JP6013352B2 - 緊急留置縫合糸及びパッケージ - Google Patents
緊急留置縫合糸及びパッケージ Download PDFInfo
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- JP6013352B2 JP6013352B2 JP2013538868A JP2013538868A JP6013352B2 JP 6013352 B2 JP6013352 B2 JP 6013352B2 JP 2013538868 A JP2013538868 A JP 2013538868A JP 2013538868 A JP2013538868 A JP 2013538868A JP 6013352 B2 JP6013352 B2 JP 6013352B2
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Description
本出願は、米国特許法第119条(e)の下で、2010年11月9日出願の米国特許仮出願番号第61/411,918号、及び2010年11月10日出願の同第61/412,389号の利益を請求するものであり、これらの仮出願は、参照によりその全体を本明細書に組み込まれる。
本発明は、広義には、外科手技用のフィラメント、外科手技用のフィラメントを製造する方法、及びその使用法に関するものである。
a.第1の端部、第2の端部、及び周辺部と、
b.複数のリテーナであって、第1の端部の動きの方向に組織を通る縫合糸の動きを容認し、かつ第1の端部の動きの方向と反対の方向に組織を通る縫合糸の動きを防止する、縫合糸の第1の端部と縫合糸上の第1の軸方向位置との間の、縫合糸の第1の部分上のリテーナ、及び第2の端部の動きの方向に組織を通る縫合糸の動きを容認し、かつ第2の端部の動きの方向と反対の方向に組織を通る縫合糸の動きを防止する、縫合糸の第2の端部と縫合糸上の第2の軸方向位置との間の、縫合糸の第2の部分上のリテーナと、
c.第1の軸方向位置と第2の軸方向位置との間の把持係合要素と、を備える、縫合糸。
a.把持係合要素と、
b.少なくとも3つの縫合糸セグメントであって、それぞれの縫合糸セグメントが、縫合糸セグメントの第1の端部と縫合糸セグメントの第2の端部との間に、第1の端部の動きの方向に組織を通る縫合糸の動きを容認し、かつ第1の端部の動きの方向と反対の方向に組織を通る縫合糸セグメントの動きを防止するように複数のリテーナを有し、それぞれの縫合糸セグメントの第2の端部が把持係合要素に付着された、縫合糸セグメントと、を備える、取り外し可能な多方向性留置システム。
a.双方向性留置縫合糸を提供することであって、縫合糸が、複数のリテーナであって、縫合糸の第1の端部の動きの方向に組織を通る縫合糸の動きを容認し、かつ第1の端部の動きの方向と反対の方向に組織を通る縫合糸の動きを防止するための、縫合糸の第1の端部と縫合糸上の第1の軸方向位置との間の縫合糸の第1の部分の上のリテーナ、並びに縫合糸の第2の端部の動きの方向に組織を通る縫合糸の動きを容認し、かつ第2の端部の動きの方向と反対の方向に組織を通る縫合糸の動きを防止するための、縫合糸の第2の端部と縫合糸上の第2の軸方向位置との間の縫合糸の第2の部分の上のリテーナを有する、双方向性留置縫合糸を提供することと、
b.縫合糸の第1の端部を、創傷の第1の端部と第2の端部との間の第1の挿入点で組織内に挿入することと、
c.縫合糸の第1の端部を、第1の展開経路に沿って、創傷の交互の側の組織を通して、第1の出口点まで、創傷の第1の端部に向かって引くことと、
d.縫合糸の第2の端部を、創傷の第1の端部と第2の端部との間の第2の挿入点で、縫合糸の第1の挿入点と第2の挿入点との間の部分を残して、組織内に挿入することと、
e.縫合糸の第2の端部を、第2の展開経路に沿って、創傷の交互の側の組織を通して、第2の出口点まで、創傷の第2の端部に向かって引くことと、
f.恒久的な治療の前に、創傷からの縫合糸の除去のために、第1の挿入点と第2の挿入点との間の部分に沿って、縫合糸を切断することと、を含む、方法。
a.一方向性留置縫合糸を提供することであって、縫合糸が、縫合糸の第1の端部と第2の端部との間における、第1の端部の動きの方向に組織を通る縫合糸の動きを容認し、かつ第1の端部の動きの方向と反対の方向に組織を通る縫合糸の動きを防止する複数のリテーナ、及び縫合糸の第2の端部における把持係合要素を有する、縫合糸を提供することと、
b.把持係合要素を少なくとも部分的に創傷の外側に位置付けることと、
c.縫合糸の第1の端部を創傷の挿入点において組織内に挿入することと、
d.縫合糸の第1の端部を展開経路に沿って、創傷の交互の側の組織を通して、組織の外側の出口点まで、創傷の端部に向かって引くことと、を含む、方法。
a.多方向性留置システムを提供することであって、システムが、把持係合要素、及び少なくとも2つの縫合糸セグメントであって、それぞれの縫合糸セグメントが、縫合糸セグメントの第1の端部と縫合糸セグメントの第2の端部との間に、第1の端部の動きの方向に組織を通る縫合糸の動きを容認し、かつ第1の端部の動きの方向と反対の方向に組織を通る縫合糸セグメントの動きを防止するように複数のリテーナを有し、それぞれの縫合糸セグメントの第2の端部が把持係合要素に付着された、縫合糸セグメントを有する、システムを提供することと、
b.把持係合要素を少なくとも部分的に創傷の外側に位置付けることと、
c.第1の縫合糸セグメントの第1の端部を、創傷の第1の挿入点において組織に挿入することと、
d.第1の縫合糸セグメントの第1の端部を、第1の展開経路に沿って、創傷の交互の側の組織を通して、第1の出口点まで、創傷の第1の端部に向かって引くことと、
e.第2の縫合糸セグメントの第1の端部を、第1の挿入点の近位にある第2の挿入点において、組織内に挿入することと、
f.第2の縫合糸セグメントの第1の端部を、第2の展開経路に沿って、創傷の交互の側の組織を通して、第2の出口点まで、創傷の第2の端部に向かって引くことと、を含む、方法。
a.多方向性留置システムを提供することであって、システムが、把持係合要素及び少なくとも3つの縫合糸セグメントであって、それぞれの縫合糸セグメントが、縫合糸セグメントの第1の端部と縫合糸セグメントの第2の端部との間に、第1の端部の動きの方向に組織を通る縫合糸の動きを容認し、かつ第1の端部の動きの方向と反対の方向に組織を通る縫合糸セグメントの動きを防止するように複数のリテーナを有し、それぞれの縫合糸セグメントの第2の端部が把持係合要素に付着された、縫合糸セグメントを有する、システムを提供することと、
b.組織の頂点の近位に把持係合要素を位置付けることと、
c.第1の縫合糸セグメントの第1の端部を第1の組織の頂点内に挿入し、かつ第1の縫合糸セグメントの第1の端部を組織の外に引くことと、
d.第2の縫合糸セグメントの第1の端部を第2の組織の頂点内に挿入し、かつ第2の縫合糸セグメントの第1の端部を組織の外に引くことと、
e.第3の縫合糸セグメントの第1の端部を第3の組織の頂点において組織内に挿入し、かつ第3の縫合糸セグメントの第1の端部を組織の外に引くことと、を含む、方法。
a.把持係合要素を縫合糸セグメントから切断することと、
b.縫合糸セグメントを、その第2の端部によって組織の外へ引くことと、を含む、方法。
a.少なくとも1つの表面を有する基部と、
b.縫合糸セグメントを基部に解除可能に固定するためのセグメントホルダと、
c.把持係合要素を基部に解除可能に固定する把持係合要素ホルダと、を備える、パッケージ。
d.外側筐体と、
e.少なくとも1つの縫合糸セグメントに付着された把持係合要素を有する留置縫合糸を含む縫合パッケージと、を備える、キット。
a.第1の端部、第2の端部、及び周辺部を有する縫合糸本体と、
b.複数のリテーナであって、第1の端部の動きの方向に組織を通る縫合糸の動きを容認し、かつ第1の端部の動きの方向と反対の方向に組織を通る縫合糸の動きを防止する、縫合糸の第1の端部と縫合糸上の第1の軸方向位置との間の、縫合糸の第1の部分上のリテーナ、及び第2の端部の動きの方向に組織を通る縫合糸の動きを容認し、かつ第2の端部の動きの方向と反対の方向に組織を通る縫合糸の動きを防止する、縫合糸の第2の端部と縫合糸上の第2の軸方向位置との間の、縫合糸の第2の部分上のリテーナと、
c.第1の軸方向位置と第2の軸方向位置との間の把持係合要素であって、縫合本体が第1の軸方向位置と第2の軸方向位置との間で糸を通される、少なくとも2つの開口部を有する把持係合要素と、を備える、縫合糸。
以下で用いられ得る特定の用語の定義は、次のものを含む。
特定の実施形態に基づいて、本発明は、一方向性の、双方向性の、多方向性の緊急留置縫合糸及びシステムを提供する。本発明の縫合糸及びシステムは、緊急縫合糸又はシステムの除去を容易にする把持係合要素を備え、いくつかの実施形態では、把持係合要素は、指を係合するように適合されてもよく、一方で、他の実施形態は、手術道具(ピンセットなどの)を係合するように適合されてもよい。そのサイズ、形状、色、テクスチャー、又はこれらの任意の組み合わせのいずれかに起因して、これは、容易に検出できるようにも構成される。創傷閉鎖から本発明の緊急縫合糸又はシステムを除去するために、いくつかの実施形態では、把持係合要素は、把持され(ここでも指又は手術道具によって)、縫合糸の残りから切断され、ひいては、それぞれの留置セグメントを最初に展開された方向で組織から除去することを可能にする。他の実施形態では、把持係合要素は把持され、その後それぞれの留置セグメントは、それに続く留置セグメントの除去を容易にするために把持係合要素及び互いから切断されてもよい。把持係合要素は、連続ループ(円状及び楕円状ループを含む)、多角形、ハンドル付きループ、タブ、部分的ループ、及び部分的多角形を含む、任意の数の構成で提供されてもよい。これには、把持係合要素の組織内への通過を避けるための、それぞれの端部の組織止め具を含む。これらは、剛性であっても可撓性であってもよい。
本発明に基づく双方向性緊急縫合糸の実施形態が、図1〜図7に示される。図1では、縫合糸100は、第1の留置縫合糸セグメント102aと、第2の留置縫合糸セグメント102bと、リング106aを備える把持係合要素106と、を含む。一般にリング106aは、いずれかの人が自分の指をそのリングを通すことができ、その人が次いでリングを第1の留置縫合糸セグメント102a及び第2の留置縫合糸セグメント102bから引きはなすことができる、いかなる形状であってもよい。例えば、リングは、図1に示すように丸くてもよく、あるいは楕円状若しくは多角形状、又はリングが開口若しくは開口部を備える限り、他の形状とすることができる可能性がある。図1に示すように、把持係合要素106は、好ましくはリング106aに沿った異なる場所で、セグメント102bの近位端108b及びセグメント102aの近位端108aに接合する。第1の留置縫合糸セグメント102aは、組織内にあるとき、遠位端又は展開端104aの動きの方向に組織を通るセグメント102aの動きを容認し、遠位端104aの動きの方向と反対の方向に組織を通る縫合糸の動きに抵抗するように配向された複数のリテーナ103aを含む。反対に、第2の留置縫合糸セグメント102bは、組織内にあるとき、第2のセグメント102bの遠位端又は展開端104bの動きの方向に組織を通るセグメント102bの動きに抵抗し、かつ端部104bの動きの方向と反対の方向に組織を通るセグメントの動きに抵抗するように配向された複数のリテーナ103bを含む。所望により、セグメント102aは、針112aに固着されてもよく、所望によりセグメント102bは針112bに固着されてもよく、いずれかの又は両方の針は、所望により、図1に示すように曲がっていてもよい。
本発明の縫合糸は、図10に示す例などの、一方向性の実施形態も含む。縫合糸1000は、留置縫合糸セグメント1002と、セグメント1002の近位端で脱離要素1008に近接するアンカー要素1006と、を含む。留置縫合糸セグメント1002は、組織内にあるとき、鋭い端部1004の動きの方向に組織を通るセグメント1002の動きを容認し、かつ端部1004の動きの方向と反対の方向に組織を通る縫合糸の動きに抵抗するように配向された複数のリテーナ1003を含む。縫合糸が一旦組織内に完全に展開されると、把持係合アンカー1006が端部1004に向かう方向の縫合糸の動きに抵抗するように作用する。脱離要素1008は、セグメント1002から要素1006を除去できるように、強く引くこと、曲げること、又はねじることなどの破壊動作を要するように適合され、脆い材料、縫合糸材料のより小さい直径(それによって、縫合糸の他の部分よりも引張り強さが低い)又は取り外し可能なコネクタを備えてもよい。
留置縫合糸システムは、3つ以上の縫合糸セグメントを備えてもよい。留置縫合糸システムは、用途により、最高約10個の縫合糸セグメント又はより多くを含む、1つ、2つ又はそれより多くの縫合糸セグメントを有してもよい。例えば、図11に示すように、縫合糸システム1100は、中央リング1106から放射する5つの留置縫合糸セグメント1102a〜eを有する。それぞれの縫合糸セグメント1102a〜eは、針をその展開端部1104a〜eに、及びコネクタ1108a〜1108eをその他の端部に有し、それぞれのコネクタは、そのそれぞれの縫合糸セグメントをリング1106に接合する。患者に対してより良好な医療が利用可能となったときに、リングの除去及びそれに続く縫合糸セグメントの一時的な創傷閉鎖からの除去を容易にするために、コネクタは、全体として又は部分的に脆い材料で製造されてもよい。あるいは、コネクタは、縫合糸システムの除去の前に、縫合糸セグメントから切断されてもよい。
本明細書で説明した縫合糸及びシステムは、縫合糸セグメント、端部及び把持係合要素がからまるのを防止し、縫合糸又はシステムの、パッケージからの容易な取り出しを提供するために適合するようにパッケージ内に装填されてもよい。
本明細書に記載の縫合スレッドは、制限なしに、射出成形、スタンピング、切断、レーザー、押出し成形等を含む任意の適切な方法によって生成されてもよい。切削に関しては、高分子スレッド又はフィラメントは、縫合糸本体用に製造又は購入されてもよく、その後リテーナを縫合糸本体上に切り込むことができ、リテーナは、手動切断、レーザー切断、又は切削刃、切削砥石、砥石車等を用いた機械的に機械切削されてもよい。切削の間に、切り込み210の大きさ、形状及び深さを制御するために、切削装置又は縫合糸のいずれかが互いに対して移動されてもよく、又は両方が移動されてもよい。フィラメント上でバーブを切り込むための特定の方法は、表題「Method Of Forming Barbs On A Suture And Apparatus For Performing Same」のGenovaらの米国特許出願整理番号第09/943,733号、及び表題「Barbed Sutures」のLeungらの米国特許出願整理番号第10/065,280号に記載され、これらの両方は、参照により本明細書に組み込まれる。縫合スレッドは、任意の適切な生体適合性材料で製作されてもよく、縫合糸の強度、弾力性、寿命、又は他の品質を向上させるために、あるいは、組織を互いに接合すること、組織を再位置決めすること、又は外的要素を組織に付着させることの他に、更なる機能を果たすように縫合糸を備えるために、任意の適切な生体適合性材料で更に処理されていてもよい。
(1) 取り外し可能な双方向性留置縫合糸であって、
a.第1の端部、第2の端部、及び周辺部と、
b.複数のリテーナであって、前記第1の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第1の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸の動きを防止する、前記縫合糸の前記第1の端部と前記縫合糸上の第1の軸方向位置との間の、前記縫合糸の第1の部分上のリテーナ、及び前記第2の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第2の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸の動きを防止する、前記縫合糸の前記第2の端部と前記縫合糸上の第2の軸方向位置との間の、前記縫合糸の第2の部分上のリテーナと、
c.前記第1の軸方向位置と前記第2の軸方向位置との間の把持係合要素と、を備える、縫合糸。
(2) 前記把持係合要素がループを備える、実施態様1に記載の縫合糸。
(3) 前記ループが不連続的である、実施態様2に記載の縫合糸。
(4) 前記把持係合要素がタブを備える、実施態様1に記載の縫合糸。
(5) 前記把持係合要素が、縫合糸セグメントを備え、前記縫合糸セグメントが、そのそれぞれの端部に、前記縫合糸セグメントが組織内に入るのを防止するための止め具を有する、実施態様1に記載の縫合糸。
(7) 前記縫合糸が、前記把持係合要素と前記第1の軸方向位置及び前記第2の軸方向位置との間に、前記縫合糸からの前記把持係合要素の除去を容易にするための脆い部分を更に備える、実施態様6に記載の縫合糸。
(8) 前記把持係合要素が、強化された把持表面を更に備える、実施態様6に記載の縫合糸。
(9) 前記把持係合要素が、前記縫合糸の前記周辺部よりも大きい周辺部を有する、実施態様1に記載の縫合糸。
(10) 前記縫合糸が、前記把持係合要素と前記第1の軸方向位置及び前記第2の軸方向位置との間に、前記縫合糸からの前記把持係合要素の除去を容易にするための脆い部分を更に備える、実施態様9に記載の縫合糸。
(12) 前記把持係合要素が、強化された把持表面を更に備える、実施態様1に記載の縫合糸。
(13) 前記縫合糸が、前記把持係合要素と前記第1の軸方向位置及び前記第2の軸方向位置との間に、前記縫合糸からの前記把持係合要素の除去を容易にするための脆い部分を更に備える、実施態様1に記載の縫合糸。
(14) 前記把持係合要素と前記縫合糸とを接続する、取り外し可能なコネクタを更に備える、実施態様1に記載の縫合糸。
(15) 前記把持係合要素が少なくとも部分的に可撓性である、実施態様1に記載の縫合糸。
(17) 前記把持係合要素が、前記縫合糸の残りの部分とは異なる材料を含む、実施態様1に記載の縫合糸。
(18) 前記ループの構成が、円、楕円、及び多角形を含むクラスから選択される、実施態様2に記載の縫合糸。
(19) 取り外し可能な多方向性留置システムであって、
a.把持係合要素と、
b.少なくとも3つの縫合糸セグメントであって、それぞれの縫合糸セグメントが、前記縫合糸セグメントの第1の端部と前記縫合糸セグメントの第2の端部との間に、前記第1の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第1の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸セグメントの動きを防止するように複数のリテーナを有し、それぞれの縫合糸セグメントの第2の端部が前記把持係合要素に付着された、縫合糸セグメントと、を備える、取り外し可能な多方向性留置システム。
(20) 前記把持係合要素がループを備える、実施態様19に記載のシステム。
(22) 前記把持係合要素がタブを備える、実施態様19に記載のシステム。
(23) 前記把持係合要素が、縫合糸セグメントを備え、前記縫合糸セグメントが、そのそれぞれの端部に、前記縫合糸セグメントが組織内に入るのを防止するための止め具を有する、実施態様19に記載のシステム。
(24) 前記ループが円状である、実施態様20に記載のシステム。
(25) 前記ループが楕円状である、実施態様20に記載のシステム。
(27) 緊急の創傷閉鎖の方法であって、
a.双方向性留置縫合糸を提供することであって、前記縫合糸が、複数のリテーナであって、前記縫合糸の第1の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第1の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸の動きを防止するための、前記縫合糸の前記第1の端部と前記縫合糸上の第1の軸方向位置との間の前記縫合糸の第1の部分の上のリテーナ、並びに前記縫合糸の第2の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第2の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸の動きを防止するための、前記縫合糸の前記第2の端部と前記縫合糸上の第2の軸方向位置との間の前記縫合糸の第2の部分の上のリテーナ、を有する、双方向性留置縫合糸を提供することと、
b.前記縫合糸の前記第1の端部を、前記創傷の第1の端部と第2の端部との間の第1の挿入点で組織内に挿入することと、
c.前記縫合糸の前記第1の端部を、第1の展開経路に沿って、前記創傷の交互の側の組織を通して、第1の出口点まで、前記創傷の前記第1の端部に向かって引くことと、
d.前記縫合糸の前記第2の端部を、前記創傷の前記第1の端部と前記第2の端部との間の第2の挿入点で、前記縫合糸の前記第1の挿入点と前記第2の挿入点との間の部分を残して、組織内に挿入することと、
e.前記縫合糸の前記第2の端部を、第2の展開経路に沿って、前記創傷の交互の側の組織を通して、第2の出口点まで、前記創傷の前記第2の端部に向かって引くことと、
f.恒久的な治療の前に、前記創傷からの前記縫合糸の除去のために、前記第1の挿入点と前記第2の挿入点との間の前記部分に沿って、前記縫合糸を切断することと、を含む、方法。
(28) 前記縫合糸の前記第2の端部を組織内に挿入する工程が、前記縫合糸の前記第1の端部を前記創傷の前記第1の端部に向かって引く工程の前に遂行される、実施態様27に記載の方法。
(29) 緊急の創傷閉鎖の方法であって、
a.一方向性留置縫合糸を提供することであって、前記縫合糸が、前記縫合糸の第1の端部と第2の端部との間における、前記第1の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第1の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸の動きを防止する複数のリテーナ、及び前記縫合糸の前記第2の端部における把持係合要素を有する、縫合糸を提供することと、
b.前記把持係合要素を少なくとも部分的に前記創傷の外側に位置付けることと、
c.前記縫合糸の前記第1の端部を前記創傷の挿入点において組織内に挿入することと、
d.前記縫合糸の前記第1の端部を展開経路に沿って、前記創傷の交互の側の組織を通して、前記組織の外側の出口点まで、前記創傷の端部に向かって引くことと、を含む、方法。
(30) 前記一方向性縫合糸が、前記把持係合要素の近位にある脆い部分を更に備える、実施態様29に記載の方法。
a.多方向性留置システムを提供することであって、前記システムが、把持係合要素、及び少なくとも2つの縫合糸セグメントであって、それぞれの縫合糸セグメントが、前記縫合糸セグメントの第1の端部と前記縫合糸セグメントの第2の端部との間に、前記第1の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第1の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸セグメントの動きを防止するように複数のリテーナを有し、それぞれの縫合糸セグメントの第2の端部が前記把持係合要素に付着された、縫合糸セグメントを有する、システムを提供することと、
b.前記把持係合要素を少なくとも部分的に前記創傷の外側に位置付けることと、
c.第1の縫合糸セグメントの前記第1の端部を、前記創傷の第1の挿入点において組織内に挿入することと、
d.前記第1の縫合糸セグメントの前記第1の端部を、第1の展開経路に沿って、前記創傷の交互の側の組織を通して、第1の出口点まで、前記創傷の第1の端部に向かって引くことと、
e.第2の縫合糸セグメントの前記第1の端部を、前記第1の挿入点の近位にある第2の挿入点において、組織内に挿入することと、
f.前記第2の縫合糸セグメントの前記第1の端部を、第2の展開経路に沿って、前記創傷の交互の側の組織を通して、第2の出口点まで、前記創傷の第2の端部に向かって引くことと、を含む、方法。
(32) 前記留置システムが、少なくとも第3の縫合糸セグメントを備え、前記第3の縫合糸セグメントが、前記縫合糸セグメントの第1の端部と前記縫合糸セグメントの第2の端部との間に、前記第1の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第1の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸セグメントの動きを防止するように複数のリテーナを有し、前記第3の縫合糸セグメントの前記第2の端部が前記把持係合要素に付着される、実施態様31に記載の方法。
(33) 前記第3の縫合糸セグメントの前記第1の端部を、前記第1の挿入点及び前記第2の挿入点のうちの少なくとも1つの近位にある第3の挿入点において、組織内に挿入することと、前記第3の縫合糸セグメントの前記第1の端部を、第3の展開経路に沿って、前記創傷の交互の側の組織を通して、第3の出口点まで、前記創傷の第3の端部に向かって引くことと、を更に含む、実施態様32に記載の方法。
(34) 前記把持係合要素が前記縫合糸セグメント間の接続を備える、実施態様31に記載の方法。
(35) 少なくとも3つの組織の頂点を有する星状の創傷緊急閉鎖を達成する方法であって、
a.多方向性留置システムを提供することであって、前記システムが、把持係合要素、及び少なくとも3つの縫合糸セグメントであって、それぞれの縫合糸セグメントが、前記縫合糸セグメントの第1の端部と前記縫合糸セグメントの第2の端部との間に、前記第1の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第1の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸セグメントの動きを防止するように複数のリテーナを有し、それぞれの縫合糸セグメントの第2の端部が前記把持係合要素に付着された、縫合糸セグメントを有する、システムを提供することと、
b.前記組織の頂点の近位に前記把持係合要素を位置付けることと、
c.第1の縫合糸セグメントの前記第1の端部を第1の組織の頂点内に挿入し、かつ前記第1の縫合糸セグメントの前記第1の端部を前記組織の外に引くことと、
d.第2の縫合糸セグメントの前記第1の端部を第2の組織の頂点内に挿入し、かつ前記第2の縫合糸セグメントの前記第1の端部を前記組織の外に引くことと、
e.第3の縫合糸セグメントの前記第1の端部を第3の組織の頂点において組織内に挿入し、かつ前記第3の縫合糸セグメントの前記第1の端部を前記組織の外に引くことと、を含む、方法。
a.前記把持係合要素を前記縫合糸セグメントから切断することと、
b.前記縫合糸セグメントを、その第2の端部によって前記組織の外へ引くことと、を含む、方法。
Claims (9)
- 取り外し可能な双方向性留置縫合糸であって、
a.第1の端部、第2の端部、及び周辺部と、
b.複数のリテーナであって、前記第1の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第1の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸の動きを防止する、前記縫合糸の前記第1の端部と前記縫合糸上の第1の軸方向位置との間の、前記縫合糸の第1の部分上のリテーナ、及び前記第2の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第2の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸の動きを防止する、前記縫合糸の前記第2の端部と前記縫合糸上の第2の軸方向位置との間の、前記縫合糸の第2の部分上のリテーナと、
c.前記第1の軸方向位置と前記第2の軸方向位置との間の前記周辺部から連続的に延びるリングまたは閉ループを含む把持係合要素と、を備える、縫合糸。 - 前記把持係合要素が、縫合糸セグメントを備え、前記縫合糸セグメントが、そのそれぞれの端部に、前記縫合糸セグメントが組織内に入るのを防止するための止め具を有する、請求項1に記載の縫合糸。
- 前記把持係合要素が、前記縫合糸の前記周辺部よりも大きい周辺部を有する、請求項1に記載の縫合糸。
- 前記把持係合要素が、強化された把持表面を更に備える、請求項1〜3のいずれか一項に記載の縫合糸。
- 前記縫合糸が、前記把持係合要素と前記第1の軸方向位置及び前記第2の軸方向位置との間に、前記縫合糸からの前記把持係合要素の除去を容易にするための脆い部分を更に備える、請求項1に記載の縫合糸。
- 前記把持係合要素と前記縫合糸とを接続する、取り外し可能なコネクタを更に備える、請求項1に記載の縫合糸。
- 前記把持係合要素が、前記縫合糸の残りの部分とは異なる材料を含む、請求項1に記載の縫合糸。
- 取り外し可能な多方向性留置システムであって、
a.把持係合要素と、
b.少なくとも3つの縫合糸セグメントであって、それぞれの縫合糸セグメントが、前記縫合糸セグメントの第1の端部と前記縫合糸セグメントの第2の端部との間に、前記第1の端部の動きの方向に組織を通る前記縫合糸の動きを容認し、かつ前記第1の端部の前記動きの方向と反対の方向に組織を通る前記縫合糸セグメントの動きを防止するように複数のリテーナを有し、それぞれの縫合糸セグメントの第2の端部が前記把持係合要素に付着された、縫合糸セグメントと、を備え、
前記把持係合要素が前記縫合糸セグメントから連続的に延びるリングまたは閉ループを含む、取り外し可能な多方向性留置システム。 - 前記把持係合要素が、縫合糸セグメントを備え、前記縫合糸セグメントが、そのそれぞれの端部に、前記縫合糸セグメントが組織内に入るのを防止するための止め具を有する、請求項8に記載のシステム。
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EP3138506A1 (en) | 2017-03-08 |
WO2012064902A3 (en) | 2012-08-02 |
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EP2637574A4 (en) | 2014-09-24 |
BR112013011582A2 (pt) | 2016-08-09 |
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