thereto is fixed to each guide rod 240 in this manner, the skeletal model 12 is fixed to the brackets 152. The subsequent operations are the same as in the first embodiment, and orthopedic procedure training using the endoscope 16 can be performed, for example, according to the interlaminar method shown in Fig. 17(a) or the transforaminal method shown in Fig. 17(b) described above.

[0155] In the orthopedic procedure training device 200 of this embodiment configured as described above, at least a portion of the wall 46 of the water tank 14 is formed of an elastic wall member 90 through which the endoscope 16 can be inserted, and therefore the same effects as in the first embodiment can be achieved. In particular, in this embodiment, the skeletal model 12 can be moved to multiple positions inside the water tank 14 by the model position setting mechanism 202, and the distance and direction (angle) from the insertion hole 188 through which the endoscope 16 is inserted to the skeletal model 12 can be changed. This makes it possible to change the distance from the insertion hole 188 to the skeletal model 12, for example, depending on the body type of the patient expected to undergo surgery and the length of the endoscope expected to be used. That is, when assuming a large patient or a long endoscope, the skeletal model 12 can be moved away from the elastic wall member 90 to increase the distance from the insertion hole 188 to the skeletal model 12, and when assuming a slender patient or a short endoscope, the skeletal model 12 can be moved closer to the elastic wall member 90 to decrease the distance from the insertion hole 188 to the skeletal model 12. This allows for more practical training tailored to the body shape of each patient and the length of the endoscope being used.

[0156] In this embodiment, the model position setting mechanism 202 is configured to include a guide mechanism 206 that guides the base member 204 so that it can move in the horizontal direction (particularly the left-right direction), and a lock mechanism 208 that positions the base member 204 at multiple positions in the horizontal direction (particularly the left-right direction). As a result, when moving the skeletal model 12, it is only necessary to move the base member 204 rather than the skeletal model 12 itself, which makes it easier to move the skeletal model 12 and also reduces the risk of damage to the skeletal model 12.

[0157] Furthermore, the guide mechanism 206 is configured to include a pair of guide rods 240, 240 and guide holes 214, 214 through which each guide rod 240 is inserted, and the locking mechanism 208 is configured by rotating each guide rod 240 about its central axis to engage the outer circumferential surface of each guide rod 240 with the inner circumferential surface of each guide hole 214. In other words, the locking mechanism 208 can be easily switched between locked and unlocked by the simple operation of rotating each guide rod 240 about its central axis.

[0158] In particular, a plurality of guide hole protrusions 238 are provided on the inner peripheral surface of each guide hole 214, and a plurality of guide rod protrusions 250 (recesses 252) are also provided on the outer peripheral surface of each guide rod 240, and each guide hole protrusion 238 fits into each recess 252 and bites into the outer peripheral surface of each guide rod 240, thereby positioning each guide hole 214 (base member 204) with respect to each guide rod 240. That is, in addition to the interlocking action between the outer peripheral surface of each guide rod 240 and the inner peripheral surface of each guide hole 214 (each guide hole protrusion 238), the fitting of each guide hole protrusion 238 into each recess 252 also achieves positioning between each guide rod 240 and each guide hole 214 (base member 204), so that each guide rod 240 can be more firmly fixed to the base member 204.

[0159] Next, FIG. 28 shows an endoscopic orthopedic procedure training device 260 as a third embodiment of the present invention. In the second embodiment, the base member 204 to which the bracket 152 of the skeletal model 12 is attached is slidable in the left-right direction along the guide rods 240 and can be fixed at any position. However, in this embodiment, the model support unit 61 of the first embodiment is provided at two locations spaced apart in the left-right direction, and the bracket 152 can be selectively attached at a first position 262 and a second position 264, which are spaced apart in the left-right direction. That is, in this embodiment, a model position setting mechanism 266 is configured that includes both model support units 61 and movably and fixedly sets the skeletal model 12 to a plurality of different positions (first position 262 and second position 264) inside the water tank 14. Note that the model support unit 61 in this embodiment has the same structure as in the first embodiment, and therefore detailed description thereof will be omitted by assigning the same reference numerals in the drawings as in the first embodiment.

[0160] In the orthopedic technique training device 260 of this embodiment, at least a portion of the wall 46 of the water tank 14 is formed of the elastic wall member 90 through which the endoscope 16 can be inserted, thereby achieving the same effects as in the first embodiment. Furthermore, the model position setting mechanism 266 of this embodiment can fix the skeletal model 12 at different positions in the left-right direction (a first position 262 and a second position 264), thereby making it possible to change the distance from the insertion hole 188 provided in the elastic wall member 90 to the skeletal model 12, thereby achieving the same effects as in the second embodiment. In particular, in the third embodiment, the first position 262 and the second position 264 at which the skeletal model 12 can be fixed are set in advance, and the user only needs to select either the first position 262 or the second position 264. This eliminates the need to precisely set the distance between the insertion hole 188 (elastic wall member 90) and the skeletal model 12, making it easier to fix the skeletal model 12 to the water tank 14.

[0161] Although the embodiments of the present invention have been described above, the present invention should not be construed as being limited by the specific descriptions in such embodiments, and can be implemented in various forms with various changes, modifications, improvements, etc. made based on the knowledge of those skilled in the art.

[0162] For example, in the above embodiment, the elastic wall member 90 was provided on the right vertical wall portion 28 of the peripheral wall portion 26. However, instead of or in addition to the right vertical wall portion, an elastic wall member may be provided on the left vertical wall portion or the upper wall portion. Note that in the above embodiment, the elastic wall member 90 was provided on the right vertical wall portion 28, which is one of the four vertical wall portions 28. However, for example, the elastic wall member may be provided across two or more adjacent vertical wall portions among the four vertical wall portions. That is, for example, the elastic wall member may be provided across the entire opening 50 (upper opening 22 and opening portion 48) of the water tank 14 in the above embodiment. In this case, since the training is performed in a blind state, i.e., the operation by the endoscope cannot be visually confirmed from above and training is performed only using images acquired from the endoscope via a monitor, a training device for skilled practitioners who are more familiar with orthopedic procedures can be provided. Furthermore, in the above embodiment, the elastic wall member 90 is composed of one member, but it may be composed of multiple members, and for example, a valve body may be disposed on the upper wall portion of the elastic wall member, and the endoscope may be inserted through the valve body.

[0163] Furthermore, while in the above embodiment, the opening 48 is provided over the entire right-side vertical wall 28, the opening covered by the elastic wall member may be provided partially in the peripheral wall (each vertical wall) or the upper wall. That is, the opening needs only to be large enough so that the periphery of the opening does not impede the movement of the endoscope during large movements such as hand-down. Furthermore, if the opening is window-shaped in any of the vertical walls, it is preferable that the opening widens downward from the upper end of the vertical wall. Furthermore, if the opening is provided partially in one wall, it is preferable that the periphery of the opening has an edge-like abutment that protrudes toward the elastic wall member. By providing such an edge-like abutment, the sealing effect of the elastic wall member can be stably exerted.

[0164] In the above embodiment, the upper rod 98 and the lower rod 100 were inserted through the upper and lower edge portions of the elastic wall member 90, respectively, but the upper rod and the lower rod may be fixed to the outer or inner surface of the elastic wall member, or may be separate from the elastic wall member and fixed to the upper fixing member and the lower fixing member in a state where the upper and lower edge portions of the elastic wall member are sandwiched between them.

[0165] The pressing mechanism that presses the elastic wall member from the outside is not limited to the aspects described in the first, second, and third embodiments. The pressing mechanism may be, for example, a mechanism that uses a screw mechanism or a cam mechanism to continuously apply a pressing force with a simple operation, or a mechanism that provides a coil spring between the elastic wall member and the peripheral wall of the receiving tank, so that the elastic wall member is pressed against the water tank by the elastic restoring force generated by the compression deformation of the coil spring.

[0166] The positioning mechanism for horizontally positioning the water tank and the receiving tank is not limited to the above-described embodiment. For example, a generally rectangular frame-shaped protrusion may be provided that protrudes upward from the bottom wall of the receiving tank and covers each of the tank legs from the outside. Such protrusions may be provided around the entire periphery or may be provided partially around the periphery.

[0167] The connecting means for holding the water tank and receiving tank in the attached state is not limited to the one using permanent magnets as described in the above embodiment. For example, as in the above embodiment, recesses and protrusions may be provided between the water tank legs and the bottom wall of the receiving tank, and these recesses and protrusions may be press-fitted together, or claws protruding from the water tank may be designed to hook onto the bottom wall or peripheral wall of the receiving tank.

[0168] Furthermore, in the above embodiment, the elastic wall member 90 extends below the surface of the specified amount of water 18 in the water tank 14, so that when the endoscope 16 is inserted, the endoscope 16 can be inserted into the water 18 without an air layer in between, but this is not limited to this. That is, even if the elastic wall member is provided only above the surface of the training liquid (water) in the water tank, for example, after inserting the endoscope (or the perforating member) into the elastic wall member, the tip of the endoscope may be inserted into the training liquid by pushing the endoscope (or the perforating member) downward.

[0169] Furthermore, in the above embodiment, the skeleton model 12 is fixed to the bracket 152, and the bracket 152 is fixed to the bottom wall 24 of the water tank 14 by the model support members 61, 210, but this is not limited to this. That is, the bracket is not essential, and the specific structure of the model support member is not limited. For example, the skeleton model and the bottom wall of the water tank may be provided with recesses and protrusions that fit or lock with each other, and these recesses and protrusions may be press-fitted or locked to secure the skeleton model to the bottom wall of the water tank. Note that the model support member does not have to be provided on the bottom wall of the water tank, but may be provided on the peripheral wall of the water tank, or the skeleton model may be fixed across both the bottom wall and the peripheral wall.

[0170] Furthermore, in the second and third embodiments, the model position setting mechanisms 202, 266 were provided to set the skeletal model 12 fixedly and movable to a plurality of different positions within the water tank 14, but the method for changing the distance from the insertion hole to the skeletal model is not limited to the above. That is, the position of the skeletal model may be fixed, while the wall of the water tank in which the endoscope insertion hole is provided may be moved to change the distance from the insertion hole to the skeletal model. In particular, by making the position of the insertion hole changeable in combination with changing the position of the skeletal model, the distance from the insertion hole to the skeletal model can be adjusted over a greater distance.

[0171] Furthermore, while in the second embodiment the base member 204 is movable in one direction (left-right), it may be movable in multiple directions. For example, by providing a base plate to which the pair of guide rods 240, 240 in the second embodiment are fixed and supporting the base plate movably relative to the bottom wall of the water tank by another pair of guide rods, the base member 204 can be moved in different directions together with the pair of guide rods 240, 240, thereby making the base member 204 movable in, for example, two horizontal orthogonal axial directions (for example, left-right and front-back).

[0172] Furthermore, in the second embodiment, the locking mechanism 208 is configured by an interlocking action in which the outer peripheral portion of the guide rod 240 (guide rod convex portion 250) and the inner peripheral portion of the guide hole 214 (guide hole convex portion 238) interlock so as to overlap in the axial direction, but the specific structure of the locking mechanism is not limited thereto. For example, the outer peripheral surface of the guide rod and the inner peripheral surface of the guide hole may be non-circular and have substantially similar shapes corresponding to each other, allowing movement at a specific relative position in the circumferential direction, and then the guide rod may be rotated circumferentially relative to the guide hole from there to press the inner and outer peripheral surfaces against each other in the radial direction, thereby interlocking them, or a locking mechanism may be configured that prevents movement of the base member by frictional force or the like.

[0173] Furthermore, in the second embodiment, the guide rod 240 was rotatable around the central axis, but it is also possible to make the guide hole rotatable by providing a rotatable sleeve in the base member, while employing a non-rotatable guide rod, which also makes it possible to switch between fixing and moving the base member by the relative rotation of the guide hole and the guide rod.

[0174] Furthermore, in the third embodiment, the skeleton model 12 could be fixed at two locations, the first location 262 and the second location 264, which were spaced apart from each other in the left-right direction. However, for example, by providing a plurality of model support parts 61 as in the first embodiment, the skeleton model may be fixed at three or more locations in the aquarium that are spaced apart from each other in the left-right direction and / or the front-to-back direction.

[0175] Furthermore, while the orthopedic procedure training devices 10, 200, and 260 of the above-described embodiments are intended for training in herniated disc surgery and the skeletal model 12 simulates a lumbar vertebra, this is not limited thereto. That is, the orthopedic procedure training device of the present invention can be applied to training for bone-related disorders in various parts of the human or animal body, and a skeletal model corresponding to the desired training, such as treatment for disorders of joints including tendons, can be appropriately adopted. Furthermore, depending on the type of skeletal model and the procedure, the skeletal model may be fixedly supported in a rotated state in any direction, in addition to being inverted front-to-back as in the above-described embodiments. In particular, by being rotatable around a vertical line, it becomes easier to change the horizontal direction of the skeletal model while aligning the vertical direction of the bones in the actual procedure with the vertical direction of the skeletal model, making it even more suitable for orthopedic procedure training.

[0176] REFERENCE SIGNS LIST 10 Orthopedic technique training device (first embodiment) 12 Skeleton model 14 Water tank 16 Endoscope 18 Water (training liquid) 20 Device body 22 Upper opening 24 Bottom wall portion 26 Peripheral wall portion 28, 28a, 28b, 28c Vertical wall portion 30 Upper wall portion 32 Through hole 34 Valve body 36 Thin portion 40 Upper wall holding portion 42 Placement portion 46 Wall portion 48 Opening portion 50 Opening 52 Edge-shaped abutment portion 54 Upper fixing member 56 Upper support recess 57 Removal prevention member 58 Lower fixing member 60 Lower support recess 61 Model support portion 62 First fixing portion 64 Second fixing portion 66 First fixing groove 68 Rotating member 70 Pressing portion 72 Knob portion 74 Lever member 76 Storage groove 78 Water tank leg 80 Positioning recess 82 Permanent magnet 84 Through hole 86 Water tank drain port 88 Water tank port member 89 Tube 90 Elastic wall member 92 Right flat portion 94 Upper flat portion 96 Curved wall portion 98 Upper rod 100 Lower rod 102 Grip portion 104 Mounting recess 106 Receiving tank 108 Pressing mechanism 110 Bottom wall 112 Peripheral wall 114 Receiving tank leg 116 Through hole 118 Receiving tank drain port 120 Receiving tank port member 122 Tube 124 Positioning protrusion 126 Permanent magnet 127 Positioning mechanism 128 Connecting means 129 Screw hole 130 Pressing plate 132 Screw 134 Knob 136 Fastening portion 138 Recess 140, 142 Intervertebral disc 144 Gap 146 Nerve model 146a Portion simulating cauda equina 146b Portion simulating nerve root 148 Internal material 150 Covering layer 152 Bracket 154 Pin hole 156 Engagement protrusion 158 Main body 160 First lumen 162 Second lumen 164 Third lumen 166 Suction port 168 Discharge port 170 Camera 172 Slit 174 Valve 176 Suction tube 178 Discharge tube 180 Cable 182 Connector 184 Dilator (perforating member) 186 Sheath (perforating member) 188 Insertion hole 200 Orthopedic technique training device (second embodiment) 202 Model position setting mechanism 204 Base member 206 Guide mechanism 208 Lock mechanism 210 Model support part 212 Mounting part 214 Guide hole 216 Upper opening 217a, 217b Wall part 218,220 Fixing groove 222 Drain hole 223 Opening 224 Bracket fixing mechanism 226 Spring portion 228 Protruding tip portion 230 Rear protruding portion 232 Fixation switching portion 234 Knob portion 236 Contact portion 238 Guide hole side convex portion (convex portion) 240 Guide rod 242 Fixing member 244 Lever portion 246 Core rod 248 Flat surface 250 Guide rod side convex portion (convex portion) 252 Concave portion 254 Pressing mechanism 256 Pressing member 260 Orthopedic technique training device (third embodiment) 262 First position 264 Second position 266 Model position setting mechanism L3 Third lumbar vertebra L4 Fourth lumbar vertebra L5 Fifth lumbar vertebra

Claims

1. A tank for holding training fluids, A model support unit that positions and supports a training skeleton model inside the water tank, An elastic wall member made of an elastic material that constitutes at least a part of the wall of the water tank and through which an endoscope can be inserted. A training device for orthopedic procedures that includes the following features.

2. In the elastic wall member, The orthopedic procedure training device according to claim 1, wherein a hole for inserting the endoscope can be formed by puncturing with a perforating member, and the hole for inserting the endoscope is closed by removing the perforating member based on the elasticity of the elastic wall member itself.

3. The elastic wall member constitutes at least a part of the peripheral wall of the water tank, The orthopedic procedure training device according to claim 1 or 2, wherein the upper portion of the elastic wall member is a curved wall portion that curves inward to cover the upper opening of the water tank.

4. The orthopedic technique training device according to claim 3, wherein the peripheral wall portion of the water tank is rectangular cylindrical in shape having four flat vertical wall portions as a whole, and the elastic wall member is arranged in an opening portion provided in at least one of the vertical wall portions.

5. The elastic wall member is in the shape of a rectangular sheet, and the upper and lower edges of the elastic wall member are fixedly attached to the water tank, thereby mounting the elastic wall member in a state of tension in the vertical direction. The orthopedic procedure training device according to claim 4, wherein in the attached state, both widthwise portions of the elastic wall member are pressed against and sealed against edge-shaped contact portions which are convex toward the opening side on both widthwise sides of the opening.

6. An upper rod is attached to the upper end edge of the elastic wall member, and a lower rod is attached to the lower end edge. The orthopedic procedure training device according to claim 5, wherein the elastic wall member is mounted in a state of tension in the vertical direction by detachably fixing the upper rod and the lower rod to the water tank.

7. The aforementioned opening is formed over the entire width of one of the vertical wall sections. The orthopedic technique training device according to claim 5, wherein the edge-shaped contact portion is formed by the edges of the vertical wall portions located on both sides adjacent to the one vertical wall portion in the circumferential direction, and the widthwise portions of the elastic wall member are pressed against each other.

8. The orthopedic procedure training device according to claim 4, wherein a pressing mechanism is provided to press the outer peripheral portion of the elastic wall member from the outside in at least a portion of the portion that overlaps with and seals against the vertical wall portion.

9. The orthopedic technique training device according to claim 8, wherein a separate receiving tank is provided below the water tank, the receiving tank having an upward opening larger than the outer circumference of the water tank, and the pressing mechanism for pressing the elastic wall member from the outside is provided between the elastic wall member and the peripheral wall of the receiving tank.

10. The orthopedic procedure training device according to claim 9, wherein the pressing mechanism includes a block-shaped pressing member made of an elastic material.

11. In the elastic wall member, The orthopedic procedure training device according to claim 1 or 2, wherein a visually observable position marker indicating the planned insertion position of the endoscope can be displayed.

12. The orthopedic surgery training apparatus according to claim 1 or 2, wherein a specified water level is set in the water tank for immersing the skeletal model in water, and the region in the water tank that extends below the specified water level is composed of the elastic wall member.

13. The aforementioned water tank comprises vertical wall sections that constitute the peripheral wall section and an upper wall section that covers the upper opening. The orthopedic procedure training device according to claim 1 or 2, wherein the vertical wall portion and the upper wall portion are transparent.

14. The wall portion of the water tank is provided with a hole for inserting the endoscope, The tank is equipped with a model position setting mechanism that allows the skeletal model to be moved to and fixed in multiple different positions within the tank. The orthopedic procedure training device according to claim 1 or 2, wherein the distance from the insertion hole to the skeletal model can be changed by moving the skeletal model.

15. Inside the tank, a base member is provided to which the skeletal model can be attached and detached. The orthopedic procedure training device according to claim 14, wherein the model position setting mechanism is configured to include a guide mechanism for guiding the base member so that it can move in the horizontal direction, and a locking mechanism for positioning the base member at multiple positions in the direction of movement by the guide mechanism.

16. The guide mechanism is configured to include a guide rod and a guide hole provided in the base member through which the guide rod is inserted. The orthopedic procedure training device according to claim 15, wherein the outer circumference of the guide rod and the inner circumference of the guide hole interlock as the guide rod rotates relative to each other around the central axis of the guide hole, and the locking mechanism is configured such that the movement of the base member in the axial direction of the guide rod is prevented and fixed by this interlocking action.

17. The orthopedic procedure training device according to claim 16, wherein in the locking mechanism, protrusions extending in the circumferential direction are formed on the outer circumferential surface of the guide rod and the inner circumferential surface of the guide hole, and the interlocking action is achieved when the protrusions on the guide rod side and the protrusions on the guide hole side interlock so that they overlap in the axial direction due to relative rotation of the guide rod and the guide hole about the central axis.

18. An orthopedic surgery training device comprising a tank that contains a training liquid and in which a training skeletal model can be placed in an immersed state in the liquid, wherein an endoscope is inserted from outside the tank to train surgical techniques on the skeletal model, A training device for orthopedic procedures, wherein a separate receiving tank is positioned below the aforementioned water tank, and the upward opening of the receiving tank is larger than the circumference of the water tank.

19. The water tank is detachably attached to the receiving tank, The orthopedic procedure training apparatus according to claim 18, which is provided with a positioning mechanism for positioning the water tank and the receiving tank relative to each other in the horizontal direction.

20. The orthopedic procedure training apparatus according to claim 18 or 19, wherein the liquid storage capacity of the receiving tank is equal to or greater than the specified liquid storage capacity in the water tank during training.

21. The water tank is provided with an openable and closable water tank drain outlet, and the water tank drain outlet is positioned to open into the receiving tank, The orthopedic procedure training device according to claim 18 or 19, wherein the receiving tank is also provided with an openable and closable receiving tank drain port.

22. The orthopedic procedure training device according to claim 18 or 19, wherein the endoscope can be inserted into the vertical wall portion that constitutes the peripheral wall portion of the water tank.

23. The orthopedic procedure training device according to claim 22, wherein the position in the vertical wall portion of the water tank into which the endoscope can be inserted is set to be below the specified water level during training.

24. The orthopedic procedure training apparatus according to claim 18 or 19, wherein a connecting means is provided to restrict the separation of the water tank and the receiving tank and to hold the receiving tank in an attached state to the water tank.

25. The orthopedic procedure training device according to claim 24, wherein the connecting means is configured using permanent magnets.