JP5881312B2 - Suture organizer - Google Patents

Description

  The present invention relates to a suture organizer used in a surgical operation, and more specifically, in order to assist the operation of a forceps used to hold a suture used in pancreaticobiliary-duodenum and the like. The present invention relates to a suture organizer that prevents twisting.

  In general, when a surgical site is sutured and anastomosed (sutured) in a surgical operation, a large amount of suture is used, and a plurality of forceps for holding the suture are suspended around the surgical field. There are known various types of suture organizers for organizing sutures and preventing the sutures from twisting together because the sutures cannot be smoothly operated if they are twisted together. ing.

  The suture organizer described in Patent Document 1 has a ring shape so as not to obstruct the surgical field, and the upper portion of the link-like main body portion is tapered upward to hold the thread. A pair of cuts are continuously inserted in a direction perpendicular to the ring, and a V-shaped groove is provided at the top of the cut, and the lower part of the main body is fixed to the covering cloth. Is opened.

  The suture organizer having such a configuration can reduce the labor of the person engaged in the operation, can keep the thread reliably without worrying about damage to the visceral tissue due to the tension of the thread without being damaged at a low cost. .

JP 2002-325770 A

  In pancreaticobiliary-duodenal surgery, an annular suture holder used for valve replacement in cardiac surgery when performing anastomosis (suture) between the pancreatic duct and jejunum and anastomosis (suture) between the bile duct and jejunum. It is known to use a suture organizer that arranges sutures and prevents the sutures from twisting.

  However, according to the conventional suture organizer, the structure is such that the suture is held in the notch formed in the upper surface of the suture organizer, but the upper surface and the surface are operated so that the operation looks into the upper surface of the suture organizer. In many cases, however, it is difficult to grasp the position of the cut formed on the upper surface and is difficult to use.

  In addition, the suture holder for cardiac surgery is high in height, difficult to perform anastomosis (suture) operation, and difficult to move the suture holder itself for use in pancreaticobiliary duodenal surgery and the like. . In addition, since the suture holder is expensive, there is a problem that the cost increases.

  Further, since the conventional suture holding groove is formed to extend radially from the center of the suture organizer, the suture is detached from the suture holding groove, and an appropriate tension can be applied to the suture. There was also a problem that it was not possible.

  The present invention has been made to solve the above-mentioned problems, and it is easy to grasp the position of the suture holding groove that holds the suture even during the operation, and the suture does not come off from the suture holding groove. An object of the present invention is to provide a suture organizer that is easy to handle during surgery.

A suture organizer according to the present invention that solves the above-mentioned problems has an arcuate body, and the suture organizer has a suture holding groove formed on the upper surface of the body. Each has an inner circumferential slit and an outer circumferential slit formed by triangular grooves extending in a direction perpendicular to the upper surface, and the suture retaining groove communicates the inner circumferential slit and the outer circumferential slit , The main body is formed to be inclined with respect to the arc-shaped center line of the main body .

  In the suture organizer according to the present invention, it is preferable that a plurality of the inner circumferential slit and the outer circumferential slit are formed with their phases shifted from each other.

  Furthermore, in the suture organizer according to the present invention, it is preferable that the suture holding grooves are formed at equal intervals along the arc shape of the main body.

  In the suture organizer according to the present invention, it is preferable that the main body has flexibility.

  Furthermore, in the suture organizer according to the present invention, it is preferable that a grip portion is formed at an end portion of the main body.

  According to the present invention, the inner peripheral wall and the outer peripheral wall of the main body are respectively formed with an inner peripheral slit and an outer peripheral slit extending in the vertical direction, and the suture retaining groove communicates the inner peripheral slit and the outer peripheral slit. Even when the suture organizer is viewed from above, the position of the suture holding groove can be accurately grasped.

  Further, according to the present invention, since the inner circumferential slit and the outer circumferential slit are formed out of phase with each other, the suture holding groove is formed inclined with respect to the center line of the arcuate body, so that the suture can be securely It can be held and the suture can be prevented from coming off.

  Furthermore, according to the present invention, since the suture holding groove is formed to be inclined with respect to the arc-shaped center line of the main body, the suture can be reliably held and the suture is prevented from coming off. be able to.

  Furthermore, according to the present invention, since the suture holding grooves are formed at equal intervals along the arc shape of the main body, a plurality of sutures can be arranged at the same time.

  Furthermore, according to the present invention, since the main body has flexibility, the shape can be changed flexibly according to the site where the operation is performed, and it can be handled easily.

  In addition, according to the present invention, since the grip portion is formed at the end of the main body, the suture organizer can be easily and reliably fixed by fixing the grip portion around the surgical field.

The perspective view which shows the suture organizer which concerns on 1st Embodiment. The top view of the suture organizer which concerns on 1st Embodiment. The A section enlarged view in FIG. The figure explaining the use condition of the suture organizer which concerns on 1st Embodiment. The perspective view which shows the suture organizer which concerns on 2nd Embodiment.

[First Embodiment]
The suture organizer according to the present invention will be described below with reference to the drawings. The following embodiments do not limit the invention according to each claim, and all combinations of features described in the embodiments are not necessarily essential to the solution means of the invention. Absent.

  FIG. 1 is a perspective view showing a suture organizer according to the first embodiment, FIG. 2 is a top view of the suture organizer according to the first embodiment, and FIG. FIG. 4 is an enlarged view of part A, and FIG. 4 is a diagram for explaining a use state of the suture organizer according to the first embodiment.

  As shown in FIGS. 1 and 2, the suture organizer 1 according to the present embodiment has an arc-shaped main body 10 and is formed in a substantially C shape so as to substantially surround the surgical field. . Here, the substantially C-shape refers to a shape in which a part of the ring is cut out, and the arcuate body 10 has an arc of 200 to 300 °, more preferably 220 to 270 °, and still more preferably 250 °. Is formed. A grip portion 14 that is narrower than the main body 10 is integrally formed at both ends of the main body 10. The main body 10 includes an upper surface 11 and an inner peripheral wall 12 and an outer peripheral wall 13 that extend from both ends of the upper surface 11 in the width direction, and are formed in a rectangular cross section.

  Furthermore, the main body 10 and the grip part 14 are formed of a flexible material, and, for example, a foamed polyethylene sponge is preferably used. Due to the flexibility of the main body 10 and the grip 14, the suture organizer 1 according to this embodiment is formed to be freely deformable in the circumferential direction and the axial direction of the suture organizer 1.

  Further, the inner peripheral wall 12 and the outer peripheral wall 13 are formed with an inner peripheral slit 21 and an outer peripheral slit 22 that extend in a direction orthogonal to the upper surface 11. Furthermore, the inner peripheral slit 21 and the outer peripheral slit 22 are formed as triangular grooves so that the suture can be smoothly guided to the suture holding groove 20 described later. The inner circumferential slit 21 and the outer circumferential slit 22 have an opening angle of 60 to 120 °, more preferably 60 to 90 °, still more preferably 90 °, and a depth of 2 to 5 mm, more preferably 2 to 3 mm. More preferably, it is 2 mm.

  A plurality of inner circumferential slits 21 and outer circumferential slits 22 are formed at equal intervals along the arc shape of the main body 10. For example, the interval between adjacent inner circumferential slits 21 is 3 to 15 from the center of the arc of the main body 10. It is formed with an interval of °, more preferably 3 to 8 °, still more preferably 5 °. The interval between adjacent outer peripheral slits 22 is also formed to be the same as the interval between inner peripheral slits 21, and the inner peripheral slit 21 and the outer peripheral slit 22 are in phase with each other along the arc-shaped radial direction of the main body 10. Are arranged.

  On the upper surface 11, a suture holding groove 20 that connects an arbitrary inner peripheral slit 21 and an outer peripheral slit 22 is formed. The suture holding groove 20 is formed as a half cut having a certain depth from the upper surface 11 and does not divide the main body 10. The depth of the suture holding groove 20 may be any depth as long as the suture can be held. However, the thickness of the main body 10 is set so that the main body 10 does not tear from the suture holding groove 20 as a starting point. It is preferable to form about 1/5. Specifically, the thickness of the main body 10 is 10 to 25 mm, more preferably 15 to 20 mm, still more preferably 20 mm, and the suture holding groove 20 is 2 to 4 mm, more preferably 4 mm. .

  Further, as shown in FIG. 3, since the inner peripheral slit 21 and the outer peripheral slit 22 are arranged out of phase with each other along the radial direction of the arc shape of the main body 10, the suture holding groove 20 is formed in the main body 10. It is formed to be inclined from the center line of the arc shape. The inclination of the suture holding groove 20 is preferably 5 to 20 °, more preferably 10 to 15 °, and still more preferably 10 ° from the arcuate center line of the main body 10. Therefore, in this case, the phase difference between the inner peripheral slit 21 and the outer peripheral slit 22 is also set to 5 to 20 °, more preferably 10 to 15 °, and still more preferably about 10 °.

  Next, as shown in FIGS. 1 and 2, the gripping portion 14 is formed so as to become narrower toward both ends of the main body 10 as described above, and can be sandwiched with forceps or the like. Further, the width of the tip of the gripping part 14 is formed to be approximately half the width of the main body 10. Specifically, when the width of the main body 10 is 20 mm, it is preferable that the main body 10 is formed to have a width of 5 to 10 mm, more preferably 10 mm. As described above, since the grasping portion 14 is formed in a tapered shape at both ends of the main body 10, the suture organizer 1 is placed around the operative field by fixing the grasping portion 14 around the operative field with forceps or the like. It can be fixed securely. In addition, since the main body 10 has flexibility, the main body 10 can be appropriately deformed into a shape according to the state around the operative field, so that the suture organizer 1 is fixed at an optimal position and shape. be able to.

  As shown in FIG. 4, the suture organizer 1 according to this embodiment is used by being fixed around the surgical field by grasping the grasping portion 14 using forceps. The end of the suture is held by mosquito forceps, and the mosquito forceps are not arranged around the surgical field but are arranged outside the suture organizer 1. A plurality of sutures extend from the operative field. Since each suture is held in the suture holding groove 20, the sutures are neatly aligned in the radial direction of the suture organizer 1. It is possible to prevent drowning.

  Further, since the suture holding groove 20 is formed so as to communicate with the inner peripheral slit 21 and the outer peripheral slit 22 formed in the inner peripheral wall 12 and the outer peripheral wall 13 of the main body 10, the suture arrangement according to the present embodiment. Even when the container 1 is viewed from the upper surface 11, since the inner peripheral slit 21 and the outer peripheral slit 22 are formed by triangular grooves, the position can be accurately grasped by visual observation, and the suture is held. The position of the groove 20 can also be grasped at the same time.

  Furthermore, since the suture holding groove 20 is formed to be inclined from the arc-shaped center line of the main body 10, even when an appropriate tension is applied to the suture, the suture is reliably held. And can prevent the suture from coming off.

  Furthermore, since the suture organizer 1 according to the present embodiment has an inner peripheral wall 12 and an outer peripheral wall 13 that extend from the upper surface 11 and both ends in the width direction of the upper surface 11 and is formed in a rectangular cross section, Even when used for pancreaticobiliary-duodenal surgery or the like, the height is set so that an anastomosis (suture) operation can be easily performed. Moreover, since the suture holder 1 is formed of a foamed polyester sponge, it can be manufactured only by punching and can be easily manufactured. Furthermore, since it is formed of a single material that does not use metal or the like, it is easy to handle without being separated at the time of disposal.

  Although the suture organizer 1 according to the first embodiment described above has the arc-shaped main body 10 and has been described as being formed in a substantially C shape so as to substantially surround the surgical field. The suture organizer according to the present invention is not limited to the case where the main body 10 is formed in a substantially C shape as shown in the first embodiment. Therefore, the suture organizer 2 according to the second embodiment will be described next.

[Second Embodiment]
FIG. 5 is a perspective view showing a suture organizer according to the second embodiment. In addition, the same code | symbol is attached | subjected about the same or similar member as 1st Embodiment mentioned above, and the detailed description is abbreviate | omitted.

  As shown in FIG. 5, the suture organizer 2 according to the present embodiment has a main body 10a formed in an arc shape, but has a shorter overall length than the suture organizer 1 according to the first embodiment. Is formed. Due to the short overall length, it is not curved so as to be able to surround the surgical field. Specifically, the main body 10a is formed in an arc of 30 to 60 °, more preferably 40 to 55 °, and still more preferably 47 °.

  Also, the suture organizer 2 according to the present embodiment has a suture holding groove 20 formed in a half cut on the upper surface 11 in the same manner as the suture organizer 1 according to the first embodiment, and holds the suture. The groove 20 communicates with the inner peripheral slit 21 and the outer peripheral slit 22 formed in the inner peripheral wall and the outer peripheral wall of the main body 10a, and is formed to be inclined from the arc-shaped center line.

  Furthermore, the suture organizer 2 according to the present embodiment is formed of a flexible material, similar to the suture organizer 1 according to the first embodiment, and at both ends of the main body 10a, A tapered gripping portion 14 is formed.

  The suture organizer 2 according to the present embodiment formed in this way can be arranged at a narrow position, and can be easily arranged at a position where it is difficult to arrange a large suture organizer. In addition, by using a plurality of suture organizers 2 according to the present embodiment and arranging them in a circumferential shape, a larger surgical field can be surrounded, and an arrangement according to the surgical field can be easily applied. . The suture organizer 2 according to the present embodiment can perform a threading operation before anastomosis (suture) at a free position, and can perform an appropriate operation at the time of anastomosis (suture) operation while holding the thread. Can be done without being.

  As mentioned above, although preferred embodiment of this invention was described, the technical scope of this invention is not limited to description of the said embodiment. Various modifications or improvements can be added to the embodiment.

  For example, in the above embodiment, the case where the width of the tip of the gripping part 14 is formed in a tapered shape that is formed to be approximately half the width of the main body 10 or 10a has been described. However, the width dimension of the distal end portion of the grip portion 14 may be any shape.

  Moreover, in the said embodiment, although the case where the main bodies 10 and 10a were formed in cross-sectional rectangular shape was demonstrated, the cross-sectional shape of the main bodies 10 and 10a is not limited to such a form, For example, circular, an ellipse, The trapezoidal shape may be used.

  Moreover, the suture organizer 1 according to the first embodiment and the suture organizer 2 according to the second embodiment can be used in combination. Using the suture organizer 2 according to the second embodiment in combination with the suture organizer 1 according to the first embodiment is more effective in pancreaticobiliary-duodenal surgery or the like. In pancreaticobiliary-duodenal surgery, anastomosis (suture) of a plurality of organs such as pancreatic duct and jejunum, bile duct and jejunostomy (suture) is often required. Organs such as pancreaticobiliary duodenum and the like can be operated more efficiently and safely if the anastomosis (suture) operation can be performed with an adequate field of view when performing anastomosis (suture) from an optimal angle that differs for each organ. be able to.

  Specifically, for example, the first anastomosis (suture) operation procedure is performed using the suture organizer 1 according to the first embodiment for the first anastomosis (suture) operation procedure, and then the next anastomosis (suture). ) The pancreatic duct-jejunostomy, which is an operation procedure, is performed using the suture organizer 2 according to the second embodiment. At this time, the suture organizer 2 according to the second embodiment is arranged / fixed at a suitable portion of the suture organizer 1 according to the first embodiment without being arranged / fixed by using the grip 14. The anastomosis (suture) between the organs can be performed from a suitable position, and the tension of the suture can be applied to the organ during surgery or during anastomosis (suture). Can be increased.

  In this case, the suture organizer 1 according to the first embodiment and the suture organizer 2 according to the second embodiment are fixed to the suture organizer 2 according to the second embodiment. It arrange | positions on the outer side of the suture organizer 1 which concerns on a form, and hold | maintains also to the suture organizer 1 which concerns on 1st Embodiment in the state hold | maintained to the suture organizer 2 which concerns on 2nd Embodiment. Can be fixed. The suture organizer 2 according to the second embodiment is arranged outside the suture organizer 1 according to the first embodiment, and the suture is held by the suture organizer 2 according to the second embodiment. It can also be fixed. According to this fixing method, the suture organizer 2 according to the second embodiment is pulled toward the suture organizer 1 according to the first embodiment by the tension of the suture, so that the second embodiment The suture organizer 2 according to the second embodiment can be fixed by contacting the suture organizer 2 according to the first embodiment. Furthermore, the suture organizer 1 according to the first embodiment and the suture organizer 2 according to the second embodiment can be fixed by being sandwiched by forceps or the like.

  It is apparent from the description of the scope of claims that embodiments with such changes or improvements can be included in the technical scope of the present invention.

1, 2 suture organizer, 10, 10a body, 11 upper surface, 12 inner peripheral wall, 13 outer peripheral wall, 14 gripping portion, 20 suture retaining groove, 21 inner peripheral slit, 22 outer peripheral slit.

Claims (5)

Having an arc-shaped body,
In the suture organizer in which a suture holding groove is formed on the upper surface of the main body,
The inner peripheral wall and the outer peripheral wall of the main body are respectively formed with an inner peripheral slit and an outer peripheral slit formed by triangular grooves extending in a direction orthogonal to the upper surface,
The suture organizing device is characterized in that the suture holding groove communicates with the inner peripheral slit and the outer peripheral slit and is inclined with respect to the arc-shaped center line of the main body . The suture organizer according to claim 1, wherein
The suture organizer, wherein the inner peripheral slit and the outer peripheral slit are formed in a plurality of phases out of phase with each other. The suture organizer according to claim 1 or 2 ,
The suture organizing device, wherein the suture holding grooves are formed at equal intervals along an arc shape of the main body. The suture organizer according to any one of claims 1 to 3 ,
The suture organizer, wherein the main body has flexibility. The suture organizer according to any one of claims 1 to 4 ,
A suture organizer, wherein a grip portion is formed at an end of the main body.

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