JP2019193704A - Fixing tool for automatic suturing instrument, automatic suturing instrument and tissue suturing set - Google Patents

Abstract

To provide a fixing tool for an automatic suturing instrument reliably fixing a tissue-reinforcing material to an automatic suturing instrument even if it is an automatic suturing instrument having a structure that both ends of a cartridge attachment portion are closed, the automatic suturing instrument and tissue suturing set using the same.SOLUTION: A fixing tool for an automatic suturing instrument is for fixing a tissue-reinforcing material to the automatic suturing instrument, and includes: a pair of clips the cross-sectional shapes of which are each a V-shape; and a connection part connecting the clips so that the pair of clips is parallel to each other. The inside surfaces of the clips each have an attachment portion for being attached to the automatic suturing instrument. The connection part penetrates the inside surfaces of the clips and is connected with the clips on the outside surface.SELECTED DRAWING: Figure 1

Description

The present invention relates to an automatic suturing device fixing jig, an automatic suturing device, and a tissue suturing device using the same, which can securely fix a tissue reinforcing material to the automatic suturing device even if the both ends of the cartridge attachment site are closed. Regarding the set.

Conventionally, a stapler type automatic suturing device in which a large number of staples are embedded is used for tissue suturing. However, there is a problem of air leakage from the sutured part when applied to the lung or the like, and problems such as tissue damage or tearing may occur when applied to a soft tissue.

Accordingly, a bioabsorbable reinforcing material (hereinafter also referred to as a tissue reinforcing material) is used together with an automatic suturing device in order to prevent air leakage, body fluid leakage, and tissue damage (for example, Patent Documents 1 and 2). The reinforcement material of patent documents 1 and 2 stitches together two opposite sides of one bioabsorbable nonwoven fabric, or two bioabsorbable nonwoven fabrics or one bioabsorbable nonwoven fabric and one stretchable knitted fabric. A cylindrical structure is formed by overlapping and sewing two opposing sides. Then, the end of the cartridge of the automatic suturing device is inserted into the cylinder to be attached to the automatic suturing device, and the tissue is reinforced by being sutured together with the tissue. Moreover, since the reinforcing material is made of a bioabsorbable non-woven fabric, the reinforcing material is finally absorbed into the living body after the reinforcement becomes unnecessary.

On the other hand, weight loss surgery for excising part of the stomach is performed as a treatment for obesity. In weight loss surgery, the excision range is large, and a long distance must be sewn at a time. Therefore, an automatic suturing device having a long cartridge is used. Some of these long automatic suturing devices have a structure in which both ends of the cartridge mounting portion are closed, and there is a problem that conventional cylindrical reinforcing materials cannot be attached to the cartridge. It was. In addition, in order to attach a reinforcing material to an automatic suturing device having a structure in which both ends of the cartridge mounting site are closed, a flat bioabsorbable nonwoven fabric is passed between the cartridges of the automatic suturing device, and is fixed by sewing, etc. However, there is also a problem that it is very complicated to perform at the operation site.

JP 08-047526 A Japanese Patent No. 4675237

In view of the above problems, the present invention provides an automatic suturing device fixing jig, an automatic suturing device, and an automatic suturing device capable of securely fixing a tissue reinforcing material to the automatic suturing device even if the both ends of the cartridge attachment site are closed. An object of the present invention is to provide a tissue suturing set using the.

The present invention is an automatic suturing device fixing jig for fixing a tissue reinforcing material to an automatic suturing device, wherein the automatic suturing device fixing jig includes a pair of clips each having a V-shaped cross section, and a pair of the above described A connecting portion for connecting the clips so that the clips are parallel to each other, an inner surface of the clip has an attachment portion for attaching to the automatic suturing device, and the connecting portion is provided on the inner side of the clip. It is an automatic suturing device fixing jig that penetrates the surface and is connected to the clip on the outer surface.
Hereinafter, the present invention will be described in detail.

The inventors of the present invention have a structure in which both long sides of the tissue reinforcing material are sandwiched by a pair of clip-shaped jigs connected by a connecting portion, and both ends of the cartridge attachment site are closed by fixing the jig to an automatic suturing device. The present inventors have found that a tissue reinforcing material can be fixed to the automatic suturing device and have completed the present invention.

The fixing jig for an automatic suturing device of the present invention has a pair of clips having a V-shaped cross section.
The clip plays a role of fixing the tissue reinforcing material by sandwiching the end portion on the long side of the tissue reinforcing material. Further, by adopting a structure in which a pair of clips are attached to the automatic suturing device, the tissue reinforcing material can be fixed even in an automatic suturing device having a structure in which both ends of the cartridge attachment site are closed. Here, the V-shape refers to a shape that can sandwich the tissue reinforcing material, and a cross-sectional shape such as a U-shape is also included in the V-shape.

The inner surface of the clip has an attachment site for attachment to an automatic suturing device.
By connecting the attachment part to the attachment part of the automatic suturing device, the fixing device for the automatic suturing device of the present invention is fixed to the automatic suturing device. The shape of the attachment site is not particularly limited as long as the fixing device for an automatic suturing device can be fixed to the automatic suturing device, and examples thereof include a convex shape, a concave shape, an L shape, and a band shape.

The material of the clip is not particularly limited as long as it is hard enough not to be deformed, and examples thereof include plastic and metal. Among these, a metal is preferable because it is difficult to deform, and titanium is more preferable because it is lighter.

The fixing jig for an automatic suturing device according to the present invention has a connecting portion that connects the clips so that the pair of clips are parallel to each other.
The connecting portion serves to securely fix the tissue reinforcing material by pulling the clip in the closing direction when the automatic suturing device fixing jig sandwiching the tissue reinforcing material is attached to the automatic suturing device. Note that the connecting portion is formed at a position that does not overlap the stitched site such as both ends of the cartridge mounting site. Moreover, it is preferable that the said connection part is formed so that it may become the same height as the surface of a cartridge, when it attaches to an automatic suturing device from a viewpoint of suppressing the float between a tissue reinforcement material and a cartridge.

The connecting portion penetrates the inner surface of the clip and is connected to the clip on the outer surface.
When the connecting portion is connected to the outer surface of the clip, the clip is closed by the stress from the connecting portion when the automatic suturing device fixing jig is attached to the automatic suturing device, so that the tissue reinforcing material is securely fixed. be able to. Moreover, since the said connection part is cut | disconnected with a structure | tissue and a tissue reinforcement material at the time of a stitch | suture and excision by an automatic suturing device, after a suture and excision are finished, a clip is released and a tissue reinforcement material is separated easily. be able to. Here, the inner surface is a surface that comes into contact with the automatic suturing device when the fixing device for the automatic suturing device of the present invention is attached to the automatic suturing device among the two surfaces formed by the V-shaped cross-sectional shape. The outer surface refers to a surface in contact with the outside.

The shape of the through hole provided for the connecting portion to penetrate the inner surface of the clip may be any shape, and may be an open through hole connected to the upper side of the inner surface of the clip. In particular, when the connection portion between the connecting portion and the clip is located below the cartridge surface of the automatic suturing device when attached to the automatic suturing device, the through hole is connected to the upper side of the inner surface of the clip. An open through hole is preferable. When the connection portion between the connecting portion and the clip is positioned below the cartridge surface of the automatic suturing device when attached to the automatic suturing device, the automatic suturing device pushes the connecting portion upward. At this time, if the through hole is a closed through hole, the connecting portion cannot move, and therefore the connecting portion may be cut by the force applied from the automatic suturing device and the force applied from the through hole. When the through hole has a shape opened in the upper side direction, the connecting portion can freely move in the upper side direction, and thus unintentional cutting of the connecting portion can be suppressed. Examples of the shape of the open through hole include a concave shape, a U shape, and a V shape. In the present specification, the “upper side” refers to a side opposite to the side where the inner surface and the outer surface of the clip are in contact. “Lower” refers to the direction opposite to the direction of the upper side.

The material of the connecting part is not particularly limited, and examples thereof include plastic and thread. Among these, a thread is preferable because it is less likely to have foreign matter remaining and obstructed when the clip is opened, and a bioabsorbable thread is more preferable because it is highly safe even if it remains in the living body.

Examples of the bioabsorbable polymer constituting the bioabsorbable yarn include polyglycolide, polylactide (D, L, DL form), glycolide-lactide (D, L, DL form) copolymer, glycolide-ε. -Caprolactone copolymer, lactide (D, L, DL form)-ε-caprolactone copolymer, poly (p-dioxanone), glycolide-lactide (D, L, DL form)-ε-caprolactone copolymer, etc. Examples include synthetic absorbable polymers such as α-hydroxy acid polymer polymers, and naturally absorbable polymers such as collagen, gelatin, chitosan, and chitin. These may be used independently and 2 or more types may be used together. For example, when the synthetic absorbent polymer is used as the bioabsorbable polymer, a natural absorbent polymer may be used in combination. Among these, α-hydroxy acid is a homopolymer or copolymer obtained by polymerizing at least one monomer selected from the group consisting of glycolide, lactide, ε-caprolactone, dioxanone and trimethylene carbonate because it exhibits high strength. A polymer polymer is suitable, and since it exhibits an appropriate decomposition behavior, an α-hydroxy acid polymer polymer that is a homopolymer or copolymer obtained by polymerizing a monomer containing glycolide is more preferred.

When polyglycolide (a homopolymer or copolymer of glycolide) is used as the bioabsorbable polymer, the preferred lower limit of the weight average molecular weight of polyglycolide is 30000, and the preferred upper limit is 1000000. If the weight average molecular weight of the polyglycolide is less than 30000, the strength may be insufficient and a sufficient tissue reinforcing effect may not be obtained. If the weight average molecular weight exceeds 1000000, the degradation rate in the body may be slowed and a foreign body reaction may occur. is there. The minimum with a more preferable weight average molecular weight of the said polyglycolide is 50000, and a more preferable upper limit is 300000.

When the connecting portion is a yarn, the thickness of the yarn is preferably 0.05 mm or more from the viewpoint of durability and handleability.

The length of the connecting portion is preferably the same as the length of the short side of the automatic suturing device.
By making the length of the connecting portion the same as the length of the short side of the automatic suturing device, the stress of the connecting portion when attached to the automatic suturing device can be made large enough to fix the tissue reinforcing material.

As described above, the fixing device for an automatic suturing device of the present invention has an attachment portion on the inner surface of the clip, and is fixed to the automatic suturing device by connecting the attachment portion to the attachment portion of the automatic suturing device. Such an automatic suturing device having an attachment site corresponding to the attachment site of the fixing device for an automatic suturing device of the present invention is also one aspect of the present invention.

The automatic suturing device of the present invention has an attachment site corresponding to the attachment site of the fixing jig for the automatic suturing device of the present invention.
The shape of the attachment site is not particularly limited as long as it corresponds to the shape of the attachment site of the automatic suturing device fixing jig. For example, when the attachment part of the automatic suturing device fixing jig is convex, a concave attachment part is hooked, when it is concave, a convex attachment part is hooked, and when it is L-shaped, an L-shaped protrusion is hooked. What is necessary is just a to-be-attached site | part which has a groove | channel which can do.

The automatic suturing device of the present invention preferably has a groove corresponding to the connecting portion of the fixing device for the automatic suturing device of the present invention.
When the automatic suturing device of the present invention has a groove corresponding to the connecting portion, the automatic suturing device fixing jig can be more reliably fixed by hooking the connecting portion into the groove. The groove preferably has a bottom portion deeper than the height of the connecting portion when the automatic suturing device fixing jig is attached to the automatic suturing device.

As described above, by using the automatic suturing device fixing jig and the automatic suturing device according to the present invention, the tissue reinforcing material can be securely fixed to the automatic suturing device even when the both ends are closed. Can prevent air leaks, fluid leaks, and tissue damage. A tissue suturing set comprising such a tissue reinforcing material, the automatic suturing device fixing jig of the present invention and the automatic suturing device of the present invention is also one aspect of the present invention.

The said tissue reinforcement material is not specifically limited, The tissue reinforcement material conventionally used for an automatic suturing device can be used. Examples of the material for the tissue reinforcing material include bioabsorbable polymers and non-absorbable polymers. Of these, bioabsorbable polymers are preferable from the viewpoint of safety. The bioabsorbable polymer can be the same as the bioabsorbable thread.

The form of the tissue reinforcing material is not particularly limited, and examples thereof include knitted fabric, woven fabric, nonwoven fabric, and film. Among these, non-woven fabrics are preferable from the viewpoints of flexibility, breathability, ease of passing staples, difficulty in leaking body fluids, and the like.

When the tissue reinforcing material is a nonwoven fabric, the basis weight of the nonwoven fabric is not particularly limited, but a preferred lower limit is 3 g / m ² and a preferred upper limit is 300 g / m ² . When the basis weight of the nonwoven fabric is 3 g / m ² or more, it can be a tissue reinforcing material having sufficient strength, and when it is 300 g / m ² or less, the tissue reinforcement is superior in adhesion to the tissue. It can be a material. The more preferable lower limit of the basis weight of the bioabsorbable nonwoven fabric is 5 g / m ² , and the more preferable upper limit is 100 g / m ² .

It is preferable that the tissue reinforcing material has a cut in a portion that comes into contact with the connecting portion when the tissue reinforcing material is attached to a fixing jig for an automatic suturing device. Interference with a connection part can be prevented by having a cut | notch in the part which a tissue reinforcement material contacts with a connection part.

The method for producing the non-woven fabric is not particularly limited. A conventionally known method such as a wet method can be used.

According to the present invention, even if an automatic suturing device has a structure in which both ends of a cartridge attachment site are closed, an automatic suturing device fixing jig, an automatic suturing device, and the like that can securely fix a tissue reinforcing material to the automatic suturing device are used. A tissue suture set can be provided.

It is a schematic diagram showing an example of the fixing jig for automatic suturing devices of the present invention. It is a schematic diagram showing a mode that a structure | tissue reinforcement material is mounted | worn to the fixing jig for automatic suturing devices. It is the schematic diagram showing a mode that the fixing jig for automatic suturing devices of this invention with which the tissue reinforcement material was mounted | worn is attached to the automatic suturing device of this invention. It is the schematic diagram showing the mode of the fixing jig for automatic suturing devices, the automatic suturing device, and the tissue reinforcing material of the present invention after the completion of suturing and excision.

Hereinafter, embodiments of the present invention will be described in more detail with reference to the drawings. However, the present invention is not limited to these embodiments.

The schematic diagram showing an example of the fixing jig for automatic suturing devices of this invention was shown to Fig.1 (a), (b). The fixing device for an automatic suturing device according to the present invention has a structure in which a connecting portion 2 is connected between a pair of clips 1 having a V-shaped cross section so that the clips are parallel to each other. A through hole 4 is provided on the inner surface of the clip 1, and the connecting portion 2 is connected to the clip 1 on the outer surface of the clip 1 through the through hole 4. On the inner surface of the clip 1, an attachment portion 3 for connection to an automatic suturing device is formed. The through hole 4 may have a closed shape as shown in FIG. 1 (a) or an open shape connected to the upper side as shown in FIG. 1 (b).

FIG. 2 is a schematic diagram showing a state in which the tissue reinforcing material is attached to the automatic suturing device fixing jig. The automatic suturing device fixing jig of the present invention attaches the tissue reinforcing material 5 to the automatic suturing device fixing jig by sandwiching the ends of the long side of the tissue reinforcing material 5 between the two clips 1. Here, it is preferable that the tissue reinforcing material 5 has a notch in a portion in contact with the connecting portion 2 in order to prevent interference with the connecting portion 2.

FIGS. 3A and 3B are schematic views showing how the fixing device for an automatic suturing device of the present invention to which the tissue reinforcing material is attached is attached to the automatic suturing device of the present invention. As shown in FIG. 3 (a), the automatic suturing device fixing jig to which the tissue reinforcing material 5 is attached connects the attachment site 3 and the attachment site 7 formed on the automatic suturing device 6 to thereby achieve the present invention. It is fixed to the automatic suturing device 6. When the automatic suturing device fixing jig is fixed to the automatic suturing device 6, the outer surface of the clip 1 is pulled toward the automatic suturing device by the stress of the connecting portion as shown in FIG. Thus, the tissue reinforcing material 5 is securely fixed. Here, the automatic suturing device 6 preferably has a groove at a position corresponding to the connecting portion 2 on the cartridge surface in addition to the attachment site 7. Since the groove is provided, the automatic suturing device fixing jig and the tissue reinforcing material can be more reliably fixed by hooking the connecting portion into the groove.

In the case where the automatic suturing device 6 does not have the above groove, in order to prevent the floating between the cartridge surface of the automatic suturing device 6 and the connecting portion 2, the connecting portion 2 is attached with a fixing jig for the automatic suturing device. In this case, it is preferably formed at the same height as the cartridge surface of the automatic suturing device. Further, when the automatic suturing device 6 does not have the groove and the connection portion 2 and the clip 1 are formed at a position lower than the height of the cartridge surface, it is formed on the inner surface of the clip 1. The formed through-hole 4 is preferably an open through-hole connected to the upper side as shown in FIG. By forming the through-hole 4 in a shape connected to the upper side, the connecting part 2 can move freely in the upper side direction even if a force to push up the connecting part 2 in the upper side direction is applied from the automatic suturing device. Unintentional cutting of the part 2 can be prevented.

FIG. 4 is a schematic diagram showing the state of the fixing device for an automatic suturing device, the automatic suturing device, and the tissue reinforcing material of the present invention after the suturing and excision are completed. After the automatic suturing device fixing jig and the tissue reinforcing material are fixed to the automatic suturing device, the affected area is sutured and excised. In excision, the tissue 9 and the tissue reinforcing material 5 are cut between the suture sites 8, and at this time, the connecting portion 2 existing under the tissue reinforcing material is also cut. When the connecting portion 2 is cut, the stress from the connecting portion 2 disappears, so the outer surface of the clip 1 moves in the direction in which the clip opens. As a result, since the tissue reinforcing material 5 is released from fixation, the tissue reinforcing material 5 can be easily separated.

According to the present invention, even if an automatic suturing device has a structure in which both ends of a cartridge attachment site are closed, an automatic suturing device fixing jig, an automatic suturing device, and the like that can securely fix a tissue reinforcing material to the automatic suturing device are used. A tissue suture set can be provided.

DESCRIPTION OF SYMBOLS 1 Clip 2 Connection part 3 Attachment part 4 Through-hole 5 Tissue reinforcement 6 Automatic suturing device 7 Attached part 8 Suture part 9 Tissue

Claims (4)

An automatic suturing device fixing jig for fixing a tissue reinforcing material to an automatic suturing device,
The fixing device for an automatic suturing device has a pair of clips having a V-shaped cross section and a connecting portion that connects the clips so that the pair of clips are parallel to each other.
The inner surface of the clip has an attachment site for attachment to an automatic suturing device;
The fixing device for an automatic suturing device, wherein the connecting portion penetrates an inner surface of the clip and is connected to the clip on an outer surface. An automatic suturing device having an attachment site corresponding to an attachment site of the fixing jig for an automatic suturing device according to claim 1. The automatic suturing device according to claim 2, further comprising a groove corresponding to the connecting portion of the fixing device for the automatic suturing device according to claim 1. A tissue suturing set comprising a tissue reinforcing material, a fixing jig for an automatic suturing device according to claim 1, and an automatic suturing device according to claim 2 or 3.

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