JP3886010B2 - 滴形リング付き胸骨縫合用ワイヤー - Google Patents

滴形リング付き胸骨縫合用ワイヤー Download PDF

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JP3886010B2
JP3886010B2 JP2003278659A JP2003278659A JP3886010B2 JP 3886010 B2 JP3886010 B2 JP 3886010B2 JP 2003278659 A JP2003278659 A JP 2003278659A JP 2003278659 A JP2003278659 A JP 2003278659A JP 3886010 B2 JP3886010 B2 JP 3886010B2
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wire
sternum
drop
ring
cone
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JP2005040404A (ja
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小関智明
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小関医科株式会社
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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
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
    • A61B17/823—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage for the sternum
    • 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
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06114—Packages or dispensers for needles or sutures
    • A61B17/06133—Packages or dispensers for needles or sutures of parallelepipedal shape, e.g. made of rectangular or slightly oval panels
    • 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
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06166—Sutures
    • 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
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06004—Means for attaching suture to needle
    • A61B2017/06042—Means for attaching suture to needle located close to needle tip

Description

本発明は、心臓外科手術の胸骨閉鎖の際に用いるワイヤーに関するものである。
胸骨縫合に用いられる材料は、ワイヤーの端部に胸骨貫通用の針が接続されているものと、ワイヤーの両端が細くなっていて、胸骨を貫通させた錐の先端に通し、引上げるタイプに大別される。両端を細くするための加工法は、特許文献１及び２等で既に提案されている。また、特許文献３では結節時に結び目を作りやすいという目的で輪を持つ手術用縫合糸が提案されており、図３において、錐を用いて胸骨を貫通させ、輪の部分をフックを用いて引上げて縫合を行う方法が示されている。特許文献４及び５ではこれらの発明を複合する形で、細くなったワイヤーの端部に針を付けることを提案している。
特開平１０−３３５５３ 特開２００２−７８７１２（Ｐ２００２−７８７１２Ａ） 特開２００１−１９８１３１（Ｐ２００１−１９８１３１Ａ） 特開２００２−２２４１２２（Ｐ２００２−２２４１２２Ａ） 特開２００３−７９６３２（Ｐ２００３−７９６３２Ａ）
ワイヤーの端部に針が接続されているタイプは、胸骨への侵襲が大きく、出血するため、止血に手間取る。骨の脆い老人の場合、骨折する場合もある。
錐を使用し、胸骨を貫通させるタイプは、錐の先端に穴が開いている場合、小さな穴にワイヤーを通していくことが困難で、手間取る。
文献３記載の輪を持つ糸の内、しなやかな糸素材を使用した場合、胸骨の裏側に出ている錐の先端に輪を持っていく操作が面倒であり、輪部分を指で支える必要から、錐先端で手を傷付ける可能性がある。金属製ワイヤーであれば、輪部分を大きめのリング形状とし、そのまま手前からアプローチできるが、この形状を真円リングとした場合、複数本のワイヤーが収納容器内で絡まり、取り出しにくい。
ワイヤー中心部が太く、両端が細くなっており、ワイヤーの両先端が滴形のリング形状となっていることを特徴とする滴形リング付き胸骨縫合用ワイヤーとした。
以上説明したように本発明によれば、針付きワイヤーを使用する時のような、胸骨への侵襲がなく、錐のフックにリングを引っ掛けるだけの簡便な操作でワイヤーを胸骨に通すことが可能で、手術時間は短縮される。収納ケースからの取り出しも容易で絡まることなく、スムーズに引き抜くことができる。
図１は、本発明の１実施例であって、収納ケースからの取り出しの様子を示している。ワイヤーの素材はＳＵＳ３１６Ｌ、ワイヤー中央の太い部分は直径0.8mm〜0.9mm、長さ約30cmであり、その両端に同じく素材ＳＵＳ３１６Ｌで、外径約0.45mm、長さ約20cm、請求項２記載の製造方法により撚り上げられ、先端形状が滴型リング１a、１bとなったワイヤーが接続されている。通常の心臓手術では5〜6本ワイヤーを使用するので、収納ケース３の中にワイヤー5本又は6本セットされていることが多い。通常ワイヤーの太い部分２を取り、一本ずつ引抜く。ワイヤー両端のリングが真円の場合、リング同士が入り込み合い、取り出し方向に引くと、リングの肩部分が当たり、抜きにくい。絡まり合うとリングが変形し、更に抜き取りは困難となる。リング形状を滴型にすると、肩部分が傾斜し窄まっているので、ワイヤー同士が絡まずに容易に引き抜くことができる。
図２はワイヤーの使用図である。先端にフックの付いた錐４で胸骨を貫通させ、胸骨内側でフックにワイヤーのリングを引っ掛け、錐を引上げる。切開された胸骨の両側で同じ操作を行い、すべてのワイヤーを胸骨に通した後、ワイヤーの太い部分で締結する。
胸骨縫合用ワイヤーの両端を滴形リング形状とすることによって、収納ケースに収められた複数本のワイヤーが絡まずに取り出せる。リング付きワイヤーは、フック付き錐と併用することによって、心臓外科手術における胸骨縫合を、簡便且つ迅速に行うことが可能となる。
滴型リング付きワイヤーの取り出しを示した説明図である。 滴型リング付きワイヤーの使用方法を示した説明図である。
符号の説明
１a、１b 滴型リング
２ ワイヤー太い部分
３ 収納ケース
４ 錐

Claims (1)

  1. 心臓外科手術の胸骨閉鎖の際に用いるワイヤーであり、中心部が太く、両端が細くなっており、断面が滴形の棒の半円形部側に細いワイヤーの中心を掛け、手前に引き、両端が収束された細いワイヤーをモーターの軸に固定し、回転により撚り上げることにより滴形リングを形成し、モーター軸に固定された側の断端を定尺に切断し、中心部の太いワイヤーの両端に縦方向にレーザー、放電、ドリル等によって穴を開け、撚り上げた滴形リングワイヤーの切断端部を太いワイヤーの両端に挿入し、外周を圧着固定することにより一体とし、錐によって胸骨を貫通させ、滴形のリング部分を錐先端に引っ掛け、引き上げることにより胸骨内にワイヤーを通す構造であることを特徴とする滴形リング付き胸骨縫合用ワイヤー。
JP2003278659A 2003-07-23 2003-07-23 滴形リング付き胸骨縫合用ワイヤー Expired - Lifetime JP3886010B2 (ja)

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JP2003278659A JP3886010B2 (ja) 2003-07-23 2003-07-23 滴形リング付き胸骨縫合用ワイヤー
US10/861,852 US20050021087A1 (en) 2003-07-23 2004-06-04 Sternum suture wire with teardrop ring

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