JP2794162B2 - Surgical marker - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical marker used as a marker at the time of endoscopic surgery, and more particularly, a lead wire fixed to the rear end of a marker needle. BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical marker for placing a marker needle at a target site in a patient's body before surgery and performing a surgical operation using a lead wire as a marker during a laparoscopic liver operation or the like.

[0002]

2. Description of the Related Art Endoscopic surgery using an endoscope for various intrathoracic lesions has become more popular in recent years as a non-invasive method than thoracotomy and laparotomy.

[0003] Conventionally, as a marker for endoscopic surgery, a dye injection method in which an injection needle such as a PTC needle or a caterane needle is inserted near a lesion under the guide of a CT scanner and an appropriate amount of a dye such as indigo carmine is injected. Has been adopted. This dye injection method works well as a marker when surgery is performed within a short time after dye injection, but the dye diffuses over time, making the lesion area inaccurate and qualifying as a marker. Have a problem that lacks.

[0004] As another marker of the conventional endoscopic surgery, a marker called a hook wire developed for a mammary gland is known. This hook wire for the mammary gland is formed of a stainless steel wire, and has a hook portion formed at the tip of a straight needle portion of about 4 cm to 6 cm. The hook portion side of the tip faces the vicinity of the lesion under the guide of the CT scanner. In addition, the rear end is exposed from the body surface and is left indwelling, and this is used as a marker during surgery. According to the hook wire for the mammary gland, the problem caused by the diffusion dilution of the dye described in the dye injection method is solved.

[0005]

However, the above-mentioned conventional hook wire has problems in the following points. (1) Since the conventional hook wire is large, there is a risk of crushing the tissue. For example, thoracoscopic surgery is often performed on peripheral small lung field lesions, and tissue crushing would interfere with pathological diagnosis. (2) Due to the large size of the conventional product, complications such as pneumothorax were feared when trying to deal with multiple lesions at once, that is, trying to place multiple hook wires in advance in one operation. (3) In the conventional hook wire, since the metal part at the rear end of the wire is exposed on the body surface, it requires careful attention in managing the movement of the patient and gives an uncomfortable feeling to the patient.

The present invention has been made in view of the above circumstances, and has as its object to provide a surgical marker that ensures safety as a marker and that functions well.

[0007]

According to a first aspect of the present invention, there is provided a marker for surgery which is placed at a target site in a patient's body and which is attached to the marker and exposed to the body surface. With a lead wire, the marker needle is made of a stainless steel wire having a spring property,
A straight needle portion having an appropriate length, and a hook needle portion having an appropriate length formed at an end of the straight needle portion with an angle forming a hook portion; It is characterized by being provided fixedly to the rear end of the portion.

According to a second aspect of the present invention, in the surgical marker according to the first aspect, the hook needle portion is formed by twisting the stainless wire through a torsion portion which is formed without forming a gap portion. It is characterized by being provided continuously at the tip of the portion. According to a third aspect of the present invention, in the surgical marker according to the first or second aspect, the rear end of the straight needle portion of the marker needle is formed as a trumpet-shaped enlarged portion. Things.

[0009]

According to the present invention, since the marker needle is composed of the straight needle portion and the hook needle portion, the marker needle is stably retained at the target portion, and the free end side of the lead wire is exposed to the body surface. Thus, the lead effectively functions as a marker for the target lesion area to be removed.

[0010] Since the marker needle can be downsized and the lead wire can be made thin, it is possible to prevent complications such as pneumothorax and to cope with multiple lesions.

Since only the thin lead wires are exposed on the body surface,
Management becomes easy and discomfort is alleviated.

[0012]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a perspective view showing one embodiment of a surgical marker according to the present invention, FIG. 2 is a side view thereof, and FIG.
Fig. 4 is an enlarged cross-sectional view taken along the line A, Fig. 4 is an explanatory view for explaining the operation of the marker needle of the surgical marker, and Fig. 5 is a side view showing an example of an insertion needle used when the same is placed at a target site. FIG. 6 and FIG. 6 are explanatory views showing a step of pushing the marker needle to the target site using the same insertion needle. FIGS. 7 and 8 are process explanatory views showing an outline of the step of placing the marker at the target site.

In FIG. 1 to FIG. 8, a surgical marker according to this embodiment has a marker needle 1 to be placed at a target site in a patient's body, and is attached to the rear end of the marker needle 1 and exposed to the outside from the body surface. And a lead wire.

The marker needle 1 is formed of a stainless steel wire 3 having a spring property. The material of this wire 3 is
For example, an austenitic, martensitic, precipitation hardening or other stainless steel is arbitrarily selected and employed. The diameter of the stainless wire 3 is set in accordance with the target part to be used, etc., but generally it is 0.1 to 0.5.
It will be set within the range of about millimeters, for example, in the range of about 0.2 to 0.35 mm for lung surgery, liver surgery and the like.

The marker needle 1 has a straight needle portion 4 of an appropriate length.
And a hook needle portion 5 of an appropriate length connected to the portion 4 at an appropriate angle θ so as to form a hook portion at the tip of the straight needle portion 4. The hook needle portion 5 of this embodiment is formed by twisting the stainless wire 3 so as not to form a void portion and folding the stainless wire 3 at an angle θ toward the straight needle portion 4. It is connected to the tip. With this configuration, the hook needle portion 5
Is elastically closed when receiving a pressing force in the direction of the straight needle portion 4 and overlaps with the straight needle portion. When the pressing force is released, it opens by a spring action and returns to its original shape.
Further, as will be described later, the operation of inserting and pushing out the insertion needle (tube) when placing the marker needle can be performed smoothly.

The lengths of the straight needle portion 4 and the hook needle portion 5 are not particularly limited. For example, the straight needle portion 4 is in a range of about 20 to 4 mm, and the hook portion 5 is 15 to 2 mm.
The range can be set in the range of about millimeters, preferably the range of about 15 to 5 mm for the former 4 and about 10 to 3 mm for the latter 5. In this case, if the lengths of both portions 4 and 5 are set to be much longer than the above-mentioned dimensions, it will deviate from the purpose of miniaturization. It may cause trouble.

The hook needle portion 5 functions so as to stably fix and position the marker needle 1 at a target site in a body tissue of a patient by synergistic action with the straight needle portion 4. The angle θ with the part 4 is, for example, 15 degrees or more.
It can be set within a range of about 45 degrees.

One end of the lead wire 2 is fixed to the rear end of the straight needle portion 4. As means for fixing the wire 2,
In the same manner as the thread mounting of the conventional suture needle with a thread, for example, a needle hole, a split groove, or the like in the axial direction is formed at the rear end of the straight needle portion 4 (a needle hole 7 in the drawing). A method of inserting the end of the lead wire 2 and caulking 8 can be adopted.
In the embodiment, an enlarged diameter portion 9 is formed in which the rear end of the straight needle portion 4 is enlarged in a trumpet shape. The enlarged diameter portion 9 is formed so that the pushing operation when the marker needle 1 is indwelled can be performed more favorably, and is formed as desired.

The lead wire 2 is led out from the rear end of the marker needle 1 to be placed in the body, and the free end side is exposed (exposed) outside the body to serve as a marker. For example, by setting the distance to about 25 to 35 cm, the object can be sufficiently achieved. The diameter of the wire 2 is selected according to the material thereof, the size of the diameter of the stainless wire 3 of the marker needle 1, and the like, but it is desirable to form the wire 2 as thin as possible.

The material of the lead wire is not particularly limited, but is preferably a material which has flexibility, is hard to be cut easily, and has a property of not dissolving in a living body. Monofilament (single yarn) made of Tetron, polypropylene, polyester and other synthetic fibers, knitting yarn, twisted yarn, single yarn made of silk, hemp and other natural fibers, knitting yarn, twisted yarn, or single fiber line A stainless steel thread can be exemplified. When a stainless steel yarn is used, the system is preferably about 0.1 mm or less from the viewpoint of flexibility.

The surgical marker of this embodiment is constructed as described above. Next, the method of use and operation of the marker will be described. The marker needle 1 is placed at a target site using an insertion needle 11 such as a PTC needle or a block needle as shown in FIG. The insertion needle 11 has an outer needle 12 having a hollow needle (tube needle) 12B having a length of, for example, about 15 cm attached to a needle base 12A, and a solid needle 13B having a length corresponding to the needle 12B attached to the needle base 13A. The needles 12C, 13C of the two needles 12, 13 are cut obliquely. As the insertion needle 11, a needle having a size (diameter) corresponding to the size (diameter) of the marker needle 1 to be used is selected and adopted. In a normal case, the needle 11 in a range of about 18 gauge to 30 gauge is used. Is selected from This needle 11
Is specified by the outer diameter, for example, 21 gauge is
0.81 mm, 22 gauge 0.71 mm, 24 gauge 0.7.
56 mm and 27 gauge are 0.41 mm. 7 and 8, reference numeral 14 denotes a patient's body, 15 denotes an abdominal wall without a chest wall, 16 denotes an organ such as a lung or a liver, and 17 denotes a lesion.

As shown in FIG. 7A, the inner needle 13 is connected to the outer needle 12.
After inserting the insertion needle 11 into the target site (organ 16) under the CT scanner or the ultrasonic guide in a state where the needle 17 is in contact with the lesion 17 as shown in FIG.
The inner needle 13 is removed. Next, after inserting the tip portion (twisted portion 6) of the marker needle 1 from the needle base 12A side of the outer needle 12, the inner needle 13 or a separately prepared pusher needle (not shown) is inserted into the outer needle 12. Push the marker needle 1. As a result, the hook needle portion 5 of the marker needle 1 receives a pressing force by the inner wall of the tube of the outer needle 12 and is elastically closed so as to overlap with the straight needle portion 4 to smoothly enter the hollow needle 12B of the outer needle 12. It is inserted and can easily pass through the needle 12B (see FIG. 6). In this case, when the hook needle portion 5 receives the pressing force, it easily closes to the straight needle portion 4 side. In addition,
When the marker needle 1 is pushed out using a pusher needle (hollow needle) instead of the inner needle 13, after inserting the tip of the marker needle 1 from the base side of the outer needle 12, the lead wire 2 is disconnected from the free end. The free end side of the wire 2 is inserted through the pusher needle to be drawn out from the base end of the pusher needle. In this state, the pusher needle is inserted into the outer needle 12 and the marker needle is pushed.

The hook needle portion 5 of the marker needle 1 of this embodiment is formed by connecting the stainless wire 3 to the straight needle portion 4 via a twisted portion 6 which is twisted without forming a gap. By receiving the pressing force, the hook needle portion can entirely overlap the straight needle portion 4 without any gap. Therefore, according to the marker needle 1 of this embodiment, the outer needle 12 having an inner diameter slightly larger than twice the diameter of the stainless wire 3 can be passed.

Next, as shown in FIG. 8A, the inner needle 13 is pushed into the outer needle 12, and the marker needle 1 is pushed out from the needle tip 12C to the vicinity of the lesion. As a result, the hook needle portion 5 is released from the pressing force, and expands (opens) by the spring action,
It will return to its original shape. After confirming with a CT scanner or the like that the marker needle 1 has been pushed out to an appropriate target portion and the hook needle portion has returned to the original shape, the inner needle 13 is checked.
Then, the outer needle 12 is removed. As a result, the marker needle 1 is placed at the target site, and the lead wire 2 penetrates through the chest wall or abdominal wall 15 from the surface of the organ 16 through the thoracic cavity or abdominal cavity and is exposed to the body surface (see FIG. 8B). At the time of endoscopic surgery, operation is performed using the lead wire 2 led out from the surface of the organ 16 at the target site as a marker. If necessary, the portion of the lead wire 2 exposed on the body surface is held by forceps or the like, and the target portion is pulled. The marker needle is removed at the time of resection of a lesion.

FIG. 9 is a side view showing another embodiment of the surgical marker according to the present invention, and FIG. 10 is an enlarged sectional view taken along line BB of FIG. Hook needle part 5 of marker needle 1 of this embodiment
Is formed by twisting the stainless wire 3 so as not to form a void portion, and then bending the stainless wire 3 at an appropriate angle θ with the straight needle portion 4 in a direction opposite to the twisting direction. It is connected to the tip of the straight needle portion 4 via the curved portion 6B. Since other configurations are the same as those of the above-described embodiment, the same components are denoted by the same reference numerals and description thereof will be omitted.

The surgical marker of the present embodiment has the above-described configuration, and is used in exactly the same manner as in the above-described embodiment, and has the same effect.

FIG. 11 is a side view showing still another embodiment of the surgical marker according to the present invention, and FIG. 12 is an explanatory view for explaining the operation of the marker needle of the marker. The hook needle portion 5 of the marker needle 1 of the present embodiment bends the stainless wire 3 into a V shape by giving an appropriate angle θ to the straight needle portion 4 side, and straightens the straight needle portion 4 through the bent portion 6C. It is connected to the tip of. Other configurations are the same as those of the above-described embodiment, and are denoted by the same reference numerals.

The marker for surgery of this embodiment is constructed as described above, and the marker needle 1 of this embodiment is simpler to manufacture than the marker needle of the above embodiment. When a pressing force is applied to the needle portion 5 to close the needle portion 4 toward the straight needle portion 4, as shown in FIG. 12, both needle portions do not completely overlap, and a slight gap 18 is formed between them.
Therefore, it is necessary to select the outer needle 12 having a somewhat larger inner diameter than the marker needle 1 of the above-described embodiment as the outer needle 12 to be used for indwelling. Other functions and methods of use are the same as in the above-described embodiment.

[0029]

According to the present invention, it is possible to provide a surgical marker capable of ensuring safety as a marker, functioning well, and being miniaturized.

Since the size of the marker needle can be reduced and the lead wire can be made thinner, complications such as pneumothorax can be prevented and multiple lesions can be dealt with.

Since only the thin lead wires are exposed on the body surface,
The management becomes easy, and the discomfort given to the patient is alleviated as compared with the conventional hook wire.

By retaining the exposed body surface of the lead wire, it becomes possible to easily tow the lesion during surgery.

According to the third aspect of the present invention, since the enlarged diameter portion is formed at the rear end of the straight needle portion, the operation for pushing the marker needle inserted into the outer needle is smooth and easy. become.

[Brief description of the drawings]

FIG. 1 is a perspective view showing one embodiment of a surgical marker according to the present invention.

FIG. 2 is a side view of the same.

FIG. 3 is an enlarged sectional view taken along line AA of FIG. 1;

FIG. 4 is an explanatory diagram for explaining an operation of the marker needle of the surgical marker;

FIG. 5 is a side view showing an example of an insertion needle used when placing the marker needle at a target site.

FIG. 6 is an explanatory diagram showing a step of pushing a marker needle to a target site using the insertion needle.

FIG. 7 is an explanatory view showing an outline of a first step in placing the marker needle at a target site.

FIG. 8 is an explanatory diagram showing an outline of a subsequent step in the same manner.

FIG. 9 is a side view showing another embodiment of the surgical marker according to the present invention.

FIG. 10 is an enlarged sectional view taken along line BB of FIG. 9;

FIG. 11 is a side view showing still another embodiment of the surgical marker according to the present invention.

FIG. 12 is an explanatory diagram for explaining the operation of the marker needle of the marker.

[Explanation of symbols]

 1 Marker needle 2 Lead wire 3 Stainless wire 4 Straight needle part 5 Hook needle part 8 Swaged θ Angle

Claims (3)

(57) [Claims] 1. A marker needle to be placed at a target site in a patient's body, and a lead wire attached to the marker needle and exposed on the body surface, wherein the marker needle is made of a stainless steel wire having spring properties. A straight needle part of appropriate length,
The tip of the straight needle portion has a hook needle portion of an appropriate length formed at an angle forming a hook portion, and the lead wire is provided with one end fixed to the rear end of the straight needle portion. A surgical marker, characterized in that: 2. The hook needle portion is connected to the tip of the straight needle portion through a twisted portion obtained by twisting the stainless wire without forming a gap. The surgical marker according to 1 above. 3. The surgical marker according to claim 1, wherein the rear end of the straight needle portion of the marker needle is formed in a diameter-enlarged portion having a trumpet-shaped diameter.