Commercialized the vascular models, and kidney model “EXSURG” with a realistic feel and texture for surgery training. Contribute to skill improvement of physiciansTecno Cast Co.,Ltd
Kidney model “EXSURG”
Points to remember
- Manufacture by incorporating the opinion of users
- Pursue realistic texture
- Adapt the models to each case
For patients undergoing surgery, physicians who can give good results with technical capability is important. Artificial models close to humans are used for practice to improve the technical skills of young physicians. Tecno Cast Co., Ltd. is a company that manufactures such biological models. Skilled physicians have repeatedly conducted sensory tests on the vascular and kidney models manufactured by the company, and a sense of touch and texture that are close to humans has been achieved. In particular, the kidney models, based on the request of physicians, have not only the feel and texture of an actual kidney, but they can also reproduce tumors which are lesions. The models contribute to the technical improvement of surgical procedures.
Mr. Shibata, director of the company, says that the reason why the vascular and kidney models manufactured by Tecno Cast can achieve a feeling close to that of the living body is because of the main raw material Polyvinyl Alcohol (PVA) which is blended with other materials. PVA is an excellent hydrophilic material and is used in “Adhesive pastes”, and “Cooling gel sheets”.
Although the company is mainly engaged in dental technology, when the widespread use of dental implants started about ten years ago, they manufactured practice models for dental implants in which the gum and bone material they used closely matched the living body. Mr. Hashikawa, a professor from the plastic surgery department of Kobe University, observed the use of PVA material for gingiva and requested vascular models (hereinafter referred to as “vascular model”) for practicing anastomosis on micro blood vessels based on which they started the production.
Conventional vascular models are often manufactured using silicon, but the models do not conduct electricity and texture is different from the actual blood vessels and had problems that the force during anastomosis was different from clinical conditions.
The vascular model of Tecno Cast, which pursued reality by repeated sensory testing, adjusting the size and content of PVA molecules, has elasticity and friction close to the texture of blood vessels in the living body, and a near-clinical feel can be experienced while performing the surgical technique of micro anastomosis carried out using a microscope that requires extremely delicate force adjustment, and its advantage is that infection and hygiene management are very easy compared to the practice of using animals such as rats.
Vascular models of length 60 mm and 80 mm are available.
Vascular models of 80 mm are available in 7 sizes 0.5, 0.7 mm, 1 mm, 2 mm, 3 mm, 4 mm and 5 mm, and it is possible to learn while increasing the difficulty of anastomosis starting with the bigger blood vessels and then moving on to the smaller blood vessels.
The 60 mm model has the texture of blood vessel walls that are thin, reproducing non-healthy blood vessels, and there are two types of outer diameter 1 mm and 2 mm. This model in addition to Japan is being used overseas in countries such as the United States, Spain, Argentina, Thailand, Chile, France, and Mexico, mainly for plastic surgery and neurosurgery.
Development of a model (hereinafter referred to as the kidney model) for partial nephrectomy training was started at the request of Dr. Shuzi Isoya, Urology Department, Juntendo University. The advantage of this model is that it is not just an imitation of the kidney, but rather a model which can be used for practicing partial resection of tumors. Pigs may be used for surgical practice, but these animals are not sick, and the tumors cannot be reproduced, and from the perspective of animal protection in recent years, there was a need for models specialized in providing training on the same surgical procedure using chemicals, and they started manufacturing such models.
The hardness of the tumor and parenchyma of the kidney are different, and touch perception close to the actual parts can be experienced. Unlike models made of silicon that cannot conduct electricity, electric scalpels and ultrasonic echoes can be used on this model, and training of clipping and suturing the blood vessels is possible as the blood vessels are embedded in the tumor part.
Also, “EXSURG” offers the following three types of treatment with different levels of difficulty, and practice can be carried out assuming various cases.
Level 1: Tumors can be identified immediately
Level 2: Locations can be identified, but the entire tumor cannot be seen.
Level 3: Location, where the tumor is buried, cannot be identified
These three types were developed for surgical practice using kidney models in Thailand, and Dr. Isoya presented the research on the training results using the kidney models at the UAA (Urological Association of Asia congress/Urological Association of Asia) held in Hong Kong in 2017 and was awarded the Best Abstract Presentation.
In 2019, the company plans to release a training model for debridement to remove necrotic tissue of decubitus (generally known as “Bedsores”). It is an initial training model to remove necrotic tissue.
The company is also looking for partners while developing products that will help physicians improve their skills. Specifically, they are interested in companies engaged in or conducting workshops on dry labs (performed without using animals for medical training), centers providing medical training, and medical equipment manufacturers.
In the medical world, an increasing number of medical devices are being developed with different ideas and concepts, which differ significantly from conventional surgical techniques, such as remote-controlled robots.
By collaborating with such partners, it may be possible to train physicians for acquiring skills to handle robots and the latest medical devices using vascular and kidney models. Mr. Shibata said he wants to help physicians so that they can handle the new equipment with peace of mind.
The body structure of each person is significantly different, and there are many difficulties in improving technical skills without experience and knowledge. However, if the cases with individual differences can be experienced from the training stage, it will help young physicians to acquire basic technologies and become confident. Such training methods will improve the level of medical treatment and help build a society where more patients can undergo surgery with peace of mind.
Interview Date: March 19, 2019
We manufacture biological models using PVA (polyvinyl alcohol). Our products, which are hydrated and are very similar to living organisms, are ideal for surgical training. It is much easier to set up without requiring hygienic management considering infection compared to animal-derived material. You can also use electric devices such as electric scalpels and echoes.
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