JP2001087272A - Automatic suturing unit for excising living body tissue - Google Patents

Automatic suturing unit for excising living body tissue

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Publication number
JP2001087272A
JP2001087272A JP27124799A JP27124799A JP2001087272A JP 2001087272 A JP2001087272 A JP 2001087272A JP 27124799 A JP27124799 A JP 27124799A JP 27124799 A JP27124799 A JP 27124799A JP 2001087272 A JP2001087272 A JP 2001087272A
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cartridge
staples
body
suturing
portion
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JP27124799A
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Japanese (ja)
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Motoko Iwabuchi
素子 岩渕
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Motoko Iwabuchi
Matsuda Ika Kk
素子 岩渕
松田医科株式会社
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Priority to JP27124799A priority Critical patent/JP2001087272A/en
Publication of JP2001087272A publication Critical patent/JP2001087272A/en
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Abstract

PROBLEM TO BE SOLVED: To provide a suturing unit capable of suturing an outer peripheral part of a small section with small force by one time operation. SOLUTION: This automatic suturing unit is composed of a body 1 having an openable/closable one sandwiching member for shouldering one of sandwiching by being positioned on the under side of a living body tissue by enclosing so as to surround a tumor existing in the living body tissue (a) and a cartridge 3 installed in the body in response to the sandwiching member, where the cartridge 3 encloses staples 17, plural pushing-out blocks 18 for pushing out the staples and left/right each one actuators 19 for moving the pushing- out blocks in the direction for pushing out the staples in a resin case, and the left/right one actuators installed in the cartridge are actuated with a time difference by operating an operation lever arranged in the body for installing the cartridge to successively push down the pushing-out blocks 18 arranged along an arranging shape of the staples to suture the outer periphery of a biopsy small section including the tumor in a single operation.

Description

【発明の詳細な説明】 DETAILED DESCRIPTION OF THE INVENTION

【0001】 [0001]

【発明の属する技術分野】本発明は、人体の生体組織切除用自動縫合器に関し、詳しくは生体組織から生検のための小切片を切り取る時に、該小切片の外側周囲(人体側に残る生体組織)をステープルで縫合する縫合器に関する。 The present invention relates to relates to human body tissue ablation stapler, details when cut small sections for biopsy from the living tissue, the living body that remains around the outside (the body side of the small sections about suture instrument for suturing a tissue) with staples.

【0002】 [0002]

【従来の技術】人体の内臓を病理学的に調べる生検は、 Pathologically examine biopsy BACKGROUND OF THE INVENTION human body of internal organs,
腫瘍等が含まれた部位の生体組織の小切片を切り取って行なわれるが、その小切片の切除に当たっては人体側に残る生体組織の切り取り部の外周はステープルで縫合するようになっている。 Is performed by cutting a small slice of living tissue tumor site or the like is included, the outer periphery of the cut portion of the living tissue remaining in the body side when resection of the small sections is designed to suture staples. その小切片の切り取りに際して使用される縫合器は数多く提案されているが、それらは何れもハンドルの先部に上下方向に開閉する一対の直線棒状の挟持部が形成され、その一方の挟持部にステープルを収容した直線形態のカートリッジが着脱可能に装着され、挟持部で生体組織を挟持後、ハンドル部に設けられた操作子を操作することでカートリッジのステープルが打ち出されて挟持する生体組織を縫合するように構成されている。 Its suturing device that is used when cut small sections have been proposed, they are both holding portions of the pair of linear rod-like opening and closing vertically to the front portion of the handle is formed on the clamping portion of the one suturing straight form of a cartridge containing the staples is mounted detachably, after clamping the body tissue at the clamping portion and the staple cartridge by operating the operating element on the handle portion is struck out the biological tissue for clamping It is configured to. 例えば、特開平10−195号公報等が挙げられる。 For example, JP-A-10-195 Publication, and the like.

【0003】しかし、上記した従来の縫合器は生体組織を挟持する挟持部が直線棒状に形成されているため、生体組織から小切片を切り取るためにはその切除しようとする小切片の周りを数回の操作で囲むことに成る。 However, since the conventional suturing device described above is that clamping portion for holding the living tissue is formed in a straight rod shape, number around the small sections in order to cut a small section from the living tissue to be its cut made to be enclosed in times of operation. 即ち、小切片の切り取りを平面略V字形状に行う場合は、 That is, when performing cut small slices on a plane substantially V-shape,
縫合器による挟持を小切片の左側と右側から一度づつ行なう合計二回、平面略台形状に行う場合は前記左右からの縫合をその先端を交叉させずに行ない、三回目に前記二回の縫合を結ぶように行なうことになる。 Suturing instrument once at a time is performed a total of twice the holding from the left and right small sections with, in the case of performing the plane substantially trapezoidal performed without crossing the tip suture from the right and left, the two times of suturing the third time It will be carried out so as to connect.

【0004】 [0004]

【発明が解決しようとする課題】従って、上記した従来の縫合器で生体組織から生検のための小切片を切除しようとした場合は、少なくとも縫合器を2回以上操作しなければ切り取ろうとする腫瘍部分の外側を縫合することができないものであり、その為に切除作業に手数を要し、取り出しに時間が掛かるといった不便さを有する。 [SUMMARY OF THE INVENTION Therefore, if you try to cut small sections for biopsy from the tissue in the conventional suturing device described above, when you Kiritoro to be operated more than once at least suturing device are those that can not be sewn outside the tumor portion, requires labor to cut work therefore, has the inconvenience of such time-consuming to retrieve.
そして、その小切片の位置が深部の場合、胸腔内操作が困難になるため、胸部又は腹部の切開幅(開口部)の大きさも大きくなるという問題点を有する。 Then, when the position of the small sections is deep, for intrathoracic operation it becomes difficult, has a problem that the greater the size of the incision width of the chest or abdomen (opening).

【0005】更に、生体組織を縫合するステープルは一回の縫合毎にカートリッジを交換して行ない、しかも2 Furthermore, the staples for suturing living tissue performed by replacing the cartridge every single suture, yet 2
回、3回の操作でV形或いは台形等に区画するため、ステープルが重なり合ったり、又、不要な部分にステープルが打ち込まれるという問題点を有する。 Times, with for partitioning the V-shaped or trapezoidal or the like in three operations, or overlapping staple, also the problem that the staple is driven into the unnecessary portion.

【0006】本発明者は、上記問題点を解決するものとして、上下方向に開閉する一対の挟持部材の挟持部を環状とし、その環状の挟持部にステープルを配置すると共に、そのステープルを打ち出す打ち出し部材を装備した縫合機を、特願平10−285419号として提案済みである。 [0006] The present inventors have as to solve the above problems, with the holding portions of the pair of clamping members for opening and closing in the vertical direction and annular, placing the staples holding portions of the annular, launch hammer out the staple the stapler equipped with a member, has already been proposed as Japanese Patent Application No. 10-285419. ところで、上記提案の縫合器は、環状の挟持部に沿って平面略馬蹄形に配列したステープルの全部を一度に打ち出す構造であるため、ステープルを打ち出すために大きな力を必要とし、縫合作業が大変であるという不具合を有する。 Incidentally, the suturing instrument of the proposals are the structure set out all of the staples arranged in a plane substantially horseshoe shape along the clamping portion of the annular once, and requires a large force to hammer out the staples, suturing operation is very It has the disadvantage that there is.

【0007】本発明は、上記した従来の技術が有する問題点に鑑みてなされたもので、その目的とするところは、カートリッジに内蔵されたステープルの打ち出し操作を、小さな力で簡単に行なうことが出来る縫合器を提供することにある。 [0007] The present invention has been made in view of the problems which the prior art described above has, and it is an object of the staple of launch operations built into the cartridge, be easily performed with a small force to provide a suturing instrument capable. 更に、本発明の他の目的は切断した小切片を、その外周縁を閉じたまま取り出すことができる機能を備えた縫合器を提供することにある。 Furthermore, another object of the present invention is to provide a suturing device having a function that can be taken out while the small sections were cut, closing the outer peripheral edge.

【0008】 [0008]

【課題を解決するための手段】上記の課題を達成するために本発明が講じた技術的手段は、人体の生体組織から生検用小切片を切除するために腫瘍を含む小切片の外周部分を縫合する縫合器であって、生体組織中に存在する腫瘍を囲むように包囲して該生体組織の下側に位置して挟持の一方を担う開閉可能な挟持部材を備えた本体と、 Technical measure taken by the present invention for achieving the above object, according to an aspect of the outer peripheral portion of the small sections containing tumor to ablate small sections biopsy from the body of the living tissue the suture instrument for suturing a body having an openable clamping member which surrounds so as to surround the tumor present in the body tissue positioned below the biological tissue is responsible for one of the clamping,
その挟持部材と対応して本体に装着する、樹脂製ケースにステープルとそのステープルを押し出す複数の押し出しブロックとその押し出しブロックを前記ステープルを押し出す方向に移動させる左右1個ずつの作動子を組み込んだ他方の挟持部材を担うカートリッジとからなり、 Attached to the body in correspondence with its clamping members, the other incorporating operating element of a plurality of extrusion block and the extrusion block to push the staples and their staples resin case one by one right and left to move in the direction to push the staples It consists of a cartridge carrying the holding member,
前記挟持部材における挟持部は環状に形成し、且つ前記カートリッジにおけるケースも環状に形成すると共に、 With holding portions of the clamping member is formed in an annular shape, and also the case in the cartridge to form a ring,
その環状のケースに根元側を除いてステープルを収容し、カートリッジが装着される本体に設けた操作レバーを操作することで該カートリッジに装着した左右1個の作動子が時間差をおいて作動し、ステープルの配置形態に沿って配置した押し出しブロックを順次押し下げて、 As the annular casing except root side accommodating a staple cartridge is actuated right one operating element mounted on the cartridge by operating the operation lever provided in the main body to be mounted is staggered, sequentially depressing the extrusion block disposed along the staple arrangement form,
腫瘍を含む生検用小切片の外周を一動作で縫合することを特徴とする。 The outer periphery of the small sections biopsy, including tumor characterized by suturing in one operation.

【0009】上記挟持部材及びカートリッジにおける挟持部の環状の形態としては、少なくとも腫瘍部分を取り囲む形状とし、周囲が閉塞された環状(O形)だけでなく、環状の一部が切り欠かれたV形、U形、C形等でもよいものである。 [0009] As the cyclic form of sandwiching portions of the sandwiching member and the cartridge, a shape surrounding at least the tumor portion, not only the annular (O-shaped) ambient is closed, V a part of the annular notched shape, U-shaped, but may be a C-shaped or the like. 又、縫合器の主体を構成する本体の形状は、直線棒状の主幹の後端に後方下向きにグリップが連設された片手持ちのピストル形に形成されている。 The shape of the body that constitutes the main body of the suturing instrument, grip the rear downward is formed on the pistol of possession hand which is consecutively provided at the rear end of the straight rod-shaped trunk. そして、この本体に対して開閉可能に取り付けられる挟持部材は、グリップの前方に配置される引き金様のレバーをグリップ側に引き寄せる(握る)ことで挟持部材が閉じ、レバーがグリップから離れることで、挟持部材は開くように構成されている。 Then, clamping member mounted to be openable and closable with respect to this body, a trigger-like lever arranged in front of the grip pulls the grip side (gripped) closed clamping member by, that the lever moves away from the grip, clamping member is configured to open.

【0010】上記本体に装着するカートリッジは、合成樹脂材で成形した樹脂製ケースに、環状(O形)或いはV形、U形、C形等のステープル収容部と、ステープル収容部の外側に取付用柄部が連設されており、その取付用柄部を本体の先部に設けたセット筒に差し込むことによって装着固定し得るように構成されている。 [0010] cartridge mounted on the main body, the resin case molded by a synthetic resin material, an annular (O-type) or V-shaped, U-shaped, a staple housing portion of the C shape or the like, mounted on the outside of the staple housing portion use handle portion is continuously provided, and is configured so as to mount the fixed by inserting the mounting shank to the set tube provided in the tip portion of the main body. そして、 And,
環状等のステープル収容部には、ステープルが2列又は3列互い違いに配列されて平面略V字形或いは平面U字形に配置され、更にそのステープルの上方には該ステープルを押し出す押し出し爪を備えた押し出しブロックが複数個装備されている。 Extruding the staple containing portion of the annular or the like, staples are arranged in two rows or three rows staggered has been flat, substantially V-shaped or flat U-shape, even above the staples provided with a pushing pawl to push the staples block is equipped with a plurality. そして、その押し出しブロックは、ステープルを押し出すために垂直下方に移動し得るように収容配置されており、この押し出しブロックを垂直下方に移動させる作動子は、該押し出しブロックが収容された環状路内を周方向に移動することで押し下げられる。 Then, the extruded block is housed disposed so as to move vertically downward to push the staples, actuator for moving the extrusion block vertically downward, an annular passage for the extruded block is accommodated depressed by moving in the circumferential direction. 即ち、作動子の水平移動を、押し出しブロックの垂直方向の動きに変換するため、押し出しブロックの上面は傾斜面に形成する。 That is, to convert the horizontal movement of the actuating element, the vertical movement of the extrusion block, the upper surface of the extrusion block is formed as an inclined surface.

【0011】上記カートリッジにセットされるステープルは、肺の生体組織の縫合においては肺は外周縁の厚さが薄く、外周縁から内方に入るに従い次第に厚くなるため、縫合部位の手前側と先端側(奥側)でステープルの針脚に長短差を付けると共に、ステープルの幅に広狭差を付けるようにする。 [0011] staples set in the cartridge, in the suturing of lung biological tissue lung small thickness of the outer peripheral edge, since the gradually thicker accordance enters from the outer circumferential edge inward, the front side and the tip of the suture site side with attaching a length difference staple Hariashi in (back side), so as give a wide or narrow difference in the width of the staple. 即ち、手前側には針脚の長さが短く且つ幅の広いステープルを配置し、先端側(奥側)の湾曲部には針脚が長く且つより曲線的に縫合できるように幅の狭いステープルを配置し、それにより確実に縫合し得るようにする。 That is, the front side is disposed a wide staples and width shorter length of Hariashi distal end side narrow as the curved portion of the (back side) can be curved suturing than and longer Hariashi staple It was placed, thereby to be reliably sutured. 尚、本発明の一動作で腫瘍部分を囲む形状に縫合する場合は、針脚の長さよりもステープルの幅に広狭差を付けることが重要である。 In the case of suturing the shape surrounding the tumor portion in one operation of the present invention, it is important to give a wide or narrow difference staple width than the length of the Hariashi.

【0012】上記ステープルの針脚の先端を受け止める挟持部材の環状等の挟持部は、その環状の内側が開放されたままでもよいが、その挟持部の内側を閉塞してもよく、その閉鎖する底板部材は透明、不透明の何れでもよい。 [0012] clamping portion of the annular or the like of the clamping member for receiving the tip of Hariashi of the staple may remain inside the annular is open but may be closed inside of the clamping portion, to its closed the bottom plate member is transparent, it may be either opaque.

【0013】又、上記押し出しブロックを垂直下方に移動させる作動子は、平面略馬蹄形に配置された押し出しブロックを効率良く、且つ円滑に作動させるために平面略馬蹄形に配置した押し出しブロックを略中央位置で左右に区分けし、その左右の押し出しブロックを別々の作動子で操作するよう、左右に1個ずつ設ける。 [0013] Further, actuator for moving the extrusion block vertically downward, efficiently arranged extruded block into flat, substantially horseshoe-shaped, and smoothly approximate center the placed extruded block into flat, substantially horseshoe to actuate in is divided into right and left, so as to operate the extrusion block in the left and right separate operating element, it provided one each on the left and right. そして、 And,
左右の作動子は、夫々区分けされた押し出しブロックを確実に作動し得るように左右の作動子の作動開始タイミングに時間差を設けてある。 Left and right actuator is in operation start timing of the left and right operating element so as to reliably operate the respective segmented extrudate block is provided with a time difference.

【0014】上記作動子の動作開始に時間差を生じさせる方法としては、該作動子が本体に設けた操作レバーに係合して作動される時、作動子に連結するワイヤーの長さを変えたり、操作レバーのフックとワイヤーに設けた係合子との引っ掛かるタイミングをずらす等の方法が挙げられる。 [0014] As a method for causing a time difference between start of operation of the operating element, when the operating element is actuated in engagement with the operating lever provided on the body, changing the length of the wire to be connected to the operating element , and a method such as shifting the timing caught with the engaging element provided on the hook and the wire of the operating lever.

【0015】又、上記縫合器にはステープルによる縫合ラインの内側に沿って、腫瘍を含む生検用小切片を生体組織から切断するカッターを備えてもよい。 [0015] Further, in the above suturing device along the inside of the suture line by staples, small sections biopsy, including tumor may comprise a cutter for cutting the living tissue. その場合、 In that case,
上記カッターはカートリッジに組み込んでも、カートリッジを装着する本体に装着されていてもよい。 The cutter is also incorporated in the cartridge may be attached to the main body for mounting the cartridge. カートリッジに内蔵する場合は、前記した作動子同様、左右1個のカッターをカートリッジ先端の縫合ライン内側の専用収納スペースに収納すると共に、夫々左右のワイヤーに接続する。 When incorporated in the cartridge, the same operating element described above, the housing right and left one cutter dedicated storage space of the suture line inside of the cartridge tip, connected to the respective left and right wire. そして、ステープルを加締める(ファイヤーする)動作に僅かに遅れて動作することにより、生体組織がステープルで縫合された後に切断できるようにする。 The crimped staple (to fire) by operating with a slight delay in the operation, the biological tissue is to be cut after being sutured with staples. カッターを本体に装着する場合は、先端にカッターの付いた2枚の薄い平板を、カートリッジにおける縫合ラインの内側に設けた専用通路に沿って押し出すことにより、左右別々に生体組織を切断するものとする。 When mounting the cutter body, the two thin plates with a cutter tip by extruding along a dedicated path provided inside of the suture line in the cartridge, as to cut the left and right separately biological tissue to. 尚、 still,
カッターの通る専用通路は、カートリッジ又は本体の何れに形成してもよいものである。 Dedicated passage through which a cutter is intended to be formed on either the cartridge or the main body.

【0016】更に、上記挟持部材及びカートリッジにおける環状の挟持部の内側に、縫合及び切断後に前記挟持部材とカートリッジによる生体組織の挾着を解除した時、カッターで切断された生検用小切片の外周縁を上下より挾着して保持する把持手段を設けると便利である。 Furthermore, on the inner side of the clamping portion of the annular in the clamping member and the cartridge, the suture and the biological tissue by the clamping member and the cartridge after cutting when releasing the 挾着, biopsy for small sections cut by the cutter the provision of gripping means for holding the outer peripheral edge and 挾着 than the vertical is convenient.
その把持手段は、把持するための部材の一方に挟持部材を兼用してもよく、勿論、挟持部材とは別途に把持専用の部材を設けてもよいものである。 Its gripping means may be used also one the clamping member of members for gripping, of course, the clamping member in which may be separately provided gripping special member.

【0017】上記請求項1記載の手段によれば、生体組織を挟持する開閉可能な一方(下側)の挟持部材と本体に装着するステープル、押し出しブロック及び作動子を内蔵したカートリッジが、生体組織中に存在する腫瘍部分を囲む環状(O形)、V形、U形、C形等に形成されていることで、前記腫瘍部分を含む小切片の縫合を平面略V字形、平面略U字形、平面略C字形等に一動作で行なうことができる。 According to the means according to the first aspect, openable while sandwiching the biological tissue staples attaching the holding member and the main body of the (lower), the cartridge having a built-in extrusion block and the actuating element, a biological tissue cyclic (O type), V-shaped surrounding the tumor moiety present in, U-shaped, that is formed in a C shape or the like, flat, substantially V-shape suturing small slice containing the tumor portion, flat, substantially U-shaped can be performed in one operation to flat, substantially C-shaped and the like. そして、上記生体組織の縫合は、下側の挟持部材を閉じて、操作レバーを操作することで左右の作動子が時間差をおいて作動し、カートリッジに収容された押し出しブロックを左右とも順次押し下げ、環状に配置されたステープルを順番に加締めつけて縫合するため、小さな力で簡単に縫合することが出来る。 The suturing of the body tissue closes the lower clamping member, operating element of the right and left by operating the operation lever is operated with a time difference, successively depressing the extrusion block contained in the cartridge both the right and left, for suturing tightened pressurized staples arranged annularly in turn, it can be easily sewn with a small force. そして、挟持部が上記したように環状をなしているため、生体組織を挟持部材で挟むことで硬いシコリ状の腫瘍部分の検出を縫合器で行なうことが可能となる。 Then, since the clamping portion is an annular shape as described above, it is possible to perform the detection of hard lumps shaped tumor portion by sandwiching the living tissue clamping member in the suture instrument. そして、下側に位置する挟持部材の挟持部(生体組織の下側に位置する挟持部材)の開口部が底板で閉鎖された場合は、生体組織中に腫瘍が存在すれば該腫瘍は底板で支えられるため、本体に装着されるカートリッジの環状部内で上方に盛り上がり、腫瘍の探索を視覚によって容易に行なうことが可能となる。 Then, when the opening of the clamping portion of the clamping member positioned on the lower side (clamping member positioned on the lower side of the living tissue) is closed by a bottom plate, the tumor in the bottom plate if there is a tumor in a biological tissue since the supported, raised upwardly in the annular portion of the cartridge mounted to the main body, it is possible to easily perform the visual search of the tumor. 又、請求項2、3、4の手段によれば、腫瘍を含む小切片の外周を縫合した後、カッターを操作することで、縫合ラインの内側に沿って腫瘍を含む小切片を生体組織から切り離すことが出来る。 Further, according to the means of claim 2, 3, 4, after stitching the outer periphery of the small sections containing tumor, by operating the cutter, small sections containing tumor from the living tissue along the inside of the suture line it can be disconnected. 更に、請求項5の手段によれば、カッターで切断した小切片の外周縁を上下より挟んで閉じた状態に保持出来るため、生体組織の縫合、切断、取り出しを単一の器具で行うことができる。 Furthermore, according to the means of claim 5, since it held in the outer periphery of the small sections were cut with a cutter closing across from the upper and lower, suturing of biological tissue, cutting, be taken out with a single instrument it can.

【0018】 [0018]

【発明の実施の形態】以下、本発明の実施の形態を図面に基づいて説明する。 BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, an embodiment of the present invention with reference to the accompanying drawings. 図1は本発明に係る生体組織切除用自動縫合器の外観図で、該縫合器Aは、縫合器の主体を構成する本体1と、その本体1に対して開閉可能に取り付けられた下側の挟持部材2と、前記本体1の先部に装着して挟持部材2とで生体組織aを挟むカートリッジ3とで構成されている。 Figure 1 is a external view of a biological tissue ablation stapler according to the present invention, suture engager A includes a main body 1 constituting a main body of the suturing device, the lower side attached to be openable and closable with respect to the main body 1 a clamping member 2, and a cartridge 3 which sandwich the biological tissue a by the pinching member 2 is attached to the front portion of the main body 1.

【0019】本体1の形状は、ステンレス材からなる直線棒状の主幹1aの後端に後方下向きにグリップ1bが連設された片手持ちのピストル形に形成されており、その本体1の主幹1a内に挟持部材2の後部がピン4で上下回動可能に軸支され、その挟持部材2のピン4による軸支部より後方の端部が、グリップ1bの前側にピン7 The shape of the body 1, a grip 1b rearwardly downward to the rear end of the trunk 1a of linear rod shape made of a stainless steel material is formed into a pistol-shaped retention hand which is continuously provided, in the main trunk 1a of the main body 1 rear part of the clamping member 2 is rotatably supported to be vertically pivoted by a pin 4, the end portion of the rear of the shaft support on pin 4 of the clamping member 2, the pin 7 on the front side of the grip 1b
で回動可能に軸支される引き金様のレバー5と一体の連杆6の先端にピン8で連結されている。 It is coupled in the tip of the connecting rod 6 of the trigger-like lever 5 integrally pivotally supported by a pin 8. 即ち、レバー5 In other words, the lever 5
をグリップ1b側に引き寄せる(握る)ことで挟持部材2がピン4を軸として上方に閉じ、レバー5がグリップ1bから離れることで、挟持部材2がピン4を軸として下方に開くように構成されている。 The pull on the grip 1b side (hold) the closed upper clamping member 2 is a pin 4 as an axis in, when lever 5 is moved away from the grip 1b, the clamping member 2 is configured to open downward pins 4 as an axis ing. 尚、挟持部材2を開閉操作するレバー5には、該レバー5を常に「開」方向に付勢する戻しバネ9と、閉動されたレバー5をその状態に保持する掛け止め機構10と、その掛け止め機構1 Incidentally, the lever 5 for opening and closing operation of the clamping member 2, a latch mechanism 10 for holding a return spring 9 for urging the lever 5 is always in the "open" direction, closing has been the lever 5 in the state, the latching mechanism 1
0を解除するリリースレバー11が設けられている。 Release lever 11 is provided for releasing the 0.

【0020】又、本体1における主幹1aには、本体1 [0020] In addition, in the main trunk 1a of the main body 1, the main body 1
にセットされるカートリッジ3に収容されているステープルを押し出し縫合する操作レバー12を収容する空間13が区画形成され、その空間13にカートリッジ3の柄部をセットするための受筒14が上下回動可能に取り付けられている。 Accommodating the operation lever 12 for suturing extruding the staples contained in the cartridge 3 is set into the space 13 is partitioned and formed, receiving cylinder 14 is vertically rotated for setting the handle portion of the cartridge 3 into the space 13 which it can be attached. その受筒14は、カートリッジ3の柄部を受け入れる偏平筒状をなし、その受筒の底面には、 Its receiving cylinder 14, forms a flat cylindrical shape for receiving the shank of the cartridge 3, the bottom surface of the receiving cylinder,
空間13に収容した操作レバー12と、カートリッジ3 An operating lever 12 which is accommodated in the space 13, the cartridge 3
の柄部に組み込んだ作動手段15とを噛み合わせる開口14'が切欠形成されている。 Opening 14 'is notched formed to engage the actuating means 15 incorporating the handle portion. そして、この受筒14を前方上向きに起立回動した状態でカートリッジ3の柄部を差し込みが停止される位置まで差し込み、その状態で受筒14を水平状態に倒すことで、操作レバー12とカートリッジ3の柄部に組み込んだ作動手段20との噛み合いが確立され、カートリッジ3のセットが完了される。 Then, insertion to the position where the receiving cylinder 14 is insert the handle portion of the cartridge 3 in a standing state rotated forwardly upwardly is stopped, by defeating receiving cylinder 14 in a horizontal state in this state, the operation lever 12 cartridge incorporated in the handle portion of the 3 engagement between the actuating means 20 is established, a set of cartridge 3 is completed.

【0021】生体組織aを挟持する挟持部材2は、ステンレス材を用いて形成した環状の挟持部2aと、その挟持部2aの後部に連設した柄部2bとで構成され、挟持部2aは平面略玉子形に形成されて径の大きい方に前記柄部2bが連設されている。 [0021] clamping member 2 for holding the body tissue a, and the holding portion 2a of the annular formed using a stainless steel, is composed of a shank 2b which is provided continuously to the rear portion of the clamping portion 2a, sandwiching portion 2a the handle portion 2b is continuously provided is formed in a flat, substantially egg-shaped to the larger diameter. そして、環状の挟持部2a And, an annular clamping portion 2a
の上面には本体1に装着されるカートリッジ3から押し出されるステープルの脚先端を受け止め且つ内側への折り曲げをスムーズに行なわしめる受け凹部16がカートリッジ3に収容されるステープルに対応させて凹設されている。 To the upper surface is recessed in correspondence with the staple receiving recess 16 occupying smoothly bent into and inner receiving the leg tip of the staple is pushed out from the cartridge 3 is mounted in the main assembly 1 is accommodated in the cartridge 3 there. 又、本縫合器が縫合した後の生体組織aを切り取るカッターを備えたものである場合は、カッターの刃先が入るスリット15を形成する。 Further, when the suturing device is one that includes a cutter to cut the biological tissue a after stitching to form a slit 15 in which the cutting edge of the cutter enters. 更に、環状の挟持部2aはその内側の開口を開放させたままでもよいが、挟持部2aの開口下側を底板で閉鎖してもよい。 Furthermore, an annular clamping portion 2a may be left to open the opening of the inner, the opening lower holding portion 2a may be closed with a bottom plate. 挟持部2 Clamping portion 2
aの開口下側を底板で閉鎖した場合は、生体組織aを挟持部材2とカートリッジ3で挟んで硬いシコリ状の腫瘍部分の検出を行う際、生体組織中に腫瘍が存在すれば、 If it closes the opening under side of a in the bottom plate, making the detection of hard lumps shaped tumor portion across the biological tissue a by pinching member 2 and the cartridge 3, if there is a tumor in the body tissue,
該腫瘍は底板で支えられるため、カートリッジ3の環状部内で上方に盛り上がり、腫瘍の探索を視覚によって容易に行うことが可能となる。 The tumor because it is supported by the bottom plate, raised upwardly in the annular portion of the cartridge 3, it is possible to easily perform the visual search of the tumor.

【0022】本体に装着するカートリッジ3は、合成樹脂材で成形した環状(玉子形)のステープル収容部3a The cartridge 3 is mounted on the main body, the staple housing portion 3a of the molded annular synthetic resin material (egg-shaped)
と、ステープル収容部3aの外側に取付用柄部3bを一体に連設した樹脂製ケースと、前記ステープル収容部3 When the resin case and integrally connected to the mounting shank 3b to the outside of the staple accommodating portion 3a, said staple housing portion 3
a内に収容される複数列(図面では2列)のステープル17と、該ステープル17を押し出す多数個の押し出しブロック18、及び押し出しブロック18を垂直下方に移動させる左右1個ずつの作動子19、更に前記作動子19に連結した作動手段20とで構成されている。 A plurality of rows and staples 17 (two rows in the drawing), the plurality of extruded block extruding the staples 17 18, and extrusion block 18 right and left moving vertically downwards one by one of the actuator 19 which is housed in a, is constituted further by the actuating means 20 coupled to the actuator 19.

【0023】上記ステープル収容部3aの平面形状は、 The planar shape of the staple accommodating portion 3a,
前記した挟持部材2における挟持部2aの平面形状(玉子形)と同一の形状に形成されている。 They are formed in the same shape as the planar shape of the clamping portion 2a (egg-shaped) in the clamping member 2 described above. 尚、カートリッジ3の平面形状における最大幅の寸法(挟持部材の挟持部の横幅と同じ)は、本縫合器を体内に差し入れるために切開する切り口の大きさに影響を与えるため、より切り口を小さくするためには最大幅部分に配置するステープルの列を最少の2列にする。 The size of the maximum width in the plane shape of the cartridge 3 (same as the width of the clamping portion of the clamping member) has an impact on the size of the incision to incision to insert the present suturing instrument into the body, the more cut in order to reduce to a row of staples to be placed at the substantial portion to a minimum of two rows. 上記環状のステープル収容部3aには、ステープル17が2列互い違いに配列されてステープル収容部3aの先端側から取付用柄部3b The aforementioned annular staple accommodating portion 3a, the staple 17 is two rows staggered has been mounting shank 3b from the front end side of the staple containing portion 3a
側に向かって平面略V字形或いは平面U字形に配置され、更にそのステープル17の上方には該ステープルを押し出す押し出し爪23を備えた押し出しブロック18 Toward the side being arranged in a plane substantially V-shaped or flat U-shaped, extruded block 18 still is above the staple 17 comprises a pushing pawl 23 for pushing the staple
が複数個装備されている。 There has been a plurality of equipment.

【0024】そして、その押し出しブロック18は、ステープル17を押し出すために垂直下方に移動し得るように収容配置されており、この押し出しブロック18を垂直下方に移動させる作動子19は、該押し出しブロック18が収容された環状路21内を周方向に移動することで押し下げられる。 [0024] Then, the extruded block 18 is accommodated arranged so as to move vertically downward to push the staples 17, actuator 19 for moving the extrusion block 18 vertically downward, said extrusion block 18 There is depressed by moving the contained annular channel 21 in the circumferential direction. 即ち、作動子19の水平移動を、 That is, the horizontal movement of the actuator 19,
押し出しブロック18の垂直方向の動きに変換するため、押し出しブロック18の上面は該作動子19の移動方向に向かって上向きの傾斜面18aに形成されている。 To convert the vertical movement of the extruded block 18, the upper surface of the extrusion block 18 is formed in an upward inclined surface 18a toward the direction of movement of the actuator 19. その傾斜面18aの勾配は、ステープル17を押し出すに必要な移動量を発生する角度とする。 Its slope of the inclined surface 18a is an angle for generating a movement amount required to push the staples 17.

【0025】ステープル収容部3aに内蔵されるステープル17は、該収容部3aの後側の略1/3を除いた部分に2列配置収容し、その収容する全体のステープル1 The staples 17 incorporated in the staple accommodating portion 3a, two columns arranged contained in the portion excluding the approximately one-third of the rear side of the accommodating portion 3a, the entire staple 1 to the housing
7は線径及び幅が同一のものでもよいが、縫合の対象となる生体組織の厚さに合わせて変化させてもよい。 7 is the wire diameter and the width may be the same, may be changed to suit the thickness of the living tissue to be sewn object. 例えば、外周縁が薄く内方に至るにしたがって厚くなる肺組織にあってはその2列のステープル17は前半部と後半部で針脚の長さとステープルの幅を変えると効果的である。 For example, the staple 17 of the two rows In the thicker lung tissue according to the outer peripheral edge reaches thin inwardly is effective to change the length and staple width Hariashi in the first half portion and the latter half portion. 特に収容部3aの前半部は先端部が略V字形に湾曲しているため、後半部の直線部に比べて漏れが生じ易く、その為、例えば前半部に針脚が長く且つ幅が狭いステープルを密に配置し、後半部には針脚が短く且つ幅が広いステープルを配置する。 In particular, since the first half of the housing portion 3a of the tip portion is curved in a substantially V-shape, easily occurs leakage as compared with the linear portion of the rear half portion, Therefore, for example Hariashi is long and narrow in the first half staple the closely arranged, in the latter half portion placing Hariashi is short and wide staples. 尚、内外2列に配置されるステープル17は夫々ステープル収容部3aに上下方向に貫通して開設した独立の孔22に収容されている。 Incidentally, staples 17 arranged in two inner and outer rows are housed in separate holes 22 opened through vertically respectively staple accommodating portion 3a.
尚、ステープルの配置は針脚の長さが同じで幅が上記のように広狭差のあるステープルを配置しても効果的である。 The arrangement of the staple length is the same width of Hariashi is also effective to place staples with wide and narrow difference as described above.

【0026】上記ステープル17を押し出す押し出しブロック18は、内外2列配置されたステープル17の3 [0026] 3 of the extrusion block 18, inner and outer two rows disposed staple 17 to extrude the staple 17
個乃至4個を一単位として押し下げるもので、前記した傾斜面18bと反対側の面(下面)に、受け持ちのステープル17に対応する押し出し爪23が下方に突出させて一体に形成されている。 In which depress number to four as a unit, on the surface opposite to the inclined surface 18b mentioned above (the lower surface), is formed integrally pushing pawl 23 corresponding to the charge of the staple 17 to protrude downward.

【0027】又、上記押し出しブロック18は後述する作動子19の水平移動で垂直下方に押し下げられるが、 [0027] Also, although the extruded block 18 is pushed vertically downwards by a horizontal movement of the actuator 19 to be described later,
その垂直方向への動きを円滑に行わせるために、該押し出しブロック18の周壁面とステープル収容部3aの周面との接合面、或いはブロック18相互の接合面に、凹凸係合の案内手段を形成してもよいものである。 The movement in the vertical direction in order to smoothly, the junction surface of the peripheral wall surface and the peripheral surface of the staple housing portion 3a of the extrusion block 18, or the bonding surface of the block 18 each other, the guide means concavo-convex engaging in which it may be formed.

【0028】上記押し出しブロック18を先端側から後方側に向かって順次押し下げる作動子19は、環状路2 The actuator 19 pressing down successively toward the rear side of the extruded block 18 from the tip side, the annular passage 2
1に沿った移動が円滑に行なわれるようにその形状を球体とし、そうした作動子19を2個設けて、平面略馬蹄形に配置した押し出しブロック18の全てを一挙(1秒程度)、且つ確実に押し下げることができるように構成してある。 Its shape so movement is smoothly performed along the 1 and sphere, such a actuator 19 two provided, all the extruded block 18 which is arranged in a plane substantially horseshoe stroke (about 1 second), and reliably it is configured to be able to depress. 即ち、平面略馬蹄形に配置した押し出しブロック18を略中央位置で左右に区分けし、その左右の押し出しブロック18を別々の作動子で操作するよう、左右に1個ずつ設ける。 That, is divided into right and left the extrusion block 18 which is arranged in a plane substantially horseshoe shaped with a substantially central position, so as to operate the extrusion block 18 of the right and left separate operating element, provided one each on the left and right. そして、左右1個ずつの作動子19 Then, one by one left and right actuator 19
は、夫々区分けされた左右列の押し出しブロック18を確実に作動し得るように左右の作動子19の作動開始タイミングに時間差が設けてある。 The time difference to the operation start timing of the left and right actuator 19 as the extrusion block 18 of each divided by left and right columns can operate reliably is provided. 図示の例は、右側に配置した作動子19aが先に移動を開始して左側列の押し出しブロック18を押し下げ、その作動子19aが少なくとも左側に配置された作動子19bの移動路上を横切って通過した後に左側に配置された作動子19bが移動を開始するようにしてある。 In the illustrated example, it pushes down the extruded block 18 in the left column actuator 19a disposed on the right and start moving ahead across the moving path of the actuator 19b to which the operating element 19a is disposed on at least the left passage actuator 19b disposed on the left side after the are to be started to move.

【0029】左右の作動子19a,19bの作動開始に時間差を付ける作動手段20は、図3に示すように、左右の作動子19a,19bに夫々ワイヤー24a,24 The right and left actuator 19a, the actuating means 20 to attach a time difference to the operation start of 19b, as shown in FIG. 3, right and left actuator 19a, respectively 19b, s wire 24a, 24
bが連結され、そのワイヤー24a,24bは環状路2 b is connected, the wires 24a, 24b are annular passage 2
1の先端部でクロスさせて反対側に配設し、環状に配設した各押し出しブロック18に切欠したスリット18b It is crossed with one of the distal end portion disposed on the opposite side, a slit 18b which is notched into the extrusion block 18 which is disposed in an annular
を通って取付用柄部3bに導入し、その取付用柄部3b Introducing the mounting handle portion 3b through a handle portion 3b for the attachment
に導入したワイヤー24a,24bの長さに長短差を付け、その先端部に係合子25a,25bを取り付けて構成されている。 Wire 24a was introduced into, with a length difference in the length of 24b, engaging element 25a, and is configured by attaching a 25b at its distal end. そして、取付用柄部3bに導入したワイヤー24a,24bの長さの差は、前記した作動開始の時間差を発生するもので、本体1の主幹1aに設けた操作レバー12と一体のフックの初期位置(操作レバーの原点位置)から各ワイヤーの係合子25a,25bまでの長さに差を付けてある Then, the wire 24a was introduced into mounting shank 3b, the difference in length of 24b, intended to generate a time difference between the start operation mentioned above, the integral with the operating lever 12 is provided on the trunk 1a of the body 1 hook Initial position from the (home position of the operating lever) of the wire engaging member 25a, is with a difference in length up to 25b

【0030】上記作動手段20と係合して押し出しブロック18を作動する操作レバー12は、前記した作動手段20のワイヤー24a,24bが嵌入すると共に、ワイヤー24a,24bに連結された係合子25a,25 [0030] The actuation means 20 engaged with the extrusion operation lever for operating the block 18 12, the wire 24a of the actuating means 20 described above, with 24b are fitted, engaging member 25a which is connected to the wire 24a, 24b, 25
bが当接係合する熊手様のフック26を一体的に連結保持し、操作レバー12を主幹1aに沿ってグリップ1b b is integrally connected holding rake-like hook 26 which abuttingly engages the grip 1b along the operating lever 12 to the trunk 1a
側に引くことで作動子19a,19bが作動手段20を介して作動される。 Actuator 19a by pulling on the side, 19b is actuated via the actuating means 20.

【0031】上記した形態は生体組織の縫合のみを行う縫合器であるが、上記縫合器にはステープル17による縫合ラインの内側に沿って、腫瘍を含む生検用小切片を生体組織aから切断するカッター27を備えてもよい。 [0031] While embodiments described above are suturing device that performs only suturing living tissue, in the above suturing device along the inside of the suture line by staples 17, cut small slices biopsy including tumor from the tissue a it may include a cutter 27 to.
その場合、上記カッター27はカートリッジ3に組み込んでも、カートリッジ3を装着する本体1に装着されていてもよい。 In that case, the cutter 27 is also incorporated in the cartridge 3 may be attached to the main body 1 for mounting the cartridge 3. 以下、そのカッター27の装着構造について説明する。 The following describes the mounting structure of the cutter 27. 図3はカートリッジ3に内蔵する場合で、 Figure 3 is a case of internal to the cartridge 3,
前記した作動子19a,19b同様、左右1個ずつのカッター27a,27bをカートリッジ3におけるステープル収容部3aの内側に区画形成した専用収納スペース28に収納すると共に、カッター27a,27bに夫々ワイヤー29a,29bを接続し、そのワイヤー29 Actuator 19a described above, 19b similarly, the left and right one by one cutter 27a, 27b together with housing dedicated storage space 28 which is partitioned and formed on the inner side of the staple housing portion 3a of the cartridge 3, the cutter 27a, husband 27b s wire 29a, connect the 29b, the wire 29
a,29bの反対側は作動子19のワイヤー24a,2 a, the other side of 29b is the actuator 19 wires 24a, 2
4b同様、取付用柄部3b側に導入し、且つ作動開始のタイミングに時間差が生じるように、係合子30a,3 4b similarly introduced into mounting shank 3b side, and so that the time difference in the timing of the start operation occurs, the engaging element 30a, 3
0bの取付位置までの長さに長短差を付けてある。 0b are given the length difference in the length to the mounting position of the. そして、このカッター27a,27bの作動は、ステープル17を加締める(ファイヤーする)動作に僅かに遅れて動作することにより、生体組織がステープルで縫合された後に切断できるようにする。 Then, the cutter 27a, and 27b operation, crimped staple 17 (to fire) by operating with a slight delay in the operation, the biological tissue is to be cut after being sutured with staples.

【0032】カッターを本体1に装着する場合は、図7、8に示すように先端にカッター31a,31bの付いた2枚の薄い帯板32a,32bを、カートリッジ3 [0032] When mounting the cutter body 1, the cutter 31a to the tip as shown in FIGS. 7 and 8, two thin strip 32a marked with a 31b, a 32b, the cartridge 3
におけるステープル収容部3aの内側に区画形成した専用通路33に沿って押し出すことにより、左右別々に生体組織を切断するものとする。 By extrusion along a dedicated path 33 partitioned and formed on the inner side of the staple housing portion 3a of shall cut left and right separately biological tissue. 尚、カッター31a,3 In addition, the cutter 31a, 3
1bの通る専用通路33は、カートリッジ又は本体の何れに形成してもよいものである。 Dedicated passageway 33 through which a 1b are those may be formed on either the cartridge or the main body. (図示はカートリッジ3に専用通路33を形成してある) そして、帯板32a,32bを前方へ押し出す操作は、 (Shown is formed a dedicated passageway 33 in the cartridge 3) The operation to push strip 32a, and 32b to the forward,
ステープル17を加締める操作レバー12とは別の操作レバーを設けて行ってもよいが、図7、8に示すように、ステープル17を加締める操作レバー12を利用して行ってもよい。 The operating lever 12 crimped staple 17 may be performed by providing a separate control lever, but as shown in FIGS. 7 and 8, may be performed using the operating lever 12 crimped staple 17. 即ち、操作レバー12はステープル1 That is, the operation lever 12 is the staple 1
7を加締めるためにグリップ1b側に引き寄せるが、全てのステープル17の加締めを完了した時点、又はそれ以降に操作レバー12と一体のフック26と帯板32 While pulling the grip 1b side 7 to crimping, the time to complete the crimping of all staples 17, or subsequent to the hook 26 integral with the operating lever 12 the strip 32
a,32bの後端が係合し、操作レバー12の押動で帯板32a,32bが前方に押し出されるようにする。 a, the rear end of the 32b engages, strip 32a by pushing the operating lever 12, 32b is to be pushed forward. その構成としては、操作レバー12と一体のフック26に帯板32a,32bの後端が嵌着係合する受け枠34を取り付け、他方、帯板32a,32bの後端側方には該帯板32a,32bの後端を前記受け枠34と係合する方向に付勢する付勢手段(スプリング)35を設ける。 As the arrangement, the strip 32a to the hook 26 integral with the operating lever 12, the attachment receiving frame 34 the trailing edge of 32b is fitted engagement, the other, the strip 32a, the rear end side of 32b the band plate 32a, is provided urging means (spring) 35 for urging the rear end of the 32b in a direction to be engaged with the receiving frame 34 above.
これにより、ステープル17の加締めを完了してフック26が帯板32a,32bの後端を通過すると同時に付勢手段(スプリング)35の作用で受け枠34に該帯板32a,32bの後端が嵌入係合される。 Thus, to complete the crimping hook 26 strip 32a of the staple 17, at the same time urging means passes through the rear end of 32 b (spring) 35 belt-plate 32a to the receiving frame 34 by the action of, 32b rear end of the There is engaged fitted engagement. 図中、36は操作レバー12を初期位置に戻す戻しバネである。 In the figure, 36 is a return spring returning the operating lever 12 to the initial position.

【0033】挟持部材2及びカートリッジ3における環状の挟持部の最内側には、カッター27(または31) [0033] The innermost clamping portion of the annular in pinching member 2 and the cartridge 3, the cutter 27 (or 31)
で切断された生検用小切片の外周縁を上下より挾着して保持する把持手段37を設けてもよい。 In the outer peripheral edge of the cut biopsy small sections it may also be provided gripping means 37 for holding and 挾着 than the vertical. その把持手段3 The gripping means 3
7は、挟持部材2における挟持部2aの底板43と、環状を呈した上側の把持部材39とで構成され、上側の把持部材39はカートリッジ3における環状の挟持部3a 7 includes a bottom plate 43 of the clamping portion 2a of the clamping member 2 is composed of an upper gripping member 39 an annular shape, the upper gripping member 39 is an annular holding portion 3a of the cartridge 3
の内側に嵌合する環状の把持部39aと、この把持部3 An annular gripping portion 39a to be fitted on the inside of, the gripping portion 3
9aの外周に柄部39bが連設されて形成されている。 Shank 39b is formed is continuously provided on the outer periphery of 9a.
そして、柄部39bの前部が本体1にピン38で上下回動可能に支持され、そのピン38による枢着点より柄部39bの端部側には該把持部材39の把持部39a側を挟持部材2における挟持部2aの底板43側に回動付勢するバネ40が本体1との間に張設されている。 The front part of the handle portion 39b is supported to be vertically pivoted by a pin 38 to the main body 1, the grip portion 39a side of the pin 38 gripping member 39 on the end of the shank 39b from the pivot point by spring 40 to rotate urging the bottom plate 43 side of the clamping portion 2a of the clamping member 2 is stretched between the main body 1.

【0034】また、把持部材39をバネ40の引張り力に抗して回動不可に保持する機構は、縫合及び切断を操作する操作レバー12の下部押杆42の下端面に前記把持部材39の柄部39bの上面が当接することで行い、 Further, a mechanism for holding the gripping member 39 to disable rotated against the pulling force of the spring 40, the gripping member 39 to the lower end surface of the lower pushing rod 42 of the operating lever 12 for operating the sewing and cutting performed by the upper surface of the shank 39b abuts,
この両者の当接が解除された時、把持部材39がバネ4 When the contact of both is released, the gripping member 39 is spring 4
0の作用でピン38を中心として回動され、把持部39 Is rotated the pin 38 as the center by the action of 0, the grip portion 39
aが底板43側に強く押し付けられ、それにより切断された小切片の外周縁を底板43とで挟持する。 a is strongly pressed against the bottom plate 43 side, thereby sandwiched between the bottom plate 43 of the outer peripheral edge of the small sections is cut. 操作レバー12との当接を解除する構成は、把持部材39の柄部39bに操作レバー12の下部押杆42が嵌入する通孔41を開設し、操作レバー12をスライドして通孔41 Configured to release the contact between the operating lever 12 is opened through hole 41 of the lower pushing rod 42 is fitted in the operation lever 12 to the handle portion 39b of the gripping member 39, through hole 41 by sliding the operation lever 12
の位置に位置した時、通孔41は操作レバー12の下部押杆42に嵌まり当接が解除される。 When located in the position of hole 41 is fits abuts the bottom pushing rod 42 of the operating lever 12 is released. 通孔41の開設位置は、操作レバー12を操作して縫合及び切断を完了する位置とし、操作レバー12を本体1の後方へ引くだけの操作で縫合及び切断を完了する形態の場合は柄部39 Opening the position of hole 41, and completed position suturing and cutting by operating the operating lever 12, when the operation lever 12 of the completed form the suture and cutting by the operation of only pulling rearward of the main body 1 shank 39
bの端部寄りに開設し、操作レバー12をカートリッジ3側に押して縫合後の生体組織の切断を行う形態の場合はピン38寄りに開設する。 Opened towards the end portions of the b, and the operating lever 12 when in the form of performing the cutting of the biological tissue after the suture push the cartridge 3 side to open the pin 38 closer. 尚、把持部材39の柄部3 Incidentally, the handle portion 3 of the gripping member 39
9bが操作レバー12の下部押杆42と当接している時は、把持部材39の把持部39aがカートリッジ3の挟持部3aの高さ内に保持されているようにする。 When 9b is in contact with the lower pushing rod 42 of the operating lever 12, the grip portion 39a of the gripping member 39 is so held in the height of the clamping portion 3a of the cartridge 3.

【0035】以上の如く構成した縫合器(カッター及び把持手段を備えた縫合器)Aの作業手順に付いて説明する。 The above as constituting the suture instrument (suturing device equipped with a cutter and holding means) attached to the work procedures of A will be described. 先ず、本体1の先部に設けてある受け筒14を上方に引き起こし、これにカートリッジ3の取付用柄部3b First, it causes receiving cylinder 14 that is provided on the tip portion of the main body 1 upwardly, this mounting handle portion 3b of the cartridge 3
を差し込み定着する。 The plug fixing. 受け筒14を水平状態に倒す。 Defeat receiving cylinder 14 in the horizontal state. それにより、本体1 As a result, the main body 1
に装備した操作レバー12のフック26とカートリッジ3の作動手段20が噛み合い係合する。 Actuating means 20 of the hook 26 and the cartridge 3 equipped with the operating lever 12 to the meshing engagement. 挟持部材2を開いた状態で生体組織aを挟み、レバー5を操作して該挟持部材2とカートリッジ3とで挟みながら腫瘍部分を探し出す。 Sandwiching the living tissue a with open clamping member 2, locating the tumor portion while being sandwiched between 該挟 support member 2 and the cartridge 3 by operating the lever 5. この時、生体組織中に腫瘍等が有ると、挟持部材2の挟持部2aの底板43上に支えられるため、該腫瘍部分はカートリッジ3の環状部の中で上方に突出し、それにより挟持部材2とカートリッジ3で挟んだ時の感触に加えて視覚によって容易に認識することが出来る。 At this time, when the tumor or the like is present in the body tissue, because it is supported on the bottom plate 43 of the clamping portion 2a of the clamping member 2, the tumor portion protrudes upward in the annular portion of the cartridge 3, thereby pinching member 2 it can readily be visually recognized in addition to the touch when sandwiched between the cartridge 3 and. 腫瘍部分が見つかった場合は、その腫瘍が悪性か良性かを調べる為に、該腫瘍を含んだ部分を小切片として切り取る。 If the tumor part was found, in order to find out whether the tumor is malignant or benign, cut out the part that contains the tumor as small sections. その切取りは、当該部分をレバー5を操作して挟持部材2とカートリッジ3で挟持し、その状態で操作レバー12を手前側(グリップ側)に一挙に引き寄せてステープル17の押し出し縫合(ステープリング) Its cut is sandwiched the part clamping member 2 and the cartridge 3 by operating the lever 5, the front side of the operating lever 12 in this state extrusion suturing of the staple 17 attracts at once (the grip side) (stapling)
と、カッター27による生体組織aの切断(カッティング)を行う。 When carried out the cutting of biological tissue a by the cutter 27 (cutting). 操作レバー12を操作して生体組織aの切断が完了すると、把持手段37を構成する把持部材39の把持部39aが挟持部材2の底板43側に回動作動して切断した小切片の外周縁を挟持部材2の底板43とで挟みつける。 When by operating the operating lever 12 for cutting the living tissue a is completed, the outer peripheral edge of the small sections grip portion 39a of the gripping member 39 is disconnected by rotating operation on the bottom plate 43 side of the clamping member 2 constituting the holding means 37 the pinching in the bottom plate 43 of the clamping member 2. 小切片の挟持が確立した時点で、リリースレバー1 When the holding of the small sections has been established, the release lever 1
1を操作してレバー5を解放し、挟持部材2を下方に開動すると、小切片の周囲の生体組織を挟持しているカートリッジ3との挟持が解放され、本体1を切開部より体外に引き出すことが可能となる。 1 to release the lever 5 is operated, and when the opening motion of the pinching member 2 downward, is sandwiched freeing the cartridge 3, which sandwich the biological tissue around the small sections, draw the body from the incision body 1 it becomes possible. 小切片は挟持部材2と把持部材39とで挟持されているため、持ち運び移動が可能となる。 Since the small sections which are clamped by the clamping member 2 and the gripping member 39, it is possible to carry the mobile.

【0036】 [0036]

【発明の効果】本発明の生体組織切除用自動縫合器は請求項1に記載の構成により、生体組織から小切片を切り取る時の縫合を、一回の操作で確実に行うことが出来る。 Biological tissue ablation stapler of the present invention exhibits a structure according to claim 1, the suture when cutting small sections from the tissue can be reliably performed in a single operation. そして、その縫合に要する力は、環状に配したステープルを複数に分割した押し出しブロックで順次加締める為、大きい力は必要なく、簡単に操作することができる。 Then, the force required for the suture, since the tightening sequentially pressurized by extrusion blocks obtained by dividing staples arranged annularly a plurality, large force is not required and can be easily operated. 又、請求項2乃至4に記載の構成により、腫瘍部を含む小切片を体内側に残る生体組織から縫合によって隔離した状態で切断することができる。 Further, it can be cut in a state of being isolated by the configuration according to claims 2 to 4, by suturing small sections containing tumor section from the biological tissue remains in the body side. 更に、請求項5に記載の構成により、生体組織から切断した腫瘍部を含む小切片を、他の器具を使用することなく、切断した小切片の外周縁を閉じたまま持ち運ぶことができる。 Furthermore, the arrangement according to claim 5, a small slice containing the tumor portion cut from the tissue, without the use of other instruments, can be carried without opening the outer peripheral edge of the cut small slices. そして、把持手段を縫合器から分離し得るように構成した場合には、小切片の運搬を把持手段のみで行うことができる。 When it is configured to be able to separate the gripping means from the suturing instrument, it can be carried out only by gripping means transportation of small sections. 因って、従来の縫合器よりも使用勝手の良い自動縫合器を提供することができる。 Due, it is possible to provide an arbitrarily good stapler use than conventional suture instrument.

【図面の簡単な説明】 BRIEF DESCRIPTION OF THE DRAWINGS

【図1】図1は本発明に係る自動縫合器の実施の形態の一例を示す概略図である。 FIG. 1 is a schematic diagram showing an example of an embodiment of stapler according to the present invention.

【図2】本体にカートリッジを装着し挟持部材を閉じ始めた状態を示す同概略図である。 Figure 2 is a similar schematic view showing the state began closing the mounting and clamping member of the cartridge body.

【図3】ステープル及びカッターを内蔵し、且つ把持手段を装着したカートリッジを示す横断平面図である。 Figure 3 incorporates a staple and a cutter, a cross-sectional plan view showing the cartridge mounted and gripping means.

【図4】ステープルを押し出す押し出しブロック及びカッターを操作レバーで作動させた状態の同横断平面図である。 4 is a similar cross-sectional plan view of a state in which actuates the extrusion block and the cutter push the staples in the operating lever.

【図5】図4に示すカートリッジの先端側を直線状に展開して示す拡大断面図で、(a)はステープル部、 [5] The front end side of the cartridge shown in FIG. 4 in enlarged cross-sectional view illustrating deployed linearly, (a) shows the staple unit,
(b)はカッター部を示す。 (B) shows a cutter unit.

【図6】操作レバーを引いてステープリング及びカッティングを完了した状態を示す概略図である。 6 is a schematic view showing the completed stapling and cutting by pulling the operating lever.

【図7】カッターを本体側に装備した形態を示す横断面図である。 [7] The cutter is a transverse sectional view showing an embodiment equipped on the main body side.

【図8】図7の作動状態を示す同横断面図である。 8 is a similar cross-sectional view showing an operation state of FIG.

【図9】生体組織を挟持部材とカートリッジで挟んだ状態を示す拡大断面図である。 9 is an enlarged sectional view showing a state sandwiching the living tissue clamping member and the cartridge.

【図10】切断した小切片を把持手段で挟持し、挟持部材の閉動を解除した状態を示す概略図である。 [10] The cut small sections were held between the gripping means is a schematic view showing a state releasing the closing of the clamping member.

【図11】図1に示した縫合器の要部を示す分解斜視図である。 11 is an exploded perspective view showing a main part of the suture instrument shown in FIG.

【符号の説明】 DESCRIPTION OF SYMBOLS

A…縫合器 a…生体組織 1…本体 2…挟持部材 3…カートリッジ 12…操作レバー 17…ステープル 18a,18b…押し出しブロック 19…作動子 27,31…カッター 37…把持手段 A ... suturing a ... tissue 1 ... body 2 ... clamping member 3 ... cartridge 12 ... lever 17 ... staples 18a, 18b ... extrusion block 19 ... actuator 27, 31 ... Cutter 37 ... gripping means

Claims (5)

    【特許請求の範囲】 [The claims]
  1. 【請求項1】 人体の生体組織から生検用小切片を切除するために腫瘍を含む小切片の外周部分を縫合する縫合器であって、生体組織中に存在する腫瘍を囲むように包囲して該生体組織の下側に位置して挟持の一方を担う開閉可能な一方の挟持部材を備えた本体と、その挟持部材と対応して本体に装着する、樹脂製ケースにステープルとそのステープルを押し出す複数の押し出しブロックとその押し出しブロックを前記ステープルを押し出す方向に移動させる左右1個ずつの作動子を組み込んだ他方の挟持部材を担うカートリッジとからなり、前記挟持部材における挟持部は環状に形成し、且つ前記カートリッジにおけるケースも環状に形成すると共に、その環状のケースに根元側を除いてステープルを収容し、カートリッジが装着される本体 1. A suturing device for suturing an outer peripheral portion of the small sections containing tumor to ablate small sections biopsy from human body tissue, surrounds so as to surround the tumor present in the living body tissue a body having one of the clamping member open as possible responsible for one of the clamping positioned below the biological tissue Te, attached to the body in correspondence with its clamping members, the staples resin case the staple extruded and a plurality of extruded blocks the cartridge carrying the other clamping member incorporating an actuation element of the extrusion block one by one right and left to move in the direction to push the staples, sandwiching portion in the clamping member is formed annularly and with casing is also formed in an annular in said cartridge, accommodates staples except root side to the annular casing, body cartridge is mounted に設けた操作レバーを操作することで該カートリッジに装着した左右1個の作動子が時間差をおいて作動し、ステープルの配置形態に沿って配置した押し出しブロックを順次押し下げて、腫瘍を含む生検用小切片の外周を一動作で縫合することを特徴とする生体組織切除用自動縫合器。 Left one operating element mounted on the cartridge is operated with a time difference by operating the operation lever provided in, successively depressing the extrusion block disposed along the staple arrangement form, biopsies, including tumor stapler for biological tissue ablation, characterized by suturing the outer periphery of use small sections in one operation.
  2. 【請求項2】 上記ステープルによる縫合ラインの内側に沿って、腫瘍を含む生検用小切片を生体組織から切断するカッターを備えている請求項1記載の生体組織切除用自動縫合器。 Wherein said along the inner side of the suture line by staples, stapler for biological tissue ablation according to claim 1, characterized in that includes a cutter small sections biopsy cutting from the living tissue, including tumor.
  3. 【請求項3】 上記カッターがカートリッジに組み込まれていることを特徴とする請求項2記載の生体組織切除用自動縫合器。 3. A stapler for biological tissue ablation according to claim 2, characterized in that the cutter is incorporated in the cartridge.
  4. 【請求項4】 上記カッターが、カートリッジを装着する本体に装着されていることを特徴とする請求項2記載の生体組織切除用自動縫合器。 Wherein said cutter, stapler for biological tissue ablation according to claim 2, characterized in that it is mounted on the body for mounting the cartridge.
  5. 【請求項5】 上記挟持部材及びカートリッジにおける環状の挟持部の内側に、縫合及び切断後に前記挟持部材とカートリッジによる生体組織の挾着を解除した時、カッターで切断された生検用小切片の外周縁を上下より挾着して保持する把持手段を設けたことを特徴とする請求項2乃至請求項4の何れかに記載の生体組織切除用自動縫合器。 Inside of 5. A clamping portion of the annular in the clamping member and the cartridge, when releasing the 挾着 of biological tissue by the clamping member and the cartridge after suturing and cutting biopsy for small sections cut by the cutter stapler for biological tissue ablation according to any one of claims 2 to 4, characterized in that a gripping means for holding the outer peripheral edge and 挾着 than the vertical.
JP27124799A 1999-09-24 1999-09-24 Automatic suturing unit for excising living body tissue Pending JP2001087272A (en)

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