JP3150576U - Drawstring suture needle and purse string suture device - Google Patents

Abstract

A purse string suturing needle and a purse string suturing device capable of reducing the laparotomy width as much as possible when performing purse string suturing of a digestive system tissue or the like. The suture needles 14a and 14b have flexible portions that can be easily bent during the operation except for the puncture end whose hardness has been increased by partial heat treatment. During the purse string suturing, the flexible portions of the suture needles 14a and 14b are appropriately bent to enable the treatment in a narrow space. Further, in order to guide the suture needles 14a and 14b to the sewing holes 13a and 13b, the sewing holes 13a and 13b of the suturing device 10 are provided with a tapered needle introduction portion at at least one end. [Selection] Figure 6

Description

  The present invention relates to a purse string suturing needle and a purse string suturing device, and more particularly to an improvement of a purse string suturing needle and a purse string suturing device that can reduce the laparotomy width as much as possible when performing purse string suturing of digestive organ tissues and the like.

  When performing surgical removal of a tubular tissue such as the digestive tract, such as the stomach, it is necessary to rejoin the cut end by anastomosis. For example, in a total gastrectomy operation, it is necessary to perform an anastomosis between the esophagus and the intestine, and such an anastomosis of the tubular tissue is usually performed by a purse string anastomosis.

  Patent Document 1 shows an example of such a surgical purse string suturing device, in which a tube wall of a tissue sandwiched between upper and lower jaws is positioned by a groove formed by each jaw, and the groove is formed. A purse string suture can be performed by guiding a suture through the passage.

  FIG. 1 shows an example of a forceps 12 having such a purse string suture device 10. As shown in FIG. 2, the purse string suturing device 10 is composed of a pair of upper jaws 10a and lower jaws 10b meshed vertically, and a plurality of teeth 11a and 11b are arranged on each of the jaws 10a and 10b. Provided, each tooth 11a, 11b has a structure that opposes and opposes by the operation of the forceps 12. Further, the jaws 10a and 10b are provided with sewing holes 13a and 13b penetrating the teeth 11a and 11b, respectively.

  On the other hand, as shown in FIG. 3, the purse string suture needle has two suture needles 14a and 14b, and each end of the purse string suture thread 15 is coupled to the tail end of each needle 14a and 14b.

  FIG. 3 shows a state in which the tubular tissue is anastomosed with the purse string suture device 10 shown in FIG. FIG. 3A shows a state in which the tubular tissue 16 is sandwiched between the upper and lower jaws 10a and 10b by the purse string suture device 10, and the suture needles 14a and 14b are inserted into the sewing holes of the jaws 10a and 10b in this state. When inserted into 13a, 13b, the suture needles 14a, 14b sew the tube wall of the tubular tissue 16 as shown in FIG. 3 (b), and only the tube wall is drawn into a purse-like shape without closing the tubular tissue 16. It becomes possible to sew on. FIG. 3 (c) shows a state in which the suture needle 14a is removed from the purse string suture device 10, and the suture needle 14a is retracted from the purse string suture device 10 as indicated by an arrow, and the suture thread anastomoses the tubular tissue. be able to.

  FIG. 4 shows another conventional example of the purse string suturing device 10, in which the teeth 11a, 11b of the jaws 10a, 10b are arranged so as to mesh with each other. As a result, as shown in FIG. 4 (b), the tubular tissue 16 is held by the purse string suture device 10 while being sandwiched between the teeth 11a and 11b, and in this state, as shown in FIG. 4 (c). Further, the suture needles 14a and 14b can guide the suture thread 15 to the tube wall of the tubular tissue. Also in this case, the needle 14a extracted from the purse string suturing device 10 can be retracted from the purse string suturing device 10 as shown by the arrow in FIG.

JP-A-6-142107 Specification

  In such a conventional purse string suturing device, the purse string suturing needle 14 to be used is made of an ordinary steel material, and is inserted into the purse string suturing device 10 and pulled out from the purse string suturing device 10 as shown in FIG. Therefore, there is a problem in that a large space is required around the perforation, and therefore, in order to perform the purse string suture, a large laparotomy width must be taken. For example, in the case of total gastrectomy, an anastomosis between the esophagus end and the intestine is performed. Generally, the outer diameter of the esophagus has a diameter of about 20 to 30 mm, and the esophagus is sandwiched by the purse string suture device 10. Requires a width of 32 to 47 mm. Therefore, the sandwiching part width of the normal purse string suture device 10 requires a width of about 40 to 50 mm. And, in order to operate a normal suture in the abdomen, it is necessary to make it about 10 mm longer than the width of the purse string suture device. As a result, the laparotomy width for the purse string suture is 140 to 170 mm or more. It is known that you need it. In particular, in order to use the conventional straight needle as it is, it is necessary to perform an operation with care for needle piercing in a narrow operation space, and it is necessary to increase the wider operation space, that is, the laparotomy width. there were.

  In the present invention, in order to solve the above-described conventional problems, the purse string suture needle has two suture needles, each end of the purse string suture thread coupled to the respective tail ends and penetrating through the sewing hole of the purse string suture device. Each of the suture needles has a flexible part that can be easily bent during the operation except for the puncture end.

  The purse string suturing device according to the present invention includes a purse string suture needle and a purse string suture device, and the sewing hole of the purse string suture device is provided with a tapered needle introduction portion at at least one end. It is characterized by.

  Since the present invention has the above-described configuration, the suture needle has a flexibility that can be easily bent by the fingertip of the operator during the operation except for the puncture end. For this purpose, the suture needle is attached to the purse string suture device. When inserting the sewing needle into the sewing hole, the tip of the suture needle can be introduced into the sewing hole from above the wide operating space. From this state, the suture needle is pushed into the sewing hole obliquely from above, and the sewing needle is sequentially sewn. Deformed into a straight needle in the hole. In addition, when the suture needle is pulled out from the purse string suture device, only the puncture end is pulled out, and the puncture end is grasped and pulled up obliquely, so that the suture needle is bent again and is separated from the suture device. It is possible to easily perform a procedure in a narrow space without touching other tissues in the vicinity.

  Further, according to the present invention, the sewing hole of the purse string suture device is also provided with a tapered needle introduction portion at at least one end, so that it is easy to insert or remove the suture needle into the sewing hole. It becomes possible to bend the flexible suture needle part. As a result, by using the purse string suture needle or purse string suture device according to the present invention, it becomes possible to reduce the laparotomy width for the purse string anastomosis.

It is a perspective view which shows an example of the forceps which has the conventional common purse string suture device. It is principal part sectional drawing which shows the general shape of the conventional purse string suture device. It is explanatory drawing which shows the suturing process of the conventional purse string suturing. It is explanatory drawing of the purse string suturing using the other conventional purse string suture device. It is a figure which shows suitable embodiment of the purse string suture needle which concerns on this invention. It is explanatory drawing of the purse string anastomosis using the purse string suture needle which concerns on this invention. It is explanatory drawing of the purse string anastomosis using the purse string suture needle which concerns on this invention for another purse string suture device. It is principal part sectional drawing which shows suitable embodiment of the purse string suture device which concerns on this invention. It is principal part sectional drawing of the purse string suture device shown in FIG. FIG. 10 is a side view of FIG. 9. It is principal part sectional drawing which shows other embodiment of the purse string suture device which concerns on this invention.

  In FIG. 5, the purse string suture needle 14 according to the present invention is divided into two in its axial direction, and the puncture end 21 remains as hard steel as in the conventional needle, while the portion 22 other than the puncture end 21 is It consists of the flexible part 22 which has the softness | flexibility which can be easily bent by the surgeon during an operation. In order to obtain such mechanical characteristics, the purse string suture needle according to the present invention can impart the above different mechanical properties by quenching only the puncture end during the heat treatment of the needle.

  In addition, when a conventional ordinary tempered needle is used, similar mechanical characteristics can be obtained by performing an annealing process except for the puncture end. FIG. 6 is an explanatory view of a purse string suture using the purse string suture device 10 similar to the conventional one shown in FIG. 3. The suture needles 14a and 14b are inserted into the sewing holes 13a and 13b of the purse string suture device 10 obliquely from above. At this time, the suture needles 14a and 14b are configured such that sufficient treatment can be performed even with a small laparotomy width by bending a flexible portion except for the puncture end. In addition, since the suture needles 14a and 14b are guided from the wide opening above to the sewing hole of the purse string suture device 10, it is possible to reliably prevent accidents such as the needle being erroneously pierced into tissues other than the surgical site. As is apparent from FIGS. 6B and 6C, it is understood that the flexible portions of the suture needles 14a and 14b are bent back straight as they advance through the sewing holes 13a and 13b. When the suture needles 14a and 14b are extracted from the sewing holes 13a and 13b, as shown in FIGS. 6D and 6E, the flexible portion 22 is again bent upward so that the suture needles 14a and 14b can be easily obtained. Can be detached from the purse string suture device 10. As apparent from the purse string suture in FIG. 6, the use of the suture needles 14a and 14b according to the present invention can remarkably reduce the actual treatment space, and can use a wide space opened above the affected area. Since the treatment can be performed, it is possible to perform a treatment that does not cause a false puncture or the like.

  FIG. 7 shows a suturing operation using another type of purse string suturing device 10 shown in FIG. 4. As in the case of FIG. 6, the suturing needles 14a and 14b are appropriately bent and operated to minimize the space. It becomes possible to perform purse string suture.

  In the purse string suturing shown in FIGS. 6 and 7, the suture device 10 and the suturing device 10 are further sewn by providing tapered needle introduction portions in the sewing holes 13 a and 13 b of the conventional purse string suturing device 10 shown in FIG. 2. The handling of the needles 14a and 14b can be facilitated.

  8, 9 and 10 show an improvement of such a purse string suturing device, and tapered needle introduction portions 24a and 24b and 25a and 25b are provided at both ends of the sewing holes 13a and 13b. The needle introduction portions 24a, 24b, 25a, 25b can easily guide the puncture portion of the suture needle of the present invention to the sewing hole. Similarly, when the suture needle is extracted from the sewing hole, the operation can be easily performed.

  FIG. 11 shows an embodiment in which needle introduction portions 24a and 24b are provided in the sewing holes 13a and 13b of the other conventional purse string suture device 10 shown in FIG. 4, and the sewing holes 13a and 13b are the same as in FIG. It is possible to easily introduce and remove the suture needles 14a and 14b.

  10 Drawstring suture device, 10a Upper jaw, 10b Lower jaw, 11a, 11b Teeth, 13a, 13b Sewing hole, 14a, 14b Suture needle, 15 Suture, 16 Tubular tissue, 21 Puncture, 22 Flexible, 24, 25 Tapered needle introduction part.

Claims (2)

Each tail end is coupled to each end of a purse string suture and includes two suture needles that pass through the suture hole of the purse string suture device;
A purse string suture needle characterized in that each suture needle has a flexible part that can be easily bent during surgery except for the puncture end. A purse string suture needle according to claim 1 and a purse string suture device,
A purse string suturing device, wherein the sewing hole of the purse string suturing device is provided with a tapered needle introduction portion at at least one end.

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