JP2002219133A - Aid for vascular anastomosis - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enable the easy insertion/extraction of a hollow conduit into/from a vascular lumen and prevent the loss of an aid for vascular anastomosis before an operation. SOLUTION: The hollow conduit having both open ends is used for the insertion into a blood vessel. Characteristically, the aid for vascular anastomosis is provided with a thread-shaped traction means, one end of which is connected to a central part of the hollow conduit and the other end of which is connected to a tag, which is equipped with a holding means and a tissue connecting means.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a vascular anastomosis assisting device for use in performing coronary artery bypass surgery or vascular bypass surgery for treating coronary artery disease.

[0002]

2. Description of the Related Art In some cases, stenosis occurs in a blood vessel due to arteriosclerosis or the like, and it is difficult or impossible to obtain a blood flow to the peripheral side. In such a case, a bypass operation is performed in which the patient's own artery or artificial blood vessel is anastomosed between the central side and the peripheral side while bypassing the stenotic portion of the blood vessel.

[0003] In performing this anastomosis, in order to obtain a good visual field of the anastomotic portion, the bleeding from the anastomotic portion is generally suppressed by temporarily compressing both ends of the anastomotic blood vessel.
The method of stopping is adopted. On the other hand, if the stenotic part is not completely closed, there is a concern that peripheral blood may be adversely affected by blocking blood flow during vascular anastomosis. The present inventors have disclosed a vascular anastomosis assisting device as disclosed in Japanese Patent Application Laid-Open No. H11-335. The assisting device comprises a hollow conduit having an annular protrusion (bulging portion) at an end and a thread-like removing means at a central portion, and has elasticity capable of self-restoring a bent hollow conduit after being inserted into a blood vessel. Is required.

[0004]

By using the above-mentioned anastomosis assisting device, it has become possible to perform a vascular anastomosis without completely blocking blood flow. However, as the above-mentioned vascular anastomosis was repeated, problems to be improved became clear. First, it is difficult to insert the hollow conduit into a blood vessel. During the operation, it is not easy to insert the hollow conduit directly into the blood vessel from the opening (incision) of the blood vessel. Therefore, in order to facilitate the insertion, it is necessary to secure the (blood vessel) opening.

[0005] Second, there is a point to be improved with respect to the yarn which is a means for pulling the hollow conduit. When removing an anastomosis assisting tool from a blood vessel after anastomosis, it is necessary to hold and pull the thread-like traction means, but due to the thin thread, it may not be able to grasp well or lose the end of the thread . Therefore, a small plate (tag) attached to the opposite end of the yarn connected to the hollow conduit has been devised for the purpose of holding or confirming the end of the yarn (and other necessary information). ing.

[0006] Indeed, removal of the hollow conduit from within the blood vessel
This was made easier by the attachment of the tag to the end of the thread. In addition, the tag may interfere with the operation during the operation, and it is necessary to move the placement position. In this case, the movement is easy. However, conventional tags are not designed in consideration of grasping, so it is difficult to grasp, and when moving the tag with tweezers or sliding when pulling, removing the hollow conduit (anastomosis aid) from inside the blood vessel, It was troublesome.

[0007]

According to the present invention, the above object has been attained by the following constitution. That is, a first aspect of the present invention is a blood vessel anastomosis assisting device having a hollow conduit for inserting a blood vessel having open ends and a guide wire for guiding the conduit when the blood vessel is inserted into the blood vessel. A resilient and thread-like traction means is coupled to the central portion of the hollow conduit to prevent blood leakage (prevents blood leakage from the gap between the outer wall of the hollow conduit and the inner wall of the blood vessel when the hollow conduit is inserted into the blood vessel). The prevention means is formed on the outer surface of the hollow conduit, and the flexible guide wire has a higher elasticity than the blood vessel to be inserted, and has a thickness and an axial length of the hollow conduit which can be inserted into the lumen of the hollow conduit. A blood vessel anastomosis assisting device having a length of 1.2 times or more.

In many cases, the (protruding) guide end can be inserted into the blood vessel with the guide wire previously inserted into the hollow conduit and the guide wire end protruding from the hollow conduit end. So easy to use. In addition, the above-mentioned freely insertable means that the guide wire is freely inserted in the hollow conduit lumen,
It can be withdrawn and passed through, and more specifically, the outer diameter of the guide wire is smaller than the inner diameter of the hollow conduit.

Further, since the guide wire is inserted into the hollow conduit, the stiffness of the entire blood vessel anastomosis assisting device is strengthened, and the insertion becomes easier than when the hollow conduit alone is inserted into the blood vessel. However, since the guide wire may not be necessary, the guide wire and the conduit may be separately put in the same bag and sterilized, and the guide wire may be inserted into the hollow conduit as needed.

The blood leak preventing means is an annular bulge formed on the outer surface of the hollow conduit, and the outer periphery of the annular bulge is 1.1 to 2.0 of the outer periphery of the hollow conduit. Is more preferred. Preferably, the guide wire has a higher modulus than the hollow conduit. The length of the guide wire is 2.0 to 5.0 times the axial length of the hollow conduit because the length of the guide wire is too short to be useless, and too long is an obstacle and wasteful. Is preferred. Also, when the guide wire is inserted into a blood vessel,
A predetermined waist strength is required, but if it is too hard, it damages the blood vessel wall.
A range of 0D is preferable, and a range of 40 to 50D is more preferable.

A second aspect of the present invention is a hollow conduit for inserting a blood vessel having open ends, the conduit having a self-restoring property and, when the hollow conduit is inserted into the blood vessel, the outer wall of the hollow conduit and the blood vessel. Blood leakage preventing means for preventing blood leakage from the gap with the inner wall is formed on the outer surface of both ends of the hollow conduit, and the conduit has a thread-like shape having one end connected to the center of the conduit and the other end connected to the tag. Wherein the tag is provided with a gripping means and a tissue coupling means.

The provision of the gripping means on the tag makes it easier to withdraw and move the obstructive tag when removing the hollow conduit, and the provision of the tissue coupling means prevents the hollow conduit from being lost from the surgical field. In addition, it can be temporarily connected (temporarily fixed) to the tissue near the operation site.

If the tag is large, it interferes with the operation. If the tag is small, it is difficult to grasp the hollow conduit when removing it from the blood vessel, and it is difficult to write necessary items (standards, etc.) on the surface of the tag. Those having an appropriate size are desirable. The thickness of the tag is desirably thin because a through hole is formed as described later and a thread may pass therethrough. The preferred shape and dimensions of the tag are substantially rectangular, 10 to 20 mm in length, 5 to 15 mm in width, and 0.5 to 2.0 in wall thickness.
mm.

It is preferable that the tag is provided with a gripping means and a tissue coupling means which is used in combination with the gripping means and the tissue coupling means, since the tag itself can be made small and does not hinder the operation. Also, if the tags are the same size,
A device that combines the above two means can take up a larger writing space.

Although various embodiments of the gripping means and the tissue connecting means are conceivable, a simpler and more effective one is one in which a through hole is formed in the tag. The through hole formed in the tag is easy to grasp with tweezers etc. when pulling the hollow conduit,
Power is easily transmitted. Also, by passing the suture through the through hole and temporarily sewing the tag to the tissue and temporarily fixing it,
Loss of the vascular anastomosis assisting device can be prevented.

If the size of the through hole is too large, there is a concern that the strength of the tag may be reduced or the display portion may be reduced. Therefore,
The diameter of the through hole is preferably 1 to 5 mm, and more preferably 2 to 5 mm.
３3 mm is more preferable.

The position where the through hole on the tag is formed is as follows:
It is desirable to have a distance in the range of 0.5 to 10 mm from the edge of the tag 6, more preferably 1 to 5mm. Here, the distance is, as shown in FIG.
And the shortest distance d1 between the tag and the tag edge 9. If the distance from the edge is large, it is necessary to open the tip of a gripping instrument such as tweezers widely when gripping, which is troublesome. Conversely, if the distance is too small, the through hole may be damaged in terms of strength.

[0018]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Various embodiments of the present invention will be described below. One embodiment of the present invention is a vascular anastomosis assisting device having a hollow conduit for inserting a blood vessel having open ends and a guide wire for guiding the conduit into a blood vessel when the hollow conduit is used. Self-restoring and thread-like traction means is coupled to the central portion of the hollow conduit to prevent blood leakage from the gap between the outer wall of the hollow conduit and the inner wall of the blood vessel when the hollow conduit is inserted into the blood vessel. The leak prevention means is formed on the outer surface of the hollow conduit, the flexible guide wire has a higher elasticity than the blood vessel to be inserted, and has a thickness and an axial length of the hollow conduit that can be inserted into the hollow conduit lumen. It is a vascular anastomosis assisting device characterized by having a length of 1.2 times or more.

[0019] Further, in the above-mentioned blood vessel anastomosis assisting tool, a guide wire is inserted into a hollow conduit in advance, and a guide wire end protrudes from the hollow conduit end.

[0020] Further, in the vascular anastomosis assisting device, the length of the guide wire is 2.0 to 5.0 times the length in the axial direction of the hollow conduit.

Further, the wire has a Shore hardness of 30 to 8
The vascular anastomosis assisting device in a range of 0D.

A hollow conduit for inserting a blood vessel having open ends, which has a self-restoring property and, when the hollow conduit is inserted into a blood vessel, a hollow space between the outer wall of the hollow conduit and the inner wall of the blood vessel. Blood leakage prevention means for preventing blood leakage is formed on the outer surfaces of both ends of the hollow conduit, and the conduit further comprises a thread-like traction means having one end connected to the center of the conduit and the other end connected to the tag. The tag is provided with a grasping means and a tissue connecting means, which is a blood vessel anastomosis assisting tool.

[0023] Further, the blood vessel anastomosis assisting tool is provided with the tag provided with a gripping means and a tissue coupling means which is also used as the gripping means and the tissue coupling means.

[0024] Further, in the blood vessel anastomosis assisting tool, the gripping means and the tissue connecting means are through holes formed in the tag.

[0025] Further, there is provided the blood vessel anastomosis assisting device wherein the diameter of the through hole is 1 to 5 mm.

[0026] Further, in the blood vessel anastomosis assisting tool, the through hole is formed at a distance of 0.5 to 10 mm from an edge of the tag.

[0027]

BRIEF DESCRIPTION OF THE DRAWINGS Preferred embodiments of the present invention will be briefly described with reference to the drawings. FIG. 1 shows one embodiment of the blood vessel anastomosis assisting device of the present invention. In one example, the vascular anastomosis assisting device 1 mainly includes a hollow conduit 10 and a guide wire 4. At the other end of the hollow conduit 10, a drag string 5 having a tag 6 coupled thereto is coupled to the other end, and the tag 6 is formed with a through hole 7 penetrating therethrough.
In the lumen of the hollow conduit 10, a guide wire 4 is provided at both ends thereof.
It is inserted in a state protruding from both ends of the hollow conduit.

Both ends of the hollow conduit are bulged in a ring shape,
The two bulging portions 2 are formed with gentle curves at both ends. The drag string 5 has one end connected to the center of the hollow conduit 10 and another end connected to a small hole 8 formed in the tag 6.

Next, the shape and dimensions of the blood vessel anastomosis assisting device 1 of this embodiment will be described. The axial length of the hollow conduit 10 is 1.2 mm, the axial length of the central portion 3 is 12.0 mm,
The axial length of one bulge 2 is 2.5 mm. The outer diameter of the bulging portion 2 is about 1.5 mm (the inner diameter is about 0.5 m).
m), the outer diameter of the central portion 3 is about 0.7 mm (the inner diameter is the same as the bulging portion). The outer diameter of the guide wire 4 is about 0.4 mm and the length is 50.0 mm.

Next, the material of each component will be described. The hollow conduit is formed entirely of a polyamide resin, and has flexibility and self-healing properties (even if it is bent by applying a force, when the force is released, it naturally returns to its original straight state). The guide wire 4 is also formed of a polyamide resin, and has flexibility and self-restoring property like a hollow conduit.

Next, the mode of use of the tag of the blood vessel anastomosis assisting device 1 of the present invention will be described. When removing the blood vessel anastomosis assisting tool from the blood vessel, the tag is pulled by grasping the through hole 7 with tweezers or the like. Thereby, the pulling string 5 can be firmly gripped and pulled, and the hollow conduit can be pulled out. Further, when performing the A-C bypass operation, if the vascular anastomosis assisting device is sewed to the living tissue in the vicinity of the operative site with a suture in advance and temporarily fixed, the device can be used immediately and can be lost. Don't worry. For the temporary fixing, it is convenient to pass a suture through the through hole 7 formed in the tag and sew one or two stitches to the tissue.

[0032]

The use of the guide wire together with the hollow conduit makes it easier to insert the hollow conduit into the vessel lumen. Further, by providing the gripping means and the tissue connecting means to the tag connected to the hollow conduit, the hollow conduit can be firmly gripped and the hollow conduit can be pulled, and the anastomosis assisting device can be prevented from being lost in advance.

[Brief description of the drawings]

FIG. 1 is a schematic view showing an example of a blood vessel anastomosis assisting device of the present invention.

FIG. 2 is a schematic view showing a tag for indicating a formation position of a through hole.

[Explanation of symbols]

 1. Vascular anastomosis aid 2. Swelling part 3. Central part 4. Guidance wire 5. Tow line 6. Tags 7. 7. Through hole Stoma 9. Tag edge 10. Hollow conduit 11. End of through hole d1. Shortest distance from the edge of the tag to the end of the through hole

Claims (9)

[Claims] 1. A hollow conduit for inserting a blood vessel having open ends at both ends;
A vascular anastomosis aid having a guide wire for guiding the conduit into a blood vessel, wherein the hollow conduit has a self-restoring property, and a thread-like traction means is connected to a central portion of the hollow conduit. When the hollow conduit is inserted into the blood vessel, blood leakage preventing means is formed on the outer surface of the hollow conduit to prevent blood leakage from the gap between the outer wall of the hollow conduit and the inner wall of the blood vessel. A blood vessel anastomosis assisting tool having higher elasticity than a blood vessel to be inserted, and having a thickness that can be inserted into the lumen of the hollow conduit and a length of 1.2 times or more the axial length of the hollow conduit. 2. A guide wire is inserted into the hollow conduit beforehand,
2. The vascular anastomosis assisting device according to claim 1, wherein an end portion of the guide wire projects from an end portion of the hollow conduit. 3. The vascular anastomosis assisting device according to claim 1, wherein the length of the guide wire is 2.0 to 5.0 times the length in the axial direction of the hollow conduit. 4. The vascular anastomosis assisting device according to claim 1, wherein the Shore hardness of the wire is in the range of 30 to 80D. 5. A hollow conduit for inserting a blood vessel having open ends, the conduit having a self-restoring property and, when the hollow conduit is inserted into a blood vessel, a hollow space between an outer wall of the hollow conduit and an inner wall of the blood vessel. Blood leakage prevention means for preventing blood leakage is formed on the outer surfaces of both ends of the hollow conduit, and the conduit further comprises a thread-like traction means having one end connected to the center of the conduit and the other end connected to the tag. An anastomosis assisting device for a blood vessel, wherein a gripping means and a tissue connecting means are provided on the tag. 6. A blood vessel anastomosis assisting device according to claim 5, wherein said tag is provided with a grasping means and a tissue connecting means which is used for both said grasping means and said tissue connecting means. 7. The vascular anastomosis assisting device according to claim 6, wherein the grasping means and the tissue connecting means are through holes formed in the tag. 8. The vascular anastomosis assisting device according to claim 7, wherein the diameter of the through hole is 1 to 5 mm. 9. The vascular anastomosis assisting tool according to claim 7, wherein the position of the through hole is 0.5 to 10 mm from the edge of the tag.