JPH05337123A - Suture ligator for organism - Google Patents

Abstract

PURPOSE:To provide a suture ligator for organisms which facilitates the suture ligation of an organic tissue with a smaller size and eliminates thermal effect on an organism to achieve higher safety. CONSTITUTION:In a suture ligator for organisms which comprises a bio- absorbable material to perform a suture ligation of an organic tissue by thermal deformation, a clip 1 as suture ligator body comprises a hinge part 2 and grip parts 3 and 3 and 3. The clip 1 is made of the bio-absorbable material at a thermal distortion starting temperature of above 45 deg.C and below 100 deg..

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a living body suturing and ligating device for suturing and ligating ducts such as bile ducts and blood vessels of a living body.

[0002]

2. Description of the Related Art For example, in the operation of gallbladder calculi, etc., when the operation to remove the gallbladder is performed to prevent recurrence, the connection between the bile duct and the bile duct is cut off. Since it passes through, it is necessary to cut the gallbladder duct with a knife or the like and at the same time ligate it with suture.

In such a gallbladder calculus operation or the like, a suture ligature tool for penetrating the abdominal wall or the like to be inserted into the body cavity and sutured or ligated the tissue in the body cavity is used. This suture ligature is made of a bioabsorbable material made of a homopolymer or a copolymer such as polydioxane, polydioxanone, polylactide and polyglycolide. For example, U.S. Pat.
No. 541 shows a bioabsorbable clip made of polydioxanone.

Also, US Pat. No. 4,889,119 discloses a bioabsorbable stapler-like suturing device made of polylactide, polyglycolide or polydioxane.

Since the suture and ligature made of these bioabsorbable materials is gradually decomposed and absorbed in the living body, it is considered to be highly safe because it does not remain in the living body as a foreign substance for a long period of time. It has been widely used in the surgical field in place of the metal suture and ligature that has been used.

[0006]

However, while the conventional suture and ligature made of a metal material fixes the living tissue by utilizing plastic deformation, the bioabsorbable suture and ligature has a plasticity. Since deformation cannot be used, it is necessary to provide a mechanical fixing means, which complicates the structure and increases the size, which causes a increase in the number of coins.

[0007] Therefore, in order to solve the problem as described above, paying attention to the fact that the bioabsorbable material is a thermoplastic deformation,
A method of fixing a biological tissue by heating and thermally deforming a suture ligature made of a bioabsorbable material has been considered.

However, since the heat-deformation temperature of the bioabsorbable material that has been put into practical use is in the range of 120 ° C. to 220 ° C., it is difficult to safely heat and soften it in the living body.
It is impractical because heat may adversely affect living tissues.

The present invention has been made in view of the above circumstances, and it is an object of the present invention to provide a living body which is small in size, easy to suture and ligate a living tissue, and does not exert a thermal influence on the living body. To provide a suture and ligature for use.

[0010]

In order to achieve the above-mentioned object, the present invention relates to a living body suture ligature tool which is made of a bioabsorbable material and which sutures and ligates living tissue by thermal deformation.
The body of the suture and ligature has a thermal deformation starting temperature of 45 degrees Celsius or higher,
It is characterized by being formed of a bioabsorbable material having a temperature of 100 degrees or less.

[0011]

The body of the suture and ligature is thermally deformed in the range of 45 ° C to 100 ° C to ligate the living tissue with suture and ligation, and the tissue is fixed without any mechanical fixing means. It does not have a physical effect.

[0012]

Embodiments of the present invention will be described below with reference to the drawings.

1 to 4 show a first embodiment. As shown in FIG. 1, a clip 1 as a main body of a suture ligature comprises a hinge portion 2 and two grip portions 3 and 3 connected by the hinge portion 2. Projections 4 and 4 are provided.

This clip 1 is formed of a homo- or copolymer of dioxane, lactide, dioxanone or glycolide, and by making 5 to 30% by weight of the polymer a relatively low molecular weight substance having a molecular weight of 10,000 or less. The heat distortion temperature is 100 ° C. or lower, and preferably the heat distortion temperature is 45 ° C. to 80 ° C.

FIG. 2 shows a clip applicator 5 for gripping and ligating the clip 1. The insertion portion 6 of the clip applicator 5 is formed by a small diameter pipe,
Clip holding portions 8 and 9 which can be opened and closed with a hinge 7 as a fulcrum are provided at the tip of the insertion portion 6. Recesses 10 are provided on the surfaces of the clip gripping portions 8 and 9 that face each other, and the projections 4 and 4 of the clip 1 are engaged with the recesses 10. A connecting member 12 is attached to the base end portion of one clip gripping portion 9 via a connecting pin 11.
Is connected, and the operating rod 13 is connected to the connecting member 12.

The operating rod 13 is inserted into the insertion portion 6 so as to be movable back and forth, and projects from the base end portion of the insertion portion 6.
At the base end of the insertion portion 6, a fixed handle 14 and an operation handle 17 which is composed of a movable handle 16 which is rotatably supported by a pivot pin 15 on the fixed handle 14 are provided.

Then, the movable handle 16 and the operating rod 13 are connected to each other, and the operating rod 17 is moved forward and backward by the operating handle 17, and the clip gripping portions 8 and 9 are connected.
Can be opened and closed.

A fluid passage 18 is formed inside the insertion portion 6, and one end side of the fluid passage 18 has a tip opening 1 of the insertion portion 6.
9, and the other end side communicates with a connection mouthpiece 20 provided on the base end side of the insertion portion 6. A syringe 21 is detachably connected to the connection mouthpiece 20.

Next, the clip 1 constructed as described above.
A method of ligating the biological duct 22 such as a bile duct or a blood vessel of a living body with the clip applicator 5 will be described. As shown in FIG. 3, the clip grippers 8 and 9 of the clip applicator 5 are opened, the clip 1 is sandwiched between the clip grippers 8 and 9, and the projections 4 and 4 are recessed.
When the clip 1 is engaged with the clip 1, the clip 1 is in a state where it does not easily drop from the clip gripping portions 8 and 9.

The operator grasps the operation handle 17 to insert the insertion portion 6 into the body cavity of the living body, inserts the target living body conduit 22 between the grasping members 3 of the clip 1, and When the movable handle 16 is gripped, the operation rod 13 advances to close the clip gripping portions 8 and 9, and the living body conduit 22 is crushed by the gripping members 3 and 3 of the clip 1.

In this state, when a heating fluid such as hot water having a temperature capable of thermally deforming the clip 1 is pressure-fed from the syringe 21, the heating fluid passes through the fluid passage 18 and the insertion portion 6
It is ejected toward the clip 1 from the tip opening 19 of the.

When the clip 1 is heated by the heating fluid, the clip 1 is softened by heating, and as shown in FIG. 4, the grasping members 3 are deformed so as to wrap the living body conduit 22. Next, when cold water is pumped from the syringe 21, the cold water is ejected toward the clip 1 from the tip end opening 19 of the insertion portion 6 through the fluid passage 18. Therefore, the clip 1 is cooled and hardened by cold water, is solidified in a state where the gripping members 3 of the clip 1 are deformed as shown in FIG. 4, and the living body conduit 22 is ligated.

According to this embodiment, the living body conduit 22 can be easily ligated by thermally deforming the clip 1 with the heating fluid, and no mechanical fixing means is required for the clip 1, so that the clip can be miniaturized. It is safe because it is easy to simplify and has a low heat distortion temperature, so there is no risk of exerting a thermal effect on the living body.

FIG. 5 shows a second embodiment, and the same components as those of the first embodiment are designated by the same reference numerals and the description thereof will be omitted. A concave portion 23 is provided on the inner surface of one clip grip portion 9 of the clip applicator 5 for gripping and ligating the clip 1, and a heating element 24 such as a diode or a ceramic heater is housed in the concave portion 23. ing. The heating element 24 is connected to a lead wire 25 built in the insertion portion 6, and the lead wire 25 is led out to the outside from the base end portion of the insertion portion 6 and connected to a power source (not shown).

Therefore, similarly to the first embodiment, the clip gripping portions 8 and 9 are closed and the gripping members 3 and 3 of the clip 1 are closed.
After crushing the living body duct 22 by means of the above, the heating element 24 is energized to heat the clip 1 to a temperature at which the clip 1 can be thermally deformed to be softened by heating, and then the clip 1 is cooled and hardened to hold the grip member 3. , 3 are solidified in a deformed state, and the living body conduit 22 can be ligated.

The means for heating and cooling the clip 1 is not limited to the first and second embodiments, and heating by laser light, heating with warm air or the like is used, and cooling is performed by blowing gas. Alternatively, a cooling means such as a refrigerant may be used.

6 and 7 show a second embodiment. As shown in FIG. 6, the stapler 3 as the main body of the suture and ligature tool.
1 is provided with claw portions 32, 32 having sharp tips for piercing living tissue at both ends, and at a position about 1/3 from both ends, and on the side opposite to the claw portions 32, 32. Are provided with concave portions 33, 33.

The stapler 31 is formed of a homo- or copolymer of dioxane, lactide or glycolide, and has a heat distortion temperature of 45 by mixing 5 to 40% by weight of plasticity of fatty acid or fatty acid ester at the time of molding. The temperature is set to 80 ° C to 80 ° C.

As the plasticizer, various commercially available plasticizers can be used, but from the viewpoint of safety to the living body, dibutyl sebacate, epoxidized soybean oil, dibutyl stearate, epoxidized safflower oil, oleic acid. Ester, linoleic acid ester and the like are preferable.

In the case of suturing a living tissue using the stapler 31, first, the stapler 31 is heated and softened, and then the living tissues 34a, 34b to be sutured are claw portions 32, 32.
7 is inserted and deformed as shown in FIG. 7, and then the stapler 31 is cooled and hardened to suture and fix the biological tissues 34a and 34b. A dedicated or general-purpose suturing device may be used to heat, deform, and cure the stapler 31.

According to this embodiment, the stapler 31 is heated to a temperature at which it can be thermally deformed to be softened by heating, and then the stapler 31 is cooled and hardened, whereby the stapler 31 is solidified in a deformed state, and a living body is formed. Organization 34
Since a and 34b can be reliably sutured and no mechanical fixing means is required for the stapler 31, it is easy to downsize and simplify the stapler 31, and the thermal deformation temperature is low, so that there is no thermal influence on the living body. There is no fear of giving and it is safe.

FIG. 8 shows a fourth embodiment. The clip 35 having the same shape as that of the first embodiment is formed of a homo- or copolymer of dioxane, lactide or glycolide, and when molded, 5 to 40% by weight of the polymer is a bio-based oily contrast agent such as uro. By mixing Graphin and Lipiodol (both are trade names), the heat distortion temperature is set to 45 ° C to 80 ° C.

The method of use is the same as that of the first embodiment, and in addition to the effect of the first embodiment, since a contrast agent is mixed, the position can be confirmed by seeing through from outside the body by X-ray. .. Further, since the clip 35 is absorbed by the living body and the contrast agent in the clip 35 is also absorbed, there is an effect that the absorption state of the clip 35 can be confirmed by fluoroscopy.

FIG. 9 shows a fifth embodiment, and FIG. 10 shows a sixth embodiment.
An example of is shown. In both Examples, since the bioabsorbable material is extremely low in strength, the suture and ligature such as a clip or stapler made of the bioabsorbable material needs to be thick and large in order to have sufficient strength. It was made paying attention to.

First, the clip 36 shown in the fifth embodiment.
1 to 1 selected from bioabsorbable ceramics TCP (3 calcium phosphate), HAP (hydroxyapatite), and 4 calcium phosphate in a homo- or copolymer of dioxane, lactide or glycolide.
It is formed by mixing 2 to 45% by weight of ceramic powder.

By mixing the ceramic powder, the strength can be improved, and the clip 36 can be made thinner and smaller. Further, since the bioabsorbable ceramic powder is mixed, the ceramic powder is also absorbed by the living body together with the bioabsorbable resin material.
6 does not remain in the living body. It should be noted that the bioabsorbable resin material may be one that has been conventionally used, or one that has a reduced heat distortion temperature shown in the first to fourth embodiments.

The stapler 37 shown in the sixth embodiment is an A-comprising a bioabsorbable glass-ceramic apatite microcrystal and worstonite microcrystal in homo- or copolymer of dioxane, lactide or glycolide.
5 to 45 W crystallized glass filler or fiber
It is a molded product with a mixture of wt%.

By mixing the glass-ceramic powder, the strength is improved, and the stapler 37 can be made thinner and smaller. Further, since the bioabsorbable ceramic powder is mixed, the ceramic powder is also absorbed by the living body together with the bioabsorbable resin material, so that the stapler 37 does not remain in the living body.

Further, the absorption rate of the glass ceramics is low, and the safety is high even if the glass ceramics remain in the living body. It should be noted that the bioabsorbable resin material may be one that has been conventionally used, or one that has a reduced heat distortion temperature shown in the first to fourth embodiments.

FIG. 11 shows a seventh embodiment. The indwelling clip 38 as the main body of the suture and ligature has the front end portion 3 for gripping and occluding a bile duct organ, a fallopian tube, a blood vessel and the like.
9 and 39 and a dogleg-shaped rear end portion 40. A convex portion 41 is provided on the rear end surfaces of the front end portions 39, 39, and a concave portion 42 fitted to the convex portion 41 is provided on the front end of the rear end portion 40.
Is provided, and the front end portions 39, 39 are integrally connected to the rear end portion 40. Engagement protrusions 43 and engagement recesses 44 are provided at the front end portions of the front end portions 39, 39 so as to be engaged with each other and not to be separated from the living tissue after the lumen organ is sandwiched.

The clip 38 is made of a bioabsorbable material so that it can be decomposed and absorbed after being placed in the body. The clip 38 has thick front ends 39, 39 and a thin rear end 40.
The material is adjusted so that the rear end portion 40 has a slower absorption speed than the front end portions 39, 39 in order to make the decomposition and absorption speed of the above into the living body uniform.

Here, the factors relating to the biodegradation rate of the bioabsorbable material will be described. Factors peculiar to materials that regulate the degradation rate of bioabsorbable materials are (1) molecular weight, (2)
Polymerization composition, (3) residual monomer amount, (4) regularity of molecular arrangement are listed. To speed up the absorption rate, (1) reduce the molecular weight, (2) poly-D, L-lactic acid and glycolic acid copolymerization In the combination, the ratio of glycolic acid may be increased, (3) the amount of residual monomer may be increased, and (4) the crystallinity of the molecule may be increased.

Based on the above results, the front end portions 39, 39 having a high absorption rate are made of, for example, a material having a molecular weight of about 100,000, poly-D, L-lactic acid: glycolic acid = 80: 20, and a residual monomer amount of 14% by weight. Used. On the other hand, the rear end portion 40 having a slow absorption rate has a molecular weight of about 200,000, poly D,
L lactic acid: glycolic acid = 100: 0, residual monomer amount 0
Weight percent of material is used.

The clip 38 formed of such a material is introduced into the body cavity by a usual method, and the applicator ligates and closes the luminal organ in the body cavity. The front end portions 39, 39 having a large wall thickness are made of a material having a high absorption rate, while the rear end portion 40 having a small wall thickness is formed.
Is made of a material having a low absorption rate, and thus the clip 38 as a whole is absorbed by the living body at a uniform rate and disappears.

As described above, since the absorption speed of the clip 38 is not affected by the thickness of the clip 38, and the entire clip is absorbed uniformly, the rear end portion 40 having a smaller thickness is absorbed earlier than in the conventional case. The problem of falling off is eliminated.

FIG. 12 shows the eighth embodiment. Similar to the seventh embodiment, the indwelling clip 45 as a main body of a suture ligature for gripping and occluding internal luminal organs such as the bile duct, fallopian tube, and blood vessel has a front end portion 46, 46 and a dogleg shape. Rear end 47
And are integrally molded.

Then, as in the seventh embodiment, the material factors that change the absorption speed are adjusted so that the front end portions 46, 46 are made of a material that absorbs faster than the rear end portion 47. That is, the material composition of the front end portions 46, 46 and the rear end portion 47 changes in an inclined manner.

The clip 45 thus formed is introduced into the body cavity by a normal method, and the applicator ligates and occludes the luminal organ in the body cavity, thereby achieving the same effect as that of the seventh embodiment. As a result, the entire clip 45 is absorbed by the living body at a uniform speed and disappears. According to this embodiment, since the clip 45 is integrally molded, there is no fear that the front end portions 46, 46 and the rear end portion 47 are separated from each other, and the manufacture is easy.

It should be noted that the example of changing the rate of absorption into the living body is not limited to the clip, but may be applied to a stapler or a mesh, and the shapes of the clip and scapera are limited to those of the embodiment. Not a thing.

The embodiments shown in FIGS. 13 to 20 show clips, staplers, etc. having different structures and shapes.
Both of them are made of a bioabsorbable material so as to be decomposed and absorbed after being placed in the body as in the seventh and eighth embodiments. Furthermore, in order to make the rate of decomposition and absorption into the living body of the part with large wall thickness and the part with small wall thickness uniform, the absorption rate of the part with large wall thickness is adjusted to be slower than the part with smaller wall thickness by adjusting the material. is doing.

FIG. 13 shows a ninth embodiment. Clip 5
No. 1 is provided with anti-slip teeth 53 on the inner surface of the grip portion 52. By providing the non-slip teeth 53, the non-slip teeth 53 bite into the tissue of the biological duct when the biological duct is ligated, and the tightening and fixing force of the clip 51 is improved, so that the clip 51 can be prevented from moving and falling off.

FIG. 14 shows a tenth embodiment. In the clip 54 shown in FIG. 5A, a fixing projection 56 having a sharp tip is provided substantially inside the center of one grip 55, and the other grip 57 has a connecting projection 56 corresponding to the fixing projection 56. The hole 58 is provided. Therefore, FIG.
As shown in FIG. 5, when the living body conduit 59 is ligated by the clip 54, the fixing projection 56 penetrates the living body conduit 59 and engages with the connecting hole 58 to improve the fixing force, so that the clip 54 moves and falls off. Can be prevented.

FIG. 15 shows the eleventh embodiment. In the clip 60 shown in FIG. 6A, a first grip member 61 and a second grip member 62 are rotatably connected by a hinge portion 63, and the clip 60 is attached to the outer peripheral portion of the tip end portion of the first grip member 61. Are formed with ratchet teeth 64. Second gripping member 62
Is connected by a ratchet member 67 that engages two ratchet plates 65, 66 provided substantially in parallel with each other at the tip end thereof with the ratchet teeth 64.

Therefore, when the living body conduit 68 is ligated by the clip 60 as shown in FIG.
The gripping member 61 and the second gripping member 62 of the ratchet tooth 6
4 and the ratchet member 67 are connected to each other.
Moreover, since a plurality of ratchet teeth 64 are provided, the tightening allowance can be freely selected, and the clip 60 of the same size can cope with the living body conduits 68 having various diameters. Further, as shown in FIG. 7C, the living body conduit 68 is sandwiched between the second grip member 62 and the grip plates 65 and 66, so that the tightening is strong and the clip 60 does not move or fall off. It can be prevented.

FIG. 16 shows a twelfth embodiment. In the stapler 69 shown in FIG. 6A, a main body 70 has two leg portions 71 rotatably provided by a hinge portion 72. Engagement holes 73 are provided at both ends of the main body 70, and projections 74 that engage with the engagement holes 73 are provided in the leg portions 71. Therefore, as shown in FIG.
When the stitches 5 and 76 are sewn together, since the projection 74 is engaged with the engagement hole 73, there is no possibility that the leg portion 71 will open and the stapler 69 will fall out.

FIG. 17 shows a thirteenth embodiment. A stapler 77 shown in FIGS. 9A and 9B is a stapler main body 78 shown in the third embodiment and the stapler main body 78.
And a fixing member 79 having an opening that can be fitted when deformed to sew.

Therefore, as shown in FIG. 7C, the living tissues 80 and 81 are sewn and fixed by the stapler main body 78, and the fixing member 79 is fitted to the stapler main body 78, whereby the stapler 77 is deformed and dropped. Can be prevented.

FIG. 18 shows a fourteenth embodiment. The stapler 80 shown in FIG.
And a protrusion 8 that can be fitted into the recess 82 of the stapler body 81 when the stapler body 81 is deformed for sewing.
And a fixing member 84 having a number 3.

Therefore, as shown in FIG. 6B, the living tissues 85 and 86 are sewn and fixed by the stapler main body 81, and the fixing member 84 is fitted into the stapler main body 81 to deform or drop the stapler 80. Can be prevented.

FIG. 19 shows a fifteenth embodiment. The clip 87 shown in FIGS. 9A and 9B has a first fixing member 89 and a second fixing member 9 connected by a hinge portion 88.
0, a fixing projection 91 having ratchet teeth is projectingly provided at the tip of the first fixing member 89, and a fitting portion 92 for fitting with the fixing projection 91 is provided on the second fixing member 90. It is provided. The fitting portion 92 is provided with a ratchet member 93 that engages with the ratchet teeth of the fixing projection 91.

Therefore, the fixing projection 91 is attached to the fitting portion 93.
The ratchet teeth and the ratchet member 93 mesh with each other to firmly ligate the living body conduit, and the amount of tightening force can be adjusted by changing the meshing position of the ratchet teeth and the ratchet member 93.

FIG. 20 shows a sixteenth embodiment. In the suturing tool 94 shown in FIG. 7A, a spiral suture needle 96 and a rotation stopping needle 97 are provided on a disk-shaped main body 95. Therefore, as shown in FIG. 7B, the body tissue 95 is rotated to insert the suture needle 96 into the living tissues 98 and 99, whereby the living tissues 98 and 99 can be sutured by the suture needle 96, and the rotation stopping needle 97 is also provided. This makes it possible to prevent the suturing tool 94 from falling off.

[0063]

As described above, according to the present invention, the main body of the suture ligature made of the bioabsorbable material is formed of the bioabsorbable material having the thermal deformation starting temperature of 45 ° C or higher and 100 ° C or lower. As a result, there is an effect that it is possible to provide a suture and ligature for living body that is small in size, easy to suture and ligate a living tissue, does not exert a thermal influence on a living body, and is highly safe.

[Brief description of drawings]

FIG. 1 is a side view of a clip showing a first embodiment of the present invention.

FIG. 2 is a vertical sectional side view of the clip applicator of the same embodiment.

FIG. 3 is a side view showing a grip portion of the clip applicator of the embodiment.

FIG. 4 is a side view showing a state in which a living body duct is ligated by the clip of the embodiment.

FIG. 5 is a vertical sectional side view of a clip applicator showing a second embodiment of the present invention.

FIG. 6 is a side view of a clip showing a third embodiment of the present invention.

FIG. 7 is a cross-sectional view showing a state in which biological tissue is sutured with the clip of the same embodiment.

FIG. 8 is a side view of a clip showing a fourth embodiment of the present invention.

FIG. 9 is a side view of a clip showing a fifth embodiment of the present invention.

FIG. 10 is a side view of a stapler showing a sixth embodiment of the present invention.

FIG. 11 is a perspective view of a clip showing a seventh embodiment of the present invention.

FIG. 12 is a perspective view of a clip showing an eighth embodiment of the present invention.

FIG. 13 is a perspective view of a clip showing a ninth embodiment of the present invention.

FIG. 14 is a perspective view and a usage state diagram of a clip showing a tenth embodiment of the present invention.

FIG. 15 is a perspective view and a use state diagram of a clip showing an eleventh embodiment of the present invention.

FIG. 16 is a perspective view and a use state diagram of a stapler showing a twelfth embodiment of the present invention.

FIG. 17 is a perspective view of a stapler showing a thirteenth embodiment of the present invention.

FIG. 18 is a perspective view and a state of use of a stapler showing a fourteenth embodiment of the present invention.

FIG. 19 is a perspective view and a fragmentary sectional view of a clip showing a fifteenth embodiment of the present invention.

FIG. 20 is a perspective view and a state of use of a suturing tool showing a sixteenth embodiment of the present invention.

[Explanation of symbols]

1 ... Clip (main body of suture ligature), 2 ... Hinge part, 3 ...
Gripping part, 22 ... Living body conduit.

[Procedure amendment]

[Submission date] March 3, 1993

[Procedure Amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0008

[Correction method] Change

[Correction content]

However, since the heat-deformation temperature of the bioabsorbable material that has been put into practical use is in the range of 120 ° C. to 220 ° C., temperature control such as heating and cooling is difficult, and stable fusion bonding is difficult. ..

[Procedure Amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0009

[Correction method] Change

[Correction content]

The present invention has been made in view of the above circumstances, and an object thereof is to make it compact, easy to suture and ligate a living tissue, and to control the temperature by a simple method.
( EN) Provided is a suture and ligature for living body, which can be controlled and can perform stable fusion bonding .

[Procedure 3]

[Document name to be amended] Statement

[Correction target item name] 0011

[Correction method] Change

[Correction content]

[0011]

The body of the suture ligature is thermally deformed in the range of 45 ° C. to 100 ° C. and the living tissue is sutured and ligated. It can be easily and stably fused.

[Procedure amendment 4]

[Document name to be amended] Statement

[Name of item to be corrected] 0023

[Correction method] Change

[Correction content]

According to this embodiment, the living body conduit 22 can be easily ligated by thermally deforming the clip 1 with the heating fluid, and no mechanical fixing means is required for the clip 1, so that the clip can be miniaturized. The method can be performed by a method that is easy to simplify and has a low heat distortion temperature, so that heating and cooling are easy.

[Procedure Amendment 5]

[Document name to be amended] Statement

[Correction target item name] 0031

[Correction method] Change

[Correction content]

According to this embodiment, the stapler 31 is heated to a temperature at which it can be thermally deformed to be softened by heating, and then the stapler 31 is cooled and hardened so that the stapler 31 is hardened in a deformed state, and Organization 34
Since the a and 34b can be reliably sewn together and the stapler 31 does not need a mechanical fixing means, the stapler 31 can be easily downsized and simplified, and the heat deformation temperature is low, so that heating and cooling are easy. Can be done in any way.

[Procedure Amendment 6]

[Document name to be amended] Statement

[Correction target item name] 0042

[Correction method] Change

[Correction content]

Here, the factors relating to the biodegradation rate of the bioabsorbable material will be described. Factors peculiar to materials that regulate the degradation rate of bioabsorbable materials are (1) molecular weight, (2)
Polymerization composition, (3) residual monomer amount, and (4) molecular arrangement regularity are listed. Regarding the molecular weight, the larger the molecular weight, the slower the absorption rate, and the lower the molecular weight, the faster the absorption rate. Regarding the polymerization composition, taking a copolymer of polylactic acid and polyglycolic acid as an example, the lower the proportion of glycolic acid, the slower the decomposition rate, and the higher the proportion of glycolic acid, the faster the decomposition rate. In addition, as the amount of residual monomer increases, the decomposition rate tends to increase. Regarding the molecular arrangement, the higher the crystallinity, the slower the decomposition rate, and the lower the crystallinity, the faster the decomposition rate. Taking polylactic acid as an example, since lactic acid has an optical isomer, poly-L lactic acid obtained by polymerizing only the L-form and poly-D lactic acid obtained by polymerizing only the D-form have high crystallinity and a slow decomposition rate. Poly-D and L-lactic acid, which are L-form copolymers, become amorphous and have a faster decomposition rate.

[Procedure Amendment 7]

[Document name to be amended] Statement

[Correction target item name] 0043

[Correction method] Change

[Correction content]

According to the above results, the front end portions 39, 39 having a high absorption rate have, for example, an average molecular weight of about 100,000 and poly-D, L lactic acid: glycolic acid = 80: 20 .
A material that is a polymer and has a residual monomer amount of 14% by weight is used. On the other hand, the rear end portion 40 having a slow absorption rate has an average molecular weight.
The amount is about 200,000 and does not contain residual monomer.
A homopolymer of Li-D lactic acid is used.

Front Page Continuation (72) Inventor Akito Mukaizawa 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Shuichi Kimura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Ori Inpass Optical Industry Co., Ltd. (72) Inventor, Tsukakoshi Iso 2-43-2 Hatagaya, Shibuya-ku, Tokyo Orimpus Optical Industry Co., Ltd. (72) Inventor Yumi Hirao 2-43-2 Hatagaya, Shibuya-ku, Tokyo Ori (72) Inventor Akio Nakata 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Shiro Bito 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd.

Claims (1)

[Claims] 1. A suture and ligature for living body, which is made of a bioabsorbable material and which sutures and ligates biological tissue by thermal deformation,
The body of the suture and ligature has a thermal deformation starting temperature of 45 degrees Celsius or higher,
A suture and ligature for living body, which is formed of a bioabsorbable material of 100 degrees or less.