JPH07132123A - Hollow organ fixing appliance - Google Patents

Abstract

PURPOSE:To easily and surely fix the ill hollow organ and to greatly shorten the time for joining by forming the fixing appliance of a magnetic material which is at least partly magnetized. CONSTITUTION:For example, this hollow organ fixing appliance 1 is a hollow tubular body opened at both ends and its middle part is molded of a nonmagnetic material 3. The appliance is provided with the magnetic materials 2 near the apertures at both ends. The magnetic materials 2 are joined on the extension line of the nonmagnetic material 3. Namely, magnetic rubber sheets are used for the magnetic materials 2 and a sheet consisting of a nylon resin is used for the nonmagnetic material 3. The magnetic materials 2 are molded to a tubular form and are thermally fused to the surface of the nonmagnetic material 3. Joining methods include adhering and fusing in the case of the magnetic materials 2 and nonmagnetic material 3 consisting of porous films, etc. Knitting of the magnetic materials 2 into the nonmagnetic material 3 is possible as well in the case of knitted fabrics, woven fabrics or non-woven fabrics.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a therapeutic instrument used for attaching a hollow organ such as a blood vessel, trachea, esophagus or intestine to an anastomosis and fixing the organ.

[0002]

2. Description of the Related Art As a method for anastomosing hollow organs such as blood vessels and intestinal tracts, a method of simply suturing the anastomosis portion with a suture thread has been performed for a long time, but the anastomosis is impossible in a pathological organ. I often experienced cases that were too hard or, on the contrary, too soft, with many difficulties, especially for small diameter blood vessels. Therefore, there is a problem that the surgery requires experience and skill and takes a long time. Therefore, in order to improve such a point, JP-A-61-61
No. 217170 and Japanese Utility Model Laid-Open No. 61-29720 disclose instruments for assisting an anastomosis operation.

[0003]

Since the conventional instrument for anastomosis is intended for use as a splint, the hollow organ to be fixed must have a sufficient length.
In particular, the fixation of small blood vessels existing in pathological organs or deep surgical sites has a problem that it is difficult to locate them at the anastomosis site.
That is, it is very dangerous because the device moves from the anastomotic part even if it is misaligned during the anastomosis and it has to be retried many times, or even if it is tied around with a suture to fix the hollow organ and the device. There was a problem. Further, as the anastomosis of the hollow organ, end side, side end, side side anastomosis and the like are often used, but in the prior art, only the end-to-end anastomosis is mentioned and other anastomosis methods are not mentioned at all. Regarding the shortening of the operation time, a slight shortening was recognized as compared with the anastomosis method using only a suture, but it was hard to say that it was an epoch-making method.

The present invention can easily and reliably fix a pathological hollow organ to anyone in the hollow organ anastomosis which requires such conventional experience and skill, and the anastomosis time can be greatly shortened. It is another object of the present invention to provide a therapeutic instrument capable of completing an anastomosis operation without extracorporeal circulation even in coronary artery bypass surgery.

[0005]

DISCLOSURE OF THE INVENTION The present invention which solves the above-mentioned object is a fixing device to be used by being attached to a hollow organ to be fixed, wherein at least a part of the fixing device is magnetized. A hollow organ fixing device characterized by having a magnetic material.

Further, the present invention comprises at least two or more hollow organ fixing devices, at least one of the hollow organ fixing devices having a partially magnetized magnetic material. It consists of a fixture.

In the present specification, "fixation" includes not only anastomosis for connecting hollow organs to each other, but also all cases in which other objects are attached to, connected to, or brought into contact with hollow organs.

In the present invention, the magnetized magnetic material means
Platinum-cobalt based magnet alloys, samarium-cobalt based magnet alloys, iron / chromium / cobalt based magnet alloys, neodymium-iron-boron based magnet alloys, and other alloys with magnetic properties or powder particles of magnets selected arbitrarily, rubber, synthetic resin Any material, such as a material obtained by mixing with a biopolymer material or the like, may be used and is not particularly limited. Alternatively, a commercially available magnetic rubber sheet or the like may be used.

The magnetic force performance of the magnetic material used in the present invention is not particularly limited, and there is no possibility that the magnetic material will come off naturally when it is implanted in a living body, and when the surgeon applies a certain amount of force. It suffices if it can be removed. Specifically, the residual magnetic flux density (Br) is 10 to 11 kG, the coercive force (Hc) is 4.5 to 5.5 kOe, and the maximum energy product ((BH) max) is 2
Those in the range 0 to 25 MGOe are preferred.

In the present invention, the magnetized magnetic material may be present on at least a part of the hollow organ fixing device, preferably on the fixed end, and in particular, the entire hollow organ fixing device is magnetized. It doesn't have to be. In this case, the non-magnetic body portion other than the magnetized magnetic material of the hollow organ fixing device may be any synthetic polymer material, various metal materials, rubber, synthetic resin, biopolymer material, etc. It is not something that will be done.

Further, in the present invention, when fixing is performed by at least two or more hollow organ fixing devices, not all hollow organ fixing devices need to have a magnetized magnetic material, but at least one of them can be attached. It suffices that there is a magnetized magnetic material and it can be fixed to a material that does not have a magnetized magnetic material.

In the present invention, the magnetized magnetic material and non-magnetic material portion are preferably formed of a film body such as a porous film and a knitted fabric, a woven fabric or a non-woven fabric, but not limited thereto.

The shape of the hollow organ fixing device of the present invention is not particularly limited, and examples thereof include a hollow tubular body, a spiral coil body, and a wire body. When used as a hollow tubular body and a spiral coil body, its outer diameter is preferably substantially equal to the inner diameter of the pathological organ, and the inner diameter should be a diameter that does not impair the function of the pathological organ. .

The thickness, strength, etc. of the hollow organ-fixing device of the present invention are not particularly limited, and it is preferable to use them properly according to the condition of the affected area. The material may be used thickly, and the soft material may be used thinly in a region where flexibility is required.

Further, the hollow organ fixing device of the present invention can be used for fixing living organs to each other and between living organs and artificial organs by connecting them to living organs. At that time, the living organ and the magnetized hollow organ fixing device according to the present invention must be joined, and as a method thereof, a method of suturing the magnetized hollow organ fixing device at the end of the living organ or a living body For example, there is a method in which a magnetized hollow organ fixing device having an outer diameter that is the same as the inner diameter of the organ end is inserted and the surface of the living organ end is fastened with a thread.

Specifically, the hollow organ fixing device of the present invention comprises:
During surgery for coronary artery bypass surgery or revascularization of small arteries such as peripheral arteries of the lower extremities, the organs (vessels) of other parts of the patient's own site were collected and used as a graft. By joining a hollow organ-fixing device, both ends of the affected part of the artery will be incised during surgery (both ends of the incision will be tied in advance to stop bleeding)
A T-shaped magnetized hollow organ-fixing device was fitted into the device, wound on it with a thread and fixed, and then the graft and T
By fixing the magnetized hollow organ fixing device with magnetism using magnetism (similar to Example 5 described later), complicated sutures are not required and surgery can be easily performed in a short time. it can.

Further, after the above-mentioned operation, it is necessary to remove the air in the graft in order to prevent the blood and the air remaining in the graft from contacting and coagulating to form a thrombus. However, according to the present invention, the graft is once removed. Therefore, air can be easily removed.

The hollow organ fixing device of the present invention is used for performing an internal shunt type blood access for extracorporeal blood circulation in artificial hemodialysis and the like for anastomosis of an artery and a vein and for piercing a puncture needle. By using the present invention for a shunt (artificial blood vessel), it is possible to easily replace a damaged inner shunt by performing artificial hemodialysis (piercing with a puncture needle) several times.

Specifically, a T-shaped magnetized hollow organ fixing device is prepared by incising a part of an artery and a vein which are parallel to each other (preliminarily binding both ends of the incision part with a thread to stop bleeding). Insert it and fix the inner shunt magnetized at both ends. When the inner shunt is damaged by performing artificial hemodialysis (piercing with a puncture needle) several times, it can be easily replaced with a new inner shunt simply by incising the skin on the surface of the affected part.

[0020]

The present invention will be described more specifically below with reference to the accompanying drawings. 1, FIG. 2, FIG. 3, FIG. 4 and FIG. 5 each show one example of the embodiment of the hollow organ fixing device of the present invention.

(Embodiment 1) The hollow organ fixing device 1 shown in FIG. 1 is composed of a hollow tubular body having open ends.
The intermediate portion is molded from the non-magnetic material 3 and the magnetic material 2 is provided near the openings at both ends. Even if the magnetic material 2 is bonded on the extension line of the non-magnetic body 3, it is bonded on the surface of the non-magnetic body 3. Examples of the joining method include adhesion and fusion when the magnetic material 2 and the non-magnetic body 3 are made of a film such as a porous film, and the magnetic material 2 when made of a knitted fabric, a woven fabric or a non-woven fabric. It is also possible to obtain it by weaving it into the non-magnetic body 3. In this embodiment, a magnetic rubber sheet (made by Serimag) is used as the magnetic material 2,
A sheet made of nylon resin was used for the non-magnetic body 3, the magnetic material 2 was formed into a tubular shape, and heat-fused to the surface of the non-magnetic body 3.

(Embodiment 2) A hollow organ fixing device 21 shown in FIG. 2 is made of a hollow tubular body having both ends open, and is entirely made of a magnetic material 22. The magnetic material 22 is a film-shaped material such as a porous film, or a knitted fabric, a woven fabric, or a nonwoven fabric. In this example, a magnetic rubber sheet (manufactured by Serimag) was used to form a tube.

(Embodiment 3) The hollow organ fixing device 31 shown in FIG. 3 is a linear body. Magnetic material 3 as a whole
Alternatively, the core material may be formed of non-magnetic material (not shown), and the core material may be covered with the magnetic material 32. In this example, the pathological organ has a small diameter, and when a hollow organ fixing device made of a hollow tubular body is used, the inner diameter thereof may be remarkably thin and the function as an organ may be impaired. By providing it on at least a part of the inner surface of the pathological organ, the inner diameter of the pathological organ can be maintained almost as it is. Further, although the hollow organ fixing device 31 can be used as a single piece, a plurality of hollow organ fixing tools 31 may be provided as long as the inner diameter can be maintained without impairing the function of a pathological organ. In this embodiment, the whole is formed of a neodymium iron boron magnet alloy.

(Embodiment 4) The hollow organ fixing device 41 shown in FIG. 4 comprises a spiral coil body. Entirely magnetic material 42
Alternatively, a non-magnetic material (not shown) may be used as a core material and the periphery thereof is covered with the magnetic material 42 to be molded. It is effective to use the hollow organ fixing device 41 at a site where there is a risk of kinking in a pathological organ near the joint. In this embodiment, the whole is formed of a neodymium iron boron magnet alloy.

(Embodiment 5) Next, an example of use of the present invention will be described. Neodymium iron boron magnetic powder and nylon resin were kneaded and then magnetized to obtain a hollow organ fixing device 51 having a branch shown in FIG. The hollow organ fixing device 1 shown in FIG. 1 and the hollow organ fixing device 51 having a branch were sterilized with ethylene oxide gas and then actually fixed by an animal experiment. The left and right femoral arteries of a hybrid dog with a body weight of 12 kg were exposed, and the blood flow was blocked with vascular forceps, and then a vertical incision was made in the blood flow direction. Thereafter, as shown in FIG. 5, a T-shaped hollow organ fixing device 51 having a branch was inserted into the left and right blood vessels, the hollow organ fixing device 1 was connected, and blood flow was restarted. The time required during this period was about 3 minutes, and there was no blood leakage even after the blood flow was restarted.

As a comparison, when a similar connection with a vascular suture was tried, the time required was about 35 minutes.

Example 6 A test example of coronary artery bypass surgery using the present invention will be described.

The effect was confirmed by an animal experiment using a mixed breed dog having a body weight of 32 kg. After 12 mg / kg of ketamine was intravenously administered for anesthesia, the patient was connected to a respirator and adjusted to breathe. The left 5th-6th intercostal space was opened, and the left coronary artery was exposed after pericardiotomy. Separately, the internal thoracic artery was peeled off, and the hollow organ-fixing instrument obtained in Example 2 was inserted into both ends and tied and fixed with a thread to prepare a graft. An artificial coronary artery occlusive lesion was created by inserting a clip into a part of the exposed coronary artery. Next, the main trunk side (central side) and the left circumflex branch side (peripheral side) of the coronary artery occlusive lesion were tied with a thread to stop the blood flow. And
Longitudinal incisions are made in the central side and the peripheral side of the coronary artery occlusive lesion (at both sites where hemostasis is made), and a T-shaped magnetized hollow organ fixing device is inserted into each of them I tied it up and fixed it.

First, one end of the graft was fixed to a hollow organ fixing device provided on the central side, and the thread that had stopped hemostasis on the central side was gradually loosened and blood was allowed to flow to remove air in the graft. After confirming that the air had been removed, the other end of the graft was fixed to the hollow organ fixing device on the peripheral side, and the thread that had been bleeding at both ends was removed to resume blood flow.

The time required during this period was about 5 minutes, and the wound was closed and observed for up to 1 month, but no abnormality was observed.

[0031]

INDUSTRIAL APPLICABILITY In the medical field, the present invention can be easily operated by using a fixing method using magnetic force for a pathological organ or a small organ which is difficult to anastomosed, and the operation time is short. Bring the effect of living.

[Brief description of drawings]

FIG. 1 is a side view showing an example of an embodiment of the present invention.

FIG. 2 is a side view showing an example of another embodiment of the present invention.

FIG. 3 is a side view showing an example of another embodiment of the present invention.

FIG. 4 is a side view showing an example of another embodiment of the present invention.

FIG. 5 illustrates an example of use of the present invention. Explanation of reference numerals 1, 21, 31, 41, 51 ... Fixing device for hollow organ, 2, 22, 32, 42, 52 ... Magnetic material, 3.
..Non-magnetic material, 4 ... Femoral artery,

Claims (4)

[Claims] 1. A fixture for use in attaching to a plurality of hollow organs and anastomosing the plurality of hollow organs, wherein at least a part of the fixture is made of a magnetized magnetic material. Organ fixation device. 2. The hollow organ fixing device according to claim 1, which has a hollow tubular structure. 3. The hollow organ fixing device according to claim 1, which has a hollow T-shaped tubular structure. 4. A fixing instrument having a hollow tubular structure attached to at least one of the plurality of hollow organs, and a fixing instrument having a hollow T-shaped tubular structure attached to at least one of the other hollow organs. The hollow organ fixing device according to claim 1, which comprises a device.