CN105513476A - eye surgery training simulator - Google Patents
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Abstract
Description
技术领域technical field
本发明涉及一种眼部手术训练模拟器,尤指一种能让眼科医师模拟练习连续环形撕囊手术的模拟器材。The invention relates to an eye surgery training simulator, in particular to a simulator that enables ophthalmologists to practice continuous circular capsulorhexis surgery.
背景技术Background technique
眼睛的作用,是通过传输光线,经过称为角膜的透明外部,并由结晶状的水晶体,将影像聚焦至视网膜上来提供视力;聚焦的影像质量受到许多因素的影响,包含眼睛的大小及形状,以及角膜和水晶体的透明度;当水晶体因老化、紫外线伤害或其它因素变得混浊甚至硬化较不透明时,将导致光线和影像无法被传送到视网膜上,造成视觉模糊,就代表罹患了白内障。The function of the eye is to provide vision by transmitting light through a transparent exterior called the cornea, and focusing the image onto the retina by a crystalline lens; the quality of the focused image is affected by many factors, including the size and shape of the eye, And the transparency of the cornea and lens; when the lens becomes cloudy or even hardened and less transparent due to aging, ultraviolet damage or other factors, it will prevent light and images from being transmitted to the retina, resulting in blurred vision, which means suffering from cataracts.
造成白内障的原因是多重的,无法用单一的药水加以治疗,充其量只能推迟白内障进行的速度,至今为止,手术是唯一有效的白内障治疗方法。现代白内障手术在手术步骤上环环相扣,每一步骤的成功与否,都会影响后续的手术步骤是否顺利进行;在白内障摘除手术[CataractExtraction]中,晶体乳化术[Phaco]是目前最安全的手术,手术中,有一项撕囊的动作,也就是晶状体前囊膜的连续环形撕囊[continuouscurvilinealcapsulorrhexis,以下简称为CCC]步骤,这是整个白内障手术的首要关键步骤,它提供了一个边缘光滑的前囊膜环形开口,确保晶状体悬韧带及外围囊膜的完整性,保证人工晶状体在囊袋内的稳定性;其能否成功完成,将直接影响整个白内障手术过程的顺利进行。撕囊的手术工具是撕囊镊或截囊针,由于撕囊镊的使用对于囊膜的控制比较好,因此对初学者较为有利,故以下的探讨中,我们将以撕囊镊作为CCC的使用工具。The reason that causes cataract is multiple, can't be treated with single liquid medicine, can only delay the speed that cataract carries out at best, so far, operation is the only effective cataract treatment method. In modern cataract surgery, the surgical steps are interlocking, and the success of each step will affect whether the subsequent surgical steps can be carried out smoothly; in cataract extraction [Cataract Extraction], phacoemulsification [Phaco] is currently the safest During the operation, there is a capsulorhexis action, that is, the continuous curvilinealcapsulorrhexis (hereinafter referred to as CCC) step of the anterior lens capsule, which is the first key step in the entire cataract operation, and it provides a smooth edge. The circular opening of the anterior capsule ensures the integrity of the zonular ligament of the lens and the surrounding capsule, and the stability of the intraocular lens in the capsular bag; whether it can be successfully completed will directly affect the smooth progress of the entire cataract surgery process. The surgical tool for capsulorhexis is capsulorhexis forceps or capsulorhexis forceps. Since the use of capsulorhexis forceps is better for controlling the capsule, it is more beneficial for beginners. Therefore, in the following discussion, we will use capsulorhexis forceps as the CCC. use tools.
在临床上,成熟期、过熟期的老年性白内障以及部分先天性白内障、外伤性白内障、核性白内障等的手术中,很难分辨撕囊口边缘,故要完成一个标准的CCC有相当的难度,这是因为白内障手术时,会先在透明角膜的一侧,切出一个切口,以进行后续的动作,随着医疗科技的不断进步,切口的位置从巩角膜转移至角膜处,切口的大小也从以前的12mm、6mm、3至3.5mm,逐渐缩小直到目前的1.8至2.2mm,而要在一个如此之小的范围内,来进行CCC动作,在施作上便有一定的难度。Clinically, it is difficult to distinguish the edge of the capsulorhexis in the operation of mature and overmature senile cataract and some congenital cataracts, traumatic cataracts, nuclear cataracts, etc., so it is quite difficult to complete a standard CCC. Difficulty, this is because during cataract surgery, an incision will be made on one side of the transparent cornea for subsequent operations. With the continuous advancement of medical technology, the position of the incision has shifted from the sclera to the cornea. The size has gradually shrunk from the previous 12mm, 6mm, 3 to 3.5mm to the current 1.8 to 2.2mm, and it is difficult to perform CCC actions in such a small range.
因此,施术者必须要经常进行白内障手术操作的模拟训练,如此才能提高CCC的手术成功率,而目前的模拟训练方式,主要是通过对人工眼睛或动物眼睛进行施术训练,但此训练方式不但成本高、施术也不方便,而且训练至能为病人施术的水平,其整体所要花费的时间非常冗长,更重要的是在训练完成之后,仍需不断反复练习、接触,否则CCC的成功率仍会下降,如此便会降低医疗质量,若要再次训练,却容易占用医师过多的医疗时间。Therefore, operators must often carry out simulation training of cataract surgery, so as to improve the success rate of CCC surgery, and the current simulation training method is mainly to perform operation training on artificial eyes or animal eyes, but this training method Not only is the cost high and the operation is inconvenient, but it also takes a long time to train to the level of being able to perform operations on patients. More importantly, after the training is completed, repeated practice and exposure are still required, otherwise CCC will suffer The success rate will still decrease, which will reduce the quality of medical treatment. If you want to train again, it will easily take up too much medical time for doctors.
其次,传统的CCC训练方式,不能确实反应出病人眼睛上的施术状况,因为训练中所使用的替代眼睛的是人工眼睛或动物眼睛[例如猪眼],而这两种替代眼睛虽能让受训者学习到基本的施术技术,但往后在病人眼睛上施术时却无法顺利适用,因为人眼在手术过程中是,眼球受到眼球肌肉的影响而不时转动,但人工眼睛或动物眼睛却不会转动,所以要训练到能在病人眼睛上的施术水平,不是那么容易及轻松的。Secondly, the traditional CCC training method cannot truly reflect the operation status of the patient's eyes, because the replacement eyes used in the training are artificial eyes or animal eyes [such as pig eyes]. The trainees learn the basic surgical techniques, but they cannot be applied smoothly when performing surgery on the patient's eyes later, because the human eye is affected by the eyeball muscles and rotates from time to time during the operation, but artificial eyes or animal eyes But it cannot rotate, so it is not so easy and relaxed to train to the level of performing surgery on the patient's eyes.
正因为如此,CCC的训练或再训练,需要使用到大量的人工眼睛或动物眼睛,如果以人工眼睛训练,成本会是非常高,以动物眼睛训练,成本虽低,但训练时动物眼睛气味容易影响施术者,而且动物的眼睛更有保存不易,不能长期存放的问题。Because of this, the training or retraining of CCC requires the use of a large number of artificial eyes or animal eyes. If training with artificial eyes, the cost will be very high. Although the cost of training with animal eyes is low, the animal eyes are easy to smell during training. It affects the performer, and the eyes of animals are more difficult to preserve and cannot be stored for a long time.
因此,如何提供一种能让医师能便于训练应用、并可重复使用、又能降低训练成本、且施作容易、无保存问题,更能模拟真实眼睛的眼部手术训练模拟器,便成为本发明欲改进的课题。Therefore, how to provide an eye surgery training simulator that can facilitate training applications for doctors, be reusable, reduce training costs, be easy to perform, have no storage problems, and better simulate real eyes has become an important objective. Invent the subject to be improved.
发明内容Contents of the invention
本发明的主要目的在于提供一种眼部手术训练模拟器,能降低学习成本、更为贴近于真实眼睛状态、且让施术者能便于练习、以提高手术成功率。The main purpose of the present invention is to provide an eye surgery training simulator, which can reduce the learning cost, be closer to the real eye state, and allow the operator to practice conveniently, so as to improve the success rate of the operation.
为解决上述问题及达到本发明的目的,本发明的技术手段,是这样实现的,为一种眼部手术训练模拟器,所述手术训练模拟器包括:上端具有容纳槽体、下方具有底座、中间以支架连接的座体;上半部顶端中央处具有模拟瞳孔的穿孔、而下半部置入于所述容纳槽体内、并能如眼球般转动的中空球体;覆盖在所述中空球体上半部顶端表面、并将所述穿洞封闭、能模拟前囊膜、并能随时更换的薄膜片体;面积大于薄膜片体、并覆盖薄膜片体且贴合在所述中空球体上半部顶端表面的透明定位片体,所述定位片体更具有对应于所述穿孔的孔洞;以两个插脚、近距离固定在上述中空球体之穿孔侧旁,能供撕囊镊的两夹镊穿入后、限制两夹镊左右位移的定位插件;及至少一条其一端与所述中空球体下半部连接、另一端与所述容纳槽体底部连接、并能模拟眼球肌肉提供复归力、让中空球体于转动后得以复回原位的弹性组件。In order to solve the above-mentioned problems and achieve the purpose of the present invention, the technical means of the present invention is realized in the following way. It is an eye surgery training simulator. The base is connected by a bracket in the middle; the top half of the upper part has a perforation that simulates the pupil, and the lower half is a hollow sphere that is placed in the accommodating tank and can rotate like an eyeball; it is covered on the hollow sphere Half of the top surface, and close the perforation, can simulate the anterior capsule, and can be replaced at any time; the area is larger than the film sheet, and covers the film sheet and is attached to the upper half of the hollow sphere The transparent positioning sheet on the top surface, the positioning sheet has a hole corresponding to the perforation; it is fixed on the side of the perforation of the above-mentioned hollow sphere with two pins at a close distance, and can be used for the two clips of the capsulorhexis forceps to pass through After entering, the positioning plug-in that limits the left and right displacement of the two tweezers; and at least one of its one ends is connected with the lower half of the hollow sphere, and the other end is connected with the bottom of the accommodating tank, and can simulate the eyeball muscles to provide a return force, so that the hollow The elastic component that allows the ball to return to its original position after rotation.
更优选的是,所述弹性组件是直条形、为异戊二烯的聚合物材质、并具有弹力伸缩作用的橡皮筋带。More preferably, the elastic component is a straight rubber band made of isoprene polymer and has elastic stretching effect.
更优选的是,所述弹性组件是具有弹性伸缩作用的拉伸弹簧。More preferably, the elastic component is a tension spring with elastic expansion and contraction.
更优选的是,所述容纳槽体为中空的锥形槽,其上方设置了上槽口、下方设置下槽口,所述上槽口的直径大于下槽口的直径,所述上槽口的入口处具有一段等径槽口。More preferably, the accommodating tank body is a hollow tapered tank, an upper notch is arranged above it, and a lower notch is arranged below it, the diameter of the upper notch is larger than the diameter of the lower notch, and the upper notch There is a section of equal diameter notch at the entrance.
更优选的是,所述弹性组件的一端,与所述中空球体底部中央连接;而所述弹性组件的另一端,在往下延伸穿出容纳槽体的下槽口后,再转折朝上固定在所述容纳槽体的底部外侧壁。More preferably, one end of the elastic component is connected to the center of the bottom of the hollow sphere; and the other end of the elastic component, after extending downward through the lower notch of the receiving tank, is turned upward and fixed on the outer side wall of the bottom of the accommodating tank.
更优选的是,所述容纳槽体底部外侧壁具有L形小卡勾,而弹性组件的另一端具有若干个等间距设置的凸出环节,所述任一凸出环节能勾挂在小卡勾上。More preferably, the outer wall of the bottom of the receiving tank has a small L-shaped hook, and the other end of the elastic component has several protruding links arranged at equal intervals, and any of the protruding links can be hooked on the small card. Check it.
更优选的是,所述弹性组件的另一端,是以贴片稳固黏贴在所述容纳槽体的底部外侧壁。More preferably, the other end of the elastic component is firmly pasted on the bottom outer wall of the receiving tank with a patch.
更优选的是,所述座体还包括有:至少一个连接在所述容纳槽体侧边以供撕囊镊上部定位的定位框;及至少一个设置在上述座体的底座位置、并对应在定位框正下方,能供撕囊镊底部定位的定位槽。More preferably, the base further includes: at least one positioning frame connected to the side of the receiving tank for positioning the upper part of the capsulorhexis forceps; Directly below the positioning frame, there is a positioning groove for positioning the bottom of the capsulorhexis forceps.
更优选的是,所述中空球体的穿孔旁设置了两个窄距的定位孔;所述定位插件是具有两个插脚的ㄇ形杆,所述两个插脚穿过所述定位片体后,再插入于所述定位孔内,使ㄇ形杆伫立在中空球体表面。More preferably, two positioning holes with a narrow distance are arranged beside the perforation of the hollow sphere; the positioning insert is a ㄇ-shaped rod with two prongs, and after the two prongs pass through the positioning sheet, Then insert it into the positioning hole, so that the ㄇ-shaped rod stands on the surface of the hollow sphere.
更优选的是,所述穿孔的直径为8mm,所述孔洞的直径等于或者小于所述穿孔的直径,所述定位插件的两个插脚间的距离为2至3mm,所述定位插件至穿孔中心点的间距为5.5至7.5mm。More preferably, the diameter of the perforation is 8 mm, the diameter of the hole is equal to or smaller than the diameter of the perforation, the distance between the two pins of the positioning insert is 2 to 3 mm, and the positioning insert is at the center of the perforation. The pitch of the dots is 5.5 to 7.5mm.
与现有技术相比,本发明的作用及效果如下:Compared with prior art, effect and effect of the present invention are as follows:
第一点:本发明中,以容纳槽体作为眼窝,以中空球体模拟眼球,以穿孔模拟瞳孔,以弹性组件模拟眼球肌肉,以薄膜片体模拟眼睛的前囊膜,再以定位片体覆盖薄膜片体并贴于中空球体表面上,再以孔洞对应着穿孔,如此便能提供眼科CCC手术训练模拟器,来供施术者练习连续环形撕囊手术,其不但容易使用、无保存问题,更重要的是,能模拟真实眼睛的状况,不会有训练与实做不符,导致施术成功率低的问题发生。The first point: In the present invention, the receiving tank is used as the eye socket, the eyeball is simulated by the hollow sphere, the pupil is simulated by the perforation, the eyeball muscle is simulated by the elastic component, the anterior capsule of the eye is simulated by the thin film, and then covered by the positioning sheet The film sheet is attached to the surface of the hollow sphere, and the holes correspond to the perforations, so that an ophthalmic CCC surgery training simulator can be provided for the operator to practice continuous circular capsulorhexis surgery. It is not only easy to use, no storage problems, More importantly, it can simulate the condition of the real eye, and there will be no discrepancy between training and practice, resulting in a low success rate of surgery.
第二点:本发明中,通过定位插件的使用,能限制撕囊镊的位移,进而取代透明角膜一侧的切口,故更贴近于真实手术的状况,重要的是,能免除开切口的步骤,让施术者能便于练习连续环形撕囊,提高熟练度与成功率。The second point: In the present invention, the displacement of the capsulorhexis forceps can be limited through the use of the positioning plug-in, and then the incision on the side of the transparent cornea can be replaced, so it is closer to the actual operation situation, and the most important thing is that the step of opening the incision can be avoided , so that the operator can easily practice continuous circular capsulorhexis, improving proficiency and success rate.
第三点:本发明中,整体手术训练模拟器的成本不高,能大大降低使用价格,另一方面,整个手术训练模拟器在使用后需要替换的部分仅只有薄膜片体,而定位片体则视使用期限来决定是否更换,因此整个维护和训练成本降低,非常有利于训练推广。The third point: in the present invention, the cost of the overall surgical training simulator is not high, which can greatly reduce the use price. On the other hand, the part that needs to be replaced after use of the whole surgical training simulator is only the film sheet, and the positioning sheet It depends on the service life to decide whether to replace it, so the overall maintenance and training costs are reduced, which is very conducive to training promotion.
附图说明Description of drawings
图1是本发明所提供的锁的眼部手术训练模拟器一种具体实施方式的立体示意图;Fig. 1 is the three-dimensional schematic diagram of a specific embodiment of the eye surgery training simulator of the lock provided by the present invention;
图2是本发明所提供的锁的眼部手术训练模拟器一种具体实施方式的立体分解示意图;Fig. 2 is a three-dimensional exploded schematic diagram of a specific embodiment of the lock eye surgery training simulator provided by the present invention;
图3是本发明所提供的锁的眼部手术训练模拟器一种具体实施方式的剖面示意图;Fig. 3 is a schematic cross-sectional view of a specific embodiment of the eye surgery training simulator of the lock provided by the present invention;
图3A是为图3中符号3A的放大图;Figure 3A is an enlarged view of symbol 3A in Figure 3;
图4是本发明所提供的锁的眼部手术训练模拟器一种具体实施方式配合撕囊镊应用于手术练习时的实施示意图;Fig. 4 is the implementation schematic diagram when a specific embodiment of the eye surgery training simulator of the lock provided by the present invention cooperates with the capsulorhexis forceps for surgical practice;
图5是本发明中所提供的锁的眼部手术训练模拟器一种具体实施方式连续环形撕囊的构造放大示意图;Fig. 5 is an enlarged schematic view of the continuous annular capsulorhexis structure of a specific embodiment of the lock eye surgery training simulator provided by the present invention;
图6是本发明所提供的锁的眼部手术训练模拟器一种具体实施方式配合撕囊镊应用于手术练习时的俯视实施示意图;Fig. 6 is a top view implementation schematic diagram of a specific embodiment of the eye surgery training simulator of the lock provided by the present invention when it is used in surgical practice with capsulorhexis forceps;
图7是本发明所提供的锁的眼部手术训练模拟器一种具体实施方式配合撕囊镊应用于手术练习时、正确与错误施术的对比实施示意图;Fig. 7 is a schematic diagram of a specific embodiment of the lock eye surgery training simulator provided by the present invention when it is used in surgical practice with capsulorhexis forceps, and a comparison implementation diagram of correct and incorrect operations;
图8是本发明所提供的锁的眼部手术训练模拟器另一种具体实施方式的立体示意图。Fig. 8 is a three-dimensional schematic view of another embodiment of the lock eye surgery training simulator provided by the present invention.
符号说明:Symbol Description:
1、座体,11、容纳槽体,111、上槽口,112、下槽口,113、等径槽口,12、定位框,13、定位槽,14、底座,15、支架,16、小卡勾,2、中空球体,21、穿孔,22、定位孔,23、小孔,3、弹性组件,31、凸出环节,3a、一端,3b、另一端,4、定位片体,41、孔洞,5、薄膜片体,51、环形膜片,52、环形开口,53、定位插件,6、定位插件,100、手术训练模拟器,200、撕囊镊,A、定位轴心。1, seat body, 11, accommodating tank body, 111, upper notch, 112, lower notch, 113, equal diameter notch, 12, positioning frame, 13, positioning groove, 14, base, 15, bracket, 16, Small hook, 2, hollow sphere, 21, perforation, 22, positioning hole, 23, small hole, 3, elastic component, 31, protruding link, 3a, one end, 3b, the other end, 4, positioning sheet, 41 , hole, 5, film body, 51, annular diaphragm, 52, annular opening, 53, positioning plug-in, 6, positioning plug-in, 100, surgical training simulator, 200, capsulorhexis forceps, A, positioning axis.
具体实施方式detailed description
以下依据附图所示的实施例详细说明:Below according to the embodiment shown in accompanying drawing, describe in detail:
如图1至图3所示,图中揭示出一种眼部手术训练模拟器100,主要是由座体1、中空球体2、弹性组件3、定位片体4、薄膜片体5、定位插件6所组成,另搭配撕囊镊200来实施。As shown in Fig. 1 to Fig. 3, a kind of eye surgery training simulator 100 is disclosed in the figure, which is mainly composed of a seat body 1, a hollow sphere 2, an elastic component 3, a positioning sheet 4, a film sheet 5, and a positioning insert It consists of 6 institutes and is implemented with 200 capsulorhexis forceps.
上述座体1包括,上端具有容纳槽体11、下方具有底座14、及位于中间连接容纳槽体11与底座14的支架15;由该支架15支撑容纳槽体11,以使其位于适当高度位置,便于施术者练习;其次,该支架15也能作为能调整式的伸缩支架,以随时改变高度,适应施术者的需求。Above-mentioned seat body 1 comprises, upper end has containing tank body 11, has base 14 below, and is positioned at the support 15 that connects containing tank body 11 and base 14 in the middle; Holds containing tank body 11 by this support 15, so that it is positioned at proper height position , is convenient for the operator to practice; secondly, the bracket 15 can also be used as an adjustable telescopic bracket to change the height at any time to meet the needs of the operator.
上述中空球体2,其上半部顶端中央处具有模拟瞳孔的穿孔21,而下半部则置入于上述容纳槽体11内,并能在容纳槽体11内如同眼球般的转动,因此容纳槽体11如同眼窝,中空球体2如同眼球。The above-mentioned hollow sphere 2 has a perforation 21 simulating the pupil at the top center of its upper half, and the lower half is placed in the above-mentioned receiving tank 11, and can rotate like an eyeball in the receiving tank 11, so it can accommodate The groove body 11 is like an eye socket, and the hollow sphere 2 is like an eyeball.
所述容纳槽体11为中空锥形槽,其上方设置了上槽口111、下方设置了下槽口112,该上槽口111的直径大于下槽口112的直径,又上槽口111的入口处具有一段等径的槽口113。当中空球体2的下半部置入容纳槽体11内时,中空球体2的横轴线会位于等径槽口113的位置,而横轴线以下的球体将与上槽口111线性接触,如此一来,就使中空球体2在容纳槽体11能够灵活转动。Described accommodating tank body 11 is hollow tapered groove, and its top is provided with upper notch 111, and lower notch 112 is provided with, and the diameter of this upper notch 111 is greater than the diameter of lower notch 112, and the diameter of last notch 111 There is a notch 113 of equal diameter at the entrance. When the lower half of the hollow sphere 2 is placed in the receiving tank 11, the horizontal axis of the hollow sphere 2 will be located at the position of the equal-diameter notch 113, and the spheres below the horizontal axis will be in linear contact with the upper notch 111, so that Then, the hollow sphere 2 can flexibly rotate in the receiving tank 11 .
上述薄膜片体5,覆盖在上述中空球体2上半部顶端表面,并将穿洞21封闭,其能模拟前囊膜,而且能随时替换更新。The above-mentioned film sheet 5 covers the top surface of the upper half of the above-mentioned hollow sphere 2 and closes the perforated hole 21, which can simulate the anterior capsule and can be replaced and updated at any time.
上述定位片体4,为底面具有背胶的透明片,面积大于上述薄膜片体5,其覆盖薄膜片体5并黏贴在中空球体2上半部顶端表面;其更具有对应于上述穿孔21的孔洞41,孔洞41裸露出薄膜片体5。为便于手指黏贴及撕取,该定位片体4以矩形实施为佳,而且定位片体4底面的背胶,能重复撕黏。The above-mentioned positioning sheet 4 is a transparent sheet with adhesive on the bottom surface, the area is larger than the above-mentioned film sheet 5, it covers the film sheet 5 and is pasted on the top surface of the upper half of the hollow sphere 2; it also has holes corresponding to the above-mentioned perforations 21 The hole 41, the hole 41 exposes the film body 5. For the convenience of finger sticking and tearing, the positioning sheet 4 is preferably implemented in a rectangular shape, and the adhesive on the bottom surface of the positioning sheet 4 can be repeatedly torn and glued.
上述定位插件6,具有两个插脚,并近距离固定在上述中空球体2的穿孔21旁侧。The above-mentioned positioning insert 6 has two prongs, and is fixed close to the side of the through-hole 21 of the above-mentioned hollow sphere 2 .
上述弹性组件3,至少为一条,一端3a与中空球体2的底部连接、另一端3b与上述容纳槽体11的底部连接,其能模拟眼球肌肉提供复归力、让中空球体2于转动后得以复回原位。由于人类的眼球肌肉共有6条,因此本发明可视需要而增设多条,设置的位置以对称设置为佳,例如左右对称设置,或前后对称设置。The above-mentioned elastic component 3 is at least one, one end 3a is connected to the bottom of the hollow sphere 2, and the other end 3b is connected to the bottom of the above-mentioned accommodating tank 11, which can simulate the eyeball muscles to provide a return force, so that the hollow sphere 2 can recover after rotation. back to the original position. Since there are 6 eyeball muscles in human beings, the present invention can add more as required, and the positions for setting are preferably symmetrical, such as left-right symmetrical setting, or front-back symmetrical setting.
请参考图4至图5,本发明是供施术者练习连续环形撕囊手术,其借助中空球体2来模拟眼球、以穿孔21来模拟瞳孔、弹性组件3来模拟眼球肌肉、薄膜片体5来模拟前囊膜,定位片体4则用来固定薄膜片体5;在练习过程中,藉由撕囊镊200将孔洞41中的薄膜片体5予以连续环形撕裂,以形成撕裂膜片51及环形开口52。整体而言,此手术训练模拟器100容易使用,无保存问题,最重要的一点是,模拟眼球的中空球体2在施作时,受到弹性组件3的牵制及拉引,能如同真眼般的转动回位,有效地模拟出真眼的状况,让训练与实作状况更接近。Please refer to Fig. 4 to Fig. 5, the present invention is for the operator to practice continuous annular capsulorhexis operation, it uses hollow sphere 2 to simulate eyeball, perforation 21 to simulate pupil, elastic component 3 to simulate eyeball muscles, film sheet 5 To simulate the anterior capsule, the positioning sheet 4 is used to fix the film sheet 5; in the practice process, the film sheet 5 in the hole 41 is continuously torn circularly by the capsulorhexis forceps 200 to form a tearing membrane Sheet 51 and annular opening 52. On the whole, this surgical training simulator 100 is easy to use, and there is no storage problem. The most important point is that the hollow sphere 2 simulating the eyeball is restrained and pulled by the elastic component 3 during operation, so that it can move like a real eye. Turn back to the position, effectively simulating the condition of the real eye, making training and practice closer.
其次,定位插件6的应用,能模拟透明角膜一侧的切口,便于施术者使用撕囊镊200进行练习,如此更能贴近于真实手术的状况。由于使用定位插件6能免除开切口的步骤,并能使施术者专注于练习连续环形撕囊,所以能提高手术的熟练度与成功率。Secondly, the application of the positioning plug-in 6 can simulate the incision on one side of the transparent cornea, which is convenient for the operator to use the capsulorhexis forceps 200 for practice, so that it can be closer to the real operation situation. Because the use of the positioning insert 6 can eliminate the step of opening the incision and allow the operator to concentrate on practicing continuous circular capsulorhexis, so the proficiency and success rate of the operation can be improved.
参考图6,施术时,首先将撕囊镊200前端导入定位插件6内,然后对孔洞41中的薄膜片体5进行连续环形撕裂,在上图中,撕囊镊200将撕裂膜片51由右往左撕起,下图中,撕囊镊200将撕裂膜片51由左往右撕起,因此手术中,撕囊镊200必须左右移动的,由于左右移动的距离不得太大,因此以不超过定位插件6两个插脚的间距为原则,换言之,撕囊镊200只能在两插脚之间移动,不能触碰任何插脚,及不能去推动定位插件6,否则将使中空球体2产生转动,如此续环形撕囊就会失败。Referring to Fig. 6, during operation, firstly, the front end of the capsulorhexis forceps 200 is introduced into the positioning insert 6, and then the film sheet 5 in the hole 41 is continuously torn circularly. In the figure above, the capsulorhexis forceps 200 will tear the film The sheet 51 is torn from right to left. In the figure below, the capsulorhexis forceps 200 tear the torn membrane 51 from left to right. Therefore, during the operation, the capsulorhexis forceps 200 must move left and right. Therefore, it is a principle not to exceed the distance between the two pins of the positioning insert 6. In other words, the capsulorhexis forceps 200 can only move between the two pins, and cannot touch any pins, and cannot push the positioning insert 6, otherwise it will make the hollow The ball 2 rotates, so that the continuous annular capsulorhexis will fail.
图6所示的是正确的连续环形撕囊手术状态图,在连续环形撕囊的施术过程中,为了要求环形开口52的完整,及更接近圆形,就必须要避免眼球转动,因此施术中不能碰到透明角膜一侧的切口,因为一旦碰到,眼球就会被带动,导致施术困难,严重时更会导致手术失败,产生后遗症,就因为如此,一般会要求连续环形撕囊施术时,在撕囊镊200伸入切口并碰触到前囊膜51后,须以位在切口处的撕囊镊200作为一假想的定位轴心A,在以该定位轴心A来调整撕囊镊200的前端位移,而定位插件6除了能替代切口之外,还能让施术者练习假想定位轴心A的存在,以期顺利进行连续环形撕囊。What Fig. 6 shows is the state diagram of correct continuous annular capsulorhexis operation, in order to require the integrity of the annular opening 52, and closer to the circle, it is necessary to avoid eyeball rotation during the operation of continuous annular capsulorhexis. The incision on the side of the transparent cornea should not be touched during the operation, because once touched, the eyeball will be moved, making the operation difficult, and in severe cases, the operation will fail and cause sequelae. Because of this, continuous circular capsulorhexis is generally required During the operation, after the capsulorhexis forceps 200 extend into the incision and touch the anterior capsule 51, the capsulorhexis forceps 200 at the incision must be used as an imaginary positioning axis A, and the positioning axis A is used to Adjust the displacement of the front end of the capsulorhexis forceps 200, and the positioning insert 6 can not only replace the incision, but also allow the operator to practice the existence of the imaginary positioning axis A, in order to smoothly perform continuous circular capsulorhexis.
在本发明中,因连续环形撕裂的手术非要求重点,故以下的说明中,不详加讨论如何完成连续环形撕裂的技巧及手段。In the present invention, since the operation of continuous circular tearing is not required to be the key point, in the following description, the techniques and means of how to complete continuous circular tearing will not be discussed in detail.
图7上图所示,施术者正使用撕囊镊200进行连续环形撕囊,下图则揭示出不正确的动作,即撕囊镊200的前端部分触碰定位插件6的右插脚并朝右移动,导致中空球体2朝右顺时针转动,如此一来连续环形撕囊就会不成功,就算完成连续环形撕囊,也算不上成功;反之,撕囊镊200的前端部分触碰定位插件6的左插脚并朝右移动[图中未示出],导致中空球体2朝左逆时针转动,那么连续环形撕囊就会不成功,就算完成连续环形撕囊,也算不上成功。所以当手持撕囊镊200不触碰及不推动定位插件6,就表示续环形撕囊手术已有进步,让施术者自己看到进步,就能有信心完成连续环形撕囊的手术。As shown in the upper figure of Fig. 7, the operator is using the capsulorhexis forceps 200 to perform continuous annular capsulorhexis, while the lower figure reveals an incorrect action, that is, the front end of the capsulorhexis forceps 200 touches the right pin of the positioning insert 6 and moves toward Moving to the right causes the hollow sphere 2 to rotate clockwise to the right, so the continuous circular capsulorhexis will be unsuccessful, even if the continuous circular capsulorhexis is completed, it is not considered successful; The left pin of plug-in 6 moves to the right [not shown in the figure], causing the hollow sphere 2 to rotate counterclockwise to the left, so the continuous circular capsulorhexis will be unsuccessful, even if the continuous circular capsulorhexis is completed, it is not successful. Therefore, when the hand-held capsulorhexis forceps 200 does not touch or push the positioning plug-in 6, it means that the continuous circular capsulorhexis operation has progressed, and the operator can see the progress by himself, and can complete the continuous circular capsulorhexis operation with confidence.
请再参图1及图2,为了便于施术者收纳及取用撕囊镊200,在上述容纳槽体11的侧边设置供撕囊镊200上部定位的定位框12;及对应在定位框12正下方、并设置在上述底座14的位置、能供撕囊镊200底部定位的定位槽13。需说明的是,图式中所揭示的座体1只是一种较佳实施例,其仍有其它不同的实施范例,如图8所示,在上述容纳槽体11的左右两侧设置供撕囊镊200上部定位的定位框12,相对地,在座体1的左右两侧分别设置供撕囊镊200底部定位的定位槽13,所述定位框12与定位槽13呈上下垂直对称设置。基于上述,定位框12及定位槽13的数量也能增为三个以上,需视实际状况来设置,但以设置一至四个为佳。Please refer to Fig. 1 and Fig. 2 again, in order to facilitate the operator to store and take the capsulorhexis forceps 200, a positioning frame 12 for positioning the upper part of the capsulorhexis forceps 200 is set on the side of the above-mentioned accommodation tank body 11; and corresponding to the positioning frame 12, and is provided at the position of the above-mentioned base 14, the positioning groove 13 for positioning the bottom of the capsulorhexis forceps 200. It should be noted that the seat body 1 disclosed in the drawings is only a preferred embodiment, and there are still other different implementation examples. As shown in FIG. The positioning frame 12 positioned on the top of the capsulorhexis forceps 200 is oppositely arranged on the left and right sides of the base body 1 for positioning grooves 13 for positioning the bottom of the capsulorhexis forceps 200, and the positioning frame 12 and the positioning groove 13 are vertically symmetrically arranged. Based on the above, the number of positioning frames 12 and positioning slots 13 can also be increased to more than three, depending on the actual situation, but preferably one to four.
其次,图1中所示的支撑架15仅为一个,另也能以两个或多个实施,并以等间距围绕在容纳槽体11的四周;或者,以柱形的中空管柱取代多根支撑架15来实施也是可以的。Secondly, the support frame 15 shown in Figure 1 is only one, and it can also be implemented in two or more, and surround the housing tank 11 at equal intervals; or, replace it with a cylindrical hollow pipe column It is also possible to implement with multiple support frames 15 .
上述穿孔21的直径为8mm,所述孔洞41为与该穿孔21相同大小,所述定位插件6的两个插脚的距离为2至3mm,定位插件6至穿孔21中心点的间距为5.5至7.5mm。The diameter of the above-mentioned perforation 21 is 8 mm, the hole 41 is the same size as the perforation 21, the distance between the two pins of the positioning insert 6 is 2 to 3 mm, and the distance between the positioning insert 6 and the center point of the perforation 21 is 5.5 to 7.5 mm. mm.
上述穿孔21是用来模拟瞳孔,该尺寸能更贴近于实际眼睛的状态,而孔洞41须对准穿孔21,所以孔洞41与穿孔21的直径相同,或者孔洞41直径略小于穿孔21;而定位插件6的两个插脚的距离,能依据透明角膜一侧的切口的尺寸来进行变动,以利于训练;且定位插件6至穿孔21中心点的间距,是一个适宜撕囊镊200进行手术的距离。The above-mentioned perforation 21 is used to simulate the pupil, and the size can be closer to the actual state of the eye, and the hole 41 must be aligned with the perforation 21, so the diameter of the hole 41 is the same as that of the perforation 21, or the diameter of the hole 41 is slightly smaller than the perforation 21; and the positioning The distance between the two pins of the plug-in 6 can be changed according to the size of the incision on one side of the transparent cornea, so as to facilitate training; and the distance between the positioning plug-in 6 and the center point of the perforation 21 is a suitable distance for operation with the capsulorhexis forceps 200 .
本发明中,弹性组件3如图面所示是直条形、异戊二烯的聚合物材质、并具有弹力伸缩作用的橡皮筋带;或者,是具有弹性伸缩作用的拉伸弹簧[图中未示出];通过不同弹性组件3的应用,能提供不同的弹力变化,能提供更多元化的练习,以满足训练需要,提升手术的熟练度,进一步提高手术成功率。In the present invention, the elastic component 3 is a straight strip, isoprene polymer material, and a rubber band with elastic expansion and contraction as shown in the figure; or, it is a stretch spring with elastic expansion and contraction [in the figure Not shown]; through the application of different elastic components 3, different elastic changes can be provided, and more diversified exercises can be provided to meet training needs, improve surgical proficiency, and further improve the success rate of surgery.
上述中,异戊二烯的聚合物材质是一种以乳胶与橡胶混合的材质,具有极佳的弹力,而且容易取得及制造,价格便宜,可随时增设或减少以改变弹力,因此很适合作为本发明的弹性组件3。Among the above, the polymer material of isoprene is a material mixed with latex and rubber. It has excellent elasticity, is easy to obtain and manufacture, and is cheap. It can be added or decreased at any time to change the elasticity, so it is very suitable as a Elastic component 3 of the present invention.
上述中,拉伸弹簧的弹力稳固,不易变形或变质,又寿命长,故适合用于日常复习或大量练习时使用,进以保持施术者手术的稳定性,是一种仅次于橡皮筋带使用的弹性组件3。Among the above, the elastic force of the stretch spring is stable, not easy to deform or deteriorate, and has a long life, so it is suitable for daily review or a large number of exercises, so as to maintain the stability of the operator's operation. Belt used elastic component3.
请参图3,上述弹性组件3的一端3a,与该中空球体2底部中央连接;所述弹性组件3的另一端3b,往下延伸并朝容纳槽体11内的下槽口112往外穿出后,再转折朝上固定在容纳槽体11的底端外壁。在实物里,弹性组件另一端3b以固定在容纳槽体11的前侧外壁或后侧外壁为佳,因为中空球体2在朝左或朝右转向时,弹性组件3所受到的拉力才能均一及平衡。Please refer to Fig. 3, one end 3a of the above-mentioned elastic component 3 is connected to the center of the bottom of the hollow sphere 2; Afterwards, it is fixed on the outer wall of the bottom end of the housing tank body 11 by turning upwards. In reality, it is better to fix the other end 3b of the elastic component on the front side outer wall or the rear side outer wall of the receiving tank body 11, because when the hollow sphere 2 turns to the left or right, the tensile force on the elastic component 3 can be uniform and stable. balance.
通过上述设置方式,能让中空球体2的转动配合弹性组件3所产生的弹性回馈,能迅速将中空球体2复回原位;这种较简单的设计方式,不但接近于真实眼睛的状况,更让施术者能顺利的练习应用,而且能大大地降低练习成本。Through the above arrangement, the rotation of the hollow sphere 2 can cooperate with the elastic feedback generated by the elastic component 3, and the hollow sphere 2 can be quickly returned to its original position; this relatively simple design method is not only close to the condition of the real eye, but also It allows the practitioners to practice and apply smoothly, and can greatly reduce the cost of practice.
上述弹性组件3为橡皮筋带时,其与该容纳槽体11底部外侧壁连接的另一端3b,以非固接的方式结合,例如图2所示的容纳槽体11底部外侧壁具有L形小卡勾15,而弹性组件3的另一端3b则具有数个等间距设置的凸出环节31,透过凸出环节31勾挂在小卡勾15上能随时调整改变弹性组件3的弹力。再者,如图8揭示,也能以胶片7来贴合弹性组件3的另一端3b,当弹性组件3的弹力降低时,只需将弹性组件3的另一端3b朝外上拉,再以胶片7黏贴固定即可,操作方便且迅速省时。When the above-mentioned elastic component 3 is a rubber band, the other end 3b connected to the bottom outer wall of the receiving tank 11 is combined in a non-fixed manner. For example, the outer wall of the bottom of the receiving tank 11 shown in FIG. 2 has an L-shaped The small hook 15, and the other end 3b of the elastic component 3 has several protruding links 31 arranged at equal intervals, and the elastic force of the elastic component 3 can be adjusted and changed at any time by hooking on the small hook 15 through the protruding links 31. Furthermore, as shown in Figure 8, the other end 3b of the elastic component 3 can also be pasted with the film 7. When the elastic force of the elastic component 3 decreases, only the other end 3b of the elastic component 3 needs to be pulled outward, and then The film 7 can be pasted and fixed, and the operation is convenient, quick and time-saving.
上述中,所述弹性组件3为拉伸弹簧时,就能由容纳槽体11底部外侧壁的L形小卡勾15勾挂,就能随时调整弹力的大小,又调整方便且容易。借助可重复粘贴的定位片体4,能让薄膜片体5便于安装定位,而且不容易位移,并且在使用后能易于薄膜片体5的更换,而定位片体4在使用过期后,能淘汰换新。In the above, when the elastic component 3 is a tension spring, it can be hooked by the L-shaped small hook 15 on the outer wall of the bottom of the receiving tank 11, so that the elastic force can be adjusted at any time, and the adjustment is convenient and easy. With the help of the positioning sheet 4 that can be pasted repeatedly, the film sheet 5 can be easily installed and positioned, and it is not easy to be displaced, and the replacement of the film sheet 5 can be facilitated after use, and the positioning sheet 4 can be eliminated after use expires Renewed.
再参图2,上述中空球体2的穿孔21旁设置两个窄距的定位孔22,所述定位插件6是具有两个插脚的ㄇ形杆,当两个插脚穿过定位片体4后,再插入所对应的两个定位孔22内,而使ㄇ形杆伫立在中空球体2表面上。前述定位孔22的设置,能让定位插件6便于拆装,以便取下定位片体4后,能再重新放置薄膜片体5。Referring to Fig. 2 again, the perforation 21 of the above-mentioned hollow sphere 2 is provided with two positioning holes 22 with a narrow distance, and the positioning insert 6 is a U-shaped bar with two pins. When the two pins pass through the positioning sheet 4, Then insert in the corresponding two positioning holes 22, and make the U-shaped rod stand on the surface of the hollow sphere 2. The setting of the aforementioned positioning hole 22 can make the positioning insert 6 easy to disassemble, so that after the positioning sheet 4 is removed, the film sheet 5 can be placed again.
上述是依据图式所示的实施例详细说明本发明的构造、特征及作用效果,以上所述仅为本发明较佳实施例,但本发明不以图面所示限定实施范围,因此举凡与本发明意旨相符的修饰性变化,只要在均等范围内都应涵属于本发明专利范畴内。The above is a detailed description of the structure, features and effects of the present invention based on the embodiments shown in the drawings. The above descriptions are only preferred embodiments of the present invention, but the present invention does not limit the scope of implementation as shown in the drawings. Modification changes consistent with the intent of the present invention shall fall within the scope of the patent of the present invention as long as they are within an equal range.
Claims (10)
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