JP6402458B2 - Organ fixing device and organ fixing device - Google Patents

Description

  The present invention relates to an organ fixing tool and an organ fixing device.

  An organ fixing device that is used to fix an internal organ of a subject to the inner surface of a body wall by a minimally invasive technique has been proposed. For example, in Patent Document 1, an organ fixing tool (suture tool) is fed into the stomach through a puncture needle punctured in the abdominal wall and stomach wall before the gastrostoma is formed, and the suture of the organ fixing tool is pulled up to pull the stomach wall. An organ-fixing device is described that lifts and fixes to the abdominal wall. An organ fixing tool to be sent into the stomach is composed of a rod-shaped locking portion and a suture thread whose tip is fixed so as to be orthogonal to the locking portion. It is.

  An organ fixing tool (suture tool) of Patent Document 1 is a metal locking portion formed in a rod shape, and a suture thread made of nylon extending perpendicularly to the locking portion from the axial center portion of the locking portion. And is composed of. As a method of fixing the suture thread to the locking portion, a ring-shaped groove is provided on the peripheral surface of the locking portion, and the distal end portion of the suture thread is formed in a ring shape to be engaged with the groove. It is disclosed that an engagement hole is provided in the portion and the distal end portion of the suture thread is connected to the engagement hole.

  In addition, various organ fixing devices have been proposed. The organ fixing device of Patent Document 2 is formed into a substantially T-shape by forming a rod-like locking portion by bundling a suture made of nylon and extending the suture in an orthogonal direction from the center thereof. The suture thread is wound around the locking portion and fixed in a state of being bent at a right angle at the center of the locking portion (see FIG. 2 of Patent Document 2).

In the organ fixing tool (internal organ lifting tool) of Patent Document 3, a vertical hole perpendicular to the axial center is formed in a substantially central portion in the axial direction of a rod-shaped rod made of a metal wire, and the vertical hole is sutured. The thread is slidably inserted. The suture thread inserted into the longitudinal hole is bent at a right angle on the opposite side or inside of the rod and fixed to the end portion of the rod by caulking.
The end of the suture thread is fixed by caulking after being inserted into an insertion hole formed in the end of the rod. The suture thread is inserted into the rod and then bent at a right angle below or inside the rod and fixed to the rod.

  Such an approximately T-shaped organ fixing tool is delivered from the puncture needle after being delivered into the organ while being loaded inside the puncture needle (see FIG. 8 of Patent Document 1 and Patent Document 2). FIG. 6 and FIG. 4 of Patent Document 3).

  In recent years, it has been required to reduce the outer diameter and the inner diameter of a puncture needle because of the demand for minimally invasiveness. In the organ fixation devices of Patent Document 1 and Patent Document 2, the suture is sharply bent and accommodated inside the small-diameter puncture needle so as to be in close contact with the rod-shaped locking portion. In the organ fixing device of Patent Document 3, the suture is pulled out of the body through the outside of the puncture needle. In such a case, the suture is attached at the distal end so as to be closely attached along the rod or the puncture needle so as to be minimally invasive. It is bent at a right angle (see FIG. 4 of Patent Document 3).

JP 2006-296914 A JP 2006-296696 A JP 2010-154883 A

  In the above-described conventional organ fixing device, the suture needle is loaded into the puncture needle in a state where the distal end of the suture is bent at a right angle. For this reason, the distal end of the suture thread is brazed and plastically deformed, and even if the locking portion or the rod (hereinafter also referred to as “organ locking portion”) is delivered from the puncture needle, the organ fixing tool is substantially T The problem is not to restore it to a letter shape. That is, since the suture thread is plastically deformed at a right angle at the most advanced part rising from the organ locking part, the organ locking part sent into the organ is maintained in the standing state when it is accommodated in the puncture needle. In other words, there is a case where it is not displaced in a substantially T-shaped sideways manner (see FIG. 5C of Patent Document 3). In this case, even if the suture thread removed from the organ fixing device is pulled up, the standing organ locking portion passes through the puncture hole formed in the body wall or organ, and the organ cannot be lifted.

  The present invention has been made in view of the above-described problems, and provides an organ fixing device and an organ fixing device in which an organ locking portion fed into an organ is securely locked to the organ. .

According to the present invention, an organ locking portion having an elongated shape, and a suture thread that is connected to the organ locking portion so as to be able to advance and retreat, and the organ locking portion is disposed at a distal end portion of the suture thread. An organ fixing tool is provided, which is provided so as to be capable of advancing and retracting, and is formed with an anchor portion that restricts the organ locking portion from moving toward the distal end side of the suture .

Further, according to the present invention, an elongated organ locking portion and an anchor that is connected to the organ locking portion so as to be able to advance and retreat and restricts the organ locking portion from moving toward the distal end side of the suture thread. An organ fixing device including a suture thread formed at a distal end portion, a housing portion for housing the organ locking portion, and a delivery mechanism for sending the organ locking portion from the housing portion to the outside. An organ fixing device is provided, wherein the organ locking portion is housed in the housing portion in a state of being engaged with a position closer to the proximal end side than the anchor portion with respect to the suture thread. The

  According to the organ fixing device and the organ fixing device of the present invention, the anchor portion and the organ locking portion formed at the distal end portion of the suture thread can advance and retreat, so the organ locking portion is provided in the housing portion such as a puncture needle. In housing, the organ locking part can be engaged with the suture thread at a position retracted from the anchor part. For this reason, even if the suture is bent inside the accommodating portion and plastically deformed along the organ locking portion, the plastic deformation can be prevented from reaching the vicinity of the anchor portion in the suture. Therefore, according to the present invention, the locking portion fed into the organ can be displaced in a desired direction with respect to the suture and can be securely locked to the organ.

It is a schematic diagram which shows the organ fixing tool of 1st embodiment of this invention, (a) is a front view, (b) is a top view. It is a figure which shows an example of an organ fixing device, (a) is a front view, (b) is a right view. It is a schematic diagram which shows the state with which the organ fixing tool of 1st embodiment was loaded in the puncture needle. It is a partial longitudinal cross-sectional view of the organ fixing device showing an initial state in which a puncture needle is punctured into a body cavity wall and a stomach wall. (A)-(d) is a cross-sectional schematic diagram which shows the state from which an organ locking part is delivered from a puncture needle. It is a schematic diagram which shows the indwelling state of the organ fixing tool of 1st embodiment. It is a schematic diagram which shows the organ fixing tool of 2nd embodiment of this invention, (a) is a top view which shows an accommodation state, (b) is the BB sectional drawing of (a), (c) is an indwelling state. FIG. It is a schematic diagram which shows the organ fixing tool of the 1st modification of this invention, (a) is a top view which shows an accommodation state, (b) is the BB sectional drawing of (a), (c) is (a) ) Is a cross-sectional view taken along the line C-C of FIG. It is a schematic diagram which shows the organ fixing tool of the 2nd modification of this invention, (a) is a front view which shows an accommodation state, (b) is a top view which shows an accommodation state, (c) is a front view which shows an indwelling state It is. It is sectional drawing which shows typically the accommodation state of the organ fixing tool of the 3rd modification of this invention.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. In all the drawings, the same constituent elements are denoted by the same reference numerals, and redundant description is omitted as appropriate. In the following description, the vertical direction in FIG. 2 may be described as the vertical direction in the organ fixing device, and the horizontal direction in FIG. 2 may be described as the horizontal direction in the organ fixing device. The relative relationship of the components of the tool is described for convenience, and the direction during production or use thereof is not necessarily limited. In addition, the upper end side of the organ fixing device may be referred to as a proximal end side, and the lower end side may be referred to as a distal end side.

<First embodiment>
An organ fixing device 100 and an organ fixing device 10 according to an embodiment of the present invention will be described with reference to FIGS. FIG. 1 is a schematic view showing an organ fixing device 10 of the first embodiment. FIG. 1A is a front view thereof, and FIG. 1B is a plan view thereof. FIG. 2 is a view showing an example of the organ fixing device 100, FIG. 2 (a) is a front view thereof, and FIG. 2 (b) is a right side view thereof. FIG. 3 is a schematic diagram showing a state in which the organ fixing device 10 according to the first embodiment of the present invention is loaded on the puncture needle 130. In FIG. 1 to FIG. 3, the proximal end side of the suture thread 30 is omitted from illustration with an appropriate length.

  First, an outline of the present embodiment will be described. As shown in FIG. 1, an organ fixing device 10 according to the present embodiment includes an elongated organ locking portion 20 and a suture thread 30 connected to the organ locking portion 20 so as to be able to advance and retreat. ing. At the distal end portion of the suture thread 30, an anchor portion 32 that is provided so as to be able to advance and retreat with respect to the organ locking portion 20 and restricts the movement of the organ locking portion 20 toward the distal end side is formed.

  The organ locking part 20 has a thread engaging part 22 that allows the suture 30 to pass therethrough. The suture 30 intersects the longitudinal direction of the organ locking part 20 in a state where the organ locking part 20 is moved to the distal end side of the suture 30 and the thread engaging part 22 and the anchor part 32 are engaged. Connected to stand up in the direction. Hereinafter, the state in which the suture thread 30 intersects at the intermediate portion of the organ locking portion 20 as shown in FIG. Moreover, the state in which the organ fixing device 10 is substantially T-shaped may be referred to as an indwelling state. Further, the movement of the organ locking part 20 to the distal end side (distal side) of the suture thread 30 may be referred to as advancement of the organ locking part 20.

  Next, this embodiment will be described in detail.

As shown in FIGS. 2 and 3, the organ fixing device 100 of the present embodiment includes an organ fixing tool 10, a housing part (puncture needle 130), and a delivery mechanism (plunger 200). As described above, the organ fixing device 10 has an elongated organ locking portion 20 and an anchor that is connected to the organ locking portion 20 so as to be able to advance and retreat, and restricts movement of the organ locking portion 20 toward the distal end side. And a suture thread 30 formed at the distal end portion.
The accommodating portion is a means for accommodating the organ locking portion 20 of the organ fixing device 10, and in this embodiment, the lumen of the puncture needle 130 corresponds to the accommodating portion. In addition, instead of the present embodiment, the internal space of the housing 110 may be used as a housing portion for the organ locking portion 20. The delivery mechanism (plunger 200) is a mechanism for delivering the organ locking part 20 from the housing part (puncture needle 130) to the outside.
As shown in FIG. 3, in the organ fixing device 100 of the present embodiment, the accommodating portion (puncture) is performed in a state where the organ locking portion 20 is engaged with the suture thread 30 at a position proximal to the anchor portion 32. Needle 130).

  The organ fixing device 10 of the present embodiment is configured such that the thread engaging portion 22 and the anchor portion 32 that are engaged with each other in the indwelling state are capable of advancing and retreating, and therefore, when the organ fixing device 10 is loaded into the organ fixing device 100. The anchor part 32 can be separated from the organ locking part 20 (thread engaging part 22). For this reason, even when the organ locking portion 20 is housed and used inside the small-diameter puncture needle 130 (see FIG. 2), the position of the bent portion 36 that can be brazed inside the puncture needle 130 and generated in the suture thread 30. Can be separated from the anchor portion 32. For this reason, when the organ locking part 20 moves forward to the distal end part of the suture 30 and the anchor part 32 and the thread engaging part 22 are engaged, and the organ fixing device 10 is in the indwelling state, the bent part 36. Thus, the organ locking portion 20 and the suture thread 30 have a desired crossing angle, that is, a substantially right angle. Thereby, the organ locking part 20 of this embodiment is reliably locked to the organ (stomach wall 320: see FIG. 6).

  The organ locking part 20 is an elongated member made of a material such as metal, resin or ceramic. Although the organ locking part 20 of this embodiment is a square bar shape, it is not restricted to this. It may be a round bar, a bar shape obtained by cutting a part of the round bar, or a hollow tubular pipe having an axial hole penetrating in the longitudinal direction. The organ locking portion 20 of the present embodiment has a linear shape in the longitudinal direction, but may instead be a curved shape or an elongated annular shape.

  The suture thread 30 is a thin line made of metal or resin. The material is not particularly limited, but synthetic resin such as nylon can be used as an example. The side where the anchor part 32 is provided among the sutures 30 is referred to as the distal end side.

  The anchor portion 32 is a portion formed at the distal end portion of the suture thread 30 and having a larger diameter than the suture thread 30. Although the anchor part 32 of this embodiment is formed in the forefront of the suture thread 30, the present invention is not limited to this. The anchor portion 32 can be formed by various methods. As an example, a knot formed by tying the suture 30 once or a plurality of times may be used, or an adhesive or other member may be attached to the suture 30 as the anchor portion 32. In addition, it may be a melted part formed by heating and melting the suture 30 to form a lump. The breaking strength between the anchor portion 32 and the suture 30 is preferably higher than the tensile strength of the suture 30 itself.

  As shown in FIG. 3, the organ fixing device 100 of the present embodiment includes a plurality of organ fixing devices 10 (10a and 10b) each including an organ locking portion 20 (20a and 20b) and sutures 30 (30a and 30b). It has. The organ locking portion 20b in one organ fixing device 10b is inserted between the organ locking portion 20a of another adjacent organ fixing device 10a with the anchor portion 32 of the organ fixing device 10b interposed therebetween, and the accommodating portion (puncture). Needle 130). The state of the organ fixing device 10 when the organ locking part 20 is housed in the housing part as shown in FIG. 3 may be referred to as a housed state.

  The thread engaging portion 22 of the organ locking portion 20 is formed with a through hole 26 formed in the radial direction with respect to the organ locking portion 20. The outer diameter of the anchor portion 32 of the suture thread 30 is larger than the inner diameter of the through hole 26, and the suture thread 30 is inserted through the through hole 26 and secured by the anchor portion 32. Thereby, the suture thread 30 can move forward and backward without disengaging from the organ locking portion 20. Further, since the thread engaging portion 22 has the opening of the through hole 26, the anchor portion 32 can be fitted into the opening and can be stably locked to the organ locking portion 20.

  In the present embodiment, the through hole 26 is formed in the orthogonal direction with respect to the organ locking part 20. In addition, the depth direction of the through hole 26 may be inclined with respect to the thickness direction of the through hole 26 as described in the second embodiment (see FIG. 7). The organ locking part 20 of the present embodiment has a solid rod shape, and the through hole 26 penetrates the organ locking part 20. In addition, when a hollow tubular pipe having an axial hole is used for the organ locking part 20, the through hole 26 may be a through-hole penetrating the organ locking part 20 in the diametrical direction, or reaches the axial hole and is diametrically oriented. Alternatively, non-penetrating side holes may be used.

  In the indwelling organ fixing device 10, the anchor portion 32 is engaged with the thread engaging portion 22, and the suture 30 is inserted into the through hole 26. As shown in FIG. 1A, the thread engaging portion 22 of the present embodiment is an open end on the distal side (lower side) of the through hole 26. In addition, the thread engaging portion 22 may be formed inside the through hole 26.

  The suture thread 30 can advance and retreat through the through hole 26 of the organ locking part 20 through the thread engaging part 22. In the indwelling state, the intersecting direction of the suture thread 30 with respect to the organ locking part 20 may coincide with the depth direction of the through hole 26 or may be different. In the organ fixing device 10 of the present embodiment, the suture 30 is orthogonal to the organ locking portion 20 in the indwelling state, and the extending direction of the straight region 34 of the suture 30 matches the depth direction of the through hole 26. ing. As in the second embodiment, the depth direction of the through hole 26 may be different from the extending direction of the straight region 34 of the suture 30 (see FIG. 7C).

  The organ fixing device 100 includes a puncture needle 130 that accommodates the organ locking portions 20a and 20b, a casing 110 that has a cylindrical shape and holds the proximal end portion of the puncture needle 130, and the organ locking portions 20a and 20b. And a plunger 200 delivered from 130 openings 132. The plunger 200 includes a stem 220 slidably accommodated in the housing 110, a push operation unit 210 formed at the upper end of the stem 220, and a push rod that is attached to the lower end of the stem 220 and is inserted through the puncture needle 130. 230. When the push-in operation unit 210 is pushed down and the push rod 230 is lowered by the length of about one of the organ locking parts 20, the organ locking part 20 (20a) housed on the distal end side of the puncture needle 130 is moved. Is delivered from the opening 132 of the puncture needle 130. Further, when the pushing operation unit 210 is pushed and the push rod 230 is lowered with a stroke of approximately one length of the organ locking unit 20 or more, the organ housed on the proximal end side of the puncture needle 130. The locking portion 20 (20b) is delivered from the opening 132 of the puncture needle 130.

The organ fixing device 100 of this embodiment includes a plurality of sliders 151 and 152. The sliders 151 and 152 are arranged side by side in the vertical direction, and are attached to the housing 110 so as to be able to be pushed individually. The sliders 151 and 152 are engaged with the stem 220 of the plunger 200 in a non-pressed state protruding from the housing 110, and the engagement is released by pushing the sliders 151 and 152 individually, and the stem 220 is moved to the slider 151. -It can pass through 152. More specifically, in the initial state shown in FIG. 2, the stem 220 is locked to one of the slider 151 or 152, and the plunger 200 is restricted from being pushed down. The stem 220 is formed with a large-diameter portion 222 and a small-diameter portion 224. The small-diameter portion 224 can pass through the sliders 151 and 152 regardless of the state of the sliders 151 and 152. The sliders 151 and 152 are engaged. The large diameter portion 222 is formed at a plurality of locations on the stem 220. In FIG. 2 (b), the large-diameter portion 222 on the proximal end side of the stem 220 is illustrated, and the large-diameter portion 222 on the distal end side housed in the housing 110 is not shown. By pushing one of the sliders 151 or 152, the locking of the large diameter portion 222 is released, and the stem 220 and the plunger 200 can be pushed down. Thereby, the organ locking part 20 is delivered from the puncture needle 130.
Further, the large diameter portion 222 of the stem 220 is engaged with the other of the slider 151 or 152 at a position where the plunger 200 is pushed down by a stroke corresponding to approximately one stroke of the organ locking portion 20. As a result, the second organ locking part 20 (20b) is not continuously transmitted after the first organ locking part 20 (20a). Then, by pushing the other of the sliders 151 and 152, the locking of the large diameter portion 222 is released, and the stem 220 and the plunger 200 can be further pushed down. Thereby, the second organ locking part 20 (20b) can be delivered from the puncture needle 130 at a desired position and timing.

  As shown in FIG. 3, the organ locking part 20a is accommodated on the distal end side of the puncture needle 130, and the organ locking part 20b is accommodated on the proximal end side thereof. The puncture needle 130 is provided with a slit 134 connected to the opening 132. The width dimension of the slit 134 is larger than the diameter of the suture thread 30 and smaller than the width dimension of the organ locking part 20. The suture thread 30a connected to the organ locking part 20a is pulled out from the slit 134 of the puncture needle 130 and extends to the proximal end side along the outer surface of the puncture needle 130. The suture thread 30b connected to the organ locking portion 20b is inserted into the puncture needle 130 and drawn into the housing 110 (not shown in FIG. 3) through the proximal end opening 136 of the puncture needle 130. . As shown in FIG. 2A, an opening is formed in the vicinity of the lower end of the housing 110. The suture thread 30b is pulled out of the housing 110 through the thread path 140.

  A holding band 160 is attached around the casing 110. The holding band 160 frictionally holds the sutures 30a and 30b in close contact with the casing 110 so as to be slidable. This prevents the organ locking portions 20a and 20b from falling by their own weight from the puncture needle 130. On the other hand, when the organ locking portions 20a and 20b are delivered from the puncture needle 130 by pushing down the plunger 200, the suture thread 30a and 30b pass through the holding belt 160 with substantially no resistance and are detached from the housing 110.

  As shown in FIGS. 1 and 3, a straight region 34 is formed at the distal end portion of the suture thread 30 adjacent to the proximal end side of the anchor portion 32. Due to the presence of the straight region 34, the organ locking part 20 and the suture thread 30 intersect at a substantially right angle in a state where the anchor part 32 is engaged with the organ locking part 20.

  The accommodated suture 30 is bent before and after passing through the through hole 26 of the organ locking portion 20. That is, a bent portion 36 is formed at the distal end portion of the suture thread 30 adjacent to the proximal end side of the linear region 34. The length of the suture thread 30 from the bent portion 36 to the anchor portion 32 is equal to or longer than the length from the end portion (tip portion 24) in the longitudinal direction of the organ locking portion 20 to the thread engaging portion 22. As a result, as shown in FIG. 3, the anchor portion 32 can be positioned more distal than the distal end portion 24 of the organ locking portion 20 in a state where the bent portion 36 is aligned with the through hole 26. In other words, when the bent portion 36 of the suture 30 is accommodated in the puncture needle 130 in accordance with the through hole 26 of the organ locking portion 20, the anchor portion 32 and the organ locking portion 20 having a diameter larger than that of the suture 30 are combined. The puncture needle 130 can be accommodated at different positions in the proximal direction. Thereby, since the anchor part 32 and the organ locking part 20 can be accommodated in the lumen of the small-diameter puncture needle 130, a minimally invasive procedure is possible.

  The bent portion 36 may be bent in advance on the suture 30 before being accommodated in the puncture needle 130. Alternatively, even when the suture 30 is inserted into the through-hole 26 and accommodated in the puncture needle 130, the suture 30 is folded when the organ fixing device 100 is used, and the bent portion 36 is formed. Good.

  The gap width between the inner peripheral surface of the housing part (puncture needle 130) and the organ locking part 20 is larger than the wire diameter of the suture thread 30 and smaller than the outer diameter of the anchor part 32. As a result, as shown in FIG. 3, the suture thread 30 is accommodated in the puncture needle 130 along the organ locking portion 20, and when the organ locking portion 20 is pushed downward, the anchor portion 32 is moved to the organ locking portion 20. And pushed down by the organ locking part 20 without entering the gap between the puncture needle 130. The outer diameter of the anchor portion 32 is the diameter when the anchor portion 32 is substantially spherical, and when the anchor portion 32 is non-spherical such as a prismatic shape, the anchor portion 32 is projected in the extending direction of the suture thread 30. The smallest dimension. Further, the gap width between the inner peripheral surface of the storage portion (puncture needle 130) and the organ locking portion 20 is the inner peripheral surface of the storage portion and the organ in the case where the transverse cross section (short cross section) of the storage portion is assumed. This is the maximum dimension in the radial direction of the accommodating portion of the gap with the locking portion 20. According to the organ fixing device 100 of the present embodiment, the anchor part 32 cannot enter the gap regardless of the orientation of the anchor part 32, so the anchor part 32 is stably pushed down together with the organ locking part 20. .

  As shown in FIG. 3, in the organ fixing device 100 of the present embodiment, the suture thread in a state where the linear region 34 formed between the anchor portion 32 and the bent portion 36 is along the organ locking portion 20. 30 and the organ locking part 20 are accommodated in the accommodating part (puncture needle 130). In this way, by accommodating the straight region 34 along the organ locking portion 20 in the housing portion (puncture needle 130), the straight shape of the straight region 34 is protected, so that the organ fixing device 10 can be reliably secured in the indwelling state. It is substantially T-shaped.

  FIG. 4 is a partial longitudinal sectional view of the organ fixing device 100 showing an initial state in which the puncture needle 130 is punctured into the body cavity wall 310 and the stomach wall 320. The proximal end side of the organ fixing device 100 is not shown. The organ fixing device 100 according to the present embodiment is used when, for example, the stomach wall 320 is attracted and fixed to the body cavity wall 310, and other organs are fixed to the body cavity wall 310, or organs are fixed to each other. It may be used for procedures.

  The subject is punctured with the puncture needle 130 of the organ fixing device 100 in an initial state in which the plunger 200 is not pushed in and the sliders 151 and 152 are not pushed in. The puncture needle 130 sequentially punctures the body cavity wall 310 and the stomach wall 320 to allow the opening 132 to reach the stomach. In this state, by pushing one of the sliders 151 and 152, the pushing restriction of the plunger 200 is released. Thereafter, the plunger 200 is operated to push down the push rod 230, whereby the organ locking portion 20 a housed on the distal end side of the puncture needle 130 is delivered from the puncture needle 130. The plunger 200 is locked to the other of the sliders 151 and 152 in a state in which the push rod 230 is pushed down by the length of about one of the organ locking portions 20a and the organ locking portion 20a is delivered, and the plunger 200 is locked to the other. Press down is regulated. Then, by pushing the other of the sliders 151 and 152, the plunger 200 and the push rod 230 can be pushed down again. When the plunger 200 is further pushed in from this state, the organ locking portion 20b accommodated on the proximal end side of the puncture needle 130 is delivered from the puncture needle 130.

  FIGS. 5A to 5D are schematic cross-sectional views showing a state in which the organ locking portion 20 (20a) is delivered from the puncture needle 130. FIG.

  As shown in FIG. 5A, the suture thread 30 has a bent portion 36 on the proximal end side of the anchor portion 32. The organ locking part 20 is housed in the housing part (puncture needle 130) in a state of being engaged with the bent part 36. Then, as shown in FIGS. 5B and 5C, the organ locking portion 20 sent to the outside from the housing portion (puncture needle 130) moves to the distal end side of the suture 30, and the anchor portion 32. By engaging, the bent portion 36 is separated from the organ locking portion 20 toward the proximal end side. As a result, the organ fixing device 10 is substantially T-shaped in the indwelling state shown in FIG.

  The bent portion 36 of the suture thread 30 is accommodated in the accommodating portion (puncture needle 130) in a state where it is elastically biased by the organ locking portion 20. Since the through-hole 26 of the present embodiment is formed perpendicular to the longitudinal direction of the organ locking portion 20, the suture thread 30 inserted through the through-hole 26 is sharply bent before and after the through-hole 26 and is organs. Along the locking portion 20. Therefore, the bent portion 36 formed by plastically deforming the suture thread 30 is further elastically deformed and accommodated in the puncture needle 130.

  As shown in FIG. 5 (b), the bent portion 36 of the suture thread 30 applies an elastic restoring force to the organ locking portion 20 in the direction of decreasing the bending angle. The bending angle of the bent portion 36 of the suture thread 30 is an angle formed by the extending direction of the suture thread 30 at the center of the bent portion 36 and the extending direction of the suture thread 30 on the proximal side of the bent portion 36. . The organ locking portion 20 is loaded with moments M 1 and M 2 from the bent portion 36 of the suture 30. On the other hand, moments M3 and M4 are applied to the organ locking part 20 from the puncture needle 130. The organ locking part 20 is limited in rotational movement in the inclination direction (in the direction of the paper surface in FIG. 5B) by the inner wall surface of the puncture needle 130, and the moments M1 to M4 are around the center of gravity of the organ locking part 20. It is balanced.

  When the organ locking part 20 is sent out from the puncture needle 130 by being pushed down by the push rod 230 of the plunger 200, the moments M3 and M4 from the inner wall surface do not act. For this reason, the organ locking part 20 is urged in the inclination direction by the moments M1 and M2 due to the elastic restoring force of the bending part 36 and rotates. As shown in FIG. 5 (c), the rotational force in the inclined direction is changed by the turning force around the suture thread 30 to turn the organ locking portion 20. The turning direction of the organ locking part 20 is determined by the asymmetry of a minute external force acting on the organ locking part 20.

  For this reason, as shown in FIGS. 5C and 5D, the organ locking part 20 sent out vertically downward from the housing part (puncture needle 130) turns around the suture thread 30 while anchoring 32. To fall. The falling organ locking part 20 is indicated by a virtual line. The organ locking part 20 delivered from the puncture needle 130 moves to the distal end side along the suture 30 by the weight of the organ locking part 20 and the elastic restoring force of the bending part 36, and the anchor formed in the straight region 34. Part 32 is reached. As a result, the suture thread 30 rises substantially orthogonally from the organ locking portion 20, and the organ fixing device 10 is placed in a substantially T-shaped indwelling state.

  The same applies to the case where the organ locking portion 20b accommodated on the proximal end side of the puncture needle 130 is delivered. The organ locking part 20b differs from the organ locking part 20a in that the connected suture 30b is inserted into the puncture needle 130, but the organ locking part 20b delivered from the puncture needle 130 is anchored. The turning operation until reaching the part 32 and being in the indwelling state is common to the organ locking part 20a.

  FIG. 6 is a schematic view showing an indwelling state of the organ fixing device 10 of the present embodiment. When the organ fixing device 10 is delivered into the stomach, the puncture needle 130 is withdrawn from the subject. The organ locking part 20 extends along the inner surface of the stomach wall 320, the suture 30 extends upward, and the organ locking part 20 and the suture 30 form a substantially T-shape. The suture thread 30 is removed from the housing 110 (see FIG. 4), and the upper end side of the suture thread 30 remains outside the body cavity wall 310. By pulling the suture thread 30 above the body cavity wall 310, the stomach wall 320 is lifted toward the body cavity wall 310. With the stomach wall 320 drawn to the inner surface of the body cavity wall 310, the suture 30 is fixed on the outer surface of the body cavity wall 310 by a locking tool (not shown) or tied to another suture. Fixed. As a result, the stomach wall 320 is fixed in close contact with the body cavity wall 310.

  By pulling the suture 30 and lifting the stomach wall 320, tension is applied to the suture 30 and the bent portion 36 extends substantially linearly. For this reason, when the suture thread 30 passes through the inside of the puncture hole 330 of the puncture needle 130 formed in the body cavity wall 310 and the stomach wall 320, the bent portion 36 does not become an obstacle. FIG. 6 illustrates a state in which the bent portion 36 is positioned on the surface of the body cavity wall 310 in a state where the stomach wall 320 is in close contact with the body cavity wall 310, but the present invention is not limited to this, and a part or all of the bent portion 36 is punctured. It may be located inside the hole 330.

<Second embodiment>
FIG. 7 is a schematic view showing the organ fixing device 10 of the second embodiment of the present invention. The proximal end side of the suture thread 30 is not shown. FIG. 7A is a front view showing an accommodation state of the organ fixing device 10, FIG. 7B is a sectional view taken along line BB (front) in FIG. 7A, and FIG. 7C shows an indwelling state. It is a front view.

  The organ fixing device 10 of the present embodiment is different from the first embodiment in that the through hole 26 is a long hole extending in the longitudinal direction of the organ locking part 20. The organ fixing device 10 of the present embodiment is also different from the first embodiment in that the through hole 26 is an oblique hole and the depth direction thereof is inclined with respect to the radial direction of the organ locking part 20. . The opening on the distal side of the through hole 26 (below in FIGS. 7A and 7C) is the thread engaging portion 22.

  The organ locking part 20 has two slits 27a and 27b on the distal side (left side of FIG. 7A) and the proximal side (right side of FIG. 7A) from the opposite side in the radial direction. It is further different from the first embodiment in that it is cut with a depth dimension less than half of the thickness of 20. The slits 27a and 27b are smoothly connected to the upper and lower openings of the long hole (through hole 26), respectively, and extend on the opposite side of the organ locking part 20 in the axial direction.

  The depth dimensions of the slits 27 a and 27 b (the vertical dimension in FIG. 7A) are preferably larger than the wire diameter of the suture thread 30. In addition, the width dimension of the slits 27 a and 27 b (the vertical dimension in FIG. 7B) is preferably larger than the wire diameter of the suture thread 30 and smaller than the outer diameter of the anchor portion 32.

  As in the first embodiment, the organ fixing device 10 of the present embodiment is provided with an anchor portion 32 that is provided so as to be able to advance and retreat with respect to the organ locking portion 20 and restricts the advancement of the organ locking portion 20. It is formed at the tip. Further, a linear region 34 is formed adjacent to the proximal end side of the anchor portion 32, and a bent portion 36 is formed adjacent to the proximal end side of the linear region 34. The length of the suture thread 30 from the bent portion 36 to the anchor portion 32 is equal to or longer than the length from the end portion (tip portion 24) in the longitudinal direction of the organ locking portion 20 to the thread engaging portion 22.

  As shown in FIG. 7C, the organ locking portion 20 is moved to the distal end side of the suture thread 30 and the suture engaging portion 22 and the anchor portion 32 are engaged with each other (an indwelling state). The thread 30 is connected so as to rise in a direction intersecting the longitudinal direction of the organ locking portion 20.

Since the through hole 26 is a long hole as in the organ fixing device 10 of the present embodiment, the bending angle of the bent portion 36 of the suture 30 can be made shallower than that of the first embodiment. Thereby, the relative movement between the suture thread 30 and the organ locking part 20 becomes smooth, and the organ fixing device 10 is more reliably transitioned from the housed state of FIG. 7A to the indwelling state of FIG. 7C. Can do. Further, since the through-hole 26 is an oblique hole, the bending angle of the bent portion 36 of the suture thread 30 can be further reduced, and the anchor portion 32 and the suture thread 30 can be placed in the indwelling state shown in FIG. Slightly proximal positions are supported by the distal opening (thread engaging portion 22) of the through hole 26 and the inner edge of the proximal opening, respectively. For this reason, the indwelling organ fixing tool 10 can be stabilized.
Furthermore, by providing slits 27a and 27b that are continuous with the openings at both ends of the through hole 26 (long hole) and extend on the opposite side in the axial direction, as shown in FIG. In the organ fixing device 10, the suture thread 30 can be accommodated in the slits 27a and 27b. Therefore, when accommodating the organ locking part 20 in the puncture needle 130 (see FIG. 3), it is not necessary to increase the diameter of the puncture needle 130 by the diameter of the suture thread 30, in other words, a puncture needle having a small diameter. 130 can be a minimally invasive procedure.

  The present invention is not limited to the above-described embodiment, and includes various modifications and improvements as long as the object of the present invention is achieved.

  For example, in the organ fixing device 10 of each embodiment described above, the suture 30 is inserted in the radial direction of the elongated organ locking portion 20 in the accommodated state, and the bent portion 36 is formed in the suture 30. Although illustrated, this invention is not limited to these. Specifically, each drawing in FIG. 8 is a schematic diagram showing an organ fixing device 10 according to a first modification of the present invention. The proximal end side of the suture thread 30 is not shown. 8 (a) is a plan view showing the accommodation state of the organ fixing device 10, FIG. 8 (b) is a cross-sectional view taken along line BB (front) of FIG. 8 (a), and FIG. 8 (c) is FIG. FIG. 8D is a front view showing an indwelling state of the organ fixing device 10.

  In the organ fixing device 10 of the first modification, the suture thread 30 is inserted in the axial direction of the organ locking portion 20 in the accommodated state, and the bent portion 36 is not formed on the proximal end side of the anchor portion 32. This is different from the above embodiments. The organ locking part 20 has two slits 27a and 27b on the distal side (left side in FIG. 8A) and the proximal side (right side in FIG. 8A) from the opposite side in the radial direction. It is cut with a depth dimension exceeding half of the thickness of 20. Thereby, the suture thread 30 can be inserted in the axial direction of the organ locking part 20 in the accommodated state. The slits 27 a and 27 b partially overlap in the axial direction of the organ locking part 20 so as to share the through hole 26 provided in the center of the organ locking part 20 in the axial direction. The thread engaging portion 22 is the lower end of the through hole 26.

  When the organ locking part 20 is delivered from the puncture needle 130 of the organ fixing device 100 (see FIG. 4), the organ locking part 20 rotates with its own weight around the through hole 26 with respect to the suture thread 30. Thereby, the suture thread 30 is accommodated in the through hole 26 and connected so as to rise in the crossing direction (radial direction) with respect to the longitudinal direction of the organ locking portion 20. Then, the anchor portion 32 engages with the thread engaging portion 22 and becomes a substantially T-shaped organ fixing device 10 shown in FIG.

  In the organ fixing device 10 of each of the embodiments and the first modified example, the through hole 26 that is formed in the radial direction with respect to the organ locking portion 20 is formed, and the suture thread 30 is inserted. However, the present invention is not limited thereto, and the suture thread 30 is not located inside the hole of the organ locking part 20 but around the organ locking part 20. You may pass through the stop 20 so as to be able to advance and retract. Specifically, each drawing of FIG. 9 is a schematic view showing an organ fixing device 10 of a second modification of the present invention. The proximal end side of the suture thread 30 is not shown. FIG. 9A is a front view showing an accommodation state of the organ fixing device 10, FIG. 9B is a plan view showing the accommodation state, and FIG. 9C is a front view showing an indwelling state.

The organ fixing device 10 of the second modification has a loop portion 50 at the tip of the suture thread 30, and the suture thread 30 is attached to the organ locking portion by attaching the loop portion 50 around the organ locking portion 20. 20 is different from the above-described embodiments and the first modification. A thread engagement portion 22 is formed as a narrow-diameter neck at the central portion of the organ locking portion 20 in the axial direction. The loop portion 50 is made of an oval plate or the like and has a predetermined rigidity. The loop portion 50 does not substantially increase in diameter in the width direction of the organ locking portion 20 (vertical direction in FIG. 9B). Flexibility to bend out. The material of the loop portion 50 is not particularly limited, but from the viewpoint of reducing the load on the stomach wall 320, a resin material similar to the suture thread 30 such as nylon may be used, or a soft resin having a durometer hardness lower than that of the suture thread 30. Materials may be used. The loop portion 50 can be formed by molding the above resin material into a plate shape.
The short diameter dimension of the loop part 50 is larger than the outer diameter of the thread engaging part 22 and smaller than the outer diameter of the large diameter part of the organ locking part 20 excluding the thread engaging part 22. The major axis dimension of the loop part 50 is arbitrary. The length of the suture thread 30 (loop part 50) from the bent part 36 to the anchor part 32 is shorter than the length from the end part (tip part 24) in the longitudinal direction of the organ locking part 20 to the thread engaging part 22. Or equivalent or better.
The loop part 50 has a straight region 34 and a bent part 36, and the tip of the loop part 50 corresponds to the anchor part 32. The small-diameter thread engaging portion 22 is inserted into the loop portion 50 and can advance and retreat along the loop portion 50. The bent portion 36 of the suture thread 30 (loop portion 50) is housed in the housing portion (puncture needle 130) while being elastically biased by the organ locking portion 20.

  When the organ locking part 20 is delivered from the puncture needle 130 of the organ fixing device 100 (see FIG. 4), the organ locking part 20 rotates with respect to the suture thread 30 by its own weight and the elastic restoring force of the bending part 36. . As a result, the thread engaging portion 22 is advanced and engaged with the anchor portion 32 of the loop portion 50, and the suture thread 30 (the loop portion 50) rises in a crossing direction (radial direction) with respect to the longitudinal direction of the organ locking portion 20. So that they are connected. Thereby, as shown in FIG.9 (c), the organ fixing tool 10 becomes a substantially T shape, and is detained.

  In the organ fixing device 10 according to the embodiment and the modification described above, the anchor part 32 is engaged with the distal end side of the organ locking part 20 in the housed state, but the present invention is not limited to this.

  FIG. 10 is a cross-sectional view schematically showing an accommodation state of the organ fixing device 10 according to the third modified example of the present invention. The proximal end side (the right side in FIG. 10) of the suture 30 and the puncture needle 130 is not shown.

  The organ locking part 20 of the present modification includes a housing part 28 that houses at least a part of the anchor part 32. The accommodating portion 28 is provided at a position different from the thread engaging portion 22 in the longitudinal direction of the organ locking portion 20 (left and right direction in FIG. 10). A bent portion 36 is formed at the distal end portion of the suture thread 30 adjacent to the proximal end side of the linear region 34. The length of the suture thread 30 from the bent portion 36 to the anchor portion 32 is equal to the length from the accommodating portion 28 to the thread engaging portion 22 in the organ locking portion 20.

  According to this modification, the organ fixing device 10 can be accommodated in the puncture needle 130 in a state where the anchor portion 32 is accommodated in the accommodating portion 28 of the organ locking portion 20. For this reason, the organ locking part 20 and the anchor part 32 can be accommodated inside the puncture needle 130 having a limited inner diameter. According to the organ fixing device 10 of this modification, the anchor portion 32 is housed in the housing portion 28 and protected by the organ locking portion 20, so that the force pushing the plunger 200 and the push rod 230 is substantially applied to the anchor portion 32. Is not loaded. For this reason, unexpected plastic deformation is prevented from occurring in the suture thread 30 (straight region 34) in the vicinity of the anchor portion 32, and the organ fixing device 10 can be reliably made substantially T-shaped in the indwelling state.

  The accommodating portion 28 of the present modification is a concave portion cut in the thickness direction of the organ locking portion 20 from one or more peripheral surfaces of the rod-shaped organ locking portion 20. The maximum value of the thickness dimension (dimension in the direction perpendicular to the longitudinal direction of the organ locking part 20) of the organ locking part 20 and the anchor part 32 in a state where the anchor part 32 is fitted in the housing part 28 is It is less than the content of puncture needle 130. The accommodating portion 28 may be a bottomed recess formed by engraving a part of the thickness of the organ locking portion 20 or may be a through-hole penetrating the organ locking portion 20. In the present modification shown in FIG. 10, the accommodating portion 28 is provided on the distal end side (left side in FIG. 10) of the thread engaging portion 22 (through hole 26). Thereby, the bending angle of the bending part 36 which passes the through-hole 26 can be made shallow. Instead of this modification, a thin stepped portion may be formed on the distal end side of the organ locking portion 20 as the accommodating portion 28, and the anchor portion 32 may be engaged with the stepped portion and accommodated in the puncture needle 130.

  In a state where the anchor portion 32 is accommodated in the accommodating portion 28, the straight region 34 extends along the organ locking portion 20. Thereby, the dimension in the longitudinal direction from the accommodating portion 28 to the through hole 26 (yarn engaging portion 22) is substantially equal to the length of the linear region 34.

  In this modification, the accommodating portion 28 is cut into a surface different from the surface (upper and lower surfaces in FIG. 10) in which the opening of the through hole 26 is formed. When the surface on which the through-hole 26 is opened is the main surface and the side surface on which the accommodating portion 28 is formed, the main surface has a larger width dimension than the side surface. In other words, the thickness dimension (vertical dimension in FIG. 10) with respect to the main surface of the organ locking part 20 is smaller than the thickness dimension with respect to the side surface (depth dimension in FIG. 10). Thereby, according to this modification, while the depth dimension of the through-hole 26 can be reduced, the depth dimension of the accommodating part 28 can be enlarged sufficiently, and the anchor part 32 can be accommodated suitably.

  However, instead of this modification, the accommodating portion 28 may be formed on the main surface of the organ locking portion 20, and the accommodating portion 28 is provided on the proximal end side with respect to the thread engaging portion 22 (through hole 26). May be.

  In the organ fixture 10 according to the first to third modifications, the linear region 34 is also formed adjacent to the proximal end side of the anchor portion 32 that restricts the advancement of the organ locking portion 20. Thereby, when the anchor part 32 engages with the organ locking part 20 and the organ fixing device 10 is in the indwelling state, the straight region 34 of the suture 30 rises from the organ locking part 20 at a substantially right angle. The organ fixing device 10 is surely substantially T-shaped and locked to the organ.

Each said embodiment and each modification include the following technical thoughts.
(1) An elongated organ locking portion, and a suture thread connected to the organ locking portion so as to be able to advance and retreat, and a distal end portion of the suture with respect to the organ locking portion. An organ fixture having an anchor portion that is provided so as to be capable of advancing and retreating and that restricts movement of the organ locking portion toward the distal end side.
(2) The organ locking portion includes a thread engaging portion that allows the suture to pass through, and the suture moves the organ locking portion to a distal end side of the suture to thereby form the thread engaging portion. The organ fixing device according to the above (1), which is connected so as to stand up in a direction crossing the longitudinal direction of the organ locking portion in a state where the anchor portion and the anchor portion are engaged.
(3) The organ fixing device according to (2), wherein a linear region is formed adjacent to the proximal end side of the anchor portion at the distal end portion of the suture thread.
(4) A bent portion is formed adjacent to the proximal end side of the linear region at the distal end portion of the suture, and the length of the suture from the bent portion to the anchor portion is the organ The organ fixing device according to the above (3), which is equal to or longer than the length from the longitudinal end of the locking portion to the thread engaging portion.
(5) The organ locking part includes a storage part that stores at least a part of the anchor part at a position different from the thread engagement part in the longitudinal direction of the organ locking part, The distal end portion is formed with a bent portion adjacent to the proximal end side of the linear region, and the length of the suture from the bent portion to the anchor portion is from the accommodating portion in the organ locking portion. The organ fixing device according to (3), which is equivalent to a length up to the thread engaging portion.
(6) The thread engaging portion is formed with an opening formed in a radial direction with respect to the organ locking portion, and an outer diameter of the anchor portion of the suture is set to be equal to that of the through hole. The organ fixing tool according to any one of (2) to (5) above, wherein the organ fixing tool is larger than an inner diameter, and the suture thread is inserted through the through hole and retained by the anchor portion.
(7) The organ fixing device according to (6), wherein the through hole is a long hole extending in a longitudinal direction of the organ locking portion.
(8) The organ fixing device according to (6) or (7), wherein the through hole is an oblique hole whose depth direction is inclined with respect to a radial direction of the organ locking portion.
(9) A suture thread in which an elongated organ locking portion and an anchor portion that is connected to the organ locking portion so as to be able to advance and retreat and restrict movement of the organ locking portion toward the distal end are formed at the distal end portion. An organ fixing device including: an accommodating portion that accommodates the organ retaining portion; and a delivery mechanism that delivers the organ retaining portion to the outside from the accommodating portion. An organ fixing device, wherein the organ fixing device is housed in the housing portion in a state where the suture thread is engaged with a position closer to a proximal end side than the anchor portion.
(10) The suture has a bent portion on the proximal end side of the anchor portion, and the organ locking portion is accommodated in the accommodating portion in a state of being engaged with the bent portion. (9) The organ locking portion delivered to the distal end moves toward the distal end side of the suture and engages with the anchor portion, whereby the bent portion is separated from the organ locking portion toward the proximal end side. An organ fixing device according to 1.
(11) The organ fixing device according to (10), wherein the bent portion of the suture is housed in the housing portion in a state of being elastically biased by the organ locking portion.
(12) The suture includes a straight region between the anchor portion and the bent portion, and the suture and the organ locking in a state in which the straight region is aligned with the organ locking portion. The organ fixing device according to (10) or (11), wherein a part is housed in the housing part.
(13) Any one of (9) to (12) above, wherein the organ locking portion that is sent vertically downward from the housing portion falls to the anchor portion while turning around the suture thread. The organ fixing device according to claim 1.
(14) A plurality of the organ fixing devices each including the organ locking portion and the suture thread, wherein one of the organ locking portions is located between the other adjacent organ locking portions. The organ fixing device according to any one of (9) to (13), which is inserted and housed in the housing portion.
(15) The organ fixing device according to (14), wherein a gap width between the inner peripheral surface of the accommodating portion and the organ locking portion is larger than a wire diameter of the suture and smaller than an outer diameter of the anchor portion. .

10, 10a, 10b: organ fixing tools 20, 20a, 20b: organ locking part 22: thread engaging part 24: tip part 26: through hole 27a, 27b: slit 28: accommodating part 30, 30a, 30b: suture 32: Anchor part 34: Straight region 36: Bending part 50: Loop part 100: Organ fixing device 110: Housing 130: Puncture needle 132: Opening 134: Slit 136: Proximal opening 140: Yarn path 151, 152: Slider 160 : Holding band 200: Plunger 210: Pushing operation part 220: Stem 222: Large diameter part 224: Small diameter part 230: Push rod 310: Body cavity wall 320: Stomach wall 330: Puncture holes M1 to M4: Moment

Claims (10)

An organ locking portion having an elongated shape, and a suture thread connected to the organ locking portion so as to be able to advance and retreat,
An anchor portion that is provided at the distal end portion of the suture so as to be capable of advancing and retreating with respect to the organ locking portion and restricts the organ locking portion from moving toward the distal end side of the suture is formed .
The organ locking portion has a thread engaging portion that allows the suture to pass through,
The suture is in a direction intersecting with the longitudinal direction of the organ locking portion in a state where the organ locking portion is moved to the distal end side of the suture and the thread engaging portion and the anchor portion are engaged. Connected to stand up,
A linear region is formed adjacent to the proximal end side of the anchor portion at the distal end portion of the suture,
The distal end portion of the suture has a bent portion adjacent to the proximal end side of the linear region, and the length of the suture from the bent portion to the anchor portion is the organ locking portion. An organ fixing device having a length equal to or longer than a length from an end portion in a longitudinal direction to the thread engaging portion . An organ locking portion having an elongated shape, and a suture thread connected to the organ locking portion so as to be able to advance and retreat,
An anchor portion that is provided at the distal end portion of the suture so as to be capable of advancing and retreating with respect to the organ locking portion and restricts the organ locking portion from moving toward the distal end side of the suture is formed .
The organ locking portion has a thread engaging portion that allows the suture to pass through,
The suture is in a direction intersecting with the longitudinal direction of the organ locking portion in a state where the organ locking portion is moved to the distal end side of the suture and the thread engaging portion and the anchor portion are engaged. Connected to stand up,
A linear region is formed adjacent to the proximal end side of the anchor portion at the distal end portion of the suture,
The organ locking part includes an accommodating part that accommodates at least a part of the anchor part at a position different from the thread engaging part in the longitudinal direction of the organ locking part,
The distal end portion of the suture has a bent portion adjacent to the proximal end side of the linear region, and the length of the suture from the bent portion to the anchor portion is the organ locking portion. An organ fixing tool having a length equal to a length from the housing part to the thread engaging part in An organ locking portion having an elongated shape, and a suture thread connected to the organ locking portion so as to be able to advance and retreat,
An anchor portion that is provided at the distal end portion of the suture so as to be capable of advancing and retreating with respect to the organ locking portion and restricts the organ locking portion from moving toward the distal end side of the suture is formed .
The organ locking portion has a thread engaging portion that allows the suture to pass through,
The suture is in a direction intersecting with the longitudinal direction of the organ locking portion in a state where the organ locking portion is moved to the distal end side of the suture and the thread engaging portion and the anchor portion are engaged. Connected to stand up,
The thread engagement portion is formed with an opening formed in a crossing direction with respect to the longitudinal direction of the organ locking portion,
The outer diameter of the anchor portion of the suture is larger than the inner diameter of the through-hole, and the suture is inserted into the through-hole and secured by the anchor portion.
The organ fixing tool , wherein the through hole is a long hole whose longitudinal direction is the longitudinal direction of the organ locking portion . An organ locking portion having an elongated shape, and a suture thread connected to the organ locking portion so as to be able to advance and retreat,
An anchor portion that is provided at the distal end portion of the suture so as to be capable of advancing and retreating with respect to the organ locking portion and restricts the organ locking portion from moving toward the distal end side of the suture is formed .
The organ locking portion has a thread engaging portion that allows the suture to pass through,
The suture is in a direction intersecting with the longitudinal direction of the organ locking portion in a state where the organ locking portion is moved to the distal end side of the suture and the thread engaging portion and the anchor portion are engaged. Connected to stand up,
The thread engagement portion is formed with an opening formed in a crossing direction with respect to the longitudinal direction of the organ locking portion,
The outer diameter of the anchor portion of the suture is larger than the inner diameter of the through-hole, and the suture is inserted into the through-hole and secured by the anchor portion.
The organ fixing tool, wherein the through hole is an oblique hole whose depth direction is inclined with respect to a direction orthogonal to the longitudinal direction of the organ locking portion . An elongated organ locking portion and a suture, and the suture is movably connected to the organ locking portion and restricts the organ locking portion from moving toward the distal end side of the suture. anchor unit for is formed on the tip portion, and the organ-fixing instrument,
An accommodating portion for accommodating the organ locking portion;
A delivery mechanism for delivering the organ locking part from the housing part to the outside, and
The organ locking part is housed in the housing part in a state of being engaged with the suture thread at a position closer to the proximal side than the anchor part,
The suture has a bent portion on the proximal end side of the anchor portion, and the organ locking portion is accommodated in the accommodating portion while being engaged with the bent portion, and is sent out from the accommodating portion to the outside. Further, the organ locking portion moves toward the distal end side of the suture thread and engages with the anchor portion, whereby the bent portion is separated from the organ locking portion toward the proximal end side. apparatus. The organ fixing device according to claim 5 , wherein the bent portion of the suture is housed in the housing portion in a state of being elastically biased by the organ locking portion. The organ locking part is housed in the housing part by being biased in a tilting direction by a moment due to an elastic restoring force of the bent part,
The organ locking portion sent vertically downwardly from said receiving portion, said pivots to the inclined direction, according to claim 6, characterized in that falling to the anchor portion while swirling around the suture Organ fixation device. A straight region is formed between the anchor portion and the bent portion in the suture, and the suture and the organ locking portion are in the state where the straight region is aligned with the organ locking portion. The organ fixing device according to claim 6 or 7 , which is accommodated in the accommodating portion. Each including an elongated organ locking portion and a suture, wherein the suture is connected to the organ locking portion so as to be able to advance and retreat, and the organ locking portion moves toward the distal end side of the suture. A plurality of organ fixing devices , wherein the anchor portion to be regulated is formed at the distal end portion;
An accommodating portion for accommodating a plurality of the organ locking portions;
A delivery mechanism for delivering the organ locking part from the housing part to the outside, and
The organ locking part is housed in the housing part in a state of being engaged with the suture thread at a position closer to the proximal side than the anchor part,
One organ locking part is housed in the housing part with the anchor part interposed between other organ locking parts adjacent to each other. The organ fixing device according to claim 9 , wherein a gap width between an inner peripheral surface of the housing portion and the organ locking portion is larger than a wire diameter of the suture thread and smaller than an outer diameter of the anchor portion.

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