JPS635697Y2 - - Google Patents

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Publication number
JPS635697Y2
JPS635697Y2 JP1985050087U JP5008785U JPS635697Y2 JP S635697 Y2 JPS635697 Y2 JP S635697Y2 JP 1985050087 U JP1985050087 U JP 1985050087U JP 5008785 U JP5008785 U JP 5008785U JP S635697 Y2 JPS635697 Y2 JP S635697Y2
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JP
Japan
Prior art keywords
staple
suture
intestinal tract
intestinal
end surface
Prior art date
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Expired
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JP1985050087U
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JPS61165708U (ja
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Priority to JP1985050087U priority Critical patent/JPS635697Y2/ja
Priority to US06/843,257 priority patent/US4708141A/en
Publication of JPS61165708U publication Critical patent/JPS61165708U/ja
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Publication of JPS635697Y2 publication Critical patent/JPS635697Y2/ja
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A61B17/1155—Circular staplers comprising a plurality of staples

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Physiology (AREA)
  • Surgical Instruments (AREA)

Description

【考案の詳細な説明】 ［考案の技術分野］ この考案は溶解性腸管吻合具に係り、切断され
ている腸管同士を吻合する際に、腸管内に挿入し
て使用することで腸管同士を内翻した状態にて容
易にステープルによつて縫合し、しかも、縫合後
腸管内からの回収を必要とせず自然排泄できるよ
うにした溶解性腸管吻合具に関するものである。
［考案の技術的背景とその問題点］ 従来、患部を切除した後、切除された腸管同士
を縫合して吻合する際には、腸管自体が柔らかい
ので非常に縫合し難く、そのため、縫合に費やす
時間が手術時間の中で大きな割合を占ていた。
そのため、腸管同士を容易にステープル等より
縫合できるようにすべく各種実験が行われ器具等
が開発されている。ところが、腸管同士を吻合す
るには、柔らかい腸管同士を押えながら縫合しな
ければならず、しかも、腸管同士を吻合して閉じ
てしまうから腸管内に器具等を挿入して縫合する
には別の箇所に器具取出し孔を開穿しなければな
らないので、その分更に手術時間が伸びてしまう
欠点がある。そのため、腸管内に器具等を挿入し
ないで腸管の外側からステープル縫合により施術
する器具が開発されているが、この縫合器具には
腸管押え機構と縫合機構とを両方備えていなくて
はならず、縫合器具自体が複雑な機構を呈し、器
具自体も高価で、又、取扱いも難しいという欠点
があつた。
［考案の目的］ この考案は、上述した欠点等に鑑み、非常に簡
単な構造のもので、切離されている柔らかい腸管
同士を内翻した状態にて容易にステープルによつ
て縫合でき得るようにすることを目的として案出
されたものである。
［考案の概要］ 叙上の目的を達成するため、この考案は、腸管
内の液体によつて溶解可能な材料にて形成すると
共に腸管内に挿入可能な外径を有する筒状体とし
てそれぞれ形成した縫合受体とステープル収容体
と縫合押体とからなり、縫合受体の後端面には、
ステープル受溝を有し且つ腸管内の液体によつて
溶解不可能な硬質材にて形成されている受座を適
数個円周方向へ埋設し、ステープル収容体は、前
端面を縫合受体の後端面に対峙させるべく配する
と共に、この前端面における前記受座のステープ
ル受溝に対応する位置へステープルを保持するス
テープル保持孔をそれぞれ開穿し、縫合押体に
は、前記受座と同様な材料にて形成され且つ各ス
テープル保持孔内のステープルをステープル受溝
方向に押圧するステープル押圧板をそれぞれ植設
したことに存するものである。
［考案の実施例］ 以下、図面を参照してこの考案の一実施例を説
明すると次の通りである。
すなわち、図に示す符号は１は縫合受体１であ
り、腸管２内の液体、主に水分等を吸収して溶け
去る材料にて形成され、腸管２内に挿入可能な外
径を有する円筒状を呈していて、その先端の角は
腸管２内に挿入し易いようにＲ面取りをしてお
く。
そして、この縫合受体１の後端面３には、周面
４近傍に周方向へ複数個の受座５が埋設してあ
る。この受座５はステンレス鋼の如き耐蝕性を有
し且つ腸管内の液体によつて溶解不可能な硬質材
にて形成され、後記ステープル６の針先が当接し
た時にその針先を内側へ折曲して縫合させるステ
ープル受溝７が形成されているものである。
又、縫合受体１の後端面３の中心には、縫合受
体１の内周面と連続している内周面を有するガイ
ド筒８を立設しておき、このガイド筒８における
縫合受体１の後端面３近傍には、第２図及び第３
図に示すように、腸管２吻合の際に腸管２の内面
の粘膜９を糸２４の如きもので結んでおいて縫合
時にずれないようにするための二つのすべり止め
溝１０をガイド筒８の円周方向へ形成し、このガ
イド筒８における縫合受体１側のすべり止め溝１
０から後端までの軸心方向へキー溝１１を180゜間
隔を設けて２本形成してある。
一方、図に示す符号１２はステープル収容体で
あり、前記縫合受体１と同様の材料にて形成さ
れ、且つ縫合受体１と略同径の円筒状を呈してい
る。
そして、このステープル収容体１２は、前記ガ
イド筒８に外嵌摺動可能な内周を有すると共に、
このガイド筒８に外嵌させた際、前記キー溝１１
に係合してガイド筒８に対してステープル収容体
１２を回転させないようにするキー１３をガイド
筒８の内周に形成する。ステープル収容体１２の
前端面１４における周面近傍には、ガイド筒８に
ステープル収容体１２を外嵌させて縫合受体１の
後端面３とステープル収容体１２の前端面１４と
を対峙させた時に、前記ステープル受溝７に対応
した位置にステープル６を保持するステープル保
持孔１５を開穿すべく、この保持孔１５を有する
ステープル保持筒１６を埋設する。このステープ
ル保持筒１６は、プラスチツクの如き材料にて形
成された角筒状のもので、ステープル収容体１２
に埋設することでステープル収容体１２の前端面
から後端面までステープル６を保持するステープ
ル保持孔１５が貫通した状態に形成するものであ
る。尚、ステープル保持孔１５は、ステープル保
持筒１６を埋設せず、腸管内の液体によつて溶解
可能な材料にて形成されているステープル収容体
１２に直接開穿しても良いことは言うまでもな
い。
更に、図に示す符号１７は縫合押体１７であ
り、縫合受体１と同様の材料で、且つ縫合受体１
のガイド筒８に外嵌摺動可能な内周と縫合受体１
の外径に対し略同径の外径とを有する筒状を呈し
ていて、その後端の角は腸管２内に挿入し易いよ
うにＲ面取りをしておく。
そして、縫合受体１のガイド筒８にステープル
収容体１２と縫合押体１７とを外嵌した際に、ス
テープル収容体１２の後端面２１と対峙する縫合
押体１７の前端面２０には、後端面２１に開孔し
ている前記受座５と同様な材料にて形成されてい
るステープル保持孔１５に対応してステープル押
圧板１８をそれぞれ植設し、縫合押体１７をステ
ープル収容体１２方向へ移動させることでステー
プル保持孔１５内に保持したステープル６を前記
ステープル受溝７方向へステープル押圧板１８に
よつて押圧するものである。しかも、縫合押体１
７内周には、前記キー溝１１に係合して縫合押体
１７の回転止めを行ないステープル保持孔１５と
ステープル押圧板１８と合致するようにするキー
１９が形成されているものである。
又、前記縫合受体１の周面４と縫合押体１７の
周面２２とには、鉗子を掛止するための鉗子掛け
溝２３をそれぞれ形成しておくものである。
次に、これが使用を説明すると次の通りであ
る。
すなわち、先ず最初に、第２図に示すように、
切離された腸管２の一方へ縫合受体１を先端から
挿入してガイド筒８のみを外部に突出させてお
く。次に、ガイド筒８にステープル収容体１２と
縫合押体１７とを外嵌させてステープル収容体１
２の後端面２１側からステープル保持筒１６のス
テープル保持孔１５へステープル押圧板１８をそ
れぞれ挿入する。その時にステープル保持孔１５
の前端面１４側からステープル６を挿入してステ
ープル保持筒１６内に保持させておく。
そして、この状態で、切離された腸管２の他方
へ縫合押体１７とステープル収容体１２とを挿入
し、次に切離された腸管２の両方の粘膜９を引き
延ばして糸２４の如きもので各々すべり止め溝１
０に縛りつけて腸管２をずれないようにしてお
く。
そこで、腸管２の上から鉗子（図示せず）によ
つて縫合受体１の鉗子掛け溝２３と縫合押体１７
の鉗子掛け溝２３とを挾持して縫合押体１７を縫
合受体１方向へ押圧移動させる。その時に、腸管
２の切離端２５は、それぞれ縫合受体１の後端面
３中心方向へ、及びステープル収容体１２の中心
方向へだれ込むようにして内翻する状態に保持し
ておくものである。
そうすると、第３図に示すように、切離された
腸管２の切離端２５同士は内翻した状態でステー
プル６により縫合されるものである。そして、縫
合後適当な時間経過すると、縫合受体１、ステー
プル収容体１２、及び縫合押体１７は腸管２内の
液体によつて溶解する。その結果、腸管２内には
前記受座５、ステープル保持筒１６、及びステー
プル押圧板１８、そして粘膜９を縛つておいた糸
２４のみが残り、これら自体は、非常に小さいも
のであるから、腸管２内から自然排泄されるもの
であり、その時点で吻合が完了する。
又、前記縫合受体１、ステープル収容体１２、
縫合押体１７は、前述の如く共に腸管２内の液
体、主に水分等を吸収して溶け去る材料にて形成
され、その材料としては、例えば、ゼラチン、ア
ルブミン、デキストリン、キトサン、プルーラン
等の天然高分子材、或いは、ヒドロキシプロピル
セルロース、ヒドロキシプロピルメチルセルロー
ス、メチルセルロース、カルボキシメチルセルロ
ース、カルボキシメチルエチルセルロース等の誘
導体、そしてポリビニルアルコール、ポリアクリ
ルアミド、ポリアクリル酸、ポリエチレンオキシ
ド、ポリビニルピノリドン等の合成高分子材等を
挙げることができる。
そして、必要に応じては、前記材料の表面に難
水溶性高分子材としてのエチルセルロース、セル
ロースアセテート等にて薄くコーテイングして縫
合受体１、ステープル収容体１２、縫合押体１７
が所定時間水に溶けないようにしても良い。
次に、これらの縫合受体１、ステープル収容体
１２、縫合押体１７の製造法を示すと、前記天然
高分子材、セルロース誘導体、合成高分子材等を
水又は有機溶媒にて溶してから成形のための型に
流し込み、形を保ちつつ水又は有機溶媒を除去し
て乾燥させて形成するものである。
その一例を示すと、アルカリ処理ゼラチン（新
田ゼラチン＃200）に対し、１〜1.25倍程度の精
製水を加えて室温にて膨潤させる。
その後、60℃〜70℃水溶液中で溶解させ、激し
く撹拌してあらかじめ60℃〜70℃に加温しておい
た成形用金属型（図示せず）に流し込む。
成形用金属型に流し込んだ後、この型を氷冷し
て前記ゼラチンをゲル化させ型から取りだす。取
り出したゼラチンゲルは、型によつて前記縫合受
体１、ステープル収容体１２、縫合押体１７の形
状にそれぞれ成形されていて、それぞれをその内
径と同径のテフロン製の棒に外嵌させ冷蔵庫内に
２時間以上放置して凍結させる。
完全に凍結したゼラチンを前記テフロン製の棒
に外嵌せたまま凍結乾燥機にて８〜30時間脱水乾
燥させる。
そして、完全に脱水乾燥させたゼラチンをテフ
ロン製の棒から抜き取り、5W／Ｖ％エチルセル
ロース（東京化成工業製、45CPS）エタノール溶
液に浸してから室温にて乾燥し、ゼラチン表面に
エチルセルロースの被膜をコーテイングして完成
するものである。
ここで、前記溶解したゼラチンを激しく撹拌す
るのは、ゼラチン中に小気泡を入れることで乾燥
による収縮を均一にし、その収縮率を小さくする
目的で行なわれるものであり、又、凍結乾燥によ
り脱水するのは、乾燥によるゼラチンの収縮を少
なくするためのものであり、更に、ゼラチン表面
をエチルセルロースの被膜でコーテイングするの
は、水のゼラチンへの浸透をある程度防ぎ、30〜
60分間はゼラチンの強度を保つことを目的とする
ものである。尚、エチルセルロースの膜厚を調節
することでゼラチンの軟化、溶解の時間を制御す
ることができる。
［考案の効果］ 如上の如く構成したこの考案は、腸管２内の液
体によつて溶解可能な材料にて形成すると共に腸
管２内に挿入可能な外径を有する筒状体としてそ
れぞれ形成した縫合受体１とステープル収容体１
２と縫合押体１７とからなるから、腸管２内に挿
入したままに放置しておいても所定時間経過すれ
ば腸管２内の液体によつて溶解されるので、腸管
２の別の箇所に器具取出し孔を開穿しなくとも自
然消滅し縫合時間の短縮を図ることができるもの
である。
そして、縫合受体１の後端面３には、ステープ
ル受溝７を有し且つ腸管内の液体によつて溶解不
可能な硬質材にて形成されている受座５を適数個
円周方向へ埋設し、ステープル収容体１２は、前
端面１４を縫合受体１の後端面３に対峙させるべ
く配すると共に、この前端面１４における前記受
座５のステープル受溝７に対応する位置へステー
プル６を保持するステープル保持孔１５をそれぞ
れ開穿し、縫合押体１７には、前記受座と同様な
材料にて形成され且つ各ステープル保持孔１５内
のステープル６をステープル受溝７方向に押圧す
るステープル押圧板１８をそれぞれ植設したこと
により、縫合押体１７のステープル押圧板１８に
よつてステープル保持孔１５内のステープル６を
押圧すれば、切離された腸管２同士の切離端２５
を縫合受体１の後端面３とステープル収容体１２
の前端面１４との間に配することで腸管２同士を
内翻した状態にて容易にステープル６によつて腸
管２同士を吻合することができる。
しかも、吻合完了後、腸管２内に残された縫合
受体１、ステープル収容体１２、縫合押体１７は
前述の如く腸管２内に分泌する液体によつて溶解
してしまい、腸管２内には受座５及びステープル
押圧板１８等の非常に小さいものがばらばらにな
つて残るのみであり、これらの小さいものは難な
く自然排泄されるのである。従つて、縫合が完了
した後の器具取出しのための再手術の必要がない
ため、手術時間の大幅な短縮を図ることができる
と共に、患者の吻合部分の回復も非常に早くなる
ものである。
以上説明したように、この考案によれば、非常
に簡単な構造のもので特別な器具を使用しなくと
も腸管同士を内翻した状態にてステープルにより
容易に吻合することができ、又、吻合後に器具を
取出すための再手術を必要としないから、ステー
プルによつて縫合することと相俟つて手術時間の
大幅な短縮を図ることができると共に、患者の回
復も非常に早くなり、そして、材料費も安価であ
るから、手術費用も安価になり患者の負担を軽減
することができる等の実用上有益な効果を奏する
ものである。
【図面の簡単な説明】
図面はこの考案の一実施例を示すもので第１図
は一部切欠分解斜視図、第２図は腸管内に挿入時
の正断面図、第３図は峰合時の正断面図である。 １……縫合受体、２……腸管、３……後端面、
４……周面、５……受座、６……ステープル、７
……ステープル受溝、８……ガイド筒、９……粘
膜、１０……すべり止め溝、１１……キー溝、１
２……ステープル収容体、１３……キー、１４…
…前端面、１５……ステープル保持孔、１６……
ステープル保持筒、１７……縫合押体、１８……
ステープル押圧板、１９……キー、２０……前端
面、２１……後端面、２２……周面、２３……鉗
子掛け溝、２４……糸、２５……切離端。

Claims (1)

    【実用新案登録請求の範囲】
  1. 腸管内の液体によつて溶解可能な材料にて形成
    すると共に腸管内に挿入可能な外径を有する筒状
    体としてそれぞれ形成した縫合受体とステープル
    収容体と縫合押体とからなり、縫合受体の後端面
    には、ステープル受溝を有し且つ腸管内の液体に
    よつて溶解不可能な硬質材にて形成されている受
    座を適数個円周方向へ埋設し、ステープル収容体
    は、前端面を縫合受体の後端面に対峙させるべく
    配すると共に、この前端面における前記受座のス
    テープル受溝に対応する位置へステープルを保持
    するステープル保持孔をそれぞれ開穿し、縫合押
    体には、前記受座と同様な材料にて形成され且つ
    各ステープル保持孔内のステープルをステープル
    受溝方向に押圧するステープル押圧板をそれぞれ
    植設したことを特徴とする溶解性腸管吻合具。
JP1985050087U 1985-04-04 1985-04-04 Expired JPS635697Y2 (ja)

Priority Applications (2)

Application Number Priority Date Filing Date Title
JP1985050087U JPS635697Y2 (ja) 1985-04-04 1985-04-04
US06/843,257 US4708141A (en) 1985-04-04 1986-03-24 Soluble suturing device for an intestine

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP1985050087U JPS635697Y2 (ja) 1985-04-04 1985-04-04

Publications (2)

Publication Number Publication Date
JPS61165708U JPS61165708U (ja) 1986-10-14
JPS635697Y2 true JPS635697Y2 (ja) 1988-02-17

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Family Applications (1)

Application Number Title Priority Date Filing Date
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Country Status (2)

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US (1) US4708141A (ja)
JP (1) JPS635697Y2 (ja)

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US4708141A (en) 1987-11-24

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