JP7410130B2 - Healing promotion device - Google Patents

Description

TECHNICAL FIELD The present invention relates to a healing promoting device.

In the medical field, techniques for surgically joining biological organs (for example, gastrointestinal anastomosis) are known. It is also known that when the above-mentioned procedure is performed, it is important as a postoperative prognostic factor that there is no delay in healing at the junction where living organs are joined.

Various methods and medical instruments are used to join biological organs. For example, there are methods for suturing living organs with biodegradable suture threads, and mechanical joining devices that perform anastomosis using staplers (see Patent Document 1). ) has been proposed. In particular, when performing anastomosis using a mechanical joining device, it is possible to increase the joining force between living organs at the joint compared to methods using sutures, which reduces the risk of suture failure. becomes possible.

Special Publication No. 2007-505708

However, the degree of progression of fusion at the joint also depends on the state of the living tissue at the site to be joined (site to be joined) of the patient. Therefore, even when using a joining device such as that described in Patent Document 1, for example, it may not be possible to sufficiently reduce the risk of suture failure depending on the state of the patient's living tissue.

Therefore, an object of the present invention is to provide a fusion promoting device that can reduce the risk of suturing failure after a surgical operation or the like.

A fusion promoting device according to an embodiment of the present invention is a fusion promoting device used when joining the digestive tract that has been cut due to the resection of the digestive tract, and the device is a fusion promoting device that is used to join the digestive tract that has been cut due to the resection of the digestive tract, and is configured to connect one part of the digestive tract to be joined to the other part. a sheet-like main body that is disposed between the to-be-joined parts and promotes the fusion of living tissues; and a suppressing part that suppresses fusion between the extending part and living tissue located on the outer periphery of the extending part, the suppressing part being arranged in a circumferential direction on the outer periphery of the extending part. are arranged uniformly along the

According to the fusion promoting device of the present invention, by sandwiching the main body between the living organs to be joined, it is possible to promote the fusion of the living tissues of the living organs. Moreover, since the healing promoting device includes an extension portion that covers the region to be joined, it is possible to suppress the main body portion from falling off from the living organ. From the above, the operator can effectively reduce the risk of suturing failure of living organs.

FIG. 1 is a perspective view showing a healing promoting device according to an embodiment of the present invention. FIG. 1 is a plan view showing a healing promoting device according to the present embodiment. 3 is a sectional view taken along line 3-3 in FIG. 2. FIG. FIG. 3 is an enlarged cross-sectional view of a part of the cross section taken along line 4-4 in FIG. 2; 4 is a diagram corresponding to FIG. 3 of a healing promoting device according to modification 1. FIG. 4 is a diagram corresponding to FIG. 3 of a healing promoting device according to modification 2. FIG. 4 is a diagram corresponding to FIG. 3 of a healing promoting device according to modification 3. FIG. 4 is a diagram corresponding to FIG. 3 of a healing promoting device according to modification example 4. FIG. It is a flow chart showing each procedure of a treatment method using a healing promoting device. It is a flowchart showing the procedure of an embodiment of the treatment method (colon anastomosis). FIG. 2 is a schematic cross-sectional perspective view for explaining colorectal anastomosis. FIG. 2 is a schematic cross-sectional view for explaining colorectal anastomosis. FIG. 2 is a schematic cross-sectional view for explaining colorectal anastomosis. FIG. 2 is a schematic cross-sectional view for explaining colorectal anastomosis.

Embodiments of the present invention will be described below with reference to the accompanying drawings. In addition, in the description of the drawings, the same elements are given the same reference numerals, and redundant description will be omitted. Further, the dimensional ratios in the drawings are exaggerated for convenience of explanation and may differ from the actual ratios.

1 to 4 are diagrams for explaining the configuration of a healing promoting device 100 according to an embodiment of the present invention.

<Healing promotion device 100>
As shown in FIGS. 11 to 14, the fusion promoting device 100 can be applied to procedures for joining predetermined biological organs (eg, gastrointestinal anastomosis). As will be described later, in the description herein, a colon anastomosis will be described as an example of a procedure using the fusion promoting device 100.

As shown in FIGS. 1 to 3, the fusion promoting device 100 includes a main body 10 disposed between one body part and the other body organ to be joined; The extending portion 20 extends along the intersecting direction (vertical direction in FIG. 3) that intersects the plane direction (the paper direction in FIG. 2), and the suppressing portion 30 is fixed to the outer peripheral side of the extending portion 20. have Each configuration of the healing promoting device 100 will be described below.

<Main body part 10>
The main body portion 10 has a sheet shape that promotes healing of living tissues. The main body portion 10 can be formed of, for example, a biodegradable sheet member (thin film-like member).

A plurality of through holes 15 are formed in the main body portion 10 . As shown in FIGS. 1 and 2, the plurality of through holes 15 are provided regularly and periodically in the surface direction of the main body portion 10. As shown in FIGS. However, the plurality of through holes 15 may be provided randomly in the surface direction of the main body portion 10.

As shown in FIG. 4, the through hole 15 extends substantially perpendicularly between the front surface 11 and the back surface 12 along the thickness direction of the main body portion 10 (vertical direction in FIG. 4). Note that the through hole 15 may be bent in a zigzag shape or curved between the front surface 11 and the back surface 12 in a cross section along the thickness direction of the main body portion 10.

The through hole 15 has a substantially circular planar shape (the shape when the front surface 11 or the back surface 12 of the main body portion 10 is viewed from above). However, the planar shape of the through hole 15 is not particularly limited, and may be, for example, an ellipse or a polygon (rectangle, triangle, etc.). Further, each through hole 15 may have a different planar shape or a different cross-sectional shape.

The main body portion 10 has a substantially circular shape. However, the shape of the main body portion 10 is not particularly limited, and may be, for example, an ellipse or a polygon (rectangle, triangle, etc.).

The thickness T (see FIG. 4) of the main body portion 10 is not particularly limited, but is preferably 0.05 to 0.3 mm, more preferably 0.1 to 0.2 mm. When the thickness of the main body part 10 is 0.05 mm or more (especially when it is 0.1 mm or more), the main body part 10 can be provided with enough strength to not be damaged when the healing promoting device 100 is handled. On the other hand, when the thickness of the main body part 10 is 0.3 mm or less (especially when it is 0.2 mm or less), the main body part 10 closely adheres to the living tissue to which the main body part 10 is applied and follows the living tissue. It can be provided with sufficient flexibility.

The main body 10 has a ratio of the diameter D of the through holes 15 (the distance D shown in FIG. 4) to the pitch P of the through holes 15 (the distance P shown in FIG. 4, which is the distance between adjacent through holes 15). is preferably 0.25 or more and less than 40. Note that when the planar shape of the through hole 15 is a perfect circle, the hole diameter D of the through hole 15 is equal to the diameter of the perfect circle. On the other hand, when the planar shape of the through hole 15 is not a perfect circle, the diameter of a perfect circle ( (equivalent circle diameter) can be set as the hole diameter D of the through hole 15.

Since the main body portion 10 has a plurality of through holes 15, there are multiple values of the hole diameter D corresponding to each through hole 15. Therefore, in this embodiment, when calculating the value of the ratio described above, the arithmetic mean value of two or more points of the hole diameter D values corresponding to the plurality of through holes 15 is used as the representative value of the hole diameter D. . On the other hand, the pitch P of the plurality of through holes 15 is defined as the shortest distance between the openings of two through holes 15. However, regarding the value of pitch P, there are a plurality of values of pitch P corresponding to combinations of adjacent through holes 15. Therefore, in this embodiment, when calculating the above ratio value, the arithmetic mean value of two or more pitch P values corresponding to the combinations of adjacent through holes 15 is used as the representative value of the pitch P. shall be.

Note that the pitch P of the through holes 15, the hole diameter D, the ratio of the hole diameter D to the pitch P, etc. are merely examples, and the present invention is not limited thereto.

As shown in FIGS. 1 to 3, the main body portion 10 has a hole 16 near the center. The hole 16 may be formed in the main body 10 in advance, or may be created by the surgeon during the procedure.

The main body 10 can be made of biodegradable material. There are no particular limitations on the material of the main body 10, and examples thereof include biodegradable resin. Examples of biodegradable resins include known ones such as those described in Japanese Translated Patent Publication No. 2011-528275, Japanese Translated Patent Application Publication No. 2008-514719, International Publication No. 2008-1952, Japanese Translated Patent Publication No. 2004-509205, etc. Biodegradable (co)polymers can be used. Specifically, (1) selected from the group consisting of aliphatic polyester, polyester, polyacid anhydride, polyorthoester, polycarbonate, polyphosphazene, polyphosphate, polyvinyl alcohol, polypeptide, polysaccharide, protein, and cellulose. Polymer; (2) Examples include copolymers composed of one or more monomers constituting the above (1). That is, the biodegradable sheet is selected from the group consisting of aliphatic polyesters, polyesters, polyanhydrides, polyorthoesters, polycarbonates, polyphosphazenes, polyphosphates, polyvinyl alcohols, polypeptides, polysaccharides, proteins, and cellulose. It is preferable that at least one biodegradable resin selected from the group consisting of a polymer and a copolymer composed of one or more monomers constituting the polymer is included.

Although the method for manufacturing the main body portion 10 is not particularly limited, for example, a method may be mentioned in which fibers made of the above-mentioned biodegradable resin are manufactured and a mesh-shaped sheet is manufactured using the fibers. Methods for producing fibers made of biodegradable resin are not particularly limited, and include, for example, electrospinning (electrospinning, electrostatic spinning), melt blowing, and the like. The main body part 10 may select and use only one type of the above-mentioned methods, or may select two or more types and combine them as appropriate. In addition, as another example of the manufacturing method of the main body part 10, the biodegradable sheet according to the present invention can be produced by spinning fibers made of the above-mentioned biodegradable resin according to a conventional method and knitting the obtained fibers into a mesh shape. May be manufactured.

The main body part 10 induces a biological reaction by the constituent material such as biodegradable resin that constitutes the main body part 10 . Through this action, the main body 10 induces the expression of biological components such as fibrin. The biocomponents thus induced can penetrate through the through holes 15 of the main body 10 and accumulate, thereby promoting healing. Therefore, by arranging the main body portion 10 between the biological organs to be joined, fusion is promoted by the above-described mechanism.

Note that the material of the main body portion 10 does not need to be biodegradable as long as it can promote fusion of living organs. Moreover, the main body part 10 does not need to have the through-hole 15 formed therein, regardless of the material, as long as it is possible to promote the fusion of living organs.

<Extension part 20>
As shown in FIG. 3, the extension part 20 is constructed continuously and integrally with the main body part 10. The extension part 20 extends downward in FIG. 3 from the outer peripheral edge of the main body part 10. The extension portion 20 has a size that can cover the region to be joined (see FIG. 11). In other words, the inner diameter of the extending portion 20 is configured to be larger than the outer diameter of the part to be joined.

As shown in FIGS. 1 to 3, the extending portion 20 is configured to extend from the main body portion 10 along one side in the intersecting direction (only the lower side in FIG. 3).

As shown in FIGS. 1 and 3, a plurality of through holes 25 are formed in the extension portion 20, similarly to the main body portion 10. The pitch, hole diameter, direction, shape, etc. in which the through holes 25 of the extension portion 20 are provided are the same as those of the through holes 15 provided in the main body portion 10, and therefore, description thereof will be omitted. Further, like the main body portion 10, the extension portion 20 can be made of a biodegradable material.

Note that the material of the extension portion 20 does not need to be biodegradable as long as it can promote fusion of living organs. Moreover, the extension part 10 does not need to have the through-hole 25 formed therein, regardless of the material, as long as it is possible to promote the fusion of living organs.

Further, it is preferable that the thickness T1 (see FIG. 3) of the extension portion 20 is the same as the thickness T of the main body portion 10. Note that the thickness T1 of the extending portion 20 may be different from the thickness T of the main body portion 10.

Further, in the extending portion 20, the value of the ratio of the hole diameter of the through holes 25 to the pitch of the through holes 25 may be the same as the value of the ratio of the hole diameter of the through holes 15 to the pitch of the through holes 15 in the main body portion 10. can. In addition, in the extending portion 20, the value of the ratio of the hole diameter of the through holes 25 to the pitch of the through holes 25 may be different from the value of the ratio of the hole diameter of the through holes 15 to the pitch of the through holes 15 in the main body portion 10. .

The extension portion 20 is formed by being shaped integrally and continuously with the main body portion 10 .

<Suppression part 30>
The suppressing portion 30 suppresses fusion between the extending portion 20 and living tissue located on the outer periphery of the extending portion 20 . In this embodiment, the suppressing part 30 is a covering member fixed to the outer peripheral side of the extending part 20. Although the method of fixing the suppressing part 30 to the extending part 20 is not particularly limited, it may be fixed using an adhesive, for example.

The material constituting the suppressing portion 30 is not limited as long as healing can be suppressed, but for example, nonwoven fabric can be used. Further, the suppressing portion 30 can be made of a biodegradable material similarly to the main body portion 10.

In this embodiment, the suppressing parts 30 are uniformly arranged along the circumferential direction on the outer periphery of the extending part 20, as shown in FIG.

According to the fusion promoting device 100 configured as described above, the mesh size is prepared to be larger than the anastomosis diameter, taking into account that the intestinal thickness differs from person to person, so that even if the mesh protrudes from the anastomosis, Since the protruding portion forms an extension part 20 along the extending direction of the intestinal tract and a suppressing part 30 is provided on the outer periphery of the extension part 20, the fusion promoting device 100 may unintentionally adhere to surrounding tissues. This can be prevented.

As described above, the fusion promoting device 100 according to the present embodiment has a sheet-like shape that is placed between one part of a living organ to be joined and another part to be joined, and promotes the fusion of living tissues. It has a main body part 10, and an extension part 20 that extends along a direction intersecting the surface direction of the main body part 10 and covers a part to be joined. According to the healing promoting device 100 configured in this manner, by sandwiching the main body portion 10 between the living organs to be joined, it is possible to promote healing of the living tissues of the living organs. Moreover, since the healing promoting device 100 includes the extension portion 20 that covers the region to be joined, it is possible to suppress the main body portion 10 from falling off from the living organ. Moreover, the extension part 20 can further suppress the main body part 10 from falling off from the living organ due to the extension part 20 itself adhering to the living organ. Furthermore, even if the body fluid inside the biological organ leaks from the gap between the extension portion 20 and the biological organ, further leakage may occur due to the extension portion 20 itself adhering to the biological organ. can be prevented. From the above, the operator can effectively reduce the risk of suturing failure of living organs.

Further, the extending portion 20 extends from the main body portion 10 along only one side in the intersecting direction. According to the healing promoting device 100 configured in this manner, it is possible to suppress the main body portion 10 from falling off from the living organ with a simple configuration.

The healing promoting device 100 further includes a suppressing portion 30 that suppresses healing between the extending portion 20 and the living tissue located on the outer periphery of the extending portion 20. According to the fusion promoting device 100 configured in this way, even if the mesh size is prepared to be larger than the anastomosis diameter in consideration of the fact that the intestinal thickness differs from person to person, even if the mesh protrudes from the anastomosis, Since the protruding portion forms an extension part 20 along the extending direction of the intestinal tract and a suppressing part 30 is provided on the outer periphery of the extension part 20, the fusion promoting device 100 is prevented from unintentionally adhering to surrounding tissue. can be prevented.

Moreover, the suppressing part 30 is a covering member fixed to the outer peripheral side of the extending part 20. According to the healing promoting device 100 configured in this way, it is possible to prevent the healing promoting device 100 from unintentionally adhering to surrounding tissue with a simple configuration.

Although the healing promoting device 100 has been described above through the embodiments, it is not limited to the description of the embodiments, and various modifications can be made without departing from the gist thereof. Modifications of the healing promoting device will be described below. In the description of the modification, the description of the configuration and contents described in the healing promoting device 100 according to the above-described embodiment will be omitted as appropriate.

<Modification 1>
With reference to FIG. 5, the configuration of a healing promoting device 200 according to Modification 1 will be described. FIG. 5 is a diagram corresponding to FIG. 3 of a healing promoting device 200 according to modification 1.

As shown in FIG. 5, the fusion promoting device 200 according to Modification 1 includes a main body 10 disposed between one joint site and the other joint site of biological organs to be joined; It has an extending portion 120 that extends along the intersecting direction (vertical direction in FIG. 5) that intersects with the surface direction of FIG. The main body part 10 has the same configuration as the main body part 10 of the healing promoting device 100 according to the embodiment described above, so a description thereof will be omitted.

As shown in FIG. 5, the extension portion 120 is constructed continuously and integrally with the main body portion 10. The inner diameter of the extending portion 120 is configured to be larger than a region E1 where a first engagement device 710 and a second engagement device 720, which will be described later, face each other and overlap with the main body 10 in between. Further, the inner diameter of the extending portion 120 is configured to be larger than the outer diameter of the welded portion.

As shown in FIG. 5, the extending portion 120 is configured to extend from the outer peripheral edge of the main body portion 10 along both sides in the intersecting direction (vertical direction in FIG. 5).

The extending portion 120 is provided with a through hole 125, as shown in FIG. The pitch, hole diameter, direction, shape, etc. of the through-holes 125 are the same as those of the through-holes 25 of the extension portion 20 of the healing promoting device 100 according to the first embodiment, and therefore the description thereof will be omitted.

According to the healing promoting device 200 configured as described above, since the extension portions 120 extend on both sides in the cross direction, it is possible to more preferably suppress the main body portion 10 from falling off from the living organ.

<Modification 2>
Next, with reference to FIG. 6, the configuration of a healing promoting device 300 according to Modification 2 will be described. FIG. 6 is a diagram corresponding to FIG. 3 of a healing promoting device 300 according to Modification 2. As shown in FIG.

As shown in FIG. 6, a healing promoting device 300 according to Modification 2 includes a main body 10 disposed between one joint site and the other joint site of biological organs to be joined; 10 (vertical direction in FIG. 6). The main body part 10 has the same configuration as the main body part 10 of the healing promoting device 100 according to the embodiment described above, so a description thereof will be omitted.

In modification 2, the extension portion 220 is configured separately from the main body portion 10. In Modification 2, the extending portion 220 also functions as a suppressing portion 230. The extension portion 220 is configured to extend from the outer peripheral edge of the main body portion 10 .

As the material constituting the extension part 220, the same material as the suppressing part 30 of the healing promoting device 100 according to the embodiment can be used.

According to the healing promoting device 300 configured as above, since the extending portion 220 can also be used as the suppressing portion 230, the healing promoting device 300 has a simpler configuration than the healing promoting device 100 according to the embodiment. The risk of suturing failure of living organs can be effectively reduced.

<Modification 3>
Next, with reference to FIG. 7, the configuration of a healing promoting device 400 according to modification example 3 will be described. FIG. 7 is a diagram corresponding to FIG. 3 of a healing promoting device 400 according to modification 3.

As shown in FIG. 7, a healing promoting device 400 according to modification 3 includes a main body 10 disposed between one joint site and the other joint site of biological organs to be joined; 10. The extension portion 20 extends along a cross direction (vertical direction in FIG. 7) that intersects with the surface direction of FIG.

The healing promoting device 400 according to the third modification is different from the healing promoting device 100 according to the embodiment in that the suppressing part 30 is not provided.

According to the fusion promoting device 400 configured in this way, fusion between the extension part 20 and the living tissue located on the outer periphery of the extension part 20 cannot be suppressed, but the main body part 10 is separated from the living organ. Falling off can be suppressed.

The fusion promoting device 400 according to the third modification further includes a suppressing part (not shown) that is provided separately from the extending part 20 and is configured to be movable in a direction crossing the extending part. You can. According to the healing promoting device 400 configured in this manner, the suppressing portion can suppress healing between the extending portion 20 and the living tissue located on the outer periphery of the extending portion 20.

<Modification 4>
Next, with reference to FIG. 8, the configuration of a healing promoting device 500 according to modification example 4 will be described. FIG. 8 is a diagram corresponding to FIG. 3 of a healing promoting device 500 according to modification 4.

The healing promoting device 500 according to the fourth modification intersects the main body 10 disposed between one joint site and the other joint site of the biological organ to be joined in the surface direction of the main body section 10. It has an extending portion 20 extending along the cross direction (vertical direction in FIG. 8) and a suppressing portion 530 fixed to the outer peripheral side of the extending portion 20. The main body part 10 and the extension part 20 have the same configuration as the main body part 10 and the extension part 20 of the healing promoting device 100 according to the embodiment described above, so the description thereof will be omitted.

As shown in FIG. 8, the suppressing portion 530 has an L-shaped tip so as to cover the end portion 20A of the extending portion 20.

According to the healing promoting device 500 configured in this manner, it is possible to suitably suppress the end portion 20A of the extending portion 20 from fusing with the surrounding tissue around the outer periphery of the extending portion 20.

<Embodiment of treatment method (biological organ anastomosis)>
Next, a treatment method using the healing promoting device will be explained.

FIG. 9 is a flowchart showing each procedure of the treatment method using the healing promoting device.

The treatment method includes placing a fusion promoting device having a sheet-like main body that promotes fusion of living tissues between one part to be joined and the other part to be joined to which living organs are to be joined (S11). , joining one part to be joined and the other part to be joined with at least a part of the main body of the fusion promoting device being placed between one part to be joined and the other part to be joined (S12); ,including.

The living organ to be joined by the treatment method and the part to be joined in the living organ are not particularly limited and can be arbitrarily selected. However, in the following explanation, a colon anastomosis will be used as an example. Further, as the healing promoting device used in each procedure described below, it is possible to select any one from among the healing healing devices described above, for example. However, in the following description, a usage example of the healing promoting device 100 according to the embodiment shown in FIG. 1 will be described as a typical example that can be suitably used for each procedure. Further, in each of the techniques described below, detailed descriptions of known technique procedures and known bonding devices will be omitted as appropriate.

Hereinafter, in the description of this specification, "arranging a fusion promoting device between living organs" means that the fusion promoting device is placed in direct or indirect contact with a living organ, The fusion promoting device is placed with a spatial gap formed between them, or the fusion promoting device is placed in both conditions (for example, the fusion promoting device is placed in contact with one biological organ). , the fusion promoting device is placed in a state where it is not in contact with the other biological organ). In addition, in the description of this specification, "periphery" does not define a strict range (area), but a predetermined range (area) as long as the purpose of treatment (connection of biological organs) can be achieved. means. In addition, the order of the procedural steps described in each treatment method can be changed as appropriate as long as the purpose of the treatment can be achieved. In addition, in the description of this specification, "relatively approach" means both to bring two or more objects to be brought closer to each other and to bring only one object closer to the other.

<Embodiment of treatment method (colon anastomosis)>
FIG. 10 is a flowchart showing the procedure of an embodiment of the treatment method (colorectal anastomosis), and FIGS. 11 to 14 are diagrams for explaining the colorectal anastomosis.

In the treatment method according to the present embodiment, the biological organ to be joined is a large intestine that has been cut due to the resection of a cancerous tumor. Specifically, the biological organs to be joined are the oral side A1 of the cut large intestine and the anal side A2 of the cut large intestine. In the following explanation, the procedure for joining the mouth area on the proximal side A1 of the cut large intestine (one part to be joined) and a part of the intestinal wall on the anal side A2 of the cut large intestine (the other part to be joined) is described. explain.

As shown in FIG. 10, the treatment method according to the present embodiment includes arranging a fusion promoting device 100 between the periphery of the mouth of the large intestine and the intestinal wall of the large intestine (S101); bringing the walls relatively close together (S102), sandwiching the main body 10 of the fusion promoting device 100 between the periphery of the mouth of the large intestine and the intestinal wall of the large intestine (S103), Joining the fusion promoting device 100 with the main body 10 sandwiched between the wall and the wall (S104), and placing the main body 10 of the fusion promoting device 100 between the periphery of the mouth of the large intestine and the intestinal wall of the large intestine. (S105).

Next, the treatment method according to this embodiment will be specifically explained with reference to FIGS. 11 to 14.

As shown in FIG. 11, the operator inserts the first engagement instrument 710 of the joining device 700 into the oral side A1 of the large intestine. The operator places the second engagement instrument 720 of the joining device 700 on the anal side A2 of the large intestine. Prior to placing the second engagement instrument 720 on the anal side A2 of the large intestine, the operator forms a through hole A21 in the anal side A2 of the large intestine for inserting the second engagement instrument 720 of the joining device 700. I'll keep it. Note that the timing of forming the through hole A21 is not particularly limited as long as it is before the second engagement instrument 720 is placed.

As the joining device 700, for example, a known device used for colorectal anastomosis can be used. Examples of the first engagement instrument 710 and the second engagement instrument 720 that constitute the joining device 700 include an anvil and a trocar. Along with the engagement of the first engagement instrument 710 and the second engagement instrument 720, the joining device 700 cuts the biological tissue disposed between the first engagement instrument 710 and the second engagement instrument 720. The circumference of the excised living tissue is sutured in a circumferential manner using staples. The first engagement instrument 710 is, for example, an instrument that includes a cylindrical engaged portion 711, and the second engagement instrument 720 is inserted into and engaged with the engaged portion 711 of the first engagement instrument 710, for example. This is an instrument equipped with an engaging pin 721 that is fitted together.

The operator inserts the engaged portion 711 of the first engaging instrument 710 into the oral side A1 of the large intestine, and performs purse string suturing with the engaged portion 711 protruding, thereby forming a sutured portion A11. The outer surface of the sutured portion A11 has a shape that partially protrudes toward the convex side due to suturing.

Next, as shown in FIGS. 11 and 12, the operator places the fusion promoting device 100 between the oral side A1 of the large intestine and the anal side A2 of the large intestine. At this time, the operator places the healing promoting device 100 so that the extension part 20 covers the proximal side A1 of the large intestine. Then, the operator passes the engaged portion 711 of the first engaging instrument 710 through the hole 16 of the main body portion 10 . Therefore, it is possible to prevent the healing promoting device 100 from falling off from the oral side A1 of the large intestine while the operator is performing the procedure.

Next, while maintaining the extension portion 20 covering the oral side A1 of the large intestine, the operator relatively moves the first engagement instrument 710 and the second engagement instrument 720 as shown in FIG. approach and engage. The operator places the first engaging instrument 710 and the second engaging instrument 720 around the mouth on the proximal side A1 of the large intestine, on the main body 10 of the healing promoting device 100, and on the intestinal wall on the anal side A2 of the large intestine. The periphery of the formed through hole A21 is sandwiched. The operator places a part of the proximal side A1 of the large intestine sandwiched between the first engaging instrument 710 and the second engaging instrument 720, a part of the main body 10 of the fusion promoting device 100, and the anus of the large intestine. A part of the side A2 is cut off by the joining device 700. At the same time, the surgeon operates the joining device 700 to join the circumference of the excised region with staples (not shown).

Next, as shown in FIG. 14, the operator takes the joining device 700 out of the living body, for example, from the anal side A2 of the large intestine through the anus. Here, in the above procedure, the joining device 700 punches out each constituent member sandwiched in the joining device 700 using a punching blade (not shown) built into the first engagement instrument 710 or the second engagement instrument 720. Therefore, the region E2 in which the joining device 700 punches out the joined biological organs is on the inner side of the region E1 where the first engagement instrument 710 and the second engagement instrument 720 face each other and overlap with the main body 10 in between. Located in

According to such a treatment method, a joining procedure (for example, gastrointestinal can reduce the risk of suture failure after anastomosis).

Further, since the fusion promoting device 100 used is configured such that the extension portion 20 covers the oral side A1 of the large intestine, the fusion promoting device 100 can be prevented from falling off from the living organ. Therefore, the risk of suturing failure after surgery or the like can be reduced.

In addition, in the healing promoting device 400 according to Modification Example 3, a suppressing part (not shown) that is provided separately from the extending part 20 and is configured to be movable in a direction crossing the extending part is further provided. In this configuration, as shown in FIG. 14, after the main body portion 10 is sandwiched, the suppressing portion can be moved and placed so as to cover the sandwiched portion.

This application is based on Japanese Patent Application No. 2019-064718 filed on March 28, 2019, the disclosure content of which is incorporated by reference in its entirety.

10 main body,
11 Surface,
12 Back side,
15 through hole,
16 hole,
20, 120, 220 extension part,
25, 125 through hole,
30, 130, 230, 530 suppressor,
100, 200, 300, 400, 500 healing promoting device,
700 joining equipment,
710 first engagement device,
711 Engaged part,
720 second engagement device,
721 Engagement pin,
A1 mouth side,
A11 suture part,
A2 Anal side,
A21 Through hole.

Claims (7)

This is a healing promoting device used when joining the digestive tract that has been cut due to the resection of the digestive tract, and is placed between one part of the digestive tract to be joined and the other part to be joined, and is used to promote the healing of living tissue. A sheet-like main body that promotes healing;
an extending portion extending along a cross direction intersecting a plane direction of the main body portion and covering the to-be-joined portion;
a suppressing part that suppresses fusion between the extending part and living tissue around the digestive tract located on the outer periphery of the extending part ,
The suppressing portion is a healing promoting device, wherein the suppressing portion is uniformly arranged along the circumferential direction on the outer periphery of the extending portion . The fusion promoting device according to claim 1, wherein the extension portion extends from the main body portion only along one side in the intersecting direction. The fusion promoting device according to claim 1, wherein the extending portion extends from the main body portion along both sides in the intersecting direction. The fusion promoting device according to any one of claims 1 to 3 , wherein the suppressing part is constituted by the extending part. The healing promoting device according to any one of claims 1 to 3 , wherein the suppressing part is a covering member fixed to the outer peripheral side of the extending part. The healing promoting device according to claim 5 , wherein the covering member is formed to cover an end portion of the extending portion located in the crossing direction. The healing promoting device according to any one of claims 1 to 3, wherein the suppressing part is provided separately from the extending part and is configured to be movable in the cross direction with respect to the extending part. device.