JP2010075318A - Puncture needle aid - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a puncture needle aid capable of simplifying the operation of a puncture needle and capable of reducing the number of puncture positions when an organ and the skin are fixed at a plurality of positions. <P>SOLUTION: The puncture needle aid 10 is used when the abdominal wall is punctured with an insertion puncture needle 20 or extraction puncture needle 30, used when the stomach wall is fixed to the abdominal wall with a suture thread 38. The puncture needle aid is composed of right-angled plates 11 and 12, and a pair of joints 13. The right-angled plates 11, 12 have needle insertion holes 16, 16a, 16b and 16c for inserting the insertion puncture needle 20 or extraction puncture needle 30. In addition, engagement grooves 14 and 15 are disposed on the front surface of the right-angled plate 11, and an engagement groove 18, etc. are disposed on the rear surface of the right-angled plate 12, so that the right-angled plates 11 and 12 are deformably assembled by setting joints 13 respectively in the engagement grooves 14, 18 and 15, etc. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a puncture needle assisting tool used when puncturing a patient's body with a plurality of puncture needles for suturing a portion to be sutured composed of an organ and a skin side portion in the patient's body.

  2. Description of the Related Art Conventionally, a medical suture tool including a plurality of puncture needles has been used to sew and fix a sutured portion in a patient's body, particularly a sutured portion including an organ and a skin side portion. For example, for people whose function of ingesting food by their own mouth has decreased due to aging or illness, fluid food and drink such as liquid food and nutrients are supplied into the stomach using a gastrostomy tube. However, the gastrostomy tube is attached with a hole formed in the abdomen of the patient. In such a case, in order to properly attach the gastrostomy tube, it has been performed in advance to fix the abdominal wall and the stomach wall using a medical suturing tool (see, for example, Patent Document 1).

This medical suturing tool includes two puncture needles installed in parallel at a distance through a connecting plate having a pair of connecting holes and an insertion length adjusting plate having a pair of fitting holes. When suturing is performed, first, the two puncture needles are simultaneously punctured into the sutured portion of the patient. Next, while passing the suture through one puncture needle, the other puncture needle was passed through an inner needle with a loop body consisting of a wire connected to the tip, and the suture body was grasped by the loop body within the patient's body. Pull out the inner needle from the puncture needle. Then, after pulling out the two puncture needles from the patient, the suture is completed by tying both side portions of the suture thread protruding outside the patient's body. Also, the tip of the puncture needle into which the inner needle is inserted is formed in a curved shape and the tip opening faces sideways, so that when the inner needle is pushed into the puncture needle, the loop body moves in the lateral direction. It protrudes to the outside while extending. For this reason, the loop body can grasp the suture thread.
JP-A-5-161655

  However, in the conventional medical suturing tool, puncture resistance is increased because two puncture needles are punctured simultaneously. For this reason, it was necessary to put effort in balance, and the medical staff required skill. Further, when the organ and the skin side part are fixed by, for example, four sutures using this medical suturing tool, it is necessary to puncture and fix the two parts four times, Therefore, a total of 8 punctures had to be made, which was a burden on the patient and was not easy to operate for medical staff.

  The present invention has been made to cope with such problems, and its purpose is to facilitate the operation of the puncture needle and to reduce the number of puncture points when the organ and the skin side portion are fixed at a plurality of locations. It is to provide a puncture needle assisting device.

  In order to achieve the above-described object, a structural feature of the puncture needle assisting device according to the present invention is that a plurality of puncture needles used when fixing an organ to the skin side portion with a suture thread are separated from the skin side portion to the organ side. A puncture needle assisting tool used when puncturing a needle, comprising a pair of frame forming members whose inner peripheral edge is formed into a polygonal frame shape by overlapping and engaging at a predetermined position. By changing the engagement position of the frame forming member, the deformable frame body can be formed with a plurality of puncture needles parallel to the deformable frame body whose inner peripheral edge can be formed into polygons having different sizes. That is, a plurality of needle insertion holes for insertion from a direction orthogonal to the direction are formed at intervals.

  According to the puncture needle assisting device according to the present invention configured as described above, when the puncture needle is punctured into the patient's body, first, the puncture needle assisting device is arranged at the sutured portion of the patient's body, and the puncture is performed. The sutured part can be punctured through a puncture needle through one of the plurality of needle insertion holes of the needle assisting tool. Next, by puncturing the sutured part through the other needle through the needle insertion hole that is spaced from the needle insertion hole through which the puncture needle is passed, the two puncture needles can be punctured into the patient's body in parallel. . In this case, since the puncture needles can be punctured one by one, the puncture resistance can be reduced, and the operation is facilitated because it is not necessary to puncture while balancing the two puncture needles. Further, since the puncture needle moves along the needle insertion hole, the puncture needle is punctured into the body in an appropriate state without being displaced.

  In addition, when another puncture needle is punctured into the patient's body in parallel with the two puncture needles that have already been punctured, they are separated from the two needle insertion holes through which the puncture needles are inserted, respectively. By puncturing the sutured portion through another puncture needle through the needle insertion hole, it is possible to puncture the patient's body in parallel with the three puncture needles. Similarly, when the fourth puncture needle is punctured, it is only necessary to repeat the same simple operation. Therefore, the operation is easy and the puncture needle can be punctured into the body in an appropriate state. Further, this puncture needle assisting tool is composed of a deformable frame body composed of a pair of frame forming members, and the inner peripheral edge portion is enlarged by changing the engagement position in a state where the pair of frame forming members are stacked. It can be formed into polygons of different sizes. For this reason, the length between each puncture needle which punctures a to-be-sewn part can be adjusted arbitrarily.

  Another structural feature of the puncture needle assisting device according to the present invention is that each of the pair of frame forming members is formed of an L-shaped plate member, and the polygon formed by the deformable frame is square or rectangular. It is in.

  According to this, when the pair of frame forming members are assembled so that the deformable frame body is square, the needle insertion holes are provided in the portions located at the four corners of the square, and the puncture needle is passed through each needle insertion hole. Thereby, a to-be-sewn part can be fixed in four places arrange | positioned at equal intervals. In this case, only four places need to puncture the puncture needle. In addition, the interval between the puncture needles can be set arbitrarily, and the puncture needle can be punctured only in the needle insertion holes located at the corners of two or three of the four corners. Furthermore, the polygon formed by the deformable frame can be made rectangular by moving the other frame forming member so that each piece is parallel or orthogonal to one frame forming member. The lengths of the L-shaped pieces of the frame forming member are preferably the same, but may be different.

  Still another structural feature of the puncture needle assisting device according to the present invention is that each of the pair of frame forming members is formed of a V-shaped plate member, and the polygon formed by the deformable frame is triangular. is there. According to this, when the polygon formed by the deformable frame is an equilateral triangle, needle insertion holes are provided in the portions corresponding to the three corners of the triangle, and the puncture needle is passed through each needle insertion hole. Thus, the stitched parts can be fixed at three points arranged at equal intervals. In this case, only three places need to puncture the puncture needle. In addition, the interval between the puncture needles can be set arbitrarily, and the puncture needle can be punctured only in the needle insertion holes corresponding to the two corners of the three corners. Further, the polygon formed by the deformable frame may be a triangle other than a regular triangle.

  Still another structural feature of the puncture needle assisting device according to the present invention is that a front-facing groove extending along the longitudinal direction of one frame forming member is formed on the surface of one frame forming member of the pair of frame forming members. In addition, a back-facing groove extending along the longitudinal direction of the other frame-forming member is formed on the back surface of the other frame-forming member, and a pair is provided via joints that are movably engaged with the front-facing groove and the back-facing groove, respectively. The frame forming member is assembled.

  According to this, by changing the engagement position between the joint and the front-facing groove and the engagement position between the joint and the back-facing groove, a portion where the front-facing groove and the back-facing groove in the pair of frame forming members overlap and intersect Can be changed. Thereby, the interval between the needle insertion hole provided in one frame forming member and the needle insertion hole provided in the other frame forming member can be arbitrarily changed. That is, the joint includes a portion located on the back side that engages with the front-side groove and a portion located on the front side that engages with the back-side groove, and the front-side groove and the back-side groove change the engagement position. While engaging the joint.

  Moreover, it is preferable that the front-facing groove and the back-facing groove have a shape in which a wide portion is formed with a gap between elongated grooves extending at a constant width. In addition, the portion of the joint located on the back side (front facing groove side) and the portion located on the front side (back facing groove side) are each subjected to resistance from both sides of the groove with respect to a thin portion extending with a certain width. If it is located in a wide part, it should be engaged with that part in a stable state. According to this, the space | interval of a needle insertion hole can be changed according to the space | interval of the wide part formed in the front surface groove | channel and the back surface groove | channel. In this case, the surface is a surface away from the body when the puncture needle assisting device is placed on the surface of the patient's body, and the back surface is a surface in contact with the body.

  Still another structural feature of the puncture needle assisting device according to the present invention is that a plurality of magnets are provided by alternately exposing surfaces having different polarities on the surface of one of the pair of frame forming members. Embedded in the longitudinal direction of the other frame forming member, and a plurality of magnets are spaced apart in the longitudinal direction of the other frame forming member by alternately exposing surfaces having different polarities on the back surface of the other frame forming member. And the pair of frame forming members are assembled by adsorbing the magnets of one frame forming member and the magnets of the other frame forming member having different magnetism.

  According to this, a pair of frame forming members are assembled in a predetermined state by adsorbing the magnets of one frame forming member and the magnets of the other frame forming member having different polarities of the exposed surfaces to each other. Can do. Moreover, the magnet of one frame forming member and the magnet of the other frame forming member which adsorb | suck can be changed arbitrarily, and, thereby, the needle insertion hole provided in one frame forming member, and the other The distance from the needle insertion hole provided in the frame forming member can be changed.

  Still another structural feature of the puncture needle assisting device according to the present invention is that the angle of the two sides of the L shape is bisected from the inside of the L shape corner of one of the pair of frame forming members. The support piece is extended so that the angle of the two sides of the L-shape is bisected from the inside of the L-shape corner of the other frame forming member, and the two support pieces are overlapped with each other. Provided on the front surface of the piece and the back surface of the other support piece are groove portions for moving the support pieces relative to each other along the longitudinal direction, and protrusions that engage with the groove portions. The frame forming member is assembled.

  According to this, the part which a pair of frame formation member overlaps and cross | intersects can be changed by changing the engagement position of a groove part and a protrusion. Thereby, the interval between the needle insertion hole provided in one frame forming member and the needle insertion hole provided in the other frame forming member can be changed. In this case, it is preferable that the groove portion has a shape in which a wide portion is formed while keeping a space in a groove extending with a constant width. Then, the protrusion can move while receiving resistance from both sides of the groove with respect to a portion extending at a certain width of the groove, and when positioned on a wide portion, the protrusion is engaged in a stable state. Make sure you do. According to this, the space | interval of a needle insertion hole can be changed according to the space | interval of the wide part formed in the groove part. Further, the polygon formed by the pair of frame forming members is preferably a square, but can also be a rectangle.

  Still another structural feature of the puncture needle assisting device according to the present invention is that a scale is provided along the longitudinal direction of the pair of frame forming members. According to this, the length between the needle insertion holes, that is, the length between the puncture needles can be confirmed by looking at the scale.

  Still another structural feature of the puncture needle assisting tool according to the present invention resides in that a cylindrical guide portion for guiding the puncture needle into the needle insertion hole is provided on the peripheral edge portion of the plurality of needle insertion holes. This facilitates the operation of passing the puncture needle through the needle insertion hole.

(First embodiment)
Hereinafter, a first embodiment of the present invention will be described in detail with reference to the drawings. FIG. 1 shows a puncture needle assisting tool 10 according to the embodiment. This puncture needle auxiliary tool 10 is configured by assembling right-angle plates 11 and 12 as a pair of frame forming members according to the present invention with a pair of joints 13 (see FIG. 2). The right-angle plates 11 and 12 are each made of an elongated L-shaped plate made of polypropylene or polyethylene, and the right-angle plates 11 and 12 constitute a deformable frame according to the present invention. Further, the portions corresponding to the two L-shaped sides of the right-angle plates 11 and 12 have the same width and length.

  The right-angle plate 11 is arranged on the lower side (the patient's body side), and extends along the longitudinal direction of the piece 11a on the surface (upper surface) of the piece 11a of the pieces 11a and 11b corresponding to the two sides of the L shape. The engagement groove 14 is formed, and the engagement groove 15 along the longitudinal direction of the piece 11b is formed on the surface (upper surface) of the piece 11b. A needle insertion hole 16 is formed at the corner of the boundary between the piece 11a and the piece 11b. The engagement grooves 14 and 15 constitute a front-facing groove according to the present invention. The engaging groove 14 includes a wide portion 14a located on the lower side and a narrow portion 14b located on the upper side. The wide portion 14a is a bottomed groove having a low height extending from the approximate center of the tip end surface of the piece 11a toward the connecting portion side of the piece 11a with the piece 11b, and the upper portion communicates with the narrow portion 14b. Yes.

  The narrow portion 14b is formed of a narrow notch portion having a lower portion communicating with the wide portion 14a and an upper portion communicating with the outside. The narrow portion 14b has a plurality of recesses that are recessed in an arc shape at regular intervals (10 mm intervals) in the longitudinal direction. A positioning recess 14c is formed. The positioning recess 14c is formed so that the overall shape including the narrow portion 14b located between the arc-shaped portions on both sides is circular in plan view, and the maximum width of the positioning recess 14c is The width of the narrow portion 14b is slightly larger. And the needle insertion hole 16a (refer FIG. 3) is formed in the part below the positioning recessed part 14c in the bottom part of the piece 11a.

  The diameter of the needle insertion hole 16a is set to be smaller than the width of the narrow portion 14b (diameter through which an insertion puncture needle outer needle 21 and an extraction puncture needle outer needle 31 described later can pass). The engagement groove 15 includes a wide portion (not shown) located on the lower side and a narrow portion 15b located on the upper side. The wide portion is a bottomed groove having a low height extending from the approximate center of the tip surface of the piece 11b toward the connecting portion of the piece 11b with the piece 11a, and the upper portion communicates with the narrow portion 15b. . The narrow portion 15b is formed of a narrow notch portion having a lower portion communicating with a wide portion and an upper portion communicating with the outside, and a plurality of positioning portions in which both sides are recessed in an arc shape at regular intervals (10 mm intervals) in the longitudinal direction. A recess 15c is formed.

  The positioning recess 15c is formed so that the overall shape including the narrow portion 15b located between the arc-shaped portions on both sides is circular in plan view, and the maximum width of the positioning recess 15c is The width of the narrow portion 15b is slightly larger. A needle insertion hole (not shown) having the same diameter as the needle insertion hole 16a is formed in a portion below the positioning recess 15c at the bottom of the piece 11a. The needle insertion hole 16 located at the corner of the right-angle plate 11 is a small-diameter hole penetrating from the upper surface to the lower surface of the right-angle plate 11, and the diameter is set to be the same as the needle insertion hole 16a and the like. Yes.

  The length between the needle insertion hole 16a and the needle insertion hole 16 located on the needle insertion hole 16 side in the piece 11a and the needle insertion hole 16a and the needle insertion hole 16 located on the needle insertion hole 16 side in the piece 11b The length between each is also set to 10 mm. Further, on both sides of the upper surface of the piece 11a and the piece 11b, 10, 20, 30, 40 (40 at intervals of 10 mm from the connecting side of the piece 11a and the piece 11b toward the tip side, respectively, along the longitudinal direction. Is hidden and cannot be seen.) A scale indicating the length is given. Caps 17 are attached to the distal ends of the pieces 11a and 11b, respectively, and the open ends of the engaging grooves 14 and the engaging grooves 15 are closed.

  The right-angle plate 12 is arranged on the upper side (the side away from the patient's body), and on the back surface (lower surface) of the piece 12a of the pieces 12a and 12b corresponding to the two sides of the L shape, An engagement groove 18 (see FIG. 3) along the longitudinal direction is formed, and an engagement groove (not shown) along the longitudinal direction of the piece 12b is formed on the back surface (lower surface) of the piece 12b. A needle insertion hole 16b is formed at the corner of the boundary between the piece 12a and the piece 12b. The engagement groove 18 or the like constitutes the back-facing groove according to the present invention. As shown in FIG. 3, the engagement groove 18 includes a wide portion 18 a located on the upper side and a narrow portion 18 b located on the lower side. The wide portion 18a is formed of a low-headed groove extending from the approximate center of the front end surface of the piece 12a toward the connecting portion side of the piece 12a with the piece 12b, and the lower portion communicates with the narrow portion 18b. Yes.

  The narrow portion 18b is formed of a narrow notch portion whose upper portion communicates with the wide portion 18a and whose lower portion communicates with the outside (the narrow portion 14b in the state of FIG. 3), and has a constant interval (10 mm interval) ), A plurality of positioning recesses (not shown) whose both sides are recessed in an arc shape are formed. The positioning recess is formed so that the entire shape including the narrow portion 18b located between the arc-shaped portions on both sides is circular when viewed from below, and the maximum width of the positioning recess Is slightly larger than the width of the narrow portion 18b. Although not shown, the engagement groove formed on the back surface of the piece 12b is also composed of a wide portion located on the upper side and a narrow portion located on the lower side. The positioning recesses are formed at regular intervals (10 mm intervals) in the longitudinal direction.

  The needle insertion hole 16b is configured by a small diameter hole penetrating from the upper surface to the lower surface of the right-angle plate 12, and the diameter thereof is the same as the diameter of the needle insertion holes 16, 16a. In addition, a portion positioned above each positioning recess on the upper surface of the piece 12a of the right-angle plate 12 and a portion positioned above each positioning recess on the upper surface of the piece 12b of the right-angle plate 12 are spaced by a certain distance in the longitudinal direction. Four (a total of eight) needle insertion holes 16c are formed (at intervals of 10 mm). The lower part of the needle insertion hole 16c communicates with the wide portion 18a of the piece 12a and the piece 12b, respectively.

  The length between the needle insertion hole 16c and the needle insertion hole 16b located on the needle insertion hole 16b side in the piece 12a and the needle insertion hole 16c and the needle insertion hole 16b located on the needle insertion hole 16b side in the piece 12b The length between each is also set to 10 mm. Further, on both sides of the upper surfaces of the pieces 12a and 12b, the lengths of 10, 20, 30, and 40 are spaced by 10 mm from the connecting side of the pieces 12a and 12b toward the tip side in the longitudinal direction. The scale which shows this is given. Further, as shown in FIG. 3, small ribs 19a and 19b having a semicircular cross section extending in parallel along the longitudinal direction of the pieces 12a and 12b are formed on the lower surface of the right-angle plate 12. Yes.

  The ribs 19a and 19b reduce the frictional resistance between the piece 12a and the piece 11a and between the piece 12b and the piece 11b, and the slidability of the right-angle plate 12 with respect to the right-angle plate 11 is improved. Caps 17 are attached to the distal ends of the pieces 12a and 12b, respectively, and the open ends of the engagement grooves 18 and the like are closed. A spacer 12 c having the same thickness as that of the right-angle plate 11 is attached to the lower surface of the corner portion of the right-angle plate 12. A needle insertion hole (not shown) having the same diameter as that of the needle insertion hole 16b penetrates vertically in a portion of the spacer 12c positioned below the needle insertion hole 16b. By providing the spacer 12c, the puncture needle auxiliary tool 10 can be installed in a stable state on a horizontal plane.

  As shown in FIG. 2, each of the pair of joints 13 is formed by connecting a pair of disk-shaped sliding portions 13a and 13b each having a hole at the center thereof with a cylindrical engagement shaft 13c. Yes. The sliding portion 13a can slide inside the wide portion 14a and the like in the engaging grooves 14 and 15 of the right-angle plate 11, and the sliding portion 13b is a wide portion such as the engaging groove 18 and the like of the right-angle plate 12. The inside of 18a etc. can be slid. The engaging shaft 13c has a diameter that is the same as or slightly larger than the widths of the narrow portions 14b, 15b of the right-angle plate 11 and the narrow portions 18b of the right-angle plate 12, and the positioning recesses 14c, 15c of the right-angle plate 11 and It is slightly smaller than the maximum width of the positioning recess.

  As shown in FIG. 3, one joint 13 is attached to the engagement groove 14 and the engagement groove 18, and the other joint 13 is the engagement groove 15 and the other engagement of the right angle plate 12. Attached to the groove. Each joint 13 has a narrow portion 14b or the like in a state in which the engagement shaft 13c is in pressure contact with both sides of the narrow portion 14b or the like when a pressing force in the longitudinal direction of the engagement groove 14 or the like is applied. When the pressing force is released when the engaging shaft 13c is positioned inside each positioning recess 14c or the like, it stops at that position. Therefore, the puncture needle assisting tool 10 increases or decreases the size of the square or rectangle formed at the inner peripheral edge by changing the engagement position of the pair of joints 13 with respect to the right-angle plates 11 and 12. can do. That is, the interval between the needle insertion holes 16 and 16a and the needle insertion holes 16b and 16c can be changed to an arbitrary length.

  The puncture needle assisting device 10 configured in this way is used as an assisting tool when puncturing the patient's body with the insertion puncture needle 20 shown in FIG. 4 and the extraction puncture needle 30 shown in FIG. . The insertion puncture needle 20 includes the insertion puncture needle outer needle 21 shown in FIG. 6 and the insertion puncture needle inner needle 22 shown in FIG. The insertion puncture needle outer needle 21 is composed of a stainless steel cylindrical body having an insertion hole 21a through which the insertion puncture needle inner needle 22 is inserted, and has a proximal end (upper end in the state of FIG. 6). Part) is made of a resin hub 23. The hub portion 23 is formed in a cylindrical shape, and a guide hole 23a communicating with the insertion hole 21a is formed therein.

  The guide hole 23a has a large diameter on the upper side and a small diameter on the lower side. This makes it easy to insert the insertion needle 22 into the insertion hole 21a from above the hub portion 23. A plate-like positioning portion 24 is attached below the hub portion 23 of the insertion puncture needle outer needle 21 at a distance from the hub portion 23. The positioning portion 24 is attached to the insertion puncture needle outer needle 21 by inserting the insertion puncture needle outer needle 21 into a hole formed in the central portion, and the attachment position is the insertion puncture needle outer needle. 21 is appropriately set according to the amount of protrusion of the lower portion of the positioning portion 24 (the sum of the length inserted into the suture portion and the vertical length of the puncture needle assisting tool 10).

  The insertion puncture needle inner needle 22 is composed of a thin stainless steel rod that can be inserted into the insertion hole 21a of the insertion puncture needle outer needle 21, and has a proximal end (the upper end in the state of FIG. 7). A cap-shaped hub portion 25 made of resin. The distal end portion (lower end portion) of the insertion puncture needle inner needle 22 is cut in an oblique direction. When the insertion puncture needle inner needle 22 is inserted into the insertion hole 21a of the insertion puncture needle outer needle 21, the upper portion of the hub portion 23 enters the inside of the hub portion 25, resulting in the state shown in FIG. . The extraction puncture needle 30 includes the extraction puncture needle outer needle 31 shown in FIG. 8 and the extraction puncture needle inner needle 32 shown in FIG. The take-out puncture needle outer needle 31 is composed of a stainless steel cylindrical body having an insertion hole 31a through which the take-out puncture needle inner needle 32 is inserted, and has a proximal end (upper end in the state of FIG. 8). Part), a resin hub part 33 is attached.

  The hub portion 33 is formed in a cylindrical shape, and a guide hole 33a communicating with the insertion hole 31a is formed therein. The guide hole 33a is formed with a large diameter on the upper side and a small diameter on the lower side. This makes it easy to insert the puncture needle inner needle 32 for extraction into the insertion hole 31a from above the hub portion 33. Further, the distal end portion (lower end portion) of the extraction puncture needle outer needle 31 is cut in an oblique direction, and the opening portion 31b is formed so as to be seen from the lateral direction by this cutting. A plate-like positioning portion 34 is attached below the hub portion 33 of the extraction puncture needle outer needle 31.

  The positioning portion 34 is attached to the extraction puncture needle outer needle 31 by inserting the extraction puncture needle outer needle 31 into a hole formed in the center portion, and the attachment position thereof is the extraction puncture needle outer needle. 31 is appropriately set according to the protruding amount of the lower part from the positioning part 34 (the sum of the length of the needle inserted into the suture part and the length of the puncture needle assisting tool 10 in the vertical direction). The extraction puncture needle inner needle 32 includes a small-diameter stainless steel inner needle 35 that can be inserted through the insertion hole 31 a of the extraction puncture needle outer needle 31, and an annular shape provided at the tip of the inner needle 35. It is comprised by the capture part 36 and the hub part 37 provided in the upper end part of the inner needle 35. As shown in FIG. The capturing part 36 is formed of a finer linear body that is thinner than the inner needle 35, and is bent from the tip of the inner needle 35 so as to draw a circle in a substantially horizontal direction.

  The capture portion 36 has flexibility, and is easily deformed by applying a light force so as to extend in one direction and extends straight. However, when the force for deforming is released, the capture portion 36 is restored to the original ring shape. A recess (not shown) that can accommodate the upper portion of the hub portion 33 is formed in the lower portion of the hub portion 37. For this reason, when the inner needle 32 for extraction puncture needle is inserted into the insertion hole 31 a of the outer needle 31 for extraction puncture needle while the capture portion 36 is extended linearly, the hub portion is inserted into the hub portion 37. The upper part of 33 enters, and it will be in the state shown in FIG. In this case, the capture part 36 protrudes outside from the opening 31b of the extraction puncture needle outer needle 31 and returns to the annular shape.

  Next, a case where, for example, the patient's abdominal wall and stomach wall are sutured at four locations using the puncture needle assisting tool 10, the insertion puncture needle 20, and the extraction puncture needle 30 will be described. In this suturing, first, the puncture needle assisting tool 10 is placed on the skin surface in the abdominal wall of the patient. In this case, among the needle insertion holes 16, 16a, 16b, 16c, the intervals between the needle insertion holes 16, 16a, 16b, 16c located at the four corners of the puncture needle assisting tool 10 are the same as the insertion puncture needle 20 and the extraction puncture. The assembly position of the right-angle plates 11 and 12 is adjusted so as to be the length between the portions where the needle 30 is punctured. This adjustment is performed by moving the right angle plate 12 back and forth or right and left with respect to the right angle plate 11.

  Then, the distal end side of the extraction puncture needle 30 in a state where the capture portion 36 is accommodated in the extraction puncture needle outer needle 31 and the hub portion 37 is positioned above the hub portion 33 of the extraction puncture needle outer needle 31. The part is inserted from above into, for example, the needle insertion hole 16 of the puncture needle assisting tool 10, and is inserted into the abdominal wall and stomach wall from the skin surface of the abdomen of the patient. In this case, the extraction puncture needle 30 is inserted until the positioning portion 34 hits the upper surface of the puncture needle assisting tool 10. Next, the extraction puncture needle inner needle 32 is inserted into the extraction puncture needle outer needle 31, and the capture portion 36 is protruded from the opening 31b of the extraction puncture needle outer needle 31. At this time, the capture part 36 is made to spread downward on the center side of the puncture needle assisting tool 10.

  Next, another puncture needle 30 for extraction is accommodated in the puncture needle outer needle 31 for taking out the capture portion 36, and the puncture needle auxiliary tool 10 is placed in a state where the puncture needle outer needle 31 for extraction is positioned upward. The needle is inserted into the needle insertion hole 16b from above and inserted into the abdominal wall and stomach wall from the skin surface of the patient's abdomen. Then, the extraction puncture needle inner needle 32 is inserted into the extraction puncture needle outer needle 31, and the capture portion 36 is caused to protrude from the opening 31b of the extraction puncture needle outer needle 31. The capturing part 36 is also spread toward the lower side of the center side of the puncture needle assisting tool 10.

  Next, the distal end portion of the insertion puncture needle 20 is inserted into the needle insertion hole 16c on the distal end side of the piece 12b of the puncture needle assisting tool 10, and is inserted into the abdominal wall and stomach wall from the skin surface of the abdomen of the patient. Also in this case, the insertion puncture needle 20 is inserted until the positioning portion 24 hits the upper surface of the puncture needle auxiliary tool 10. Similarly, the distal end portion of the other insertion puncture needle 20 is inserted into the needle insertion hole 16c on the distal end side of the piece 12a of the puncture needle assisting tool 10, and pierced from the skin surface of the patient's abdomen into the abdominal wall and stomach wall. Include. As a result, the two extraction puncture needles 30 and the two insertion puncture needles 20 are punctured in parallel to the abdominal wall and stomach wall, respectively, and the distal end portions of the two insertion puncture needles 20 have two Located in the vicinity of the capture unit 36. In this state, the insertion puncture needle inner needle 22 is extracted from each of the two insertion puncture needles 20.

  Next, two suture threads 38a and 38b and two suture threads 38c and 38d (see FIG. 10) are inserted into the insertion hole 21a from the guide hole 23a of the hub portion 23 of the two insertion puncture needle outer needles 21, respectively. , And the distal end portion thereof protrudes from the opening 21 b of each insertion puncture needle outer needle 21 and is positioned in the capture portion 36. In this case, as shown in FIG. 10, the capture part 36 of the extraction puncture needle 30 inserted through the needle insertion hole 16 is used as a capture part 36a, and the capture part of the extraction puncture needle 30 inserted through the needle insertion hole 16b. When 36 is the capture part 36b, the sutures 38a and 38d are positioned in the capture part 36a, and the sutures 38b and 38c are positioned in the capture part 36b.

  That is, the two sutures 38 inserted from the same insertion puncture needle outer needle 21 are positioned in different capture portions 36, and are inserted from the different insertion puncture needle outer needles 21 into the respective capture portions 36. The inserted two sutures 38 come to be positioned. Next, the hub portions 37 of the two extraction puncture needle inner needles 32 are respectively pulled upward to move the extraction puncture needle inner needle 32 to the upper side of the extraction puncture needle outer needle 31. As a result, the distal end portion of each suture thread 38 is engaged with the corresponding capture portion 36 and pulled together with the capture portion 36 to the inside of the extraction puncture needle outer needle 31.

  As a result, each suture 38 is pressed against the edge of each corresponding opening 31b and engaged with the edge of each opening 31b. In this state, by pulling out the two insertion puncture needle outer needles 21 and the two extraction puncture needles 30 from the patient's body, both ends of each suture thread 38 penetrate the stomach wall and the abdominal wall, respectively. Project outside the patient's body. Then, the puncture needle assisting tool 10, the two insertion puncture needle outer needles 21 and the two extraction puncture needles 30 are removed from the suture thread 38, and as shown in FIG. 11, four suture threads 38a, 38b. , 38c and 38d are connected to each other to complete the suturing process. According to this, it is possible to fix the stomach wall and the abdominal wall by four stitches only by puncturing the insertion puncture needle outer needle 21 and the extraction puncture needle 30 at four locations. In this case, the stitch shape formed by each suture thread 38 is a square as shown in FIG.

  Furthermore, arbitrary things other than what is located in the four corners among the needle insertion holes 16, 16a, 16b, and 16c can be used. Further, when changing the interval between each insertion puncture needle outer needle 21 and the extraction puncture needle 30, for example, the right angle plate 12 is moved relative to the right angle plate 11 so as to be parallel to the piece 11a or the piece 11b. Accordingly, the size of the square or rectangle formed on the inner peripheral edge of the puncture needle assisting tool 10 can be arbitrarily changed. Moreover, the space | interval can be confirmed by seeing the scale provided on the upper surface of the puncture needle auxiliary tool 10 in that case.

  As described above, in the puncture needle assisting device 10, when the stomach wall and the abdominal wall of the patient are fixed using the insertion puncture needle 20 and the extraction puncture needle 30, first, the portion to be sutured of the patient's body. The puncture needle assisting tool 10 is arranged on the outside, and the extraction puncture needle 30 and the insertion puncture needle outside the predetermined needle insertion hole 16 of the needle insertion holes 16, 16a, 16b, 16c of the puncture needle assisting tool 10 are provided. The needles 21 can be punctured one by one in order. Therefore, the puncture resistance when puncturing the extraction puncture needle 30 and the insertion puncture needle outer needle 21 can be reduced, and the operation becomes easy. Further, since the extraction puncture needle 30 and the insertion puncture needle outer needle 21 move along the needle insertion hole 16 and the like, they are punctured into the body in an appropriate state without being displaced.

  Furthermore, according to the puncture needle assisting tool 10, the stomach wall and the abdominal wall can be fixed at three to four places. When the stomach wall and abdominal wall are fixed by three sutures, it is only necessary to puncture at three places. When the stomach wall and the abdominal wall are fixed by sutures at four places, it is only necessary to puncture at four places. Further, the puncture needle assisting tool 10 is composed of a pair of right-angle plates 11 and 12 assembled through a pair of joints 13, and the engagement position between the pair of joints 13 and the pair of right-angle plates 11 and 12 is determined. By changing the distance, the interval between the needle insertion holes 16 can be arbitrarily adjusted. Furthermore, since the scale is provided along the longitudinal direction of the pair of right-angle plates 11, 12, the length between the needle insertion holes 16 and the like can be confirmed by looking at the scale.

(Second Embodiment)
FIG. 12 shows a puncture needle assisting tool 40 according to the second embodiment of the present invention. This puncture needle auxiliary tool 40 is configured by assembling a right-angle plate 41 disposed on the lower side and a right-angle plate 42 disposed on the upper side with a plurality of magnets 43 and 43a. The right-angle plates 41 and 42 are each made of an elongated L-shaped plate made of polypropylene or polyethylene, and the right-angle plates 41 and 42 constitute a deformable frame according to the present invention. The portions corresponding to the two L-shaped sides of the right-angle plates 41 and 42 have the same width and length. In the pieces 41a and 41b constituting the right-angle plate 41, four needle insertion holes 46 penetrating from the front surface to the back surface are formed at regular intervals from the connecting portion of the pieces 41a and 41b toward both distal ends. Furthermore, one needle insertion hole 46 (9 in total) is formed in the connecting portion of the pieces 41a and 41b.

  Further, four concave portions 44 (two of a total of eight are hidden and cannot be seen) are formed on the surfaces of the pieces 41a and 41b at regular intervals from the tips of the pieces 41a and 41b toward the connecting portion. And a magnet 43 is installed in each recess 44. The magnets 43 are arranged in a state where the surfaces with different magnetism are alternately exposed, and the S pole, the N pole, the S pole, and the N pole from the tip portions of the pieces 41a and 41b to the connecting portion side, respectively. A magnet 43 that exposes is disposed. In the pieces 42a and 42b constituting the right-angle plate 42, four (total 10) needle insertion holes 46a penetrating from the front surface to the back surface are constant from the connecting portions of the pieces 42a and 42b toward both distal ends. The needles are formed at intervals, and one needle insertion hole 46a (9 in total) is formed at the connecting portion of the pieces 42a and 42b.

  Further, on the back surfaces of the pieces 42a and 42b, four (a total of eight) concave portions 44a (see FIG. 13) are formed at regular intervals from the tip end portions of the pieces 42a and 42b toward the connecting portion side. A magnet 43a is installed in the recess 44a. The magnets 43a are arranged in a state where the surfaces with different magnetism are alternately exposed, and the N poles, the S poles, the N poles, and the S poles from the tip portions of the pieces 42a and 42b to the connecting portion side, respectively. The magnet 43a which exposed is disposed. That is, the right-angle plate 41 and the right-angle plate 42 have the same configuration except that the polarities of the exposed surfaces of the magnet 43 and the magnet 43a are reversed. For this reason, the puncture needle assisting device 40 can increase or decrease the size of the square or rectangle formed at the inner peripheral edge by changing the magnet 43 and the magnet 43a that are attracted to each other.

  When the abdominal wall and stomach wall of the patient are sutured at four locations using the puncture needle assisting tool 40, the insertion puncture needle 20 and the removal puncture needle 30, the assembly positions of the right-angle plates 41 and 42 are adjusted. The same operation as described above is performed. That is, the same operation as that of the above-described embodiment is performed except that the assembly position of the right-angle plates 41 and 42 is adjusted by attracting the arbitrary magnet 43 and the arbitrary magnet 43a. Other functions and effects of the puncture needle assisting tool 40 are the same as the functions and effects of the puncture needle assisting tool 10 described above.

(Third embodiment)
FIG. 14 shows a puncture needle assisting tool 50 according to the third embodiment of the present invention. The puncture needle assisting tool 50 includes a lower plate 51 disposed on the lower side and an upper plate 52 disposed on the upper side. The lower plate 51 and the upper plate 52 are respectively made of polypropylene or polyethylene, and the lower plate 51 and the upper plate 52 constitute a deformable frame according to the present invention. The lower plate 51 includes pieces 51a and 51b arranged at right angles, and a lower support piece 53 extending so as to bisect the angles of the pieces 51a and 51b from the inner portion of the connecting portion (corner portion) of the pieces 51a and 51b. It consists of

  In the pieces 51a and 51b, 11 needle insertion holes 56 (two needle insertion holes 56 located at the tip portions of the pieces 51a and 51b) that pass through from the front surface (upper surface) to the back surface (lower surface) are hidden and cannot be seen. ) Are formed between the connecting portions of the pieces 51a and 51b and the tip portions of the pieces 51a and 51b at a constant interval. Further, on the surface of the lower support piece 53, an engagement groove portion 54 is formed extending from the distal end portion of the lower support piece 53 toward the connecting portion side with the pieces 51a and 51b. The engaging groove portion 54 is formed in a shape in which four positioning concave portions 54a are formed in a long and narrow groove having a constant depth, and both sides are recessed in an arc shape at regular intervals in the longitudinal direction. In addition, four needle insertion holes 56 penetrating from the front surface to the back surface are also formed in the lower support piece 53 at regular intervals.

  The upper plate 52 includes pieces 52a and 52b arranged at right angles, and an upper support piece 55 extending so as to bisect the angle of the pieces 52a and 52b from the inner portion of the connecting portion (corner portion) of the pieces 52a and 52b. It consists of Each of the pieces 52a and 52b has a total of eleven needle insertion holes 56a including five needle insertion holes 56a penetrating from the front surface to the back surface and one needle insertion hole 56a provided at a corner portion. A fixed interval is formed between the connecting portion 52b and the tip portions of the pieces 52a and 52b. The upper support piece 55 is positioned below the pieces 52a and 52b so as to be stepped with respect to the pieces 52a and 52b. That is, the upper support piece 55 protrudes downward and is located in the engagement groove portion 54, and a pair of protrusions 57 protruding on both sides are provided on both sides of the tip portion. The protrusion 57 can be engaged with the positioning recess 54 a of the engagement groove 54.

  The pair of protrusions 57 are in contact with each other at both sides of the narrow portion of the engaging groove portion 54 when a pressing force is applied toward the back side of the engaging groove portion 54 from the state of FIG. When the pressing force is released when moving inside the mating groove 54 and positioned inside each positioning recess 54a, it stops at that position. For this reason, the puncture needle auxiliary tool 50 has a square size formed by the inner peripheral edge portions of the pieces 51a and 51b and the pieces 52a and 52b by changing the engagement position between the protrusion 57 and the positioning recess 54a. Can be made larger or smaller. That is, the interval between the needle insertion hole 56 and the needle insertion hole 56a can be changed to an arbitrary length.

  When the abdominal wall and stomach wall of the patient are sutured at four locations using the puncture needle assisting tool 50, the insertion puncture needle 20 and the removal puncture needle 30, the assembly position of the lower plate 51 and the upper plate 52 is set. After adjusting, perform the operation described above. That is, the same operations as those of the above-described embodiments are performed except that the assembly position of the lower plate 51 and the upper plate 52 is adjusted by changing the engagement position between the protrusion 57 and the positioning recess 54a. Other functions and effects of the puncture needle assisting tool 50 are the same as the functions and effects of the puncture needle assisting tool 10 and the like described above.

(Fourth embodiment)
FIG. 15 shows a puncture needle assisting tool 60 according to the fourth embodiment of the present invention. This puncture needle auxiliary tool 60 is composed of a V-shaped plate 61 disposed on the lower side and a V-shaped plate 62 disposed on the upper side. Each of the V-shaped plate 61 and the V-shaped plate 62 is made of a polypropylene plate, and the V-shaped plate 61 and the V-shaped plate 62 constitute a deformable frame according to the present invention. The V-shaped plate 61 is composed of pieces 61a and 61b arranged at an angle of 60 degrees. A total of nine needle insertion holes 66 penetrating from the front surface to the back surface are formed in the pieces 61a and 61b, respectively, with a constant interval between the connecting portions of the pieces 61a and 61b and the tip portions of the pieces 61a and 61b. ing.

  Although not shown, engagement holes are formed at regular intervals on the surfaces of the pieces 61a and 61b. The V-shaped plate 62 is composed of pieces 62a and 62b arranged at an angle of 60 degrees. A total of nine needle insertion holes 66a penetrating from the front surface to the back surface are formed in the pieces 62a and 62b, respectively, with a fixed interval between the connecting portions of the pieces 62a and 62b and the tip portions of the pieces 62a and 62b. ing. In addition, engagement protrusions (not shown) that can be engaged with the engagement holes of the V-shaped plate 61 at regular intervals are formed on the surfaces of the pieces 62a and 62b. According to this, the sutured part can be fixed at three places arranged at equal intervals, and the insertion puncture needle 20 and the extraction puncture needle 30 need only be three places. Other functions and effects of the puncture needle assisting tool 60 are the same as the functions and effects of the puncture needle assisting tool 10 and the like described above.

  FIG. 16 shows a puncture needle assisting tool 70 according to a modification. In this puncture needle assisting tool 70, the pieces 71a and 71b of the right-angle plate 71 are rotatably connected via a hinge 73, and the pieces 72a and 72b of the right-angle plate 72 are rotatably connected via a hinge 73a. The other configuration is the same as that of the puncture needle assisting tool 10 shown in FIG. According to this, the shape of the puncture needle auxiliary tool 70 can be made not only a square or a rectangle but also a rhombus with different angles at the four corners, and the usability is further improved. Other functions and effects of the puncture needle assisting tool 70 are the same as the functions and effects of the puncture needle assisting tool 10 described above.

  As still another modification, a cylindrical guide portion is provided on the peripheral edge of the needle insertion hole 16 of each puncture needle assisting tool 10 and the like, and the insertion puncture needle 20 and the removal puncture needle 30 are inserted into the needle insertion hole 16 and the like. It is also possible to facilitate the insertion into the inside. This facilitates the operation of passing the puncture needle through the needle insertion hole. Further, the means for changing the engagement position of the pair of frame forming members provided in each of the above-described embodiments can be used in place of the corresponding means of other embodiments that can use the means.

  Moreover, the puncture needle auxiliary tool according to the present invention is not limited to the above-described embodiment, and can be implemented with appropriate modifications. For example, in the embodiment described above, the puncture needle assisting tool 10 or the like is used when puncturing the extraction puncture needle 30 or the insertion puncture needle 20 for suturing the abdominal wall and stomach wall. 10 etc. can be used not only for suturing the abdominal wall and stomach wall but also for puncture needles used for suturing other parts of the body. Moreover, in each embodiment mentioned above, although the puncture needle auxiliary tool 10 grade | etc., Is comprised with polypropylene or polyethylene, you may comprise with what apply | coated silicone to polycarbonate.

It is the perspective view which showed the puncture needle auxiliary tool which concerns on 1st Embodiment of this invention. It is the perspective view which showed the joint. It is sectional drawing which showed the state which assembled | attached a pair of right-angle plate with the joint. It is the front view which showed the puncture needle for insertion. It is the front view which showed the puncture needle for extraction. It is the front view which showed the puncture needle outer needle for insertion. It is the front view which showed the puncture needle inner needle for insertion. It is the front view which showed the puncture needle outer needle for extraction. It is the front view which showed the puncture needle inner needle for extraction. It is explanatory drawing which showed the positional relationship of a capture part and a suture. It is explanatory drawing which showed the state which tied the suture thread. It is the top view which showed the puncture needle auxiliary tool which concerns on 2nd Embodiment of this invention. It is sectional drawing which showed the state which assembled | attached a pair of right-angle plate with the magnet. It is the top view which showed the puncture needle auxiliary tool which concerns on 3rd Embodiment of this invention. It is the top view which showed the puncture needle auxiliary tool which concerns on 4th Embodiment of this invention. It is the perspective view which showed the puncture needle auxiliary tool which concerns on a modification.

Explanation of symbols

  10, 40, 50, 60, 70 ... puncture needle assisting device, 11, 12, 41, 42, 71, 72 ... right angle plate, 13 ... joint, 14, 15, 18 ... engagement groove, 16, 16a, 16b, 16c, 46, 46a, 56, 56a, 66, 66a ... Needle insertion hole, 20 ... Insertion needle, 30 ... Removal needle, 38, 38a, 38b, 38c, 38d ... Suture, 43, 43a ... Magnet , 51 ... lower plate, 52 ... upper plate, 53 ... lower support piece, 54 ... engagement groove, 55 ... upper support piece, 61, 62 ... V-shaped plate.

Claims (8)

A puncture needle auxiliary tool used when puncturing a plurality of puncture needles used when fixing an organ to a skin side portion with a suture from the skin side portion to the organ side,
The inner peripheral edge portion is formed by a pair of frame forming members formed in a polygonal frame shape by overlapping and engaging at a predetermined position, and by changing the engagement position of the pair of frame forming members, A plurality of deformable frames that can be formed into polygons having different sizes in the inner peripheral edge, and a plurality of puncture needles that are inserted in parallel from the direction perpendicular to the frame surface of the deformable frame. A puncture needle assisting device, wherein the needle insertion holes are formed at intervals.   The puncture needle assisting device according to claim 1, wherein each of the pair of frame forming members is an L-shaped plate member, and a polygon formed by the deformable frame is a square or a rectangle.   The puncture needle assisting device according to claim 1, wherein each of the pair of frame forming members is a V-shaped plate member, and a polygon formed by the deformable frame is a triangle.   A front-facing groove extending along the longitudinal direction of the one frame forming member is formed on the surface of one of the pair of frame forming members, and the other frame is formed on the back surface of the other frame forming member. 4. A pair of frame forming members are assembled via joints that form back-facing grooves extending along the longitudinal direction of the member and are movably engaged with the front-facing grooves and the back-facing grooves, respectively. The puncture needle auxiliary tool according to any one of the above.   A surface of one frame forming member of the pair of frame forming members is alternately exposed with surfaces having different polarities, and a plurality of magnets are embedded in the longitudinal direction of the one frame forming member, with an interval therebetween. On the back surface of the other frame forming member, surfaces having different polarities are alternately exposed to embed a plurality of magnets at intervals in the longitudinal direction of the other frame forming member. The puncture needle assisting device according to any one of claims 1 to 3, wherein the pair of frame forming members are assembled by adhering surfaces having different magnetism to the magnet of the other frame forming member.   The supporting piece extends from the inside of the L-shaped corner of one frame forming member of the pair of frame forming members so as to bisect the angle of the two sides of the L shape, and the L shape of the other frame forming member The support pieces are extended so that the angles of the two sides of the L shape are bisected from the inside of the corners, and the two support pieces are overlapped with each other on the surface of one support piece and the back surface of the other support piece. The puncture according to claim 2, wherein a groove portion that is moved along the longitudinal direction and a protrusion that engages with the groove portion are provided, and the pair of frame forming members are assembled by the engagement between the groove portion and the protrusion. Needle aid.   The puncture needle auxiliary tool according to any one of claims 1 to 6, wherein a scale is provided along a longitudinal direction of the pair of frame forming members.   The puncture needle auxiliary tool according to any one of claims 1 to 7, wherein a cylindrical guide portion for guiding the puncture needle into the needle insertion hole is provided at a peripheral portion of the plurality of needle insertion holes. .

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