JPH0237773B2 - - Google Patents
Info
- Publication number
- JPH0237773B2 JPH0237773B2 JP60051352A JP5135285A JPH0237773B2 JP H0237773 B2 JPH0237773 B2 JP H0237773B2 JP 60051352 A JP60051352 A JP 60051352A JP 5135285 A JP5135285 A JP 5135285A JP H0237773 B2 JPH0237773 B2 JP H0237773B2
- Authority
- JP
- Japan
- Prior art keywords
- outer cylinder
- inner cylinder
- blood vessel
- incision
- cylinder
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
- 210000004204 blood vessel Anatomy 0.000 claims description 25
- 230000003872 anastomosis Effects 0.000 claims description 21
- 230000006835 compression Effects 0.000 claims description 2
- 238000007906 compression Methods 0.000 claims description 2
- 230000001681 protective effect Effects 0.000 claims 1
- 238000001356 surgical procedure Methods 0.000 description 15
- 210000004351 coronary vessel Anatomy 0.000 description 8
- 210000003462 vein Anatomy 0.000 description 8
- 230000002792 vascular Effects 0.000 description 5
- 208000007536 Thrombosis Diseases 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 239000000470 constituent Substances 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 230000003068 static effect Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Pathology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
Description
【発明の詳細な説明】
(1) 発明の目的
産業上の利用分野
本発明は手術時、特に血管吻合時に用いる血管
グラフトの切開口拡開器に関するものである。
グラフトの切開口拡開器に関するものである。
従来の技術
従来、血管吻合手術に際しては、医師による指
先とピンセツト、針及び糸により縫合する手技が
主であつた。唯、血管縫合器といわれる長手方向
に血管を接合する器具は知られているが、このよ
うな器具は血管側壁に設けた切開口バイパスを縫
合するような血管吻合には用いることができな
い。
先とピンセツト、針及び糸により縫合する手技が
主であつた。唯、血管縫合器といわれる長手方向
に血管を接合する器具は知られているが、このよ
うな器具は血管側壁に設けた切開口バイパスを縫
合するような血管吻合には用いることができな
い。
発明が解決しようとする問題点
静脈グラフトを用いて、冠動脈と吻合する冠動
脈バイパス手術のような場合、血管の吻合口が立
体時に展開され、良好な視野のもとで手術を行な
うことが、手術後の開存性を向上させるため重要
なことである。
脈バイパス手術のような場合、血管の吻合口が立
体時に展開され、良好な視野のもとで手術を行な
うことが、手術後の開存性を向上させるため重要
なことである。
しかるに、前記のようにピンセツトを用いて、
吻合口の展開を試みても、静止状態で立体的に、
良好な視野が得られるように切開口を保持するこ
とは極めて難しい手術となる。
吻合口の展開を試みても、静止状態で立体的に、
良好な視野が得られるように切開口を保持するこ
とは極めて難しい手術となる。
従つて、本発明は、血管吻合時にグラフトの切
開口を十分に拡開でき、安全で視野の十分とれる
器具を提供しようとするものである。
開口を十分に拡開でき、安全で視野の十分とれる
器具を提供しようとするものである。
(2) 発明の構成
問題点を解決するための手段
上記目的達成のため、本発明では血管内腔へ挿
入可能な細長い外筒と、この外筒とほぼ同じ長さ
で、外筒内へ摺動可能に挿入された内筒と、この
内筒の一端に取付けられ掌に入る程度の把持部
と、基部が前記内筒の他端に固定され、外筒内に
収納可能で、且つ、前記内筒が摺動して外筒によ
る圧縮が開放された時立的に拡開するよう附勢さ
れた複数本の線状部とから成る血管吻合用の切開
口拡開器とした。
入可能な細長い外筒と、この外筒とほぼ同じ長さ
で、外筒内へ摺動可能に挿入された内筒と、この
内筒の一端に取付けられ掌に入る程度の把持部
と、基部が前記内筒の他端に固定され、外筒内に
収納可能で、且つ、前記内筒が摺動して外筒によ
る圧縮が開放された時立的に拡開するよう附勢さ
れた複数本の線状部とから成る血管吻合用の切開
口拡開器とした。
作 用
本発明の血管吻合用の切開口拡開器は、外筒が
血管内腔へ挿入可能な細長いものとしたので、冠
動脈バイパス手術のような場合、静脈片をグラフ
トとして、中枢側断端より血管内腔へ挿入し、先
端がグラフトの切開口に位置するところで、把持
部と外筒を利用して、内筒を摺動させ、複数本の
線状部が外筒外へ出るようにすることにより、線
状部が拡開されて、切開口を外筒径より大きく拡
げることができるようになる。
血管内腔へ挿入可能な細長いものとしたので、冠
動脈バイパス手術のような場合、静脈片をグラフ
トとして、中枢側断端より血管内腔へ挿入し、先
端がグラフトの切開口に位置するところで、把持
部と外筒を利用して、内筒を摺動させ、複数本の
線状部が外筒外へ出るようにすることにより、線
状部が拡開されて、切開口を外筒径より大きく拡
げることができるようになる。
複数本の線状部の拡開には、外筒と把持部をも
つて相対的に摺動させ、線状部が外筒外へでるよ
うにすればよく、又血管内腔へ入れる場合、又術
後引出す場合には、線状部を外筒内に引込めれば
血管に何んらの傷を与えることなく、円滑に操作
ができる。
つて相対的に摺動させ、線状部が外筒外へでるよ
うにすればよく、又血管内腔へ入れる場合、又術
後引出す場合には、線状部を外筒内に引込めれば
血管に何んらの傷を与えることなく、円滑に操作
ができる。
実施例
図面は実施例を示すものである。第1図は本発
明切開口拡開器の斜視図で、第2図は内筒の線状
部が突出した状態を示す。
明切開口拡開器の斜視図で、第2図は内筒の線状
部が突出した状態を示す。
1は外筒、2は内筒である。この内筒2は外筒
とほぼ同じ程度の長さで、外筒内で摺動可能に挿
入されている。内筒2の一端には把持部3が取付
けられ、この把持部は掌に入る程度の大きさとな
つている。内筒2の他端には、基部4が内筒端に
固定された複数本の線状部5が取付けられ、これ
ら線状部5は外筒内に収納可能であると共に外筒
外へ出たときには、それぞれ外方へ拡開されるよ
う附勢されている。勿論、外方へ拡がる附勢力
は、血管の切開口を手術し易い程度に拡開するも
のであつて、血管を破壊するようなものであつて
はならない。又線状部5を先端に設けた丸み6は
血管内腔を保護するものである。
とほぼ同じ程度の長さで、外筒内で摺動可能に挿
入されている。内筒2の一端には把持部3が取付
けられ、この把持部は掌に入る程度の大きさとな
つている。内筒2の他端には、基部4が内筒端に
固定された複数本の線状部5が取付けられ、これ
ら線状部5は外筒内に収納可能であると共に外筒
外へ出たときには、それぞれ外方へ拡開されるよ
う附勢されている。勿論、外方へ拡がる附勢力
は、血管の切開口を手術し易い程度に拡開するも
のであつて、血管を破壊するようなものであつて
はならない。又線状部5を先端に設けた丸み6は
血管内腔を保護するものである。
外筒1と内筒2とは摺動可能で、相対的に摺動
され、内筒先端の線状部が外筒から出たところで
立体的に拡開されるようになつている。外筒1に
は突出した係合部7があり、把持部3には係止部
8があるので、両者を嵌合させることにより、内
筒又は外筒の回転を確実に押えて、安定して使用
できるようになつている。
され、内筒先端の線状部が外筒から出たところで
立体的に拡開されるようになつている。外筒1に
は突出した係合部7があり、把持部3には係止部
8があるので、両者を嵌合させることにより、内
筒又は外筒の回転を確実に押えて、安定して使用
できるようになつている。
冠動脈バイパス手術時の使用例を、第3図〜第
5図で示す。9は静脈グラフト、10は切開口、
11は第1吻合部、12は側々吻合をした第2吻
合部である。13は冠動脈、14は血栓、15は
縫合用糸を示す。
5図で示す。9は静脈グラフト、10は切開口、
11は第1吻合部、12は側々吻合をした第2吻
合部である。13は冠動脈、14は血栓、15は
縫合用糸を示す。
第1図に示すように、本発明切開口拡開器を、
静脈グラフト9の中枢側断端より挿入する。この
際、内筒2は線状部5が外筒1内に収納された状
態である。先端が静脈グラフト9の切開口10の
位置に来た時、内筒2を摺動させて、線状部5を
外筒外へ出すことにより切開口10は大きく拡開
される。その結果、静脈グラフト9は、端部の第
1吻合部11及び側々吻合としての第2吻合部1
2とも縫合され、冠動脈13の2つの血管におい
て血栓14がそれぞれ発生している場合でも、1
本の静脈グラフトによつて容易にバイパス手術が
可能となつた。
静脈グラフト9の中枢側断端より挿入する。この
際、内筒2は線状部5が外筒1内に収納された状
態である。先端が静脈グラフト9の切開口10の
位置に来た時、内筒2を摺動させて、線状部5を
外筒外へ出すことにより切開口10は大きく拡開
される。その結果、静脈グラフト9は、端部の第
1吻合部11及び側々吻合としての第2吻合部1
2とも縫合され、冠動脈13の2つの血管におい
て血栓14がそれぞれ発生している場合でも、1
本の静脈グラフトによつて容易にバイパス手術が
可能となつた。
本発明切開口拡開器を使用すると、切開口が十
分に立体的に拡開されるので、ピンセツト、針、
糸を利用して、視野を十分とりながら、早急に確
実に手術を行なうことができるようになつた。
分に立体的に拡開されるので、ピンセツト、針、
糸を利用して、視野を十分とりながら、早急に確
実に手術を行なうことができるようになつた。
(3) 発明の効果
本発明の血管吻合用の切開口拡開器を用いるこ
とにより、血管のような2〜6mm程度の細いグラ
フト内腔に容易に確実に挿入でき、切開口の近辺
において、外筒と把持部を利用して内筒を摺動さ
せ、線状武を突出させることができる。外筒から
出た線状部は複数本のそれぞれが立体的に拡開す
るように附勢されているので、切開口を良好に展
開するので、吻合口縁に正確に針を通す手術が容
易且つ安全にできるようになつた。従つて、冠動
脈バイパス手術のように静脈グラフトを用いた
側々吻合も容易に行なえるようになり、外科手術
に及ぼす効果は誠に大きい。
とにより、血管のような2〜6mm程度の細いグラ
フト内腔に容易に確実に挿入でき、切開口の近辺
において、外筒と把持部を利用して内筒を摺動さ
せ、線状武を突出させることができる。外筒から
出た線状部は複数本のそれぞれが立体的に拡開す
るように附勢されているので、切開口を良好に展
開するので、吻合口縁に正確に針を通す手術が容
易且つ安全にできるようになつた。従つて、冠動
脈バイパス手術のように静脈グラフトを用いた
側々吻合も容易に行なえるようになり、外科手術
に及ぼす効果は誠に大きい。
手術後は再び内筒を外筒内へ引込めば、線状部
も圧縮されて収納される。
も圧縮されて収納される。
第1図は本発明血管吻合用の切開口拡開器の斜
視図、第2図は同斜視図で、線状部を突出させた
状態を示す。第3図〜第5図は冠状動脈のバイパ
ス手術時の使用例を示す説明図である。 1……外筒、2……内筒、3……把持部、4…
…基部、5……線状部、6……丸み、7……係合
部、8……係止部。
視図、第2図は同斜視図で、線状部を突出させた
状態を示す。第3図〜第5図は冠状動脈のバイパ
ス手術時の使用例を示す説明図である。 1……外筒、2……内筒、3……把持部、4…
…基部、5……線状部、6……丸み、7……係合
部、8……係止部。
Claims (1)
- 【特許請求の範囲】 1 血管内腔へ挿入可能な細長い外筒と、この外
筒とほぼ同じ長さで、外筒内へ摺動可能に挿入さ
れた内筒と、この内筒の一端に取付けられ掌に入
る程度の把持部と、基部が前記内筒の他端に固定
され、外筒内に収納可能で、且つ、前記内筒が摺
動して外筒による圧縮が開放された時立体的に拡
開するよう附勢された複数本の線状部とから成る
血管吻合用の切開口拡開器。 2 内筒の一端に取付けられた把持部として、外
筒の端部に設けた係合部と嵌合する係止部を有す
る把持部を用いた特許請求の範囲第1項記載の血
管吻合用の切開口拡開器。 3 内筒の他端に設けた複数本の線状部が、基部
を内筒他端に固定すると共に3本の線状自由端部
が3方に拡がるよう附勢され且つ先端に保護用丸
みを設けたものである特許請求の範囲第1項記載
の血管吻合用の切開口拡開器。
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP60051352A JPS61209647A (ja) | 1985-03-14 | 1985-03-14 | 血管吻合用の切開口拡開器 |
US06/823,950 US4654028A (en) | 1985-03-14 | 1986-01-29 | Incision opening expansion holder for inosculation |
DE19863607933 DE3607933A1 (de) | 1985-03-14 | 1986-03-11 | Dehnungshalter fuer schnittoeffnungen zum gebrauch bei chirurgischen operationen |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP60051352A JPS61209647A (ja) | 1985-03-14 | 1985-03-14 | 血管吻合用の切開口拡開器 |
Publications (2)
Publication Number | Publication Date |
---|---|
JPS61209647A JPS61209647A (ja) | 1986-09-17 |
JPH0237773B2 true JPH0237773B2 (ja) | 1990-08-27 |
Family
ID=12884533
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP60051352A Granted JPS61209647A (ja) | 1985-03-14 | 1985-03-14 | 血管吻合用の切開口拡開器 |
Country Status (3)
Country | Link |
---|---|
US (1) | US4654028A (ja) |
JP (1) | JPS61209647A (ja) |
DE (1) | DE3607933A1 (ja) |
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DE4220295A1 (de) * | 1992-06-20 | 1993-12-23 | Angiomed Ag | Vorrichtung zur Korrektur der Lage eines Stents |
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US11826047B2 (en) | 2021-05-28 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising jaw mounts |
US11957337B2 (en) | 2021-10-18 | 2024-04-16 | Cilag Gmbh International | Surgical stapling assembly with offset ramped drive surfaces |
US11877745B2 (en) | 2021-10-18 | 2024-01-23 | Cilag Gmbh International | Surgical stapling assembly having longitudinally-repeating staple leg clusters |
US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
Family Cites Families (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE7736713U1 (ja) * | 1900-01-01 | Aesculap-Werke Ag Vormals Jetter & Scheerer, 7200 Tuttlingen | ||
US2137710A (en) * | 1937-12-13 | 1938-11-22 | Alfred W Anderson | Forceps |
FR2085427A1 (ja) * | 1970-04-20 | 1971-12-24 | Soichet Samuel | |
US3858586A (en) * | 1971-03-11 | 1975-01-07 | Martin Lessen | Surgical method and electrode therefor |
DE2326988B2 (de) * | 1973-05-26 | 1977-02-24 | Drägerwerk AG, 2400 Lübeck | Chirurgisches instrument zur sterilisation von frauen durch tubenligatur |
CA1018419A (en) * | 1973-07-04 | 1977-10-04 | Gerald Turp | Instrument for laparoscopic tubal cauterization |
US4174715A (en) * | 1977-03-28 | 1979-11-20 | Hasson Harrith M | Multi-pronged laparoscopy forceps |
US4249533A (en) * | 1977-05-16 | 1981-02-10 | Olympus Optical Co., Ltd. | Laser knife |
US4222380A (en) * | 1977-12-02 | 1980-09-16 | Olympus Optical Co., Ltd. | Celiac injector |
DE3012447C2 (de) * | 1980-03-31 | 1982-04-01 | Harald 7200 Tuttlingen Maslanka | Chirurgisches Greiferinstrument |
US4393872A (en) * | 1980-05-27 | 1983-07-19 | Eder Instrument Co., Inc. | Aspirating surgical forceps |
-
1985
- 1985-03-14 JP JP60051352A patent/JPS61209647A/ja active Granted
-
1986
- 1986-01-29 US US06/823,950 patent/US4654028A/en not_active Expired - Fee Related
- 1986-03-11 DE DE19863607933 patent/DE3607933A1/de active Granted
Also Published As
Publication number | Publication date |
---|---|
DE3607933A1 (de) | 1986-09-25 |
DE3607933C2 (ja) | 1989-01-26 |
JPS61209647A (ja) | 1986-09-17 |
US4654028A (en) | 1987-03-31 |
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