JPH0463694B2 - - Google Patents
Info
- Publication number
- JPH0463694B2 JPH0463694B2 JP60296552A JP29655285A JPH0463694B2 JP H0463694 B2 JPH0463694 B2 JP H0463694B2 JP 60296552 A JP60296552 A JP 60296552A JP 29655285 A JP29655285 A JP 29655285A JP H0463694 B2 JPH0463694 B2 JP H0463694B2
- Authority
- JP
- Japan
- Prior art keywords
- instrument
- blood
- blood vessel
- anastomosis
- shaped protrusion
- 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 50
- 230000003872 anastomosis Effects 0.000 claims description 28
- 239000000463 material Substances 0.000 claims description 6
- 229920002451 polyvinyl alcohol Polymers 0.000 claims description 4
- 239000002195 soluble material Substances 0.000 claims 1
- 230000002792 vascular Effects 0.000 description 7
- 238000000034 method Methods 0.000 description 5
- 208000007536 Thrombosis Diseases 0.000 description 2
- 239000000853 adhesive Substances 0.000 description 2
- 230000001070 adhesive effect Effects 0.000 description 2
- 238000004090 dissolution Methods 0.000 description 2
- 238000011017 operating method Methods 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 210000004026 tunica intima Anatomy 0.000 description 2
- 229920002307 Dextran Polymers 0.000 description 1
- HTTJABKRGRZYRN-UHFFFAOYSA-N Heparin Chemical compound OC1C(NC(=O)C)C(O)OC(COS(O)(=O)=O)C1OC1C(OS(O)(=O)=O)C(O)C(OC2C(C(OS(O)(=O)=O)C(OC3C(C(O)C(O)C(O3)C(O)=O)OS(O)(=O)=O)C(CO)O2)NS(O)(=O)=O)C(C(O)=O)O1 HTTJABKRGRZYRN-UHFFFAOYSA-N 0.000 description 1
- 208000031481 Pathologic Constriction Diseases 0.000 description 1
- 229920002472 Starch Polymers 0.000 description 1
- CZMRCDWAGMRECN-UGDNZRGBSA-N Sucrose Chemical compound O[C@H]1[C@H](O)[C@@H](CO)O[C@@]1(CO)O[C@@H]1[C@H](O)[C@@H](O)[C@H](O)[C@@H](CO)O1 CZMRCDWAGMRECN-UGDNZRGBSA-N 0.000 description 1
- 229930006000 Sucrose Natural products 0.000 description 1
- 102000003990 Urokinase-type plasminogen activator Human genes 0.000 description 1
- 108090000435 Urokinase-type plasminogen activator Proteins 0.000 description 1
- 230000002159 abnormal effect Effects 0.000 description 1
- 239000003146 anticoagulant agent Substances 0.000 description 1
- 229940127219 anticoagulant drug Drugs 0.000 description 1
- 239000002473 artificial blood Substances 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 238000002316 cosmetic surgery Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 229960002897 heparin Drugs 0.000 description 1
- 229920000669 heparin Polymers 0.000 description 1
- 229920002401 polyacrylamide Polymers 0.000 description 1
- 238000006116 polymerization reaction Methods 0.000 description 1
- 229920000036 polyvinylpyrrolidone Polymers 0.000 description 1
- 239000001267 polyvinylpyrrolidone Substances 0.000 description 1
- 235000013855 polyvinylpyrrolidone Nutrition 0.000 description 1
- 238000007127 saponification reaction Methods 0.000 description 1
- 239000008107 starch Substances 0.000 description 1
- 235000019698 starch Nutrition 0.000 description 1
- 230000036262 stenosis Effects 0.000 description 1
- 208000037804 stenosis Diseases 0.000 description 1
- 239000005720 sucrose Substances 0.000 description 1
- 229960005356 urokinase Drugs 0.000 description 1
Landscapes
- Surgical Instruments (AREA)
Description
【発明の詳細な説明】
［産業上の利用分野］
本発明は血管吻合において使用される器具に関
する。さらに詳しくは、吻合すべき血管を内部よ
り支持し吻合を効果的に実施するための器具に関
する。DETAILED DESCRIPTION OF THE INVENTION Field of the Invention The present invention relates to instruments used in vascular anastomoses. More specifically, the present invention relates to an instrument for internally supporting a blood vessel to be anastomosed and effectively performing anastomosis.
［従来の技術］
外科手術においては、異常が生じたり損傷を受
けた血管の修復のためにしばしば血管の吻合が行
われる。血管吻合は一般に縫合糸を用いて行われ
ることが多いが、特開昭49−51785号公報、特開
昭50−38388号公報及び特開昭56−3052号公報な
どには、血管可溶性のチユーブを血管内に挿入し
て血管を支持し、接着剤を用いて固定する方法も
提案されている。[Background Art] In surgical operations, vascular anastomoses are often performed to repair abnormal or damaged blood vessels. Vascular anastomosis is generally performed using sutures, but vascular anastomoses are described in Japanese Patent Application Laid-Open No. 49-51785, Japanese Patent Application Laid-Open No. 50-38388, and Japanese Patent Application Laid-Open No. 56-3052, etc. A method has also been proposed in which the tube is inserted into a blood vessel to support the blood vessel and fixed using an adhesive.
［発明が解決しようとする問題点］
脳外科や形成外科などにおいては、微小血管の
吻合が必要となることが多いが、縫合には高度の
技術が必要であり、手技に習熟した者でなければ
手術が困難であつた。また、操作が迅速で簡単な
連続縫合法は糸の締めすぎによる血管の狭窄を起
こしやすいので採用することができず、操作の煩
雑な結節縫合が行われてきた。さらに、接着剤を
用いる方法は未だ技術的に確立されていない。[Problems to be solved by the invention] Microvascular anastomosis is often required in neurosurgery, plastic surgery, etc., but suturing requires a high level of skill and can only be done by a person who is proficient in the technique. The surgery was difficult. Furthermore, the continuous suturing method, which is quick and easy to operate, cannot be used because it tends to cause stenosis of blood vessels due to over-tightening of the thread, and interrupted sutures, which are complicated to operate, have been used. Furthermore, methods using adhesives have not yet been technically established.
本発明の目的は、縫合による血管吻合を容易か
つ確実に行うことのできる器具を提供することに
ある。本発明の他の目的は、縫合時に血管を傷つ
ける虞のない器具を提供することにある。 An object of the present invention is to provide an instrument that can easily and reliably perform blood vessel anastomosis using sutures. Another object of the present invention is to provide an instrument that does not cause damage to blood vessels during suturing.
ところで、血管吻合において最も重要な点は、
吻合した際に血管の内膜（内面）同志が全周にわ
たつて密着するように固定することである。も
し、内膜同志が密着していないと血液が内膜以外
の部分に接触することになり、血栓を生成しやす
くなる。そこで、従来は血管端部を反転して内膜
を露出して２つの血管の内膜同志を完全に密着し
てから吻合していたが、反転には高度の技術を必
要とし、しかも反転時に血管内膜を傷つける虞が
あつた。したがつて本発明のさらに他の目的は、
好ましい態様として、血管を反転させることなく
内膜同志を密着させて吻合することのできる器具
を提供することにある。 By the way, the most important point in vascular anastomosis is
This is to fix the intima (inner surfaces) of the blood vessels so that they are in close contact with each other over the entire circumference when anastomoses are performed. If the intima are not in close contact with each other, blood will come into contact with parts other than the intima, making it easier to form a blood clot. Conventionally, the ends of the blood vessels were inverted to expose the intima and the intima of the two blood vessels were brought into close contact with each other before anastomosis was performed. There was a risk of damaging the lining of blood vessels. Therefore, a further object of the present invention is to
A preferred embodiment is to provide an instrument that can bring the intima into close contact with each other for anastomosis without inverting the blood vessel.
［問題点を解決するための手段］
本発明は、血管吻合に際して吻合すべき血管を
内部より支持し縫合吻合を効果的に実施するため
の器具であつて、全体がチユーブ状に成形されて
おり、器具の中央部付近には両端側より中央方向
に向かつて外径が急激に増大する円盤状の突起部
が設けられており、且つ該円盤状突起部には血管
壁を通過した縫合糸を通すための複数本の溝が器
具の軸方向に形成されてなることを特徴とする血
管吻合のための器具である。[Means for Solving the Problems] The present invention is an instrument for effectively performing suturing anastomosis by supporting the blood vessels to be anastomosed from the inside during blood vessel anastomosis, and the instrument is formed entirely into a tube shape. A disk-shaped protrusion is provided near the center of the instrument, and the outer diameter rapidly increases from both ends toward the center, and the disk-shaped protrusion is provided with a suture that has passed through the blood vessel wall. This is an instrument for blood vessel anastomosis characterized by having a plurality of grooves formed in the axial direction of the instrument for passage.
［作用］
血管の吻合において本発明の器具は以下のよう
に使用される。[Function] The device of the present invention is used in blood vessel anastomosis as follows.
すなわち、まず血管の太さに応じて適当な外径
の器具を用意し、器具の一端を吻合すべき血管の
一方に挿入するとともに他端をもう一方の血管に
挿入する。そして２つの血管端部の内膜を密着し
た後に縫合糸で縫合するのであるが、器具の中央
部付近すなわち２つの血管の接合部に複数本の溝
が設けられているので、縫合針を溝にそつて血管
に刺入することにより容易にかつ内膜を傷つける
ことなく縫合することができる。もし溝を設けて
いないと、器具と血管とが密着するので縫合針で
血管内膜を傷つける虞がある。 That is, first, an instrument with an appropriate outer diameter is prepared depending on the thickness of the blood vessel, and one end of the instrument is inserted into one of the blood vessels to be anastomosed, and the other end is inserted into the other blood vessel. After the intima at the ends of the two blood vessels are brought into close contact with each other, they are sutured with suture thread.Since multiple grooves are provided near the center of the instrument, that is, at the junction of the two blood vessels, the suture needle is inserted into the groove. By inserting the needle into the blood vessel along the line, suturing can be easily performed without damaging the intima. If the groove is not provided, the instrument and the blood vessel will come into close contact with each other, and there is a risk that the suture needle may damage the intima of the blood vessel.
［実施例］
以下、図面を用いて本発明をさらに具体的に説
明する。[Example] Hereinafter, the present invention will be explained in more detail using the drawings.
第１図は本発明の器具の好ましい実施例を示す
斜視図であり第２図は断面図である。図に示すよ
うに、器具１はチユーブ状に成形されており内腔
２を有するとともに、中央部付近の外周に複数本
の溝３，３……を有している。溝３の形状は第２
図より容易にわかるように、中央部で最も深くな
つている。また、器具の中央部付近は盛り上がつ
ており、円盤状の突起部４を形成している。この
円盤状の突起部４は、器具の両端側より中央方向
に向かつて外径が急激に増大し中央部で最大径と
なるように形成されている。突起部４の両端は、
なだらかなテーパー部５，５′へと連続しており、
丸みを設けた器具端部６，６′へと続いている。 FIG. 1 is a perspective view and FIG. 2 is a sectional view of a preferred embodiment of the device of the present invention. As shown in the figure, the instrument 1 is formed into a tube shape and has an inner cavity 2 and a plurality of grooves 3, 3, . . . on the outer periphery near the center. The shape of groove 3 is the second
As you can easily see from the figure, it is deepest in the center. Further, the vicinity of the center of the instrument is raised to form a disc-shaped protrusion 4. This disc-shaped protrusion 4 is formed so that its outer diameter rapidly increases from both ends of the instrument toward the center, reaching its maximum diameter at the center. Both ends of the protrusion 4 are
Continuing to the gentle taper parts 5 and 5',
It continues into a rounded instrument end 6, 6'.
第３図は、第１図及び第２図に示す本発明の器
具を使用して血管の吻合を行う場合の操作手順を
示す斜視図である。まず、第３図ａに示すよう
に、吻合する血管７及び８の太さに応じて適当な
大きさの器具１を用意する。次に図ｂに示すよう
に器具１の端部を血管７及び８に挿入する。そし
て図ｃに示すように血管の端部が円盤状突起部４
に達するまで器具１をさらに深く挿入すると、血
管は伸縮性に富んでいるので、血管端部は円盤状
突起部４によつてラツパ状に押し拡げられ、血管
端部の内膜同志が密着するようになる。このよう
な状態になつたら、図ｄに示すように、縫合針９
を器具に設けた溝３に通すようにして縫合してい
けば、内膜同志が密着した状態で吻合することが
できる。なお、縫合時に溝３は血管壁で覆われる
が、血管壁を透かして溝３を確認することができ
るので、問題なく運針することができる。溝３の
幅及び深さは、縫合針９及び縫合糸１０が通過で
き適切な吻合を行うことのできるものであれば、
特に制限はない。しかしながら、第２図に示すよ
うに、円盤状突起部４の表面に対する溝の侵入角
θが90゜に近くなるようにすれば、縫合時に針を
血管壁にほぼ垂直に刺入できるので、針による血
管壁の損傷を最小限に抑えることができ、好まし
い。 FIG. 3 is a perspective view showing the operating procedure when performing anastomosis of blood vessels using the instrument of the present invention shown in FIGS. 1 and 2. FIG. First, as shown in FIG. 3a, an instrument 1 of an appropriate size is prepared depending on the thickness of blood vessels 7 and 8 to be anastomosed. The ends of the device 1 are then inserted into the blood vessels 7 and 8 as shown in Figure b. As shown in Figure c, the end of the blood vessel has a disc-shaped protrusion 4.
When the instrument 1 is inserted deeper until it reaches , since the blood vessel is highly elastic, the end of the blood vessel is pushed wide by the disk-shaped protrusion 4, and the intima at the end of the blood vessel are brought into close contact with each other. It becomes like this. When this condition is reached, as shown in Figure d, insert the suture needle 9.
By passing it through the groove 3 provided in the instrument and suturing it, anastomosis can be performed with the intima in close contact with each other. Although the groove 3 is covered with the blood vessel wall during suturing, the groove 3 can be seen through the blood vessel wall, so the needle can be moved without any problem. The width and depth of the groove 3 are such that the suture needle 9 and suture thread 10 can pass therethrough and appropriate anastomosis can be performed.
There are no particular restrictions. However, as shown in FIG. 2, if the entrance angle θ of the groove with respect to the surface of the disk-shaped protrusion 4 is made close to 90°, the needle can be inserted almost perpendicularly into the blood vessel wall during suturing, so the needle This is preferable because it can minimize damage to the blood vessel wall.
本発明の器具は、血管内に留置されたままにな
るので、使用後は消失するように血液可溶性また
は血液分解性の材料で形成されていることが望ま
しい。このような材料を例示するならば、ポリビ
ニルアルコール系重合体、ポリアクリルアミド、
ポリビニルピロリドン、デキストラン、可溶性デ
ンプン及び蔗糖などを挙げることができるが、材
料の硬度及び溶解速度などの点でポリビニルアル
コール系重合体が最も好ましい。また、ポリビニ
ルアルコール系重合体は、ケン化度や重合度を変
えることによつて溶解速度を調節することができ
るので便利である。これらの材料には、吻合直後
に血栓が生成しないようにヘパリンやウロキナー
ゼなどの抗血液凝固剤を添加しておくこともでき
る。 Since the device of the present invention remains indwelled within the blood vessel, it is preferably made of a blood-soluble or blood-degradable material so that it disappears after use. Examples of such materials include polyvinyl alcohol polymers, polyacrylamide,
Examples include polyvinylpyrrolidone, dextran, soluble starch, and sucrose, but polyvinyl alcohol polymers are most preferred in terms of material hardness and dissolution rate. Furthermore, polyvinyl alcohol polymers are convenient because the dissolution rate can be adjusted by changing the degree of saponification and degree of polymerization. Anticoagulants such as heparin and urokinase can also be added to these materials to prevent thrombus formation immediately after anastomosis.
なお、本発明の器具は、天然血管同志の吻合に
使用し得ることはもちろんであるが、その他に天
然血管と人工血管との吻合に用いることもでき
る。 The instrument of the present invention can of course be used for anastomosis between natural blood vessels, but can also be used for anastomosis between natural blood vessels and artificial blood vessels.
［発明の効果］
本発明の器具は吻合すべき血管を内部より支持
するものであるので縫合を容易に行うことができ
る。また、溝が設けられているので器具と血管内
膜との間に空間が確保され、針で内膜を傷つける
ことなく縫合することができる。[Effects of the Invention] Since the instrument of the present invention supports the blood vessel to be anastomosed from the inside, suturing can be easily performed. Further, since the groove is provided, a space is secured between the instrument and the vascular intima, and suturing can be performed without damaging the vascular intima with a needle.
さらに、血管の内膜同志を容易且つ確実に密着
固定することができるので、手術の成功率を高め
ることができる。また、反転のような高度な技術
を必要としないので操作が容易であり、反転によ
る内膜損傷も起らない。そして、縫合時に血管が
器具で内部より支持されているので連続縫合を行
つても血管の狭窄が起ることはなく、縫合操作を
従来よりも迅速に行うことができる。 Furthermore, since the intima of the blood vessel can be easily and reliably fixed in close contact with each other, the success rate of the surgery can be increased. In addition, it is easy to operate because it does not require sophisticated techniques such as inversion, and intimal damage does not occur due to inversion. Further, since the blood vessel is supported from the inside by the instrument during suturing, the blood vessel does not become narrowed even when suturing is performed continuously, and the suturing operation can be performed more quickly than before.
さらにまた、器具を血液可溶性または血液分解
性の材料で形成しておけば、吻合後にやがて器具
は消失するので、血液の流れを妨げることもなく
安全で好ましい。 Furthermore, if the device is made of a blood-soluble or blood-degradable material, the device will disappear after the anastomosis, which is safe and preferable since it will not interfere with blood flow.
第１図は本発明の血管吻合用器具の実施例につ
いての斜視図であり第２図は断面図である。ま
た、第３図は本発明の器具を使用して血管の吻合
を行う場合の操作手順を示す斜視図である。
１…血管吻合用器具、２…内腔、３…溝、４…
円盤状突起部、５，５′…テーパー部、６，６′…
器具端部、７，８…血管、９…縫合針、１０…縫
合糸。
FIG. 1 is a perspective view of an embodiment of the vascular anastomosis instrument of the present invention, and FIG. 2 is a sectional view. Moreover, FIG. 3 is a perspective view showing the operating procedure when performing anastomosis of blood vessels using the instrument of the present invention. 1... Instrument for vascular anastomosis, 2... Lumen, 3... Groove, 4...
Disk-shaped protrusion, 5, 5'...tapered part, 6, 6'...
Instrument end, 7, 8... Blood vessel, 9... Suture needle, 10... Suture thread.
Claims (1)
支持し縫合吻合を効果的に実施するための器具で
あつて、全体がチユーブ状に成形されており、器
具の中央部付近には両端側より中央方向に向かつ
て外径が急激に増大する円盤状の突起部が設けら
れており、且つ該円盤状突起部には血管壁を通過
した縫合糸を通すための複数本の溝が器具の軸方
向に形成されてなることを特徴とする血管吻合の
ための器具。 ２ 溝が円盤状突起部表面にほぼ垂直に侵入する
ように形成されている特許請求の範囲第１項記載
の器具。 ３ 器具全体が血液可溶性または血液分解性の材
料で形成されてなる特許請求の範囲第１項または
第２項記載の器具。 ４ 血液可溶性材料がポリビニルアルコール系重
合体である特許請求の範囲第３項記載の器具。[Scope of Claims] 1. An instrument for effectively carrying out suturing anastomosis by supporting the blood vessels to be anastomosed from the inside during blood vessel anastomosis, and having a tube-like shape as a whole. is provided with a disc-shaped protrusion whose outer diameter increases rapidly from both ends toward the center, and the disc-shaped protrusion has a plurality of grooves for passing the suture passed through the blood vessel wall. An instrument for blood vessel anastomosis, characterized in that a is formed in the axial direction of the instrument. 2. The instrument according to claim 1, wherein the groove is formed to penetrate substantially perpendicularly into the surface of the disc-shaped protrusion. 3. The device according to claim 1 or 2, wherein the entire device is made of a blood-soluble or blood-degradable material. 4. The device according to claim 3, wherein the blood-soluble material is a polyvinyl alcohol polymer.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP29655285A JPS62152446A (en) | 1985-12-24 | 1985-12-24 | Instrument for blood anastomosis |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP29655285A JPS62152446A (en) | 1985-12-24 | 1985-12-24 | Instrument for blood anastomosis |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPS62152446A JPS62152446A (en) | 1987-07-07 |
| JPH0463694B2 true JPH0463694B2 (en) | 1992-10-12 |
Family
ID=17835012
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP29655285A Granted JPS62152446A (en) | 1985-12-24 | 1985-12-24 | Instrument for blood anastomosis |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JPS62152446A (en) |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPS6437941A (en) * | 1987-08-04 | 1989-02-08 | Shunichi Meguri | Spacer for inosculating fine blood vessel |
| WO2017033621A1 (en) | 2015-08-27 | 2017-03-02 | 村田機械株式会社 | Retrieving device and storing device |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPS4918458U (en) * | 1972-05-18 | 1974-02-16 | ||
| JPS4919596A (en) * | 1972-06-15 | 1974-02-21 | ||
| JPS5796644A (en) * | 1980-10-20 | 1982-06-16 | American Cyanamid Co | Ostomy apparatus and method |
| JPS59177039A (en) * | 1983-03-17 | 1984-10-06 | エチコン・インコ−ポレ−テツド | Connecting instrument |
| JPS6036039A (en) * | 1983-08-09 | 1985-02-25 | 村中医療器株式会社 | Blood vessel occuding auxiliary instrument |
-
1985
- 1985-12-24 JP JP29655285A patent/JPS62152446A/en active Granted
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPS4918458U (en) * | 1972-05-18 | 1974-02-16 | ||
| JPS4919596A (en) * | 1972-06-15 | 1974-02-21 | ||
| JPS5796644A (en) * | 1980-10-20 | 1982-06-16 | American Cyanamid Co | Ostomy apparatus and method |
| JPS59177039A (en) * | 1983-03-17 | 1984-10-06 | エチコン・インコ−ポレ−テツド | Connecting instrument |
| JPS6036039A (en) * | 1983-08-09 | 1985-02-25 | 村中医療器株式会社 | Blood vessel occuding auxiliary instrument |
Also Published As
| Publication number | Publication date |
|---|---|
| JPS62152446A (en) | 1987-07-07 |
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