JPS63270040A - 外科手術における縫合方法および縫合器 - Google Patents
外科手術における縫合方法および縫合器Info
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- JPS63270040A JPS63270040A JP62105327A JP10532787A JPS63270040A JP S63270040 A JPS63270040 A JP S63270040A JP 62105327 A JP62105327 A JP 62105327A JP 10532787 A JP10532787 A JP 10532787A JP S63270040 A JPS63270040 A JP S63270040A
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- 238000000034 method Methods 0.000 title claims abstract description 22
- 230000002439 hemostatic effect Effects 0.000 abstract description 4
- 238000005452 bending Methods 0.000 description 5
- 210000000936 intestine Anatomy 0.000 description 5
- 238000001125 extrusion Methods 0.000 description 3
- 206010051077 Post procedural haemorrhage Diseases 0.000 description 2
- 238000007796 conventional method Methods 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 230000023597 hemostasis Effects 0.000 description 2
- 230000000149 penetrating effect Effects 0.000 description 2
- 238000002271 resection Methods 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 208000032843 Hemorrhage Diseases 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 238000002788 crimping Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 239000004744 fabric Substances 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 235000013372 meat Nutrition 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 210000002784 stomach Anatomy 0.000 description 1
- 238000005728 strengthening Methods 0.000 description 1
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Abstract
(57)【要約】本公報は電子出願前の出願データであるた
め要約のデータは記録されません。
め要約のデータは記録されません。
Description
【発明の詳細な説明】
(産業上の利用分野)
本発明はたとえば胃や腸の部分的切除等の如き外科手術
に際し、切除面を重ね合わせてその重ね合わせ面上に多
数の鑞状をした門型のステープルを打ち込み、しかもそ
の重ね合わせ面の反対側から突出する各ステープルの両
足先端部を相互に対向方向に向けて折り曲げるようにし
たMi織の縫合方法およびこれに使用するための外科手
術用縫合器に関する。
に際し、切除面を重ね合わせてその重ね合わせ面上に多
数の鑞状をした門型のステープルを打ち込み、しかもそ
の重ね合わせ面の反対側から突出する各ステープルの両
足先端部を相互に対向方向に向けて折り曲げるようにし
たMi織の縫合方法およびこれに使用するための外科手
術用縫合器に関する。
(従来の技術)
外科的手術中、とくに臓器類の手術にあっては迅速性を
要することはいうまでもなく、このような観点からこれ
までに、たとえば第1O図に示したような縫合器が開発
されている。
要することはいうまでもなく、このような観点からこれ
までに、たとえば第1O図に示したような縫合器が開発
されている。
これは同一軸を支点として相互に開閉自在とした一対の
上部アーム1と下部アーム7とからなり、上部アーム1
には下部アーム7との対接面中心に、その長さ方向に連
続させた溝部2を有するとともに、該溝部2の両側には
下部アーム7との対向面方向に向けて貫通させたステー
プル穴3が各々所定の間隔1aを介して縦列状に設けら
れており、ステープル穴3より押出片5を後退させた状
態にて該ステープル穴3内に門型をしたワイヤー等のス
テープル11がその両足片を下部アーム7との対接面方
向に向けたまま支承させた後、縫合部位を上部アーム1
と下部アーム7をもって第10図の矢印(A−A)方向
に接近させ、下部アーム7の先端突起部10を上部アー
ム1のガイド穴4内に挿通案内させつつ挟んだ状態にお
いて、たとえばペンチ状の加圧手段により第10図の矢
印(B−B)方向に加圧し、押出金具6の各押出片5を
上部アーム1のステープル穴3内に侵入させて、各ステ
ープル穴3内に装備した鋸状のステープル11の足片を
縫合部位12の組織内に同時的に差し込む。
上部アーム1と下部アーム7とからなり、上部アーム1
には下部アーム7との対接面中心に、その長さ方向に連
続させた溝部2を有するとともに、該溝部2の両側には
下部アーム7との対向面方向に向けて貫通させたステー
プル穴3が各々所定の間隔1aを介して縦列状に設けら
れており、ステープル穴3より押出片5を後退させた状
態にて該ステープル穴3内に門型をしたワイヤー等のス
テープル11がその両足片を下部アーム7との対接面方
向に向けたまま支承させた後、縫合部位を上部アーム1
と下部アーム7をもって第10図の矢印(A−A)方向
に接近させ、下部アーム7の先端突起部10を上部アー
ム1のガイド穴4内に挿通案内させつつ挟んだ状態にお
いて、たとえばペンチ状の加圧手段により第10図の矢
印(B−B)方向に加圧し、押出金具6の各押出片5を
上部アーム1のステープル穴3内に侵入させて、各ステ
ープル穴3内に装備した鋸状のステープル11の足片を
縫合部位12の組織内に同時的に差し込む。
差し込まれたステープル11は上記矢印(B−B)方向
の加圧をさらに強めることによりステープル間1の両足
先端部のみが縫合部位Ml織を貫通した後下部アーム7
の各対応するステープル足片受は部9において相互に対
向方向に折り曲げられて縫合部位を縫合するものである
(第11図参照)。
の加圧をさらに強めることによりステープル間1の両足
先端部のみが縫合部位Ml織を貫通した後下部アーム7
の各対応するステープル足片受は部9において相互に対
向方向に折り曲げられて縫合部位を縫合するものである
(第11図参照)。
また切断された腸端を相互に突き合わせて縫合する場合
においても特に図示はしないがディスポーザブルローデ
ィングユニソトを用いて第13図に示したように突き合
わせた腸の縫合部位12に対し複数のステープル11の
ステープルトップが間欠的にしかも円形をなずべ(相互
に一定の間隔を介して内周側と外周側とに二列配置され
、しかも各列における間欠部を相互にカバーし合うよう
に対応位置に配置されるべくして縫合することも研究さ
れている。
においても特に図示はしないがディスポーザブルローデ
ィングユニソトを用いて第13図に示したように突き合
わせた腸の縫合部位12に対し複数のステープル11の
ステープルトップが間欠的にしかも円形をなずべ(相互
に一定の間隔を介して内周側と外周側とに二列配置され
、しかも各列における間欠部を相互にカバーし合うよう
に対応位置に配置されるべくして縫合することも研究さ
れている。
(発明の解決すべき問題点)
上記した縫合器の出現は外科手術に際し、ステープル大
向に支承させた多数の鋸状をしたステープルをもって同
時的に縫合部位12を縫合することができることから迅
速を尊ぶ外科手術において大きな進展をもたらしたと評
価できる。
向に支承させた多数の鋸状をしたステープルをもって同
時的に縫合部位12を縫合することができることから迅
速を尊ぶ外科手術において大きな進展をもたらしたと評
価できる。
しかしながら一方において、上記の従来技(4iによる
場合においては鋸状をしたステープル11を縫合部位1
2に対して縦列的に施すものであるために縫合部位12
における肉片や皮膚片の食い込みにより各ステープルの
両足が真直下方に侵入せず、一旦外方に膨らんだ後その
先端部が相互に付き合わせ方向に折り曲げられるために
、各隣接するステープルヘッド間の間隔12a (第1
1図〜12図)あるいは、12C(第13図)をある程
度大きくしないと隣接するステープル11の各足片が相
互に干渉して縫合に支障を来たすことが多くなる。 と
ころが各ステープルヘッド間の間隔laを大きくした場
合には各ステープル間における止血効果が劣り、また両
足片間12bの離間による組織部からの出血と相俟って
止血が不完全となって好ましくないばかりでなく術後の
出血等による合併症をひきおこすことになる等の問題が
多い。
場合においては鋸状をしたステープル11を縫合部位1
2に対して縦列的に施すものであるために縫合部位12
における肉片や皮膚片の食い込みにより各ステープルの
両足が真直下方に侵入せず、一旦外方に膨らんだ後その
先端部が相互に付き合わせ方向に折り曲げられるために
、各隣接するステープルヘッド間の間隔12a (第1
1図〜12図)あるいは、12C(第13図)をある程
度大きくしないと隣接するステープル11の各足片が相
互に干渉して縫合に支障を来たすことが多くなる。 と
ころが各ステープルヘッド間の間隔laを大きくした場
合には各ステープル間における止血効果が劣り、また両
足片間12bの離間による組織部からの出血と相俟って
止血が不完全となって好ましくないばかりでなく術後の
出血等による合併症をひきおこすことになる等の問題が
多い。
(問題点を解決するための手段)
本発明は上記した従来技術における種々の問題点を解決
し外科手術の効率化と止血効果の向上をはかるようにし
たものであって、具体的には縫合部位を複数の門型をし
たステープルにより縫合する場合において、各ステープ
ルトップの少なくとも一部を隣接するステープルトップ
の幅方向側面に相互に接近させつつ直線方向もしくは円
方向に連続して組織縫合をおこなうようにしたことを特
徴とする外科手術における縫合方法、ならびに当該縫合
方法の実施に供するものであって、同一軸を支点として
相互に開閉自在とした一対の上部アームと下部アームと
からなり、上部アームには多数の門型ステープルの各足
片を下部アームとの対接面方向に向け、しかも各ステー
プルトップの少なくとも一部を隣接するステープルトッ
プの幅方向側面に相互に接近させつつアームの長さ方向
に連続して支承させるとともに、下部アームの上記した
上部アームとの隣接面には上部アームに支承される各門
型ステープルに対応する位置にステープル足片受は部を
形成してなるところの外科手術′用縫合器の構造に関す
るものである。
し外科手術の効率化と止血効果の向上をはかるようにし
たものであって、具体的には縫合部位を複数の門型をし
たステープルにより縫合する場合において、各ステープ
ルトップの少なくとも一部を隣接するステープルトップ
の幅方向側面に相互に接近させつつ直線方向もしくは円
方向に連続して組織縫合をおこなうようにしたことを特
徴とする外科手術における縫合方法、ならびに当該縫合
方法の実施に供するものであって、同一軸を支点として
相互に開閉自在とした一対の上部アームと下部アームと
からなり、上部アームには多数の門型ステープルの各足
片を下部アームとの対接面方向に向け、しかも各ステー
プルトップの少なくとも一部を隣接するステープルトッ
プの幅方向側面に相互に接近させつつアームの長さ方向
に連続して支承させるとともに、下部アームの上記した
上部アームとの隣接面には上部アームに支承される各門
型ステープルに対応する位置にステープル足片受は部を
形成してなるところの外科手術′用縫合器の構造に関す
るものである。
以下において本発明の具体的な内容を第1〜9図の実施
例をもとに説明すると、第5〜7図には本発明における
縫合方法の第1実施例が示されている。
例をもとに説明すると、第5〜7図には本発明における
縫合方法の第1実施例が示されている。
図において21は縫合用の門型をしたステープルを示し
、通常では直径Q、2mm〜1.0鶴程度のステンレス
スチール類のワイヤーが用いられ、第4図に示したよう
に中央部の水平なステープルトップ21aと、その左右
両端部を下方に折り曲げた足片21bとからなり、両足
片21bの各先端部は斜め方向に切断されて鋭突に尖ら
せである。
、通常では直径Q、2mm〜1.0鶴程度のステンレス
スチール類のワイヤーが用いられ、第4図に示したよう
に中央部の水平なステープルトップ21aと、その左右
両端部を下方に折り曲げた足片21bとからなり、両足
片21bの各先端部は斜め方向に切断されて鋭突に尖ら
せである。
ステープルトップの長さは通常3.5mm〜t3.ow
程度の範囲、足片の長さは通常3.01−〜13.01
m程度の範囲内のものが多く使用される。
程度の範囲、足片の長さは通常3.01−〜13.01
m程度の範囲内のものが多く使用される。
第1実施例においては縫合部位22に対し、各ステープ
ルトップ21aの長さ方向の端部を隣り合う別のステー
プルトップの幅方向側面に相互に接近させつつ順次直線
方向に連続して組織縫合がおこなわれている。
ルトップ21aの長さ方向の端部を隣り合う別のステー
プルトップの幅方向側面に相互に接近させつつ順次直線
方向に連続して組織縫合がおこなわれている。
組織縫合は第7図の断面によって理解できるように縫合
部位22の組織内を貫通し、反対側に突出した各ステー
プル21の左右の足片21bを内方に折り曲げてステー
プルトップ21aの下側に位置する組織を拘え込むよう
にカシメで圧迫保持することによりおこなわれる。
部位22の組織内を貫通し、反対側に突出した各ステー
プル21の左右の足片21bを内方に折り曲げてステー
プルトップ21aの下側に位置する組織を拘え込むよう
にカシメで圧迫保持することによりおこなわれる。
また第8図には本発明における縫合方法の第2実施例が
示されており、この場合においては腸端を相互に連結す
る場合の組織縫合をあられしたもので、連結する両腸端
部を外方に折り返して腸の内周面同志を重ね合わせて縫
合部位22とし、該部分に門型をしたステープル21を
その各ステープルトップ21aの長さ方向の端部を隣り
合う別のステープルトップの幅方向側面に相互に接近さ
せつつ順次円周方向に無端状に連続させて組織縫合をお
こなうようにしたものである。
示されており、この場合においては腸端を相互に連結す
る場合の組織縫合をあられしたもので、連結する両腸端
部を外方に折り返して腸の内周面同志を重ね合わせて縫
合部位22とし、該部分に門型をしたステープル21を
その各ステープルトップ21aの長さ方向の端部を隣り
合う別のステープルトップの幅方向側面に相互に接近さ
せつつ順次円周方向に無端状に連続させて組織縫合をお
こなうようにしたものである。
さらに第9図は本発明における縫合方法の第3実施例が
示されており、この場合には縫合部位に対し門型をした
ステープル21を、その各ステープルトップ21aがそ
の長さ方向に各隣り合うステープルトップに対して相互
に平行であって千鳥状に配設され、しかもそΦ長さ方向
のそれぞれの端部が隣り合う別のステープルトップ21
aの幅方向側面に相互に接近させつつ順次直線方向に連
続して組織縫合をおこなうようにしたものである。
示されており、この場合には縫合部位に対し門型をした
ステープル21を、その各ステープルトップ21aがそ
の長さ方向に各隣り合うステープルトップに対して相互
に平行であって千鳥状に配設され、しかもそΦ長さ方向
のそれぞれの端部が隣り合う別のステープルトップ21
aの幅方向側面に相互に接近させつつ順次直線方向に連
続して組織縫合をおこなうようにしたものである。
また第1〜3図には上記した縫合方法に関する各実施例
の使用に供するための縫合器の一例が示されている。
の使用に供するための縫合器の一例が示されている。
この縫合器は軸39を支点として相互に開閉自在とした
一対の上部アーム31と下部アーム36とからなり、上
部アーム31のテール部31aには軸40を支点に上部
ハンドル41が、また下部アーム36のテール部36a
には軸42を支点に下部ハンドル43がそれぞれ回動自
在に設けられ、さらに上部ハンドル41と下部ハンドル
43とは軸44により相互に矢印C−C方向に回動自在
に構成され、上部ハンドル41と下部ハンドル43とを
矢印C−C方向に回動させるにつれて軸40と42との
軸間距離が大きくなる結果上部アーム31と下部アーム
36とが相互に矢印D −D方向に接近し、かつ突出部
37が凹部32内に案内されて上・下アーム31.36
が相互に密接するように構成されている。
一対の上部アーム31と下部アーム36とからなり、上
部アーム31のテール部31aには軸40を支点に上部
ハンドル41が、また下部アーム36のテール部36a
には軸42を支点に下部ハンドル43がそれぞれ回動自
在に設けられ、さらに上部ハンドル41と下部ハンドル
43とは軸44により相互に矢印C−C方向に回動自在
に構成され、上部ハンドル41と下部ハンドル43とを
矢印C−C方向に回動させるにつれて軸40と42との
軸間距離が大きくなる結果上部アーム31と下部アーム
36とが相互に矢印D −D方向に接近し、かつ突出部
37が凹部32内に案内されて上・下アーム31.36
が相互に密接するように構成されている。
上部アーム31の先端部には凹部32を有するとともに
、その長さ方向に連続させて多数のステープル穴33が
それぞれ上部アーム31の上面から下部アーム36との
対向面に向けて貫通されており、しかもこのステープル
穴33はその長さ方向における少なくとも一部を互いに
隣り合うステープル穴の幅方向側面に相互に接近させつ
つ直線方向に連続して設けられている。
、その長さ方向に連続させて多数のステープル穴33が
それぞれ上部アーム31の上面から下部アーム36との
対向面に向けて貫通されており、しかもこのステープル
穴33はその長さ方向における少なくとも一部を互いに
隣り合うステープル穴の幅方向側面に相互に接近させつ
つ直線方向に連続して設けられている。
さらに34は上部アーム31の長さ方向に沿わせて設け
られた加圧金具を示し、その下面には上記した上部アー
ム31に貫通した各ステープル穴33内に進退が可能な
押出片35が上記各ステープル穴33の位置に対応させ
た角度位置にそれぞれ連接されている。
られた加圧金具を示し、その下面には上記した上部アー
ム31に貫通した各ステープル穴33内に進退が可能な
押出片35が上記各ステープル穴33の位置に対応させ
た角度位置にそれぞれ連接されている。
一方下部アーム36は、その先端部の上記した上部アー
ムの凹部32に対応する位置に上記凹部32に嵌入が可
能な大きさの突出部37が形成されており、しかも下部
アーム36の上記した上部アーム31に設けた多数、の
ステープル穴33にそれぞれ対応する位置にステープル
足片21bの折り曲げ四部38が形成されている。
ムの凹部32に対応する位置に上記凹部32に嵌入が可
能な大きさの突出部37が形成されており、しかも下部
アーム36の上記した上部アーム31に設けた多数、の
ステープル穴33にそれぞれ対応する位置にステープル
足片21bの折り曲げ四部38が形成されている。
この折り曲げ凹部38は第2図にも示したように、ステ
ープル21の両足片21a、21bの間隔に略等しい長
さを有するとともに、該凹部38の両端部より中間部方
向に向けて次第に深さを増し、さらに中間部においては
再度浅くなるようにそれぞれ2つの湾曲溝38a、38
bを有する。
ープル21の両足片21a、21bの間隔に略等しい長
さを有するとともに、該凹部38の両端部より中間部方
向に向けて次第に深さを増し、さらに中間部においては
再度浅くなるようにそれぞれ2つの湾曲溝38a、38
bを有する。
尚第2図は第5〜7図にあられした縫合方法実施のため
のステープル穴の構成をあられしたものであるが、第9
図にあられした縫合方法の実施のためには上部アーム3
1と下部アーム36とに設けられるステープル穴33と
押出片35.および折り曲げ凹部38の配置を上記した
第9図に示されたステープル配置に対応させて設ける必
要がある。
のステープル穴の構成をあられしたものであるが、第9
図にあられした縫合方法の実施のためには上部アーム3
1と下部アーム36とに設けられるステープル穴33と
押出片35.および折り曲げ凹部38の配置を上記した
第9図に示されたステープル配置に対応させて設ける必
要がある。
また第8図にあられされた縫合方法の実施のためには特
に図示はしないが、断面円形をした上下一対のディスポ
ーザブルローディングユニットのそれぞれの対向面に上
記第8図に示したステープル配置に対応可能なステープ
ル穴と折り曲げ凹部とを形成するものとする。
に図示はしないが、断面円形をした上下一対のディスポ
ーザブルローディングユニットのそれぞれの対向面に上
記第8図に示したステープル配置に対応可能なステープ
ル穴と折り曲げ凹部とを形成するものとする。
尚第1〜3図に示した構成の縫合器において、上部アー
ム31の内部には各ステープル穴33にそれぞれ対応す
る配列のステープル21をあらがしめ填装したカセット
装置を別途取り外し自在に設けるとより一層効率的であ
る。
ム31の内部には各ステープル穴33にそれぞれ対応す
る配列のステープル21をあらがしめ填装したカセット
装置を別途取り外し自在に設けるとより一層効率的であ
る。
(作 用)
上記した縫合器の構成において、とくに第1〜3図に示
した縫合器の作用について説明すれば、先ず第1図のよ
うに上・下部ハンドル41.43を開いて、上・下部ア
ーム31.36を相互に離間させた状態とし、上部アー
ム31内のステープル穴33内に直接に、または図示し
ないカセット装置を介して必要数のステープル21を装
填し、加圧金具34を取りつけた後、縫合部位22を上
・下アーム31.36間に挟み、上・下部レバー41.
43を相互に矢印C−C方向に駆動させることにより上
・下部アーム31.36を矢印D−D方向に相互に接近
さ共、かつ突出部37を凹部32内に案内させた後相互
に圧着させる(第3図の状態参照)。
した縫合器の作用について説明すれば、先ず第1図のよ
うに上・下部ハンドル41.43を開いて、上・下部ア
ーム31.36を相互に離間させた状態とし、上部アー
ム31内のステープル穴33内に直接に、または図示し
ないカセット装置を介して必要数のステープル21を装
填し、加圧金具34を取りつけた後、縫合部位22を上
・下アーム31.36間に挟み、上・下部レバー41.
43を相互に矢印C−C方向に駆動させることにより上
・下部アーム31.36を矢印D−D方向に相互に接近
さ共、かつ突出部37を凹部32内に案内させた後相互
に圧着させる(第3図の状態参照)。
次いで下部アーム36と加圧金具34とをペンチその他
の別の適当な加圧器具を用いて加圧金具34を上部アー
ム31の内方に侵入させる。 このときステープル穴3
3内の各ステープルはそのステープルヘッド21aを加
圧金具34の押出片35によって下方に押し下げられ、
左右の足片21bが組織内に刺し込まれ、貫通して反対
側面より突出した後、下部アーム36の各折り曲げ凹部
38の湾曲溝38a、38bに沿って内方に折り曲げら
れ、第7図に示したように内方の組織を拘え込むように
、両足片によりカシメつけて縫合を完了させる。
の別の適当な加圧器具を用いて加圧金具34を上部アー
ム31の内方に侵入させる。 このときステープル穴3
3内の各ステープルはそのステープルヘッド21aを加
圧金具34の押出片35によって下方に押し下げられ、
左右の足片21bが組織内に刺し込まれ、貫通して反対
側面より突出した後、下部アーム36の各折り曲げ凹部
38の湾曲溝38a、38bに沿って内方に折り曲げら
れ、第7図に示したように内方の組織を拘え込むように
、両足片によりカシメつけて縫合を完了させる。
(発明の効果)
本発明は上記した通り、縫合部位を複数の門型をしたス
テープルにより縫合する場合において、各ステープルト
ップの少なくとも一部を隣接するステープルトップの幅
方向側面に相互に接近させつつ直線方向もしくは円方向
に連続して組織縫合をおこなうようにしたものであるた
めに、従来の如く縦列方向に複数列ステープルを施す場
合に比べて各ステープルの端部同志の干渉の問題を生じ
ないから隣接するステープルを相互に十分に接近して施
すことが可能となり、その結果縫合部位の隙間がなくな
り止血効果が十分であること、またそのためにステープ
ルを複数列に配置する必要がなくなり、縫合部位におけ
る縫合が簡素化され、手術後の出血等による合併症も予
防され、しがも治癒期間を著しく短縮できること、さら
に縫合器の構造を簡素化できる等種々の有益な効果を奏
する。
テープルにより縫合する場合において、各ステープルト
ップの少なくとも一部を隣接するステープルトップの幅
方向側面に相互に接近させつつ直線方向もしくは円方向
に連続して組織縫合をおこなうようにしたものであるた
めに、従来の如く縦列方向に複数列ステープルを施す場
合に比べて各ステープルの端部同志の干渉の問題を生じ
ないから隣接するステープルを相互に十分に接近して施
すことが可能となり、その結果縫合部位の隙間がなくな
り止血効果が十分であること、またそのためにステープ
ルを複数列に配置する必要がなくなり、縫合部位におけ
る縫合が簡素化され、手術後の出血等による合併症も予
防され、しがも治癒期間を著しく短縮できること、さら
に縫合器の構造を簡素化できる等種々の有益な効果を奏
する。
第1図は本発明方法の実施に供する縫合器の側面図、第
2図は第1図の縫合器における上・下部アームの要部を
あられした斜視図、第3図は第1図の縫合器を閉じた状
態の側面図、第4図はステ−プルの拡大側面図、第5図
および第6図は縫合方法の一例をあられした斜視図、第
7図は第6図のB −B線矢視力向の部分断面図、第8
図は本発明における別の縫合方法をあられした縫合部位
の要部正面図、第9図は本発明におけるさらに別の縫合
方法をあられしたステープルの配置図、第1O図は従来
の縫合器における上・下部アームの構造をあられした要
部斜視図、第11図はステープルを用いた従来の縫合方
法の一例をあられした要部斜視図、第12図は第11図
におけるA−A線矢視方向の断面図、第13図はステー
プルを用いた従来の縫合方法の別の例をあられした要部
斜視図である。
2図は第1図の縫合器における上・下部アームの要部を
あられした斜視図、第3図は第1図の縫合器を閉じた状
態の側面図、第4図はステ−プルの拡大側面図、第5図
および第6図は縫合方法の一例をあられした斜視図、第
7図は第6図のB −B線矢視力向の部分断面図、第8
図は本発明における別の縫合方法をあられした縫合部位
の要部正面図、第9図は本発明におけるさらに別の縫合
方法をあられしたステープルの配置図、第1O図は従来
の縫合器における上・下部アームの構造をあられした要
部斜視図、第11図はステープルを用いた従来の縫合方
法の一例をあられした要部斜視図、第12図は第11図
におけるA−A線矢視方向の断面図、第13図はステー
プルを用いた従来の縫合方法の別の例をあられした要部
斜視図である。
Claims (2)
- (1)縫合部位を複数の門型をしたステープルにより縫
合する場合において、各ステープルトップの少なくとも
一部を隣接するステープルトップの幅方向側面に相互に
接近させつつ直線方向もしくは円方向に連続して組織縫
合をおこなうようにしたことを特徴とする外科手術にお
ける縫合方法。 - (2)同一軸を支点として相互に開閉自在とした一対の
上部アームと下部アームとからなり、上部アームには多
数の門型ステープルの各足片を下部アームとの対接面方
向に向け、しかも各ステープルトップの少なくとも1部
を隣接するステープルトップの幅方向側面に相互に接近
させつつアームの長さ方向に連続して支承させるととも
に、下部アームの上記した上部アームとの対接面には上
部アームに支承される各門型ステープルに対応する位置
にステープル足片受け部を形成した外科手術用縫合器。
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP62105327A JPS63270040A (ja) | 1987-04-28 | 1987-04-28 | 外科手術における縫合方法および縫合器 |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP62105327A JPS63270040A (ja) | 1987-04-28 | 1987-04-28 | 外科手術における縫合方法および縫合器 |
Publications (1)
Publication Number | Publication Date |
---|---|
JPS63270040A true JPS63270040A (ja) | 1988-11-08 |
Family
ID=14404624
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP62105327A Pending JPS63270040A (ja) | 1987-04-28 | 1987-04-28 | 外科手術における縫合方法および縫合器 |
Country Status (1)
Country | Link |
---|---|
JP (1) | JPS63270040A (ja) |
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US11717291B2 (en) | 2021-03-22 | 2023-08-08 | Cilag Gmbh International | Staple cartridge comprising staples configured to apply different tissue compression |
US11826042B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Surgical instrument comprising a firing drive including a selectable leverage mechanism |
US11723658B2 (en) | 2021-03-22 | 2023-08-15 | Cilag Gmbh International | Staple cartridge comprising a firing lockout |
US11737749B2 (en) | 2021-03-22 | 2023-08-29 | Cilag Gmbh International | Surgical stapling instrument comprising a retraction system |
US11826012B2 (en) | 2021-03-22 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising a pulsed motor-driven firing rack |
US11806011B2 (en) | 2021-03-22 | 2023-11-07 | Cilag Gmbh International | Stapling instrument comprising tissue compression systems |
US11849945B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Rotary-driven surgical stapling assembly comprising eccentrically driven firing member |
US11786239B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Surgical instrument articulation joint arrangements comprising multiple moving linkage features |
US11903582B2 (en) | 2021-03-24 | 2024-02-20 | Cilag Gmbh International | Leveraging surfaces for cartridge installation |
US11896219B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Mating features between drivers and underside of a cartridge deck |
US11744603B2 (en) | 2021-03-24 | 2023-09-05 | Cilag Gmbh International | Multi-axis pivot joints for surgical instruments and methods for manufacturing same |
US11793516B2 (en) | 2021-03-24 | 2023-10-24 | Cilag Gmbh International | Surgical staple cartridge comprising longitudinal support beam |
US11896218B2 (en) | 2021-03-24 | 2024-02-13 | Cilag Gmbh International | Method of using a powered stapling device |
US11849944B2 (en) | 2021-03-24 | 2023-12-26 | Cilag Gmbh International | Drivers for fastener cartridge assemblies having rotary drive screws |
US11944336B2 (en) | 2021-03-24 | 2024-04-02 | Cilag Gmbh International | Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments |
US11857183B2 (en) | 2021-03-24 | 2024-01-02 | Cilag Gmbh International | Stapling assembly components having metal substrates and plastic bodies |
US11786243B2 (en) | 2021-03-24 | 2023-10-17 | Cilag Gmbh International | Firing members having flexible portions for adapting to a load during a surgical firing stroke |
US11832816B2 (en) | 2021-03-24 | 2023-12-05 | Cilag Gmbh International | Surgical stapling assembly comprising nonplanar staples and planar staples |
US11918217B2 (en) | 2021-05-28 | 2024-03-05 | Cilag Gmbh International | Stapling instrument comprising a staple cartridge insertion stop |
US11723662B2 (en) | 2021-05-28 | 2023-08-15 | Cilag Gmbh International | Stapling instrument comprising an articulation control display |
US11826047B2 (en) | 2021-05-28 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising jaw mounts |
US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
US11980363B2 (en) | 2021-10-18 | 2024-05-14 | Cilag Gmbh International | Row-to-row staple array variations |
US11957337B2 (en) | 2021-10-18 | 2024-04-16 | Cilag Gmbh International | Surgical stapling assembly with offset ramped drive surfaces |
US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
US11992214B2 (en) | 2021-12-14 | 2024-05-28 | Cilag Gmbh International | Control systems for surgical instruments |
US11992208B2 (en) | 2022-04-12 | 2024-05-28 | Cilag Gmbh International | Rotary drive systems for surgical instruments |
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