JP4149112B2 - Vaginal laceration suture tool - Google Patents

Description

[0001]
[Industrial application fields]
The present invention relates to a device for suturing a vagina wall tear that is often seen especially at the time of childbirth.
[0002]
[Prior art]
During childbirth, lacerations associated with childbirth can occur in the vaginal wall. This laceration is concealed by bleeding from the uterine ostium and the laceration itself, often making it difficult to suture. In such a case, the uterine ostium was pressed with gauze using a colposcope inserted into the vagina and sutured while preventing vaginal bleeding, but the colposcope is basically not suitable for uterine ostium compression, and instead bleeding There was a problem of losing the whole image of the laceration. Therefore, the present inventor previously disclosed a suture of a vaginal wall laceration as disclosed in Japanese Patent Application Laid-Open No. 05-184583 in which a suture window is provided in the length direction of a cylindrical body having a distal end blocking portion that is large enough to be inserted into a vagina after delivery Suggested tools. Specifically, the cylindrical body is provided with a groove on the substantially opposite side of the window and a handle in the opening so that the window can hold a tissue-affinity membrane. As a result, as compared with the case of using a colposcope, the suture of the vagina wall laceration was much easier.
[0003]
[Problems to be solved by the invention]
The suturing tool disclosed in Japanese Patent Laid-Open No. 05-184583 mentioned above has been used by a surgeon with a handle provided at the opening of the cylindrical body for holding during suturing. However, since there are various aspects of lacerations to be sutured, the following problems have become apparent. That is, (1) If the laceration is deep or multidirectional, it must be sutured while rotating the cylindrical body, and in this case, the assistant's hand holding the handle and holding the instrument will interfere with the stitching. May be. Also, (2) depending on the direction of the laceration, the handle is not always in a position where it can be easily held, and in this case, it becomes impossible to support the instrument stably. Since the previously proposed suturing tool is an ideal instrument for suturing, it was decided to study in order to solve the above problems and to make the instrument easier to use.
[0004]
[Means for Solving the Problems]
The result of the study consists of a cylindrical body that can be inserted into the vagina after childbirth and a frame that is extrapolated in the vicinity of the opening at the rear end of this cylindrical body. A vaginal wall that opens a suture window on the side as a part, a main handle is provided in the vicinity of the opening at the rear end, the frame is provided with a sub handle, and the sub handle can be rotated at an arbitrary angle with respect to the main handle A laceration suture tool. The sewing window is basically provided with a constant width along the insertion direction of the cylindrical body. This suturing tool also enables (1) providing a concave groove on the side surface of the cylindrical body so that at least the terminal end reaches the opening, or (2) holding the tissue affinity film in the suturing window. The concave groove is provided in parallel with the stitching window so as to be concave inward on the facing side surface.
[0005]
The suturing device of the present invention has the following features: (1) The distal end of the tubular body as the obstruction prevents blood from flowing into the tubular body while suppressing bleeding from the uterine ostium, and (2) the suture aligned with the laceration The laceration is sutured from the window. Since blood does not flow into the cylindrical body, the suturing window is not hidden by bleeding, and the side surfaces other than the suturing window of the cylindrical body press the vaginal wall, so that suturing is facilitated. Bleeding is guided out of the vagina along a concave groove provided on the side surface. The tissue affinity film held in the suture window enables sutures while preventing blood from flowing from the suture window into the tubular body even during severe bleeding. Since the tissue affinity film is harmless to human tissue, there is no problem even if it is brought into close contact with the laceration and sutured as it is.
[0006]
The feature of the present invention is that a main handle provided in the vicinity of the opening of the cylindrical body, a sub handle provided in the frame extrapolated in the vicinity of the opening, and two handles for supporting the instrument are provided. It is in. As a result, even when the tubular body is rotated with the main handle and the suture window is properly aligned with the laceration, the frame body can be fixed in position relative to the tubular body. Change the angle so that the secondary handle protrudes in a direction that is easy to hold, so that the instrument can be supported in a stable state. As described above, since the frame body may be fixed in position or rotated independently of the cylindrical body, the frame body and the cylindrical body are separated from each other so that they can rotate freely.
[0007]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings. 1 is a front view showing an example of a suture tool for vagina wall tear according to the present invention, FIG. 2 is a plan view of the suture tool, and FIG. 3 is a cross-sectional view taken along the line AA in FIG. 4 and FIG. 5 are plan views corresponding to FIG. 2 showing a use state of the suturing tool. The suturing tool shown in this example is made of metal or plastic having an outer diameter and a length that allow the tubular body 1 to be inserted into the vagina, an outer diameter of 7 to 8 cmφ, and a length of about 11 cm. The front end is a closed portion 2, and the rear end is an opening 5. The sewing window 3 is provided on a side surface extending from the closing portion 2 to the opening portion 5 at a distal end with a width of about 3 cm in a straight line in the insertion direction of the cylindrical body 1. A main handle 6 protrudes from the edge of the opening 5, and a frame 8, which is a feature of the present invention, is extrapolated in the vicinity of the opening 5, and a sub-handle 9 protrudes from the frame 8.
[0008]
On the side of the cylindrical body 1, a concave groove 4 is formed integrally with the cylindrical body 1 so as to extend in the insertion direction on the opposite side of the suturing window 3, and the terminal end reaches the opening 5. The concave groove 4 serves as a blood discharge channel for bleeding. In this example, the tissue affinity film 7 is attached to the suture window 3 so that blood does not flow into the tubular body 1 when bleeding is large. This tissue affinity film 7 is not necessary when there is little bleeding, and can be used or not used as appropriate. This tissue affinity film 7 is made of a material derived from starch or PVA, and is configured as a film that is absorbed into the body tissue over time or decomposed over time.
[0009]
As apparent from FIG. 2, the frame body 8 is merely extrapolated with respect to the cylindrical body 1 so as to be freely rotatable, and the relative position of the main handle 6 is fixed while only the sub-handle 9 is relatively fixed. Can be rotated freely. Thus, for example, when the assistant sits beside the operator and wants to hold the instrument, as shown in FIG. 4, the main handle 6 is tilted in the 2 o'clock direction and the sub handle 9 is rotated in the 12 o'clock direction. Can hold the instrument stably. Further, when it is difficult to hold from above, it is preferable to rotate the frame body 8 as appropriate and hold the sub handle 9 in the 6 o'clock direction as seen in FIG. As described above, the main handle 9 changes the direction of the suture window 3 with respect to the laceration, rotates the frame 8 as appropriate, and the assistant holds the auxiliary handle 9 so that the instrument is stably held, so that quick and easy suturing is possible. Enable.
[0010]
FIG. 6 is a front view corresponding to FIG. 1 of another example of the suturing tool in which the engaging protrusion 11 provided on the cylindrical body 1 is engaged with the rotating groove 10 provided on the frame body 8. The cylindrical body 1 shown in FIG. 1 and below has a substantially cylindrical shape with a circular cross section on the assumption that the cylindrical body 1 is rotated and used, and simplification of the shape of one frame at the time of manufacture, and the mounting and rotation of the extrapolated frame body 8 are easy. I have to. Moreover, since the frame body 8 can be removed after the operation, the groove 4 and other cylindrical bodies 1 can be washed or sterilized. On the other hand, in the example of FIG. 6, the engagement protrusion 11 provided on the cylindrical body 1 is engaged with the rotation groove 10 provided on the frame body 8 while the frame body 8 is basically removable. The frame 8 is prevented from falling off during use. When removing the frame body 8, the engaging protrusion 11 is pulled out of the rotating groove 10 through the separation groove 13 provided at the end of the rotating groove 10. Thereby, the washing | cleaning or sterilization of the ditch | groove 4 and the other cylindrical body 1 becomes easy like the above-mentioned.
[0011]
【The invention's effect】
When the suture tool for vaginal wall laceration of the present invention is used, the intravaginal laceration can be sutured without any trouble regardless of bleeding. In particular, the stitching window can be freely positioned by the main handle that rotates the cylinder state, and the instrument itself can be held by the secondary handle that protrudes from the frame. Even when there are many directions, quick and easy stitching is possible. Such a suturing device is particularly suitable for suturing vaginal wall lacerations often observed immediately after delivery, but can also be used for lacerations due to other factors. Thus, the suturing tool of the present invention greatly contributes to the safety of the mother body.
[Brief description of the drawings]
FIG. 1 is a front view showing an example of a suture tool for vagina wall tear according to the present invention.
FIG. 2 is a plan view of the suturing tool.
FIG. 3 is a cross-sectional view taken along the line AA in FIG. 1 (the frame body is rotated 90 degrees).
FIG. 4 is a plan view corresponding to FIG. 2 showing a use state of the suturing tool.
FIG. 5 is a plan view corresponding to FIG. 2 showing a use state of the suturing tool.
FIG. 6 is a front view corresponding to FIG. 1 of another example of the suturing tool.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Cylindrical body 2 Blocking part 3 Suture window 4 Groove 5 Opening part 6 Main handle 7 Tissue affinity membrane 8 Frame body 9 Sub handle
10 Rotating groove
11 Engagement protrusion
13 Release groove

Claims (2)

It consists of a cylindrical body that can be inserted into the vagina after delivery, and a frame body that is extrapolated near the opening at the rear end of the cylindrical body. A vaginal laceration suture tool that opens and has a main handle in the vicinity of the opening at the rear end, the frame has a sub-handle, and the sub-handle can be rotated at an arbitrary angle with respect to the main handle. The vaginal wall laceration suturing device according to claim 1, wherein the side surface of the cylindrical body is provided with a concave groove whose terminal end reaches the opening.

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