JP2010511436A - 穿孔の巾着縫合閉鎖用内臓アンカー - Google Patents
穿孔の巾着縫合閉鎖用内臓アンカー Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00637—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for sealing trocar wounds through abdominal wall
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0409—Instruments for applying suture anchors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0414—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0417—T-fasteners
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
- A61B2017/0454—Means for attaching and blocking the suture in the suture anchor the anchor being crimped or clamped on the suture
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
- A61B2017/0458—Longitudinal through hole, e.g. suture blocked by a distal suture knot
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0464—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1142—Purse-string sutures
Abstract
Description
Claims (24)
- 生体壁における穿孔を塞ぐための医療器具であって、
相互に反対側にある第1の端部と第2の端部とを有する縫合糸と、
一組の内臓アンカーであって、各内臓アンカーは、相互に反対側にある端部を有するクロスバーを含み、前記縫合糸が前記クロスバーの各々に摺動自在に取り付けられた、一組の内臓アンカーと、
を備え、前記縫合糸の前記第1の端部と前記第2の端部とは独立して引っ張ることが可能であり、それにより前記縫合糸が前記内臓アンカーの各々に対して移動して前記穿孔が塞がれる、医療器具。 - 前記縫合糸を引っ張ることにより前記内臓アンカー間の距離が小さくなり、前記穿孔が巾着縫合式に塞がれる、請求項1に記載の医療器具。
- 各内臓アンカーが前記生体壁の片側に配置され、前記縫合糸の前記第1の端部及び前記第2の端部が前記生体壁の反対側に配置される、請求項1に記載の医療器具。
- 各内臓アンカーが前記クロスバーの前記相互に反対側の端部間に通路を含み、前記通路が、前記縫合糸が通過する入口と出口とを有し、前記入口と前記出口とが、0.001mmより大きく且つ1.0mmより小さい前記クロスバーの外径より小さい距離だけ、離間される、請求項1に記載の医療器具。
- 前記一組の内臓アンカーを送達するためのオーバーチューブをさらに備え、前記オーバーチューブは一組のルーメンを有し、各ルーメンは内臓アンカーを受け入れ、前記縫合糸のうち前記内臓アンカー間に位置する部分は、前記オーバーチューブの遠位端において前記ルーメンの外側に延在する、請求項1に記載の医療器具。
- 前記一組のルーメンにより摺動自在に受け入れられる一組の穿刺針であって、前記一組の内臓アンカーを中に受け入れる一組の穿刺針をさらに備える、請求項5に記載の医療器具。
- 縫合糸を組織に結び付けるための内臓アンカーであって、
相互に反対側にある第1の端部と第2の端部とを有するクロスバーであって、長手方向軸線を画定するクロスバーと、
前記クロスバーの前記相互に反対側にある端部間に位置する通路であって、前記縫合糸を中に摺動自在に受け入れる通路と、
を備え、前記通路が、前記縫合糸が通過する入口と出口とを有し、前記入口と前記出口とが、0.001mmより大きく且つ1.0mmより小さい前記クロスバーの外径より小さい距離だけ、離間される、内臓アンカー。 - 前記入口と前記出口とが、0.001mmより大きく、且つ1mmより小さい距離だけ離間される、請求項7に記載の内臓アンカー。
- 前記通路が前記長手方向軸線と平行に延在する、請求項7に記載の内臓アンカー。
- 前記クロスバーが、ルーメンを画定する管状壁を有するカニューレで構成され、前記壁にある第1の開口が前記入口を画定し、且つ前記壁にある第2の開口が前記出口を画定する、請求項7に記載の内臓アンカー。
- 前記第1の開口が、前記カニューレの前記第1の端部に形成された第1の長手方向スロットであり、且つ前記第2の開口が、前記カニューレの前記第2の端部に形成された第2の長手方向スロットであり、及び前記管状壁が前記第1のスロットと前記第2のスロットとの間に延在するストリップ部分を含む、請求項10に記載の内臓アンカー。
- 前記クロスバーと接続されたワイヤをさらに備え、前記通路が前記ワイヤと前記クロスバーとの間に画定される、請求項7に記載の内臓アンカー。
- 前記クロスバーが、ルーメンを画定する管状壁を有するカニューレで構成され、前記管状壁は第1の開口と第2の開口とを画定し、前記ワイヤの第1の端部が前記第1の開口を挿通し、前記ワイヤの第2の端部が前記第2の開口を挿通する、請求項11に記載の内臓アンカー。
- 前記ワイヤの前記第1の端部及び前記第2の端部が、前記カニューレの前記ルーメン内部に固定される、請求項13に記載の内臓アンカー。
- 前記クロスバーに接続されたロッドをさらに備え、前記通路が前記ロッドと前記クロスバーとの間に画定される、請求項13に記載の内臓アンカー。
- 前記クロスバーが、ルーメンを画定する管状壁を有するカニューレで構成され、及び前記ロッドが前記カニューレの前記ルーメン内部に固定される、請求項15に記載の内臓アンカー。
- 前記管状壁が前記ルーメンと連通する開口を画定し、前記開口が前記ロッドへのアクセスを提供する、請求項16に記載の内臓アンカー。
- 前記ロッドが前記長手方向軸線と平行に延在する、請求項16に記載の内臓アンカー。
- 前記ロッドが前記長手方向軸線と垂直に延在する、請求項16に記載の内臓アンカー。
- 縫合糸と接続された一組の内臓アンカーであって、各内臓アンカーが前記縫合糸と摺動自在に取り付けられたクロスバーを含む一組の内臓アンカーを使用して、生体壁にある穿孔を塞ぐための方法であって、
各内臓アンカーを、前記穿孔の外周に隣接する前記生体壁に挿通するステップであって、各内臓アンカーが前記生体壁の遠位側にあり、前記縫合糸の端部が前記生体壁の近位側にある、ステップと、
前記縫合糸の前記端部を引っ張るステップであって、それにより前記内臓アンカー間の距離を小さくし、前記穿孔の周りの前記生体壁を圧縮する、ステップと、
前記縫合糸の前記端部を固定することにより前記生体壁の圧縮を維持して前記穿孔を塞ぐステップと、
を含む、方法。 - 前記挿通するステップが、前記穿孔が巾着縫合式に塞がれるように前記一組の内臓アンカーを前記穿孔の周りに配置することを含む、請求項20に記載の方法。
- 前記挿通するステップが、前記一組の内臓アンカーを前記穿孔の周りに半環状形又は環状形で順次配置することを含む、請求項20に記載の方法。
- 前記挿通するステップが、前記一組の内臓アンカーを前記穿孔の両側に順次配置することを含む、請求項20に記載の方法。
- 前記引っ張るステップが、前記縫合糸の前記端部を独立して引っ張ることを含む、請求項20に記載の方法。
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US87202306P | 2006-11-30 | 2006-11-30 | |
US60/872,023 | 2006-11-30 | ||
PCT/US2007/085769 WO2008067384A2 (en) | 2006-11-30 | 2007-11-28 | Visceral anchors for purse-string closure of perforations |
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JP2010511436A true JP2010511436A (ja) | 2010-04-15 |
JP2010511436A5 JP2010511436A5 (ja) | 2011-01-13 |
JP5270565B2 JP5270565B2 (ja) | 2013-08-21 |
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US (1) | US8551139B2 (ja) |
EP (1) | EP2094167B1 (ja) |
JP (1) | JP5270565B2 (ja) |
AT (1) | ATE514382T1 (ja) |
AU (1) | AU2007325204B2 (ja) |
CA (1) | CA2671030C (ja) |
WO (1) | WO2008067384A2 (ja) |
Cited By (1)
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- 2007-11-28 EP EP07868914A patent/EP2094167B1/en active Active
- 2007-11-28 AT AT07868914T patent/ATE514382T1/de not_active IP Right Cessation
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WO2008067384A3 (en) | 2008-09-25 |
CA2671030C (en) | 2013-10-08 |
EP2094167B1 (en) | 2011-06-29 |
US8551139B2 (en) | 2013-10-08 |
EP2094167A2 (en) | 2009-09-02 |
JP5270565B2 (ja) | 2013-08-21 |
WO2008067384A2 (en) | 2008-06-05 |
AU2007325204B2 (en) | 2013-06-06 |
US20080132948A1 (en) | 2008-06-05 |
ATE514382T1 (de) | 2011-07-15 |
CA2671030A1 (en) | 2008-06-05 |
AU2007325204A1 (en) | 2008-06-05 |
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