JPH07289558A - Suture implement - Google Patents

Suture implement

Info

Publication number
JPH07289558A
JPH07289558A JP8657494A JP8657494A JPH07289558A JP H07289558 A JPH07289558 A JP H07289558A JP 8657494 A JP8657494 A JP 8657494A JP 8657494 A JP8657494 A JP 8657494A JP H07289558 A JPH07289558 A JP H07289558A
Authority
JP
Japan
Prior art keywords
thread
forceps
suture
outer cylinder
needle
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.)
Granted
Application number
JP8657494A
Other languages
Japanese (ja)
Other versions
JP3476902B2 (en
Inventor
Takahiro Ogasaka
高宏 小賀坂
Toshihiko Suzuta
敏彦 鈴田
Shirou Bitou
士郎 備藤
Minoru Tsuruta
稔 鶴田
Naoki Uchiyama
直樹 内山
Kunihide Kaji
国英 梶
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Corp
Original Assignee
Olympus Optical Co Ltd
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Olympus Optical Co Ltd filed Critical Olympus Optical Co Ltd
Priority to JP08657494A priority Critical patent/JP3476902B2/en
Priority to US08/360,397 priority patent/US5643293A/en
Publication of JPH07289558A publication Critical patent/JPH07289558A/en
Application granted granted Critical
Publication of JP3476902B2 publication Critical patent/JP3476902B2/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Abstract

PURPOSE:To efficiently carry out an operation to suture viable tissues over a relatively wide range in the celom. CONSTITUTION:This suture implement is provided with an inside cylinder 2 which is mounted annularly with four pieces of yarn 7A to 7D for suture forming a loop part 7L for knots, an outside cylinder 3 which has a yarn housing part 9 housing the loop 7L and has yarn detaining grooves 11A'... for detaining both ends 7a, 7b of the loop part 7L of the yarn 7A to 7D for suture and dot display parts 12A, 12B... which discretely discriminate four pieces of the yarn 7A to 7D for suture.

Description

【発明の詳細な説明】Detailed Description of the Invention

【０００１】[0001]

【産業上の利用分野】本発明は体腔内を内視鏡で観察し
つつ外科手術をする環境下で、糸の縫合・結紮を行う縫
合用具に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a suturing tool for suturing and ligating a thread in an environment where a surgical operation is performed while observing the inside of a body cavity with an endoscope.

【０００２】[0002]

【従来の技術】近年、体腔内を内視鏡で観察しつつ外科
手術をすることが多く行われている。このように内視鏡
からの平面的な映像をモニターで見ながら、動きの限定
される体腔内で特殊な道具を操作しなければならないと
いう環境下においては、糸の縫合・結紮を行うことは非
常に難しい。そのため、簡単に糸しばりを行う道具や方
法が多数開発されている。2. Description of the Related Art In recent years, surgical operations are often performed while observing the inside of a body cavity with an endoscope. In such an environment in which a special tool must be operated within a body cavity with limited movement while watching a flat image from the endoscope on a monitor, it is not possible to sew or ligate a thread. very hard. Therefore, many tools and methods for easily tightening the thread have been developed.

【０００３】現在、一般に行われている縫合結紮方法に
は体外結紮と体内結紮とがある。ここで、体外結紮は、
一旦体腔内で生体組織に糸を挿通させた後、この糸の両
端を体外に取出し、体外で結び目をつくり、この結び目
を体内に送るための専用の道具等で再度、体内に送ると
いうものである。At present, there are an external ligature and an internal ligature as the generally used suture ligation methods. Here, the extracorporeal ligation is
Once the thread is inserted through the living tissue in the body cavity, both ends of this thread are taken out of the body, a knot is made outside the body, and the knot is sent again to the body with a special tool for sending the knot into the body. is there.

【０００４】これと同様の方法で糸を結ぶ道具の例が、
米国特許第５，１４４，９６１号に記載されている。こ
れは、あらかじめ、針付き糸の一端（針から離隔する側
の端部）を中空の棒に巻き付け、この中空の棒上に結び
目を形成しておく。そして、体腔内には、この棒に巻き
付けられていない部分の糸と針だけを挿入し、縫った後
に体外にその糸を取出し、中空棒の内孔にその糸を通
し、結び目を棒から外して、その中空の棒を押し進めて
体腔内に結び目を送るものである。An example of a tool for tying threads in a similar manner is
It is described in US Pat. No. 5,144,961. For this, one end of the thread with needle (the end on the side away from the needle) is wound around a hollow rod, and a knot is formed on this hollow rod. Then, in the body cavity, insert only the thread and needle that are not wrapped around this rod, take out the thread outside the body after sewing, pass the thread through the inner hole of the hollow rod, and remove the knot from the rod. Then, the hollow rod is pushed forward to send a knot into the body cavity.

【０００５】一方、体内結紮を行う場合は、腹腔鏡下手
術用の２本の鉗子を用いて、通常の開腹手術と同様に男
−女結び（２重結紮）、あるいは男−女−男結び（３重
結紮）を行ったりする。このような結紮については更に
後述する。On the other hand, in the case of performing internal ligation, two forceps for laparoscopic surgery are used, and a male-female knot (double ligation) or a male-female-knot ( For example, triple ligation) is performed. Such ligation will be described further below.

【０００６】また、体内で結び目つくる作業を簡略化す
る方法には米国特許第５，２３４，４４５号に示される
ようなものがある。これは、針付き糸の途中に略投げ縄
状のループと結び目を形成し、それより後端側の糸を中
空の棒の内部に通しておくものである。Further, as a method for simplifying the work of knotting in the body, there is a method shown in US Pat. No. 5,234,445. In this method, a substantially lasso-shaped loop and a knot are formed in the middle of the needled thread, and the thread on the rear end side is passed through the hollow rod.

【０００７】この場合、結び目はこの棒内には入らな
い。そして、棒を体腔内に挿入し、その先端に装着され
たループと針糸を体腔内に入れ、別の鉗子で針を持ちな
がら組織を縫った後、今度は鉗子をループに通してから
針側の糸をつかみ、この針側の糸を引張ってループ内に
通すと同時に、中空棒を押して結び目を送る。これによ
り、略投げ縄状のループが締まって結び目を形成する。In this case, the knot does not fit in this rod. Then, insert the rod into the body cavity, put the loop and needle thread attached to the tip into the body cavity, sew the tissue while holding the needle with another forceps, then pass the forceps through the loop and then the needle. Grab the side thread and pull the needle side thread through the loop while pushing the hollow bar to feed the knot. This tightens the substantially lasso-shaped loop to form a knot.

【０００８】また、体腔内で２本の鉗子により、結紮す
る方法では、例えば使用する道具は、腹腔鏡下手術用の
鉗子（図９および図１０（Ａ），（Ｂ）参照）であり、
この様な鉗子を２本操作して、前述した様に通常の開腹
手術の様に男−女結び、あるいは男−女−男結びを行
う。In the method of ligating with two forceps in the body cavity, for example, the tool used is a forceps for laparoscopic surgery (see FIGS. 9 and 10 (A), (B)).
By operating two such forceps, as described above, a male-female knot or a male-female-male knot is performed as in the normal laparotomy.

【０００９】この時の手順の１例としては、まず一方の
Ａ鉗子で、糸の一端（ａ端）をとり、他方のＢ鉗子に巻
き付ける。続いて、糸のａ端を把持したＡ鉗子はその糸
を把持したままの状態で維持させ、糸を巻き付けられた
Ｂ鉗子で糸の他端（ｂ端）を把持する。As one example of the procedure at this time, first, one A forceps is used to take one end (a end) of the thread and wind it around the other B forceps. Subsequently, the A forceps holding the a end of the thread keeps the thread held as it is, and the other end (b end) of the thread is held by the B forceps wound with the thread.

【００１０】ここで、Ａ鉗子を、Ｂ鉗子の先端方向へ移
動させ、巻き付けた糸の輪をＢ鉗子を越えて、糸のｂ端
上にもってくる。この状態で、両方の鉗子を互いに逆方
向に引張り、巻き付けた糸の輪を締めると結び目ができ
る。Here, the A forceps is moved toward the tip of the B forceps, and the loop of the wound thread is brought over the B forceps and onto the b end of the thread. In this state, pulling both forceps in the opposite directions and tightening the loop of the wound thread forms a knot.

【００１１】なお、男−女結びや、男−女−男結びなど
は、この巻き付け方向を逆にして２あるいは３回同じこ
とを繰り返すことで行われる。ちなみに、男−女結びを
行った場合は図５（Ｂ）の様な結び目となる。A male-female knot, a male-female-male knot, etc. are performed by reversing the winding direction and repeating the same two or three times. By the way, when a male-female knot is performed, a knot as shown in FIG. 5 (B) is obtained.

【００１２】こうして得られる結び目は固く強いもので
あり、また２本の鉗子により糸の両端を結び目を中心に
直横に逆方向に引くことで、糸を確実に締め付けること
が可能となる。このように行うことで締め具合の調節等
を行いやすい。The knot thus obtained is firm and strong, and the two forceps pull both ends of the thread in the opposite direction to the side of the knot so that the thread can be securely tightened. By performing in this way, it is easy to adjust the tightening degree.

【００１３】[0013]

【発明が解決しようとする課題】しかしながら、上記従
来構成のものにあっては、体外で結び目をつくる場合に
は体内に導いた糸の両端を一旦、体外に引き出す必要が
あるので、鉗子の出し入れ動作が多くなり、その作業が
面倒である。さらに、体内で比較的広い範囲に亙り生体
組織を縫合する場合には縫合作業を複数回繰り返す必要
があるので、その作業が一層困難なものとなる問題があ
る。However, in the case of the above-mentioned conventional structure, in order to tie a knot outside the body, it is necessary to once pull out both ends of the thread guided into the body, so that the forceps are taken in and out. There are many movements, and the work is troublesome. Further, when suturing a living tissue over a relatively wide area in the body, the suturing work needs to be repeated a plurality of times, which causes a problem that the work becomes more difficult.

【００１４】また、糸の両端を体外に出すため、非常に
長い糸が必要となるので、体外に出す際、糸が貫通され
た生体組織が、この糸で長くこすられるおそれがある。
さらに、結び目を体内に送りこむための専用の道具も必
要になり、コスト高になる問題があるうえ、このように
結び目を体外から体内に送りこむ方法では結び目を固く
締めることは難しい場合がある。Since both ends of the thread are taken out of the body, a very long thread is required. Therefore, when the thread is taken out of the body, the living tissue penetrated by the thread may be rubbed with the thread for a long time.
Further, a special tool for feeding the knot into the body is required, which causes a problem of high cost, and it may be difficult to tighten the knot by the method of feeding the knot from the body into the body.

【００１５】また、２本の腹腔鏡下手術用の鉗子を用い
て体内にて結紮を行う場合にはやはり、前述した様な特
殊な環境下での作業となるため、通常の開腹手術の様な
操作は非常に難しい問題がある。特に、鉗子に糸を巻き
付けるような作業は困難であり、技術や熟練も必要とな
る。さらに、ここでも体内で比較的広い範囲に亙り生体
組織を縫合するために縫合作業を複数回繰り返す場合に
は、その作業に時間もかかり、一層困難なものとなる問
題がある。Further, when performing ligation in the body using two forceps for laparoscopic surgery, the operation is performed in the special environment as described above, and therefore, it is performed as in a normal laparotomy. Operation is a very difficult problem. In particular, the work of winding a thread around the forceps is difficult and requires skill and skill. Further, here again, when the suturing operation is repeated a plurality of times in order to suture the living tissue over a relatively wide area in the body, the operation takes time and there is a problem that it becomes more difficult.

【００１６】また、略投げ縄状のループにより、糸のも
う一端をしめつけて結び目をつくる方法では、結び目が
比較的弱く、結び目がほどけてしまうおそれがある。な
お、棒の先端に略投げ縄状のループを取付け、体腔内に
挿入する場合などにおいては、通常の縫う作業を行なう
２本の鉗子を挿入するための２つの穴を患者の体表にあ
ける必要があることに加え、この棒を挿入するための穴
をもう一つ新たに患者の体表にあける必要があり、患者
の負担が増大するおそれがある。さらに、この場合も複
数針の縫合を行う際には、毎回鉗子の出し入れ作業が必
要になるので、その作業が面倒なものとなる問題があ
る。Further, in the method of tightening the other end of the thread by the substantially lasso-shaped loop to form a knot, the knot may be relatively weak and the knot may be untied. In addition, when attaching a substantially lasso-shaped loop to the tip of the rod and inserting the loop into a body cavity, two holes for inserting two forceps for performing a normal sewing operation are formed on the body surface of the patient. In addition to the need, it is necessary to make another hole for inserting this rod on the body surface of the patient, which may increase the burden on the patient. Further, in this case as well, when performing the suturing of a plurality of needles, it is necessary to take in and out the forceps each time, so that there is a problem that the work becomes troublesome.

【００１７】本発明は上記事情に着目してなされたもの
で、その目的は、体腔内で比較的広い範囲に亙り生体組
織を縫合する作業を能率よく行なうことができる縫合用
具を提供することにある。The present invention has been made in view of the above circumstances, and an object thereof is to provide a suturing tool capable of efficiently suturing a living tissue over a relatively wide range in a body cavity. is there.

【００１８】[0018]

【課題を解決するための手段】本発明は結び目用のルー
プを形成する複数本の縫合糸を環装する円柱部材と、前
記円柱部材を遊挿し、前記ループを収納する穴を有し、
前記縫合糸の少なくとも一カ所を係止する係止部を有す
る外筒と、前記複数本の縫合糸を個別に判別する手段と
を設けたものである。SUMMARY OF THE INVENTION The present invention has a columnar member around which a plurality of sutures forming a loop for knot are looped, and a hole into which the columnar member is loosely inserted to accommodate the loop.
An outer cylinder having a locking portion that locks at least one location of the suture thread, and a means for individually discriminating the plurality of suture threads are provided.

【００１９】[0019]

【作用】複数の縫合糸に、予めその一部に例えば結紮用
のループをそれぞれ形成し、各ループを円柱部材に保持
させると共に、各ループから延びる糸の延長部を糸係止
部に係止しておく。そして、各ループの内側の空間に鉗
子等の手術用具を通し、各ループを保持した円筒部材を
手術用具の外周に配置させる。これを、体腔内に挿入
し、所要の生体組織に糸を通した後、別の鉗子などで、
最初のループを手術用具から外し、このループで結紮す
る。ついで、次の糸を選び同様にして２つ目の結紮を行
う。さらに追加したいときは、順次、次の糸を用いて結
紮を行うようにしたものである。Function: For example, a loop for ligation is formed on a part of a plurality of sutures in advance, each loop is held by a columnar member, and an extension part of a thread extending from each loop is locked by a thread locking part. I'll do it. Then, a surgical tool such as forceps is passed through the space inside each loop, and the cylindrical member holding each loop is arranged on the outer circumference of the surgical tool. After inserting this into the body cavity and passing the thread through the required biological tissue, use another forceps, etc.
The first loop is removed from the surgical tool and ligated with this loop. Then, the next thread is selected and the second ligation is performed in the same manner. When it is desired to add more, the next thread is sequentially used for ligation.

【００２０】[0020]

【実施例】以下、本発明の第１の実施例を図１乃至図１
２を参照して説明する。図１は縫合用具の糸保持部材１
の概略構成を示すものである。この糸保持部材１には内
筒２と、この内筒２が遊挿される外筒３とが設けられて
いる。DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS.
2 will be described. FIG. 1 shows a thread holding member 1 of a suturing tool.
FIG. The thread holding member 1 is provided with an inner cylinder 2 and an outer cylinder 3 into which the inner cylinder 2 is loosely inserted.

【００２１】ここで、内筒２の先端部には外径寸法が外
筒３と略同径に形成され、外筒３内に収容されない内筒
把持部４が設けられている。さらに、この内筒２の後端
部側には図３（Ｂ）に示すように外筒３内に挿入される
先細状のテーパ面が形成された糸巻き付け部５が設けら
れているとともに、内筒把持部４と糸巻き付け部５との
間には外筒３の内周壁面にはまって内筒２を固定する固
定部６が設けられている。そして、内筒２の糸巻き付け
部５には後述する図４に示す巻き方で複数本、本実施例
では４本の縫合用糸７Ａ，７Ｂ，７Ｃ，７Ｄがそれぞれ
巻き付けられ、結び目用の３重結紮のループ部７Ｌがそ
れぞれ形成されている。なお、縫合用糸７Ａ〜７Ｄは外
科手術用に用いられるものなら、どのようなものでもよ
い。Here, the inner cylinder 2 is provided with an inner cylinder grip portion 4 which is formed at the tip end portion thereof so that the outer diameter dimension thereof is substantially the same as that of the outer cylinder 3 and is not housed in the outer cylinder 3. Further, as shown in FIG. 3B, a yarn winding portion 5 having a tapered taper surface to be inserted into the outer cylinder 3 is provided on the rear end side of the inner cylinder 2, and A fixing portion 6 for fixing the inner cylinder 2 by being fitted on the inner peripheral wall surface of the outer cylinder 3 is provided between the inner cylinder grip portion 4 and the thread winding portion 5. A plurality of, in the present embodiment, four suture threads 7A, 7B, 7C, 7D are wound around the thread winding portion 5 of the inner cylinder 2 in the manner shown in FIG. Heavy-ligation loop portions 7L are respectively formed. The suture threads 7A to 7D may be any thread as long as they are used for surgical operation.

【００２２】また、図８に示すように内筒２の内腔２ａ
には内筒把持部４側に閉止部２ｂが設けられている。そ
して、この内腔２ａは内筒２の先端部側の閉止部２ｂで
終端するようになっている。さらに、この内筒２の内腔
２ａは糸巻き付け部５の部分の内径がこの糸保持部材１
と組合わせて用いられる鉗子、例えば図７に示す鉗子２
１の挿入部２１ａの径よりも大きくなるように設定され
ている。Further, as shown in FIG. 8, the inner cavity 2a of the inner cylinder 2
Is provided with a closing portion 2b on the inner cylinder gripping portion 4 side. Then, the inner cavity 2a ends at the closing portion 2b on the tip end side of the inner cylinder 2. Further, in the inner cavity 2a of the inner cylinder 2, the inner diameter of the thread winding portion 5 is the thread holding member 1
Forceps used in combination with, for example, the forceps 2 shown in FIG.
The diameter is set to be larger than the diameter of the first insertion portion 21a.

【００２３】ここで、鉗子２１には挿入部２１ａの手元
側の端部に操作部２１ｂが連結されるとともに、挿入部
２１ａの先端部にはこの操作部２１ｂの操作によって開
閉操作される把持部２１ｃが設けられている。Here, the forceps 21 has an operating portion 21b connected to the proximal end of the inserting portion 21a, and a gripping portion that is opened and closed by operating the operating portion 21b at the distal end portion of the inserting portion 21a. 21c is provided.

【００２４】また、外筒３の筒内には図２に示すように
一端部側に小径な鉗子固定部８が形成され、この鉗子固
定部８以外の部分にはこの鉗子固定部８よりも大径な糸
収納部９が形成されている。As shown in FIG. 2, a forceps fixing portion 8 having a small diameter is formed on one end side in the cylinder of the outer cylinder 3, and a portion other than the forceps fixing portion 8 has a smaller diameter than the forceps fixing portion 8. A large-diameter yarn accommodating portion 9 is formed.

【００２５】ここで、糸収納部９の長さは、内筒２の固
定部６および糸巻き付け部５の長さを足した長さとほぼ
同じ長さに設定されている。さらに、この糸収納部９の
内径は内筒２の固定部６と軽くはまりこむような大きさ
に設定されている。Here, the length of the yarn accommodating portion 9 is set to be substantially the same as the length obtained by adding the lengths of the fixing portion 6 of the inner cylinder 2 and the yarn winding portion 5. Further, the inner diameter of the thread accommodating portion 9 is set to a size such that the thread accommodating portion 9 fits lightly into the fixing portion 6 of the inner cylinder 2.

【００２６】また、鉗子固定部８の内径はこの糸保持部
材１と組合わせて用いられる鉗子２１の挿入部２１ａに
軽くしまりばめするような寸法に設定されている。さら
に、この鉗子固定部８にはその内孔からこの外筒３の外
周に向けて周方向に等間隔に６カ所に配置された放射状
の切り込み溝１０が形成されており、鉗子の挿入時に各
切り込み溝１０間の部分が比較的容易に変形して鉗子２
１の挿入部２１ａを確実に固定するようになっている。Further, the inner diameter of the forceps fixing portion 8 is set to a size such that it is lightly fitted into the insertion portion 21a of the forceps 21 used in combination with the thread holding member 1. Further, the forceps fixing portion 8 is formed with radial notch grooves 10 arranged at six positions in the circumferential direction from the inner hole toward the outer periphery of the outer cylinder 3 at equal intervals, and each of them is inserted at the time of inserting the forceps. The portion between the cut grooves 10 is relatively easily deformed to forceps 2
The insertion portion 21a of No. 1 is securely fixed.

【００２７】また、外筒３の先端部には内筒２の糸巻き
付け部５に巻き付けられた４本の縫合用糸７Ａ，７Ｂ，
７Ｃ，７Ｄの両端部をそれぞれ係止するための合計８つ
の糸係止溝１１Ａ〜１１Ｄ、１１Ａ´〜１１Ｄ´が成形
されている。これらの８つの糸係止溝１１Ａ〜１１Ｄ、
１１Ａ´〜１１Ｄ´は外筒３の先端部に周方向にそれぞ
れ等間隔で配置されている。Further, at the tip of the outer tube 3, four suture threads 7A, 7B wound around the thread winding section 5 of the inner tube 2,
A total of eight thread locking grooves 11A to 11D and 11A 'to 11D' for locking both ends of 7C and 7D are formed. These eight thread locking grooves 11A to 11D,
11A ′ to 11D ′ are arranged at equal intervals in the circumferential direction at the tip of the outer cylinder 3.

【００２８】この場合、図１１（Ｂ）に示すように外筒
３の先端部における径方向の対向位置に配置された糸係
止溝１１Ａと１１Ａ´、１１Ｂと１１Ｂ´、１１Ｃと１
１Ｃ´、１１Ｄと１１Ｄ´はそれぞれ同じ長さに設定さ
れている。さらに、糸係止溝１１Ａと１１Ａ´は外筒３
の軸心方向の長さが最も短く、１１Ｂと１１Ｂ´、１１
Ｃと１１Ｃ´、１１Ｄと１１Ｄ´の順に、長さが長くな
るように設定されている。In this case, as shown in FIG. 11 (B), the thread locking grooves 11A and 11A ', 11B and 11B', 11C and 1 are arranged at the radially opposite positions of the tip of the outer cylinder 3.
1C ′, 11D and 11D ′ are set to have the same length. Further, the thread locking grooves 11A and 11A 'are provided in the outer cylinder 3
11B and 11B ', 11 are the shortest in the axial direction of
The lengths are set to be longer in the order of C and 11C ', 11D and 11D'.

【００２９】また、各糸係止溝１１Ａ〜１１Ｄ、１１Ａ
´〜１１Ｄ´の後方にはその溝の位置を示す表示、例え
ばドット表示部１２Ａ〜１２Ｄが形成されている。これ
らのドット表示部１２Ａ〜１２Ｄは各糸係止溝１１Ａ〜
１１Ｄ、１１Ａ´〜１１Ｄ´の長さに応じて、短い組か
ら順に１、２、３、４個のドットがつけられている。例
えば、糸係止溝１１Ａと１１Ａ´には１個のドットがつ
けられたドット表示部１２Ａが形成されている。Further, each thread locking groove 11A to 11D, 11A
Display indicating the position of the groove, for example, dot display portions 12A to 12D is formed behind the 'to 11D'. These dot display portions 12A to 12D are provided in the respective thread locking grooves 11A to
According to the lengths of 11D and 11A ′ to 11D ′, 1, 2, 3, and 4 dots are added in order from the shortest set. For example, a dot display portion 12A having one dot is formed in the thread locking grooves 11A and 11A '.

【００３０】また、内筒２の糸巻き付け部５に巻かれて
いる４本の糸７Ａ〜７Ｄの各一端部には縫合用針１３が
それぞれ連結されている。さらに、内筒２の糸巻き付け
部５の最後端位置に巻き付けられている糸７Ｄにおける
針１３側の端部であるＡ端部７ａとその他端であるＢ端
部７ｂが、それぞれ外筒３の一番溝が長い糸係止溝１１
Ｄと１１Ｄ´（ドット数４個のドット表示部１２Ｄ）に
係止されている。同様に、内筒２の糸巻き付け部５にお
ける後端位置から２番目の位置に巻き付けられている糸
７Ｃの両端はそれぞれ外筒３の糸係止溝１１Ｃと１１Ｃ
´に、内筒２の糸巻き付け部５における後端位置から３
番目の糸７Ｂの両端はそれぞれ外筒３の糸係止溝１１Ｂ
と１１Ｂ´に、内筒２の糸巻き付け部５における後端位
置から４番目の糸７Ａの両端はそれぞれ外筒３の糸係止
溝１１Ａと１１Ａ´に係止されている。A suture needle 13 is connected to one end of each of the four threads 7A to 7D wound around the thread winding section 5 of the inner cylinder 2. Furthermore, the A end 7a, which is the end on the needle 13 side, and the B end 7b, which is the other end, of the thread 7D wound at the rearmost position of the thread winding section 5 of the inner cylinder 2, are respectively located on the outer cylinder 3. Thread locking groove with the longest groove 11
It is locked to D and 11D '(dot display section 12D with four dots). Similarly, both ends of the yarn 7C wound at the second position from the rear end position in the yarn winding portion 5 of the inner cylinder 2 have thread locking grooves 11C and 11C of the outer cylinder 3, respectively.
3'from the rear end position in the thread winding part 5 of the inner cylinder 2
Both ends of the second thread 7B have thread locking grooves 11B of the outer cylinder 3, respectively.
And 11B ', both ends of the fourth thread 7A from the rear end position in the thread winding portion 5 of the inner cylinder 2 are locked in the thread locking grooves 11A and 11A' of the outer cylinder 3, respectively.

【００３１】なお、ここでは縫合用糸７Ａ，７Ｂ，７
Ｃ，７Ｄは針付糸としたが、針１３のない糸であっても
よい。さらに、縫合用糸７Ａ，７Ｂ，７Ｃ，７Ｄの種類
は吸収性、非吸収性、天然、合成を問わず、どのような
ものでもよい。Here, the suture threads 7A, 7B, 7
Although C and 7D are yarns with needles, they may be yarns without the needles 13. Further, the suture thread 7A, 7B, 7C, 7D may be of any type, whether absorbable, non-absorbable, natural or synthetic.

【００３２】次に、内筒２の糸巻き付け部５に巻き付け
られる各縫合用糸７Ａ（７Ｂ，７Ｃ，７Ｄ）の巻き方に
ついて説明する。まず、図５（Ａ）に示すように内筒２
の先端方向の糸巻き付け部５に縫合用糸７Ａ（７Ｂ，７
Ｃ，７Ｄ）を１回巻き付け、第１のループ７Ｌ1 （ルー
プ１）を形成する。Next, a method of winding each suture thread 7A (7B, 7C, 7D) wound around the thread winding portion 5 of the inner cylinder 2 will be described. First, as shown in FIG. 5 (A), the inner cylinder 2
The suture thread 7A (7B, 7
C, 7D) is wound once to form a first loop 7L 1 (loop 1).

【００３３】続いて、図５（Ｂ）に示すようにループ１
に対して点線部Ａで対称になるように糸巻き付け部５に
縫合用糸７Ａ（７Ｂ，７Ｃ，７Ｄ）を巻き付け、第２の
ループ７Ｌ2 （ループ２）を形成する。Then, as shown in FIG. 5B, loop 1
On the other hand, the suture thread 7A (7B, 7C, 7D) is wound around the thread winding portion 5 so as to be symmetrical with respect to the dotted line portion A to form the second loop 7L 2 (loop 2).

【００３４】さらに、図５（Ｃ）に示すようにループ２
に対して点線部Ｂで対称となるように（つまりループ１
と同じ巻き方で）、糸巻き付け部５に縫合用糸７Ａ（７
Ｂ，７Ｃ，７Ｄ）を巻き付けることにより、第３のルー
プ７Ｌ3 （ループ３）を形成する。Further, as shown in FIG.
With respect to the dotted line portion B (that is, loop 1
And the suture thread 7A (7
B, 7C, 7D) is wound to form a third loop 7L 3 (loop 3).

【００３５】これにより、図４に示す結び目用の３重結
紮のループ部７Ｌが形成される。その後、図６（Ａ）中
に矢印で示すように縫合用糸７Ａ（７Ｂ，７Ｃ，７Ｄ）
の一端（Ａ端）７ａをこの３つのループ７Ｌ1 〜７Ｌ3
内に通してしめるとＡ端７ａ側の糸７Ａ（７Ｂ，７Ｃ，
７Ｄ）と、ループ部７Ｌの各ループ７Ｌ1 〜７Ｌ3 との
絡まり方の関係は、図６（Ｂ）に示す男−女−男結びの
３重結紮と同じになるものである。つまり、ループ７Ｌ
1 、ループ７Ｌ2 、ループ７Ｌ3 は各々図５（Ｂ）の３
重結紮の１重結紮部ｏ、２重結紮部ｐ、３重結紮部ｑに
それぞれ対応し、ループ２の巻き方の向きの違いは、男
−女−男結びの中の女結びに対応する。なお、糸７Ａ〜
７Ｄの巻き方は本実施例のものに格別に限定されるもの
ではなく、結紮が可能であれば、どのようなものでもよ
い。As a result, the loop portion 7L of the triple ligature for knot shown in FIG. 4 is formed. Then, as shown by the arrow in FIG. 6 (A), suture thread 7A (7B, 7C, 7D)
One end (A end) 7a these three loops 7L 1 ~7L 3
When threaded through the inside, the thread 7A (7B, 7C,
7D) and the loops 7L 1 to 7L 3 of the loop portion 7L are entangled in the same manner as the male-female-male knot triple ligature shown in FIG. 6B. That is, loop 7L
1 , loop 7L 2 and loop 7L 3 are respectively 3 in FIG. 5 (B).
It corresponds to the single ligature part o, the double ligature part p, and the triple ligature part q of the heavy ligature, respectively, and the difference in the winding direction of the loop 2 corresponds to the female knot in the male-female-male knot. In addition, the thread 7A ~
The winding method of 7D is not particularly limited to that of this embodiment, and any method may be used as long as it can be ligated.

【００３６】そして、糸保持部材１の内筒２、外筒３、
縫合用糸７Ａ〜７Ｄは予め図３（Ｂ）に示すように４本
の縫合用糸７Ａ〜７Ｄを内筒２の糸巻き付け部５に巻き
付け、それぞれ結び目用の３重結紮のループ部７Ｌを形
成した後、縫合用糸７Ａ〜７Ｄのループ部７Ｌを巻いた
糸巻き付け部５の部分を外筒３の糸収納部９に挿入す
る。その際、内筒２の最後端位置の糸７Ｄから７Ｃ，７
Ｂ，７Ａの順に、外筒３のそれぞれに対応する糸係止溝
１１Ｄ，１１Ｄ´〜１１Ａ，１１Ａ´に順次挟んで固定
し、最後に内筒２の固定部６を外筒３内にはめ込んで固
定するようになっている。Then, the inner cylinder 2, the outer cylinder 3 of the thread holding member 1,
As for the suture threads 7A to 7D, four suture threads 7A to 7D are wound around the thread winding portion 5 of the inner cylinder 2 in advance as shown in FIG. After the formation, the portion of the thread winding portion 5 around which the loop portion 7L of the suture threads 7A to 7D is wound is inserted into the thread storage portion 9 of the outer cylinder 3. At that time, the yarns 7D to 7C, 7 at the rearmost position of the inner cylinder 2
B and 7A in this order are sequentially sandwiched and fixed in the thread locking grooves 11D, 11D 'to 11A, 11A' respectively corresponding to the outer cylinder 3, and finally the fixing portion 6 of the inner cylinder 2 is fitted into the outer cylinder 3. It is designed to be fixed with.

【００３７】次に、上記構成の作用について説明する。
ここでは、本実施例の糸保持部材１を例えば図７に示す
鉗子２１（以下、この鉗子２１をＡ鉗子とする）と組み
合わせて使用し、図９に示すような患者の体内の生体組
織の創傷部位Ｈ0 の両側の組織Ｈ1 ，Ｈ2 間を結紮する
場合について説明する。Next, the operation of the above configuration will be described.
Here, the thread holding member 1 of the present embodiment is used in combination with, for example, forceps 21 shown in FIG. 7 (hereinafter, this forceps 21 will be referred to as A forceps), and used for the living tissue in the patient's body as shown in FIG. The case of ligating between the tissues H 1 and H 2 on both sides of the wound site H 0 will be described.

【００３８】まず、図８に示すようにＡ鉗子２１の挿入
部２１ａを内筒２、外筒３、縫合用糸７Ａ〜７Ｄが組付
けられた糸保持部材１の外筒３の後端の鉗子固定部８の
内腔に挿入する。ここで、Ａ鉗子２１を深く挿入してい
くと、Ａ鉗子２１の挿入部２１ａの先端部が内筒２の糸
巻き付け部５の内腔２ａに挿入される。First, as shown in FIG. 8, the insertion portion 21a of the A forceps 21 is attached to the inner cylinder 2, the outer cylinder 3, and the rear end of the outer cylinder 3 of the thread holding member 1 to which the suture threads 7A to 7D are assembled. It is inserted into the inner cavity of the forceps fixing portion 8. Here, when the A forceps 21 is deeply inserted, the distal end portion of the insertion portion 21a of the A forceps 21 is inserted into the inner cavity 2a of the thread winding portion 5 of the inner cylinder 2.

【００３９】この状態から更にＡ鉗子２１を押し進める
と、Ａ鉗子２１の先端部が内筒２の内腔２ａの閉止部２
ｂに当接した後、この閉止部２ｂがＡ鉗子２１によって
このＡ鉗子２１の挿入方向に押圧され、内筒２が外筒３
から押し出される。このとき、内筒２の糸巻き付け部５
に巻き付けられている糸７Ａ〜７Ｄのループ部７Ｌは、
内筒２が外筒３から押し出される動作にともないそのま
まの形を維持した状態で内筒２の糸巻き付け部５から外
れ、内筒２に変わって挿入されてきたＡ鉗子２１に巻き
付けられる。なお、内筒２の糸巻き付け部５から外れた
内筒２はＡ鉗子２１から取り外される。When the A forceps 21 is further pushed from this state, the tip end of the A forceps 21 causes the closing portion 2 of the inner cavity 2a of the inner cylinder 2 to be closed.
After contacting b, the closing portion 2b is pressed by the A forceps 21 in the insertion direction of the A forceps 21, so that the inner cylinder 2 becomes the outer cylinder 3
Is extruded from. At this time, the thread winding portion 5 of the inner cylinder 2
The loop portion 7L of the threads 7A to 7D wound around the
While the inner cylinder 2 is pushed out from the outer cylinder 3, the inner cylinder 2 is removed from the thread winding portion 5 of the inner cylinder 2 while maintaining its original shape, and is wound around the A forceps 21 that has been inserted instead of the inner cylinder 2. The inner cylinder 2 separated from the thread winding portion 5 of the inner cylinder 2 is removed from the A forceps 21.

【００４０】また、外筒３は鉗子固定部８によりＡ鉗子
２１上に軽く締まりばめ状態で固定される。このとき、
外筒３の素材の弾性と、切り込み溝１０のため、外筒３
は適度な力量にてＡ鉗子２１上をその軸心方向に移動可
能になっており、図９に示すようにＡ鉗子２１上の適当
な位置に配置された状態で保持される。The outer cylinder 3 is lightly clamped and fixed on the A forceps 21 by the forceps fixing portion 8. At this time,
Due to the elasticity of the material of the outer cylinder 3 and the cut groove 10, the outer cylinder 3
Can be moved in the axial direction of the A forceps 21 with an appropriate amount of force, and is held in a state of being arranged at an appropriate position on the A forceps 21 as shown in FIG.

【００４１】このようにＡ鉗子２１と糸保持部材１の外
筒３との組付け作業が終了した後、次に、糸保持部材１
の外筒３が組付けられたＡ鉗子２１を体腔内にトラカー
ルなどを介して挿入し、生体組織の結紮作業を行う。After the assembling work of the A forceps 21 and the outer cylinder 3 of the thread holding member 1 is completed in this way, next, the thread holding member 1
The A forceps 21 to which the outer cylinder 3 is attached is inserted into the body cavity through a trocar or the like to ligate the living tissue.

【００４２】ここで、例えば、創傷部位Ｈ0 の両側の組
織Ｈ1 ，Ｈ2 間の縫合を行う場合には、１個のドットが
つけられたドット表示部１２Ａの位置の（長さが一番短
い）一方の糸係止溝１１Ａに係止されている針付糸７Ａ
のＡ端部７ａをＡ鉗子２１で保持する。Here, for example, when the suture between the tissues H 1 and H 2 on both sides of the wound site H 0 is performed, the position of the dot display portion 12A with one dot (the length is one The shortest thread 7A with needle that is locked in one thread locking groove 11A
The A end portion 7a of A is held by the A forceps 21.

【００４３】ついで、図８に示すように創傷部位Ｈ0 の
両側の組織Ｈ1 ，Ｈ2 間に針１３を刺し、糸７Ａを組織
Ｈ1 ，Ｈ2 に通して、その糸７ＡのＡ端部７ａの部分を
Ａ鉗子２１でもう一度つかむ。Then, as shown in FIG. 8, the needle 13 is pierced between the tissues H 1 and H 2 on both sides of the wound site H 0 , and the thread 7A is passed through the tissues H 1 and H 2, and the A end of the thread 7A is inserted. The part 7a is again grasped by the A forceps 21.

【００４４】この状態で、次に別の鉗子（以下、Ｂ鉗
子）２２で、ドットが１つのドット表示部１２Ａの他方
の糸係止溝１１Ａ´に固定されている糸７ＡのＢ端部７
ｂを掴む。そして、Ｂ鉗子２２を引上げ、糸７ＡのＢ端
部７ｂを引き、図１０に示すように外筒３からこの糸７
Ａのループ部７Ｌを外したのち、Ａ鉗子２１の先端方向
に引っ張る。In this state, next, with another forceps (hereinafter, B forceps) 22, the B end portion 7 of the thread 7A in which the dot is fixed in the other thread locking groove 11A 'of the one dot display portion 12A.
grab b. Then, the B forceps 22 is pulled up, the B end portion 7b of the thread 7A is pulled, and as shown in FIG.
After removing the loop portion 7L of A, the A forceps 21 is pulled toward the tip.

【００４５】これを更に引くと、糸７Ａのループ部７Ｌ
はＡ鉗子２１から外れ、図１１に示すようにループ部７
Ｌの中に糸７ＡのＡ端部７ａが通る。この状態で、さら
にＡ鉗子２１、Ｂ鉗子２２を強く引き、図１２に示すよ
うにループ部７Ｌの結び目を強く締め付けることによ
り、創傷部位Ｈ0 の両側の組織Ｈ1 ，Ｈ2 間の縫合が行
なわれる。When this is pulled further, the loop portion 7L of the thread 7A is
Is disengaged from the A forceps 21 and, as shown in FIG.
The A end 7a of the thread 7A passes through L. In this state, the A forceps 21 and the B forceps 22 are strongly pulled, and the knot of the loop portion 7L is strongly tightened as shown in FIG. 12, whereby the suture between the tissues H 1 and H 2 on both sides of the wound site H 0 is sutured. Done.

【００４６】つづいて、もう一針縫いたい場合には、ド
ットが２つのドット表示部１２Ｂの位置の（長さが２番
目に短い）糸係止溝１１Ｂ，１１Ｂ´に係止されている
針付糸７Ｂを使用して同様の縫合操作が行なわれる。以
後は、順次、ドット数が大きく、長さが長い溝に保持さ
れる針付糸７Ｃ，７Ｄを使用して同様の縫合操作が行な
われる。そして、本実施例においては、４針までの縫合
操作ができる。Next, when it is desired to sew another stitch, the needles whose dots are locked in the thread locking grooves 11B and 11B 'at the positions of the two dot display portions 12B (the second shortest length). A similar suturing operation is performed using the attached thread 7B. After that, the same suturing operation is performed by using the needled threads 7C and 7D which are successively held in the grooves having a large number of dots and a long length. Then, in this embodiment, a suturing operation with up to 4 needles can be performed.

【００４７】そこで、上記構成のものにあっては次の効
果を奏する。すなわち、糸保持部材１の内筒２の糸巻き
付け部５に４本の縫合用糸７Ａ，７Ｂ，７Ｃ，７Ｄをそ
れぞれ巻き付けて結び目用の３重結紮のループ部７Ｌを
それぞれ形成し、糸保持部材１をＡ鉗子２１と組み合わ
せて使用する際に、内筒２の糸巻き付け部５に巻き付け
られている糸７Ａ〜７Ｄのループ部７Ｌを内筒２が外筒
３から押し出される動作にともないそのままの形を維持
した状態で内筒２に変わって挿入されてきたＡ鉗子２１
に巻き付けられるようにしたので、体腔内に挿入された
Ａ鉗子２１を体腔内から体外に引き出すことなく複数針
の縫合結紮を容易に確実に行なうことができる。Therefore, the following effects can be obtained with the above configuration. That is, four suture threads 7A, 7B, 7C and 7D are respectively wound around the thread winding portion 5 of the inner cylinder 2 of the thread holding member 1 to form triple knot loop portions 7L for knotting, respectively, and thread holding portions are held. When the member 1 is used in combination with the A forceps 21, the loop portion 7L of the threads 7A to 7D wound around the thread winding portion 5 of the inner cylinder 2 remains as it is as the inner cylinder 2 is pushed out from the outer cylinder 3. Forceps 21 inserted in place of the inner cylinder 2 while maintaining the shape of
Since the A forceps 21 inserted into the body cavity is pulled out from the body cavity to the outside of the body, the suture and ligature of a plurality of needles can be easily and reliably performed.

【００４８】そのため、患者の体内の生体組織の創傷部
位Ｈ0 の両側の組織Ｈ1 ，Ｈ2 間を結紮する場合のよう
に体腔内で比較的広い範囲に亙り生体組織を縫合する作
業を能率よく行なうことができる。Therefore, as in the case of ligating between the tissues H 1 and H 2 on both sides of the wound site H 0 of the living tissue in the patient's body, the work of suturing the living tissue over a relatively wide range in the body cavity is efficient. You can do it well.

【００４９】また、外筒３の先端部の８つの糸係止溝１
１Ａ〜１１Ｄ、１１Ａ´〜１１Ｄ´のうち、糸係止溝１
１Ａと１１Ａ´は外筒３の軸心方向の長さが最も短く、
１１Ｂと１１Ｂ´、１１Ｃと１１Ｃ´、１１Ｄと１１Ｄ
´の順に、長さが長くなるように設定するとともに、各
糸係止溝１１Ａ〜１１Ｄ、１１Ａ´〜１１Ｄ´の後方に
その溝の位置を示すドット表示部１２Ａ〜１２Ｄを形成
したので、内筒２の糸巻き付け部５に巻かれている４本
の糸７Ａ〜７Ｄの使用順番を分かりやすくすることがで
き、作業能率の向上を図ることができる。The eight thread locking grooves 1 at the tip of the outer cylinder 3
Thread locking groove 1 of 1A to 11D and 11A 'to 11D'
1A and 11A 'have the shortest axial length of the outer cylinder 3,
11B and 11B ', 11C and 11C', 11D and 11D
Since the lengths are set to become longer in the order of ', and the dot display portions 12A to 12D indicating the positions of the thread locking grooves 11A to 11D and 11A' to 11D 'are formed behind the thread locking grooves 11A to 11D. The order of use of the four yarns 7A to 7D wound around the yarn winding portion 5 of the cylinder 2 can be easily understood, and the work efficiency can be improved.

【００５０】さらに、外筒３の先端部の８つの糸係止溝
１１Ａ〜１１Ｄ、１１Ａ´〜１１Ｄ´により４本の糸７
Ａ〜７Ｄの両端部をそれぞれ係止させるようにしたの
で、糸保持部材１の外筒３が組付けられたＡ鉗子２１を
体腔内にトラカールなどを介して挿入する際に４本の糸
７Ａ〜７Ｄの装着位置がずれたり、ループ部７ＬがＡ鉗
子２１から外れるおそれがない。Furthermore, the four thread 7 are formed by the eight thread locking grooves 11A to 11D and 11A 'to 11D' at the tip of the outer cylinder 3.
Since both ends of A to 7D are locked respectively, when the A forceps 21 to which the outer cylinder 3 of the thread holding member 1 is attached is inserted into the body cavity through the trocar or the like, the four threads 7A There is no possibility that the mounting positions of 7D are displaced or the loop portion 7L is disengaged from the A forceps 21.

【００５１】また、外筒３の先端部の８つの糸係止溝１
１Ａ〜１１Ｄ、１１Ａ´〜１１Ｄ´に係止させた４本の
糸７Ａ〜７Ｄは各糸係止溝１１Ａ〜１１Ｄ、１１Ａ´〜
１１Ｄ´に沿って先端方向に引くだけで簡単に外筒３か
ら取り外すことができる。The eight thread locking grooves 1 at the tip of the outer cylinder 3
The four yarns 7A to 7D locked to 1A to 11D and 11A 'to 11D' are thread locking grooves 11A to 11D, 11A 'to
It can be easily removed from the outer cylinder 3 simply by pulling it in the distal direction along 11D '.

【００５２】さらに、糸保持部材１の外筒３がＡ鉗子２
１に組付けられた状態で、各糸７Ａ〜７Ｄのループ部７
Ｌは外筒３により覆われているため、各糸７Ａ〜７Ｄの
ループ部７ＬがＡ鉗子２１上を移動したり、外れたり、
或いはＡ鉗子２１の体腔内への挿入途中で周囲の干渉物
等に引っ掛かるおそれがない。Further, the outer cylinder 3 of the thread holding member 1 is the A forceps 2
The loop portion 7 of each of the yarns 7A to 7D in the state of being assembled to No. 1
Since L is covered by the outer cylinder 3, the loop portion 7L of each of the threads 7A to 7D moves on the A forceps 21 or comes off,
Alternatively, there is no risk of being caught by an interfering substance or the like in the middle of the insertion of the A forceps 21 into the body cavity.

【００５３】また、糸保持部材１には糸巻き付け部５を
備えた内筒２が設けられているため、Ａ鉗子２１を糸保
持部材１の外筒３に組付ける際にループ部７Ｌが崩れず
にそのままの形状でＡ鉗子２１の外周面に配置すること
ができる。また、この縫合用具の糸保持部材１を組み立
てる場合には、内筒２に４本の縫合用糸７Ａ，７Ｂ，７
Ｃ，７Ｄのループ部７Ｌを巻いて外筒３に差し込めばよ
いので、糸保持部材１を組み立てる作業を容易化するこ
とができる。Since the thread holding member 1 is provided with the inner cylinder 2 having the thread winding portion 5, the loop portion 7L collapses when the A forceps 21 is assembled to the outer cylinder 3 of the thread holding member 1. Instead, it can be arranged on the outer peripheral surface of the A forceps 21 in its original shape. When assembling the thread holding member 1 of this suturing tool, the four suture threads 7A, 7B, 7 are attached to the inner cylinder 2.
Since the loop portion 7L of C and 7D may be wound and inserted into the outer cylinder 3, the work of assembling the thread holding member 1 can be facilitated.

【００５４】さらに、創傷部位Ｈ0 の両側の組織Ｈ1 ，
Ｈ2 間を縫合する際に、Ａ鉗子２１およびＢ鉗子２２の
２本の鉗子で各縫合用糸７Ａ（または７Ｂ，７Ｃ，７
Ｄ）を強く引き、各縫合用糸７Ａ（または７Ｂ，７Ｃ，
７Ｄ）のループ部７Ｌの結び目を強く締め付けることが
できるので、強く、固い結び目を形成することができ、
確実な結紮作業を行なうことができる。Furthermore, the tissues H 1 on both sides of the wound site H 0 ,
When suturing between H 2, A forceps 21 and B 2 pieces of each stitching yarn 7A with forceps (or 7B of the forceps 22, 7C, 7
D) and pull each suture thread 7A (or 7B, 7C,
Since the knot of the loop portion 7L of 7D) can be strongly tightened, a strong and hard knot can be formed,
A reliable ligation work can be performed.

【００５５】なお、上記実施例の糸保持部材１の内筒２
の糸巻き付け部５に巻き付けられる４本の縫合用糸７
Ａ，７Ｂ，７Ｃ，７Ｄの色をそれぞれ変更する構成にし
てもよい。このように色が異なる４本の縫合用糸７Ａ，
７Ｂ，７Ｃ，７Ｄを内筒２の糸巻き付け部５に巻き付け
ることにより、使用する縫合用糸７Ａ，７Ｂ，７Ｃ，７
Ｄを迅速に識別することができるので、生体組織の縫合
作業を行う際に、何針か縫った状態で、複数の糸が重な
りあっても目的の縫合用糸７Ａ，７Ｂ，７Ｃ，７Ｄを簡
単に区別できる。The inner cylinder 2 of the thread holding member 1 of the above embodiment
Suture threads 7 wound around the thread winding portion 5 of
You may make it the structure which changes each color of A, 7B, 7C, and 7D. 4 suture threads 7A of different colors,
By winding 7B, 7C, 7D around the thread winding portion 5 of the inner cylinder 2, suture threads 7A, 7B, 7C, 7 to be used
Since D can be quickly identified, the desired suture thread 7A, 7B, 7C, 7D can be obtained even when a plurality of threads overlap with each other when sewing several stitches when performing a biological tissue suturing operation. Easy to distinguish.

【００５６】また、図１３は第１の実施例の第１の変形
例を示すものである。これは、各縫合用糸７Ａ，７Ｂ，
７Ｃ，７Ｄにおける針１３側とは反対側のＢ端部７ｂに
外筒３の先端側から数えた糸の番号となる数字をつけた
表示プレート３１Ａ，３１Ｂ，３１Ｃ，３１Ｄをそれぞ
れ設けたものである。FIG. 13 shows a first modification of the first embodiment. This is each suture thread 7A, 7B,
7C and 7D are provided with display plates 31A, 31B, 31C and 31D on the B end portion 7b on the side opposite to the needle 13 side, respectively, which are numbered as thread numbers counted from the tip side of the outer cylinder 3. is there.

【００５７】この場合には、各縫合用糸７Ａ，７Ｂ，７
Ｃ，７Ｄにおける針１３側とは反対側のＢ端部７ｂの表
示プレート３１Ａ，３１Ｂ，３１Ｃ，３１Ｄを目視する
ことにより、使用する目的の縫合用糸７Ａ（または７
Ｂ，７Ｃ，７Ｄ）の位置がすぐわかる。In this case, each suture thread 7A, 7B, 7
By visually observing the display plates 31A, 31B, 31C, 31D of the B end portion 7b on the side opposite to the needle 13 side of C, 7D, the suture thread 7A (or 7) for the purpose of use.
The position of (B, 7C, 7D) can be easily understood.

【００５８】さらに、目的の縫合用糸７Ａ（または７
Ｂ，７Ｃ，７Ｄ）のＢ端部７ｂを掴む際に、各縫合用糸
７Ａ，７Ｂ，７Ｃ，７Ｄよりも表面積が大きい各表示プ
レート３１Ａ，３１Ｂ，３１Ｃ，３１Ｄを掴むことがで
きる。そのため、各縫合用糸７Ａ，７Ｂ，７Ｃ，７Ｄを
直接掴む場合に比べて目的の縫合用糸７Ａ（または７
Ｂ，７Ｃ，７Ｄ）を掴みやすい。Further, the target suture thread 7A (or 7
(B, 7C, 7D), when grasping the B end portion 7b, each display plate 31A, 31B, 31C, 31D having a larger surface area than each suture thread 7A, 7B, 7C, 7D can be grasped. Therefore, the suture thread 7A (or 7) of the target suture is compared with the case of directly grasping each suture thread 7A, 7B, 7C, 7D.
B, 7C, 7D) is easy to grab.

【００５９】また、図１４は第１の実施例の第２の変形
例を示すものである。これは、外筒３の各糸係止溝１１
Ａ〜１１Ｄ、１１Ａ´〜１１Ｄ´の形をこの外筒３の先
端側から数えた糸の順番となる数字の形としたものであ
る。この場合も外筒３の各糸係止溝１１Ａ〜１１Ｄ、１
１Ａ´〜１１Ｄ´の形を目視することにより、使用する
目的の縫合用糸７Ａ（または７Ｂ，７Ｃ，７Ｄ）の位置
がすぐわかる。FIG. 14 shows a second modification of the first embodiment. This is the thread locking groove 11 of the outer cylinder 3.
The shapes of A to 11D and 11A 'to 11D' are the shapes of the numbers in the order of the threads counted from the tip side of the outer cylinder 3. Also in this case, the thread locking grooves 11A to 11D of the outer cylinder 3 and 1
By visually observing the shapes of 1A 'to 11D', the position of the suture thread 7A (or 7B, 7C, 7D) to be used can be immediately known.

【００６０】また、図１５は第１の実施例の第３の変形
例を示すものである。これは、各縫合用糸７Ａ（または
７Ｂ，７Ｃ，７Ｄ）の巻き方を変更したループ部７Ｍを
形成したものである。すなわち、ここでは各縫合用糸７
Ａ（または７Ｂ，７Ｃ，７Ｄ）のＡ端７ａを内筒２の糸
巻き付け部５に図１５中で矢印に示すように左方向から
複数回、例えば５回巻き付けて５重のループ７Ｍ1 〜７
Ｍ5 を形成したのち、そのＡ端７ａを同図中で右側から
ループ７Ｍ3 ，７Ｍ2 ，７Ｍ1 内に通して締める、いわ
ゆるローダーノットと呼ばれる結び目を形成する構成に
したものである。FIG. 15 shows a third modification of the first embodiment. This is a loop portion 7M in which the winding method of each suture thread 7A (or 7B, 7C, 7D) is changed. That is, here, each suture thread 7
A (or 7B, 7C, 7D) more of the left direction as shown by an arrow in FIG. 15 to the yarn-winding portion 5 of the inner cylinder 2 to A end 7a of times, for example 5 times wound fivefold loop 7M 1 ~ 7
After forming M 5 , the A end 7a is passed through the loops 7M 3 , 7M 2 and 7M 1 from the right side in the figure and tightened to form a knot called a so-called loader knot.

【００６１】また、図１６（Ａ）は第１の実施例の第４
の変形例を示すものである。これは、各縫合用糸７Ａ
（または７Ｂ，７Ｃ，７Ｄ）の巻き方をさらに変更した
ループ部７Ｎを形成したものである。すなわち、ここで
は各縫合用糸７Ａ（または７Ｂ，７Ｃ，７Ｄ）を内筒２
の糸巻き付け部５に図１６（Ａ）中で右方向から２回巻
き付けて２重のループ７Ｎ1 ，７Ｎ2 からなるループ１
を形成したのち、左側のループ７Ｎ2 の終端部を右側の
ループ７Ｎ1 の始端部と交差させて逆向きに折り返した
状態で、糸巻き付け部５に１回巻き付けてループ７Ｎ3
（ループ２）を形成したものである。Further, FIG. 16A shows the fourth embodiment of the first embodiment.
It shows a modified example of. This is each suture thread 7A
(Or 7B, 7C, 7D) is formed by further changing the winding method. That is, here, each suture thread 7A (or 7B, 7C, 7D) is inserted into the inner cylinder 2
A loop 1 consisting of double loops 7N 1 and 7N 2 wound twice from the right in FIG.
After forming the, in the state of folded end portion of the loop 7N 2 left in by intersecting the right beginning of the loop 7N 1 reverse, loop 7N 3 wound once thread winding unit 5
(Loop 2) is formed.

【００６２】そして、各縫合用糸７Ａ（または７Ｂ，７
Ｃ，７Ｄ）のＡ端７ａを同図中に矢印で示すように左方
向からループ１，２に通して締め付けた場合にはＡ端７
ａ側の各縫合用糸７Ａ（または７Ｂ，７Ｃ，７Ｄ）とル
ープ部７Ｎ側の各縫合用糸７Ａ（または７Ｂ，７Ｃ，７
Ｄ）の位置関係は図１６（Ｂ）に示すようにいわゆる外
科結びと呼ばれるものと同様になる。Then, each suture thread 7A (or 7B, 7
When the A end 7a of (C, 7D) is tightened by passing it through the loops 1 and 2 from the left as shown by the arrow in the figure, the A end 7a
Each suture thread 7A (or 7B, 7C, 7D) on the a side and each suture thread 7A (or 7B, 7C, 7) on the loop portion 7N side
The positional relationship of D) is similar to what is called a surgical knot as shown in FIG.

【００６３】また、図１７（Ａ）乃至図２０は本発明の
第２の実施例を示すものである。これは、第１の実施例
の糸保持部材１の構成の一部を次のように変更したもの
である。すなわち、ここでは外筒３の先端面に各縫合用
糸７Ａ〜７Ｄの針１３を保持する針保持穴５１Ａ〜５１
Ｄをそれぞれ設けている。各針保持穴５１Ａ〜５１Ｄは
外筒３の先端面にその周方向を１／４の等間隔に分割す
る位置に配置されている。Further, FIGS. 17A to 20 show a second embodiment of the present invention. This is a modification of a part of the structure of the yarn holding member 1 of the first embodiment as follows. That is, here, needle holding holes 51A to 51 for holding the needles 13 of the suture threads 7A to 7D on the distal end surface of the outer cylinder 3 are provided.
D are provided respectively. Each of the needle holding holes 51A to 51D is arranged on the tip surface of the outer cylinder 3 at a position where the circumferential direction thereof is divided into quarters at equal intervals.

【００６４】さらに、外筒３の先端面には隣接する一対
の針保持穴５１Ａ，５１Ｂ間、５１Ｂ，５１Ｃ間、５１
Ｃ，５１Ｄ間、５１Ｄ，５１Ａ間のそれぞれ中間位置に
糸係止溝５２Ａ，５２Ｂ，５２Ｃ，５２Ｄがそれぞれ形
成されている。Further, the front end surface of the outer cylinder 3 has a pair of adjacent needle holding holes 51A and 51B, 51B and 51C, and 51.
Thread locking grooves 52A, 52B, 52C and 52D are formed at intermediate positions between C and 51D and between 51D and 51A, respectively.

【００６５】また、各針保持穴５１Ａ〜５１Ｄの穴径は
針１３の径よりも僅かに大きく設定されている。そし
て、各針保持穴５１Ａ〜５１Ｄに針１３が後端から挿入
された場合には各針保持穴５１Ａ〜５１Ｄに針１３の後
端部とともにこの針１３の最後端に連結された各縫合用
糸７Ａ〜７ＤのＡ端部７ａが一緒に挿入されるようにな
っており、各針保持穴５１Ａ〜５１Ｄに後端から針１３
および各縫合用糸７Ａ〜７ＤのＡ端部７ａが挿入された
際に、各針保持穴５１Ａ〜５１Ｄに針１３および各縫合
用糸７Ａ〜７ＤのＡ端部７ａが適度な強度で嵌まり込む
ように設定されている。The diameter of each of the needle holding holes 51A to 51D is set to be slightly larger than the diameter of the needle 13. When the needle 13 is inserted into each of the needle holding holes 51A to 51D from the rear end, each of the needle holding holes 51A to 51D is connected to the rear end of the needle 13 together with the rear end of the needle 13 for suturing. The A ends 7a of the threads 7A to 7D are designed to be inserted together, and the needles 13 from the rear end to the needle holding holes 51A to 51D.
And when the A end 7a of each suture thread 7A to 7D is inserted, the needle 13 and the A end 7a of each suture thread 7A to 7D are fitted to each needle holding hole 51A to 51D with appropriate strength. It is set to be crowded.

【００６６】また、外筒３の外周面には各針保持穴５１
Ａ〜５１Ｄの近傍位置と、糸係止溝５２Ａ〜５２Ｄの後
端位置の近傍位置に、外筒３の先端側から数えた各縫合
用糸７Ａ，７Ｂ，７Ｃ，７Ｄの順番を示すための数字が
１〜４まで表示された表示部５３が設けられている。Each needle holding hole 51 is formed on the outer peripheral surface of the outer cylinder 3.
For indicating the order of each suture thread 7A, 7B, 7C, 7D counted from the tip side of the outer cylinder 3 at a position near A to 51D and a position near the rear end position of the thread locking grooves 52A to 52D. A display unit 53 that displays numbers 1 to 4 is provided.

【００６７】ここで、例えば内筒２の最後端位置の縫合
用糸７Ｄの縫合用針１３は４番の針保持穴５１Ｄに挿入
され、縫合用糸７ＤのＢ端部７ｂは４番の糸係止溝５２
Ｄに係止される。続いて、内筒２の後端側の糸７Ｃ，７
Ｂ，７Ａが３、２、１番の順に、その番号が表示された
各針保持穴５１Ａ〜５１Ｃにその針１３が挿入され、か
つその番号が表示された糸係止溝５２Ａ〜５２Ｃに縫合
用糸７Ｃ，７Ｂ，７ＡのＢ端部７ｂがそれぞれ係止され
るようになっている。Here, for example, the suturing needle 13 of the suture thread 7D at the rearmost position of the inner cylinder 2 is inserted into the needle holding hole 51D of No. 4, and the B end portion 7b of the suture thread 7D is No. 4 thread. Locking groove 52
It is locked to D. Then, the threads 7C, 7 on the rear end side of the inner cylinder 2
B and 7A are numbered 3, 2, and 1 in that order, the needle 13 is inserted into each needle holding hole 51A to 51C whose number is displayed, and sutured to the thread locking grooves 52A to 52C where the number is displayed. The B ends 7b of the yarns 7C, 7B, 7A are each locked.

【００６８】また、内筒２の先端部の内筒把持部４には
各針保持穴５１Ａ〜５１Ｄに挿入された縫合用針１３の
先端突出部との干渉を避ける４つの逃げ溝５４がそれぞ
れ形成されている。Further, the inner cylinder gripping portion 4 at the distal end portion of the inner cylinder 2 is provided with four relief grooves 54 for avoiding interference with the distal end protruding portions of the suturing needles 13 inserted into the needle holding holes 51A to 51D. Has been formed.

【００６９】次に、上記構成の作用について説明する。
まず、第２の実施例の糸保持部材１の使用法の一例につ
いて説明する。これは、図７に示すＡ鉗子２１のような
形状の鉗子と組み合わせて使用される。なお、Ａ鉗子２
１は把持機能があれば特にどのような種類の鉗子でもか
まわない。Next, the operation of the above configuration will be described.
First, an example of how to use the thread holding member 1 of the second embodiment will be described. This is used in combination with a forceps having a shape like the A forceps 21 shown in FIG. In addition, A forceps 2
1 may be any kind of forceps as long as it has a gripping function.

【００７０】まず、図１８に示すようにＡ鉗子２１の挿
入部２１ａを糸保持部材１の外筒３の後端の鉗子固定部
８の内腔に挿入し、第１の実施例と同様にＡ鉗子２１と
糸保持部材１の外筒３とが組付けられる。First, as shown in FIG. 18, the insertion portion 21a of the A forceps 21 is inserted into the inner cavity of the forceps fixing portion 8 at the rear end of the outer cylinder 3 of the thread holding member 1 and the same as in the first embodiment. The A forceps 21 and the outer cylinder 3 of the thread holding member 1 are assembled.

【００７１】このようにＡ鉗子２１と糸保持部材１の外
筒３との組付け作業が終了した後、次に、糸保持部材１
の外筒３が組付けられたＡ鉗子２１を体腔内にトラカー
ルなどを介して挿入し、生体組織の結紮作業を行う。After the assembling work of the A forceps 21 and the outer cylinder 3 of the thread holding member 1 is completed in this way, next, the thread holding member 1
The A forceps 21 to which the outer cylinder 3 is attached is inserted into the body cavity through a trocar or the like to ligate the living tissue.

【００７２】図１９に示すようにＡ鉗子２１とは別の鉗
子（以下Ｂ鉗子）２２を体内に挿入する。このＢ鉗子２
２は持針器がよい。さらに、図１９に示すようにＡ鉗子
２１を適当な角度に傾け、Ｂ鉗子２２で針１３を掴みや
すい状態にし、１番の針保持穴５１Ａに保持された針１
３をＢ鉗子２２でとる。As shown in FIG. 19, a forceps (hereinafter, B forceps) 22 different from the A forceps 21 is inserted into the body. This B forceps 2
2 is a needle holder. Further, as shown in FIG. 19, the A forceps 21 is tilted at an appropriate angle so that the B forceps 22 can easily grasp the needle 13, and the needle 1 held in the No. 1 needle holding hole 51A.
3 is taken with B forceps 22.

【００７３】続いて、Ｂ鉗子２２で創傷部位Ｈ0 の両側
の組織Ｈ1 ，Ｈ2 間に針１３を刺入し、組織Ｈ1 ，Ｈ2
間に糸７Ａを通した後、図２０に示すようにＡ鉗子２１
によって針１３側の糸７ＡのＡ端部７ａを把持する。さ
らに、Ｂ鉗子２２によって、糸保持部材１の１番の糸係
止溝５２Ａ内の糸７ＡのＢ端部７ｂを把持する。これ以
後は第１の実施例と同様の手法にて結紮する。[0073] Then, the needle 13 and penetrate between tissue H 1, H 2 on both sides of the wound site H 0 in B forceps 22, the tissue H 1, H 2
After passing the thread 7A between them, as shown in FIG.
The A end 7a of the thread 7A on the needle 13 side is gripped by. Further, the B forceps 22 grips the B end portion 7b of the thread 7A in the first thread locking groove 52A of the thread holding member 1. After this, ligation is performed by the same method as in the first embodiment.

【００７４】そこで、上記構成のものにあっては次の効
果を奏する。すなわち、各縫合用糸７Ａ〜７Ｄの針１３
が外筒３の先端面の針保持穴５１Ａ〜５１Ｄに保持され
ているため、使用中ではない針１３が目的部位以外の体
内臓器に接触するおそれが少ない。Therefore, the following effects can be obtained with the above-mentioned structure. That is, the needle 13 of each suture thread 7A to 7D
Is held in the needle holding holes 51A to 51D on the tip end surface of the outer cylinder 3, the needle 13 not in use is less likely to come into contact with internal organs other than the target site.

【００７５】さらに、各縫合用糸７Ａ〜７Ｄの針１３が
外筒３の先端面に形成された針保持穴５１Ａ〜５１Ｄに
まとまって保持されているので、各縫合用糸７Ａ〜７Ｄ
の針１３がバラバラに分散状態で放置されるおそれがな
い。そのため、各縫合用糸７Ａ〜７Ｄの針１３が縫合操
作の支障にならない。なお、針保持穴５１Ａ〜５１Ｄに
各縫合用糸７Ａ〜７Ｄの針１３が固定されているため、
針１３をとりやすい効果もある。Furthermore, since the needles 13 of the suture threads 7A to 7D are collectively held in the needle holding holes 51A to 51D formed in the tip end surface of the outer cylinder 3, the suture threads 7A to 7D are held.
There is no possibility that the needles 13 are left in a scattered state. Therefore, the needles 13 of the suture threads 7A to 7D do not hinder the suturing operation. Since the needles 13 of the suture threads 7A to 7D are fixed in the needle holding holes 51A to 51D,
There is also an effect that the needle 13 can be easily taken.

【００７６】また、図２１は第２の実施例の第１の変形
例を示すものである。これは、外筒３に針保持穴５１Ａ
〜５１Ｄに代えて、その部位に対応する外筒３の外周面
に内側に凹ませた磁石取付け溝６１Ａ〜６１Ｄを形成
し、各磁石取付け溝６１Ａ〜６１Ｄに針保持用の磁石６
２Ａ〜６２Ｄをそれぞれ嵌め込んだものである。そし
て、各磁石６２Ａ〜６２Ｄの磁力によって各縫合用糸７
Ａ〜７Ｄの針１３を吸着するようになっている。FIG. 21 shows a first modification of the second embodiment. This is a needle holding hole 51A in the outer cylinder 3.
51D instead of 51 to 51D, magnet mounting grooves 61A to 61D recessed inward are formed on the outer peripheral surface of the outer cylinder 3 corresponding to that portion, and the magnet 6 for holding the needle 6 in each magnet mounting groove 61A to 61D.
2A to 62D are fitted in each. Then, each suture thread 7 is generated by the magnetic force of each magnet 62A to 62D.
The needles A to 7D are sucked.

【００７７】そこで、上記構成のものにあっては、最後
に縫合を行った後、針１３を体腔内から除去する際に、
使用済みの針１３も磁石６２Ａ〜６２Ｄによって簡単に
保持して、回収できる。Therefore, in the case of the above structure, when the needle 13 is removed from the body cavity after the last suturing,
The used needle 13 can also be easily held and collected by the magnets 62A to 62D.

【００７８】また、図２２（Ａ），（Ｂ）は第２の実施
例の第２の変形例を示すものである。これは、外筒３の
先端面に隣接する一対の糸係止溝５２Ａ，５２Ｂ間、５
２Ｂ，５２Ｃ間、５２Ｃ，５２Ｄ間、５２Ｄ，５２Ａ間
にそれぞれ適度な弾性を持って外側に広がる曲り癖をつ
けた針保持部７１を設けるとともに、外筒３の外周面に
軸心方向にスライド可能なシース７２を被せたものであ
る。22A and 22B show a second modification of the second embodiment. This is between the pair of thread locking grooves 52A and 52B adjacent to the front end surface of the outer cylinder 3,
2B and 52C, 52C and 52D, and 52D and 52A are provided with needle holding portions 71 each having a proper elasticity and spreading outward, and slide on the outer peripheral surface of the outer cylinder 3 in the axial direction. It is covered with a possible sheath 72.

【００７９】ここで、糸保持部材１の外筒３が組付けら
れたＡ鉗子２１を体腔内にトラカールなどを介して挿入
する際には図２２（Ａ）に示すように針保持部７１の針
保持穴５１Ａ〜５１Ｄに保持された針１３全体を覆う位
置までシース７２が外筒３の外周面に被せられている。
そして、体腔内挿入後、図２２（Ｂ）に示すようにシー
ス７２を外筒３の後端側にスライドさせることにより、
針保持部７１が外方向に広がるようになっている。その
ため、この場合には針保持部７１から各縫合用糸７Ａ〜
７Ｄの針１３が取りやすくなる効果がある。Here, when the A forceps 21 to which the outer cylinder 3 of the thread holding member 1 is attached is inserted into the body cavity via a trocar or the like, as shown in FIG. The outer peripheral surface of the outer cylinder 3 is covered with the sheath 72 up to a position where it covers the entire needle 13 held in the needle holding holes 51A to 51D.
Then, after the insertion into the body cavity, the sheath 72 is slid to the rear end side of the outer cylinder 3 as shown in FIG.
The needle holder 71 is adapted to expand outward. Therefore, in this case, the suture threads 7A to 7A ...
There is an effect that the 7D needle 13 can be easily taken.

【００８０】また、図２３は第２の実施例の第３の変形
例を示すものである。これは、糸保持部材１の外筒３の
本体８１内に鉗子の挿入口８２を外筒３の本体８１の軸
心位置から偏心させた状態で配置するとともに、針保持
穴５１Ａ〜５１Ｄを鉗子挿入口８２の偏心方向と逆方向
に集めた状態で配置したものである。したがって、この
場合は針保持穴５１Ａ〜５１Ｄから各縫合用糸７Ａ〜７
Ｄの針１３が取りやすくなる効果がある。FIG. 23 shows a third modification of the second embodiment. This is because the forceps insertion opening 82 is arranged in the main body 81 of the outer cylinder 3 of the thread holding member 1 in a state of being eccentric from the axial center position of the main body 81 of the outer cylinder 3, and the needle holding holes 51A to 51D are arranged in the forceps. The insertion ports 82 are arranged in a state of being gathered in the direction opposite to the eccentric direction. Therefore, in this case, the suture threads 7A to 7A from the needle holding holes 51A to 51D.
This has the effect of making it easier to take the D needle 13.

【００８１】また、図２４は第２の実施例の第４の変形
例を示すものである。これは、第２の実施例の針保持穴
５１Ａ〜５１Ｄを外筒３の後端面に設け、各縫合用糸７
Ａ〜７Ｄの針１３を後ろ向きに針保持穴５１Ａ〜５１Ｄ
に挿入し、保持させるようにしたものである。このよう
な構成であると、糸保持部材１の前面に各縫合用糸７Ａ
〜７Ｄの針１３が出ていないため、通常の鉗子操作の邪
魔にならない。FIG. 24 shows a fourth modification of the second embodiment. This is because the needle holding holes 51A to 51D of the second embodiment are provided on the rear end surface of the outer cylinder 3, and each suture thread 7 is formed.
Needle holding holes 51A to 51D with A to 7D needles 13 facing backward
It is designed to be inserted into and held by. With such a configuration, each suture thread 7A is attached to the front surface of the thread holding member 1.
Since the ~ 7D needle 13 is not protruding, it does not interfere with the normal forceps operation.

【００８２】また、図２５は第２の実施例の第５の変形
例を示すものである。これは、外筒３の外周面に４つの
針保持溝９１を各縫合用糸７Ａ〜７Ｄの針１３の形に沿
って設けるとともに、各溝９１には針１３の抜け止め用
の複数の小突起９２…を設けたものである。なお、針１
３は溝９１内にはめ込むようにして保持される。このよ
うな構成であると、針１３の先端が外部に出ていないた
めに、針１３との接触により、体腔内の臓器損傷の危険
性が少ない。FIG. 25 shows a fifth modification of the second embodiment. This is to provide four needle holding grooves 91 on the outer peripheral surface of the outer cylinder 3 along the shape of the needle 13 of each suture thread 7A to 7D, and to each groove 91 a plurality of small holes for preventing the needle 13 from coming off. The projections 92 are provided. In addition, needle 1
3 is retained by being fitted in the groove 91. With such a configuration, since the tip of the needle 13 does not protrude to the outside, the risk of organ damage in the body cavity due to contact with the needle 13 is small.

【００８３】また、図２６乃至図３０（Ｂ）は本発明の
第３の実施例を示すものである。図２６は縫合用具の糸
保持部材１０１の概略構成を示すものである。この糸保
持部材１０１には内筒（糸保持手段）１０２と、この内
筒１０２に着脱可能に連結される外筒（係止手段）１０
３とが設けられている。Further, FIGS. 26 to 30B show a third embodiment of the present invention. FIG. 26 shows a schematic configuration of the thread holding member 101 of the suturing tool. An inner cylinder (thread holding means) 102 is attached to the thread holding member 101, and an outer cylinder (locking means) 10 detachably connected to the inner cylinder 102.
3 and 3 are provided.

【００８４】ここで、内筒１０２の先端部には外径寸法
が外筒１０３と略同径に形成され、外筒１０３内に収容
されない内筒把持部１０４が設けられている。さらに、
この内筒１０２の後端部側には図２７に示すように外筒
１０３内に挿入される先細状のテーパ面が形成された糸
巻き付け部１０５が設けられているとともに、内筒把持
部１０４と糸巻き付け部１０５との間には外筒１０３の
内周壁面にはまって内筒１０２を固定する固定部１０６
が設けられている。Here, an inner cylinder gripping portion 104 which is not housed in the outer cylinder 103 is provided at the front end of the inner cylinder 102 so that the outer diameter dimension thereof is substantially the same as that of the outer cylinder 103. further,
As shown in FIG. 27, a yarn winding portion 105 having a tapered surface to be inserted into the outer cylinder 103 is provided on the rear end side of the inner cylinder 102, and the inner cylinder gripping portion 104 is provided. A fixing portion 106 for fixing the inner cylinder 102 by being fitted on the inner peripheral wall surface of the outer cylinder 103 between the thread winding portion 105 and the thread winding portion 105.
Is provided.

【００８５】そして、内筒１０２の糸巻き付け部１０５
には図２８に示す巻き方で複数本、本実施例では６本の
縫合用糸１０７がそれぞれ巻き付けられ、ループ部１０
７Ｌが形成されている。このループ部１０７Ｌには図２
８に示すように後に結び目となる様に巻かれる結び目ル
ープ部１０７Ｌ1 （この部分は図４の巻き方と同様）と
それ以外のあまりの部分を巻いてある糸巻き部分１０７
Ｌ2 とが設けられている。なお、あまりの糸巻き部分１
０７Ｌ2 の先端（Ａ端部）１０７ａには針１１５が設け
られている。Then, the thread winding portion 105 of the inner cylinder 102.
28, a plurality of, and in this embodiment, six sutures 107 are wound around the loop portion 10 as shown in FIG.
7L is formed. The loop portion 107L is shown in FIG.
As shown in FIG. 8, a knot loop portion 107L 1 (this portion is similar to the winding method in FIG. 4) to be wound into a knot later and a thread winding portion 107 in which other portions are wound.
L 2 and are provided. In addition, too much spool part 1
A needle 115 is provided at the tip (A end) 107a of 07L 2 .

【００８６】また、図２７に示すように内筒１０２の内
腔１０２ａには内筒把持部１０４側に閉止部１０２ｂが
設けられている。そして、この内腔１０２ａは内筒１０
２の先端部側の閉止部１０２ｂで終端するようになって
いる。さらに、この内筒１０２の内腔１０２ａは糸巻き
付け部１０５の部分の内径がこの糸保持部材１０１と組
合わせて用いられる鉗子、例えば図７に示す鉗子２１の
挿入部２１ａの径よりも大きくなるように設定されてい
る。As shown in FIG. 27, the inner cavity 102a of the inner cylinder 102 is provided with a closing portion 102b on the inner cylinder gripping portion 104 side. The inner cavity 102a is the inner cylinder 10
It is configured to terminate at the closing portion 102b on the tip end side of No. 2. Further, in the inner cavity 102a of the inner cylinder 102, the inner diameter of the thread winding portion 105 is larger than the diameter of the forceps used in combination with the thread holding member 101, for example, the insertion portion 21a of the forceps 21 shown in FIG. Is set.

【００８７】また、外筒１０３の筒内には図２７に示す
ように一端部側に小径な鉗子固定部１０８が形成され、
この鉗子固定部１０８以外の部分にはこの鉗子固定部１
０８よりも大径な糸収納部１０９が形成されている。Further, as shown in FIG. 27, a forceps fixing portion 108 having a small diameter is formed on one end side inside the outer cylinder 103.
The forceps fixing portion 1 is provided on a portion other than the forceps fixing portion 108.
A yarn accommodating portion 109 having a diameter larger than 08 is formed.

【００８８】ここで、糸収納部１０９の長さは、内筒１
０２の固定部１０６および糸巻き付け部１０５の長さを
足した長さとほぼ同じ長さに設定されている。さらに、
この糸収納部１０９の内径は内筒１０２の固定部１０６
と軽くはまりこむような大きさに設定されている。な
お、鉗子固定部１０８には鉗子挿入口があるが、この内
径はこれと組み合わせて使用する鉗子２１の外径と軽く
締まり嵌めとなり、気密を保つ程度の寸法に設定されて
いる。Here, the length of the yarn accommodating portion 109 is the inner cylinder 1
02 is set to be approximately the same as the total length of the fixed portion 106 and the thread winding portion 105. further,
The inner diameter of the thread accommodating portion 109 is equal to the fixing portion 106 of the inner cylinder 102.
It is set so that it fits in lightly. Although the forceps fixing portion 108 has a forceps insertion port, its inner diameter is set so as to be lightly tightly fitted to the outer diameter of the forceps 21 used in combination therewith and to maintain airtightness.

【００８９】また、外筒１０３の外周面には糸通路溝１
１１が外筒１０３の軸方向に平行に設けられている。こ
の溝１１１には外筒１０３の斜め後方に向けて糸把持溝
１１２が複数（６本）設けられている。Further, the thread passage groove 1 is formed on the outer peripheral surface of the outer cylinder 103.
11 is provided parallel to the axial direction of the outer cylinder 103. In this groove 111, a plurality (six) of thread gripping grooves 112 are provided diagonally rearward of the outer cylinder 103.

【００９０】さらに、外筒１０３の先端付近には糸通路
溝１１１に連結された針脱出部１１３が設けられてい
る。これは、外筒１０３の下半分がカットされたもの
で、その部分で外筒１０３の断面は半円になっている。Further, near the tip of the outer cylinder 103, a needle escape portion 113 connected to the thread passage groove 111 is provided. In this case, the lower half of the outer cylinder 103 is cut, and the cross section of the outer cylinder 103 is a semicircle at that portion.

【００９１】また、糸把持溝１１２には内筒１０２に巻
かれた各糸１０７の針１１５側と反対側のＢ端部１０７
ｂが保持されている。さらに、外筒１０３の先端には、
糸係止溝１１４が針脱出部１１３と連なるように外筒１
０３の先端方向に斜に設けられている。なお、外筒１０
３内には内筒１０２が収納されるが、巻かれている糸１
０７は針１１５毎、外筒１０３内に全て収納されてい
る。Further, in the thread grip groove 112, the B end 107 of each thread 107 wound around the inner cylinder 102 on the side opposite to the needle 115 side.
b is retained. Furthermore, at the tip of the outer cylinder 103,
The outer cylinder 1 so that the thread locking groove 114 is continuous with the needle escape portion 113.
03 is provided obliquely in the direction of the tip. The outer cylinder 10
The inner cylinder 102 is housed in the thread 3, and the wound thread 1
07 are all stored in the outer cylinder 103 for each needle 115.

【００９２】次に、上記構成の作用について説明する。
このような構成の縫合用具においては、図７のような鉗
子２１を組み合わせて用いる。そして、この鉗子（以
下、Ａ鉗子）２１を図２９に示すように外筒１０３の後
端より挿入し、内筒１０２を押し出す。このとき、外筒
１０３は鉗子固定部１０８により、Ａ鉗子２１の外周面
に軽く締まり嵌めとなって固定される。Next, the operation of the above configuration will be described.
In the suturing tool having such a configuration, forceps 21 as shown in FIG. 7 are used in combination. Then, the forceps (hereinafter, A forceps) 21 is inserted from the rear end of the outer cylinder 103 as shown in FIG. 29, and the inner cylinder 102 is pushed out. At this time, the outer cylinder 103 is lightly tightly fitted and fixed to the outer peripheral surface of the A forceps 21 by the forceps fixing portion 108.

【００９３】続いて、このＡ鉗子２１をトラカールなど
を介して体腔内に挿入する。このとき、トラカールと糸
保持部材１０１の接触部は気密が保たれ、Ａ鉗子２１と
糸保持部材１０１の間も鉗子固定部１０８により締まり
嵌めとなっており、気密が保たれている。Subsequently, the A forceps 21 is inserted into the body cavity via a trocar or the like. At this time, the contact portion between the trocar and the thread holding member 101 is kept airtight, and the space between the A forceps 21 and the thread holding member 101 is also tightly fitted by the forceps fixing portion 108, so that the airtightness is kept.

【００９４】ついで、図３０（Ａ）に示すように別の鉗
子（Ｂ鉗子）２２を体腔内に挿入する。そして、Ｂ鉗子
２２で外筒１０３の先端から一番目の糸１０７のＢ端部
１０７ｂを把持し、糸把持溝１１２から外す。Then, as shown in FIG. 30 (A), another forceps (B forceps) 22 is inserted into the body cavity. Then, the B end portion 107b of the first thread 107 is grasped from the tip of the outer cylinder 103 by the B forceps 22 and removed from the thread grasping groove 112.

【００９５】そのまま、図３０（Ｂ）に示すようにＢ鉗
子２２にて糸１０７を引き、先端方向にループ部１０７
Ｌをスライドさせていき、糸係止溝１１４に、Ｂ端部１
０７ｂを引っ掛け、保持させる。この状態でＡ鉗子２１
の先端を若干振ると、ループ部１０７Ｌの糸巻き部１０
７Ｌ2 は簡単にほどける。このとき、結び目ループ部１
０７Ｌ1 は絡まり方が複雑であるため簡単にはほどけな
い。As it is, as shown in FIG. 30 (B), the thread 107 is pulled by the B forceps 22, and the loop portion 107 is pulled in the distal direction.
Slide L to the thread locking groove 114, and
07b is hooked and held. In this state, A forceps 21
If you slightly shake the tip of the
7L 2 is easy to untie. At this time, the knot loop part 1
07L 1 cannot be easily unraveled because the way it is entangled is complicated.

【００９６】これ以後は、第１の実施例と同様にして１
針縫合する。さらに、１針縫合を追加する場合には、順
次、外筒１０３の先端に近い方の糸１０７から、Ｂ鉗子
２２でＢ端部１０７ｂをつかみ、上記と同様の手順で１
針縫合を繰り返す。From this point onward, as in the first embodiment, 1
Needle suture. Further, in the case of adding one-needle suture, sequentially grasp the B end portion 107b with the B forceps 22 from the thread 107 closer to the tip of the outer cylinder 103, and follow the same procedure as above.
Repeat the needle suture.

【００９７】そこで、上記構成のものにあっては糸１０
７の針１１５が完全に外筒１０３内に収納されているた
め安全である。さらに、気腹を必要とする症例におい
て、気密が保たれる。Therefore, in the case of the above structure, the thread 10
It is safe because the No. 7 needle 115 is completely housed in the outer cylinder 103. Furthermore, airtightness is maintained in cases requiring pneumoperitoneum.

【００９８】また、図３１は第３の実施例の変形例を示
すものである。これは、外筒１０３の鉗子固定部１０８
が使用する鉗子２１の外径よりわずかに大きなものとな
っており、その内腔内にはＯリング１２１が装着されて
いる。そして、鉗子２１は鉗子挿入口から挿入され、外
筒１０３はＯリング１２１の締め付けにより、鉗子２１
の外周面に固定される。このような構成では、Ｏリング
１２１により鉗子２１との気密が完全に保たれる。FIG. 31 shows a modification of the third embodiment. This is the forceps fixing portion 108 of the outer cylinder 103.
Is slightly larger than the outer diameter of the forceps 21 used, and an O-ring 121 is mounted in its inner cavity. Then, the forceps 21 is inserted from the forceps insertion opening, and the outer cylinder 103 is tightened by the O-ring 121 to force the forceps 21.
Is fixed to the outer peripheral surface of. With such a configuration, the O-ring 121 completely maintains the airtightness with the forceps 21.

【００９９】また、図３２は本発明の第４の実施例の縫
合用具１３１を示すものである。これは、第３の実施例
の内筒１０２に代えて鉗子部材１３２を第３の実施例の
外筒１０３内に組み込んだものである。この場合、鉗子
部材１３２は外筒１０３の鉗子固定部１０８で固定され
ている。FIG. 32 shows a suturing tool 131 according to the fourth embodiment of the present invention. This is one in which the forceps member 132 is incorporated in the outer cylinder 103 of the third embodiment in place of the inner cylinder 102 of the third embodiment. In this case, the forceps member 132 is fixed by the forceps fixing portion 108 of the outer cylinder 103.

【０１００】この鉗子部材１３２には挿入部１３４の手
元側に操作部１３５が連結されており、この操作部１３
５の開閉レバーによって挿入部１３４の先端の把持部１
３６が開閉操作されるようになっている。An operating section 135 is connected to the forceps member 132 on the proximal side of the inserting section 134.
The grip portion 1 at the tip of the insertion portion 134 by the opening / closing lever 5
36 is opened and closed.

【０１０１】このような構成の縫合用具１３１において
は、トラカールなどにこのまま挿入し、第３の実施例と
同様に用いることができる。そのため、鉗子２１を着脱
する手間が省ける。また、通常の鉗子としても使用でき
る。The suturing tool 131 having such a structure can be inserted into a trocar or the like as it is and used in the same manner as in the third embodiment. Therefore, the labor of attaching and detaching the forceps 21 can be saved. It can also be used as a normal forceps.

【０１０２】なお、本発明は上記各実施例に限定される
ものではなく、本発明の要旨を逸脱しない範囲で種々変
形実施できることは勿論である。次に、本発明の他の特
徴的な技術事項を下記の通り付記する。The present invention is not limited to the above-mentioned embodiments, and it goes without saying that various modifications can be made without departing from the gist of the present invention. Next, other characteristic technical matters of the present invention will be additionally described as follows.

【０１０３】記 （付記項１） ループを一部に形成する複数本の縫合用
糸と、糸保持部材からなり、糸保持部材に前記糸の一部
に形成されたループを保持するループ保持部と、糸の少
なくともどこか一部を保持する糸固定部を設け、複数本
の糸を判別できる手段を設けたことを特徴とする縫合用
具。(Supplementary Note 1) A loop holding portion configured by a plurality of suture threads forming a loop partly and a thread holding member, and holding the loop formed in a part of the thread on the thread holding member. And a thread fixing part for holding at least some part of the thread, and means for distinguishing a plurality of threads are provided.

【０１０４】（付記項２） 付記項１において、糸保持
部材の少なくとも一部が、鉗子などの手術用具に着脱可
能である縫合用具。 （付記項３） 付記項１において、糸保持部材の一部に
把持機能がある縫合用具。(Additional Item 2) In the additional item 1, at least a part of the thread holding member is attachable to and detachable from a surgical instrument such as forceps. (Additional Item 3) The suturing tool according to Additional Item 1, wherein a part of the thread holding member has a gripping function.

【０１０５】（付記項４） 付記項２、３において、糸
保持部材に縫合用糸の判別手段を設けたことを特徴とす
る縫合用具。 （付記項５） 付記項２、３において、縫合用糸に判別
手段を設けた縫合用具。(Additional Item 4) In the additional items 2 and 3, a suturing tool characterized in that the thread holding member is provided with a suture thread discriminating means. (Additional Item 5) The suturing tool according to Additional Items 2 and 3, wherein the suturing thread is provided with a discriminating means.

【０１０６】（付記項６） 付記項４において、複数本
の縫合用糸を係止する糸係止部を同じ数設け、それぞれ
の糸係止部の形状を異なる物としたことを特徴とする縫
合用具。(Additional Item 6) In Additional Item 4, the same number of thread locking portions for locking a plurality of suture threads are provided, and the shape of each thread locking portion is different. Suture tools.

【０１０７】（付記項７） 付記項４において、複数本
の縫合用糸を保持する糸係止部を同じ数設け、それぞれ
の糸係止部近傍に異なる印をつけたことを特徴とする縫
合用具。(Supplementary Note 7) In Supplementary Note 4, the same number of thread locking portions for holding a plurality of suture threads are provided, and different stitches are provided near the respective thread locking portions. Tools.

【０１０８】（付記項８） 付記項６において、糸係止
部を溝とし、溝の長さを異なる物とした縫合用具。 （付記項９） 付記項７において、糸係止部近傍に異な
る字をつけた縫合用具。(Additional Item 8) In the additional item 6, the suturing tool, wherein the thread engaging portion is a groove and the length of the groove is different. (Additional Item 9) The suturing tool according to Additional Item 7, wherein different characters are provided near the thread locking portion.

【０１０９】（付記項１０） 付記項７において、糸係
止部近傍に異なる数のドットをつけたことを特徴とする
縫合用具。 （付記項１１） 付記項５において、糸をそれぞれ異な
る色とした縫合用具。(Additional Item 10) In the additional item 7, a suturing instrument characterized in that a different number of dots are provided near the thread locking portion. (Additional Item 11) The suturing device according to Additional Item 5, wherein the threads have different colors.

【０１１０】（付記項１２） 付記項５において、糸に
それぞれ異なる印をつけた縫合用具。 （付記項１３） 付記項４において、複数本の縫合糸を
係止する糸係止部を同じ数設け、糸係止部は順序だっ
て、並んでいることを特徴とする縫合用具。(Additional Item 12) The suturing device according to Additional Item 5, wherein the thread is marked differently. (Additional Item 13) In the additional item 4, the same number of thread locking portions for locking a plurality of suture threads are provided, and the thread locking portions are arranged in order and arranged.

【０１１１】（付記項１４） 付記項１、２、３におい
て、糸が針を有し、糸保持部材に針の一部もしくは針の
全部を収容する手段を設けた縫合用具。 （付記項１５） 付記項１４において、針が入る針収納
穴を設けた縫合用具。(Additional Item 14) The suturing tool according to Additional Items 1, 2, and 3, wherein the thread has a needle, and the thread holding member is provided with means for accommodating a part of the needle or the entire needle. (Additional Item 15) The suturing tool according to Additional Item 14, which is provided with a needle storage hole into which a needle is inserted.

【０１１２】（付記項１６） 付記項１４において、針
が収まる針収納溝を設けた縫合用具。 （付記項１７） 付記項１４において、針がつく磁石を
設けた縫合用具。(Additional Item 16) The suturing tool according to Additional Item 14, wherein the needle accommodating groove for accommodating the needle is provided. (Additional Item 17) The suturing instrument according to Additional Item 14, wherein a magnet attached to the needle is provided.

【０１１３】（付記項１８） 付記項１４において、針
の収容部付近に針の判別手段を設けた縫合用具。 （付記項１９） 付記項１４において、針に判別手段を
設けた縫合用具。(Additional Item 18) The suturing instrument according to Additional Item 14, wherein a needle discriminating means is provided near the needle accommodating portion. (Additional Item 19) The suturing tool according to Additional Item 14, wherein the needle is provided with a determination means.

【０１１４】（付記項２０） 付記項１４において、針
の可動手段を設けたことを特徴とする縫合用具。 （付記項２１） 付記項１において、糸保持部材は円筒
であり、円筒内部にループが収納され、上記ループは軸
方向に一列に並んでいることを特徴とする縫合用具。(Additional Item 20) A suturing instrument according to Additional Item 14, wherein a needle moving means is provided. (Additional Item 21) The suturing device according to Additional Item 1, wherein the thread holding member is a cylinder, and the loop is housed inside the cylinder, and the loops are arranged in a line in the axial direction.

【０１１５】[0115]

【発明の効果】本発明によれば結び目用のループを形成
する複数本の縫合糸を環装する円柱部材と、円柱部材を
遊挿し、前記ループを収納する穴を有し、縫合糸の少な
くとも一カ所を係止する係止部を有する外筒と、複数本
の縫合糸を個別に判別する手段とを設けたので、体腔内
で比較的広い範囲に亙り生体組織を縫合する作業を能率
よく行なうことができる。According to the present invention, there is provided at least a suture thread, which has a cylindrical member around which a plurality of sutures forming a loop for a knot are looped, a hole into which the cylindrical member is loosely inserted, and which accommodates the loop. Since an outer cylinder having a locking portion for locking one place and a means for individually discriminating a plurality of sutures are provided, the work of suturing a living tissue over a relatively wide range in a body cavity can be efficiently performed. Can be done.

【図面の簡単な説明】[Brief description of drawings]

【図１】 本発明の第１の実施例の糸保持部材を示す斜
視図。FIG. 1 is a perspective view showing a thread holding member according to a first embodiment of the present invention.

【図２】 第１の実施例の糸保持部材を一部破断して示
す側面図。FIG. 2 is a side view showing the yarn holding member of the first embodiment with a part thereof broken away.

【図３】 （Ａ）は糸保持部材の組立て状態を示す斜視
図、（Ｂ）は糸保持部材の内筒を外筒から取外した状態
を示す斜視図、（Ｃ）は外筒の糸係止溝を一部破断して
示す斜視図。3A is a perspective view showing an assembled state of the thread holding member, FIG. 3B is a perspective view showing a state in which the inner cylinder of the thread holding member is removed from the outer cylinder, and FIG. The perspective view which partially cuts and shows the stop groove.

【図４】 内筒の糸巻き付け部に巻き付けられた縫合用
糸の巻き方を説明するための説明図。FIG. 4 is an explanatory view for explaining how to wind the suture thread wound around the thread winding portion of the inner cylinder.

【図５】 （Ａ）は内筒の先端方向に縫合用糸を１回巻
いて形成された第１のループを示す側面図、（Ｂ）は第
１のループに対して点線Ａを中心に対称になるように内
筒に縫合用糸を巻いて第２のループが形成された状態を
示す側面図、（Ｃ）は第２のループに対して点線部Ｂを
中心に対称になるように内筒に縫合用糸を巻いて第３の
ループが形成された状態を示す側面図。FIG. 5 (A) is a side view showing a first loop formed by winding a suture thread once around the distal end of the inner cylinder, and FIG. 5 (B) is centered on a dotted line A with respect to the first loop. A side view showing a state in which a second loop is formed by winding a suture thread around the inner cylinder so as to be symmetrical, (C) shows that the second loop is symmetrical about the dotted line portion B The side view which shows the state in which the 3rd loop was formed by winding the suture thread around the inner cylinder.

【図６】 （Ａ）は縫合用糸のＡ端を第１〜３の３つの
ループ内に通す状態を示す概略構成図、（Ｂ）は縫合用
糸の男−女−男結びの３重結紮状態を示す概略構成図。FIG. 6A is a schematic configuration diagram showing a state in which the A end of the suture thread is passed through the first to third loops, and FIG. 6B is a male-female-male knot triple ligature of the suture thread. The schematic block diagram which shows a state.

【図７】 鉗子の概略構成を示す側面図。FIG. 7 is a side view showing a schematic configuration of forceps.

【図８】 Ａ鉗子を外筒後端の鉗子固定部の内腔に挿入
して内筒を外筒から押し出した状態を示す縦断面図。FIG. 8 is a vertical cross-sectional view showing a state in which the forceps A are inserted into the inner cavity of the forceps fixing portion at the rear end of the outer cylinder and the inner cylinder is pushed out from the outer cylinder.

【図９】 Ａ鉗子によって生体組織の創傷部位の両側の
組織間に縫合用糸を通し、Ｂ鉗子によって縫合用糸のＢ
端部を把持した状態を示す斜視図。FIG. 9: A forceps passes a suture thread between tissues on both sides of a wound site of a living tissue, and B forceps apply a suture thread B
The perspective view which shows the state which hold | gripped the edge part.

【図１０】 Ｂ鉗子によって縫合用糸のループ部を引き
出した状態を示す斜視図。FIG. 10 is a perspective view showing a state in which the loop portion of the suture thread is pulled out by B forceps.

【図１１】 Ａ鉗子によって縫合用糸のＡ端部を引張っ
てループ部の中に通す状態を示す斜視図。FIG. 11 is a perspective view showing a state in which the A end portion of the suture thread is pulled by the A forceps and passed through the loop portion.

【図１２】 Ａ鉗子およびＢ鉗子によって縫合用糸を引
張ってループ部による結び目を締め付けた状態を示す斜
視図。FIG. 12 is a perspective view showing a state in which a suture thread is pulled by A forceps and B forceps to tighten a knot by a loop portion.

【図１３】 第１の実施例の第１の変形例の糸保持部材
を示す斜視図。FIG. 13 is a perspective view showing a thread holding member of a first modified example of the first embodiment.

【図１４】 第１の実施例の第２の変形例の糸保持部材
を示す斜視図。FIG. 14 is a perspective view showing a thread holding member according to a second modification of the first embodiment.

【図１５】 第１の実施例の第３の変形例を示す縫合用
糸の巻き付け状態の斜視図。FIG. 15 is a perspective view showing a third modified example of the first embodiment in a wound state of the suture thread.

【図１６】 第１の実施例の第４の変形例を示すもの
で、（Ａ）は縫合用糸の巻き付け状態を示す斜視図、
（Ｂ）は外科結びと呼ばれる縫合用糸の巻き方を示す概
略構成図。FIG. 16 is a perspective view showing a fourth modified example of the first embodiment, in which (A) shows a wound state of the suture thread,
FIG. 3B is a schematic configuration diagram showing a method of winding a suture thread called a surgical knot.

【図１７】 本発明の第２の実施例を示すもので、
（Ａ）は糸保持部材を示す斜視図、（Ｂ）は糸保持部材
の内筒を外筒内に挿入する前の状態を示す分解斜視図。FIG. 17 shows a second embodiment of the present invention,
(A) is a perspective view showing a thread holding member, and (B) is an exploded perspective view showing a state before the inner cylinder of the thread holding member is inserted into the outer cylinder.

【図１８】 Ａ鉗子を外筒内に挿入した状態を示す斜視
図。FIG. 18 is a perspective view showing a state in which forceps A are inserted into the outer cylinder.

【図１９】 Ｂ鉗子によって縫合用の針を針保持穴から
引き出した状態を示す斜視図。FIG. 19 is a perspective view showing a state in which a suturing needle is pulled out from the needle holding hole by B forceps.

【図２０】 Ａ鉗子によって生体組織の創傷部位の両側
の組織間に縫合用糸を通し、Ｂ鉗子によって縫合用糸の
Ｂ端部を把持した状態を示す斜視図。FIG. 20 is a perspective view showing a state in which a suture thread is passed between tissues on both sides of a wound site of a biological tissue by A forceps, and a B end portion of the suture thread is grasped by B forceps.

【図２１】 第２の実施例の第１の変形例の糸保持部材
を示す斜視図。FIG. 21 is a perspective view showing a thread holding member of a first modified example of the second embodiment.

【図２２】 第２の実施例の第２の変形例を示すもの
で、（Ａ）は糸保持部材の要部構成を一部破断して示す
斜視図、（Ｂ）は外筒の先端部をシースの外側に突出さ
せた状態を示す斜視図。22A and 22B are views showing a second modification of the second embodiment, in which FIG. 22A is a perspective view showing a partial cutaway view of a main part of the thread holding member, and FIG. FIG. 4 is a perspective view showing a state in which the ridge is projected to the outside of the sheath.

【図２３】 第２の実施例の第３の変形例の糸保持部材
を示す斜視図。FIG. 23 is a perspective view showing a thread holding member of a third modification of the second embodiment.

【図２４】 第２の実施例の第４の変形例の糸保持部材
を示す斜視図。FIG. 24 is a perspective view showing a thread holding member of a fourth modified example of the second embodiment.

【図２５】 第２の実施例の第５の変形例の糸保持部材
を示す斜視図。FIG. 25 is a perspective view showing a thread holding member of a fifth modification of the second embodiment.

【図２６】 本発明の第３の実施例の糸保持部材を示す
斜視図。FIG. 26 is a perspective view showing a thread holding member according to a third embodiment of the present invention.

【図２７】 第３の実施例の糸保持部材を一部破断して
示す側面図。FIG. 27 is a side view showing the yarn holding member of the third embodiment with a part thereof broken away.

【図２８】 内筒の糸巻き付け部に巻き付けられた縫合
用糸の巻き方を説明するための説明図。FIG. 28 is an explanatory diagram for explaining how to wind the suture thread wound around the thread winding section of the inner cylinder.

【図２９】 Ａ鉗子を外筒内に挿入した状態を示す側面
図。FIG. 29 is a side view showing a state in which forceps A are inserted into the outer cylinder.

【図３０】 （Ａ）はＢ鉗子で外筒の先端から一番目の
糸のＢ端部を把持して糸把持溝から外した状態を示す側
面図、（Ｂ）はＢ鉗子によって先端方向にループ部をス
ライドさせ、糸固定溝に糸のＢ端部を引っ掛けて保持さ
せた状態を示す側面図。FIG. 30 (A) is a side view showing a state in which the B end portion of the first thread is grasped from the tip of the outer cylinder by the B forceps and removed from the thread grasping groove, and FIG. The side view which shows the state which slid the loop part, and hooked and hold | maintained the B end part of the thread | yarn to the thread | yarn fixing groove.

【図３１】 第３の実施例の第１の変形例の要部構成を
示す斜視図。FIG. 31 is a perspective view showing the main configuration of a first modification of the third embodiment.

【図３２】 本発明の第４の実施例の縫合用具を示す斜
視図。FIG. 32 is a perspective view showing a suturing tool according to a fourth embodiment of the present invention.

【符号の説明】[Explanation of symbols]

２…内筒（円柱部材）、３…外筒（係止手段）、７Ａ，
７Ｂ，７Ｃ，７Ｄ…縫合糸、７Ｌ…ループ部、９…糸収
納部（穴）、１２Ａ〜１２Ｄ…ドット表示部（判別手
段）。2 ... inner cylinder (cylindrical member), 3 ... outer cylinder (locking means), 7A,
7B, 7C, 7D ... Suture thread, 7L ... Loop section, 9 ... Thread storage section (hole), 12A to 12D ... Dot display section (discriminating means).

─────────────────────────────────────────────────────
─────────────────────────────────────────────────── ───

【手続補正書】[Procedure amendment]

【提出日】平成６年７月２０日[Submission date] July 20, 1994

【手続補正１】[Procedure Amendment 1]

【補正対象書類名】明細書[Document name to be amended] Statement

【補正対象項目名】００２８[Correction target item name] 0028

【補正方法】変更[Correction method] Change

【補正内容】[Correction content]

【００２８】この場合、図３（Ｂ）に示すように外筒３
の先端部における径方向の対向位置に配置された糸係止
溝１１Ａと１１Ａ´、１１Ｂと１１Ｂ´、１１Ｃと１１
Ｃ´、１１Ｄと１１Ｄ´はそれぞれ同じ長さに設定され
ている。さらに、糸係止溝１１Ａと１１Ａ´は外筒３の
軸心方向の長さが最も短く、１１Ｂと１１Ｂ´、１１Ｃ
と１１Ｃ´、１１Ｄと１１Ｄ´の順に、長さが長くなる
ように設定されている。In this case, as shown in FIG. 3B , the outer cylinder 3
Of the thread locking grooves 11A and 11A ', 11B and 11B', 11C and 11 arranged at radially opposite positions at the tip of the
C ′, 11D and 11D ′ are set to have the same length. Further, the thread locking grooves 11A and 11A 'have the shortest length in the axial direction of the outer cylinder 3, and are 11B, 11B' and 11C.
And 11C 'and 11D' and 11D 'are set in order of increasing length.

【手続補正２】[Procedure Amendment 2]

【補正対象書類名】明細書[Document name to be amended] Statement

【補正対象項目名】００８３[Name of item to be corrected] 0083

【補正方法】変更[Correction method] Change

【補正内容】[Correction content]

【００８３】また、図２６乃至図３０（Ｂ）は本発明の
第３の実施例を示すものである。図２６は縫合用具の糸
保持部材１０１の概略構成を示すものである。この糸保
持部材１０１には内筒１０２と、この内筒１０２に着脱
可能に連結される外筒１０３とが設けられている。Further, FIGS. 26 to 30B show a third embodiment of the present invention. FIG. 26 shows a schematic configuration of the thread holding member 101 of the suturing tool. The thread holding member 101 is provided with an inner cylinder 102 and an outer cylinder 103 detachably connected to the inner cylinder 102.

【手続補正３】[Procedure 3]

【補正対象書類名】図面[Document name to be corrected] Drawing

【補正対象項目名】図６[Name of item to be corrected] Figure 6

【補正方法】変更[Correction method] Change

【補正内容】[Correction content]

【図６】 [Figure 6]

【手続補正４】[Procedure amendment 4]

【補正対象書類名】図面[Document name to be corrected] Drawing

【補正対象項目名】図８[Correction target item name] Figure 8

【補正方法】変更[Correction method] Change

【補正内容】[Correction content]

【図８】 [Figure 8]

【手続補正５】[Procedure Amendment 5]

【補正対象書類名】図面[Document name to be corrected] Drawing

【補正対象項目名】図２４[Name of item to be corrected] Fig. 24

【補正方法】変更[Correction method] Change

【補正内容】[Correction content]

【図２４】 FIG. 24

───────────────────────────────────────────────────── フロントページの続き (72)発明者 鶴田 稔 東京都渋谷区幡ヶ谷２丁目43番２号 オリ ンパス光学工業株式会社内 (72)発明者 内山 直樹 東京都渋谷区幡ヶ谷２丁目43番２号 オリ ンパス光学工業株式会社内 (72)発明者 梶 国英 東京都渋谷区幡ヶ谷２丁目43番２号 オリ ンパス光学工業株式会社内 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Minoru Tsuruta 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Naoki Uchiyama 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Kaji Kunihide 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd.

Claims (1)

【特許請求の範囲】[Claims] 【請求項１】 結び目用のループを形成する複数本の縫
合糸を環装する円柱部材と、前記円柱部材を遊挿し、前
記ループを収納する穴を有し、前記縫合糸の少なくとも
一カ所を係止する係止部を有する外筒と、前記複数本の
縫合糸を個別に判別する手段からなることを特徴とする
縫合用具。1. A columnar member around which a plurality of sutures forming a knot loop are looped, a hole for loosely inserting the columnar member and accommodating the loop, and at least one position of the suture is provided. A suturing tool comprising an outer cylinder having a locking portion for locking and means for individually discriminating the plurality of sutures.
JP08657494A 1993-12-29 1994-04-25 Suture tool Expired - Fee Related JP3476902B2 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
JP08657494A JP3476902B2 (en) 1994-04-25 1994-04-25 Suture tool
US08/360,397 US5643293A (en) 1993-12-29 1994-12-21 Suturing instrument

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP08657494A JP3476902B2 (en) 1994-04-25 1994-04-25 Suture tool

Publications (2)

Publication Number Publication Date
JPH07289558A true JPH07289558A (en) 1995-11-07
JP3476902B2 JP3476902B2 (en) 2003-12-10

Family

ID=13890787

Family Applications (1)

Application Number Title Priority Date Filing Date
JP08657494A Expired - Fee Related JP3476902B2 (en) 1993-12-29 1994-04-25 Suture tool

Country Status (1)

Country Link
JP (1) JP3476902B2 (en)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006006955A (en) * 2004-06-28 2006-01-12 Ethicon Inc Suture anchor inserter
JP2008132325A (en) * 2006-10-31 2008-06-12 Depuy Mitek Inc Suture management system
JP2013502276A (en) * 2009-08-17 2013-01-24 カリガン、パトリック、ジョン Apparatus for accommodating a plurality of needles and method of use thereof

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006006955A (en) * 2004-06-28 2006-01-12 Ethicon Inc Suture anchor inserter
US8460309B2 (en) 2004-06-28 2013-06-11 Depuy Mitek, Llc Suture anchor inserter
JP2008132325A (en) * 2006-10-31 2008-06-12 Depuy Mitek Inc Suture management system
US9161750B2 (en) 2006-10-31 2015-10-20 Depuy Mitek, Llc Suture management system
US10959718B2 (en) 2006-10-31 2021-03-30 Depuy Synthes Products, Inc Suture management system
JP2013502276A (en) * 2009-08-17 2013-01-24 カリガン、パトリック、ジョン Apparatus for accommodating a plurality of needles and method of use thereof

Also Published As

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