JPH06237937A - 外科用縫合器 - Google Patents
外科用縫合器Info
- Publication number
- JPH06237937A JPH06237937A JP5024400A JP2440093A JPH06237937A JP H06237937 A JPH06237937 A JP H06237937A JP 5024400 A JP5024400 A JP 5024400A JP 2440093 A JP2440093 A JP 2440093A JP H06237937 A JPH06237937 A JP H06237937A
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Abstract
(57)【要約】
【目的】 ファスナの交換を容易にし、本体を繰返し使
用する。また、体腔内の生体組織に経皮的に挿入する。 【構成】 体腔内に挿入される挿入部2の先端に互いに
対向して設けられたカートリッジ7およびカートリッジ
受け体5により生体組織を挟持し、これらカートリッジ
7およびカートリッジ受け体5に収容された複数のファ
スナ4…およびリテーナ6…で組織を縫合する外科用縫
合器において、カートリッジ7およびカートリッジ受け
体5を先端ユニット3とし、挿入部2に対して着脱自在
とした。
用する。また、体腔内の生体組織に経皮的に挿入する。 【構成】 体腔内に挿入される挿入部2の先端に互いに
対向して設けられたカートリッジ7およびカートリッジ
受け体5により生体組織を挟持し、これらカートリッジ
7およびカートリッジ受け体5に収容された複数のファ
スナ4…およびリテーナ6…で組織を縫合する外科用縫
合器において、カートリッジ7およびカートリッジ受け
体5を先端ユニット3とし、挿入部2に対して着脱自在
とした。
Description
【0001】
【産業上の利用分野】本発明は内視鏡下の体腔内手術に
おいて、腸等の管状組織を切断・縫合する際に使用され
る外科用縫合器に関する。
おいて、腸等の管状組織を切断・縫合する際に使用され
る外科用縫合器に関する。
【0002】
【従来の技術】従来、この種の外科用縫合器において
は、USP5040715およびUSP5156614
に開示されたものが一般に知られている。すなわち、こ
の外科用縫合器はその基端に把持部を有し、この把持部
にはその先端から延出して挿入部が設けられている。こ
の挿入部は前記把持部に対して伸長し、かつ経皮的に挿
入可能である。
は、USP5040715およびUSP5156614
に開示されたものが一般に知られている。すなわち、こ
の外科用縫合器はその基端に把持部を有し、この把持部
にはその先端から延出して挿入部が設けられている。こ
の挿入部は前記把持部に対して伸長し、かつ経皮的に挿
入可能である。
【0003】前記挿入部の先端にはカートリッジが着脱
可能に設けられ、このカートリッジには、ほぼU字状に
成形された複数の金属ファスナが収納されている。ま
た、前記挿入部の先端には、前記金属ファスナの脚部を
折曲げるためのアンビルが前記カートリッジに対向して
設けられている。このアンビルはその端部に設けられた
板バネによってカートリッジに対して開状態に弾性的に
付勢されている。
可能に設けられ、このカートリッジには、ほぼU字状に
成形された複数の金属ファスナが収納されている。ま
た、前記挿入部の先端には、前記金属ファスナの脚部を
折曲げるためのアンビルが前記カートリッジに対向して
設けられている。このアンビルはその端部に設けられた
板バネによってカートリッジに対して開状態に弾性的に
付勢されている。
【0004】前記挿入部内には、カートリッジ内に収容
された複数の金属ファスナをカートリッジから押出し、
カートリッジとアンビルとの間に挟まれた組織に金属フ
ァスナの脚部を刺し込むための摺動部材が設けられてい
る。そして、前記把持部には、この摺動部材を摺動する
ためのハンドルが設けられている。
された複数の金属ファスナをカートリッジから押出し、
カートリッジとアンビルとの間に挟まれた組織に金属フ
ァスナの脚部を刺し込むための摺動部材が設けられてい
る。そして、前記把持部には、この摺動部材を摺動する
ためのハンドルが設けられている。
【0005】このような外科用縫合器においては、体腔
内に挿入部を経皮的に挿入し、アンビルとカートリッジ
との間に縫合対象である生体組織を挟み、把持部の操作
ハンドルを操作すると、挿入部内の摺動部材が挿入部の
先端側に摺動する。これにより、カートリッジから押出
されたファスナの脚部が生体組織を貫通してアンビルに
当接したファスナの脚部が内側に折曲することによっ
て、前記生体組織を縫合する。
内に挿入部を経皮的に挿入し、アンビルとカートリッジ
との間に縫合対象である生体組織を挟み、把持部の操作
ハンドルを操作すると、挿入部内の摺動部材が挿入部の
先端側に摺動する。これにより、カートリッジから押出
されたファスナの脚部が生体組織を貫通してアンビルに
当接したファスナの脚部が内側に折曲することによっ
て、前記生体組織を縫合する。
【0006】また、外科用縫合器においてはUSP51
56614に開示されたものも一般に知られている。す
なわち、この外科用縫合器は樹脂等の生体吸収材料から
なるファスナおよびリテーナを用いて生体組織を縫合す
るものであり、第1の本体および第2の本体から構成さ
れる。
56614に開示されたものも一般に知られている。す
なわち、この外科用縫合器は樹脂等の生体吸収材料から
なるファスナおよびリテーナを用いて生体組織を縫合す
るものであり、第1の本体および第2の本体から構成さ
れる。
【0007】前記第1の本体には2つの脚部を有するU
字型に形成されたファスナを収納保持するカートリッジ
を有する。また第2の本体には前記ファスナの脚部を嵌
入する穴部を有するリテーナを収納保持するリテーナ保
持部を有する。そして、このリテーナは、前記ファスナ
に対向する位置に収納保持されている。
字型に形成されたファスナを収納保持するカートリッジ
を有する。また第2の本体には前記ファスナの脚部を嵌
入する穴部を有するリテーナを収納保持するリテーナ保
持部を有する。そして、このリテーナは、前記ファスナ
に対向する位置に収納保持されている。
【0008】このような構成の外科用縫合器において
は、第1の本体および第2の本体を分割した状態で、カ
ートリッジおよびリテーナ保持部の間に縫合対象の生体
組織を挟持し、第1の本体および第2の本体を結合し組
立てる。そして基端の把持部に設けられたレバーを先端
に向けてスライド移動させることにより、ファスナは生
体組織に打出される。すると、このファスナの脚部が生
体組織に貫通し、リテーナの穴部に嵌入されてファスナ
とリテーナが生体組織に固定され、この生体組織は縫合
される。
は、第1の本体および第2の本体を分割した状態で、カ
ートリッジおよびリテーナ保持部の間に縫合対象の生体
組織を挟持し、第1の本体および第2の本体を結合し組
立てる。そして基端の把持部に設けられたレバーを先端
に向けてスライド移動させることにより、ファスナは生
体組織に打出される。すると、このファスナの脚部が生
体組織に貫通し、リテーナの穴部に嵌入されてファスナ
とリテーナが生体組織に固定され、この生体組織は縫合
される。
【0009】
【発明が解決しようとする課題】しかし、前者の外科用
縫合器においては、アンビルが板バネによって開状態で
挿入部に弾性固着されているため、板バネの疲労度から
使用回数が制限されている。このため、手術中に板バネ
の疲労等によりアンビルが破損してもアンビルだけを交
換することができず、外科用縫合器自体を交換しなけれ
ばならないという問題があった。また、この外科用縫合
器に生体吸収性材料のファスナを適用しようとすればア
ンビルにリテーナを収容保持する必要があるが、このア
ンビルは着脱できないためリテーナ補充が困難であると
いう虞があった。
縫合器においては、アンビルが板バネによって開状態で
挿入部に弾性固着されているため、板バネの疲労度から
使用回数が制限されている。このため、手術中に板バネ
の疲労等によりアンビルが破損してもアンビルだけを交
換することができず、外科用縫合器自体を交換しなけれ
ばならないという問題があった。また、この外科用縫合
器に生体吸収性材料のファスナを適用しようとすればア
ンビルにリテーナを収容保持する必要があるが、このア
ンビルは着脱できないためリテーナ補充が困難であると
いう虞があった。
【0010】一方、後者の外科用縫合器においては、第
1の本体と第2の本体を組立てる構成であるため、挿入
部を有していないことから、体腔内の生体組織に経皮的
に挿入できないという問題があった。
1の本体と第2の本体を組立てる構成であるため、挿入
部を有していないことから、体腔内の生体組織に経皮的
に挿入できないという問題があった。
【0011】そこで本発明の目的は、ファスナの交換が
容易で、本体を繰返し使用でき、しかも体腔内の生体組
織に経皮的に挿入できる外科用縫合器を提供しようとす
るものである。
容易で、本体を繰返し使用でき、しかも体腔内の生体組
織に経皮的に挿入できる外科用縫合器を提供しようとす
るものである。
【0012】
【課題を解決するための手段】本発明は、体腔内に挿入
される挿入部の先端に互いに対向して設けられた一対の
組織挟持体により生体組織を挟持し、組織挟持体に収容
された複数のファスナで組織を縫合する外科用縫合器に
おいて、挟持体をユニット化し、挿入部に対して着脱自
在とするものである。
される挿入部の先端に互いに対向して設けられた一対の
組織挟持体により生体組織を挟持し、組織挟持体に収容
された複数のファスナで組織を縫合する外科用縫合器に
おいて、挟持体をユニット化し、挿入部に対して着脱自
在とするものである。
【0013】また、体腔内に挿入される挿入部の先端に
互いに対向して設けられた一対の組織挟持体により生体
組織を挟持し、これら組織挟持体のうち一方の組織挟持
体に収容された複数のファスナと他方の組織挟持体に収
容されたファスナと係合するリテーナとで生体組織を縫
合する外科用縫合器において、組織挟持体に対してファ
スナとリテーナとを各々着脱自在とするものである。化
し、挿入部に対して着脱自在とするものである。
互いに対向して設けられた一対の組織挟持体により生体
組織を挟持し、これら組織挟持体のうち一方の組織挟持
体に収容された複数のファスナと他方の組織挟持体に収
容されたファスナと係合するリテーナとで生体組織を縫
合する外科用縫合器において、組織挟持体に対してファ
スナとリテーナとを各々着脱自在とするものである。化
し、挿入部に対して着脱自在とするものである。
【0014】
【作用】このような構成の本発明においては、ファスナ
またはリテーナを補充する場合には、ユニット化された
挟持体を挿入部から抜脱する。そしてファスナまたはリ
テーナを各々挟持体に充填し、再び挿入部に装着する。
またはリテーナを補充する場合には、ユニット化された
挟持体を挿入部から抜脱する。そしてファスナまたはリ
テーナを各々挟持体に充填し、再び挿入部に装着する。
【0015】
【実施例】以下、本発明の一実施例を図面を参照して説
明する。
明する。
【0016】図1は本実施例の外観を示す斜視図で、1
はグリップ部である。このグリップ部1にはその先端か
ら延出した挿入部2がグリップ部1に対して着脱自在に
設けられている。この挿入部2の先端には縫合対象であ
る生体組織を挟持し縫合するための先端ユニット3が設
けられている。
はグリップ部である。このグリップ部1にはその先端か
ら延出した挿入部2がグリップ部1に対して着脱自在に
設けられている。この挿入部2の先端には縫合対象であ
る生体組織を挟持し縫合するための先端ユニット3が設
けられている。
【0017】前記先端ユニット3は、図2に示すよう
に、挿入部2の先端に設けられたカートリッジ受け体
(第1の組織挟持体)5と、このカートリッジ受け体5
に対向して設けられ、かつカートリッジ受け体5に対し
て着脱自在に支持されたカートリッジ(第2の組織挟持
体)7とから構成されている。
に、挿入部2の先端に設けられたカートリッジ受け体
(第1の組織挟持体)5と、このカートリッジ受け体5
に対向して設けられ、かつカートリッジ受け体5に対し
て着脱自在に支持されたカートリッジ(第2の組織挟持
体)7とから構成されている。
【0018】前記カートリッジ受け体5は、その先端に
設けられたリテーナカートリッジ5Aと、このリテーナ
カートリッジ5Aを内部に保持するためのリテーナカー
トリッジ保持体5Bとからなる。
設けられたリテーナカートリッジ5Aと、このリテーナ
カートリッジ5Aを内部に保持するためのリテーナカー
トリッジ保持体5Bとからなる。
【0019】前記リテーナカートリッジ5Aは、その内
部に後述するリテーナ6…を収納保持する。また、リテ
ーナカートリッジ保持体5Bは、その内部に前記リテー
ナカートリッジ5Aを支持するリテーナ支持部5aを先
端側に有している。このリテーナ支持部5aの後端に
は、前記カートリッジ7を接続支持するためのカートリ
ッジ支持部5bが連設されており、このカートリッジ支
持部5bの後端には前記挿入部2に係止される係止部5
cが連設されている。
部に後述するリテーナ6…を収納保持する。また、リテ
ーナカートリッジ保持体5Bは、その内部に前記リテー
ナカートリッジ5Aを支持するリテーナ支持部5aを先
端側に有している。このリテーナ支持部5aの後端に
は、前記カートリッジ7を接続支持するためのカートリ
ッジ支持部5bが連設されており、このカートリッジ支
持部5bの後端には前記挿入部2に係止される係止部5
cが連設されている。
【0020】前記カートリッジ支持部5bの上面には、
カートリッジ7を接続支持するための差込み孔12が形
成されている。また、カートリッジ支持部5bの先端縁
部には、前記カートリッジ7のカートリッジ支持部5b
への挿入をガイドするスリット14が形成されている。
カートリッジ7を接続支持するための差込み孔12が形
成されている。また、カートリッジ支持部5bの先端縁
部には、前記カートリッジ7のカートリッジ支持部5b
への挿入をガイドするスリット14が形成されている。
【0021】一方、前記カートリッジ7は、その先端に
設けられたファスナカートリッジ7Aと、このファスナ
カートリッジ7Aを内部に保持するためのファスナカー
トリッジ保持体7Bとからなる。
設けられたファスナカートリッジ7Aと、このファスナ
カートリッジ7Aを内部に保持するためのファスナカー
トリッジ保持体7Bとからなる。
【0022】前記ファスナカートリッジ7Aは、その内
部に後述するファスナ4…を収納保持する。また、ファ
スナカートリッジ保持体7Bは、その内部に前記ファス
ナカートリッジ7Aを支持するファスナ支持部7aを先
端側に有している。このファスナ支持部7aの後端に
は、前記リテーナカートリッジ受け体5に接続支持され
る受け体接続部7bが連設されている。
部に後述するファスナ4…を収納保持する。また、ファ
スナカートリッジ保持体7Bは、その内部に前記ファス
ナカートリッジ7Aを支持するファスナ支持部7aを先
端側に有している。このファスナ支持部7aの後端に
は、前記リテーナカートリッジ受け体5に接続支持され
る受け体接続部7bが連設されている。
【0023】前記受け体接続部7bの後端には、前記カ
ートリッジ受け体5の差込み孔12に差込み可能に支持
されるカートリッジ支持用板バネ11が形成されてい
る。また、受け体接続部7bの側面には、支持用凸部1
3が設けられている。
ートリッジ受け体5の差込み孔12に差込み可能に支持
されるカートリッジ支持用板バネ11が形成されてい
る。また、受け体接続部7bの側面には、支持用凸部1
3が設けられている。
【0024】そして、前記カートリッジ受け体5の差込
み孔12に前記カートリッジ7のカートリッジ支持用板
バネ11を差込むとともにカートリッジ受け体5のスリ
ット14に沿ってカートリッジ7の支持用凸部13を挿
入すると、カートリッジ7はカートリッジ受け体5に対
して弾性的に回動自在に装着保持される。前記カートリ
ッジ受け体5の係止部5cには、前記挿入部2と接続す
るためのユニット保持用切欠部15が設けられている。
み孔12に前記カートリッジ7のカートリッジ支持用板
バネ11を差込むとともにカートリッジ受け体5のスリ
ット14に沿ってカートリッジ7の支持用凸部13を挿
入すると、カートリッジ7はカートリッジ受け体5に対
して弾性的に回動自在に装着保持される。前記カートリ
ッジ受け体5の係止部5cには、前記挿入部2と接続す
るためのユニット保持用切欠部15が設けられている。
【0025】前記挿入部2は、図3にも示すように、最
も外側の外套管16と、この外套管16内に設けられた
ジョーホールド管17と、このジョーホールド管17内
に設けられたカムプッシャ摺動部材18とから構成され
る。
も外側の外套管16と、この外套管16内に設けられた
ジョーホールド管17と、このジョーホールド管17内
に設けられたカムプッシャ摺動部材18とから構成され
る。
【0026】このジョーホールド管17の先端には、図
4に示すように、前記先端ユニット3のユニット保持用
切欠部15にジョーホールド管17を係止するための係
止片17aが形成されている。
4に示すように、前記先端ユニット3のユニット保持用
切欠部15にジョーホールド管17を係止するための係
止片17aが形成されている。
【0027】前記ジョーホールド管17の係止片17a
には外側面に向けて突起部17bが形成されており、一
方、前記外套管16には、図1に示すように、この外套
管16をジョーホールド管17に対して摺動方向にガイ
ドするとともに周方向の回転を防止するためのスリット
19が設けられている。
には外側面に向けて突起部17bが形成されており、一
方、前記外套管16には、図1に示すように、この外套
管16をジョーホールド管17に対して摺動方向にガイ
ドするとともに周方向の回転を防止するためのスリット
19が設けられている。
【0028】そして、この外套管16のスリット19に
ジョーホールド管17の突起部17bを嵌め込むことに
よって、外套管17はジョーホールド管17に対して摺
動自在となる。なお、前記ジョーホールド管17は、そ
の内部にカムプッシャ摺動部材18を軸方向にガイドす
るカムプッシャガイド部材20を有している。
ジョーホールド管17の突起部17bを嵌め込むことに
よって、外套管17はジョーホールド管17に対して摺
動自在となる。なお、前記ジョーホールド管17は、そ
の内部にカムプッシャ摺動部材18を軸方向にガイドす
るカムプッシャガイド部材20を有している。
【0029】前記先端ユニット3のカートリッジ7の先
端には、図5に示すように、その内部にファスナ4…が
収納保持されている。このファスナ4…は2つの脚部4
a…を有するU字形状をなし生体吸収材料で構成されて
いる。
端には、図5に示すように、その内部にファスナ4…が
収納保持されている。このファスナ4…は2つの脚部4
a…を有するU字形状をなし生体吸収材料で構成されて
いる。
【0030】前記カートリッジ7の下面(カートリッジ
受け体5に対向する面)には、その略中央に軸方向に沿
ってを前記ナイフ25をガイドするナイフガイド溝27
が設けられている。また、このナイフガイド溝27の両
側には、前記ファスナ4…を収納保持するためのファス
ナ用溝28が設けられている。
受け体5に対向する面)には、その略中央に軸方向に沿
ってを前記ナイフ25をガイドするナイフガイド溝27
が設けられている。また、このナイフガイド溝27の両
側には、前記ファスナ4…を収納保持するためのファス
ナ用溝28が設けられている。
【0031】前記ファスナ4…は、カートリッジ7内の
先端側に、軸方向に1つずつ離隔して配設され、かつこ
れらの脚部4a…を挟む位置に2つずつ配設されてい
る。これを1セットとすると、前記ナイフガイド溝28
の両側にそれぞれ1セットずつのファスナ4…が配設さ
れている。また、このファスナ4…の底部には、このフ
ァスナ4…を押出すためのファスナプッシャ29(図7
参照)が設けられている。
先端側に、軸方向に1つずつ離隔して配設され、かつこ
れらの脚部4a…を挟む位置に2つずつ配設されてい
る。これを1セットとすると、前記ナイフガイド溝28
の両側にそれぞれ1セットずつのファスナ4…が配設さ
れている。また、このファスナ4…の底部には、このフ
ァスナ4…を押出すためのファスナプッシャ29(図7
参照)が設けられている。
【0032】前記カートリッジ7内の基端側には、前記
ナイフ25と、このナイフ25の両側に設けられた一対
のカムプッシャ31と、これらナイフ25およびカムプ
ッシャ31の基端に固着されたカム継手32とが設けら
れている。このカム継手32の基端側の表面には、前記
カムプッシャ摺動部材18の先端を挿入するための溝部
33が設けられている。
ナイフ25と、このナイフ25の両側に設けられた一対
のカムプッシャ31と、これらナイフ25およびカムプ
ッシャ31の基端に固着されたカム継手32とが設けら
れている。このカム継手32の基端側の表面には、前記
カムプッシャ摺動部材18の先端を挿入するための溝部
33が設けられている。
【0033】一方、前記先端ユニット3のカートリッジ
受け体5内の先端には、その内部に前記ファスナ4…に
対向する位置にリテーナ6…が配設されている。このリ
テーナ6…は前記ファスナ4…の脚部4a…が嵌入され
る穴部6a…を有している。
受け体5内の先端には、その内部に前記ファスナ4…に
対向する位置にリテーナ6…が配設されている。このリ
テーナ6…は前記ファスナ4…の脚部4a…が嵌入され
る穴部6a…を有している。
【0034】そして、前記先端ユニット3に生体組織を
挟持しているときに、前記カムプッシャ摺動部材18を
摺動すると、このカムプッシャ摺動部材18の先端が前
記カム継手33に到達する。さらにカムプッシャ摺動部
材18を摺動すると、ナイフ25およびカムプッシャ3
1はカムプッシャ摺動部材18とともに摺動する。そし
て、このナイフ25は生体組織を切断し、カムプッシャ
31はファスナ4…をカートリッジ7から押出すように
なっている。このとき、ファスナ4…の脚部4a…は生
体組織を貫通して、リテーナ6…の穴部6a…に嵌入す
るようになっている。
挟持しているときに、前記カムプッシャ摺動部材18を
摺動すると、このカムプッシャ摺動部材18の先端が前
記カム継手33に到達する。さらにカムプッシャ摺動部
材18を摺動すると、ナイフ25およびカムプッシャ3
1はカムプッシャ摺動部材18とともに摺動する。そし
て、このナイフ25は生体組織を切断し、カムプッシャ
31はファスナ4…をカートリッジ7から押出すように
なっている。このとき、ファスナ4…の脚部4a…は生
体組織を貫通して、リテーナ6…の穴部6a…に嵌入す
るようになっている。
【0035】前記グリップ部1は、図6に示すように、
前記外套管16を摺動するための外套管摺動部材41を
有し、この外套管摺動部材41内には前記固定管42が
設けられている。さらに、この固定管42内には前記カ
ムプッシャ摺動部材18を摺動するグリップ側摺動部材
43が設けられている。
前記外套管16を摺動するための外套管摺動部材41を
有し、この外套管摺動部材41内には前記固定管42が
設けられている。さらに、この固定管42内には前記カ
ムプッシャ摺動部材18を摺動するグリップ側摺動部材
43が設けられている。
【0036】前記グリップ側摺動部材43の先端には凸
部43aが形成されている。一方、カムプッシャ摺動部
材18の基端には前記グリップ側摺動部材43の凸部4
3aを嵌挿する凹部18aが設けられている。また、前
記固定管42の先端部には、前記ジョーホールド管17
を接続するための係止孔42aが形成されている。一
方、ジョーホールド管17の基端には前記固定管42の
係止孔42aに係止するための係止つめ17cが形成さ
れている。
部43aが形成されている。一方、カムプッシャ摺動部
材18の基端には前記グリップ側摺動部材43の凸部4
3aを嵌挿する凹部18aが設けられている。また、前
記固定管42の先端部には、前記ジョーホールド管17
を接続するための係止孔42aが形成されている。一
方、ジョーホールド管17の基端には前記固定管42の
係止孔42aに係止するための係止つめ17cが形成さ
れている。
【0037】そして、挿入部2をグリップ部1に装着す
ると、グリップ側摺動部材43はカムプッシャ摺動部材
18に接続され、かつジョーホールド管17は固定管4
2に着脱自在に接続されるようになっている。
ると、グリップ側摺動部材43はカムプッシャ摺動部材
18に接続され、かつジョーホールド管17は固定管4
2に着脱自在に接続されるようになっている。
【0038】前記外套管摺動部材41には、前記ジョー
ホールド管17の係止つめ17cを固定管42の係止孔
42aから離脱させるための係止つめプッシャ44が周
方向に複数設けられている。なお、これら係止つめプッ
シャ44は外套管摺動部材41の半径方向に摺動可能で
ある。
ホールド管17の係止つめ17cを固定管42の係止孔
42aから離脱させるための係止つめプッシャ44が周
方向に複数設けられている。なお、これら係止つめプッ
シャ44は外套管摺動部材41の半径方向に摺動可能で
ある。
【0039】そして、外套管摺動部材41の周方向中心
に向けて、係止つめプッシャ44を押圧すると前記ジョ
ーホールド管17の係止つめ17cは固定管42の係止
孔42aから離脱し、固定管42からジョーホールド管
17を抜出可能となる。
に向けて、係止つめプッシャ44を押圧すると前記ジョ
ーホールド管17の係止つめ17cは固定管42の係止
孔42aから離脱し、固定管42からジョーホールド管
17を抜出可能となる。
【0040】前記外套管摺動部材41の先端の外側面に
はおねじ41aが形成されている。一方、外套管16の
基端の内側面には前記外套管摺動部材41に螺着するた
めのめねじが形成されている。外套管16とグリップ部
1の間には、この外套管16を周方向に位置決めするた
めの外套管位置決め継手46が設けられている。
はおねじ41aが形成されている。一方、外套管16の
基端の内側面には前記外套管摺動部材41に螺着するた
めのめねじが形成されている。外套管16とグリップ部
1の間には、この外套管16を周方向に位置決めするた
めの外套管位置決め継手46が設けられている。
【0041】そして、外套管16を外套管摺動部材41
に螺着して挿入部2をグリップ部1に装着する。このと
き、外套管16の前記スリット19にジョーホールド管
17の突起部17bを嵌入すると、この外套管16はジ
ョーホールド管17に対して周方向に位置決めされる。
このように位置決めされた状態で外套管位置決め継手4
6を先端方向に進行するように回転して外套管16を固
定する。
に螺着して挿入部2をグリップ部1に装着する。このと
き、外套管16の前記スリット19にジョーホールド管
17の突起部17bを嵌入すると、この外套管16はジ
ョーホールド管17に対して周方向に位置決めされる。
このように位置決めされた状態で外套管位置決め継手4
6を先端方向に進行するように回転して外套管16を固
定する。
【0042】前記グリップ部1はハンドル51および外
套管摺動レバー52を有し、このハンドル51はグリッ
プ部1に対して回動自在に設けられている。このハンド
ル51を回動操作することにより、前記グリップ側摺動
部材43が摺動し、カムプッシャ摺動部材18を介して
カムプッシャ31が摺動する。
套管摺動レバー52を有し、このハンドル51はグリッ
プ部1に対して回動自在に設けられている。このハンド
ル51を回動操作することにより、前記グリップ側摺動
部材43が摺動し、カムプッシャ摺動部材18を介して
カムプッシャ31が摺動する。
【0043】前記外套管摺動レバー52はグリップ部1
の外部に設けられ、この外套管摺動レバー52を先端方
向に摺動することによって、外套管摺動部材41を介し
て外套管16が先端方向に摺動される。
の外部に設けられ、この外套管摺動レバー52を先端方
向に摺動することによって、外套管摺動部材41を介し
て外套管16が先端方向に摺動される。
【0044】なお、前記外套管摺動部材41と固定管4
2との間およびこの固定管42とグリップ側摺動部材4
3との間、外套管16とジョーホールド管17との間お
よびこのジョーホールド管17とカムプッシャ摺動部材
18との間には、体液等がグリップ部1に侵入されるこ
とを防ぐためのリング状のシール部材53が設けられて
いる。
2との間およびこの固定管42とグリップ側摺動部材4
3との間、外套管16とジョーホールド管17との間お
よびこのジョーホールド管17とカムプッシャ摺動部材
18との間には、体液等がグリップ部1に侵入されるこ
とを防ぐためのリング状のシール部材53が設けられて
いる。
【0045】このような構成の本実施例においては、先
端ユニット3のカートリッジ受け体5とカートリッジ7
とが開いた状態で、挿入部2を体腔内に経皮的に挿入
し、これらカートリッジ受け体5とカートリッジ7と間
に縫合対象となる生体組織を挟み、外套管摺動レバー5
2を操作する。
端ユニット3のカートリッジ受け体5とカートリッジ7
とが開いた状態で、挿入部2を体腔内に経皮的に挿入
し、これらカートリッジ受け体5とカートリッジ7と間
に縫合対象となる生体組織を挟み、外套管摺動レバー5
2を操作する。
【0046】すると、外套管16は先端方向に摺動さ
れ、カートリッジ受け体5およびカートリッジ7の基端
は外套管16の先端に挿入される。そして、これらカー
トリッジ受け体5およびカートリッジ7は閉じ、生体組
織は挟持される。
れ、カートリッジ受け体5およびカートリッジ7の基端
は外套管16の先端に挿入される。そして、これらカー
トリッジ受け体5およびカートリッジ7は閉じ、生体組
織は挟持される。
【0047】このとき、グリップ部1のハンドル51を
回動操作と、グリップ側摺動部材43を介してカムプッ
シャ摺動部材18が摺動する。そして、先端ユニット3
のナイフ25およびカムプッシャ31が摺動され、この
生体組織はナイフ25によって切断される。
回動操作と、グリップ側摺動部材43を介してカムプッ
シャ摺動部材18が摺動する。そして、先端ユニット3
のナイフ25およびカムプッシャ31が摺動され、この
生体組織はナイフ25によって切断される。
【0048】このとき、カムプッシャ31が摺動される
と、図7に示すように、ファスナ4…はファスナプッシ
ャ29を介して押出される。そしてこのファスナ4…の
脚部4a…は生体組織に貫通した後、リテーナ6…の穴
部6a…に嵌入され、生体組織は縫合される。
と、図7に示すように、ファスナ4…はファスナプッシ
ャ29を介して押出される。そしてこのファスナ4…の
脚部4a…は生体組織に貫通した後、リテーナ6…の穴
部6a…に嵌入され、生体組織は縫合される。
【0049】このように生体組織を縫合した後、ファス
ナ4…およびリテーナ6…を交換する場合には、挿入部
2から先端ユニット3を引抜き、ファスナカートリッジ
7Aおよびリテーナカートリッジ5Aを交換して、挿入
部2に再び先端ユニット3を装着する。
ナ4…およびリテーナ6…を交換する場合には、挿入部
2から先端ユニット3を引抜き、ファスナカートリッジ
7Aおよびリテーナカートリッジ5Aを交換して、挿入
部2に再び先端ユニット3を装着する。
【0050】このように、カートリッジ受け体5とカー
トリッジ7をユニット化したことにより、ファスナ4…
およびリテーナ6…切れにより交換が必要な場合には、
外科用縫合器自体を交換することなく、先端ユニット3
を着脱して交換することができ、したがって交換作業を
容易に行うことができる。
トリッジ7をユニット化したことにより、ファスナ4…
およびリテーナ6…切れにより交換が必要な場合には、
外科用縫合器自体を交換することなく、先端ユニット3
を着脱して交換することができ、したがって交換作業を
容易に行うことができる。
【0051】また、カートリッジ受け体5からカートリ
ッジ7を着脱自在にしたことから、カートリッジ支持用
板バネ11の疲労等によりカートリッジ7のみが破損し
た場合には、このカートリッジ7のみを交換でき、従っ
て外科用縫合器自体の長寿命化を図ることができる。さ
らにまた、グリップ部1から挿入部2を着脱自在にした
ことから、手術中に体液等により汚染される挿入部2の
みを交換することができる。
ッジ7を着脱自在にしたことから、カートリッジ支持用
板バネ11の疲労等によりカートリッジ7のみが破損し
た場合には、このカートリッジ7のみを交換でき、従っ
て外科用縫合器自体の長寿命化を図ることができる。さ
らにまた、グリップ部1から挿入部2を着脱自在にした
ことから、手術中に体液等により汚染される挿入部2の
みを交換することができる。
【0052】なお、本実施例においては、各挟持体にぞ
れぞれファスナ4…およびリテーナ6…を複数充填し、
これらファスナ4…の脚4aをリテーナ6…に嵌入して
縫合するものについて述べたが、必ずしもこれに限定さ
れるものではなく、挟持体の一方に複数のファスナ4…
を充填し、これらファスナ4…の脚部4a…を他方の挟
持体により折曲させて縫合するものでもよい。次に、本
発明の他の実施例を図8ないし図9を参照して説明す
る。なお、前記実施例と同一部分には、同一符号を付し
て詳細な説明を省略する。
れぞれファスナ4…およびリテーナ6…を複数充填し、
これらファスナ4…の脚4aをリテーナ6…に嵌入して
縫合するものについて述べたが、必ずしもこれに限定さ
れるものではなく、挟持体の一方に複数のファスナ4…
を充填し、これらファスナ4…の脚部4a…を他方の挟
持体により折曲させて縫合するものでもよい。次に、本
発明の他の実施例を図8ないし図9を参照して説明す
る。なお、前記実施例と同一部分には、同一符号を付し
て詳細な説明を省略する。
【0053】本実施例において、前記実施例と異なる点
は、ハンドル51および外套管摺動レバー52によって
外套管16およびカムプッシャ摺動部材18を摺動させ
る代わりに、グリップ部2内に設けられたモータ62
(図9参照)を駆動することによって、これら外套管1
6およびカムプッシャ摺動部材18を摺動するところで
ある。
は、ハンドル51および外套管摺動レバー52によって
外套管16およびカムプッシャ摺動部材18を摺動させ
る代わりに、グリップ部2内に設けられたモータ62
(図9参照)を駆動することによって、これら外套管1
6およびカムプッシャ摺動部材18を摺動するところで
ある。
【0054】前記グリップ部1の外側面には、図8に示
すように、前記モータ62を駆動するための駆動スイッ
チ61が設けられ、この駆動スイッチ61はグリップ部
1内に設けられた制御ユニット81に電気的に接続され
ている。
すように、前記モータ62を駆動するための駆動スイッ
チ61が設けられ、この駆動スイッチ61はグリップ部
1内に設けられた制御ユニット81に電気的に接続され
ている。
【0055】前記グリップ部1内には、図9に示すよう
に、モータ62が設けられ、このモータ62の駆動軸6
3は長手方向に平行して設けられている。また、モータ
62のモータ軸63の先端には、ウォームギア64が設
けられている。
に、モータ62が設けられ、このモータ62の駆動軸6
3は長手方向に平行して設けられている。また、モータ
62のモータ軸63の先端には、ウォームギア64が設
けられている。
【0056】前記ウォームギア64には、第1のギア6
5が噛合っており、この第1のギア65の回転軸は前記
モータ62の駆動軸63に垂直に設けられている。ま
た、この第1のギア65には第2のギア66が噛合って
いる。そして、第2のギア66は、その回転軸が板バネ
(図示しない)で上方に付勢されている。
5が噛合っており、この第1のギア65の回転軸は前記
モータ62の駆動軸63に垂直に設けられている。ま
た、この第1のギア65には第2のギア66が噛合って
いる。そして、第2のギア66は、その回転軸が板バネ
(図示しない)で上方に付勢されている。
【0057】前記第2のギア66には、第3のギア67
が噛合っている。そして、この第3のギア67の回転軸
には、前記第2のギア66の回転軸を下方に摺動して、
前記モータ62からの回転が伝達されないようにするた
めのギアプッシャレバー68が固定されている。このギ
アプッシャレバー68は第3のギア67の回転とともに
前記グリップ部1に設けられた溝(図示しない)に沿っ
て回動し、前記第2のギア66の回転軸が下方に押し下
げられると、その位置でロックするようになっている。
が噛合っている。そして、この第3のギア67の回転軸
には、前記第2のギア66の回転軸を下方に摺動して、
前記モータ62からの回転が伝達されないようにするた
めのギアプッシャレバー68が固定されている。このギ
アプッシャレバー68は第3のギア67の回転とともに
前記グリップ部1に設けられた溝(図示しない)に沿っ
て回動し、前記第2のギア66の回転軸が下方に押し下
げられると、その位置でロックするようになっている。
【0058】ところで、外套管摺動部材41のグリップ
側の端部には、その外側面にラック69が設けられお
り、このラック69には前記第3のギア67が噛合って
いる。そして、前記モータ62が駆動されると、その回
転が第1のギア65、第2のギア66、および第3のギ
ア67に伝達し、外套管摺動部材41は先端方向に摺動
する。
側の端部には、その外側面にラック69が設けられお
り、このラック69には前記第3のギア67が噛合って
いる。そして、前記モータ62が駆動されると、その回
転が第1のギア65、第2のギア66、および第3のギ
ア67に伝達し、外套管摺動部材41は先端方向に摺動
する。
【0059】前記第1のギア65の回転軸には、前記グ
リップ側摺動部材43を摺動するための第4のギア71
が噛合っている。この第4のギア71には、第5のギア
72が噛合っており、この第5のギア72には、第6の
ギア73が噛合っている。
リップ側摺動部材43を摺動するための第4のギア71
が噛合っている。この第4のギア71には、第5のギア
72が噛合っており、この第5のギア72には、第6の
ギア73が噛合っている。
【0060】ところで、グリップ側摺動部材43のグリ
ップ側の端部には、その外側面にラック74が設けられ
おり、このラック74には前記第6のギア73が噛合っ
ている。そして、前記モータ62が駆動されると、その
回転が第4のギア71、第5のギア72、および第6の
ギア73に伝達して、グリップ側摺動部材43を介して
カムプッシャ摺動部材18は先端方向に摺動する。
ップ側の端部には、その外側面にラック74が設けられ
おり、このラック74には前記第6のギア73が噛合っ
ている。そして、前記モータ62が駆動されると、その
回転が第4のギア71、第5のギア72、および第6の
ギア73に伝達して、グリップ側摺動部材43を介して
カムプッシャ摺動部材18は先端方向に摺動する。
【0061】このような構成の本実施例においては、先
端ユニット3のカートリッジ受け体5とカートリッジ7
とが開いた状態で、挿入部2を体腔内に経皮的に挿入し
て、これらカートリッジ受け体5とカートリッジ7と間
に縫合対象となる生体組織を挟み、駆動スイッチ61を
オンすると、モータ62が駆動する。
端ユニット3のカートリッジ受け体5とカートリッジ7
とが開いた状態で、挿入部2を体腔内に経皮的に挿入し
て、これらカートリッジ受け体5とカートリッジ7と間
に縫合対象となる生体組織を挟み、駆動スイッチ61を
オンすると、モータ62が駆動する。
【0062】すると、前記モータ62の回転が第1のギ
ア65、第2のギア66、および第3のギア67に伝達
して外套管16が先端方向に摺動される。そして、外套
管16の先端にカートリッジ受け体5およびカートリッ
ジ7の基端部は外套管16の先端に挿入され、これらカ
ートリッジ受け体5およびカートリッジ7は閉じて生体
組織は挟持される。
ア65、第2のギア66、および第3のギア67に伝達
して外套管16が先端方向に摺動される。そして、外套
管16の先端にカートリッジ受け体5およびカートリッ
ジ7の基端部は外套管16の先端に挿入され、これらカ
ートリッジ受け体5およびカートリッジ7は閉じて生体
組織は挟持される。
【0063】このとき、この第3のギア67のギアプッ
シャレバー68によって、第2のギア66の回転軸は押
し下げられ、この状態でギアプッシャレバー68はロッ
クされる。すると第2のギア66は第1のギア65から
離間されて、モータ62からの回転力は伝達されなくな
り、第2のギア66および第3のギア67の回転は停止
する。従って、外套管16の摺動も停止する。
シャレバー68によって、第2のギア66の回転軸は押
し下げられ、この状態でギアプッシャレバー68はロッ
クされる。すると第2のギア66は第1のギア65から
離間されて、モータ62からの回転力は伝達されなくな
り、第2のギア66および第3のギア67の回転は停止
する。従って、外套管16の摺動も停止する。
【0064】一方、前記モータ62の回転は、第4のギ
ア71、第5のギア72、および第6のギア73にも伝
達して、グリップ側摺動部材43を介してカムプッシャ
摺動部材18は先端方向に摺動される。そして、前記外
套管16の摺動が停止した後に、カムプッシャ摺動部材
18はカム継手32に当接し、このカム継手32を介し
て、ナイフ25およびカムプッシャ31が摺動される。
ア71、第5のギア72、および第6のギア73にも伝
達して、グリップ側摺動部材43を介してカムプッシャ
摺動部材18は先端方向に摺動される。そして、前記外
套管16の摺動が停止した後に、カムプッシャ摺動部材
18はカム継手32に当接し、このカム継手32を介し
て、ナイフ25およびカムプッシャ31が摺動される。
【0065】すると、この生体組織はナイフ25に切断
されるとともにカムプッシャ31によってファスナ4…
が順に生体組織に向けて押出され、このファスナ4…の
脚部4a…は生体組織に貫通した後、リテーナ6…に嵌
入され、生体組織は縫合される。
されるとともにカムプッシャ31によってファスナ4…
が順に生体組織に向けて押出され、このファスナ4…の
脚部4a…は生体組織に貫通した後、リテーナ6…に嵌
入され、生体組織は縫合される。
【0066】こうして、生体組織が縫合されると、モー
タ62は反転し、ギアプッシャレバー68のロックが解
除される。すると、第2のギア66は板バネの復元力で
もとの位置に戻り、前記モータ62の回転は、各ギアに
伝達して外套管16およびカムプッシャ摺動部材18は
もとの位置に戻される。すると、先端ユニット3のカー
トリッジ受け体5とカートリッジ7とは開いた状態に戻
される。
タ62は反転し、ギアプッシャレバー68のロックが解
除される。すると、第2のギア66は板バネの復元力で
もとの位置に戻り、前記モータ62の回転は、各ギアに
伝達して外套管16およびカムプッシャ摺動部材18は
もとの位置に戻される。すると、先端ユニット3のカー
トリッジ受け体5とカートリッジ7とは開いた状態に戻
される。
【0067】このように、モータ62を駆動することに
よって、外套管16およびカムプッシャ摺動部材18を
摺動するようにしたので、スイッチを押すという簡単操
作で縫合を行うことができ、したがって手術者の操作の
負担を軽減することができる。なお、本実施例において
も、上述した実施例と同様の効果を奏することができ
る。次に、本発明の他の実施例を図10を参照して説明
する。なお、前記実施例と同一部分には、同一符号を付
して詳細な説明を省略する。
よって、外套管16およびカムプッシャ摺動部材18を
摺動するようにしたので、スイッチを押すという簡単操
作で縫合を行うことができ、したがって手術者の操作の
負担を軽減することができる。なお、本実施例において
も、上述した実施例と同様の効果を奏することができ
る。次に、本発明の他の実施例を図10を参照して説明
する。なお、前記実施例と同一部分には、同一符号を付
して詳細な説明を省略する。
【0068】本実施例において、前記実施例と異なる点
は、カートリッジ受け体5に対して、カートリッジ7を
着脱自在に設ける代りに、カートリッジ受け体5のリテ
ーナ支持部5aとカートリッジ支持部5bおよび係止部
5cとを別個の部材にするとともに、カートリッジ7の
みならず、リテーナ支持部5aをもカートリッジ支持部
5bに着脱自在に設けたことである。
は、カートリッジ受け体5に対して、カートリッジ7を
着脱自在に設ける代りに、カートリッジ受け体5のリテ
ーナ支持部5aとカートリッジ支持部5bおよび係止部
5cとを別個の部材にするとともに、カートリッジ7の
みならず、リテーナ支持部5aをもカートリッジ支持部
5bに着脱自在に設けたことである。
【0069】前記先端ユニット3は、挿入部2の先端に
設けられた連結部材81と、この連結部材81に着脱自
在に保持されたリテーナ保持部材(第1の組織挟持体)
82と、このリテーナ保持部材82の対向位置に、前記
連結部材81に対して着脱自在に保持されたカートリッ
ジ(第2の組織挟持体)7とから構成されている。
設けられた連結部材81と、この連結部材81に着脱自
在に保持されたリテーナ保持部材(第1の組織挟持体)
82と、このリテーナ保持部材82の対向位置に、前記
連結部材81に対して着脱自在に保持されたカートリッ
ジ(第2の組織挟持体)7とから構成されている。
【0070】前記連結部材81は略円筒形状をなし、リ
テーナ保持部材82およびカートリッジ7を着脱自在に
支持するための支持部81aを先端側に有している。こ
の支持部81aの後端には、前記挿入部2に係止される
係止部81bが連設されている。
テーナ保持部材82およびカートリッジ7を着脱自在に
支持するための支持部81aを先端側に有している。こ
の支持部81aの後端には、前記挿入部2に係止される
係止部81bが連設されている。
【0071】前記連結部材81の支持部81aの下面に
は、差込み孔12に対向した位置に、リテーナ保持部材
82を接続支持するための差込み孔83が形成されてい
る。また、支持部81aのスリット14の下方には、そ
の先端縁部に、前記リテーナ保持部材82の支持部81
aへの挿入をガイドするスリット84が形成されてい
る。
は、差込み孔12に対向した位置に、リテーナ保持部材
82を接続支持するための差込み孔83が形成されてい
る。また、支持部81aのスリット14の下方には、そ
の先端縁部に、前記リテーナ保持部材82の支持部81
aへの挿入をガイドするスリット84が形成されてい
る。
【0072】一方、前記リテーナ保持部材82には、リ
テーナカートリッジ5Aを収納保持するリテーナ支持部
82aを先端側に有している。このリテーナ支持部82
aのの後端には係止部82bが連設されている。
テーナカートリッジ5Aを収納保持するリテーナ支持部
82aを先端側に有している。このリテーナ支持部82
aのの後端には係止部82bが連設されている。
【0073】前記係止部82bの後端には前記連結部材
81の差込み孔83に差込み可能に支持される支持用板
バネ85が形成されている。また、係止部82bの側面
には、支持用凸部86が設けられている。
81の差込み孔83に差込み可能に支持される支持用板
バネ85が形成されている。また、係止部82bの側面
には、支持用凸部86が設けられている。
【0074】そして、前記連結部材81の差込み孔12
に前記カートリッジ7のカートリッジ支持用板バネ11
を差込むとともに連結部材81のスリット14に沿って
カートリッジ7の支持用凸部13を挿入すると、カート
リッジ7は連結部材81に対して弾性的に回動自在に装
着保持される。
に前記カートリッジ7のカートリッジ支持用板バネ11
を差込むとともに連結部材81のスリット14に沿って
カートリッジ7の支持用凸部13を挿入すると、カート
リッジ7は連結部材81に対して弾性的に回動自在に装
着保持される。
【0075】また、前記連結部材81の差込み孔83に
前記リテーナ保持部材82の支持用板バネ85を差込む
とともに連結部材81のスリット84に沿ってリテーナ
保持部材82の支持用凸部86を挿入すると、リテーナ
保持部材82は連結部材81に対して弾性的に回動自在
に装着保持される。
前記リテーナ保持部材82の支持用板バネ85を差込む
とともに連結部材81のスリット84に沿ってリテーナ
保持部材82の支持用凸部86を挿入すると、リテーナ
保持部材82は連結部材81に対して弾性的に回動自在
に装着保持される。
【0076】なお、連結部材81の係止部82bは上述
した実施例におけるカートリッジ受け体5の係止部5c
と同様の構成であり、挿入部2に着脱可能に設けられて
いる。
した実施例におけるカートリッジ受け体5の係止部5c
と同様の構成であり、挿入部2に着脱可能に設けられて
いる。
【0077】このような構成の本実施例においては、先
端ユニット3のリテーナ保持部材82とカートリッジ7
とが開いた状態で、挿入部2を体腔内に経皮的に挿入
し、これらリテーナ保持部材82とカートリッジ7と間
に、縫合対象となる生体組織を挟み込む。
端ユニット3のリテーナ保持部材82とカートリッジ7
とが開いた状態で、挿入部2を体腔内に経皮的に挿入
し、これらリテーナ保持部材82とカートリッジ7と間
に、縫合対象となる生体組織を挟み込む。
【0078】そして、上述の実施例と同様に外套管が先
端方向に摺動されることによって、前記リテーナ保持部
材82とカートリッジ7とが閉じて生体組織は挟持され
る。このとき、リテーナ保持部材82とカートリッジ7
とは、ともに中心軸方向に回動して閉じられる。また、
リテーナ6…を交換するときには、連結部材81からリ
テーナ保持部材82を引抜いて、新たなリテーナ6…を
充填する。
端方向に摺動されることによって、前記リテーナ保持部
材82とカートリッジ7とが閉じて生体組織は挟持され
る。このとき、リテーナ保持部材82とカートリッジ7
とは、ともに中心軸方向に回動して閉じられる。また、
リテーナ6…を交換するときには、連結部材81からリ
テーナ保持部材82を引抜いて、新たなリテーナ6…を
充填する。
【0079】このように、カートリッジ7のみならず、
リテーナ保持部材82をも連結部材81に着脱可能に保
持する構成にしたことから、生体組織を挟持するときに
はリテーナ保持部材82とカートリッジ7とは、ともに
中心軸方向に均等に回動して閉じられるので、厚い生体
組織を挟持することができる。また、リテーナ保持部材
82が破損した場合には、このリテーナ保持部材82の
みを交換することができる。なお、本実施例において
も、上述した実施例と同様の効果を奏することができ
る。次に、本発明の他の実施例を図11ないし図15を
参照して説明する。なお、前記実施例と同一部分には、
同一符号を付して詳細な説明を省略する。
リテーナ保持部材82をも連結部材81に着脱可能に保
持する構成にしたことから、生体組織を挟持するときに
はリテーナ保持部材82とカートリッジ7とは、ともに
中心軸方向に均等に回動して閉じられるので、厚い生体
組織を挟持することができる。また、リテーナ保持部材
82が破損した場合には、このリテーナ保持部材82の
みを交換することができる。なお、本実施例において
も、上述した実施例と同様の効果を奏することができ
る。次に、本発明の他の実施例を図11ないし図15を
参照して説明する。なお、前記実施例と同一部分には、
同一符号を付して詳細な説明を省略する。
【0080】先端ユニット3は、図11および図12に
示すように、挿入部2の先端に設けられた連結部材91
と、この連結部材91に着脱自在に挿入保持されたカー
トリッジ(第2の組織挟持体)92と、このカートリッ
ジ92の対向位置に、前記連結部材91に着脱自在に保
持されたリテーナ保持部材(第1の組織挟持体)93と
から構成されている。
示すように、挿入部2の先端に設けられた連結部材91
と、この連結部材91に着脱自在に挿入保持されたカー
トリッジ(第2の組織挟持体)92と、このカートリッ
ジ92の対向位置に、前記連結部材91に着脱自在に保
持されたリテーナ保持部材(第1の組織挟持体)93と
から構成されている。
【0081】前記連結部材91は略円筒形状をなし、そ
の先端側にリテーナ保持部材93およびカートリッジ9
2を着脱自在に支持するための支持部91aを有してい
る。この支持部91aの後端には、挿入部2に係止され
る係止部91bが連設されている。
の先端側にリテーナ保持部材93およびカートリッジ9
2を着脱自在に支持するための支持部91aを有してい
る。この支持部91aの後端には、挿入部2に係止され
る係止部91bが連設されている。
【0082】前記連結部材91の支持部91aの上下側
面には、それぞれリテーナ保持部材93を接続支持する
ための差込み孔94およびカートリッジ92を接続支持
するための差込み孔95が形成されている。また、支持
部91aの先端縁部には、前記リテーナ保持部材93を
支持部91aへ挿入して回動自在に支持するための切欠
部96が形成されている。
面には、それぞれリテーナ保持部材93を接続支持する
ための差込み孔94およびカートリッジ92を接続支持
するための差込み孔95が形成されている。また、支持
部91aの先端縁部には、前記リテーナ保持部材93を
支持部91aへ挿入して回動自在に支持するための切欠
部96が形成されている。
【0083】ところで、前記カートリッジ92の後端に
は、連結部材91の差込み孔94に差込み可能な支持板
97を有している。そして、カートリッジ92は、この
支持板97を差込み孔94に差込むことによって、連結
部材91に固定される。
は、連結部材91の差込み孔94に差込み可能な支持板
97を有している。そして、カートリッジ92は、この
支持板97を差込み孔94に差込むことによって、連結
部材91に固定される。
【0084】一方、前記リテーナ保持部材93の先端側
には、リテーナカートリッジ5Aを収納保持するリテー
ナ支持部93aを有している。このリテーナ支持部93
aの後端には、係止部93bが連接されている。
には、リテーナカートリッジ5Aを収納保持するリテー
ナ支持部93aを有している。このリテーナ支持部93
aの後端には、係止部93bが連接されている。
【0085】前記係止部93bの後端には、前記連結部
材91の差込み孔94に差込み可能に支持される支持用
板バネ99が形成されている。また、係止部93bの側
面には、支持用凸部100が設けられている。
材91の差込み孔94に差込み可能に支持される支持用
板バネ99が形成されている。また、係止部93bの側
面には、支持用凸部100が設けられている。
【0086】そして、前記連結部材91の差込み孔94
に前記リテーナ保持部材93の支持用板バネ99を差込
むとともに連結部材91の切欠部96にリテーナ保持部
材82の支持用凸部100を挿入すると、リテーナ保持
部材93は連結部材91に対して弾性的に回動自在に装
着保持される。
に前記リテーナ保持部材93の支持用板バネ99を差込
むとともに連結部材91の切欠部96にリテーナ保持部
材82の支持用凸部100を挿入すると、リテーナ保持
部材93は連結部材91に対して弾性的に回動自在に装
着保持される。
【0087】前記グリップ部1内には、図11に示すよ
うに、モータ105がその駆動軸106を長手方向に平
行して設けられている。そして、このモータ105の駆
動軸106の先端には、ギア107が設けられている。
このギア107は、フレキシブルシャフト108の一端
に設けられたギア109に噛合っている。
うに、モータ105がその駆動軸106を長手方向に平
行して設けられている。そして、このモータ105の駆
動軸106の先端には、ギア107が設けられている。
このギア107は、フレキシブルシャフト108の一端
に設けられたギア109に噛合っている。
【0088】前記フレキシブルシャフト108はグリッ
プ部1内から挿入部2内に延出して設けられている。こ
のフレキシブルシャフト108の他端には、図12およ
び図13に示すように、クラッチ板109が設けられて
いる。
プ部1内から挿入部2内に延出して設けられている。こ
のフレキシブルシャフト108の他端には、図12およ
び図13に示すように、クラッチ板109が設けられて
いる。
【0089】一方、前記カートリッジ7内には回転シャ
フト110が長手方向に平行して設けられ、この回転シ
ャフト110の端部には、前記フレキシブルシャフト1
08のクラッチ板109に接続するクラッチ板111が
設けられている。そして、このフレキシブルシャフト1
08の回転は、回転シャフト110に伝達されるように
なっている。
フト110が長手方向に平行して設けられ、この回転シ
ャフト110の端部には、前記フレキシブルシャフト1
08のクラッチ板109に接続するクラッチ板111が
設けられている。そして、このフレキシブルシャフト1
08の回転は、回転シャフト110に伝達されるように
なっている。
【0090】前記回転シャフト110には、図14に示
すように、2つのウォームギア121…が離隔して設け
られ、これらウォームギア121…の下部には第1のギ
ア122…が鉛直方向に回転可能に噛合っている。この
第1のギア122…の回転軸123…は長手方向に垂直
に設けられている。
すように、2つのウォームギア121…が離隔して設け
られ、これらウォームギア121…の下部には第1のギ
ア122…が鉛直方向に回転可能に噛合っている。この
第1のギア122…の回転軸123…は長手方向に垂直
に設けられている。
【0091】前記第1のギア122…の回転軸123…
にはそれぞれ、ウォームギア124…が前記回転シャフ
ト110の両側に設けられている。これらウォームギア
124…には、第2のギア125…が噛合っている。
にはそれぞれ、ウォームギア124…が前記回転シャフ
ト110の両側に設けられている。これらウォームギア
124…には、第2のギア125…が噛合っている。
【0092】前記第2のギア125…の回転軸127…
は鉛直方向に設けられている。また、これら回転軸12
7…の上端部にはそれぞれおねじ127a…が設けら
れ、下端部は、カートリッジ92に設けられた軸孔に上
方に摺動されないように挿入支持されている。これら回
転軸127…の上端部は、ファスナ保持部材128を支
持している。
は鉛直方向に設けられている。また、これら回転軸12
7…の上端部にはそれぞれおねじ127a…が設けら
れ、下端部は、カートリッジ92に設けられた軸孔に上
方に摺動されないように挿入支持されている。これら回
転軸127…の上端部は、ファスナ保持部材128を支
持している。
【0093】前記ファスナ保持部材128は、その上部
に形成されすべてのファスナを保持するファスナ保持部
128aと、このファスナ保持部128aに連設され前
記第2のギア125…の回転軸127…に係止される係
止部128b…とから構成されている。
に形成されすべてのファスナを保持するファスナ保持部
128aと、このファスナ保持部128aに連設され前
記第2のギア125…の回転軸127…に係止される係
止部128b…とから構成されている。
【0094】前記係止部128b…は、円筒形状をな
し、その内側面には、前記第2のギア125…の回転軸
127…のおねじ127a…と螺合するめねじが形成さ
れている。そして、前記第2のギア125…が回転する
と、ファスナ保持部材128は上方に摺動するようにな
っている。
し、その内側面には、前記第2のギア125…の回転軸
127…のおねじ127a…と螺合するめねじが形成さ
れている。そして、前記第2のギア125…が回転する
と、ファスナ保持部材128は上方に摺動するようにな
っている。
【0095】前記ファスナ保持部材128のファスナ保
持部128aには、図15にも示すように、ファスナ4
…が上方に脚部4a…を向けて保持されている。このフ
ァスナ保持部材128には、ファスナ保持部材128の
上方にボード129が固定して設けられ、このボード1
29には、ファスナ4…の脚部4a…を支持するための
支持孔129aが設けられている。
持部128aには、図15にも示すように、ファスナ4
…が上方に脚部4a…を向けて保持されている。このフ
ァスナ保持部材128には、ファスナ保持部材128の
上方にボード129が固定して設けられ、このボード1
29には、ファスナ4…の脚部4a…を支持するための
支持孔129aが設けられている。
【0096】前記グリップ部1内には、モータ105の
駆動制御するための制御部130が設けられている。ま
た、グリップ部1外側面には、モータ105を駆動する
ための駆動スイッチ131が設けられている。この駆動
スイッチ131は前記制御部130に電気的に接続され
ている。
駆動制御するための制御部130が設けられている。ま
た、グリップ部1外側面には、モータ105を駆動する
ための駆動スイッチ131が設けられている。この駆動
スイッチ131は前記制御部130に電気的に接続され
ている。
【0097】なお、前記挿入部2の先端部には、ジャバ
ラ形状のフレキシブル部材135が設けられている。こ
のフレキシブル部材135は、前記グリップ部1の外側
面に設けられたジョイスティック136を操作すること
によって、先端ユニットが3次元的に揺動するようにな
っている。
ラ形状のフレキシブル部材135が設けられている。こ
のフレキシブル部材135は、前記グリップ部1の外側
面に設けられたジョイスティック136を操作すること
によって、先端ユニットが3次元的に揺動するようにな
っている。
【0098】このような構成の本実施例においては、先
端ユニット3のリテーナ保持部材93とカートリッジ9
2とが開いた状態で、挿入部2を体腔内に経皮的に挿入
し、これらリテーナ保持部材93とカートリッジ92と
の間に縫合対象となる生体組織を挟み、駆動スイッチ1
31をオンすると、モータ105が駆動する。
端ユニット3のリテーナ保持部材93とカートリッジ9
2とが開いた状態で、挿入部2を体腔内に経皮的に挿入
し、これらリテーナ保持部材93とカートリッジ92と
の間に縫合対象となる生体組織を挟み、駆動スイッチ1
31をオンすると、モータ105が駆動する。
【0099】すると、前記モータ105の回転は、フレ
キシブルシャフト108を介して回転シャフト110に
伝達し、さらに、第1のギア122…および第2のギア
125…に伝達する。したがって、ファスナ保持部材1
28は上方に摺動し、これらファスナ4…は、生体組織
に向けて一斉に押出され、これらファスナ4…の脚部4
a…は生体組織に貫通し、リテーナ6…に嵌入される。
こうして生体組織は一斉に縫合される。
キシブルシャフト108を介して回転シャフト110に
伝達し、さらに、第1のギア122…および第2のギア
125…に伝達する。したがって、ファスナ保持部材1
28は上方に摺動し、これらファスナ4…は、生体組織
に向けて一斉に押出され、これらファスナ4…の脚部4
a…は生体組織に貫通し、リテーナ6…に嵌入される。
こうして生体組織は一斉に縫合される。
【0100】そして、縫合が終了すると、前記モータ1
05が逆回転し、ファスナ保持部材128はもとの位置
に戻るとともに外套管ももとの位置に戻り、カートリッ
ジ92およびリテーナ保持部材93は開いた状態に戻
る。そして生体組織は解放される。
05が逆回転し、ファスナ保持部材128はもとの位置
に戻るとともに外套管ももとの位置に戻り、カートリッ
ジ92およびリテーナ保持部材93は開いた状態に戻
る。そして生体組織は解放される。
【0101】このように、ファスナ保持部材128を摺
動してファスナ4…を生体組織に一斉に押出すようにし
たことから、生体組織を均一の厚さに縫合することがで
きる。なお、本実施例においても、上述した実施例と同
様の効果を奏することができる。
動してファスナ4…を生体組織に一斉に押出すようにし
たことから、生体組織を均一の厚さに縫合することがで
きる。なお、本実施例においても、上述した実施例と同
様の効果を奏することができる。
【0102】
【発明の効果】以上詳述したように本発明によれば、フ
ァスナの交換が容易で、本体を繰返し使用でき、しかも
体腔内の生体組織に経皮的に挿入できる外科用縫合器を
提供できるものである。
ァスナの交換が容易で、本体を繰返し使用でき、しかも
体腔内の生体組織に経皮的に挿入できる外科用縫合器を
提供できるものである。
【図1】本発明の一実施例の外観を示す正面図。
【図2】図1に示す先端ユニットの外観を示す正面図。
【図3】図2のA−A断面図。
【図4】図1に示すジョーホールド管の先端部の外観を
示す斜視図
示す斜視図
【図5】図1に示すカートリッジを示す下面図。
【図6】図1に示す外套管を示す断面図。
【図7】同実施例における作用説明図。
【図8】本発明の他の実施例の外観を示す正面図。
【図9】同実施例における断面図。
【図10】本発明の他の実施例の外観を示す断面図。
【図11】本発明の他の実施例の外観を示す斜視図。
【図12】図11に示す先端ユニットを示す図。
【図13】図11に示すカートリッジおよびリテーナ保
持部材を示す図。
持部材を示す図。
【図14】図11に示すカートリッジの断面図。
【図15】図11に示すカートリッジの一部を示す断面
図。
図。
2…挿入部、3…先端ユニット、4…ファスナ、5…カ
ートリッジ受け体、6…リテーナ、7…カートリッジ。
ートリッジ受け体、6…リテーナ、7…カートリッジ。
Claims (2)
- 【請求項1】 体腔内に挿入される挿入部の先端に互い
に対向して設けられた一対の組織挟持体により生体組織
を挟持し、前記組織挟持体に収容された複数のファスナ
で組織を縫合する外科用縫合器において、前記挟持体を
ユニット化し、前記挿入部に対して着脱自在としたこと
を特徴とする外科用縫合器。 - 【請求項2】 体腔内に挿入される挿入部の先端に互い
に対向して設けられた一対の組織挟持体により生体組織
を挟持し、これら組織挟持体のうち一方の組織挟持体に
収容された複数のファスナと他方の組織挟持体に収容さ
れた前記ファスナと係合するリテーナとで前記生体組織
を縫合する外科用縫合器において、前記組織挟持体に対
して前記ファスナと前記リテーナとを各々着脱自在とし
たことを特徴とする外科用縫合器。
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP5024400A JPH06237937A (ja) | 1993-02-12 | 1993-02-12 | 外科用縫合器 |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP5024400A JPH06237937A (ja) | 1993-02-12 | 1993-02-12 | 外科用縫合器 |
Publications (1)
Publication Number | Publication Date |
---|---|
JPH06237937A true JPH06237937A (ja) | 1994-08-30 |
Family
ID=12137118
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP5024400A Withdrawn JPH06237937A (ja) | 1993-02-12 | 1993-02-12 | 外科用縫合器 |
Country Status (1)
Country | Link |
---|---|
JP (1) | JPH06237937A (ja) |
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JP2013542760A (ja) * | 2010-09-30 | 2013-11-28 | エシコン・エンド−サージェリィ・インコーポレイテッド | 複数の締結具カートリッジを含む締結具システム |
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US11826047B2 (en) | 2021-05-28 | 2023-11-28 | Cilag Gmbh International | Stapling instrument comprising jaw mounts |
US11918217B2 (en) | 2021-05-28 | 2024-03-05 | Cilag Gmbh International | Stapling instrument comprising a staple cartridge insertion stop |
US11723662B2 (en) | 2021-05-28 | 2023-08-15 | Cilag Gmbh International | Stapling instrument comprising an articulation control display |
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 |
US11950776B2 (en) | 2022-03-04 | 2024-04-09 | Cilag Gmbh International | Modular surgical instruments |
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