JPH07328020A - Medical suture inserting tool and needle with suture used for it - Google Patents

Abstract

PURPOSE:To insert a suture between or into the tissues of a living body with a one-step action for ligation or suture. CONSTITUTION:A needle-shaped body serving as a passing means holding a suture 7 is fitted to the fitting section of a fitting member 2 serving as the first driving means. A receiving means receiving a suture 7 directly or via a needle-shaped body is fitted to the hole 4a of a holding member 4 serving as the second driving means. The fitting member 2 and the holding member 4 are rotatably fitted to a shaft 5 to constitute a suture inserting tool A. The fitting member 2 and the holding member 4 are operated to drive the needle-shaped body, and the needle-shaped body is inserted between or into tissues and coupled with the receiving means of the holding member 4. The receiving means applies pressing force to the coupled needle-shaped body or the suture 7 to hold it. When the fitting member 2 is separated from the holding member 4, the suture 7 or the needle-shaped body is held by the receiving means and removed from the fitting member 2, and it is inserted between or into tissues. The suture 7 is extended in the axial direction from the root end face of a needle holding a suture, and the needle is formed into a straight shape having a prescribed length.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical threader used when ligating or suturing an incised part in a narrow or deep part, and a needle with a thread used in this threader. It is a thing.

[0002]

2. Description of the Related Art In a surgical operation, a blood vessel around an affected area to be excised is ligated with a thread, and an incision site is sutured with a thread. For suturing a ligation or incision site of a blood vessel, a suture needle to which a thread is attached is grasped and operated by holding a needle device or a ligature suture guider to pass the thread between tissues or in the tissue,
It is performed by pulling out the thread that has passed through the tissue to the practitioner side and tying it.

When carrying out the above-mentioned ligation and suturing, the practitioner holds the needle holder in one hand to pass the suture needle between the tissues or between the tissues, and then the operator holds the needle holder and pulls out the suture needle. The operation will be performed. Therefore, when the site to be ligated or the site to be sutured is located in a deep part of the living body,
It is difficult for the practitioner to operate, and there is a demand for the development of a ligating tool and a suturing tool that can be quickly and reliably performed with one hand.

[0004] For example, the suturing device disclosed in Japanese Utility Model Publication No. 5-11859 meets the above-mentioned requirements, and the suture provided at the distal end portion is operated by operating the handle and the trigger, which are the manual parts of the forceps, with one hand. The needle is actuated to ligate or suture the surgical site.

On the other hand, in recent surgery, since the incision is made small to make the scar as small as possible, ligation and suturing work is performed in an increasingly narrow region.

[0006]

When a blood vessel is ligated by using the suturing device, it is required to perform a two-step operation including a suturing operation by a suture needle accompanying a handle operation and a thread gripping operation accompanying a trigger operation. To be done. For this reason, the complexity of the operation cannot be eliminated when performing ligation at an extremely narrow site, and the development of a device that can be ligated by a simpler operation is desired.

An object of the present invention is to provide a medical threading instrument capable of ligating a blood vessel or suturing an incision site in one step operation, and a threaded needle optimally used for the threading instrument. It is in.

[0008]

In order to solve the above-mentioned problems, a basic medical threading device according to the present invention comprises a passing means for holding a thread and allowing it to pass between tissues or between tissues, and between tissues or And a receiving means for receiving the thread passing through the tissue or the thread held by the thread.

[0009] A typical threading tool includes a passing means for holding a thread and passing between tissues or within tissues, and a first driving means for driving the passing means to pass between tissues or within tissues. What has a receiving means which receives substantially the thread which passed between the tissues or the inside of a tissue, and a 2nd drive means which drives the said receiving means, Comprising and arrange | positioning the said passage means and a receiving means so that it may oppose. Is.

In the above threading device, the first driving means and the second driving means are lever-shaped members.
It is preferable that the drive means and the second drive means are rotatably attached to a common shaft, and an operation section for applying a force to the end side is configured.

Further, the passage means is arranged with respect to the first drive means such that the tip thereof projects from the first drive means to the receiving means side, and a groove or hole through which a thread is formed is formed along the longitudinal axis. And a catching part for catching a larger part than the other part formed on the thread formed at the tip, and the receiving means is elastic to the thread held at the tip of the passing means fitted to the receiving means. It is preferable to apply force to hold the yarn and to receive the yarn as the passing means separates from the receiving means.

Further, the passing means is detachably attached to the first driving means, the distal end is arranged so as to project from the first driving means to the receiving means side, and the thread fixing portion for fixing the thread to the rear end is provided. The receiving means has an elastic force applied to and holds the passage means fitted to the receiving means, and the passage means is separated from the first drive means in accordance with the operation of the first drive means and the second drive means. It is preferable to receive it.

The threaded needle according to the present invention is formed into a straight needle shape having a predetermined length, extends the thread in the axial direction from the base end surface, and has a base end surface and a predetermined distance from the base end surface. The shape at the separated positions is substantially the same as the shape of the mounting portion formed on the first drive means, and the size is slightly smaller.

[0014]

In the above-mentioned medical threading device (hereinafter referred to as "threading device"), since the passing means and the receiving means are arranged so as to face each other, the thread held by the passing means is passed between tissues or within the tissue and The thread passed between or within the tissues is received by the receiving means by fitting the retaining portion of the to the receiving means and then separating the passing means from the receiving means. Therefore, the receiving means that has received the thread can be ligated or sewn by pulling it out from the ligation site or the suture site outside the body and tying it.

When the threading device is constructed such that the passing means can be driven by the first driving means and the receiving means can be driven by the second driving means, the practitioner can use one hand to drive the first and second driving means. By operating the means to move the passing means and the receiving means close to or away from each other, the thread can be passed between the tissues or within the tissue, and the thread passing between the tissues or within the tissue can be received by the receiving means. Therefore, the receiving means that has received the thread can be ligated or sewn by pulling it out from the ligation site or the suture site outside the body and tying it.

Further, the first and second driving means are formed in a lever shape, and each of these means is rotatably mounted on a shaft,
Since the operating portion is provided at the end, the practitioner can operate the threading tool with the same feel as operating forceps. Therefore, the practitioner can easily and surely ligate or suture without making the practitioner feel uncomfortable.

Further, the passing means is arranged so that the tip of the passing means projects from the first driving means to the receiving means side, and a groove or hole through which the thread is inserted is formed along the axis of the longitudinal direction, and the thread is formed at the tip. A locking portion for locking a portion larger than the other portion is formed, and the receiving means can hold the thread held at the tip of the passing means fitted to the receiving means by applying an elastic force. Since it is configured to, the passage means is fitted to the receiving means,
The yarn can then be received as the passing means leaves the receiving means.

Further, the passing means is detachably attached to the first driving means, the tip is arranged so as to project from the first driving means toward the receiving means, and the thread fixing portion is provided at the rear end of the passing means. Since the thread is formed and the thread is fixed to the fixing portion, and the receiving means is configured to be able to apply elastic force to the passing means fitted to the receiving means to hold the thread, the passing means is fitted to the receiving means. Then, thereafter, as the first and second driving means are separated from each other, the passing means can be received by separating from the first driving means.

Further, the threaded needle according to the present invention is formed into a straight needle shape having a predetermined length, and the thread is inserted into a blind hole formed in the base end surface to be integrated by caulking or bonding, Further, since the shape at the base end face and the position at a predetermined distance from the base end face is substantially the same as the shape of the mounting portion formed on the first drive means, and the size thereof is slightly smaller, it is detachable from the first drive means. It can be mounted so that the driving force associated with the operation of the first driving means is transmitted to the proximal end surface and can pass between tissues or within tissues. Further, when fitted to the receiving means, the first and second driving means are easily separated from each other by the separation of the first and second driving means.
It can be disengaged from the drive means.

[0020]

EXAMPLE An example of the threading tool will be described below with reference to the drawings. FIG. 1 is a side view for explaining the overall structure of a threading tool configured to rotate a mounting member and a holding member around a shaft to separate and contact a passing means and a receiving means, and FIG. 2 is a side view for hooking and receiving a thread. For explaining the essential parts of the threading device according to the first embodiment configured as described above, FIG. 3 is a diagram for explaining the configuration of the passing means and the receiving means according to the second embodiment, and FIG. 4 is another of the passing means. FIG. 5 is a view for explaining the configuration, FIG. 5 is a view for explaining a main part of a threading tool according to a third embodiment in which the passage means is configured to be attachable to and detachable from the attachment member, and FIG. 6 is a attachment member for detachably attaching the passage means. FIG. 7 is a view for explaining the ligation operation sequence, and FIG. 8 is a view for explaining the main part of the threading device according to the fourth embodiment in which the passage means is configured to be detachable from the mounting member. FIG. 9 shows the essential parts of the threading device according to the fifth embodiment in which the passing means is configured to be attachable to and detachable from the mounting member. Diagram for explaining, 10
FIG. 11 is a diagram for explaining a main part of a mounting member to which the passage means is detachably attached, FIG. 11 is a diagram for explaining an application example of the fifth embodiment, and FIG.
12 is a diagram illustrating another configuration example of the receiving means, FIG. 13 is a diagram illustrating still another configuration example of the receiving means, FIG. 14 is a diagram illustrating the configuration of a threaded needle, and FIG. 15 is a mounting member and a holding member. A side view for explaining the overall configuration of a threading tool in which members are connected by imparting springiness,
FIG. 16 is a side view for explaining the overall configuration of a threading tool in which the distal end portion of the mounting member is formed in an arc shape, and FIG. 17 is the overall configuration of the threading tool that makes it possible to easily ligate or sew deep parts. It is a side view explaining.

The threading device according to the present invention allows a practitioner to perform a one-step operation with one hand when ligating or suturing an incision site of a blood vessel and pulling it out so that the thread can pass between tissues around the blood vessel. The thread can be pulled out of the body by ligating or suturing the tissue at the incision site. Therefore, it is possible to quickly and easily ligate and suture a blood vessel or an incision site in a deep part or a narrow part of the living body. Although the case of ligating a blood vessel will be mainly described below, substantially the same operation can be performed even when suturing an incision site.

In the threading tool A shown in FIG. 1, the passing means 1 is attached to a mounting member 2 which is a lever-shaped first driving means, and the receiving means 3 is a lever-shaped second driving means. The holding member 4 and the holding member 4 are rotatably attached to the shaft 5. Handles 6 serving as operating portions are provided on one side (right side in FIG. 1) of the mounting member 2 and the holding member 4 with respect to the shaft 5, so that the practitioner can operate with the same feel as forceps. It is configured to be possible.

The passing means 1 is attached to the mounting member 2 while holding the thread 7, and passes between the tissues of the living body or within the tissue according to the grasping operation of the threading tool A, whereby the thread 7 is passed between the tissues. Alternatively, it is passed through the tissue and rotated around the blood vessel to be ligated.

In the present invention, the passage means 1 is attached to the mounting member 2
Can be integrally formed at the tip (left side in FIG. 1). However, an extremely minute slit or groove for holding the thread 7 may be formed in the passage means 1, and in consideration of the sterilization process after surgery, the sterilization process for the slit or groove may be difficult. is there. For this reason, it is preferable that the passage means 1 be configured to be attachable to and detachable from the attachment member 2 and be discarded after the operation.

The passage means 1 holds the thread 7 and passes between the tissues around the blood vessel to be ligated or passes through the tissues at the incision site. Therefore, the shape and configuration of the passage means 1 can take various forms as described later, and it is preferable to adopt the most suitable one according to the content and purpose of the operation.

The receiving means 3 directly receives the thread 7 which has passed between the tissues together with the passage means 1 or inside the tissue and is wound around the blood vessel, or directly receives the passage means 1 to substantially receive the thread 7. It is a thing. Therefore, the receiving means 3
The shape and configuration of can take various forms corresponding to the shape and configuration of the passage means 1 as described later.
That is, the optimum receiving means 3 can be adopted along with the selection of the passing means 1.

A preferred form of the receiving means 3 is a threading tool A.
When the passing means 1 is fitted into the receiving means 3 by the gripping operation of, the pressing force acts on the passing means 1 and the threading tool A
When the passing means 1 is separated from the receiving means by the opening operation of (1), the yarn 7 is directly or through the passing means 1 by the action of the pressing force.

For this reason, the receiving means 3 has an elastic body formed by molding rubber such as synthetic rubber containing urethane rubber or silicon rubber, or natural rubber, which has moderate elasticity and does not have a bad influence on the living body, and a spring property. The elastic member is made of a material such as a stainless steel plate or a phosphor bronze plate, or the holding member 4 is slit to give elasticity to the holding member itself. When the passage means 1 is formed of a magnetic material or a magnet, the receiving means 3 can be formed of a magnet or a magnetic material.

When the receiving means 3 is made of rubber, a metal plate, a magnet, a magnetic material or the like as described above, the receiving means 3 is fitted in the hole 4a formed at the tip of the holding member 4 or an adhesive. It is held in a bonded state by. Therefore, there is a possibility that an extremely minute gap is formed between the receiving means 3 and the hole 4a, and it may be difficult to perform a complete sterilization treatment after the operation. Therefore, it is preferable that the receiving means 3 is detachably attached to the holding member 4 and the receiving means 3 is discarded after the operation.

When the receiving means 3 is constructed by slitting the holding member 4 or incorporating a special mechanism, it is essential to sufficiently sterilize the processed portion and the mechanical portion.

Specific examples will be individually described below.

As shown in FIG. 2, the threading device A according to the first embodiment has a tip of the passing means 11 when the passing means 11 faces the receiving means 3 by gripping operation of the mounting member 2 and the holding member 4. The yarn 7 held by the portion is hooked and directly received.

In the figure, the passage means 11 is fixed to the tip of the mounting member 2 and is integrally formed. The tip of the passage means 11 is formed in a flat shape, and as shown in FIGS. 3A and 3B, a central protrusion 11a having a high height is formed at the center in the width direction, and both sides of the protrusion 11a are formed. A shoulder protrusion 11b is formed. Slits 11c are formed between the central protrusion 11a and the shoulder protrusion 11b, and a groove 11d is formed in the central protrusion 11a along the axial direction.

The slit 11c is formed with a size corresponding to the thickness of the thread 7. That is, the slit 11c is formed with a dimension slightly narrower than the thickness of the thread 7. Then, as shown in FIG. 7C, by engaging the thread 7 around the central projection 11a and turned to the groove 11d side with the slit 11c, the central projection 11a and the shoulder projection 11b cooperate with each other. 7
Is configured to hold.

Further, the holding member 4 is attached with a rod-shaped body 8 facing the groove 11d and having a hook-shaped hooking portion 8a formed at its tip.

In the threading tool A constructed as described above, when the grip 6 is grasped and the mounting member 2 and the holding member 4 are brought close to each other,
The passing means 11 passes between or inside the tissues while holding the thread 7, and the hook portion 8a of the rod-shaped body 8 is inserted into the groove 11d of the passing means 11.
When the hooks face each other, the hook portion 8a hooks and engages the thread 7, and the thread 7 is received while maintaining the state in which the thread 7 is engaged with the hook portion 8a as the mounting member 2 and the holding member 4 are separated from each other. Is possible.

Next, the threading tool A according to the second embodiment will be described with reference to FIG. In this embodiment, the passage means 1
Since the same means as the passage means 11 in the first embodiment is used as this, a detailed description thereof will be omitted. But the central protrusion
The groove 11d formed in 11a is unnecessary.

The receiving means 31 is arranged so as to face the passing means 11. The receiving means 31 is formed with a slit 31a corresponding to the flat shape of the passing means 11 so that the flat passing means 11 can be fitted easily. Further, the surface of the receiving means 31 facing the passing means 11 has the slits 31a for the passing means 11.
Is formed as an inclined surface 31b that is inclined from the circumferential side toward the slit 31a.

A recess is provided on the opposite side of the receiving means 31 from the passing means 11.
31c is formed, and the pressing piece 31d is formed by the inclined surface 31b and the recess 31c. Therefore, it is possible to set the thickness of the pressing piece 31d by appropriately setting the depth of the concave portion 31c, and by operating the fitted passage means 11 by appropriately setting the thickness of the pressing piece 31d. It is possible to set the pressing force to be applied.

In the threading tool A having the passing means 11 and the receiving means 31 configured as described above, the thread 7 is passed through in advance.
The thread 7 is held by the passing means 11 by engaging with the slit 11c formed in the thread 11, and in this state, the thread 7 is inserted into the affected area and the threading tool A is grasped and operated, and the passing means 11 and the receiving means 31 are used.
Are relatively close to each other and the passing means 11 is fitted into the receiving means 31. By this grasping operation, the thread 7 is rotated around the blood vessel to be ligated, and the thread 7 is pressed by the receiving means 31.

Next, when the threading tool A is opened to separate the passing means 11 from the receiving means 31, the passing means 11 is separated from the receiving means 31. At this time, the thread 7 is pushed into the slit 11c of the passing means 11 by the pressing force of the pressing piece 31d of the receiving means 31.
And is clamped by the pressing piece 31d. That is, the yarn 7 is received by the receiving means 31. After that, when the threading tool A is pulled out of the body, the thread 7 is pulled out of the body while maintaining the state of being clamped by the pressing piece 31d of the receiving means 31. Then, by pulling the threading tool A out of the body and then pulling the thread 7, the thread 7 can be easily detached from the receiving means 31.

As described above, the practitioner performs a one-step operation of simply gripping and opening and closing the handle 6 of the threading device A, whereby the thread 7 held by the passing means 11 is received around the blood vessel. It can be received by means 31.

Further, as a passage means 11 other than the above, as shown in FIG. 4, a groove 11e for retaining and holding the thread 7 at the tip is provided.
It is possible to use those having holes 11f for holding the thread 7 in the vicinity of the tip, and the like.

When the passing means 11 as described above is used, as the receiving means 3, the rod-shaped body 8 having the hook portion 8a in the first embodiment or the elastic receiving means 31 is selectively used. It is possible.

Next, the threading device A according to the third embodiment will be explained with reference to FIG.

In the present embodiment, the passage means is constituted by a rod-shaped needle-shaped body 12 having a preset length and thickness, and the tip 12a easily passes between or within tissues of a living body. A blind hole (not shown) is formed on the front end face 12b, which is the rear end face, so as to obtain a spherical shape or a pointed shape. The thread 7 is held by the needle-shaped body 12 by inserting one end of the thread 7 into the blind hole and caulking the periphery of the blind hole. As the needle-shaped body 12, it is preferable to use a threaded needle 12 described later.

A needle-shaped body is provided at the tip of the mounting member 2 of the threading device A.
A mounting portion 2a for detachably mounting the 12 is formed. The attachment portion 2a has a function of temporarily holding the attached needle-shaped body 12. That is, the mounting member 2 and the holding member 4
The needle-shaped body 12 is fitted into the receiving means 32 in accordance with the gripping operation of the needle 2, and then the needle-shaped body 12 is separated from the mounting portion 2a and received in the receiving means 32 in accordance with the opening operation of the members 2 and 4. Be done.

Mounting portion 2a for temporarily holding the needle-shaped body 12
As shown in FIG. 6, a recess 2a having a diameter substantially equal to the outer diameter of the needle-shaped body 12 is formed at a predetermined position on the tip side of the mounting member 2, and the recess 2a and the tip are formed by a slit 2b. Connected and configured.

Therefore, the thread 7 attached in advance is inserted through the slit 2b, and the needle-shaped body 12 is fitted into the recess 2a which is the mounting portion 2a. It can be attached to the mounting member 2. The needle-shaped body 12 thus mounted does not easily come off while holding the state of being fitted in the recess 2a.

The resistance generated when the needle-shaped body 12 is passed between tissues or within the tissue is transmitted to the mounting member 2 via the contact surface between the base end surface 12b of the needle-shaped body 12 and the recess 2a. . Therefore, when the needle-shaped body 12 passes through the tissue, it does not separate from the mounting member 2 or fall due to the passage resistance.

The receiving means 32 presses and holds the outer periphery of the needle-shaped body 12 when the needle-shaped body 12 is fitted with the holding operation of the thread-threading device A, and holds it when the needle-threaded body A is opened. When the mounting member 2 and the holding member 4 are separated from each other, the thread 7 is substantially received by maintaining the pressed state against the needle-shaped body 12 and separating it from the recess 2a.

Therefore, the needle-shaped body 12 is located at the center of the receiving means 32.
Hole 32 with a diameter approximately equal to or slightly smaller than the outer diameter of
a is formed, and a guide surface 32b for guiding the needle-shaped body 12 into the hole 32a is formed on the surface facing the needle-shaped body 12.

Next, the case where the blood vessel E is ligated by using the threading tool A to which the needle-shaped body 12 and the receiving means 32 are attached as described above will be described with reference to FIG.

As shown in FIG. 7A, the threading tool A is opened, that is, the needle-shaped body 12 and the receiving means 32 are separated from each other, and the needle-shaped body 12 is inserted into the back of the blood vessel E to be ligated. , Handle 6
The gripping operation is performed to fit the needle-shaped body 12 to the receiving means 32 as shown in FIG. At this time, the needle-shaped body 12 is received by the receiving means 32.
It is pressed and held by.

Then, by opening the threading tool A, the needle-shaped body 12 is detached from the recess 2a and held by the receiving means 32, and the thread 7 surrounds the blood vessel E, as shown in FIG. And is substantially received by the receiving means 32 via the needle-shaped body 12. As the threading tool A is pulled out of the body, the thread 7 is also pulled out of the body as shown in FIG. After pulling the threading device A out of the body, thread 7
It is possible to separate the thread 7 and the needle-shaped body 12 from the receiving means 32 by pulling.

Needle-like body 12 and receiving means configured as described above
At 32, the holding force of the needle-shaped body 12 by the receiving means 32 can be adjusted by appropriately setting the diameter and length of the hole 32a. However, when the needle-shaped body 12 is detached from the receiving means 32, a relatively large force may be required.

Next, the construction of the threading device A according to the fourth embodiment will be described with reference to FIG.

In the threading device A according to this embodiment, the needle-shaped body 13 having the spherical body 13a formed at the tip is detachably attached to the mounting member 2 and the spherical portion 33 for receiving the spherical body 13a.
It is a figure explaining the principal part of the threading implement A which attached to the front-end | tip of the holding member 4 the receiving means 33 which formed a. The threading device A enables the needle-shaped body 13 pressed and held by the receiving means 33 to be easily removed with a small force.

A spherical body 13a having a diameter larger than the thickness of the needle-shaped body 13 is formed at the tip of the needle-shaped body 13, and the structure other than the spherical body 13a is the same as the needle-shaped body 12 described above. It is configured.

A spherical body 13 is provided on the side opposite to the needle-shaped body 13 of the receiving means 33.
A spherical portion 33a for receiving a is formed, and the needle-shaped body 13
A guide surface 33b that guides the spherical body 13a to the spherical portion 33a is formed on the surface facing the. In addition, the spherical portion 33a and the guide surface 33
By connecting b, a hole 33c having a diameter slightly larger than the thickness of the needle-shaped body 13 and smaller than the diameter of the spherical body 13a is formed. Therefore, the protrusion 33d is formed along the circumference of the hole 33c.

In the above structure, the needle-shaped body 13 approaches the receiving means 33 as the threading tool A is gripped, and the spherical body 13a is fitted into the spherical portion 33a through the hole 33c. When the threading tool A is opened, the mounting member 2 and the holding member 4 are separated by this operation, and the needle-shaped body 13 is separated from the recess 2a and held by the spherical portion 33a of the receiving means 33.

When the threader A is pulled out of the body and the needle-shaped body 13 is detached from the receiving means 33, the thread 7 is pulled in parallel with the holding member 4 as shown in FIG. 8B. Then, the base portion 13b of the spherical body 13a engages with the protrusion 33d, and the needle-like body 13 is rotated with this engaging portion as a fulcrum. With the rotation, the side opposite to the fulcrum of the spherical portion 13a gets over the projection 33d, and the needle-shaped body 13 is detached from the receiving means 33.

As described above, by applying the leverage principle when the needle-shaped body 13 is detached from the receiving means 33, the force required to detach the needle-shaped body 13 is applied to the needle-shaped body 12 described above. 32
It is possible to make the force extremely smaller than the force required to disengage from.

When ligating using the needle-shaped bodies 12 and 13,
It is necessary to attach the needle-shaped bodies 12 and 13 to the threading tool A each time one ligation is performed, and the needle-shaped bodies 12 and 13 are discarded after each ligation.

Next, the construction of the threading device A according to the fifth embodiment will be described with reference to FIG.

The position threading tool A shown in the figure inserts and holds the thread 7 in the axial direction of the needle-shaped body 14 attached to the mounting member 2 and holds the needle-shaped body 14 in association with the grasping operation of the threading tool A. A main part of the threading device A which is fitted to the receiving device 34 and is configured such that the needle-like body 14 is detached from the receiving device 34 in accordance with the opening operation of the threading device A and the thread 7 is received by the receiving device 34. It is a figure explaining.

The needle-like body 14 is a ball formed by binding the thread 7 to a part, a knot ball, or a ball coated with an adhesive and solidified,
A thread 7 having a large-diameter portion 7a such as a ball formed by fixing a metal ball containing stainless steel to the thread is inserted along the axial direction, and the large-diameter portion 7a is locked and held at the tip. As the threading tool A is gripped, the thread 7 and the thread 7 pass through or between tissues of the living body to be fitted into the receiving means 34, and are released from the receiving means 34 when the threading tool A is opened. When thread 7
Is configured to be received by the receiving means 34.

A slit 14a having a dimension corresponding to the thickness of the thread 7 is formed in the needle-shaped body 14 for inserting the thread 7 over the entire length. The bottom of the slit 14a is a needle-shaped body 14
Is formed so as to reach the center of the needle-shaped body 14, and a spherical holding portion 14b is formed at the tip of the needle-shaped body 14 for holding the large diameter portion 7a of the thread 7. Further, the needle-shaped body 14 is detachably attached to the attachment portion 2a formed on the attachment member 2.

At the tip of the mounting member 2, there is formed a mounting portion 2a consisting of a hole 2a having a diameter slightly smaller than the outer diameter of the needle-shaped body 14 as shown in FIG. This hole 2a
Is opened to the tip side of the mounting member 2 by the slit 2b, and the slit 14a of the needle-shaped body 14 is opened via the slit 2b.
It is possible to insert the thread 7 into the thread.

An elongated hole 2c having a relatively large width is formed on the opposite side of the slit 2b from the hole 2a, and a slit 2d is formed by connecting the elongated hole 2c and the hole 2a. That is, the tip of the mounting member 2 has an elongated hole 2c, a hole 2a, a slit 2d,
Two clamping pieces 2e having a spring property are formed by 2b.

In the above structure, since the hole 2a has a diameter smaller than the outer diameter of the needle-shaped body 14, the needle-shaped body 14 is inserted into the hole 2a.
When the is attached, the needle-shaped body 14 is pressed by the holding piece 2e and firmly held. The holding force with respect to the needle-shaped body 14 by the holding piece 2e can be set to a desired value by appropriately setting the ratio of the outer diameter of the needle-shaped body 14 to the diameter of the hole 2a, the length of the long hole 2c, and the like. It is possible. Therefore, the needle-shaped body 14 does not separate from the hole 2a when passing between tissues or through tissues.

At the center of the receiving means 34 is formed a hole 34a into which the tip portion of the needle-shaped body 14 is fitted, and the tip end of the needle-shaped body 14 is formed in the hole 34a on the surface facing the needle-shaped body 14. Guide surface to guide
34b is formed. A recess 34c is formed on the opposite side of the receiving means 34.

The hole 34a is formed with a very small size (pin hole) so that the large diameter portion 7a of the thread 7 can be pressed and received. The portion into which the tip of the needle-shaped body 14 is fitted does not necessarily have to be the hole 34a, and is constituted by a piece formed by cutting the guide surface 34b of the receiving means 34 to the concave portion 34c in a one-character shape, a three-pronged shape, or a cross shape. You may.

When the needle-shaped body 14 is fitted into the receiving means 34, the pressing force applied to the needle-shaped body 14 by the receiving means 34 is equal to that of the mounting member 2.
It is necessary to be smaller than the holding force of the needle-shaped body 14 by the holding piece 2e. The pressing force of the receiving means 34 against the needle-shaped body 14 can be adjusted by the material forming the receiving means 34 and the depth of the recess 34c. Therefore, the receiving means 34 is designed in consideration of the above conditions.

In the above structure, the needle-shaped member 14 is attached to the mounting member 2
When the thread 7 on which the large diameter portion 7a is formed is attached to the attachment portion 2a of the above and the threading tool A is gripped and operated, the needle-shaped body 14
The tip of the large-diameter portion 7a that has passed through or between tissues is fitted into the receiving means 34. Then, when the threading tool A is opened, the needle-shaped body 14 is moved to the receiving means 34 by this operation.
And the large diameter portion 7a of the thread 7 is removed from the hole of the receiving means 34 at the same time.
It is pressed and held by 34a. Then, the threading tool A can be pulled out of the body and the thread 7 can be pulled to be detached from the receiving means 34.

When the needle-shaped body 14 is used, it is necessary to insert the thread 7 into the needle-shaped body 14 for each ligation, but the needle-shaped body 14 can be continuously used. . Therefore, when there are many ligation sites, only the thread 7 needs to be replaced, which is advantageous in terms of cost.

Even when such a needle-shaped body 14 is used, a void may be formed between the needle-shaped body 14 and the hole 2a which is the mounting portion 2a. For this reason, there is a risk that the voids may not be completely sterilized during the post-operative sterilization process. Therefore, it is preferable to discard the needle-shaped body 14 after each operation.

FIG. 11 is a view for explaining a main part of the threading device A to which the structure shown in the fifth embodiment is applied.

A groove 15a for holding the thread 7 having the large diameter portion 7a is formed at the tip of the needle-like body 15, and a slit for guiding the thread 7 to the practitioner side along the mounting member 2 at the rear end. 15b is formed. The needle-like end 15 is removably attached to the attaching portion 2a formed of the hole 2a formed at the tip of the attaching member 2 like the needle-like body 14 described above.

A slit 35a into which the groove 15a formed at the tip of the needle-shaped body 15 is fitted is formed in the center of the receiving means 35, and the surface facing the needle-shaped body 15 has a slit 35a. A guide surface 35b for guiding the tip to the slit 35a is formed. A recess 35c is formed on the opposite side of the receiving means 35.

In the above structure, the needle-shaped member 15 is attached to the mounting member 2
When the thread 7 having the large-diameter portion 7a is inserted and the threading tool A is gripped and operated, the needle-shaped body 15
The groove 15a passing between tissues or within the tissue and locking the large diameter portion 7a is fitted into the receiving means 35. Next, when the threading tool A is opened, the needle-shaped body 15 is moved to the receiving means in accordance with this operation.
At the same time, the large-diameter portion 7a of the yarn 7 is pressed and held by the slit 35a of the receiving means 35. Then, the threading tool A can be pulled out of the body and the thread 7 can be pulled out to be detached from the receiving means 35.

Next, a case where the receiving means 3 is made of a metal having a spring property will be described with reference to FIG.

The receiving means 36 shown in FIG. 9A is constructed by press-molding a metal plate having a spring property or capable of exhibiting a spring property by heat treatment, for example, a plate made of stainless steel and having a thickness of about 0.1 mm. It is assumed that the needle-shaped body 12 detachably attached to the attachment member 2 is received as the passage means 1.

When the receiving means 36 is fitted with the flange 36a, which fits into the recess 4b formed on the side of the hole 4a of the holding member 4 facing the passage means 1, and the distal end portion of the needle-shaped body 12, the fitting is carried out. A funnel-shaped receiving portion 36b for pressing the mating portion and a plurality of slits 36c formed in the receiving portion 36b are respectively formed.

The slit 36c is formed starting from the hem 36d of the receiving portion 36b. For this reason, when the tip portion of the needle-shaped body 11 is fitted into the receiving portion 36b, the skirt 56d may expand and a sufficiently large pressing force may not be applied. In order to solve this problem, the receiving part 36b is provided on the back side of the receiving part 36b.
O-ring-shaped member 36 that prevents the hem 36d from expanding
e is provided.

In the receiving means 36 constructed as described above, when the tip portion of the needle-shaped body 11 is fitted in the receiving portion 36b, the receiving portion 36b
It can be held by applying a pressing force to the fitted portion by 36b. Then, as the mounting member 2 and the holding member 4 are separated from each other, the needle-shaped body 12 is maintained in the state of being held by the receiving means 36 and is separated from the mounting portion 2a of the mounting member 2.

The receiving means 37 shown in FIG. 13B is constructed on the assumption that the needle-shaped body 12 is received, like the receiving means 36 described above. The receiving means 37 is formed by machining, such as lathe machining.

A flange 37a and a boss 37b are formed on the receiving means 37, and the boss 37b has substantially the same size as the hole 4a formed in the holding member 4. A drum-shaped receiving portion 37c is formed continuously with the boss 37b, and the hem of the receiving portion 37c is formed.
37d has a size slightly larger than the hole 4a. Further, a tapered guide surface 37e is formed from the flange 37a to the boss 37b to guide the tip of the needle-shaped body 12 toward the receiving portion 37c, and further, the receiving portion 37c is formed with a plurality of slits 37f.

Therefore, when the receiving means 37 is fitted in the hole 4a, the hem 37d is restricted by the hole 4a and deforms, so that the receiving portion 37c can be given a spring property.

In the receiving means 37 constructed as described above, when the tip portion of the needle-shaped body 11 is fitted in the receiving portion 37c, the receiving portion 37c
It can be held by applying a pressing force to the fitted portion by 37c. Then, as the mounting member 2 and the holding member 4 are separated from each other, the needle-shaped body 12 is maintained in the state of being held by the receiving means 37 and is separated from the mounting portion 2a of the mounting member 2.

Next, still another structure of the receiving means 3 will be described with reference to FIG.

The receiving means 38 shown in the figure has a hole formed by a leaf spring 38 incorporated in the holding member 4 so as to receive the needle-shaped body 12 in cooperation with the hole 4a formed in the holding member 4. A pressing force is applied to the needle-shaped body 12 fitted in the 4a.

The leaf spring 38 is formed by processing a metal plate having a spring property, for example, a plate made of stainless steel and having a thickness of about 0.3 mm. The leaf spring 38 includes a pressing piece 38a that faces the hole 4a of the holding member 4 and presses the needle-shaped body 12, and a support arm 38b provided at a predetermined position of the pressing piece 38a.

In the vicinity of the hole 4a formed in the holding member 4, there is formed a recess 4c into which the plate spring 38 is incorporated, and the support arm 38b of the plate spring 38 is locked at a predetermined position of this recess 4c. The locking portion 4d is formed. A tapered guide surface 4e is formed on the side of the hole 4a facing the needle-shaped body 12.

In the receiving means 38 constructed as described above, a pressing force is applied to the needle-shaped body 12 fitted in the hole 4a by the pressing piece 38a of the leaf spring 38 so that the needle-shaped body 12 is brought into pressure contact with the hole 4a. Can be held at. Then, as the mounting member 2 and the holding member 4 are separated from each other, the needle-shaped body 12 is maintained in the state of being held by the receiving means 37 and is separated from the mounting portion 2a of the mounting member 2.

In the above structure, it is preferable to provide the needle-shaped body 12 with a groove for engaging with the pressing piece 38a of the leaf spring 38 for the purpose of surely receiving the needle-shaped body 12. In this case, the leaf spring 38 is formed in the shape of a lever having a long length, a pin is provided on the holding member 4, and the leaf spring 38 is rotatably attached to the pin so that the pressing piece 38a always projects into the hole 4a. When the practitioner pushes the other end side of the needle member 12 out of the holding member and pushes the protruding portion, the pressing piece 38a is retracted from the hole 4a and the needle-shaped body 12 is removed from the hole 4a. It may be configured.

Next, the threaded needles forming the needle-shaped body 12 will be described with reference to FIG. In the following embodiments of threaded needles, the same parts as those of the needle-shaped body 12 or parts having the same function are designated by the same reference numerals.

The threaded needle 12 is formed in the shape of a straight needle having a predetermined length, and the tip 12a corresponds to a tissue to be passed, for example, a spherical or It is formed in a pointed shape. In addition, the thread 7 is the end face
It extends from 12b in the axial direction of the threaded needle 12. That is, a blind hole or groove having a size corresponding to the specifications of the thread 7 is formed on the base end surface 12b of the threaded needle 12, and the blind hole is formed by inserting the end of the thread 7 into the blind hole or groove. The corresponding portions can be held by caulking (see (a) in the figure) or by adhering (see (b) and (c) in the figure). Further, as will be described later, the thread 7 can be integrally molded by the insert molding method to form the threaded needle 12 made of synthetic resin.

The sectional shape of the body portion 12c of the threaded needle 12 is not particularly limited. That is, since the threaded needle 12 is not gripped by the needle holder during surgery, it does not have to have a shape that is supposed to be gripped by the needle holder.

The base end portion 12d of the threaded needle 12 is temporarily held in a state of being fitted to the mounting portion 2a formed on the mounting member 2.
Therefore, at least the portion that fits into the mounting portion 2a and that corresponds to the bottom portion and the edge portion of the mounting portion 2a must have a size that is substantially equal to or slightly smaller than the mounting portion 2a. .

That is, as shown in FIG. 10A, when the groove 12e formed by caulking coincides with the opening edge of the mounting portion 2a, the threaded needle 12 is held in the mounting portion 2a in a stable state. Is difficult.

When the threaded needle 12 is mounted on the mounting portion 2a of the mounting member 2, the base end surface 12b contacts the bottom portion of the mounting portion 2a and the driving force acting on the mounting member 2 is transmitted. For this reason, it is necessary for the base end surface 12b holding the yarn 7 to have a clear step with respect to the yarn 7.

The thread 7 used for ligating a blood vessel has a thickness of about 0.3 mm to 0.4 mm, and the thread 7 used for suturing an incision has a thickness of about 0.2 mm to 0.3 mm. It is a degree. When ligating or suturing, the force required to pass the threaded needle 12 between tissues or within tissues is about 50 g to 2 g.
It is about 00g. When the above-mentioned force is applied to the base end surface 12b, a step (exposed surface of the base end surface 12b) of about 0.1 mm may be formed around the yarn 7. Therefore, the thickness of the threaded needle 12 is set to about 0.8 mm to 1 mm.

When the threading needle 12 is attached to the threading tool A shown in FIG. 1 and ligation or suturing is performed, the tip 12a of the threading needle 12 is rotated according to the distance from the shaft 5 to the mounting portion 2a. Then, the receiving means 3 is fitted. Therefore, if the length of the threaded needle 12 is long, a force in the direction intersecting the long axis of the threaded needle 12 acts when the tip 12a is fitted into the receiving means 3, and a smooth fitting can be achieved. There is a possibility that it will not. Therefore, the total length of the needle 12 with thread is 3 mm to 10 mm.
It is set in the range of mm.

As shown in FIG. 13, when the threaded needle 12 is used in the threading tool A having the receiving means 3 constituted by the leaf spring 38, the threaded needle 12 is completely separated from the tip 12a of the threaded needle 12 by a predetermined distance. A groove 12f is formed along the circumference. Groove 12f is a leaf spring
It is for engaging the pressing piece 38a of 38, and this groove 12
By forming f, it is possible to reliably hold and receive the threaded needle 12 fitted in the hole 4a of the holding member 4.

The distance from the tip 12a to the groove 12f is not limited. However, it is preferable that the groove 12f is formed in a portion where the portions connecting to both sides of the groove 12f are parallel to each other and have a dimension substantially equal to the diameter of the hole 4a, for example, the body portion 12c. In this case, the threaded needle 12 does not wobble when fitted into the hole 4a and held by the leaf spring 38.

As a material for forming the threaded needle 12, it is preferable to use SUS303 (stainless steel) or BSBM (free cutting brass), which is relatively inexpensive. By using such a material, the cost of the threaded needle 12 can be reduced.

Further, a synthetic resin material is molded and processed, and the needle with thread 12
Can also be configured. In this case, it is preferable that the thread 7 is integrated by the insert molding method simultaneously with the molding of the threaded needle 12 so as to extend in the axial direction of the threaded needle 12 from the original end face 12b. The threaded needle 12 manufactured by this method can be supplied to a doctor in a sterilized state in advance, and the threaded needle 12 after use can be easily discarded.

Next, the mounting member 2 to which the passage means 1 is attached
Another structure of the holding member 4 to which the receiving means 3 is attached will be described.

FIG. 15 is a view for explaining the structure of the threading tool B in which the mounting member 2 and the holding member 4 are connected to each other with a spring property. The threading tool B is configured so that a practitioner can operate it with the same feel as tweezers.

The threading device B includes a mounting member 2 and a holding member 4.
Is formed with appropriate rigidity, and the original portion (right side of FIG. 15) is provided with spring properties and is joined to each other. Even in the threading tool B configured as described above, the passing means 11 is integrated with the mounting member 2 as in the above-described embodiments, or the needle-shaped bodies 12 to 14 are detachably attached and the holding member 4 is provided. It is possible to attach the receiving means 31 to 38 to and to ligate a blood vessel or suture an incision site.

FIG. 16 is a view for explaining the structure of the threading tool C in which the tip of the mounting member 2 is formed in an arc shape. In the figure,
Like the threading tool A, the mounting member 2 and the holding member 4 are attached to the shaft 5 and are configured to be rotatable with respect to each other.

On the mounting side of the passage means 1 of the mounting member 2, a linear straight portion 2f having a preset length from the shaft 5 is formed, and the above-mentioned length is provided on the tip side of the straight portion 2f. An arc portion 2g having a radius is formed. The passage means 1 is attached to the tip of the arc portion 2g. The mounting side of the receiving member 3 of the holding member 4 extends linearly from the shaft 5, and the receiving unit 3 is mounted at a position corresponding to the length of the linear portion 2f of the mounting member 2.

In the threading tool C configured as described above, the passage means 1 moves on the same circumference in accordance with the opening / closing operation of the handle 6, and the receiving means 3 arranged on the circumference. Detach and contact in a substantially straight line. Therefore, the receiving operation of the yarn 7 by the receiving means 3 can be performed more accurately and reliably.

That is, when the passing means 1 is the needle-shaped bodies 12 and 13 detachably attached to the mounting member 2, the needle-shaped bodies 12 and 13 with respect to the receiving means 3 are opened and closed as the threading tool C is opened and closed. Since they are fitted in a straight line, the needle-shaped bodies 12, 13 do not have a repulsive force. Therefore, it is possible to surely fit the needle-shaped bodies 12 and 13 into the receiving means 3.

FIG. 17 is a view for explaining the construction of a threading device D which is capable of performing ligation and suturing in an extremely deep position, for example, laparoscopic surgery. In the figure, the mounting member 2
The holding member 4 is arranged at the tip side of the casing 41 having a predetermined length (about 300 mm to 400 mm depending on the site to be ligated), and at least one member 2 and 4 can be brought into contact with and separated from the other member. Is configured. In this embodiment, the holding member 4 is fixed to the tip of the casing 41, and the mounting member 2 is rotatably attached to a shaft (not shown).

The casing 41 is attached to an operation grip 42 provided with a trigger 43, and the trigger 43 and the mounting member 2 are connected via a conductive member such as a wire or rod (not shown) arranged inside the casing 41. ing.
When the mounting member 2 and the holding member 4 are configured to be able to come into contact with and separate from each other, it is necessary to connect the trigger 43 to the mounting member 2 and the holding member 4 by a conductive member.

Therefore, when the practitioner operates the trigger 43, this operation force is transmitted to the mounting member 2 via the conductive member, and each member 2 approaches the holding member 4 and is held by the passing means 1. 7 is received by the receiving means 3.

In the threading tool E constructed as described above, the casing 41 is preferably made of a flexible material, and the thickness thereof is preferably such that it can be inserted into the endoscope. . By configuring the threading tool E under the above conditions, it is possible to easily perform ligation and suturing in laparoscopic surgery performed while being monitored by the endoscope.

Particularly when ligating during laparoscopic surgery,
Currently, so-called medical clips are often used. However, when the clip is used, there are problems that the shape is large, the clip may come off from the ligation site, the blood vessel must be separated from the surrounding tissue, and the like. As a result, it becomes possible to avoid each of the above problems.

In each of the threading tools A to E described above, each constituent member can be made of a metallic material such as stainless steel, but it can also be made of a synthetic resin molded product. For example, when the threading tools A to E are configured by molding and assembling members such as the mounting member 2, the holding member 4, and the shaft 5 with a synthetic resin, they can be supplied to a doctor in a sterilized state in advance. It is possible, and it is possible to easily dispose of the threading tools A to E after use.

[0122]

As described above in detail, in the threading device according to the present invention, the thread is wound around the blood vessel to ligate or suture the incision site by a one-step operation of opening and closing the threading device. The thread can be pulled out of the body by pulling the threading tool out of the body after the above operation is completed. Therefore, the ligation operation and the suturing operation can be performed easily and promptly and surely.

Further, by using the threaded needle according to the present invention, it is possible to further improve the operability of the threading tool.

[Brief description of drawings]

FIG. 1 is a side view illustrating the overall configuration of a threading tool configured to rotate a mounting member and a holding member about an axis to separate and contact a passing means and a receiving means.

FIG. 2 is a diagram illustrating a main part of the threading device according to the first embodiment configured to hook and receive a thread.

FIG. 3 is a diagram illustrating a configuration of a passing means and a receiving means according to a second embodiment.

FIG. 4 is a diagram illustrating another configuration of the passing means.

FIG. 5 is a view for explaining a main part of a threading device according to a third embodiment in which a passing means is configured to be attachable to and detachable from a mounting member.

FIG. 6 is a diagram illustrating a main part of a mounting member that detachably mounts a passage unit.

FIG. 7 is a diagram illustrating a ligation operation sequence.

FIG. 8 is a view for explaining a main part of a threading device according to a fourth embodiment in which the passing means is configured to be attachable to and detachable from the mounting member.

FIG. 9 is a view for explaining a main part of a threading device according to a fifth embodiment in which a passing means is configured to be attachable to and detachable from a mounting member.

FIG. 10 is a diagram illustrating a main part of a mounting member that detachably mounts a passage unit.

FIG. 11 is a diagram illustrating an application example of the fifth embodiment.

FIG. 12 is a diagram illustrating another configuration example of a receiving unit.

FIG. 13 is a diagram illustrating still another configuration example of the receiving unit.

FIG. 14 is a diagram illustrating a configuration of a threaded needle.

FIG. 15 is a side view illustrating an overall configuration of a threading tool in which a mounting member and a holding member are connected to each other by imparting a spring property.

FIG. 16 is a side view illustrating an overall configuration of a threading tool in which a tip portion of a mounting member is formed in an arc shape.

FIG. 17 is a side view for explaining the overall configuration of a threading tool that enables easy ligation or suturing of deep parts.

[Explanation of symbols]

 A to D Threading tool 1,11 Passing means 11c Slits 11d, 11e Groove 11f Hole 12 Needle-like body, needle with thread 12a Tip 12b Proximal end face 12c Body 12d Proximal end 12e Groove 12f Groove 13-15 Needle-like body 13a Spherical body 14a, 15a Slit 2 Mounting member 2a Mounting part, recess, hole 2e Holding piece 2f Straight part 2g Arc part 3,31 to 38 Receiving means 31a Slit 32a Hole 33a Spherical part 4 Holding member 4a Hole 5 Shaft 6 Handle 7 Thread 7a Large diameter part 41 Casing 42 Grip 43 Trigger

Claims (14)

[Claims] 1. A pass-through means for holding a thread and passing between tissues or within a tissue, and a receiving means for receiving a thread held by the passing means or a passing means passing between tissues or within a tissue. The medical threader. 2. Passing means for holding a thread and passing between tissues or within tissues; first driving means for driving the passing means to pass between tissues or within tissues; and passing between tissues or within tissues. A threading device for medical use, characterized in that it has a receiving means that substantially receives the thread and a second driving means that drives the receiving means, and that the passing means and the receiving means are arranged facing each other. 3. The first drive means and the second drive means are lever-shaped members, and the first drive means and the second drive means are provided.
The threading device for medical use according to claim 2, characterized in that the driving means is rotatably attached to a common shaft, and an operation section for applying a force to the end side is configured. 4. The passing means has a yarn holding portion which is arranged with respect to the first driving means such that the tip of the passing means projects from the first driving means toward the receiving means, and which holds a thread near the tip. The threading device for medical use according to claim 2 or 3, which is characterized. 5. The threading device for medical use according to claim 4, wherein the receiving means has a hooking portion for hooking and receiving the thread when the receiving means faces the thread. 6. The yarn passing through the passage means is arranged with respect to the first drive means such that the tip of the passage means projects from the first drive means toward the receiving means, and inserts a thread formed along the longitudinal axis. The threading device for medical use according to any one of claims 2 to 4, further comprising a locking portion that locks a groove or hole and a portion formed on the tip and larger than other portions formed on the thread. Ingredient 7. The receiving means applies elastic force to the yarn held at the tip of the passing means fitted to the receiving means to hold the yarn, and receives the yarn as the passing means separates from the receiving means. The medical threading device according to any one of claims 2 to 4 or 6, wherein the threading device is a medical threading device. 8. A thread, wherein the passing means is detachably attached to the first driving means, the tip is arranged so as to project from the first driving means toward the receiving means, and the thread is fixed to the rear end. The threading device for medical use according to claim 2 or 3, which has a fixing portion. 9. The medical threading device according to claim 8, wherein the passing means is made of a magnetic material or a magnet. 10. The receiving means applies elastic force to and holds the passage means fitted to the receiving means, and the passage means is moved from the first drive means in accordance with the operation of the first drive means and the second drive means. The medical threading device according to any one of claims 2, 3, 8 and 9, characterized in that it is detached and received. 11. The medical thread according to claim 9, wherein the receiving means is made of a magnet or a magnetic body, and the passing means fitted therein is applied with an attracting force to hold the thread substantially to receive the thread. Threading. 12. The second driving means is provided with a holding portion, and the receiving means is detachably attached to the holding portion, according to any one of claims 2, 3, 5, 7, 10, and 11. The medical threader described in. 13. The threaded needle used as the passage means according to claim 8, wherein the threaded needle is formed in a straight needle shape having a predetermined length, and the thread is extended from the base end surface in the axial direction. In addition, the shape at the base end surface and at a position separated from the base end surface by a predetermined distance is substantially the same as the shape of the mounting portion formed in the first drive means, and the size is formed slightly smaller. Needle with thread. 14. The threaded needle according to claim 13, wherein a tip end portion of the threaded needle is formed in a taper shape and a groove is formed over a whole circumference at a position separated from the tip by a predetermined distance.