JP3102614U - Tissue holder - Google Patents

Abstract

[PROBLEMS] With the advancement of medical treatment, there is a demand for an inexpensive, safe, reliable, convenient, tissue-retaining tool as an auxiliary tool that can reduce labor and perform advanced medical treatment with peace of mind.
A clip is fixed to each end of a flexible and self-supporting metal wire, and the clip is used to open a grip portion, a fulcrum 22, and the grip portion around the fulcrum. A tissue holder having a pressing portion, wherein at least one of the clips has a flexible member on a gripping surface of the gripping portion.
[Selection diagram] FIG.

Description

  The present invention relates to a tissue holding device that can securely hold a living tissue such as a blood vessel and a nerve without being damaged in a medical field, for example, in a surgical operation, so that a safe surgical treatment can be performed. The present invention relates to a tissue holder for performing various medical treatments.

  2. Description of the Related Art Conventionally, for example, in a surgical operation, it has been desired that a living tissue can be reliably held without being damaged, and held so as not to hinder the operation, so that a reliable operation can be performed. This is because, in some cases, surgery with micron precision is required, and thus skilled techniques are required, and medicine is rapidly becoming more advanced with the development of science.

  With the advancement of such medical treatment, the environment for that purpose has become very important.At the time of surgery, it is necessary to hold the target living tissue or the living tissue near the target so as to be compatible with the operation. It is important to manually hold the instrument with instruments such as forceps and tweezers, which may cause problems such as damaging living tissue or hindering advanced surgery. Since there are so many examples of holding blood vessels, the emergence of such a tissue holder has been greatly desired.

  For this reason, instruments for holding living tissue have been developed, and for example, various vein grasping instruments used in vascular anastomosis surgery are known. Also, various clamps for blood vessels are known. For example, it is disclosed in Japanese Unexamined Patent Application Publication Nos. Hei 10-277504, 2001-505810, and 2613801.

  These conventional devices for holding living tissues are expensive and are not generally used, or are very large and cannot be used in a small turn, or are more likely to damage living tissues, and still rely on human labor. Means are common. As a result, the success rate of advanced medical care has not improved as expected.

  Recently, new biological tissue holders have been proposed, and the conventional drawbacks can be eliminated. For example, a tissue holder presented at the 7th Annual Meeting of the Japanese Coronary Artery Surgery Society in February 2002 has been proposed and is beginning to be used. The tissue holder uses a memo holder (Sebone, trademark of Maruzen Seisakusho Co., Ltd.) used for stationery, and it is reported that it is very effective at academic societies, etc., and is used clinically. ing.

  However, the tissue holder presented at the above conference is difficult to sterilize due to the complicated structure of a large number of connecting parts, and the appearance of a tissue holder that is inexpensive and easy to sterilize is strongly desired. . Preferably, one that can withstand at least EOG sterilization (ethylene oxide gas sterilization) is desired.

  The present invention is intended to solve these conventional disadvantages and provide an inexpensive, safe, reliable, and convenient medical holding device for advanced medical treatment. The purpose of the present invention is to provide an auxiliary tool that can reliably perform medical treatment.

  The present inventors fix a clip to each end of a flexible and self-supporting metal wire, and the clip is used to open the grip portion around a fulcrum and a fulcrum. It has been found that a tissue holder having a pressing portion and at least one of the clips having a flexible member on a gripping surface of the gripping portion solves the problem.

  In the tissue holder, when the metal wire is fixed to a corner of the pressing portion, it is more preferable in view of securing a visual field and operability. Furthermore, in the case where the metal wire is a memory shape alloy and has a structure that is resistant to heating as a whole, it is possible to return to the original shape when performing heat sterilization (eg, autoclave sterilization). It is possible.

  When the tissue holder is manufactured and sold, preferably, the sterilization is performed with the tissue holder held in a sterilized and sealed plastic bag, and the bag is kept in the bag until immediately before medical treatment. It is preferable to handle the holder with the holder in place to prevent contamination of the tissue holder and prevent infection by various pathogens due to the contamination.

  The clip is made of a material such as metal or plastic. In the case of plastic, a clip obtained by coating the metal wire with plastic is also used. As the plastic, polypropylene, polyethylene, polycarbonate, silicon-based resin, fluorine-based resin or the like which does not adversely affect the living tissue is used. The same plastic material is used for the bag. At this time, by coloring the plastic of the clip and / or the bag, the purpose of use can be clearly indicated. In addition, the clipping force of the clip is selected within a range that does not damage the living tissue by taking the shape of the clip into consideration and securely holding the clip, while also considering the flexible member on the tissue holding side.

  For example, when performing a thoracotomy operation in cardiovascular surgery and holding the entire tissue holder with the clip on the thoracotomy device, a considerable amount of clamping force is required for secure holding. Therefore, it is preferable that the angle of the inner surface of the grip portion of the clip is changed in a plurality of steps, and the angle is steeper toward the inner side, and is gradually reduced toward the outer end of the grip portion. When being held between three stages of the chest opener having a thickness of 6 mm, 8 mm, and 12 mm, it is preferable to be able to hold in parallel from the outer gripping surface to the inner gripping surface.

  The material and thickness of the metal wire are appropriately selected, the shape can be easily deformed by hand at the time of clinical use, and the living tissue has a soft flexibility that can be easily moved to an appropriate place by hand, and One that is self-supporting so that the position can be maintained in a tissue holding state is selected. For example, aluminum, nickel, alloys such as titanium, aluminum, and soft stainless steel, which have little effect on living tissue, are selected from those having moderate rigidity with no strength rigidity, and a component which dissolves into blood and exerts an influence. Those not included are used. The thickness varies depending on the material, hardness and the like, but in general, the one in millimeters (0.2 to several millimeters) is preferably used. Preferably, a flexible and self-supporting material close to the memo holder is used.

  The metal wire and the clip are fixed by fusion, adhesion, mechanical connection (for example, universal joint or free rotation connection between a ball portion and a receiving recess). The metal wire may be coated with plastic, but in this case, since the metal is prevented from contacting with blood or the like, the applicable range of the material of the metal to be used can be expanded, and an inexpensive metal can be selected. . As the type of plastic used for the coating, the plastic used for the clip can be used, but a soft plastic can also be used. The method used for the free rotation coupling is a typical example of the method used for the memo holder.

  The flexible member is an elastic member, preferably a soft resin, such as a urethane-based resin, a silicon-based resin, a fluorine-based resin, and a low-molecular-weight soft polyethylene resin. For example, a soft and elastic porous resin of a urethane resin, for example, a urethane sponge is preferably used.

  In addition, a hydrogel or the like can be used as the flexible member. However, the selection of the material of the flexible member is performed in consideration of sterilization, the clamping force of the clip, the purpose of use, and the like as an overall configuration. The material of the flexible member, the material, considering that the clip does not damage the living tissue and that the living tissue is securely held, and in the case where the holding tissue is a blood vessel, it is desirable to stop bleeding. It is selected according to the purpose, such as when there is no or when it is desired. However, it is preferable that the material is selected so as to be applicable to a wide range of applications. In some cases, flexible members of different materials are provided on the same gripping surface at different positions, and an object to be gripped is selected by using the positions properly. You can also. In this case, if the flexible members at the respective positions are color-coded, the identification is further facilitated and the flexible members are easily used properly.

  Further, as the flexible member, different materials can be used for the grip surfaces of the two grip portions of the same clip, and in this case, those having different flexibility and / or elasticity are used in an appropriate combination. For example, as described above, one in which one is a medical urethane sponge, the other is a medical urethane rubber, and each is adhered to each of the gripping surfaces with a medical adhesive is used. Alternatively, of the two clips, one gripping surface is made of the same material, but each clip uses a flexible member of a different material, and depending on the purpose, a clip on an appropriate side may be selected and used properly. It is possible, and if the colors of the clips are different at this time, it is easy to use them properly.

  Since the present invention is configured as described above, the structure is simple, the manufacturing is easy, the material cost can be reduced, and the sterilization at the time of manufacturing is easy. In addition, since it is easy to sterilize, it can be repeatedly used in some cases, so that it can be used at a lower cost. In addition, since the sterilized state at the time of manufacture is good, safe clinical use is possible, problems due to infection can be eliminated, and handling is facilitated. Moreover, all the advantages of the recent new biological tissue holder can be utilized. For example, it is easy to use, secures and secures living tissue, ensures a high medical success rate, prevents infection, and does not damage living tissue. Other effects will be further clarified by the following description.

  The present invention is configured as described above, and can be variously modified according to the purpose, and can take various forms. For example, when sacrificing sterilization performance to some extent and placing emphasis on ease of use, the mechanical connection between the ball portion and the receiving recess is selected as the connection between the clip and the metal wire. For example, a long convex portion of a neck portion is provided at one end of the pressing portion of the clip, and the ball portion is provided at the tip thereof, while the concave portion receiving the ball portion is provided at an end of the metal wire, and the ball portion is provided. The recess allows a rotatable connection. The clip is made of plastic, and polyurethane is attached to a gripping surface of the gripping portion. The metal wire is coated with polyethylene, and the clip at the other end is also made of plastic, the flexible member is not used on the gripping surface, and the connection with the metal wire is likewise free rotation of the ball portion and the receiving recess. The neck portion supporting the ball portion and the position where the neck portion is provided are configured in the same manner as described above. The thus configured tissue holder has an effect of being very easy to use.

  On the other hand, when mainly considering sterilization for reuse, an exposed metal wire is fused to one end of the pressing portion of the same metal clip, and a heat-resistant medical device is attached to the gripping surface of one clip. Those to which urethane rubber is adhered are preferably used. In this case, the gripping force of the clip is set relatively weak. However, the other clip may be made of metal, but the rubber attached with a medical adhesive can be firmly supported, for example, when attached to a thoracotomy device. Power can be strong.

  Hereinafter, the present invention will be described in more detail with reference to the drawings. However, the present invention is not limited to these examples, and examples are appropriately selected in consideration of the purpose of use and the like within the scope of the present specification.

  FIG. 1 is a conceptual diagram showing a normal state of a tissue holder according to an embodiment of the present invention. For example, it is suitable for use in coronary artery bypass surgery. 1 is a 3 mm diameter aluminum metal wire coated with polyethylene, and 2 and 3 are polypropylene clips. FIG. 2 is a conceptual diagram of a tissue holder showing a condition before use or after heat sterilization when a memory shape alloy is selected as the metal wire 1 not covered with plastic in the embodiment. In this case, the clips 2 and 3 are selected to withstand the heating. If the heating cannot be performed sufficiently, another sterilization method is used in combination. For example, a sterilization method using gas or electron beam is used.

  FIG. 3 is a conceptual diagram showing a use state of the embodiment. With one clip 3 of the tissue holder holding the device or platform 4 used during the procedure and the other clip 2 holding a living tissue (eg, a blood vessel) 10, the metal wire does not interfere with the medical treatment. It is bent into such a shape and maintains that state.

  FIG. 4 is a detailed conceptual diagram of at least the clip 2 on the living tissue side in the embodiment, and the clip 3 can have the same structure. A metal wire 28 is fused and fixed to the clip pressing portion 21, and reaches the grip portion 24 via the fulcrum 22. Although not shown, a spring urges the grip portion 24 in the holding direction around the fulcrum. A flexible member (urethane sponge on one side and urethane rubber on the other side) 25 is provided on the grip portion 24.

  FIG. 5 is a perspective view of the clip of the embodiment, and FIG. 6 is a plan view. The joining part of the metal wire 1 of the pressing part 21 on the opposite side of the fulcrum 22 of the grip part 24 of the clip 2 is provided on one side 27 of the end part 26 of the pressing part, and this joining position secures the visual field during the procedure. Was very effective. Since the tissue holder of the present invention according to the embodiment has no many joints between the two clips 2 and 3, the sterilization is very easy and the manufacturing is simplified. In particular, for example, in the embodiment of FIG. 2, repeated use was easily performed. On the other hand, the conventional joint having many joint portions has insufficient sterilization in the joint, and it takes a long time for sterilization during manufacturing. Also, it could not be reused. The result of the present invention is that it is easy to use during the procedure and the operation can be performed with peace of mind.

  FIG. 7 is a perspective view of another embodiment relating to the clip 2, which is used for a vascular suture operation or the like. The pressing portion 31 of the clip 2 fixed to the metal wire 1 of Example 1 covered with polyethylene is connected to a grip portion 34 via a fulcrum 32. One of the grip portions 34 has a concave portion, and when the blood vessel is gripped, the suture portion is positioned in the concave portion so that a suturing operation can be performed in the concave portion. The same flexible member and clip material as those used in Example 1 (for example, FIG. 4) were used. The result of actually performing a vascular suture operation using this example was very good.

  FIG. 8 is a conceptual cross-sectional view of an example of a clip on a side supporting a table or the like according to another embodiment, in which the angle of the inner surface of the grip portion of the clip is changed in a plurality of steps, and the steeper the inner side, This is an example in which the distance is gradually reduced toward the outer end of the grip portion. The clip has a fulcrum 46 and a neck portion 49 and a ball portion 48 at the tip of a pressing portion 47 for opening and closing the grip portion 42. The ball portion 48 enters into a concave portion (not shown) provided at the end of the metal wire to perform free rotation coupling. The grip portion 42 has a thin urethane rubber adhered to the entire inner surface, and has a tip portion having three levels of angle inclination on the inner surface. A steep angle portion 43, a middle angle portion 44, and a gentle angle portion 45 are provided, and when the 12 mm, 8 mm, and 6 mm pedestals are sequentially held, the angles are adjusted so that the gripping surfaces are substantially parallel in the vertical direction. Selected. As a result, the tissue holder can be firmly fixed to the thoracotomy device. The material of the clip part was stainless steel.

  FIG. 9 is an example of another clip used on the support side, in which a gripping area is increased and a clip having a wide gripping surface is used for secure clamping. The upper gripping portions of the gripping portions 51, 52, and 54 each having a thin polyurethane rubber adhered to the inner surface thereof are substantially separated from each other at the center, and are constituted by the gripping portions 51 and 52. The pressing portion 55 presses the gripping portion 51 side. An engaging portion 56 is provided so that when the grip portion 51 is opened, the grip portion 52 can be simultaneously opened. When the pressing part 55 on the grip part 52 side is pressed to open the grip part 52, the grip part 51 remains in the closed state. Each grip is urged by a spring 53 in the closing direction. The ball portion 50 is freely rotated and connected to a concave portion (not shown) at the end of the metal wire. The large gripping area enables reliable clamping. The material of the entire clip was selected from polypropylene.

  The clip according to this embodiment can also be used on the tissue holding side. In this case, the strength of the spring is selected, and a polyurethane sponge is used instead of the polyurethane rubber. When used as a tissue holding part in this way, it is used as shown in FIG. 7 and is used for vascular suture surgery and the like. For example, since the blood vessels can be sequentially grasped by the grasping units 51 and 52, there is an effect that it is easy to select the grasping position of the blood vessel and set the grasping state.

  As described above, the use of tissue holders will be promoted in various medical treatments, and a wide range of advanced medical treatments will be possible and the success rate of medical treatment will be improved. It is expected that a large amount of the tissue holder is required in combination with the fact that patients can receive medical care with a sense of security.

  FIG. 2 is a conceptual view of a tissue holder according to one embodiment of the present invention.   It is a conceptual diagram in case the metal wire is a shape memory alloy in the said Example.   It is a conceptual diagram of the use state in the said Example.   FIG. 3 is a conceptual enlarged view of a clip in the embodiment.   It is a perspective view of the clip of the embodiment.   FIG. 6 is a plan view of the clip of FIG. 5.   FIG. 4 is a perspective view of a clip according to another embodiment of the present invention.   It is a key map of other examples.   It is a conceptual perspective view of a wide clip concerning other examples.

Explanation of reference numerals

1 metal wire 2 clip (tissue holding part)
3 clips (support)
4 Support 10 Living tissue 21 Pressing part 22 Supporting point 24 Gripping part 25 Flexible member 27 Joining position 31 Pressing part 32 Supporting point 34 Holding part 43 Steep-angle holding part 44 Medium-angle holding part 45 Slow-angle holding part 51 Holding part 52 Grip part 54 Grip part 56 Engagement part

Claims (4)

  A clip is fixed to each end of a flexible and self-supporting metal wire, and the clip has a grip portion, a fulcrum, and a pressing portion for opening the grip portion around the fulcrum. A tissue holding device, wherein at least one of the clips has a flexible member on a gripping surface of the gripping portion, and is fixed to the metal wire by the pressing portion.   The tissue holder according to claim 1, wherein the metal wire is covered with plastic, and the metal wire is fixed at a corner of the pressing portion.   The tissue holder according to claim 2, wherein a sponge is attached to both gripping surfaces of the one clip, and rubber is attached to both gripping surfaces of the other clip.   A sterile and sealed plastic bag and a clip secured to each end of a flexible and self-supporting metal wire within the bag, the clip comprising a gripper, a fulcrum and A pressing portion for opening the grip portion around the fulcrum, and at least one of the clips has a flexible member on a grip surface of the grip portion, and the pressing portion applies a flexible member to the metal wire. The fixed tissue holder, wherein the tissue holder includes a sterilized tissue holder.

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