JPH0630945A - 縫合器 - Google Patents
縫合器Info
- Publication number
- JPH0630945A JPH0630945A JP5117190A JP11719093A JPH0630945A JP H0630945 A JPH0630945 A JP H0630945A JP 5117190 A JP5117190 A JP 5117190A JP 11719093 A JP11719093 A JP 11719093A JP H0630945 A JPH0630945 A JP H0630945A
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- Prior art keywords
- cartridge
- suturing
- staple
- anvil
- tissue
- Prior art date
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Abstract
(57)【要約】
【目的】例えば、経皮的に体腔内に挿入して体腔内組織
を縫合、切断する際に、その被縫合部に対して縫合部材
を容易にアプローチでき、操作性が簡単で、安全かつ確
実に縫合できる縫合器を提供することにある。 【構成】操作部1と、この操作部1に設けられた挿入部
2と、この挿入部2の先端部に設けられ複数のステープ
ルを収納するカートリッジ3およびこのカートリッジ3
に対向するアンビル4とからなる縫合部5と、前記ステ
ープルを組織へ打出し留置させるステープル放出手段と
してのプッシャとを具備した縫合器において、プッシャ
の少なくとも一部は、前記挿入部2または縫合部5の形
状に追従して変形可能に可撓性を有することを特徴とす
る。
を縫合、切断する際に、その被縫合部に対して縫合部材
を容易にアプローチでき、操作性が簡単で、安全かつ確
実に縫合できる縫合器を提供することにある。 【構成】操作部1と、この操作部1に設けられた挿入部
2と、この挿入部2の先端部に設けられ複数のステープ
ルを収納するカートリッジ3およびこのカートリッジ3
に対向するアンビル4とからなる縫合部5と、前記ステ
ープルを組織へ打出し留置させるステープル放出手段と
してのプッシャとを具備した縫合器において、プッシャ
の少なくとも一部は、前記挿入部2または縫合部5の形
状に追従して変形可能に可撓性を有することを特徴とす
る。
Description
【0001】
【産業上の利用分野】この発明は、腹壁等を貫通して体
腔内に挿入し、体腔内の生体組織を縫合する縫合器に関
する。
腔内に挿入し、体腔内の生体組織を縫合する縫合器に関
する。
【0002】
【従来の技術】例えば、胆のう結石手術等において、再
発防止のために胆のうごと摘出手術を行う場合、胆管と
胆のう管との接続部を切断するが、この胆のう管には胆
のう動脈、胆のう静脈が通っているため、胆のう管をナ
イフ等によって切断すると同時に縫合する必要がある。
発防止のために胆のうごと摘出手術を行う場合、胆管と
胆のう管との接続部を切断するが、この胆のう管には胆
のう動脈、胆のう静脈が通っているため、胆のう管をナ
イフ等によって切断すると同時に縫合する必要がある。
【0003】このような胆のう結石手術等においては腹
壁等を貫通して体腔内に挿入して体腔内の組織を縫合す
る縫合器が用いられている。この種の縫合器には従来、
例えば実公昭38−19282号公報、実公昭60−4
1924号公報および特開平3−12126号公報等で
知られている。
壁等を貫通して体腔内に挿入して体腔内の組織を縫合す
る縫合器が用いられている。この種の縫合器には従来、
例えば実公昭38−19282号公報、実公昭60−4
1924号公報および特開平3−12126号公報等で
知られている。
【0004】実公昭38−19282号公報は、外科的
に胃の縫合に使用される縫合器であり、ステープルとス
テープル押出し機構を有するステープル把持部材とアン
ビル部材からなり、両者ともその形状が胃の大湾に沿う
ように湾曲しており、ステープル把持部材の末端のヒン
ジピンによってアンビル部材と開閉自在に接続されてい
る。
に胃の縫合に使用される縫合器であり、ステープルとス
テープル押出し機構を有するステープル把持部材とアン
ビル部材からなり、両者ともその形状が胃の大湾に沿う
ように湾曲しており、ステープル把持部材の末端のヒン
ジピンによってアンビル部材と開閉自在に接続されてい
る。
【0005】実公昭60−41924号公報は、外科的
に癌核を縫合する縫合器であり、鋏状の結紮器本体で、
本体に支点を挟んだ一方を挟持部、他方を柄として十分
に長く形成し、嘴状に腹部が向い合い、一方にステープ
ルを保持し、他方がアンビルからなり、患部に合わせて
湾曲している挟持部からなり、前記柄を開閉することに
より開閉自在に設けられている。
に癌核を縫合する縫合器であり、鋏状の結紮器本体で、
本体に支点を挟んだ一方を挟持部、他方を柄として十分
に長く形成し、嘴状に腹部が向い合い、一方にステープ
ルを保持し、他方がアンビルからなり、患部に合わせて
湾曲している挟持部からなり、前記柄を開閉することに
より開閉自在に設けられている。
【0006】特開平3−12126号公報は、経皮的に
体腔内に挿入され、体腔内組織を縫合する縫合器で、挿
入部と、この挿入部の先端部に開閉自在に設けられ一方
がアンビル、他方がステープルを保持するカートリッジ
からなる縫合部材と、前記挿入部の先端部に設けられカ
ートリッジからステープルを打出すファイリングレバー
と、縫合部材を開閉せしめる縫合開閉レバーとから構成
されている。
体腔内に挿入され、体腔内組織を縫合する縫合器で、挿
入部と、この挿入部の先端部に開閉自在に設けられ一方
がアンビル、他方がステープルを保持するカートリッジ
からなる縫合部材と、前記挿入部の先端部に設けられカ
ートリッジからステープルを打出すファイリングレバー
と、縫合部材を開閉せしめる縫合開閉レバーとから構成
されている。
【0007】
【発明が解決しようとする課題】ところで、実公昭38
−19282号公報は、アンビルとステープル保持部材
のみで構成され、挿入部を持ってないため、経皮的に体
腔内に挿入できない。また、縫合部材に組織を切断する
切断手段がないため、組織を切断するときには別途切断
器を用意しなくてはならない。
−19282号公報は、アンビルとステープル保持部材
のみで構成され、挿入部を持ってないため、経皮的に体
腔内に挿入できない。また、縫合部材に組織を切断する
切断手段がないため、組織を切断するときには別途切断
器を用意しなくてはならない。
【0008】実公昭60−41924号公報は、体腔内
に経皮的に挿入して使用する際、縫合部材の開閉のため
の柄を開閉できるように体腔壁(腹壁、胸壁等)を切開
しなければならないため、侵襲が大きく、また切断手段
がないため、別途切断器を用意しなくてはならない。
に経皮的に挿入して使用する際、縫合部材の開閉のため
の柄を開閉できるように体腔壁(腹壁、胸壁等)を切開
しなければならないため、侵襲が大きく、また切断手段
がないため、別途切断器を用意しなくてはならない。
【0009】特開平3−12126号公報は、縫合部材
が挿入部の中心軸に対してストレートに形成されてい
る。したがって、体腔内に癒着部があり、腔間が狭い時
には縫合部材をアプローチしにくく、また組織縫合部が
挿入部の軸方向に存在しない場合、別途把持鉗子等によ
って組織を縫合部材に挿入、把持してやらなければなら
ない。
が挿入部の中心軸に対してストレートに形成されてい
る。したがって、体腔内に癒着部があり、腔間が狭い時
には縫合部材をアプローチしにくく、また組織縫合部が
挿入部の軸方向に存在しない場合、別途把持鉗子等によ
って組織を縫合部材に挿入、把持してやらなければなら
ない。
【0010】このように従来の縫合器は、いずれも操作
性が悪く、別の処置具が必要になったり、手術時間が長
くかかり、患者に与える負担が大きいという問題があ
る。また、USP5040715の縫合装置は、トラカ
ールに挿入可能な直径を有する細長い挿入部の先端に、
ステープル列とカッターが設けられた処置部があり、後
端側にはこの装置を把持、挿作する把持部が設けられて
いる。
性が悪く、別の処置具が必要になったり、手術時間が長
くかかり、患者に与える負担が大きいという問題があ
る。また、USP5040715の縫合装置は、トラカ
ールに挿入可能な直径を有する細長い挿入部の先端に、
ステープル列とカッターが設けられた処置部があり、後
端側にはこの装置を把持、挿作する把持部が設けられて
いる。
【0011】前記処置部と挿入部は直線状をなしてお
り、挿入部から処置部の方へ移動し、ステープルを放出
したり、カッターを走らせるための部材をその内部に有
している。
り、挿入部から処置部の方へ移動し、ステープルを放出
したり、カッターを走らせるための部材をその内部に有
している。
【0012】しかしながら、図33に示すように、内視
鏡下処置を行う場合、体壁aに設けられた小孔または小
切開部bを通して前記縫合装置cを挿入するため、目的
の臓器dに対しての処置部eのアプローチ角度の自由度
が少なく、同図(b)のように、B−B線またはC−C
線で切離を行おうとしても、同図(a)から解るように
A−A線でしか切離できない。B−B線で切離したい場
合には、A−A線となることにより、余分な部分を切ら
なければならない。また、C−C線で切りたい場合に
は、開腹手術をせざるを得ない。
鏡下処置を行う場合、体壁aに設けられた小孔または小
切開部bを通して前記縫合装置cを挿入するため、目的
の臓器dに対しての処置部eのアプローチ角度の自由度
が少なく、同図(b)のように、B−B線またはC−C
線で切離を行おうとしても、同図(a)から解るように
A−A線でしか切離できない。B−B線で切離したい場
合には、A−A線となることにより、余分な部分を切ら
なければならない。また、C−C線で切りたい場合に
は、開腹手術をせざるを得ない。
【0013】また、図34のような場合、肺fに発生し
た腫瘍gをD−D線に沿って切り取りたいが、ステープ
ルを放出したり、カッターを走らせるための処置部eと
挿入部hは直線状であるため、E−Eのように切らざる
を得ず、必要以上に切離を行わざるを得ない。
た腫瘍gをD−D線に沿って切り取りたいが、ステープ
ルを放出したり、カッターを走らせるための処置部eと
挿入部hは直線状であるため、E−Eのように切らざる
を得ず、必要以上に切離を行わざるを得ない。
【0014】この発明は、前記事情に着目してなされた
もので、その目的とするところは、経皮的に体腔内に挿
入して体腔内組織を縫合、切断する際に、その組織縫合
部に対して縫合部を容易にアプローチでき、操作性が簡
単で、安全かつ確実に縫合でき、また手術時間を短縮す
ることができる縫合器を提供することにある。
もので、その目的とするところは、経皮的に体腔内に挿
入して体腔内組織を縫合、切断する際に、その組織縫合
部に対して縫合部を容易にアプローチでき、操作性が簡
単で、安全かつ確実に縫合でき、また手術時間を短縮す
ることができる縫合器を提供することにある。
【0015】
【課題を解決するための手段】この発明は前記目的を達
成するために、請求項1は、操作部と、この操作部に接
続された挿入部と、この挿入部の先端部に設けられ複数
のステープルを収納する第1の挟持部材およびこの第1
の挟持部材に対向する第2の挟持部材とからなる縫合部
と、前記ステープルを組織へ打出し留置させるステープ
ル放出手段とを具備した縫合器において、ステープル放
出手段の少なくとも一部は、前記挿入部または縫合部の
形状に追従して変形可能に可撓性を有することを特徴と
する。
成するために、請求項1は、操作部と、この操作部に接
続された挿入部と、この挿入部の先端部に設けられ複数
のステープルを収納する第1の挟持部材およびこの第1
の挟持部材に対向する第2の挟持部材とからなる縫合部
と、前記ステープルを組織へ打出し留置させるステープ
ル放出手段とを具備した縫合器において、ステープル放
出手段の少なくとも一部は、前記挿入部または縫合部の
形状に追従して変形可能に可撓性を有することを特徴と
する。
【0016】請求項2は、操作部と、この操作部に接続
された挿入部と、この挿入部の先端部に設けられ複数の
ステープルを収納する第1の挟持部材およびこの第1の
挟持部材に対向する第2の挟持部材とからなる縫合部
と、前記ステープルを組織へ打出し留置させるステープ
ル放出手段とを具備した縫合器において、前記挿入部ま
たは縫合部の少なくとも一方には湾曲部が形成され、前
記ステープル放出手段の少なくとも一部は、前記湾曲部
の形状に追従して変形可能に可撓性を有することを特徴
とする。
された挿入部と、この挿入部の先端部に設けられ複数の
ステープルを収納する第1の挟持部材およびこの第1の
挟持部材に対向する第2の挟持部材とからなる縫合部
と、前記ステープルを組織へ打出し留置させるステープ
ル放出手段とを具備した縫合器において、前記挿入部ま
たは縫合部の少なくとも一方には湾曲部が形成され、前
記ステープル放出手段の少なくとも一部は、前記湾曲部
の形状に追従して変形可能に可撓性を有することを特徴
とする。
【0017】
【作用】例えば、挿入部の先端部に設けた縫合部を経皮
的に体腔内に挿入し、縫合部を被縫合部に位置決めし、
第1と第2の挟持部材によって被縫合部を挟持し、ステ
ープル放出手段によってステープルを組織内に打出し、
そのステープルを留置して組織を縫合する。
的に体腔内に挿入し、縫合部を被縫合部に位置決めし、
第1と第2の挟持部材によって被縫合部を挟持し、ステ
ープル放出手段によってステープルを組織内に打出し、
そのステープルを留置して組織を縫合する。
【0018】
【実施例】以下、この発明の各実施例を図面に基づいて
説明する。図1〜図8は第1の実施例で、図1は縫合器
の全体構成を示す。1は操作部本体で、この操作部本体
1には挿入部2の基端部が矢印方向に回転自在に連結さ
れている。挿入部2の先端部には第1の挟持部材として
のカートリッジ3と第2の挟持部材としてのアンビル4
とからなる縫合部5が設けられている。操作部本体1に
は縫合部5を開閉する開閉操作部6とステープル操作部
7が設けられている。
説明する。図1〜図8は第1の実施例で、図1は縫合器
の全体構成を示す。1は操作部本体で、この操作部本体
1には挿入部2の基端部が矢印方向に回転自在に連結さ
れている。挿入部2の先端部には第1の挟持部材として
のカートリッジ3と第2の挟持部材としてのアンビル4
とからなる縫合部5が設けられている。操作部本体1に
は縫合部5を開閉する開閉操作部6とステープル操作部
7が設けられている。
【0019】図2〜図7に示すように、前記挿入部2
は、内筒8とこの内筒8に対して軸方向に進退自在に嵌
合された外筒9とから構成されている。この内筒8の先
端部における両側部には広角V字状のばね材からなる一
対の継手10の基端部が枢支され、これら継手10の先
端部間には内筒8と直交する方向にヒンジピン11が架
設されている。このヒンジピン11の両端部は外筒9の
側壁に設けられた略T字状のスリット12に挿入され、
外筒9の進退時および継手10の上下時のガイド部を形
成している。
は、内筒8とこの内筒8に対して軸方向に進退自在に嵌
合された外筒9とから構成されている。この内筒8の先
端部における両側部には広角V字状のばね材からなる一
対の継手10の基端部が枢支され、これら継手10の先
端部間には内筒8と直交する方向にヒンジピン11が架
設されている。このヒンジピン11の両端部は外筒9の
側壁に設けられた略T字状のスリット12に挿入され、
外筒9の進退時および継手10の上下時のガイド部を形
成している。
【0020】さらに、内筒8の先端部における上部内面
には係合凹部13が設けられているとともに、この係合
凹部13の近傍に位置する先端には前方に突出する突出
片14が設けられ、この突出片14の上面には板ばね1
5が設けられている。
には係合凹部13が設けられているとともに、この係合
凹部13の近傍に位置する先端には前方に突出する突出
片14が設けられ、この突出片14の上面には板ばね1
5が設けられている。
【0021】一方、前記カートリッジ3の基端部には基
端側に開口するL字状のヒンジ溝16が設けられ、この
ヒンジ溝16には開口から挿入することにより、前記ヒ
ンジピン11が上下方向に回動自在および着脱自在に係
合されている。
端側に開口するL字状のヒンジ溝16が設けられ、この
ヒンジ溝16には開口から挿入することにより、前記ヒ
ンジピン11が上下方向に回動自在および着脱自在に係
合されている。
【0022】また、前記アンビル4の基端部の上面には
前記係合凹部13に係合する係合凸部17が設けられ、
アンビル4の基端部の下面は前記板ばね15に弾性的に
圧接されている。つまり、板ばね15の弾性押圧力によ
ってアンビル4の係合凸部17を係合凹部13に係合す
る方向に付勢している。
前記係合凹部13に係合する係合凸部17が設けられ、
アンビル4の基端部の下面は前記板ばね15に弾性的に
圧接されている。つまり、板ばね15の弾性押圧力によ
ってアンビル4の係合凸部17を係合凹部13に係合す
る方向に付勢している。
【0023】したがって、前記挿入部2の内筒8にはカ
ートリッジ3とアンビル4がその基端部を支点として上
下方向に回動(開閉)自在であり、カートリッジ3は継
手10の弾性力によって、アンビル4は板ばね15の弾
性力によって開方向に付勢され、内筒8に対して進退自
在な外筒9を前進することにより、カートリッジ3とア
ンビル4の基端部が外筒9に嵌合して縫合部5が閉じら
れるように構成されている。
ートリッジ3とアンビル4がその基端部を支点として上
下方向に回動(開閉)自在であり、カートリッジ3は継
手10の弾性力によって、アンビル4は板ばね15の弾
性力によって開方向に付勢され、内筒8に対して進退自
在な外筒9を前進することにより、カートリッジ3とア
ンビル4の基端部が外筒9に嵌合して縫合部5が閉じら
れるように構成されている。
【0024】さらに、カートリッジ3とアンビル4とか
らなる縫合部5は、その長手方向の略中間部から挿入部
2の軸方向に対して略90゜湾曲している。そして、こ
のカートリッジ3とアンビル4の幅方向の中間部には長
手方向に亘ってカッタガイド溝18,19が湾曲して設
けられ、このカッタガイド溝18,19の内部を後述す
るワイヤカッタ20がスライドするようになっている。
らなる縫合部5は、その長手方向の略中間部から挿入部
2の軸方向に対して略90゜湾曲している。そして、こ
のカートリッジ3とアンビル4の幅方向の中間部には長
手方向に亘ってカッタガイド溝18,19が湾曲して設
けられ、このカッタガイド溝18,19の内部を後述す
るワイヤカッタ20がスライドするようになっている。
【0025】前記カートリッジ3の内面にはカッタガイ
ド溝18を挟んで両側には複数のスリット21…が2列
配置され、これらスリット21…にはプッシャ21aが
突没自在に収納され、このプッシャ21aの上面にはス
テープル22が1個づつ脚部22aを上向きにし、しか
も上方へ突出自在に収納されている。さらに、カートリ
ッジ3の内部にはプッシャ21a…に対向してプレート
ガイド溝23が設けられ、このプレートガイド溝23の
内部を後述するステープル放出手段としてのプッシャプ
レート24がスライドするようになっている。
ド溝18を挟んで両側には複数のスリット21…が2列
配置され、これらスリット21…にはプッシャ21aが
突没自在に収納され、このプッシャ21aの上面にはス
テープル22が1個づつ脚部22aを上向きにし、しか
も上方へ突出自在に収納されている。さらに、カートリ
ッジ3の内部にはプッシャ21a…に対向してプレート
ガイド溝23が設けられ、このプレートガイド溝23の
内部を後述するステープル放出手段としてのプッシャプ
レート24がスライドするようになっている。
【0026】前記アンビル4の内面にはカッタガイド溝
19を挟んで両側に前記スリット21…と対応して列を
なした凹溝からなる成形溝25…が設けられ、この成形
溝25はステープル21の脚部21aを互いに内側に折
曲することができるように底面が円弧面に形成されてい
る。
19を挟んで両側に前記スリット21…と対応して列を
なした凹溝からなる成形溝25…が設けられ、この成形
溝25はステープル21の脚部21aを互いに内側に折
曲することができるように底面が円弧面に形成されてい
る。
【0027】前記ワイヤカッタ20およびプッシャプレ
ート24は前記挿入部2の内筒8の内部に収納されてい
る。まず、ワイヤカッタ20について説明すると、内筒
8には前記カートリッジ3とアンビル4に設けられたカ
ッタガイド溝18,19と対応する凹溝26,27が設
けられ、これら凹溝26,27には可撓性を有するカッ
タホルダ28,28がスライド自在に収納されている。
そして、このカッタホルダ28,28の先端部間には上
下方向にワイヤからなるナイフ部29が張設されてい
る。
ート24は前記挿入部2の内筒8の内部に収納されてい
る。まず、ワイヤカッタ20について説明すると、内筒
8には前記カートリッジ3とアンビル4に設けられたカ
ッタガイド溝18,19と対応する凹溝26,27が設
けられ、これら凹溝26,27には可撓性を有するカッ
タホルダ28,28がスライド自在に収納されている。
そして、このカッタホルダ28,28の先端部間には上
下方向にワイヤからなるナイフ部29が張設されてい
る。
【0028】また、内筒8の底面には前記カートリッジ
3とアンビル4に設けられたプレートガイド溝23と対
応するプレートガイド面30が設けられ、このプレート
ガイド面30には帯状の金属板からなるプッシャプレー
ト24が立位状態で、しかもスライド自在に支持され、
このプッシャプレート24の先端部には先端に向かって
下り勾配の傾斜面24aが形成されている。
3とアンビル4に設けられたプレートガイド溝23と対
応するプレートガイド面30が設けられ、このプレート
ガイド面30には帯状の金属板からなるプッシャプレー
ト24が立位状態で、しかもスライド自在に支持され、
このプッシャプレート24の先端部には先端に向かって
下り勾配の傾斜面24aが形成されている。
【0029】以上のように、カッタホルダ28、プッシ
ャプレート24は可撓性を有する材料で構成されてお
り、湾曲するカッタガイド溝18,19、プレートガイ
ド面30の曲率に対応して各々変形するようになってい
る。
ャプレート24は可撓性を有する材料で構成されてお
り、湾曲するカッタガイド溝18,19、プレートガイ
ド面30の曲率に対応して各々変形するようになってい
る。
【0030】そして、ワイヤカッタ20およびプッシャ
プレート24は前記操作部本体1に設けられたステープ
ル操作部7に連結されており、ステープル操作部7に手
指を掛けて引くことにより、ワイヤカッタ20およびプ
ッシャプレート24が内筒8の内部を前進し、カートリ
ッジ3およびアンビル4まで突出するようになってい
る。
プレート24は前記操作部本体1に設けられたステープ
ル操作部7に連結されており、ステープル操作部7に手
指を掛けて引くことにより、ワイヤカッタ20およびプ
ッシャプレート24が内筒8の内部を前進し、カートリ
ッジ3およびアンビル4まで突出するようになってい
る。
【0031】また、操作部本体1に設けられた開閉操作
部6は挿入部2の外筒9と連結され、内筒8に対して外
筒9を前進させることにより、カートリッジ3とアンビ
ル4の基端部が外筒9に嵌合して縫合部5が閉じ、内筒
8に対して外筒9を後退させることにより、カートリッ
ジ3とアンビル4の基端部が外筒9から突出して縫合部
5が開くようになっている。
部6は挿入部2の外筒9と連結され、内筒8に対して外
筒9を前進させることにより、カートリッジ3とアンビ
ル4の基端部が外筒9に嵌合して縫合部5が閉じ、内筒
8に対して外筒9を後退させることにより、カートリッ
ジ3とアンビル4の基端部が外筒9から突出して縫合部
5が開くようになっている。
【0032】次に、前述のように構成された縫合器の作
用について説明する。生体の腹壁等の一部を切開し、そ
の切開部分に縫合部5を押し当て、切開部分を押し開き
ながら縫合部5および挿入部2を腹腔内に挿入する。こ
のとき、縫合部5は挿入部2の軸方向に対して略90゜
湾曲しているため、縫合部5の先端部を切開部分に押し
当て、挿入部2を縫合部5の湾曲方向と逆方向に回動し
ながら切開部分を押し開くことにより、容易に腹腔内に
挿入することができる。
用について説明する。生体の腹壁等の一部を切開し、そ
の切開部分に縫合部5を押し当て、切開部分を押し開き
ながら縫合部5および挿入部2を腹腔内に挿入する。こ
のとき、縫合部5は挿入部2の軸方向に対して略90゜
湾曲しているため、縫合部5の先端部を切開部分に押し
当て、挿入部2を縫合部5の湾曲方向と逆方向に回動し
ながら切開部分を押し開くことにより、容易に腹腔内に
挿入することができる。
【0033】そして、図8(a)に示すように、挿入部
2をさらに押し進めて縫合部5を生体組織の被縫合部A
に向かって前進させる。図1に破線で示すように、操作
部本体1の開閉操作部6を引くと、挿入部2の外筒9が
後退してカートリッジ3とアンビル4の基端部が外筒9
から突出する。
2をさらに押し進めて縫合部5を生体組織の被縫合部A
に向かって前進させる。図1に破線で示すように、操作
部本体1の開閉操作部6を引くと、挿入部2の外筒9が
後退してカートリッジ3とアンビル4の基端部が外筒9
から突出する。
【0034】したがって、カートリッジ3は継手10の
復元力によって、アンビル4は板ばね15の復元力によ
って押し広げられ、縫合部5が開く。そして、被縫合部
Aをカートリッジ3とアンビル4との間に入れ、次に開
閉操作部6を図1の実線に示すように押し込むと、外筒
9が前進してカートリッジ3とアンビル4の基端部に外
筒9が嵌合し、カートリッジ3とアンビル4が閉じて縫
合部5によって被縫合部Aを挟持する。
復元力によって、アンビル4は板ばね15の復元力によ
って押し広げられ、縫合部5が開く。そして、被縫合部
Aをカートリッジ3とアンビル4との間に入れ、次に開
閉操作部6を図1の実線に示すように押し込むと、外筒
9が前進してカートリッジ3とアンビル4の基端部に外
筒9が嵌合し、カートリッジ3とアンビル4が閉じて縫
合部5によって被縫合部Aを挟持する。
【0035】この状態で、操作部本体1のステープル操
作部7を図1の矢印a方向に引くと、挿入部2の内筒8
に内挿されたプッシャプレート24とワイヤカッタ20
が前進し、プッシャプレート24はプレートガイド溝2
3に案内されて前進し、ワイヤカッタ20はワイヤガイ
ド溝18,19に案内されて前進する。
作部7を図1の矢印a方向に引くと、挿入部2の内筒8
に内挿されたプッシャプレート24とワイヤカッタ20
が前進し、プッシャプレート24はプレートガイド溝2
3に案内されて前進し、ワイヤカッタ20はワイヤガイ
ド溝18,19に案内されて前進する。
【0036】プッシャプレート24の前進に伴ってカー
トリッジ3の内部のプッシャ21aは傾斜面24aによ
って押し上げられ、スリット21の内部のステープル2
2は突出し、被縫合部Aに打ち出される。打ち出された
ステープル22の脚部22aは生体組織を貫通し、その
脚部22aはアンビル4に設けられた成形溝25によっ
て互いに内側に折り曲げられ、被縫合部Aをステープル
22によって縫合する。
トリッジ3の内部のプッシャ21aは傾斜面24aによ
って押し上げられ、スリット21の内部のステープル2
2は突出し、被縫合部Aに打ち出される。打ち出された
ステープル22の脚部22aは生体組織を貫通し、その
脚部22aはアンビル4に設けられた成形溝25によっ
て互いに内側に折り曲げられ、被縫合部Aをステープル
22によって縫合する。
【0037】このようにステープル22によって被縫合
部Aが2列づつ平行に2箇所縫合されると同時にワイヤ
カッタ20も前進するため、図8(b)に示すように、
2箇所の被縫合部の間に位置する生体組織はワイヤカッ
タ20のナイフ部29によって切断される。したがっ
て、縫合と切断が同時に行うことができる。
部Aが2列づつ平行に2箇所縫合されると同時にワイヤ
カッタ20も前進するため、図8(b)に示すように、
2箇所の被縫合部の間に位置する生体組織はワイヤカッ
タ20のナイフ部29によって切断される。したがっ
て、縫合と切断が同時に行うことができる。
【0038】また、縫合部5が挿入部2の軸方向に対し
て略90゜湾曲しているため、被縫合部Aが挿入部2の
軸線に対して平行もしくは垂直の方向に無いときに特に
アプローチしやすく、また、操作部本体1に対して挿入
部2が回転自在であるため、縫合部5を任意の方向に向
けることができる。
て略90゜湾曲しているため、被縫合部Aが挿入部2の
軸線に対して平行もしくは垂直の方向に無いときに特に
アプローチしやすく、また、操作部本体1に対して挿入
部2が回転自在であるため、縫合部5を任意の方向に向
けることができる。
【0039】図9および図10は第2の実施例を示し、
第1の実施例と同一構成部分は同一番号を付して説明を
省略する。操作部本体1の内部にはワイヤカッタ20に
接続する導電性部材31が設けられ、この導電性部材3
1は操作部本体1の外部に突出する高周波接続ピン32
に接続されている。
第1の実施例と同一構成部分は同一番号を付して説明を
省略する。操作部本体1の内部にはワイヤカッタ20に
接続する導電性部材31が設けられ、この導電性部材3
1は操作部本体1の外部に突出する高周波接続ピン32
に接続されている。
【0040】この高周波接続ピン32には高周波接続ケ
ーブル33の一端部に設けられたコネクタ34が接続さ
れ、この高周波接続ケーブル33の他端は高周波焼灼装
置35に接続されている。
ーブル33の一端部に設けられたコネクタ34が接続さ
れ、この高周波接続ケーブル33の他端は高周波焼灼装
置35に接続されている。
【0041】この実施例によれば、高周波焼灼装置35
から高周波接続ケーブル33を介して高周波接続ピン3
2に高周波電流が流れ、さらに導電性部材31を介して
ワイヤカッタ20のナイフ部29に高周波電流が通電さ
れるため、被縫合部Aの縫合時に生体組織を焼灼しなが
ら縫合することができる。また、生体組織の切除を通電
止血しながら行うので出血の恐れがないという効果があ
る。
から高周波接続ケーブル33を介して高周波接続ピン3
2に高周波電流が流れ、さらに導電性部材31を介して
ワイヤカッタ20のナイフ部29に高周波電流が通電さ
れるため、被縫合部Aの縫合時に生体組織を焼灼しなが
ら縫合することができる。また、生体組織の切除を通電
止血しながら行うので出血の恐れがないという効果があ
る。
【0042】図11〜図18は第3の実施例を示し、第
1の実施例と同一構成部分は同一番号を付して説明を省
略する。カートリッジ3はステープル22の打出される
向きと垂直をなす平面上にて湾曲する湾曲部40を有し
ている。
1の実施例と同一構成部分は同一番号を付して説明を省
略する。カートリッジ3はステープル22の打出される
向きと垂直をなす平面上にて湾曲する湾曲部40を有し
ている。
【0043】第1の実施例においては、プッシャープレ
ート24及びワイヤカッター20は、挿入部2側に設け
られていたが、本実施例においては、プッシャープレー
ト24に相当するプッシャ部材41,42及び、ワイヤ
カッター20に相当するカット部材43は共にカートリ
ッジ3内に収納されている。
ート24及びワイヤカッター20は、挿入部2側に設け
られていたが、本実施例においては、プッシャープレー
ト24に相当するプッシャ部材41,42及び、ワイヤ
カッター20に相当するカット部材43は共にカートリ
ッジ3内に収納されている。
【0044】また、プッシャ部材41,42及びカット
部材43の各々はワイヤ44,45,46により接続部
材47に連結され、フレキシブル組立体48を構成して
いる。フレキシブル組立体48はこの接続部材47に設
けた係合溝49と本体側のピン(図示しない)との係合
により挿入部2に固定されている。なお、カートリッジ
3と挿入部2が着脱自在でない場合にはこのような構成
は不要で、ワイヤ44,45,46は操作部1内まで延
長して固定してもよい。
部材43の各々はワイヤ44,45,46により接続部
材47に連結され、フレキシブル組立体48を構成して
いる。フレキシブル組立体48はこの接続部材47に設
けた係合溝49と本体側のピン(図示しない)との係合
により挿入部2に固定されている。なお、カートリッジ
3と挿入部2が着脱自在でない場合にはこのような構成
は不要で、ワイヤ44,45,46は操作部1内まで延
長して固定してもよい。
【0045】フレキシブル組立体48の各要素は各々カ
ートリッジ3内に設けられたガイド溝50,51、カッ
タガイド溝18、ガイド孔52,53,54によりガイ
ドされている。また、接続部材47はカートリッジ3の
手元側部55内にてガイド孔56によりガイドされてい
る。フレキシブル組立体48の各要素は、弾性部材によ
り形成され、各カッタガイド溝18、ガイド孔52,5
3,54の湾曲に追従して変形可能である。
ートリッジ3内に設けられたガイド溝50,51、カッ
タガイド溝18、ガイド孔52,53,54によりガイ
ドされている。また、接続部材47はカートリッジ3の
手元側部55内にてガイド孔56によりガイドされてい
る。フレキシブル組立体48の各要素は、弾性部材によ
り形成され、各カッタガイド溝18、ガイド孔52,5
3,54の湾曲に追従して変形可能である。
【0046】前記ワイヤ44,45,46の材質は、例
えばステンレス製撚りワイヤである。なお、ワイヤ4
4,45,46のガイドは手元側部材55内のガイド孔
56によらず、チューブ、コイル等のフレキシブルな部
材により行ってもよい。
えばステンレス製撚りワイヤである。なお、ワイヤ4
4,45,46のガイドは手元側部材55内のガイド孔
56によらず、チューブ、コイル等のフレキシブルな部
材により行ってもよい。
【0047】図11において、スリット21及びこれに
対応するステープル22(図示しない)の数は、湾曲の
外側列の方が、内側列よりも多い。また数の大小とは別
に、一個一個のスリット21及びステープル22の長さ
を湾曲の外側列のものを長く形成してもよい。
対応するステープル22(図示しない)の数は、湾曲の
外側列の方が、内側列よりも多い。また数の大小とは別
に、一個一個のスリット21及びステープル22の長さ
を湾曲の外側列のものを長く形成してもよい。
【0048】図16に示すように、本縫合器と組み合わ
せて使用するトラカール57は、口金部58とシース部
59とから構成されている。シース部59はフレキシブ
ルであり、縫合部5および挿入部2の湾曲形状に応じて
変形可能である。材質は例えばPTFEのようなチュー
ブである。なお、図示しないが、トラカール57の口元
に体腔内のガスの漏れを遮断する弁手段を設け、この弁
手段はフレキシブルはシース部59に対して着脱自在と
なっている。
せて使用するトラカール57は、口金部58とシース部
59とから構成されている。シース部59はフレキシブ
ルであり、縫合部5および挿入部2の湾曲形状に応じて
変形可能である。材質は例えばPTFEのようなチュー
ブである。なお、図示しないが、トラカール57の口元
に体腔内のガスの漏れを遮断する弁手段を設け、この弁
手段はフレキシブルはシース部59に対して着脱自在と
なっている。
【0049】プッシャ部材41,42、カット部材43
は、弾性部材からなるベース60に固定され、ベース6
0の先端と接続部材47はワイヤ61に接続されてい
る。これらとは別にカートリッジ3の先端部内に設けた
ピン62があり、ワイヤ61はこのプーリにより折り返
して係合している。この構成の場合は、接続部材47を
手元側へ引く動作により、プッシャ部材41,42、カ
ット部材43を作動できる。
は、弾性部材からなるベース60に固定され、ベース6
0の先端と接続部材47はワイヤ61に接続されてい
る。これらとは別にカートリッジ3の先端部内に設けた
ピン62があり、ワイヤ61はこのプーリにより折り返
して係合している。この構成の場合は、接続部材47を
手元側へ引く動作により、プッシャ部材41,42、カ
ット部材43を作動できる。
【0050】したがって、図16に示すように、カート
リッジ3、アンビル4を閉じた状態にて体腔内へ導入す
る。この際、トラカール57のシース部59は従来の硬
性のものと異り、カートリッジ3、アンビル4の湾曲に
応じて変形可能であるため湾曲部の通過が可能である。
リッジ3、アンビル4を閉じた状態にて体腔内へ導入す
る。この際、トラカール57のシース部59は従来の硬
性のものと異り、カートリッジ3、アンビル4の湾曲に
応じて変形可能であるため湾曲部の通過が可能である。
【0051】ここで、第1の実施例と異なる点のみ述べ
ると、図8(a)のに示すように、アンビル4、カート
リッジ3にて被縫合部Aを挟持する操作部1のハンドル
7の操作により、カートリッジ3内の接続部材47を介
してプッシャ部材41,42、カット部材43が各ガイ
ド部材内を移動してステープル22の押し出し、組織の
切離を行う。
ると、図8(a)のに示すように、アンビル4、カート
リッジ3にて被縫合部Aを挟持する操作部1のハンドル
7の操作により、カートリッジ3内の接続部材47を介
してプッシャ部材41,42、カット部材43が各ガイ
ド部材内を移動してステープル22の押し出し、組織の
切離を行う。
【0052】したがって、目的の被縫合部Aの形状に応
じた湾曲を有するカートリッジ3、アンビル4を用いる
ため、必要最小限の量の切除にとどめることができる。
縫合器の湾曲部分及び直線部分を摺動する各部材が湾曲
に応じて変形可能なため、湾曲部、直線部の双方に対し
て軽い力で摺動が可能である。
じた湾曲を有するカートリッジ3、アンビル4を用いる
ため、必要最小限の量の切除にとどめることができる。
縫合器の湾曲部分及び直線部分を摺動する各部材が湾曲
に応じて変形可能なため、湾曲部、直線部の双方に対し
て軽い力で摺動が可能である。
【0053】図19および図20は第4の実施例を示
し、第1の実施例と同一構成部分は同一番号を付して説
明を省略する。カートリッジ3はステープル22の打ち
出される向きと挿入部2の軸線とを含む平面内にて湾曲
する湾曲部63を有している。
し、第1の実施例と同一構成部分は同一番号を付して説
明を省略する。カートリッジ3はステープル22の打ち
出される向きと挿入部2の軸線とを含む平面内にて湾曲
する湾曲部63を有している。
【0054】プッシャ部材41,42、カット部材43
の下面は、図20に示すように、カートリッジ3の湾曲
と等しい湾曲をしている。またワイヤ部材44,45,
46との接続部分は回転自在となっている。
の下面は、図20に示すように、カートリッジ3の湾曲
と等しい湾曲をしている。またワイヤ部材44,45,
46との接続部分は回転自在となっている。
【0055】したがって、被縫合部Aの目的部位へのア
プローチ性が高い。つまり腹腔内、胸腔内の底部に存す
る臓器(腸や子宮より卵管系に移行する部位、肺門部)
をすくい上げて把持することができる。また、これによ
りカートリッジ3の先端部が良く見えて臓器の縫合した
い部位がカートリッジ3の先端部の内側にあるかどうか
を内視鏡で視認することができ手技の確実性向上にな
る。
プローチ性が高い。つまり腹腔内、胸腔内の底部に存す
る臓器(腸や子宮より卵管系に移行する部位、肺門部)
をすくい上げて把持することができる。また、これによ
りカートリッジ3の先端部が良く見えて臓器の縫合した
い部位がカートリッジ3の先端部の内側にあるかどうか
を内視鏡で視認することができ手技の確実性向上にな
る。
【0056】図21は第5の実施例を示し、第1の実施
例と同一構成部分は同一番号を付して説明を省略する。
本実施例は挿入部2に湾曲部63が設けられている。ハ
ンドル操作に応じて挿入部2内を摺動するワイヤ部材
(図示しない)は湾曲可能で、またこれをガイドするチ
ューブ部材(図示しない)も同様に可撓性を有してお
り、湾曲可能である。
例と同一構成部分は同一番号を付して説明を省略する。
本実施例は挿入部2に湾曲部63が設けられている。ハ
ンドル操作に応じて挿入部2内を摺動するワイヤ部材
(図示しない)は湾曲可能で、またこれをガイドするチ
ューブ部材(図示しない)も同様に可撓性を有してお
り、湾曲可能である。
【0057】図22〜図24は第6の実施例を示す。図
22に示すように、縫合器は、操作部70とこの操作部
70に接続された挿入部71とから構成されている。操
作部70には開閉レバー72とハンドル73が設けられ
ている。
22に示すように、縫合器は、操作部70とこの操作部
70に接続された挿入部71とから構成されている。操
作部70には開閉レバー72とハンドル73が設けられ
ている。
【0058】前記挿入部71は筒状に形成され、その挿
入部71の先端部には湾曲したカートリッジ74が接続
されている。カートリッジ74に対向してアンビル75
が設けられている。アンビル75は開閉レバー72と接
続されているとともに、アンビル75はピン76により
カートリッジ74に回転可能に取り付けられている。
入部71の先端部には湾曲したカートリッジ74が接続
されている。カートリッジ74に対向してアンビル75
が設けられている。アンビル75は開閉レバー72と接
続されているとともに、アンビル75はピン76により
カートリッジ74に回転可能に取り付けられている。
【0059】カートリッジ74内には複数列のステープ
ル22と、ステープル22を押し出すプッシャー21a
と、プッシャー21aを押し上げるプッシャープレート
24と、カット部材43が内蔵されている。プッシャー
プレート24とカット部材43はハンドル73と接続さ
れている。プッシャープレート24は、軟性の部材で構
成されている。
ル22と、ステープル22を押し出すプッシャー21a
と、プッシャー21aを押し上げるプッシャープレート
24と、カット部材43が内蔵されている。プッシャー
プレート24とカット部材43はハンドル73と接続さ
れている。プッシャープレート24は、軟性の部材で構
成されている。
【0060】切除する肺組織等の被縫合部Aをアンビル
75とカートリッジ74の間に入れる。開閉レバー72
を回転させると、アンビル75が回転して閉じ、アンビ
ル75とカートリッジ74の間に組織が挟まる。
75とカートリッジ74の間に入れる。開閉レバー72
を回転させると、アンビル75が回転して閉じ、アンビ
ル75とカートリッジ74の間に組織が挟まる。
【0061】ハンドル72を引くと、カートリッジ74
内をプッシャープレート24が湾曲しながら移動し、プ
ッシャー21aが押し上げられ、ステープル22が押し
上げられると共に、ステープル22がアンビル75に当
たり、アンビル75によりステープル22が閉じられ
る。一方、前記ハンドル73の操作によりカッターもカ
ートリッジ74内を移動し、組織の切除が行われる。
内をプッシャープレート24が湾曲しながら移動し、プ
ッシャー21aが押し上げられ、ステープル22が押し
上げられると共に、ステープル22がアンビル75に当
たり、アンビル75によりステープル22が閉じられ
る。一方、前記ハンドル73の操作によりカッターもカ
ートリッジ74内を移動し、組織の切除が行われる。
【0062】このように組織を切除する際、切除縫合線
が曲がっているため、正常な組織を切りとる面積を少な
くでき、必要な部分だけ切除することができる。アンビ
ル75の先端とカートリッジ74の先端が固定されてい
るため、組織を把持する力が大きくなる。また、閉じる
際にアンビル75がカートリッジ74に対して手元から
先端まで確実に閉じることができるため、均一に縫合す
る事ができる。
が曲がっているため、正常な組織を切りとる面積を少な
くでき、必要な部分だけ切除することができる。アンビ
ル75の先端とカートリッジ74の先端が固定されてい
るため、組織を把持する力が大きくなる。また、閉じる
際にアンビル75がカートリッジ74に対して手元から
先端まで確実に閉じることができるため、均一に縫合す
る事ができる。
【0063】図26および図27は第7の実施例を示
す。本実施例の縫合器は、操作部77にアングルノブ7
8が回動自在に設けられている。挿入部79の一部には
湾曲部80が設けられている。アングルノブ78の回動
軸78aには同軸的にアングルプーリ81が固定され、
このアングルプーリ81の外周にアングルワイヤ82が
巻き付けられている。
す。本実施例の縫合器は、操作部77にアングルノブ7
8が回動自在に設けられている。挿入部79の一部には
湾曲部80が設けられている。アングルノブ78の回動
軸78aには同軸的にアングルプーリ81が固定され、
このアングルプーリ81の外周にアングルワイヤ82が
巻き付けられている。
【0064】湾曲部80の内部には複数の湾曲駒83が
湾曲ピン84により各々回動可能に接続されており、先
端の湾曲駒83の内周には操作部77より伸びるアング
ルワイヤ82が固定されている。湾曲部80は樹脂製の
軟性チューブ80aで覆われている。
湾曲ピン84により各々回動可能に接続されており、先
端の湾曲駒83の内周には操作部77より伸びるアング
ルワイヤ82が固定されている。湾曲部80は樹脂製の
軟性チューブ80aで覆われている。
【0065】したがって、操作部77のアングルノブ7
8を操作することにより、アングルワイヤ82を介して
湾曲部80を湾曲することができ、腹腔内にて所望の角
度を取る事により目的部位に対して最良のアプローチを
とる事ができる。角度を変えて設定できるので、固定湾
曲のものに較べて様々な症例に対して、様々な部位に対
してこれ1本で対応できる。
8を操作することにより、アングルワイヤ82を介して
湾曲部80を湾曲することができ、腹腔内にて所望の角
度を取る事により目的部位に対して最良のアプローチを
とる事ができる。角度を変えて設定できるので、固定湾
曲のものに較べて様々な症例に対して、様々な部位に対
してこれ1本で対応できる。
【0066】図28〜図32は第8の実施例を示す。ア
ンビル4、カートリッジ3は、開閉用カム85の挿入部
2の軸方向に進退自在で、この前後動により開閉される
ようになっている。すなわち、アンビル4、カートリッ
ジ3は付勢ばね(図示しない)により開方向へ付勢さ
れ、開閉用カム85が前進すると閉じ、後退すると開く
ようになっている。
ンビル4、カートリッジ3は、開閉用カム85の挿入部
2の軸方向に進退自在で、この前後動により開閉される
ようになっている。すなわち、アンビル4、カートリッ
ジ3は付勢ばね(図示しない)により開方向へ付勢さ
れ、開閉用カム85が前進すると閉じ、後退すると開く
ようになっている。
【0067】挿入部2の左右両側部には板ばね86が添
設され、この板ばね86の先端が開閉カム85に固定さ
れ、板ばね86により開閉カム85が前後動されるよう
になっている。また、板ばね86は湾曲駒87に摺動可
能に係止され、板ばね86の片方を摺動させることで湾
曲駒87が湾曲するようになっている。
設され、この板ばね86の先端が開閉カム85に固定さ
れ、板ばね86により開閉カム85が前後動されるよう
になっている。また、板ばね86は湾曲駒87に摺動可
能に係止され、板ばね86の片方を摺動させることで湾
曲駒87が湾曲するようになっている。
【0068】したがって、前記板ばね86の位置関係を
変えずに(湾曲状態を保ちながら)両板ばね86を同時
に摺動させ、先端方向に移動することで湾曲したまま開
閉用カム85がアンビル4またはカートリッジ3を閉じ
ることができる。
変えずに(湾曲状態を保ちながら)両板ばね86を同時
に摺動させ、先端方向に移動することで湾曲したまま開
閉用カム85がアンビル4またはカートリッジ3を閉じ
ることができる。
【0069】前記カートリッジ3は挿入部2に対して交
換可能であり、図29〜図32に示すようにカートリッ
ジ側継手90,91により挿入部2に接続されている。
すなわち、挿入部側継手92,93はそれぞれ前記カー
トリッジ側継手90,91に対して着脱自在に接続され
ている。挿入部側継手92,93はすり割りばね構造
で、閉じるように付勢され、カートリッジ側継手90,
91が先端部側から押し込まれることでロックし、挿入
部2に設けた解除ボタン88を押すことにより、付勢が
はずれ解除される。
換可能であり、図29〜図32に示すようにカートリッ
ジ側継手90,91により挿入部2に接続されている。
すなわち、挿入部側継手92,93はそれぞれ前記カー
トリッジ側継手90,91に対して着脱自在に接続され
ている。挿入部側継手92,93はすり割りばね構造
で、閉じるように付勢され、カートリッジ側継手90,
91が先端部側から押し込まれることでロックし、挿入
部2に設けた解除ボタン88を押すことにより、付勢が
はずれ解除される。
【0070】挿入部側継手92とカートリッジ側継手9
0を結合することにより、ステープル放出手段として先
端方向に移動し、ステープル22の放出等の動作を伝達
することができ、この動きの際、コイルワイヤ94の中
を通るが、挿入部側継手92のすり割り付きばねはコイ
ルワイヤ94の中で、軸中心に圧迫されるので、ロック
が解除されない。このような構成によれば、先端部が湾
曲している状態でコイルヤイヤ95、コイルワイヤ96
が湾曲しつつステープル放出手段の動きを伝達するので
力の伝達がスムースに行われる。
0を結合することにより、ステープル放出手段として先
端方向に移動し、ステープル22の放出等の動作を伝達
することができ、この動きの際、コイルワイヤ94の中
を通るが、挿入部側継手92のすり割り付きばねはコイ
ルワイヤ94の中で、軸中心に圧迫されるので、ロック
が解除されない。このような構成によれば、先端部が湾
曲している状態でコイルヤイヤ95、コイルワイヤ96
が湾曲しつつステープル放出手段の動きを伝達するので
力の伝達がスムースに行われる。
【0071】また、本構成によれば、図示しないが、ア
ンビル4およびカートリッジ3が先端部の長手軸を略中
心として回転するような動作の時も同様に力の伝達がス
ムースに行われる。先端部が回転することによって臓器
へのアプローチ性が高くなるので本構成の応用性が高い
事を示すものである。
ンビル4およびカートリッジ3が先端部の長手軸を略中
心として回転するような動作の時も同様に力の伝達がス
ムースに行われる。先端部が回転することによって臓器
へのアプローチ性が高くなるので本構成の応用性が高い
事を示すものである。
【0072】したがって、目的の被縫合部Aの形状に応
じた湾曲を有するカートリッジ3、アンビル4を用いる
ため、必要最小限の量の切除にとどめることができる。
縫合器の湾曲部分及び直線部分を摺動する各部材が湾曲
に応じて変形可能なため、湾曲部、直線部の双方に対し
て軽い力で摺動が可能である。
じた湾曲を有するカートリッジ3、アンビル4を用いる
ため、必要最小限の量の切除にとどめることができる。
縫合器の湾曲部分及び直線部分を摺動する各部材が湾曲
に応じて変形可能なため、湾曲部、直線部の双方に対し
て軽い力で摺動が可能である。
【0073】なお、この発明は金属製のステープルを使
用する縫合器に適用するのに限定されるものではなく、
樹脂製のステープル、例えばUSP5156614に示
される生体吸収性樹脂を材質とするファスナー、リテー
ナーを用いる縫合器に適用してもよい。
用する縫合器に適用するのに限定されるものではなく、
樹脂製のステープル、例えばUSP5156614に示
される生体吸収性樹脂を材質とするファスナー、リテー
ナーを用いる縫合器に適用してもよい。
【0074】
【発明の効果】以上説明したように、この発明によれ
ば、生体組織を縫合する際に、その被縫合部に対して縫
合部を容易にアプローチでき、操作性が簡単で、安全か
つ確実に縫合できる。
ば、生体組織を縫合する際に、その被縫合部に対して縫
合部を容易にアプローチでき、操作性が簡単で、安全か
つ確実に縫合できる。
【0075】したがって、より多くの症例に低侵襲の内
視鏡下手術を適用でき、また腫瘍等を切除する際に不必
要な切除部分を少なく、低侵襲の手術を短時間に行うこ
とができるという効果がある。
視鏡下手術を適用でき、また腫瘍等を切除する際に不必
要な切除部分を少なく、低侵襲の手術を短時間に行うこ
とができるという効果がある。
【図1】この発明の第1の実施例を示す縫合器の全体の
斜視図。
斜視図。
【図2】同実施例の縫合部の分解斜視図。
【図3】同実施例の縫合部の斜視図。
【図4】同実施例の挿入部の先端部の縦断側面図。
【図5】同実施例の挿入部の先端部の縦断側面図。
【図6】同実施例の挿入部の横断正面図。
【図7】同実施例の縫合部の縦断側面図。
【図8】同実施例の縫合器の使用状態の斜視図。
【図9】この発明の第2の実施例を示す縫合器の全体の
斜視図。
斜視図。
【図10】同実施例の操作部本体の一部切欠した斜視
図。
図。
【図11】この発明の第3の実施例を示す縫合部の斜視
図。
図。
【図12】同実施例のフレキシブル組立体を示す側面
図。
図。
【図13】図12の矢印F方向から見た正面図。
【図14】図11のG−G線に沿う断面図。
【図15】図11のH−H線に沿う断面図。
【図16】同実施例の縫合器の使用状態図。
【図17】同実施例の変形例を示すフレキシブル組立体
の側面図。
の側面図。
【図18】図17に示すフレキシブル組立体の平面図。
【図19】この発明の第4の実施例を示す縫合部の斜視
図。
図。
【図20】(a)は同実施例のプッシャ部材の側面図、
(b)は縫合部の斜視図。
(b)は縫合部の斜視図。
【図21】この発明の第5の実施例を示す縫合器の側面
図。
図。
【図22】この発明の第6の実施例を示す縫合器の斜視
図。
図。
【図23】同実施例の縫合作用説明図。
【図24】同実施例の縫合作用説明図。
【図25】同実施例の縫合部の縦断側面図。
【図26】この発明の第7の実施例を示す縫合器の斜視
図。
図。
【図27】同実施例の湾曲部の一部切欠した斜視図。
【図28】この発明の第8の実施例を示す縫合部の斜視
図。
図。
【図29】同実施例のカートリッジと挿入部の接続構造
を示す斜視図。
を示す斜視図。
【図30】同実施例のカートリッジと挿入部の接続構造
を示す斜視図。
を示す斜視図。
【図31】同実施例のコイルワイヤ相互の接続構造を示
す縦断側面図。
す縦断側面図。
【図32】(a)は同実施例のコイルワイヤと操作部と
の接続構造を示す縦断側面図、(b)は(a)のI−I
線に沿う断面図。
の接続構造を示す縦断側面図、(b)は(a)のI−I
線に沿う断面図。
【図33】(a)(b)従来の縫合器の作用説明図。
【図34】従来の縫合器の作用説明図。
1…操作部 2…挿入部 3…カートリッジ 4…アンビル 5…縫合部 22…ステープル。
───────────────────────────────────────────────────── フロントページの続き (72)発明者 鶴田 稔 東京都渋谷区幡ヶ谷2丁目43番2号 オリ ンパス光学工業株式会社内 (72)発明者 塚越 壯 東京都渋谷区幡ヶ谷2丁目43番2号 オリ ンパス光学工業株式会社内 (72)発明者 中田 明雄 東京都渋谷区幡ヶ谷2丁目43番2号 オリ ンパス光学工業株式会社内 (72)発明者 鈴田 敏彦 東京都渋谷区幡ヶ谷2丁目43番2号 オリ ンパス光学工業株式会社内
Claims (2)
- 【請求項1】 操作部と、この操作部に接続された挿入
部と、この挿入部の先端部に設けられ複数のステープル
を収納する第1の挟持部材およびこの第1の挟持部材に
対向する第2の挟持部材とからなる縫合部と、前記ステ
ープルを組織へ打出し留置させるステープル放出手段と
を具備した縫合器において、 ステープル放出手段の少なくとも一部は、前記挿入部ま
たは縫合部の形状に追従して変形可能に可撓性を有する
ことを特徴とする縫合器。 - 【請求項2】 操作部と、この操作部に接続された挿入
部と、この挿入部の先端部に設けられ複数のステープル
を収納する第1の挟持部材およびこの第1の挟持部材に
対向する第2の挟持部材とからなる縫合部と、前記ステ
ープルを組織へ打出し留置させるステープル放出手段と
を具備した縫合器において、 前記挿入部または縫合部の少なくとも一方には湾曲部が
形成され、前記ステープル放出手段の少なくとも一部
は、前記湾曲部の形状に追従して変形可能に可撓性を有
することを特徴とする縫合器。
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP5117190A JPH0630945A (ja) | 1992-05-19 | 1993-05-19 | 縫合器 |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP12624692 | 1992-05-19 | ||
JP4-126246 | 1992-05-19 | ||
JP5117190A JPH0630945A (ja) | 1992-05-19 | 1993-05-19 | 縫合器 |
Publications (1)
Publication Number | Publication Date |
---|---|
JPH0630945A true JPH0630945A (ja) | 1994-02-08 |
Family
ID=26455356
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP5117190A Withdrawn JPH0630945A (ja) | 1992-05-19 | 1993-05-19 | 縫合器 |
Country Status (1)
Country | Link |
---|---|
JP (1) | JPH0630945A (ja) |
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