JP4477184B2 - Suture device - Google Patents

Description

[0001]
[Industrial application fields]
The present invention relates to a medical device used for open surgery.
[0002]
[Prior art]
When performing an operation that requires an incision, after removing the affected part, the subcutaneous part often has to be incised more than necessary in order to secure a working space necessary for suturing. As a result, it took time to recover after extensive incision. In addition, the patient suffered a lot of pain because of wide incision. Recently, a method for making a small hole and treating it has also been established, and it has been recovered in a short period of time by simple removal of the affected area. However, when the affected part is large, even if the removal operation of the affected part can be performed from a small incision part, it is necessary to suture the organs and muscles in the body after the removal. For this purpose, a work space for moving the needle is necessary, and the incision portion must be taken large. Even if the affected part can be confirmed with an endoscope or the like from the mouth or anus without incision due to diseases of the digestive organs, etc., and it can be removed, There were many cases of incision from the subcutaneous part and major surgery.
[0003]
[Problems to be solved by the invention]
The present invention provides a device for enabling a suture operation from the mouth or anus, particularly in the digestive organs, while minimizing the incision range.
[0004]
[Means for Solving the Problems]
By rotating a hollow spiral needle body having a curvature around the center of the curvature, it is possible to perform suturing after excision of the affected area. At this time, the suture thread is incorporated in a hollow needle in advance, and after the spiral needle penetrates the suture section, the suture thread is reversed, and when the needle is pulled out, only the thread remains to be sutured. If an appropriate curvature is selected according to the size of the stitched portion and the stitching operation is performed, stitching can be performed with the smallest incision portion.
[0005]
DETAILED DESCRIPTION OF THE INVENTION
In the present invention, an elastic tube is formed in a spiral shape for a needle body used in surgery, and this needle body is combined with a scope that supports the needle body in a rotatable manner and can monitor the movement of the needle tip. . By rotating the needle, it securely penetrates the piece of meat to be sewn. Moreover, since it moves according to the helical pitch, it can be reliably stitched even in a narrow space.
[0006]
【Example】
FIG. 1 is an overall sectional side view showing an embodiment of the present invention. In FIG. 1, 1 is a needle body, and 2 is a thread. The needle body 1 includes a spiral needle portion 10 made of an elastic body having a hollow inside, a needle support portion 11 having a cylindrical shape and having flexibility and torsional rigidity, and a handle for an operator to transmit a rotational motion to the needle portion. It consists of part 12.
[0007]
3 is a fiberscope. There is an objective lens 30 at the tip of the fiberscope 3. Reference numeral 31 denotes a scope body in which pixel transmission means, light transmission transmission means, direction control means of the objective lens 30 and the like are bundled. Reference numeral 32 denotes a needle body support portion that is flexible and holds the needle body 1 eccentrically with respect to the axis of the fiberscope 3 so as to be rotatable. In the space below the needle body 10 and the fiber scope 3 due to the eccentricity, a piece of meat to be described later temporarily fits in a state of continuously penetrating the needle body 10.
[0008]
Reference numeral 33 denotes a grip portion held by the operator, 34 denotes a lever for moving the direction control means of the objective lens 30, and 35 denotes an eye cup that makes it easy to see the subject viewed through the fiber scope 3. 4 indicates the eyes of the operator.
[0009]
FIG. 2 is a view as seen from the needle tip side of this device. The end portion 101 of the spiral needle portion 10 has a cut surface formed outside as viewed from the center of rotation.
[0010]
FIG. 3 is a sectional side view of the tip. The thread 2 has a length longer than that necessary for suturing in advance in the hollow portion of the needle portion 10, and the tip protrudes from the tip of the needle portion. When the thread 2 is incorporated into the needle body 1, the suction end (not shown) is used on the rear end side of the needle to make the inside of the needle body 1 have a negative pressure, and the thread 2 is pulled into the interior from the needle tip. set.
[0011]
FIG. 4 is a side sectional view of the tip during suturing. Reference numeral 5 denotes a piece of meat to be sewn.
[0012]
Next, this operation will be described. When the operator performs suturing, the operator inserts the tip of the device through the incised portion of the patient, and first holds the meat piece 5 to be sutured temporarily with a notch or the like (not shown) and fixes the needle to the center of the joint. Align the tips of the parts 10. The confirmation of this position and the subsequent work are performed while looking through the scope cup 31 and the eye cup 35 through the image captured by the objective lens 30 at the tip of the central fiberscope 3.
[0013]
When starting the stitching, the operator fixes the torso portion near the incision portion of the grip 33 with a holder or a hand (not shown), grips the other end, rotates the handle portion 12 counterclockwise while determining the position. Let Then, the needle support portion 11 is twisted, the rotation is transmitted to the needle portion 10, and the tip of the needle portion 10 bites into the meat piece 5.
[0014]
When the rotation is continued, the tip of the needle portion 10 comes out to the surface after passing through the combined meat pieces 5 because the tip of the needle portion 10 has a spiral shape. When it is further rotated, the tip of the needle portion 10 comes out to the surface after passing through the meat pieces 5 that have been combined again while moving forward by the helical pitch. In this way, the handle portion 12 is rotated to penetrate the suture portion a plurality of times.
[0015]
When the necessary stitch width has been penetrated, the thread 2 at the tip of the needle portion 10 is temporarily sandwiched between the needles. In this state, the operator rotates the handle portion 12 clockwise. Then, the needle portion 10 is sequentially detached from the meat piece 5 that has been penetrated until now, but the thread 2 is left as it is, so that it is sewn while removing the needle.
[0016]
The operator can change the direction of the needle part with the lever 34 that moves the direction control means of the objective lens 30 so that the bite 5 of the needle part 10 is not bited too much.
[0017]
【The invention's effect】
Since the needle is spiral and moves with a rotational motion, it requires almost no space for moving the needle, and can be sutured with a minimum incision.
[0018]
By forming a cut surface at least at the tip of the needle so as not to face the inside of the spiral, it is possible to prevent the needle from biting into the meat piece. For example, a cut surface in a plane perpendicular to the spiral axis may be used.
[0019]
A notch may be provided immediately below the tip of the needle, and a thread may be held in the notch. Or the hole orthogonal to a needle | hook may be sufficient.
[0020]
In the present invention, the direction of the spiral needle 1 is changed by the direction control means of the objective lens 30 of the fiberscope 3 incorporated therein, but a part or the whole of the spiral needle 1 is formed of a shape memory alloy, By energizing the shape memory alloy, it is also possible to perform optimal stitching by partially changing the direction of the needle body 1 and the helical pitch by temperature control accompanying electrical resistance.
[0021]
The spiral winding direction of the needle body 10 has been described as being left-handed in the embodiment, but may be right-handed.
[0022]
In addition, if reference lines and scales are provided in advance in the field of view of the fiberscope, the range that can be seen with the lever can be made more uniform with reference to those lines, and the needle can be moved at a stable depth.
[Brief description of the drawings]
FIG. 1 is an overall side sectional view showing an embodiment of the present invention.
FIG. 2 is a view as seen from the needle tip side of this device.
FIG. 3 is a side sectional view of a tip portion.
FIG. 4 is a side sectional view of the distal end during suturing.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Needle body 2 Thread 3 Fiber scope 4 Operator's eye 5 Flesh 10 Spiral needle part 11 Needle support part 12 Handle part 30 Objective lens 31 Fiber scope trunk part 32 Needle body support part 33 Grip part 34 Lever 35 Eye cup 101 Cut surface

Claims (7)

A spiral needle wound around at least 360 degrees ;
Needle body holding means for rotatably holding the needle body ;
Needle body rotating means for rotating the needle body ;
A suturing device comprising a thread that is temporarily fixed to the tip of the needle body. The suturing device according to claim 1, wherein the needle body is hollow so that the thread can be held in the hollow portion. The suturing device according to claim 1, wherein the spiral needle body has a spiral shape wound a plurality of times. The suturing apparatus according to claim 1, wherein the needle body holding means incorporates a scope capable of observing the movement of the tip of the needle body and movable at least in the direction of the tip. The suturing device according to claim 1, wherein the needle body has a cut surface cut in a direction not facing the inside of the spiral at a distal end. The suturing device according to claim 1, wherein the needle body has a thread holding portion that is formed by cutting at a tip or at least one of a hole orthogonal to the needle body. In a state where the thread is temporarily fixed to the tip of the spiral needle body and the tip of the needle body is bitten into the sutured part,
While rotating the needle body in the direction around the axis and passing through the sutured part a plurality of times while moving forward by the helical pitch, it penetrates only the necessary stitching width,
With the thread at the tip of the needle body locked, rotate the needle body in the direction opposite to the forward direction to remove the needle from the sutured part, and the sutured part is left as it is. A suturing device comprising means for suturing.

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