WO2013005752A1

WO2013005752A1 - Tissue-securing device

Info

Publication number: WO2013005752A1
Application number: PCT/JP2012/067028
Authority: WO
Inventors: Takumi Isoda; Ken Fujisaki; Hirotaka Namiki
Original assignee: Olympus Corporation
Priority date: 2011-07-01
Filing date: 2012-06-27
Publication date: 2013-01-10
Also published as: JP2013013490A

Abstract

This tissue-securing device (1) includes a securing part (21) configured of a linear member (22) which is wound in a spiral shape, and a gripping part (26) provided at a first end (22a) of the linear member (22). The linear member (22) penetrates a tissue by rotating the securing part (21) around the central axis (CI) of the spiral formed by the securing part (21).

Description

[DESCRIPTION]

[Title of the Invention]

TISSUE-SECURING DEVICE

[Technical Field]

[0001]

The present invention relates to a tissue-securing device that secures tissues.

Priority is claimed on Japanese Patent Application No. 2011-147170, filed on July 1, 2011, the content of which is incorporated herein by reference.

[Background Art]

[0002]

Conventionally, a suture is used when securing tissues in dissection surgery and the like. The suture is attached to a suture needle, and this suture needle is inserted through the tissues on both sides of the dissection part. The suture is thus made to pass through both tissues, and they are secured by tightening them with the suture and then ligating them.

[0003]

Ligation of suture is a delicate procedure. Depending on the case, the ligation may be inside the patient's body cavity, a procedure which requires an advanced skill from the surgeon.

Accordingly, many tissue-securing devices for securing tissues without ligation of suture (hereinafter 'device') are being considered.

[0004]

For example, a device according to Patent Document 1 is formed in the shape of a spiral-shaped coil, and its distal end is formed in the shape of a sharp-pointed needle. The outer diameter of the device is approximately 3 to 20 mm. The length of the device in the center axis direction is not less than 2 mm.

When using this device to secure tissues, a special treatment tool is used. This is because the spiral-shape of the device makes it difficult to grip. The treatment tool includes an elastic holding part including three elastic pieces, and an operation part where the proximal ends of the elastic pieces are connected together. In a natural state, the three elastic pieces spread open so that they separate from each other, and the overall outer diameter of these three elastic pieces is thus greater than the inner diameter of the device.

[0005]

When using the device with this configuration, the surgeon firstly reduces the overall outer diameter of the three elastic pieces by pinching them together with his fingers, inserts them into the device, and then releases the force of his fingers. Due to the elastic force of the elastic pieces, the treatment tool firmly holds the device.

Having pulled the tissues on both sides of the dissection part of the body in directions that bring them closer together, the surgeon positions the device so that the center axis of its spiral shape substantially matches the dissection line, and then pierces the tissue with the distal end of the device. .

When the surgeon rotates the operation part, the device held by the three elastic pieces rotates around the center axis, and the distal end of the device advances into the tissues on both sides of the dissection line. When the device reaches the required depth, the surgeon uses a cutting tool or the like to cut away the device near the surface skin, and removes the part of the device that is outside the body.

By this procedure, the tissues on both sides are secured.

[Documents of the prior art] [Patent documents]

[0006]

[Patent Document 1] Japanese Unexamined Patent Application, First Publication No. H9-47457

[Disclosure of Invention]

[Problems to be Solved by the Invention]

[0007]

However, a special treatment tool is required to secure tissue using the device described in Patent Document. Considering that it is desirable to make the device even smaller to reduce the burden on the patient, the device becomes even more difficult to grasp.

By using the device described above, securing the tissues does not require an advanced skill. However, a special treatment tool is required, making the procedure more complex.

[0008]

It is an object of the present invention to provide a tissue-securing device capable of securing tissues without using a special treatment tool.

[Means for Solving the Problem]

[0009]

To solve the problems mentioned above, this invention proposes the following measures. According to a first aspect of the present invention, a tissue-securing device includes a securing part configured of a linear member which is wound in a spiral shape, and a gripping part provided at a first end of the linear member. The linear member penetrates a tissue by rotating the securing part around a central axis of the spiral formed by the securing part.

Preferably, the gripping part extends in a direction leading away from the securing part.

Preferably, the gripping part extends in a straight line.

[0010]

Preferably, the gripping part is formed in a rod-shape which extends in parallel with the central axis.

Preferably, the gripping part is disposed on the central axis.

Preferably, a needle-shaped part is provided at a distal end of the direction that the gripping part extends in, the diameter of the needle-shaped part decreasing toward the distal end.

[0011]

Preferably, the pitch of winding the linear member is greater at a first end side of the linear member than at a second end side thereof.

Preferably, the outer diameter of the securing part is smaller at the first end side of the linear member than at the second end side thereof.

Preferably, a stopping part is provided at a second end of the securing part that is opposite to the first end of the securing part where the gripping part is provided, the stopping part having a greater penetration resistance to penetrating the tissue than the linear member.

[0012]

Preferably, the outer diameter of the stopping part is greater than the outer diameter of the linear member. Preferably, a suture is connected to the gripping part.

Preferably, a suture needle is connected to an opposite side of the suture to the one where the gripping part is connected.

[Effects of the Invention]

[0013]

According to the tissue-securing device described above, tissues can be secured without using a special treatment tool.

[Brief Description of Drawings]

[0014]

[FIG. 1] A front view showing a device according to a first embodiment of the present invention.

[FIG. 2] A plan view showing the device of the first embodiment.

[FIG. 3] An explanatory perspective view showing a procedure using the device of the first embodiment.

[FIG. 4] An explanatory perspective view showing a procedure using the device of the first embodiment.

[FIG. 5] An explanatory plan view showing a procedure using the device of the first embodiment.

[FIG. 6] A front view showing a device according to a modified example 1 of the first embodiment of the present invention.

[FIG. 7] A plan view showing a device in the modified example 1 of the first embodiment.

[FIG. 8] A front view showing a device in a modified example 2 of the first embodiment of the present invention. [FIG. 9] A front view showing a device in a modified example 3 of the first embodiment of the present invention.

[FIG. 10] A front view showing a device in a modified example 4 of the first embodiment of the present invention.

[FIG. 11] A perspective view showing a device in a modified example 5 of the first embodiment of the present invention.

[FIG. 12] A front view showing a device having another configuration in a modified example of the first embodiment of the present invention.

[FIG. 13] A perspective view showing a device in a modified example 6 of the first embodiment of the present invention.

[FIG. 14] A plan view showing a device in a modified example 6 of the first embodiment.

[FIG. 15] An overall view showing a device of a second embodiment of the present invention.

[FIG. 16] An explanatory perspective view showing a procedure using the device of the second embodiment.

[FIG. 17] An explanatory perspective view showing a procedure using the device of the second embodiment.

[FIG. 18] An explanatory perspective view showing a procedure using the device of the second embodiment.

[FIG. 19] An explanatory plan view showing a procedure using the device of the second embodiment.

[Embodiment of the Invention]

[0015] (First Embodiment)

A device according to a first embodiment of the present invention will be explained with reference to FIGS. 1 to 14.

As shown in FIGS. 1 and 2, the device 1 includes a securing part 21 configured of a linear member which is wound in a spiral shape, and a gripping part 26 provided at a first end (other end) 22a of the linear member 22.

[0016]

The linear member 22 has a first end 22a and a second end (one end) 22b. The second end 22b is positioned on an opposite side to the first end 22a. The linear member 22 is set at the same pitch PI from the second end 22b to the first end 22a. The outer diameter of the securing part 21 is formed equal from the second end 22b of the linear member 22 to the first end 22a of the linear member 22.

[0017]

The gripping part 26 is formed in a rod-shape which extends in a straight line along the direction Dl, the direction Dl is parallel with the central axis CI of the spiral shape formed by the securing part 21. The direction Dl that the gripping part 26 extends in leads away from the securing part 21. In this embodiment, the gripping part 26 extends in the direction Dl, which differs from the direction of the tangent Tl of the linear member 22 at the first end 22a.

The securing part 21 and the gripping part 26 are formed integrally by deforming the linear member 22. The cross-sectional shape of the linear member 22 orthogonal to the long direction is circular.

The gripping part 26 is preferably of a size that is easy to handle with the tweezers and the needle-holder being used. For example, in delicate surgery of a cardiovascular region or the like, the length of the gripping part 26 in the central axis CI direction is preferably approximately 2 to 10 mm. Similarly, the length of the securing part 21 in the central axis CI direction is preferably approximately 1 to 3 mm, and the outer diameter of the securing part 21 is preferably approximately 0.1 to 1 mm. Thus the device is formed in a small size.

However, when the device is used in surgery of comparatively large organs such as the stomach, the lengths of the securing part 21 and the gripping part 26 can be greater than those described above.

[0018]

In this embodiment, the linear member 22 is formed from stainless steel.

As a material for forming the linear member 22, a resin or metal with affinity to living tissue can suitably be used.

In addition to stainless steel, used in this embodiment, examples of metals that can be used include Ni-Ti alloy, Co-Cr type alloy, pure Ti, Ti alloy, Mg alloy, etc. On the other hand, a resin for forming the linear member 22 be classified in an absorbent resin and a nonabsorbent resin. The absorbent resins include PGA, PLA, PDS, TMC, Poly-epsilon-caprolactone, or a copolymer of these. The nonabsorbent resins include nylon, polyester, polypropylene, polybutester, fluorine resin, etc.

[0019]

Subsequently, a procedure using the device of the embodiment configured as described above will be explained.

Firstly, the surgeon performs appropriate treatments such as cutting away the surface skin and organ or the like that is the object of treatment. Then, as shown in FIG. 3, at tissues Wl and W2 on both sides of the dissection part, the surgeon bends the end W3 of tissue Wl and the end W4 of tissue W2 into an L-shape, and holds the surfaces of the ends W3 and W4 in a state of abutting to each other.

Next, using a pair of tweezers V, the surgeon grips the securing part 21 side of the gripping part 26, pushes the Dl -directional distal end of the gripping part 26 against the end W3, and makes the gripping part 26 puncture the ends W3 and W4.

As shown in FIG. 4, when the gripping part 26 passes through the ends W3 and W4, the surgeon uses the tweezers V to grip the distal end 26a side of the gripping part 26 protruding from the end W4 and pull the device 1 in the Dl direction, thereby puncturing the end W3 of the tissue Wl with the first end 22a of the linear member 22.

When the surgeon rotates the device 1 around the central axis CI of the securing part 21 while pulling the gripping part 26 in the Dl direction, as shown in FIGS. 4 and 5, the linear member 22 constituting the securing part 21 passes through the ends W3 and W4, which are thereby sandwiched between adjacent windings of the linear member 22 in the central axis CI direction and secured together by the elastic force of the linear member 22, the elastic forces of the deformed tissues Wl and W2, and the like. The gripping part 26 thus has an introduction function for passing the securing part 21 through the ends W3 and W4 like a conventional needle.

[0020]

As described above according to the device 1 of the embodiment, when performing the procedure, the surgeon grips the gripping part 26 with the tweezers V. The gripping part 26 is provided at the first end 22a of the linear member 22, and extends in a straight line. The cross-sectional shape of the gripping part 26 in the plane orthogonal to the direction that it extends in is constant. Therefore, even if the gripping part 26 is formed in a very small size, it can easily be gripped by pinching it with the tweezers V or the like from both sides of the Dl direction that it extends in.

The tissues Wl and W2 can be secured by using the tweezers V to rotate the device 1 around the central axis CI.

Since the gripping part 26 extends in the Dl direction that leads away from the securing part 21 , the gripping part 26 protrudes from the securing part 21. This makes it even easier to grip the gripping part 26.

[0021]

The gripping part 26 is formed in a rod-shape which extends in parallel with the central axis CI of the securing part 21. By using the tweezers V to grip the distal end 26a side of the gripping part 26, which has passed through the tissue and protrudes from the end W4, and rotating the device 1 around the central axis CI, the distal end 26a side of the gripping part 26 is covered by the tweezers V. It is thus possible to prevent tissue on the Dl side of the device 1 from being damaged by the gripping part 26.

Also, since the gripping part 26 can be made compact, it is unlikely to obstruct the procedure.

[0022]

The device 1 of this embodiment is not limited to the embodiment described above, and, as explained below, its configuration can be modified in various ways.

FIGS. 6 and 7 show a modified example 1 of the first embodiment. As in a device 2 according to the modified example 1 shown in FIGS. 6 and 7, the gripping part 26 may be configured to position on the central axis CI of the securing part 21. The gripping part 26 of the modification 1 includes a needle-shaped part 26b at its distal end 26a, the diameter of the needle-shaped part 26b decreasing toward the distal end. [0023]

According to the device 2 having this configuration, when the device 2 is rotated around the central axis CI, the position of the gripping part 26 does not deviate.

Therefore, the device 2 can be easily rotated around the central axis CI and passed through the ends W3 and W4.

The surgeon can operate the device 2 by gripping it with any tool having a gripping function, such as a needle-holder, and not only with the tweezers V. The device 2 can be operated with a gripping apparatus provided at the distal end of a robot manipulator. For example, a device with a tip rotation mechanism on the manipulator is easy to rotate and operate. Moreover, if the gripping part 26 is disposed on the central axis CI of the securing part 21, a device with a tip rotation mechanism on the manipulator is easier to rotate and operate.

Since the needle-shaped part 26b is provided at the distal end 26a of the gripping part 26, it is even easier to puncture the ends W3 and W4 with the gripping part 26.

[0024]

FIG. 8 shows a modified example 2 of the embodiment of the present invention. According to the modified example 2, in addition to the configurations of the device 2 of the modified example 1 described above, the second end 22b of the linear member 22 can be provided with a gripping part 36, as in the device 3 shown in FIG. 8. In the modified example 2, the gripping part 26 does not include the needle-shaped part 26b.

The gripping part 36 is formed in a flat-plate shape and from the same material as the linear member 22. The gripping part 36 has a large width, and extends in a straight line in a direction D2, which is the opposite direction to Dl . The linear member 22 and the gripping part 36 are connected by an adhesion or welding. According to the device 3 having this configuration, since the device 3 can be gripped from both the first end 22a side and the second end 22b side of the securing part 21, it becomes easier to operate and its versatility can be enhanced.

[0025]

In the modified example 2, the device 3 need not include the gripping part 26. This is because the device 3 can easily be operated by gripping the gripping part 36.

[0026]

FIG. 9 shows a modified example 3 of the first embodiment of the present invention. According to the modified example 3, a securing part 41 may be provided instead of the securing part 21 of the device 2 in the modified example 1, as in a device 4 shown in FIG. 9. The securing part 41 is formed such that the pitch of the linear member 22 in the central axis CI is wider at first end 22a side than that of the second end 22b side.

In the modified example 3, the pitch of the linear member 22 increases continuously from the second end 22b toward the first end 22a.

According to the device 4 having this configuration, the end W3 of the tissue Wl and the end W4 of the tissue W2 become sandwiched between adjacent windings of the linear member 22 in the central axis CI direction from the first end 22a side of the securing part 41. It therefore becomes easier to sandwich the ends W3 and W4 between the adjacent windings of the linear member 22 in the central axis CI from the first end 22a side, and the tissues Wl and W2 can be reliably secured together.

The pitch of the linear member 22 in the device 4 may be such that it increases in steps from the second end 22b to the first end 22a.

[0027] FIG. 10 shows a modified example 4 of the first embodiment of the present invention. According to the modified example 4, a securing part 51 may be provided instead of the securing part 21 of the device 2 of the modified example 1, as in a device 5 shown in FIG. 10. The securing part 51 is formed such that the outer diameter E2 of the first end 22a of the linear member 22 is smaller than the outer diameter El of the second end 22b side.

In the modified example 4, the outer diameter of the securing part 51 decreases continuously from the second end 22b toward the end 22a.

According to the device 5 having this configuration, similar effects to those of the device 4 of the modified example 3 can be obtained.

[0028]

FIG. 11 shows a modified example 5 of the first embodiment of the present invention. According to the modified example 5, in addition to the configurations of the device 2 of the modified example 1, the second end 22b of the securing part 21 may be provided with a stopping part 61.

The stopping part 61 has a flat-plate shape, and is connected to the second end 22b so that it is orthogonal to the central axis CI of the securing part 21. The stopping part 61 is formed from the same material as the linear member 22.

The outer diameter of the stopping part 61 is greater than the outer diameter of the linear member 22. The penetration resistance of the stopping part 61, which expresses the difficulty of inserting the stopping part 61 when passing it through the end W3 of the tissue Wl, is consequently greater than the penetration resistance of the linear member 22. According to the device 6 having this configuration, the device 6 can be prevented from falling out of the ends W3 and W4 due to excessive rotation of the securing part 21 around the central axis CI.

[0029]

The outer diameter of the stopping part need only be greater than the outer diameter of the linear member 22, and its shape is not restricted to the one described above. In addition to a flat-plate shape, the stopping part can have various shapes such as spherical, rectangular, etc.

Moreover, in addition to the modified examples 1 to 5, the stopping part may be configured so that adjacent windings of the linear member 22 in the central axis CI direction on the second end 22b side of the securing part 21 are secured with an adhesive agent 66 or such like, as shown in FIG. 12.

In that case, the adhesive agent 66, and the adjacent windings of the linear member 22 secured by the adhesive agent 66, constitute the stopping part.

[0030]

The stopping part may be formed by performing a chemical process or the like to roughen outer peripheral face of the linear member 22 on the second end 22b side, thereby making the penetration resistance of this section greater than the penetration resistance of other sections of the linear member 22.

[0031]

FIG. 13 and 14 show a modified example 6 of the first embodiment of the present invention. According to the modified example 6, in addition to the configurations of the device 1 of the first embodiment, the second end 22b of the linear member 22 can be provided with a gripping part 68, as in a device 7 shown in FIGS. 13 and 14. The gripping part 68 is formed in a rod-shape which extends in a straight line from the second end 22b. In this modified example, the gripping part 68 extends in a direction D3, which is the same as the direction of the tangent T2 of the linear member 22 at the second end 22b.

When configured in this way, the gripping part 68 of the device 7 can obtain similar effects to those of the gripping part 26.

[0032]

(Second Embodiment)

Subsequently, a second embodiment of the invention will be explained with reference to FIGS. 15 to 19. Parts that are identical with the first embodiment are designated with like references codes and are not repetitiously explained; only points of difference will be explained.

As shown in FIG. 15, a device 8 of this embodiment includes a securing part 71, a stopping part 72, a gripping part 26, a suture 73, and a suture needle 74. The stopping part 72 is provided at the second end 22b of the securing part 71. The gripping part 26 is the same as that in the first embodiment. The suture 73 is connected to the distal end 26a of the gripping part 26. The suture needle 74 is connected to the opposite side of the suture 73 to the side where the gripping part 26 is connected.

The linear member 22 of the securing part 71 is wound in a spiral shape such that it is closely wound in the central axis CI direction (a method of winding where, in a natural state, adjacent windings of the linear member 22 in the central axis CI direction are contacting each other).

The stopping part 72 is formed in a disk-shape, and is connected to the second end 22b of the securing part 71. As the suture 73 and the suture needle 74, a suture and a suture needle that are publicly known can be used.

[0033]

Subsequently, a procedure using the device 8 of the embodiment having the configuration described above will be explained.

Firstly, the surgeon grips the suture needle 74 with the tweezers V, and, of the tissues Wl and W2 sandwiching the dissection part, punctures the tissue Wl with the suture needle 74. As shown in FIG. 16, by gripping the suture needle 74 that has protruded from the tissue Wl with the tweezers V and pulling it, the surgeon passes the suture 73 through the tissue Wl .

As shown in FIG. 17, the surgeon punctures the tissue W2 with the suture needle 74. When the surgeon pulls the suture needle 74 away from the dissection part, as shown in FIG. 18, the surfaces of the ends W3 and W4 abut against each other. The surgeon now punctures the end W3 of the tissue Wl with the first end 22a of the linear member 22.

[0034]

Thereafter, when the surgeon rotates the device 8 around the central axis CI of the securing part 71 while pulling the gripping part 26, in a manner similar to the procedure of the device 1 of the first embodiment, the ends W3 and W4 pass through the linear member 22 constituting the securing part 71. When the ends W3 and W4 enter between adjacent windings of the linear member 22, as shown in FIG. 19, the pitch of the closely wound linear member 22 increases in the central axis CI direction.

The ends W3 and W4 are sandwiched between the windings of the linear member 22 of the device, and are secured together by the elastic force of the linear member 22, the elastic force of the deformed tissues Wl and W2, and such like. At this time, the stopping part 72 prevents the device 8 from falling out from the ends W3 and W4.

[0035]

As described above, according to the device 8 of the embodiment, by providing the suture 73, it is possible to enhance the operability when handling the small securing part 71 such as that described above. This effect is noticeable when handling delicate tissue such as blood vessels of the heart, where the surfaces of the tissues on both sides of the dissection part are not easily abutted to each other.

Since the device 8 includes the suture needle 74, its puncturing capability is increased, and it can pass easily through the end W3 of the tissue Wl.

[0036]

The device 8 of the embodiment need not include the suture needle 74. This is because a configuration without the suture needle 74 can also increase the operability when handling the securing part 71.

[0037]

While first and second embodiments of the present invention have been described in detail with reference to the drawings, the specific configuration is not limited to these embodiments, and contains modified configurations that do not depart from the main points of the invention. Moreover, it goes without saying that appropriate combinations of the configurations described in the embodiments can also be used.

For example, in the first and second embodiments, the cross-sectional shape of the linear member 22 orthogonal to the long direction is circular. However, this cross-sectional shape is not limited to circular, and can be elliptical, or a multi-angled shape such as triangular or square. [0038]

In the first and second embodiments, the gripping part 26 is rod-shaped.

However, the shape of the gripping part is not limited to this, and can be wave-shaped, L-shaped, circular arc-shaped, etc.

The devices of the first and second embodiments can favorably be used in procedures other than the dissection described in the embodiments, such as procedures performed inside the body by inserting a trocar or the like, or by inserting via a natural orifice such as the mouth.

[Industrial Applicability]

[0039]

[Explanation of Reference]

[0040]

1, 2, 3, 4, 5, 6, 7, 8 DEVICE (TISSUE-SECURING DEVICE)

21, 41, 51, 71 SECURING PART

22 LINEAR MEMBER

22a FIRST END (OTHER END)

22b SECOND END (ONE END)

26, 36, 68 GRIPPING PART

26b NEEDLE-SHAPED PART

61, 72 STOPPING PART

73 SUTURE

74 SUTURE NEEDLE CENTER OF AXIS TISSUE

Claims

[CLAIMS]

[Claim 1] A tissue-securing device comprising

a securing part configured of a linear member which is wound in a spiral shape; and

a gripping part provided at a first end of the linear member; wherein

the linear member is configured to penetrate a tissue by rotating the securing part around a central axis of the spiral formed by the securing part.

[Claim 2] The tissue-securing device according to claim 1 , wherein the gripping part extends in a direction leading away from the securing part.

[Claim 3] The tissue-securing device according to claim 2, wherein the gripping part extends in a straight line.

[Claim 4] The tissue-securing device according to claim 3, wherein the gripping part is formed in a rod-shape which extends in parallel with the central axis.

[Claim 5] The tissue-securing device according to claim 4, wherein the gripping part is disposed on the central axis.

[Claim 6] The tissue-securing device according to claim 4 or 5, further comprising

a needle-shaped part at a distal end of the direction that the gripping part extends in, the diameter of the needle-shaped part decreasing toward the distal end.

[Claim 7] The tissue-securing device according to any one of claims 1 to 6, wherein a pitch of winding the linear member is greater at a first end side of said linear member than at a second end side thereof.

[Claim 8] The tissue-securing device according to any one of claims 1 to 7, wherein the outer diameter of the securing part is smaller at the first end side of the linear member than at the second end side thereof.

[Claim 9] The tissue-securing device according to any one of claims 1 to 8, further comprising

a stopping part provided at a second end of the securing part that is opposite to the first end of the securing part where the gripping part is provided, the stopping part having a greater penetration resistance to penetrating the tissue than the linear member.

[Claim 10] The tissue-securing device according to claim 9, wherein the outer diameter of the stopping part is greater than the outer diameter of the linear member.

[Claim 11] The tissue-securing device according to any one of claims 1 to 10, further comprising a suture connected to the gripping part.

[Claim 12] The tissue-securing device according to claim 11, further comprising a suture needle connected to an opposite side of the suture to the one where the gripping part is connected.