CN103050040A

CN103050040A - Surgical planar model for use in simulation teaching of laparoscope gynecological tumor surgery

Info

Publication number: CN103050040A
Application number: CN201110305168XA
Authority: CN
Inventors: 邹长坪; 海奇
Original assignee: TIANJIN AILIQI TECHNOLOGY Co Ltd
Current assignee: TIANJIN AILIQI TECHNOLOGY Co Ltd
Priority date: 2011-10-11
Filing date: 2011-10-11
Publication date: 2013-04-17

Abstract

Radical hysterectomy, i.e., a surgical method for treating cervical carcinoma, is put forward by Wertheim over 100 years before, becomes a classic of surgical treatment of cervical carcinoma, contributes to increasing the five-year survival rate of a patient suffering from cervical carcinoma by 80-90 percent, but has the defects of great damages, the occurrence rate of 70-85 percent of postoperative urinary bladder dysfunction, and influence on the postoperative life. Laparoscope cervical carcinoma radical-curing nerve-sparing surgery can be used for improving the urinary bladder function after a cervical carcinoma surgery and protecting hypogastric nerves, and is an important surgical link for protecting urinary bladder and rectum functions. Through simulation teaching, doctors are taught with a safe and effective method, students can contact ''patients'' by means of surgical skills before starting a surgery, and damages to nerves in the true surgery are avoided. In the simulation teaching, surgical instruments are needed, but above all model ''patients'' are needed. An anatomic plane and a repeatedly-operated simulation surgery model are taken as the teaching bases of surgeries, so that the students grasp anatomic positions and surgical separation skills. A surgical planar model disclosed by the invention promotes further development of surgery simulation teaching all over the world.

Description

The operation areal model of laparoscope gynecological tumor surgical simulation teaching

A kind of model for gynecological tumor laparoscopic surgery simulation teching is especially to the neural operation areal model that keeps the simulation teching of operation of cervical carcinoma radical cure.Hypogastric nerve and the branch that enters pelvic cavity are the main nerves of domination bladder urination.The operation areal model of described laparoscope simulation teching involved in the present invention, this model can be used for the laparoscope simulation teching, and with clear and definite anatomical planes and simulation instruction doctor, how the doctor medico seeks, separate under the lower abdomen neural, with the destruction of this nerve in avoiding performing the operation.

Technical field

Keep neural radical correction:

Wertheim proposes through abdomen radical hysterectomy (radical hysterectomy) and pelvic lymphadenectomy at the beginning of last century; established the basis of Radical Treatment of Cervical Cancer; become the classics of cervical carcinoma operative treatment; nineteen fifty Meigs uses till today after improveing popularization always; make cervical carcinoma 5 annual survival rates reach 80%～90%. but the damage of this art formula is large; after the operation normal occur lower urethra and (or) bladder function; the obstacle of rectum function and sexual function; especially the vesical dysfunction incidence reaches 70%-85%[1]; to live after affecting patient's operation for cervical carcinoma. the pelvic cavity neurotrosis is to cause the neural reservation operation of the non-irrigateiest proposition pelvic cavity of the handicapped main cause .1921 Okaba-yashi of pelvic cavity viscera. technology also is used for the carcinoma of the rectum subsequently; Prostate Cancer after Radical. a large amount of clinical datas confirm that the The technology can successful bladder preservation function and sexual function. laparoscopic surgery Neuroprotective Therapy in Treating Acute cervical carcinoma can obviously be improved the bladder function of postoperative, thereby has improved greatly uterectomy surgical effect [2].

The protection superior hypogastric plexus, refreshing The, inferior hypogastric plexus are the important operation links of protection bladder and rectum function under the abdomen.What superior hypogastric plexus was comprised of sympathetic nerve is domination bladder storage urine function.To be controlled by parasympathetic nerve bladder urine storage smaller volume, increased pressure if damage this Neuropathic bladder dysfunction.Inferior hypogastric plexus is by the neural domination urinary function that forms of parasympathetic nerve.Will lose uriesthesis if damage the neural patient of inferior hypogastric plexus, can't start and urinate.Hypogastric nerve connects two clumps.If it is cut off, patient will have the symptom of mixing, and by initial bladder urine storage smaller volume, increased pressure and then produces abundant residues urine state.This may cause permanent retention catheterization pipe.

When the damage superior hypogastric plexus can separate abdominal aorta lymph node or sacrum ALN.Especially when picking up cardinal ligament or uterosacral ligament, the inferior hypogastric plexus neurotrosis may occur.When the inferior hypogastric plexus damage also may occur in from sidewall separation cardinal ligament, or from rear wall isolating bladder uterine ligaments and excision paracolpium.Dissection and the peripheral vessels anatomy relationship of understanding in detail these nerves are the bases of carrying out radical correction.

Simulation teching:

Medical science is the practicality science. traditional medical teaching, to impart knowledge to students with it patient-living person, or dead person-corpse is imparted knowledge to students with it. thereby the development of Medical simulation teaching changes traditional medical teaching, case simulation teching method, emergency care, skill operation etc. Medical simulation teaching is calm dangerous with it, the advantages such as the controllability of operation and clinical case diversity have obtained the abundant approval of International Medical Education circle. and the material of simulation teching model is greatly improved in recent years, and more and more good models produce gradually.

How to develop and be more suitable for operating model always in research and inquirement. how by simulation teching with safely and effectively method instruction doctor, medico's surgical skills is so that the student can contact " patient " before entering operation, and can in real operation, find smoothly, the safe separating blood vessel, neural, tissue is with destruction and the accidental injury of the medium vessels nerve of avoiding performing the operation.Simulation teching not only needs operation instrument equipment, and the more important thing is will have model-" patient ".Good model can make the student skillfully grasp anatomical position and operation skill. and with the visualize surgery location of operation anatomical planes model and the nervus vasculairs relation authenticity with sham operated, this invention will bring new development to the surgical simulators teaching.

Background technology:

If Radical Treatment of Cervical Cancer make cervical carcinoma 5 annual survival rates reach 80%～90%. we can be successful excision patient's tumour, incontinence is stayed in rear stool and urine storage but patient performs the operation, this can not give the hope of a real healing of patient, because patient has lost quality of life.

A kind of operation areal model that can pass through simulation teching. superior hypogastric plexus, hypogastric nerve, inferior hypogastric plexus (claiming again pelvic plexus), the root that the nerve of the branch of pelvic splanchnicnerves and bladder keeps are controlled Intraoperative operation areal model.

1. anatomy points for attention, understand superior hypogastric plexus by the operation areal model, hypogastric nerve, inferior hypogastric plexus (claiming again pelvic plexus), the anatomical position structure of the branch of pelvic splanchnicnerves and its bladder, it is mainly neural to understand the domination bladder. and Palace Neck cancer-root is controlled the autonomic nervous function of Intraoperative assessment postoperative bladder function.

2. learn by the operation areal model and practise among the Intraoperative at Office regulating blood condition pipe and neural position relationship, with learning manipulation blood vessel and neural separation.

Summary of the invention:

1, the operation areal model of laparoscope gynecological tumor surgical simulation teaching is especially to the operation areal model of the simulation teching of cervical carcinoma operation neuroprotective.

2, instruct the doctor by this model with clear and definite operation plane and simulation, how the doctor medico seeks, separate neural, with destruction neural in avoiding performing the operation, thereby change traditional imparting knowledge to students patient-living person with it, or dead person-corpse is imparted knowledge to students with it. this surgical simulation teaching operation areal model does not also have in the whole world, and this invention brings new chapter will for whole world simulation teching.

Description of drawings:

Fig. 1. the simulation connective tissue holds blood vessel

Fig. 2. neural radical correction nerve and the blood vessel of keeping, ureter position operation areal model figure

Embodiment:

Shown in the construction drawing 1+2: neural radical correction nerve and the blood vessel of keeping, the ureter position operation areal model figure areal model of performing the operation.

Claims

1. model that is used for the laparoscopic surgery simulation teching, a kind of model for gynecological tumor laparoscopic surgery simulation teching, can develop on this basis multiple operation anatomical planes model, simulate connective tissue and in conjunction with corresponding organ with the material of short texture, blood vessel, nerve, lymph node vascular pattern as shown in Figure 1, although the surgical simulation of many computer analogs is arranged at present, the student can acquire anatomical knowledge and learn less than the actual touch sensation, especially the separation of hand sensation.

2. a claim is such as the model of 1 described gynecological tumor surgical simulation teaching involved in the present invention, especially to the neural operation areal model that keeps the simulation teching of operation of cervical carcinoma; Contain anatomical planes as shown in Figure 2; Keep the refreshing The of Pen Nei Dirty, superior hypogastric plexus, to prop up be the main nerve of protection bladder urination function for refreshing The, inferior hypogastric plexus (claiming again pelvic plexus) and bladder thereof under the abdomen; Though in the past dissect and the cervical carcinoma operation in for the ignoring of hypogastric nerve neuroprotective, patient's postoperative all has dysuria, and needs long-term slotting urinary catheter.

3. press claim and can be used for the laparoscope simulation teching such as this model of model of 1 described laparoscope simulation teching involved in the present invention, hold blood vessel (artery-redness with the simulation connective tissue; Vein-blueness); Neural (white), and lymph node (Fig. 1+Fig. 2) and with clear and definite anatomical planes (Fig. 2) and simulated operation instruction doctor, how the medico seeks, and separates neural its bladder of hypogastric nerve and props up, and with the destruction of this nerve in avoiding performing the operation, impact is urinated.