CN113473921B - Healing promoting instrument - Google Patents
Healing promoting instrument Download PDFInfo
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- CN113473921B CN113473921B CN202080016201.4A CN202080016201A CN113473921B CN 113473921 B CN113473921 B CN 113473921B CN 202080016201 A CN202080016201 A CN 202080016201A CN 113473921 B CN113473921 B CN 113473921B
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- Prior art keywords
- healing
- healing promoting
- promoting instrument
- main body
- joined
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- 230000035876 healing Effects 0.000 title claims abstract description 119
- 230000001737 promoting effect Effects 0.000 title claims abstract description 100
- 210000000056 organ Anatomy 0.000 claims abstract description 51
- 230000002093 peripheral effect Effects 0.000 claims description 12
- 230000000452 restraining effect Effects 0.000 claims description 3
- 238000001356 surgical procedure Methods 0.000 abstract description 3
- 210000002429 large intestine Anatomy 0.000 description 39
- 238000000034 method Methods 0.000 description 31
- 230000004048 modification Effects 0.000 description 27
- 238000012986 modification Methods 0.000 description 27
- 238000005304 joining Methods 0.000 description 20
- 230000003872 anastomosis Effects 0.000 description 14
- 239000011295 pitch Substances 0.000 description 14
- 239000000463 material Substances 0.000 description 12
- 210000000436 anus Anatomy 0.000 description 11
- 229920006167 biodegradable resin Polymers 0.000 description 8
- 210000001035 gastrointestinal tract Anatomy 0.000 description 7
- 230000000968 intestinal effect Effects 0.000 description 7
- 239000000835 fiber Substances 0.000 description 5
- 238000004519 manufacturing process Methods 0.000 description 4
- 229920001577 copolymer Polymers 0.000 description 3
- 229920002627 poly(phosphazenes) Polymers 0.000 description 3
- 206010028980 Neoplasm Diseases 0.000 description 2
- 229920002732 Polyanhydride Polymers 0.000 description 2
- 229920001710 Polyorthoester Polymers 0.000 description 2
- 229920003232 aliphatic polyester Polymers 0.000 description 2
- 210000001124 body fluid Anatomy 0.000 description 2
- 239000010839 body fluid Substances 0.000 description 2
- 229920002678 cellulose Polymers 0.000 description 2
- 235000010980 cellulose Nutrition 0.000 description 2
- 239000000470 constituent Substances 0.000 description 2
- 150000004676 glycans Chemical class 0.000 description 2
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- 229920000515 polycarbonate Polymers 0.000 description 2
- 239000004417 polycarbonate Substances 0.000 description 2
- 229920000642 polymer Polymers 0.000 description 2
- 229920001184 polypeptide Polymers 0.000 description 2
- -1 polyphosphoesters Polymers 0.000 description 2
- 229920001282 polysaccharide Polymers 0.000 description 2
- 239000005017 polysaccharide Substances 0.000 description 2
- 229920002451 polyvinyl alcohol Polymers 0.000 description 2
- 235000019422 polyvinyl alcohol Nutrition 0.000 description 2
- 102000004196 processed proteins & peptides Human genes 0.000 description 2
- 108090000765 processed proteins & peptides Proteins 0.000 description 2
- 102000004169 proteins and genes Human genes 0.000 description 2
- 108090000623 proteins and genes Proteins 0.000 description 2
- 238000009958 sewing Methods 0.000 description 2
- 238000009987 spinning Methods 0.000 description 2
- 102000009123 Fibrin Human genes 0.000 description 1
- 108010073385 Fibrin Proteins 0.000 description 1
- BWGVNKXGVNDBDI-UHFFFAOYSA-N Fibrin monomer Chemical compound CNC(=O)CNC(=O)CN BWGVNKXGVNDBDI-UHFFFAOYSA-N 0.000 description 1
- 230000009471 action Effects 0.000 description 1
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- 230000001070 adhesive effect Effects 0.000 description 1
- 238000007664 blowing Methods 0.000 description 1
- 201000011510 cancer Diseases 0.000 description 1
- 238000007796 conventional method Methods 0.000 description 1
- 238000005520 cutting process Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000001523 electrospinning Methods 0.000 description 1
- 238000010041 electrostatic spinning Methods 0.000 description 1
- 229950003499 fibrin Drugs 0.000 description 1
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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
Abstract
Provided is a healing promoting instrument which can reduce the risk of incomplete suturing after surgery or the like. The healing promoting instrument (100) has: a sheet-like body part (10) which is disposed between one joined site and the other joined site of a biological organ to be joined, and which promotes healing of biological tissue; and an extension portion (20) which extends along a crossing direction crossing the surface direction of the main body portion and covers the bonded portion.
Description
Technical Field
The present application relates to a healing promoting instrument.
Background
In the medical field, a surgical operation (e.g., anastomosis of digestive tracts) for joining biological organs by a surgical operation is known. It is also known that in the case of performing the above-described operation, it is important that no healing delay occurs in the joint where the biological organs are joined to each other as a post-operation prognostic determinant.
Various methods and medical instruments are used in the operation of joining biological organs, and for example, a method of suturing biological organs with biodegradable sutures and a method of using a mechanical joining device for performing anastomosis by an anastomat have been proposed (see patent document 1). In particular, in the case of performing anastomosis using a mechanical joining device, the joining force between the living organs at the joined portion can be increased as compared with the method using a suture thread, and thus the risk of incomplete suturing can be reduced.
Prior art literature
Patent literature
Patent document 1: japanese patent laid-open No. 2007-505508
Disclosure of Invention
However, the extent of healing in the joint also depends on the state of the living tissue in the joint target site (joined site) of the patient, and the like. Therefore, even when the joining device described in patent document 1 is used, the risk of incomplete suturing may not be sufficiently reduced depending on the state of the living tissue of the patient.
It is therefore an object of the present application to provide a healing promoting instrument that can reduce the risk of incomplete suturing after surgery or the like.
The healing promoting instrument according to an embodiment of the present application includes: a sheet-like body portion disposed between one joined site and the other joined site of a living body organ to be joined, for promoting healing of a living body tissue; and an extension portion extending in a crossing direction crossing the surface direction of the main body portion and covering the joined portion.
Effects of the application
According to the healing promoting instrument of the present application, the body portion is sandwiched between the living organs to be joined, so that healing of the living tissues of the living organs can be promoted. In addition, since the healing promoting instrument includes the extension portion covering the joined portion, the body portion can be prevented from falling off from the living body organ. According to the above, the operator can effectively reduce the risk of incomplete suturing of the living organ.
Drawings
Fig. 1 is a perspective view showing a healing promoting instrument according to an embodiment of the present application.
Fig. 2 is a plan view showing the healing promoting instrument of the present embodiment.
Fig. 3 is a cross-sectional view taken along line 3-3 of fig. 2.
Fig. 4 is a sectional view showing a part of a section taken along line 4-4 of fig. 2 in an enlarged manner.
Fig. 5 is a view corresponding to fig. 3 of the healing promoting instrument of modification 1.
Fig. 6 is a view corresponding to fig. 3 of the healing promoting instrument of modification 2.
Fig. 7 is a view corresponding to fig. 3 of the healing promoting instrument of modification 3.
Fig. 8 is a view corresponding to fig. 3 of the healing promoting instrument of modification 4.
Fig. 9 is a flow chart showing steps of a treatment method using a healing promoting instrument.
Fig. 10 is a flowchart showing steps of an embodiment of a treatment method (colistomy).
Fig. 11 is a schematic cross-sectional perspective view for explaining the anastomosis of large intestine.
Fig. 12 is a schematic cross-sectional view for explaining the anastomosis of large intestine.
Fig. 13 is a schematic cross-sectional view for explaining the anastomosis of large intestine.
Fig. 14 is a schematic cross-sectional view for explaining the anastomosis of large intestine.
Detailed Description
Embodiments of the present application are described below with reference to the drawings. In the description of the drawings, the same elements are denoted by the same reference numerals, and repetitive description thereof will be omitted. In addition, the dimensional proportion of the drawings may be exaggerated for convenience of explanation, unlike the actual proportion.
Fig. 1 to 4 are views for explaining the structure of a healing promoting instrument 100 according to an embodiment of the present application.
< healing promoting instrument 100 >)
As shown in fig. 11 to 14, the healing promoting instrument 100 can be applied to a procedure (e.g., anastomosis of digestive tracts) for joining predetermined biological organs to each other. As described later, in the description of the present specification, the large intestine anastomosis is described as an example of an operation using the healing promoting instrument 100.
As shown in fig. 1 to 3, the healing promoting instrument 100 includes: a main body 10 disposed between one joined site and the other joined site of a living organ to be joined; an extension portion 20 extending along a crossing direction (up-down direction of fig. 3) crossing the plane direction (paper surface direction of fig. 2) of the main body portion 10; and a suppressing portion 30 fixed to the outer peripheral side of the extending portion 20. The following describes the respective structures of the healing promoting instrument 100.
< body portion 10 >)
The body 10 is formed in a sheet shape for promoting healing of a living tissue. The main body 10 can be formed of, for example, a biodegradable sheet member (film-like member).
The body 10 has a plurality of through holes 15 formed therein. As shown in fig. 1 to 2, the plurality of through holes 15 are regularly and periodically provided in the surface direction of the main body 10. However, the plurality of through holes 15 may be provided at random in the surface direction of the main body 10.
As shown in fig. 4, the through-hole 15 extends substantially perpendicularly between the front surface 11 and the rear surface 12 along the thickness direction (up-down direction in fig. 4) of the main body 10. The through-hole 15 may be bent or curved in a zigzag shape between the front surface 11 and the rear surface 12 in a cross section of the body 10 in the thickness direction.
The through hole 15 has a substantially circular planar shape (a shape when viewed from above the front surface 11 or the rear surface 12 of the main body 10). However, the planar shape of the through-hole 15 is not particularly limited, and may be, for example, elliptical or polygonal (rectangular or triangular, etc.). The planar shape and/or the cross-sectional shape may be different for each of the through holes 15.
The body portion 10 has a substantially circular shape. However, the shape of the main body 10 is not particularly limited, and may be, for example, elliptical or polygonal (rectangular or triangular, etc.).
The thickness T (see fig. 4) of the main body 10 is not particularly limited, but is preferably 0.05 to 0.3mm, and more preferably 0.1 to 0.2mm. When the thickness of the body 10 is 0.05mm or more (particularly, when the thickness is 0.1mm or more), the body 10 can have strength enough not to be broken when the healing promoting instrument 100 is used. On the other hand, when the thickness of the body 10 is 0.3mm or less (particularly, when the thickness is 0.2mm or less), the body 10 can have sufficient flexibility to closely contact with and follow the living tissue to which the body 10 is applied.
Regarding the main body 10, it is preferable that the ratio of the aperture D (distance D shown in fig. 4) of the through-holes 15 to the pitch P (distance P shown in fig. 4, distance between adjacent through-holes 15) of the through-holes 15 is 0.25 or more and 40 or less. When the planar shape of the through-hole 15 is a perfect circle, the diameter D of the through-hole 15 is equal to the diameter of the perfect circle. On the other hand, when the planar shape of the through-hole 15 is not a perfect circle, the diameter of a perfect circle (circle equivalent diameter) having the same area as the area of the opening of the through-hole 15 (the portion facing the front surface 11 or the rear surface 12 in the through-hole 15) can be set as the aperture D of the through-hole 15.
Since the body 10 has a plurality of through holes 15, there are a plurality of values of the aperture D corresponding to each through hole 15. Therefore, in the present embodiment, when calculating the above ratio, the arithmetic average value of the values of the two or more apertures D corresponding to the plurality of through holes 15, respectively, is used as the representative value of the aperture D. On the other hand, the pitch P of the plurality of through holes 15 is defined as the shortest distance between the openings of the two through holes 15. However, there are also a plurality of values of the pitch P corresponding to the combination of the adjacent through holes 15 as to the value of the pitch P. Therefore, in the present embodiment, when calculating the above ratio, an arithmetic average value of values of two or more pitches P corresponding to the combination of the adjacent through holes 15, respectively, is used as a representative value of the pitches P.
The pitch P, the aperture D, the ratio of the aperture D to the pitch P, and the like of the through holes 15 are examples, and are not limited thereto.
As shown in fig. 1 to 3, the main body 10 has a hole 16 near the center. The hole 16 may be formed in the main body 10 in advance, or may be formed by an operator during the operation.
The main body 10 can be made of a biodegradable material. The constituent material of the main body 10 is not particularly limited, and examples thereof include biodegradable resins. As the biodegradable resin, for example, a known biodegradable (co) polymer such as a biodegradable resin described in japanese patent application laid-open publication No. 2011-528275, japanese patent application laid-open publication No. 2008-514719, international publication No. 2008-1952, japanese patent application laid-open publication No. 2004-509205, and the like can be used. Specifically, (1) a polymer selected from the group consisting of aliphatic polyesters, polyanhydrides, polyorthoesters, polycarbonates, polyphosphazenes (polyphosphazenes), polyphosphoesters, polyvinyl alcohols, polypeptides, polysaccharides, proteins, and celluloses; (2) Copolymers comprising one or more monomers constituting the above (1), and the like. That is, the biodegradable sheet preferably contains at least one biodegradable resin selected from the group consisting of aliphatic polyesters, polyanhydrides, polyorthoesters, polycarbonates, polyphosphazenes, polyphosphoesters, polyvinyl alcohols, polypeptides, polysaccharides, proteins, and celluloses, and copolymers (composed of one or more monomers constituting the above polymers).
The method for producing the main body 10 is not particularly limited, and examples thereof include a method for producing fibers made of the biodegradable resin and producing a web-shaped sheet using the fibers. The method for producing the fiber made of the biodegradable resin is not particularly limited, and examples thereof include an electrospinning (electric spinning method/electrostatic spinning method) method, a melt blowing method, and the like. The main body 10 may be used by selecting only one of the above methods, or two or more methods may be appropriately combined. As another example of the method for producing the main body 10, the biodegradable sheet of the present application may be produced by spinning fibers made of the biodegradable resin described above according to a conventional method and knitting the obtained fibers into a net shape.
The main body 10 causes a biological reaction by a constituent material such as a biodegradable resin constituting the main body 10. The body 10 induces the discovery of biological components such as fibrin by this action. The living body components induced in this way accumulate so as to penetrate through the through-hole 15 of the body 10, and thereby healing can be promoted. Therefore, by disposing the body 10 between the living organs to be joined, the healing promotion by the above mechanism is generated.
The material of the main body 10 may not be biodegradable as long as it can promote healing of a living organ. The body 10 may not be formed with the through-hole 15 regardless of the material as long as it can promote healing of the living body organ.
< extension 20 >
As shown in fig. 3, the extension portion 20 is continuously and integrally formed with the main body portion 10. The extension 20 extends downward in fig. 3 from the outer periphery of the main body 10. The extension 20 has a size capable of covering the joined portion (see fig. 11). In other words, the inner diameter of the extension 20 is larger than the outer diameter of the joined portion.
As shown in fig. 1 to 3, the extension portion 20 is configured to extend from one side (only the lower side in fig. 3) of the main body portion 10 in the intersecting direction.
As shown in fig. 1 and 3, a plurality of through holes 25 are formed in the extension portion 20 in the same manner as the main body portion 10. The pitch, the aperture, the direction, the shape, and the like of the arrangement of the through holes 25 of the extension portion 20 are the same as those of the through holes 15 provided in the main body portion 10, and therefore, the description thereof will be omitted. The extension portion 20 may be made of a biodegradable material in the same manner as the main body portion 10.
The material of the extension portion 20 may not be biodegradable as long as it can promote healing of a living organ. The extension portion 10 may not be formed with the through hole 25 regardless of the material as long as it can promote healing of the living body organ.
The thickness T1 (see fig. 3) of the extension portion 20 is preferably the same as the thickness T of the body portion 10. The thickness T1 of the extension portion 20 may be different from the thickness T of the body portion 10.
In addition, the ratio of the aperture of the through-hole 25 to the pitch of the through-hole 25 in the extension portion 20 can be made the same as the ratio of the aperture of the through-hole 15 to the pitch of the through-hole 15 in the main body portion 10. The ratio of the aperture of the through-hole 25 to the pitch of the through-hole 25 in the extension portion 20 may be different from the ratio of the aperture of the through-hole 15 to the pitch of the through-hole 15 in the main body portion 10.
The extension portion 20 is formed by being given a shape in a state of being integrally and continuously constituted with the main body portion 10.
< suppressing portion 30 >)
The suppressing portion 30 suppresses healing between the extending portion 20 and the living tissue located at the outer periphery of the extending portion 20. In the present embodiment, the suppressing portion 30 is a cover member fixed to the outer peripheral side of the extending portion 20. The method of fixing the suppressing portion 30 to the extending portion 20 is not particularly limited, and is, for example, fixation by an adhesive.
The material constituting the suppressing portion 30 is not limited as long as healing can be suppressed, and for example, a nonwoven fabric can be used. The suppressing portion 30 can be made of a biodegradable material, similarly to the main body portion 10.
In the present embodiment, as shown in fig. 1, the suppressing portion 30 is similarly arranged on the outer periphery of the extending portion 20 in the circumferential direction.
According to the healing promoting instrument 100 configured as described above, the mesh size is made larger than the anastomotic part diameter in consideration of the difference in thickness of the human intestinal tract, the extending part 20 is formed along the extending direction of the intestinal tract even if the mesh is protruded from the anastomotic part, and the suppressing part 30 is provided on the outer periphery of the extending part 20, so that the adhesion of the healing promoting instrument 100 and the peripheral tissue other than the intention can be prevented.
As described above, the healing promoting instrument 100 according to the present embodiment includes: a sheet-like body portion 10 that is disposed between one joined site and the other joined site of a living body organ to be joined, and that promotes healing of a living body tissue; and an extension 20 extending along a crossing direction crossing the surface direction of the main body 10 and covering the joined portion. According to the healing promoting instrument 100 thus configured, the body 10 is sandwiched between the living organs to be joined, so that the healing of the living tissues of the living organs can be promoted. Further, since the healing promoting instrument 100 includes the extension portion 20 covering the joined portion, the body portion 10 can be prevented from falling off from the living body organ. In addition, the extension portion 20 can further inhibit the body portion 10 from falling off from the living body organ by the extension portion 20 itself adhering to the living body organ. In addition, when body fluid in the living body organ leaks out from the gap between the extension portion 20 and the joint portion where the living body organ is joined, the extension portion 20 itself adheres to the living body organ, and further leakage of body fluid can be prevented. According to the above, the operator can effectively reduce the risk of incomplete suturing of the living organ.
The extension portion 20 extends from the main body portion 10 only along one side in the intersecting direction. According to the healing promoting instrument 100 thus configured, the body 10 can be prevented from falling off from the living body organ with a simple structure.
The healing promoting instrument 100 further includes a suppressing portion 30 that suppresses healing between the extending portion 20 and the living tissue located on the outer periphery of the extending portion 20. According to the healing promoting instrument 100 thus configured, even if the mesh is made larger than the diameter of the anastomotic site in consideration of the difference in thickness of the individual intestinal tract, the extending portion 20 is formed along the extending direction of the intestinal tract at the exceeding site, and the suppressing portion 30 is provided on the outer periphery of the extending portion 20, so that the adhesion between the healing promoting instrument 100 and the peripheral tissue other than the intention can be prevented.
The suppressing portion 30 is a cover member fixed to the outer peripheral side of the extending portion 20. According to the healing promoting instrument 100 thus configured, adhesion between the healing promoting instrument 100 and peripheral tissues other than intended can be prevented with a simple structure.
Although the healing promoting instrument 100 has been described in the above embodiments, the present application is not limited to the description of the above embodiments, and various modifications may be made without departing from the gist thereof. A modified example of the healing promoting instrument will be described below. In the description of the modification, the structure and the content described in the healing promoting instrument 100 according to the above embodiment are appropriately omitted.
Modification 1 >
Referring to fig. 5, the structure of the healing promoting instrument 200 of modification 1 will be described. Fig. 5 is a view corresponding to fig. 3 of the healing promoting instrument 200 according to modification 1.
As shown in fig. 5, the healing promoting instrument 200 of modification 1 includes: a main body 10 disposed between one joined site and the other joined site of a living organ to be joined; an extension 120 extending along a crossing direction (up-down direction in fig. 5) crossing the plane direction of the main body 10; and a suppressing portion 130 fixed to the outer peripheral side of the extending portion 120. The main body 10 has the same structure as the main body 10 of the healing promoting instrument 100 according to the above embodiment, and therefore, the description thereof will be omitted.
As shown in fig. 5, the extension 120 is continuously and integrally formed with the main body 10. The inner diameter of the extension 120 is larger than a region E1 where the 1 st engagement tool 710 and the 2 nd engagement tool 720, which will be described later, sandwich the body 10 and overlap each other. The inner diameter of the extension 120 is larger than the outer diameter of the joined portion.
As shown in fig. 5, the extension portion 120 extends from the outer peripheral edge of the main body portion 10 along both sides in the intersecting direction (up-down direction in fig. 5).
As shown in fig. 5, the extension 120 is provided with a through hole 125. The pitch, the aperture, the direction, the shape, and the like of the arrangement of the through holes 125 are the same as those of the through holes 25 of the extension portion 20 of the healing promoting instrument 100 according to embodiment 1, and therefore, the description thereof will be omitted.
According to the healing promoting instrument 200 configured as described above, since the extension portion 120 extends along both sides in the intersecting direction, the body portion 10 can be more favorably prevented from falling off from the living body organ.
Modification 2 >
Next, the structure of the healing promoting instrument 300 according to modification 2 will be described with reference to fig. 6. Fig. 6 is a view corresponding to fig. 3 of a healing promoting instrument 300 according to modification 2.
As shown in fig. 6, the healing promoting instrument 300 according to modification 2 includes: a main body 10 disposed between one joined site and the other joined site of a living organ to be joined; and an extension 220 extending along a crossing direction (up-down direction in fig. 6) crossing the plane direction of the main body 10. The main body 10 has the same structure as the main body 10 of the healing promoting instrument 100 according to the above embodiment, and therefore, the description thereof will be omitted.
In modification 2, the extension 220 is formed separately from the main body 10. In modification 2, the extension 220 also functions as the suppressing portion 230. The extension 220 extends from the outer periphery of the main body 10.
As the material constituting the extension portion 220, the same material as the suppression portion 30 of the healing promoting instrument 100 of the embodiment can be used.
According to the healing promoting instrument 300 having the above-described configuration, since the extension portion 220 can also be used as the suppressing portion 230, the risk of incomplete suturing of the living organ can be effectively reduced with a simpler structure than the healing promoting instrument 100 according to the embodiment.
Modification 3 >
Next, referring to fig. 7, the structure of the healing promoting instrument 400 according to modification 3 will be described. Fig. 7 is a view corresponding to fig. 3 of a healing promoting instrument 400 according to modification 3.
As shown in fig. 7, the healing promoting instrument 400 according to modification 3 includes: a main body 10 disposed between one joined site and the other joined site of a living organ to be joined; and an extension portion 20 extending along a crossing direction (up-down direction in fig. 7) crossing the plane direction of the main body portion 10.
The healing promoting instrument 400 according to modification 3 is different from the healing promoting instrument 100 according to the embodiment in that the suppressing portion 30 is not provided.
According to the healing promoting instrument 400 configured as described above, although healing between the extension portion 20 and the living tissue located on the outer periphery of the extension portion 20 cannot be inhibited, the body portion 10 can be inhibited from falling off from the living organ.
The healing promoting instrument 400 according to modification 3 may further include a restraining portion (not shown) that is provided separately from the extension portion 20 and is movable in the intersecting direction with respect to the extension portion. According to the healing promoting instrument 400 thus configured, the healing between the extension portion 20 and the living tissue located on the outer periphery of the extension portion 20 can be suppressed by the suppressing portion.
Modification 4 >
Next, the structure of the healing promoting instrument 500 according to modification 4 will be described with reference to fig. 8. Fig. 8 is a view corresponding to fig. 3 of the healing promoting instrument 500 according to modification 4.
The healing promoting instrument 500 according to modification 4 includes: a main body 10 disposed between one joined site and the other joined site of a living organ to be joined; an extension portion 20 extending along a crossing direction (up-down direction in fig. 8) crossing the plane direction of the main body portion 10; and a suppressing portion 530 fixed to the outer peripheral side of the extending portion 20. The main body 10 and the extension 20 have the same configuration as the main body 10 and the extension 20 of the healing promoting instrument 100 according to the above embodiment, and therefore, the description thereof will be omitted.
As shown in fig. 8, the suppressing portion 530 has an L-shaped tip end to cover the end 20A of the extending portion 20.
According to the healing promoting instrument 500 thus configured, the end 20A of the extension portion 20 and the peripheral tissue of the outer periphery of the extension portion 20 can be well restrained from healing.
Implementation of the treatment method (organism organ anastomosis) >
Next, a treatment method using the healing promoting instrument will be described.
Fig. 9 is a flow chart showing steps of a treatment method using a healing promoting instrument.
The treatment method comprises the following steps: a healing promoting instrument (S11) provided with a sheet-like body part for promoting healing of a living tissue, between one joined site to be joined to a living organ and the other joined site; and joining (S12) the one joined portion and the other joined portion in a state in which at least a part of the main body portion of the healing promoting instrument is disposed between the one joined portion and the other joined portion.
The living body organ to be joined by the treatment method and the joined portion in the living body organ are not particularly limited, and may be arbitrarily selected. However, in the following description, a large intestine anastomosis is exemplified. The healing promoting instrument used in each operation described below may be any one selected from the above-mentioned healing promoting instruments, for example. However, in the following description, a use example of the healing promoting instrument 100 according to the embodiment shown in fig. 1 will be described as a representative example that can be preferably used in each operation. In each operation described below, a detailed description of a known operation procedure and a known joining device is appropriately omitted.
Hereinafter, in the description of the present specification, "disposing the healing promoting instrument between the living organs" means at least one of disposing the healing promoting instrument in a state of being in direct or indirect contact with the living organs, disposing the healing promoting instrument in a state of forming a space gap between the living organs, or disposing the healing promoting instrument in both states (for example, disposing the healing promoting instrument in a state of being in contact with one of the living organs and disposing the healing promoting instrument in a state of not being in contact with the other of the living organs). In the description of the present specification, "peripheral" does not define a strict range (region), and indicates a predetermined range (region) as long as the treatment purpose (joining of biological organs) can be achieved. The procedure described in each treatment method can be appropriately changed in order as long as the treatment purpose can be achieved. In the description of the present specification, "relatively close" means that two or more objects to be close to each other are brought close to each other, and only one of them is brought close to the other.
Implementation of the treatment method (Large intestine anastomosis) >
Fig. 10 is a flowchart showing a procedure of an embodiment of a treatment method (colistomy), and fig. 11 to 14 are views for explaining colistomy.
In the treatment method of the present embodiment, the biological organ to be joined is the large intestine which is cut along with the excision of the cancer tumor. Specifically, the biological organ to be joined is the mouth side A1 of the large intestine to be cut and the anus side A2 of the large intestine to be cut. In the following description, a procedure of joining the periphery of the mouth portion (one joined portion) of the mouth side A1 of the cut large intestine and a part of the intestinal wall (the other joined portion) of the anus side A2 of the cut large intestine will be described.
As shown in fig. 10, the treatment method of the present embodiment includes: a healing promoting instrument 100 is disposed between the periphery of the mouth of the large intestine and the intestinal wall of the large intestine (S101); relatively approaching the periphery of the mouth of the large intestine and the intestinal wall of the large intestine (S102); the main body 10 of the healing promoting instrument 100 is interposed between the periphery of the mouth of the large intestine and the intestinal wall of the large intestine (S103); in the healing promoting instrument 100, the main body 10 is joined with being sandwiched between the periphery of the mouth of the large intestine and the intestinal wall of the large intestine (S104); and leaving the main body 10 of the healing promoting instrument 100 between the periphery of the mouth of the large intestine and the intestinal wall of the large intestine (S105).
Next, the treatment method according to the present embodiment will be specifically described with reference to fig. 11 to 14.
As shown in fig. 11, the operator inserts the 1 st engagement tool 710 of the engagement device 700 into the mouth side A1 of the large intestine. The operator disposes the 2 nd engaging tool 720 of the joint device 700 on the anus side A2 of the large intestine. Before disposing the 2 nd engaging tool 720 on the anus side A2 of the large intestine, the operator forms a through hole a21 for inserting the 2 nd engaging tool 720 of the joint device 700 in the anus side A2 of the large intestine. The timing of forming the through hole a21 is not particularly limited as long as it is before the 2 nd engaging tool 720 is disposed.
As the joining device 700, for example, a known device used in large intestine anastomosis can be used. As the 1 st engaging tool 710 and the 2 nd engaging tool 720 constituting the engagement device 700, for example, an anvil (anvil) and a trocar (trocar) can be cited. The joining device 700 is configured to join the cut living body tissue around the living body tissue by a staple (staple) together with the cutting of the living body tissue disposed between the 1 st and 2 nd engaging devices 710, 720 by engaging the 1 st and 2 nd engaging devices 710, 720. The 1 st engaging tool 710 is, for example, a tool having a tubular engaged portion 711, and the 2 nd engaging tool 720 is, for example, a tool having an engaging pin 721 inserted into and engaged with the engaged portion 711 of the 1 st engaging tool 710.
The operator inserts the engaged portion 711 of the 1 st engagement tool 710 into the mouth side A1 of the large intestine, and performs purse-string suture in a state where the engaged portion 711 protrudes, thereby forming a suture portion a11. The outer surface of the sewn portion a11 has a shape that partially protrudes to the convex side with the sewing.
Next, as shown in fig. 11 and 12, the operator disposes a healing promoting instrument 100 between the mouth side A1 of the large intestine and the anus side A2 of the large intestine. At this time, the operator disposes the healing promoting instrument 100 so that the extension 20 covers the oral side A1 of the large intestine. Then, the operator passes the engaged portion 711 of the 1 st engagement tool 710 through the hole 16 of the body 10. Therefore, the healing promoting instrument 100 can be prevented from falling off from the oral side A1 of the large intestine during the operation being performed by the operator.
Next, the operator brings the 1 st engagement tool 710 and the 2 nd engagement tool 720 into close proximity and engagement with each other as shown in fig. 13, while maintaining the state in which the extending portion 20 covers the mouth side A1 of the large intestine. The operator sandwiches the periphery of the mouth portion of the mouth side A1 of the large intestine, the main body 10 of the healing promoting instrument 100, and the periphery of the through-hole a21 formed in the intestinal wall of the anus side A2 of the large intestine between the 1 st engagement tool 710 and the 2 nd engagement tool 720. The operator cuts out a part of the mouth side A1 of the large intestine, a part of the main body 10 of the healing promoting instrument 100, and a part of the anus side A2 of the large intestine, which are sandwiched between the 1 st engagement tool 710 and the 2 nd engagement tool 720, by the engagement device 700. At the same time, the operator operates the joining device 700 to join the periphery of the resected portion with a staple (not shown).
Next, as shown in fig. 14, the operator takes out the joining device 700 from the anus side A2 of the large intestine to the outside of the living body via the anus, for example. Here, in the above-described operation, the joining device 700 is pierced by each component sandwiched between the joining device 700 by a piercing tool (not shown) incorporated in the 1 st engagement tool 710 or the 2 nd engagement tool 720. Therefore, the joining device 700 positions the region E2 where the joined living body organ is perforated inside the region E1 where the 1 st engagement tool 710 and the 2 nd engagement tool 720 sandwich the body portion 10 and overlap each other.
According to such a treatment method, the risk of incomplete suturing after a joining operation (e.g., anastomosis of a digestive tract) can be reduced by a simple method in which a sheet-like main body portion provided in a healing promoting instrument is sandwiched between one joined site and the other joined site.
In addition, since the healing promoting instrument 100 to be used is configured such that the extension portion 20 covers the mouth side A1 of the large intestine, the healing promoting instrument 100 can be prevented from falling off from the living body organ. Therefore, the risk of incomplete suturing after surgery or the like can be reduced.
In addition, in the healing promoting instrument 400 according to modification 3, a restraining portion (not shown) that is provided separately from the extension portion 20 and is movable in the intersecting direction with respect to the extension portion is provided so as to be movable so as to cover the nip portion after the main body portion 10 is interposed, as shown in fig. 14.
The present application is based on japanese patent application No. 2019-064718, filed on 3/28 of 2019, the disclosure of which is incorporated by reference in its entirety.
Description of the reference numerals
10. A main body part,
11. A surface(s),
12. Back surface (back surface),
15. A through hole,
16. A hole part,
20. 120, 220 extensions,
25. 125 through holes,
30. 130, 230, 530 suppressing portions,
100. 200, 300, 400, 500 healing promoting instrument,
700. A joining device,
710. 1 st clamping device,
711. A engaged portion,
720. A2 nd engaging means,
721. A clamping pin,
A1 A mouth side,
A11 A sewing part,
A2 The anus side,
A21 And a through hole.
Claims (7)
1. A healing promoting instrument having:
a sheet-like body portion disposed between one joined site and the other joined site of a living body organ to be joined, for promoting healing of a living body tissue;
an extension portion that extends in a crossing direction crossing the surface direction of the main body portion and covers the joined portion; and
and a suppressing portion that suppresses healing between the extending portion and a living tissue located on an outer periphery of the extending portion.
2. The healing promoting instrument according to claim 1, wherein,
the extension portion extends from the main body portion only along one side of the intersecting direction.
3. The healing promoting instrument according to claim 1, wherein,
the extending portion extends from the main body portion along both sides of the intersecting direction.
4. The healing promoting instrument according to claim 1, wherein,
the suppressing portion is constituted by the extending portion.
5. The healing promoting instrument according to claim 1, wherein,
the suppressing portion is a cover member fixed to an outer peripheral side of the extending portion.
6. The healing-promoting instrument of claim 5, wherein,
the covering member is formed to cover an end portion of the extension portion located in the intersecting direction.
7. The healing promoting instrument according to claim 1, wherein,
the restraining portion is configured to be provided integrally with the extending portion and movable in the intersecting direction with respect to the extending portion.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2019-064718 | 2019-03-28 | ||
| JP2019064718 | 2019-03-28 | ||
| PCT/JP2020/014268 WO2020196881A1 (en) | 2019-03-28 | 2020-03-27 | Fusion promotion device |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN113473921A CN113473921A (en) | 2021-10-01 |
| CN113473921B true CN113473921B (en) | 2023-10-24 |
Family
ID=72608466
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202080016201.4A Active CN113473921B (en) | 2019-03-28 | 2020-03-27 | Healing promoting instrument |
Country Status (3)
| Country | Link |
|---|---|
| JP (1) | JP7410130B2 (en) |
| CN (1) | CN113473921B (en) |
| WO (1) | WO2020196881A1 (en) |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101500497A (en) * | 2006-07-07 | 2009-08-05 | 伊西康内外科公司 | A surgical stapling instrument and a staple cartridge and staple for such an instrument |
| CN102112069A (en) * | 2008-07-28 | 2011-06-29 | 因库博实验室有限责任公司 | System and method for scaffolding of anastomoses |
| CN103654902A (en) * | 2012-09-07 | 2014-03-26 | 柯惠Lp公司 | Methods for applying surgical staples to internal walls of hollow tissue organs |
Family Cites Families (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| AU7341800A (en) * | 1999-09-01 | 2001-03-26 | Origin Medsystems, Inc. | Method and apparatus for performing anastomosis |
| US7547312B2 (en) * | 2003-09-17 | 2009-06-16 | Gore Enterprise Holdings, Inc. | Circular stapler buttress |
| SE530212C2 (en) * | 2006-04-21 | 2008-04-01 | Carponovum Ab | Auxiliary tool for an anastomosis device |
| DE102015205056A1 (en) * | 2015-03-20 | 2016-09-22 | Aesculap Ag | Surgical tissue fusion instrument and support structure therefor |
| CN109199495A (en) * | 2017-07-06 | 2019-01-15 | 史源 | A kind of anastomosis ring |
-
2020
- 2020-03-27 WO PCT/JP2020/014268 patent/WO2020196881A1/en active Application Filing
- 2020-03-27 JP JP2021509673A patent/JP7410130B2/en active Active
- 2020-03-27 CN CN202080016201.4A patent/CN113473921B/en active Active
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101500497A (en) * | 2006-07-07 | 2009-08-05 | 伊西康内外科公司 | A surgical stapling instrument and a staple cartridge and staple for such an instrument |
| CN102112069A (en) * | 2008-07-28 | 2011-06-29 | 因库博实验室有限责任公司 | System and method for scaffolding of anastomoses |
| CN103654902A (en) * | 2012-09-07 | 2014-03-26 | 柯惠Lp公司 | Methods for applying surgical staples to internal walls of hollow tissue organs |
Also Published As
| Publication number | Publication date |
|---|---|
| JPWO2020196881A1 (en) | 2020-10-01 |
| CN113473921A (en) | 2021-10-01 |
| WO2020196881A1 (en) | 2020-10-01 |
| JP7410130B2 (en) | 2024-01-09 |
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