CN111091746B - Abdominal cavity open surgery simulation training evaluation system - Google Patents
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Abstract
The invention relates to an abdominal cavity open surgery simulation training evaluation system, which comprises a pleuroperitoneal cavity simulation training device (10) used for simulating a human pleuroperitoneal cavity, soft tissues and organs in the abdominal cavity and providing a student for abdominal cavity open surgery simulation training; the scalpel (20) can record the track of the surgical process and is used for simulating and training the abdominal cavity open surgery of a student, and the scalpel is provided with a wireless transmission device; and the upper computer (60) is in communication connection with the wireless transmission module of the scalpel (20) and receives the track data transmitted by the scalpel so as to evaluate the simulation training of the open abdominal surgery of the student by combining with a preset scoring rule.
Description
Technical Field
The invention relates to the technical field of medical training equipment, in particular to an abdominal cavity open surgery simulation training evaluation system.
Background
In clinical medicine teaching, the problem of knowledge abstraction and training difficulty is generally faced in surgical operation teaching, the teaching process mostly depends on maps and models, the training mode is usually that doctors operate, students look through or serve as temporary assistants, and the students rarely have the opportunity of directly performing operations. At present, most medical students can only carry out operations on human corpses or living animals, although the human corpses are the best training materials, the resources are scarce, the cost is huge, the ethical problems are complex, the dependence on teachers is high, and a large amount of teachers and materials are needed to intervene, so the living animals are the most common operation materials in teaching, but the anatomical structures of the animals still have little difference with people, and extra parasite risks can be brought to medical staff.
To solve the above problems, some solutions have been proposed by the industry in recent years, and chinese patent application CN109493667A discloses "a surgical training box and a training method thereof"; chinese patent application CN108492696A discloses "a surgical knot tying and suturing training model"; chinese patent application CN109035954A discloses a laparoscopic surgery training aid, etc. However, these solutions are only some crude specialized instruments, and can only learn and train for some operations such as suturing, knotting, holding scissors, puncturing, etc., which is far from clinical scenarios.
Disclosure of Invention
Technical problem to be solved
In view of the fact that a complete and feasible damage control operation training scheme is not available at present, the invention aims to provide an overall abdominal cavity open operation training evaluation system, provide a vivid operation object for surgical students, perform real-time feedback according to the actual operation of the students and provide objective evaluation.
(II) technical scheme
In order to achieve the purpose, the invention adopts the main technical scheme that:
an abdominal cavity open surgery simulated training evaluation system, comprising:
the thoracic and abdominal cavity simulation training device (10) is used for simulating the thoracic and abdominal cavities of a human body and soft tissues and organs in the abdominal cavities and providing a student for performing abdominal cavity open surgery simulation training;
the scalpel (20) can record the track of the surgical process and is used for simulating and training the abdominal cavity open surgery of a student, and the scalpel is provided with a wireless transmission device;
and the upper computer (60) is in communication connection with the wireless transmission module of the scalpel (20) and receives the track data transmitted by the scalpel so as to evaluate the simulated training score of the open abdominal surgery of the student by combining with a preset scoring rule.
According to a preferred embodiment of the present invention, wherein: the evaluation system also comprises a camera device (30) which is used for capturing and recording the process information of the trainee in the abdominal cavity open surgery training; the camera device (30) is in communication connection with the upper computer (60) so as to comprehensively evaluate the process information of the trainee in the abdominal cavity open surgery training and the simulated training result of the abdominal cavity open surgery of the trainee.
According to a preferred embodiment of the present invention, wherein: the pleuroperitoneal cavity simulation training device (10) comprises a semi-open pleuroperitoneal cavity model (11) and a soft tissue and organ model (12); the semi-open pleuroperitoneal cavity model (11) comprises ribs (111), a sternum frame (112), a thoracic cavity (113) and an abdominal cavity (114) for simulating the pleuroperitoneal cavity of a human body, wherein the ribs (111) and the sternum frame (112) are fixed in the thoracic cavity (113) and the abdominal cavity (114); the soft tissue and organ model (12) comprises a soft tissue model, an organ model (121) and a thoracic/abdominal aorta model (122) which are detachably arranged in the thoracic and abdominal cavity model.
According to a preferred embodiment of the present invention, wherein: the auxiliary control unit (40) is arranged in the thoracic and abdominal cavity simulation training device (10) and is in communication connection with the upper computer (60); a blood storage pool (13) is further arranged in the thoracic and abdominal cavity simulation training device (10), the blood storage pool (13) is connected with the thoracic/abdominal aorta model (122) through a peristaltic pump (131), and a pressure sensor (14) is further arranged between the blood storage pool (13) and the thoracic/abdominal aorta model (122); the pressure sensor (14) is connected in communication with the sub-control unit (40).
According to a preferred embodiment of the present invention, wherein: the organ model (121) comprises a liver (121A), bilateral kidneys (121B), a spleen (121C) and a stomach (121D), and is respectively communicated with the thoracic/abdominal aorta model (122) through a pipeline (P), and each pipeline is provided with a flow sensor (15); the flow sensor (15) is in communication connection with the sub-control unit (40).
According to a preferred embodiment of the present invention, wherein: the pipeline (P) comprises a connecting pipe (P1) and a connector (P2), one end of the connector (P2) is fixedly connected with the thoracic/abdominal aorta model (122), and the other end of the connector (P1) is detachably connected with the liver (121A), the bilateral kidney (121B), the spleen (121C) and the stomach (121D) through the connecting pipe (P1).
According to a preferred embodiment of the present invention, wherein: connector (P2) are including middle pipe portion and connector, the connector is the taper pipe, the through-hole has in the middle of the taper pipe, and the taper pipe surface is equipped with bellied ring, makes the connector easily injects in connecting pipe (P1), nevertheless is difficult for taking off from the pine of connecting pipe (P1).
According to a preferred embodiment of the present invention, wherein: the peristaltic pump (131) is driven by a peristaltic pump drive module (132); the peristaltic pump driving module (132) is in communication connection with the sub-control unit (40); the pressure sensor (14) and the flow sensor (15) transmit the collected pressure value and flow value to the sub-control unit (40) in real time, the sub-control unit (40) judges whether the pressure value and the flow value are within a preset range, and sends a control instruction to the peristaltic pump driving module (132) according to a judgment result, so that the peristaltic pump driving module (132) drives the peristaltic pump (131) to suck red liquid in the blood storage pool (13) to replenish the thoracic/abdominal aorta model (122).
According to a preferred embodiment of the present invention, wherein: the chest and abdominal cavity simulation training device (10) further comprises a chest and abdominal skin (16), wherein the chest and abdominal skin (16) is detachably combined with the semi-open chest and abdominal cavity model (11).
According to a preferred embodiment of the present invention, wherein: a convex strand self-sealing strip (116) is fixed on the semi-open pleuroperitoneal cavity model (11), and a concave strand self-sealing strip (161) is arranged at the edge of the pleuroperitoneal skin (16); or a concave-strand self-sealing strip is fixed on the semi-open pleuroperitoneal cavity model (11), and a convex-strand self-sealing strip is arranged at the edge of the pleuroperitoneal skin (16); covering the thoracoabdominal skin (16) on the surface of the semi-open thoracoabdominal cavity model (11), and enabling the concave strand self-sealing strip (161) to be combined with the convex strand self-sealing strip (116) at the corresponding position through pressing to realize the detachable connection of the thoracoabdominal skin (16) and the semi-open thoracoabdominal cavity model (11).
According to a preferred embodiment of the present invention, wherein: the soft tissue model, the organ model (121), the thoracic/abdominal aorta model (122) and the thoracic and abdominal skin (16) are made of PVA biomedical materials, are formed by physical gel, are microscopically in a three-dimensional network structure, and are designed according to the parameters of human tissues in the aspects of electrical conductivity, water content and elastic modulus.
According to a preferred embodiment of the present invention, wherein: the camera device (30) is fixed on an operating lamp (51) of an operating table (50) and used for capturing and recording process information of a student in abdominal cavity open surgery training in real time. For example, the process information comprises the operation time of the operation, and also comprises the operation actions of the trainees in the operation process, and the trainees or the scoring experts can call and review the operation actions and combine other scoring items to give scoring scores.
According to a preferred embodiment of the present invention, wherein: the thoracoabdominal skin (16) is in sealing combination with the semi-open thoracoabdominal cavity model (11), an air suction opening (115) communicated with the thoracic cavity (113) and the abdominal cavity (114) is formed in the lower side of the semi-open thoracoabdominal cavity model (11), and the air suction opening (115) is used for sucking air to enable the interior of the semi-open thoracoabdominal cavity model (11) to be in a negative pressure state.
According to a preferred embodiment of the present invention, wherein: the scalpel (20) capable of recording the trajectory of the surgical process comprises a scalpel head (21) and a scalpel handle (22), an inertial sensor (221) is arranged in the scalpel handle (22), a forward camera (222) is further arranged on one side, facing the scalpel head (21), of the scalpel handle (22), the camera lens of the forward camera is arranged in the direction facing the scalpel head (21), and a wireless transmission module (224) and a storage battery (223) are further arranged in the scalpel handle (22); the wireless transmission module (224) is in communication connection with the upper computer (60).
According to a preferred embodiment of the present invention, wherein: the scalpel (20) is in communication connection with the upper computer (60) through the wireless transmission module, track data in the operation training process are transmitted to the upper computer (60), and operation action track data of experts are prestored in the upper computer (60).
According to a preferred embodiment of the present invention, wherein: the camera device (30) is in communication connection with the upper computer (60) in a wireless or wired mode, and video records such as motion capture and the like in the operation training process are sent to the upper computer (60).
According to a preferred embodiment of the present invention, wherein: a sub-control unit (40) is arranged in the chest and abdominal cavity simulation training device (10) and is in communication connection with an upper computer (60) in a wireless or wired (preferably wireless) mode; the sub-control unit (40) mainly comprises a power management module (41), a wireless transmission module (42) and a processing module (43); the power management module (41) supplies power to the peristaltic pump driving module (132), each flow/pressure sensor, the processing module (43), the wireless transmission module (42) and the like in the thoracic and abdominal cavity simulation training device (10) to ensure that each part works stably; the processing module (43) receives data acquired by each flow/pressure sensor in real time and sends out corresponding control instructions according to a preset program; the wireless transmission module (42) is in communication connection with the upper computer (60) so as to send the acquired data of the flow/pressure sensor and the processing result of the processing module (43) to the upper computer (60).
Preferably, the scoring rule gives a score by combining 4 items of bleeding total amount, bleeding time, operation track recorded by the scalpel and matching degree of an expert database. The scoring of the abdominal cavity open surgery simulation training of the trainees can be completed by combining the upper computer (60) with preset scoring rules and program software, or manually calling the data and information collected by the upper computer (60) with the scoring rules.
The invention realizes the effect evaluation and operation evaluation of the abdominal cavity damage control operation based on space track tracking, video monitoring and distributed multi-sensors (flow sensors and pressure sensors), and performs motion capture scheme design to realize quantitative evaluation of the training process.
(III) advantageous effects
The invention has the beneficial effects that:
the invention provides an abdominal cavity open surgery simulation training evaluation system for the first time, which can be used for simulation training and actual combat exercises of abdominal cavity damage control surgery, provides a vivid surgical object for trainees/trainees, performs real-time feedback according to actual operation of the trainees/trainees, and provides objective evaluation. The invention includes but is not limited to the following technical effects:
(1) the simulation training evaluation system for the abdominal cavity open surgery has the advantages of practicability. The multifunctional medical operation instrument provides vivid visual and tactile experience, allows students to use real operation instruments for operation, such as an electric scalpel for separation and cutting, needle and thread sewing, life monitoring, anesthesia maintenance and the like, operates according to clinical actual operation procedures, is close to the characteristics of normal human tissues, and provides vivid operation force feedback and direct effect feedback.
(2) The simulation training evaluation system for the abdominal cavity open surgery has interactivity. The simulation training system is matched with actual surgical instruments, and the operation is cooperatively matched with equipment in the training process, such as a monitor, an anesthesia machine, a respirator, an infusion pump and the like, so that the training system and the equipment system are really interacted.
(3) The simulation training evaluation system for the abdominal cavity open surgery can provide objective evaluation of integrity. By combining with expert clinical decision-making experience and relevant treatment guideline standards, the evaluation and analysis of medical staff operation and system typical operation equipment operation efficiency can be objectively, professionally and standardizedly carried out under the condition of not depending on teachers, so that the quantitative evaluation and statistics during autonomous learning and evaluation during daily training can be supported.
Drawings
FIG. 1 is a front view of the semi-open pleuroperitoneal cavity model of the present invention.
FIG. 2 is a schematic view of the soft tissue and organ model inside the semi-open pleuroperitoneal cavity model of the present invention.
FIG. 3 is a schematic view of a scalpel capable of recording a surgical procedure track according to the present invention.
FIG. 4 is a schematic view of a charging seat of the scalpel capable of recording the trajectory of the surgical procedure according to the present invention.
FIG. 5 is a schematic diagram of a hybrid tracking and registering strategy for visual tracking and inertial tracking of a scalpel capable of recording a surgical procedure trajectory according to the present invention.
FIG. 6 is a front view of the thoracoabdominal skin of the thoracic and abdominal cavity simulation training device of the present invention.
FIG. 7 is a schematic view of the simulation training of the abdominal cavity injury control surgery according to the present invention.
Fig. 8 is a diagram showing the communication and control relationship among the functional modules of the simulation training and evaluation system for the abdominal cavity open surgery of the present invention.
FIG. 9 is a structural diagram of the visceral organ and thoracic/abdominal aorta connector of the thoracic and abdominal cavity simulation training device of the present invention.
FIG. 10 is a block diagram of the scoring apparatus for student's surgery according to the present invention.
[ description of reference ]
10 pleuroperitoneal cavity simulation training device, 11 semi-open pleuroperitoneal cavity model, 12 soft tissue and organ model, 111 rib, 112 thoracic skeleton, 113 thoracic cavity, 114 abdominal cavity, 115 extraction opening, 121 organ model, 121A liver, 121B bilateral kidney, 121C spleen, 121D stomach, 122 thoracic/abdominal aorta model, 13 blood storage pool, 131 peristaltic pump, 132 peristaltic pump driving module, 14 pressure sensor, 15 flow sensor, P pipeline, P1 connecting pipe, P2 connector, 16 pleuroperitoneal skin, 161 self-sealing strip of pleuroperitoneal skin, 116 semi-open pleuroperitoneal cavity model self-sealing strip, 20 scalpel, 21 knife head, 22 knife handle, 221 inertial sensor, 222 forward camera, storage battery, 224 wireless transmission module, 23 charging seat, 30 camera device, 40 sub-control unit, 41 power management module, 42 wireless transmission module, 43 processing module, operating table 50, 51 operating lamp, And 60, an upper computer.
Detailed Description
For the purpose of better explaining the present invention and to facilitate understanding, the present invention will be described in detail by way of specific embodiments with reference to the accompanying drawings.
Example one
The embodiment provides an abdominal cavity open surgery simulation training evaluation system, which includes:
the chest abdominal cavity simulation training device 10, the scalpel 20 that can take notes the operation process orbit, camera device 30, host computer 60. The pleuroperitoneal cavity simulation training device 10 is used for simulating the pleuroperitoneal cavity of a human body, and soft tissues and organs in the abdominal cavity, and providing a trainee for simulation training of an abdominal cavity open surgery; the scalpel 20 is used for simulating and training the abdominal cavity open surgery of a student, and is provided with a wireless transmission module capable of wirelessly transmitting track information; the camera device 30 is used for capturing and recording the process information of the trainee in the abdominal cavity open surgery training; the upper computer 60 is in communication connection with the wireless transmission module of the scalpel 20 and the camera device 30, receives the track data transmitted by the scalpel and the process information of the trainee in the abdominal cavity open surgery training, and evaluates the simulated training score of the trainee in the abdominal cavity open surgery by combining with a preset scoring rule. The camera device 30 can be used to comprehensively correct the evaluation result, and the camera device 30 can be omitted in other embodiments.
Further optimization and details of the above parts are described below:
referring to fig. 1 and 2, the pleuroperitoneal cavity simulation training device 10 includes a semi-open pleuroperitoneal cavity model 11 (see fig. 1) and a soft tissue and organ model 12 (ribs 111 and a sternum frame 112 are hidden in fig. 2). The semi-open thoracic and abdominal cavity model 11 comprises ribs 111, a thoracic cage 112, a thoracic cavity 113 and an abdominal cavity 114 for simulating a thoracic and abdominal cavity of a human body, wherein the ribs 111 and the thoracic cage 112 are fixed in the thoracic cavity 113 and the abdominal cavity 114. The soft tissue and organ model 12 includes a soft tissue model detachably mounted inside a thoracic and abdominal cavity model, an organ model 121, and a thoracic/abdominal aorta model 122.
As shown in fig. 2, the blood reservoir 13, the thoracic/abdominal aorta 122, the liver 121A, the bilateral kidney 121B, the spleen 121C and the stomach 121D, the connector P2, and the connecting tube P1 are replaceable components, and the rib 111 is a fixing member for the sternum frame 112. From a three-dimensional perspective, the liver 121A is primarily located in the right monster and supraabdominal regions, the spleen 121C is located in the left upper abdomen, between the left lateral aspect of the stomach 121D and septum, behind the costal arch; bilateral kidneys 121B are located in the upper posterior portion of abdominal cavity 114. The thoracic/abdominal aorta 122 extends from the right 2 nd costal cartilage to the lower part of the abdominal cavity 114 and is primarily responsible for providing blood flow to the liver 121A, bilateral kidneys 121B, spleen 121C and stomach 121D.
The organ model 121 includes a liver 121A, bilateral kidneys 121B, spleen 121C and stomach 121D, and is respectively communicated with the thoracic/abdominal aorta model 122 by a pipeline P, and each pipeline is provided with a flow sensor 15, and the flow sensors 15 are in communication connection with the sub-control unit 40. The line P may include a connecting tube P1 and a connector P2, wherein one end of the connector P2 is fixedly connected to the thoracic/abdominal aorta model 122, and the other end is detachably connected to the liver 121A, the bilateral kidney 121B, the spleen 121C and the stomach 121D, respectively, through the connecting tube P1.
Preferably, the connector P2 is constructed as shown in FIG. 9 and includes a middle tube and a connector, the connector is a tapered tube with a through hole in the middle and a raised ring on the outer surface of the tapered tube to allow the connector to be easily inserted into the connector P1 but not easily released from the connector P1.
The pleuroperitoneal cavity simulation training device 10 is also internally provided with a sub-control unit 40 and a blood storage pool 13 which are in communication connection with an upper computer 60. The blood storage tank 13 is filled with red liquid to simulate blood, is connected with the thoracic/abdominal aorta model 122 through a peristaltic pump 131, and is also provided with a pressure sensor 14 at the communication part of the blood storage tank 13 and the thoracic/abdominal aorta model 122. The pressure sensor 14 is communicatively connected to the sub-control unit 40.
The peristaltic pump 131 is driven by a peristaltic pump drive module 132, and the peristaltic pump drive module 132 is communicatively connected to the sub-control unit 40. If the thoracic/abdominal aorta model 122, the liver 121A, the bilateral kidney 121B, the spleen 121C or the stomach 121D are not damaged, the pressure sensor 14 can detect that the red liquid pressure in the thoracic/abdominal aorta model 122 beats within a fixed range, if the thoracic/abdominal aorta model 122, the liver 121A, the bilateral kidney 121B, the spleen 121C or the stomach 121D has a damage, the red liquid leaks out, the pressure sensor 14 can detect that the red liquid pressure in the thoracic/abdominal aorta model 122 is significantly reduced, meanwhile, the flow sensor 15 can monitor the outflow of the red liquid in the liver 121A, the bilateral kidney 121B, the spleen 121C and the stomach 121D in real time, the pressure sensor 14 and the flow sensor 15 transmit the collected pressure value and flow value to the sub-control unit 40 in real time, and the (processing module 43 of the sub-control unit 40) determines whether the pressure value and the flow value are within a preset range, according to the judgment result, for example, the pressure value is insufficient or the flow value is too small, a control instruction is sent to the peristaltic pump driving module 132, so that the peristaltic pump driving module 132 drives the peristaltic pump 131 to start working, and the red liquid in the blood storage tank 13 is pumped to replenish the thoracic/abdominal aorta model 122, so as to simulate bleeding after organ rupture. Wherein, the peristaltic pump 13 is used for periodically applying pressure, and the frequency is adjustable (for example, 80 times per minute).
Referring to fig. 3, a schematic view of a scalpel 20 capable of recording a surgical procedure track is shown. As shown in the figure, the scalpel 20 includes a scalpel head 21 and a scalpel handle 22, an inertial sensor 221 is disposed inside the scalpel handle 22, a forward camera 222 is further disposed on one side of the scalpel handle 22 facing the scalpel head 21, and a camera lens of the forward camera is disposed facing the scalpel head 21. A wireless transmission module 224 and a storage battery 223 are further arranged in the knife handle 22, and the wireless transmission module 224 is in communication connection with the upper computer 60.
Preferably, the inertial sensor 221 is a six-degree-of-freedom inertial sensor (e.g., ADIS16365 six-degree-of-freedom inertial sensor), and can acquire the moving track of the knife head 22 of the scalpel 20 in real time; the forward camera 222 may employ a NanEye Stereo CMOS module for acquiring the forward field of view of the scalpel 20, and the backward registration of the scalpel trajectory is realized by means of a plurality of marker points formed in the pleuroperitoneal cavity simulation training device 10 according to the relative positions of the acquired marker points in the field of view and the inertial sensor 221. The scalpel 20 is similar to a conventional scalpel in shape and size, and has no mechanical and circuit connection with the outside. The wireless transmission module 224 may be a low power consumption bluetooth module (e.g., WH-BLE102), and may wirelessly transmit the data of the six-degree-of-freedom inertial sensor and the NanEye Stereo CMOS module to the upper computer 60. Referring to fig. 3 and 4, the rear end of the handle 22 of the scalpel 20 is further provided with a charging interface, which can be a microUSB interface, for charging the battery 223. Fig. 4 shows a charging seat 23 of the scalpel 20, wherein a protruding USB connector is disposed in the middle of the charging seat 23, and the charging seat can be just inserted into a charging interface at the rear end of the handle of the scalpel 20 to achieve the purpose of electrical connection and charging. The scalpel 20 can record the scalpel track in the whole operation process, and is used for recording the track of the student in the operation process to serve as an evaluation index of training results.
As shown in fig. 5, a schematic diagram of a hybrid tracking registration strategy for the visual tracking and inertial tracking of a scalpel is shown. The scalpel 20 capable of recording the surgical motion trajectory in the embodiment combines two trajectory capturing strategies (a hybrid tracking registration strategy) of the visual tracking and the inertial tracking, mainly uses the trajectory captured by the inertial tracking, and corrects and calibrates the inertial tracking trajectory by using the trajectory captured by the visual tracking, so that the inevitable accumulated error generated by the inertial tracking can be eliminated, the characteristic loss caused by the target covering in the visual tracking is compensated frequently, and the high-precision trajectory capturing and recording can be realized.
Referring to fig. 6, the pleuroperitoneal cavity simulation training device 10 further includes a pleuroperitoneal skin 16, wherein the pleuroperitoneal skin 16 is detachably combined with the semi-open pleuroperitoneal cavity model 11. As shown in fig. 6, a convex-strand self-sealing strip 116 is fixed on the semi-open pleuroperitoneal cavity model 11, and a concave-strand self-sealing strip 161 is arranged at the edge of the pleuroperitoneal skin 16. The thoracoabdominal skin 16 is placed over the surface of the semi-open thoracoabdominal cavity model 11 and the concave strands of self-sealing strips 161 are compressed. The semi-open thoracoabdominal skin 16 is embedded and combined with the convex-strand self-sealing strip 116 at the corresponding position, so that the detachable connection of the thoracoabdominal skin 16 and the semi-open thoracoabdominal cavity model 11 is realized. Understandably, the concave-strand self-sealing strip can also be arranged on the semi-open pleuroperitoneal cavity model 11, and the convex-strand self-sealing strip is arranged at the edge of the pleuroperitoneal skin 16.
As shown in fig. 7, an air extraction opening 115 communicating with the thoracic cavity 113 and the abdominal cavity 114 is further provided at the lower side of the semi-open pleuroperitoneal cavity model 11, and after the pleuroperitoneal skin 16 is hermetically combined with the semi-open pleuroperitoneal cavity model 11, the air extraction opening 115 is extracted by an air extraction tube, so that the interior of the semi-open pleuroperitoneal cavity model 11 is in a negative pressure state.
The soft tissue model, the organ model 121, the thoracic/abdominal aorta model 122 and the thoracic and abdominal skin 16 are made of PVA biomedical materials, are formed by physical gel, are microscopically in a three-dimensional network structure, and are designed according to the parameters of human tissues so as to be close to the human tissues as much as possible.
Fig. 7 is a schematic view of simulation training of the abdominal cavity injury control surgery according to this embodiment. The operating lamp 51 is located on one side of the operating table 50, the camera device 30 is fixed in the middle of the top end of the operating lamp 51 and used for capturing and recording process information of a student in abdominal cavity open surgery training in real time, and the camera device 30 is in communication connection with the upper computer 60. The camera device 30 is fixed on the operation lamp 51 through a fixing frame, so that the irradiation direction of the camera device is consistent with that of the operation lamp 18, and the whole operation process can be recorded in real time. For example, the process information comprises the operation time of the operation, and also comprises the operation actions of the trainees in the operation process, and the trainees or the scoring experts can call and review the operation actions and combine other scoring items to give scoring scores.
Referring to fig. 8, the sub-control unit 40 is communicatively connected to the upper computer 60 via the wireless transmission module 42, and the sub-control unit 40 includes a power management module 41, a processing module 43 and the wireless transmission module 42. The power management module 41 supplies power to the flow sensor 15, the pressure sensor 14, the peristaltic pump driving module 132, the wireless transmission module 42, the processing module 43 and the like, so that stable operation of each component is guaranteed. The processing module 43 executes the corresponding program, receives the data collected by the sensors (the flow sensor 15 and the pressure sensor 14) in real time, and issues control instructions (e.g., to the peristaltic pump driving module 132) accordingly. The wireless transmission module 42 transmits the real-time data, the processing result, the instruction and the like received by the processing module 43 to the upper computer 60. The processing module 43 of the sub-control unit 40 serves as an operation and control core inside the pleuroperitoneal cavity simulation training device 10.
As shown in fig. 10, the performance evaluation of the trainee in the simulation training of the abdominal cavity open surgery includes the total bleeding amount, the bleeding time (from the flow sensor 15 and the pressure sensor 14), the surgery time (from the camera device 30 and the scalpel 20), the surgery track recorded by the scalpel (from the scalpel 20) and 4 items of matching degree of the expert database to give a score. The scoring of the simulation training of the abdominal cavity open surgery of the trainee can be completed by the upper computer 60 in combination with preset scoring rules and program software, or by manually calling data (including processing results, such as calculated hemostasis time and bleeding amount) and information collected by the upper computer 60 in combination with the scoring rules.
Taking a hemostasis and repair operation of liver rupture as an example, the process of applying the evaluation system is as follows:
(1) preparation before operation start: the semi-open pleuroperitoneal cavity model 11 is placed on an operating table 50, replaceable movable components such as soft tissues, an organ model 121, a thoracic/abdominal aorta model 122, a blood reservoir 13, a connector P2 and a connecting pipe P1 are installed in the semi-open pleuroperitoneal cavity model 11, a pleuroperitoneal skin 16 and the semi-open pleuroperitoneal cavity model 11 are mutually combined through a self-sealing strip, and gas in the semi-open pleuroperitoneal cavity model 11 is extracted by using an extraction cylinder through an extraction opening 115 arranged on the left lower side of the semi-open pleuroperitoneal cavity model 11 to form a negative pressure environment. The imaging device 30 is fixed to an operation lamp 51, and the operation lamp 51 is placed on the side of the operation table 50.
Wherein the neutron control unit 40 can be installed in the semi-open pleuroperitoneal cavity model 11 and communicate with an external host computer 60.
(2) And when the operation is started: the sub-control unit 40 starts to work, the peristaltic pump driving module drives the peristaltic pump 132 to work, the red liquid is driven into the thoracic/abdominal aorta model 122 by the blood storage tank 13 and flows into each organ model 121 by the thoracic/abdominal aorta model 122, the red liquid at the damaged part of the liver 121A flows out, at this time, the pressure sensor 14 detects that the pressure in the thoracic/abdominal aorta model 122 is insufficient, and the flow sensor 15 at the liver 121A monitors that the liquid is not cut out and sends data to the sub-control unit 40.
(3) The student starts to take a hemostasis measure, and after hemostasis succeeds, the pressure sensor 14 detects that the pressure rises and beats within a fixed range; the liver flow sensor 15 detects that fluid no longer flows out of the liver 121A; in combination with the two sensor data changes, the sub-control unit 40 can recognize the success of hemostasis and record the time spent in hemostasis, and send the recorded time to the upper computer 60.
(4) The trainee starts to excise the debridement part of the liver, the inertial sensor 221 arranged at the front end of the knife handle 22 of the scalpel 20 is combined with the camera 222 to obtain the operation track of the trainee, the tracks respectively obtained by the inertial sensor and the forward camera 222 are mutually supplemented/corrected, the track obtained by the inertial sensor 221 is mainly adopted, and the track obtained by the camera 222 is periodically adopted for correction. Meanwhile, the camera device 30 arranged on the operation lamp 51 can record the operation process in real time, and the camera device 30 sends the operation process to the upper computer 60. The track reversely recorded by the scalpel 20 is compared with the information of speed, acceleration and the like in the operation with the expert operation information prestored in the database, and the comparison result is used as the scoring basis of the debridement partial liver resection operation of the student.
(5) Referring to fig. 10, after the surgical operation is completed, the student score is given by combining 4 items of the total bleeding amount, the bleeding time, the surgical trajectory and the matching degree of the expert database.
Claims (11)
1. An abdominal cavity open surgery simulation training evaluation system, comprising:
the thoracic and abdominal cavity simulation training device (10) is used for simulating the thoracic and abdominal cavities of a human body and soft tissues and organs in the abdominal cavities and providing a student for performing abdominal cavity open surgery simulation training; the thoracic and abdominal cavity simulation training device (10) comprises a semi-open thoracic and abdominal cavity model (11) and a soft tissue and organ model (12), wherein the soft tissue and organ model (12) comprises a soft tissue model, an organ model (121) and a thoracic/abdominal aorta model (122) which are detachably arranged in the thoracic and abdominal cavity model;
the soft tissue model, the organ model (121) and the thoracic/abdominal aorta model (122) are all made of PVA biomedical materials, are formed by physical gel, are microscopically in a three-dimensional network structure, and are designed according to the parameters of human tissues in terms of electrical conductivity, water content and elastic modulus;
the scalpel (20) can record the track of the surgical process and is used for simulating and training the abdominal cavity open surgery for students, and the scalpel is provided with a wireless transmission module;
the upper computer (60) is in communication connection with the wireless transmission module of the scalpel (20) and receives the track data transmitted by the scalpel so as to evaluate the simulated training score of the open abdominal surgery of the student by combining with a preset scoring rule;
the scalpel (20) capable of recording the trajectory of the surgical process comprises a scalpel head (21) and a scalpel handle (22), an inertial sensor (221) is arranged in the scalpel handle (22), a forward camera (222) is further arranged on one side, facing the scalpel head (21), of the scalpel handle (22), the forward camera (222) is arranged in the direction facing the scalpel head (21), and a wireless transmission module (224) and a storage battery (223) are further arranged in the scalpel handle (22); the wireless transmission module (224) is in communication connection with the upper computer (60); the inertial sensor (221) is a six-degree-of-freedom inertial sensor and is used for acquiring the moving track of the scalpel (20) in real time; the forward camera (222) is used for acquiring a forward visual field of the scalpel (20) in real time, a plurality of mark points formed in the thoracic and abdominal cavity simulation training device (10) by utilizing the acquired forward visual field are used for realizing reverse registration of the trajectory of the scalpel (20) according to the relative positions of the acquired mark points in the visual field and data sensed by the inertial sensor (221); when the operation action track of the scalpel (20) is recorded, the track captured by the inertial tracking of the inertial sensor (221) is mainly used, and the track captured by the visual tracking of the forward camera (222) is used for correcting and calibrating the inertial tracking track of the inertial sensor (221);
the camera device (30) is used for capturing and recording the process information of the trainee in the abdominal cavity open surgery training; the camera device (30) is in communication connection with the upper computer (60) so as to comprehensively evaluate the process information of the trainee in the abdominal cavity open surgery training and the simulated training result of the abdominal cavity open surgery of the trainee.
2. The abdominal open surgery simulation training evaluation system according to claim 1, wherein the semi-open pleuroperitoneal cavity model (11) comprises ribs (111), a sternal frame (112), a thoracic cavity (113) and an abdominal cavity (114) for simulating the human pleuroperitoneal cavity, the ribs (111) and the sternal frame (112) being fixed in the thoracic cavity (113) and the abdominal cavity (114).
3. The simulation training evaluation system for the open abdominal surgery as claimed in claim 2, further comprising a sub-control unit (40) disposed in the simulation training device (10) for the thoracic and abdominal cavity and communicatively connected to the upper computer (60); a blood storage pool (13) is further arranged in the thoracic and abdominal cavity simulation training device (10), the blood storage pool (13) is connected with the thoracic/abdominal aorta model (122) through a peristaltic pump (131), and a pressure sensor (14) is further arranged between the blood storage pool (13) and the thoracic/abdominal aorta model (122); the pressure sensor (14) is connected in communication with the sub-control unit (40).
4. The laparoscopic surgery simulated training assessment system according to claim 3, wherein said visceral organ model (121) comprises a liver (121A), bilateral kidneys (121B), a spleen (121C) and a stomach (121D), and is respectively in communication with said thoracic/abdominal aorta model (122) by a channel (P) on each of which a flow sensor (15) is provided; the flow sensor (15) is in communication connection with the sub-control unit (40).
5. The simulated training evaluation system for abdominal cavity open surgery according to claim 4, characterized in that the pipeline (P) comprises a connecting pipe (P1) and a connector (P2), one end of the connector (P2) is fixedly connected with the thoracic/abdominal aorta model (122), and the other end is detachably connected with the liver (121A), bilateral kidney (121B), spleen (121C) and stomach (121D) through the connecting pipe (P1).
6. The abdominal cavity open surgery simulated training evaluation system of claim 4, wherein the peristaltic pump (131) is driven by a peristaltic pump drive module (132); the peristaltic pump driving module (132) is in communication connection with the sub-control unit (40); the pressure sensor (14) and the flow sensor (15) transmit the collected pressure value and flow value to the sub-control unit (40) in real time, the sub-control unit (40) judges whether the pressure value and the flow value are within a preset range, and sends a control instruction to the peristaltic pump driving module (132) according to a judgment result, so that the peristaltic pump driving module (132) drives the peristaltic pump (131) to suck red liquid in the blood storage pool (13) to replenish the thoracic/abdominal aorta model (122).
7. The abdominal open surgery simulated training evaluation system of claim 2, wherein the thoracic and abdominal cavity simulated training device (10) further comprises a thoracoabdominal skin (16), the thoracoabdominal skin (16) being detachably coupled to the semi-open thoracic and abdominal cavity model (11).
8. The abdominal cavity open surgery simulation training evaluation system according to claim 7, characterized in that a convex thigh self-sealing strip (116) is fixed on the semi-open thoracic and abdominal cavity model (11), and a concave thigh self-sealing strip (161) is arranged at the edge of the thoracic and abdominal skin (16); or a concave-strand self-sealing strip is fixed on the semi-open pleuroperitoneal cavity model (11), and a convex-strand self-sealing strip is arranged at the edge of the pleuroperitoneal skin (16); covering the thoracoabdominal skin (16) on the surface of the semi-open thoracoabdominal cavity model (11), and enabling the concave strand self-sealing strip (161) to be combined with the convex strand self-sealing strip (116) at the corresponding position through pressing to realize the detachable connection of the thoracoabdominal skin (16) and the semi-open thoracoabdominal cavity model (11).
9. The simulation training evaluation system for the abdominal cavity open surgery as recited in claim 7, wherein the thoracoabdominal skin (16) is made of PVA biomedical materials, is formed by physical gel, is microscopically in a three-dimensional net structure, and is designed by referring to parameters of human tissues in the aspects of electrical conductivity, water content and elastic modulus.
10. The simulation training evaluation system for the open abdominal surgery according to claim 1, wherein the camera device (30) is fixed on an operating lamp (51) of an operating table (50) and used for capturing and recording the process information of the trainee in the process of performing the open abdominal surgery training in real time.
11. The simulation training and evaluation system for the open abdominal surgery as recited in claim 7, wherein the thoracoabdominal skin (16) is hermetically combined with the semi-open thoracoabdominal cavity model (11), and an air suction port (115) communicated with the thoracic cavity (113) and the abdominal cavity (114) is arranged at the lower side of the semi-open thoracoabdominal cavity model (11), and the air suction port (115) is sucked by an air suction tube, so that the interior of the semi-open thoracoabdominal cavity model (11) is in a negative pressure state.
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| CN112489542A (en) * | 2020-11-20 | 2021-03-12 | 泰州市人民医院 | Abdominal cavity double-sleeve teaching mold and using method thereof |
| CN114220547B (en) * | 2021-11-23 | 2024-11-26 | 南昌大学 | A modeling method for interactive bleeding and suction in virtual surgery |
| CN115394141A (en) * | 2022-08-25 | 2022-11-25 | 温州市中心医院 | Gastric bypass operation simulation operation platform |
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