JPH08140982A - Medical suturing device - Google Patents
Medical suturing deviceInfo
- Publication number
- JPH08140982A JPH08140982A JP28674894A JP28674894A JPH08140982A JP H08140982 A JPH08140982 A JP H08140982A JP 28674894 A JP28674894 A JP 28674894A JP 28674894 A JP28674894 A JP 28674894A JP H08140982 A JPH08140982 A JP H08140982A
- Authority
- JP
- Japan
- Prior art keywords
- thread
- suture
- sheath
- suture thread
- suturing
- 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
Links
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- Surgical Instruments (AREA)
Abstract
Description
【０００１】[0001]
【産業上の利用分野】本発明は、例えば外科手術で組織
を縫合糸によって縫い合わせる際に使用される医療用縫
合器に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical suturing device used for suturing tissues with a suture in a surgical operation.
【０００２】[0002]
【従来の技術】従来、生体組織等を縫合糸によって縫い
合わせる医療用縫合器としては、例えば米国特許第3,65
7,056 号に開示されている縫合器がある。この縫合器
は、糸の結び目（糸止め）を簡単に作製するために超音
波を使用したものであり、糸と糸とを超音波によって接
続したり、或いは、ファスナに通した糸の端部を超音波
で変形させて頭部状に成形し、これによって、ファスナ
と糸とを接続するといったものである。2. Description of the Related Art Conventionally, as a medical suturing device for suturing a living tissue with a suture, for example, US Pat.
There is a suture device disclosed in No. 7,056. This suturing device uses ultrasonic waves to easily make a knot (thread stop) of the thread, and connects the thread with the ultrasonic wave, or the end of the thread passed through the fastener. Is deformed by ultrasonic waves to form a head-like shape, which connects the fastener and the thread.
【０００３】また、このような縫合器としては、その他
に、米国特許第5,171,251 号、米国特許第5,306,280
号、特開平６−７３６１号公報等に開示されるような縫
合クリップがある。この縫合クリップは、２本の足を有
するポリマー材料からなるクリップの内部に縫合糸を配
置し、この状態で前記クリップに熱を加えてクリップを
軟化させた後、クリップに圧縮力を加えてクリップの足
を閉じ、その後、熱と圧縮力とを取り除いて、縫合糸と
クリップとを繋ぎ止めるといったものである。Other such suturing devices include US Pat. No. 5,171,251 and US Pat. No. 5,306,280.
And Japanese Patent Application Laid-Open No. 6-7361. In this suture clip, a suture thread is placed inside a clip made of a polymer material having two legs, and in this state, heat is applied to the clip to soften the clip and then a compressive force is applied to the clip to clip the clip. The legs are closed and then the heat and compressive forces are removed to tie the suture and clip together.
【０００４】[0004]
【発明が解決しようとする課題】しかしながら、米国特
許第3,657,056 号に開示されている超音波縫合器によっ
て縫合糸同志を接続すると、縫合糸同士の接合面積が小
さいため、十分な接合強度を得ることができない。ま
た、糸にテンションをかけながら超音波を加えるため、
糸がそのテンションと超音波エネルギとによって切れて
しまわないように超音波の大きさやその放射時間、糸の
テンション等を許容範囲に設定する必要があり、縫合作
業や縫合強度が縫合糸それ自身によって制約されてしま
う。さらに、縫合糸の端部を頭部状に成形する作業も容
易ではない。However, when the sutures are connected by the ultrasonic suturing device disclosed in US Pat. No. 3,657,056, the sutures have a small joint area, so that sufficient joint strength can be obtained. I can't. Also, because ultrasonic waves are applied while tension is applied to the thread,
It is necessary to set the size of the ultrasonic wave, its radiation time, the tension of the thread, etc. within an allowable range so that the thread will not be cut by the tension and ultrasonic energy. You will be restricted. Further, the work of molding the end portion of the suture into a head shape is not easy.
【０００５】これに対し、前述した縫合クリップにはこ
のような欠点がない。しかし、クリップに熱を加えてク
リップ全体を軟化させるため、加熱から軟化、冷却、硬
化に要する時間が１０秒程度必要となる。このため、迅
速な縫合を行なうことができない。また、クリップと糸
とを１０秒間保持しておかなければならないため、術者
や患者にかなりの負担を強いるとともに、縫合作業の効
率が悪い。特に多くの部位をクリップする場合には、そ
の作業が非常に大変である。また、クリップがポリマー
であるため、外力によってクリップのヒンジ部が弾性変
形を起こし、その結果、クリップの両足が開いて、縫合
糸が外れてしまう虞がある。In contrast, the suture clip described above does not have such a drawback. However, since heat is applied to the clip to soften the entire clip, it takes about 10 seconds from heating to softening, cooling, and curing. For this reason, rapid suture cannot be performed. Further, since the clip and the thread have to be held for 10 seconds, a considerable burden is imposed on the operator and the patient, and the efficiency of the suturing work is poor. Especially when clipping many parts, the work is very difficult. Further, since the clip is made of polymer, the hinge portion of the clip is elastically deformed by an external force, and as a result, both legs of the clip may open and the suture may come off.
【０００６】本発明は上記事情に着目してなされたもの
であり、その目的とするところは、簡単な縫合作業によ
って十分な縫合強度を得ることができる医療用縫合器を
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 medical suturing device capable of obtaining sufficient suturing strength by a simple suturing operation.
【０００７】[0007]
【課題を解決する手段および作用】上記課題を解決する
ために、本発明の医療用縫合器は、縫合糸が接続固定さ
れて成り、前記縫合糸の一部を収容可能な少なくとも１
つの収容部を有する糸止め部材と、手術部位に挿入可能
で且つ前記糸止め部材を着脱自在にセット可能なシース
と、前記シース内に配設され且つ前記シース内にセット
された前記糸止め部材を変形させることによって糸止め
部材の前記収容部内に収容された縫合糸を締め付け固定
する糸止め手段とを具備している。In order to solve the above-mentioned problems, the medical suturing device of the present invention comprises at least one suture thread which is connected and fixed and which can accommodate a part of the suture thread.
A thread stopper member having two accommodating portions, a sheath insertable into a surgical site and capable of detachably setting the thread stopper member, and the thread stopper member disposed in the sheath and set in the sheath And a thread stopping means for tightening and fixing the suture thread accommodated in the accommodating portion of the thread stopping member.
【０００８】上記構成によれば、糸止め部材の収容部内
に縫合糸を引き込んだ状態で糸止め手段により糸止め部
材を変形させて縫合糸を締め込み固定することができ
る。つまり、糸止め手段は、縫合糸が糸止め部材によっ
て締め付けられて糸止め部材に結合されるように、糸止
め部材を変形させることができる。特に、前記糸止め手
段が、超音波振動エネルギによって前記糸止め部材を変
形させる場合には、縫合作業を一層迅速に行なうことが
できる。According to the above construction, the suture thread can be tightened and fixed by deforming the suture thread by the thread stopping means in a state where the suture thread is drawn into the accommodating portion of the thread stopping member. That is, the thread stopping means can deform the thread stopping member such that the suture thread is tightened by the thread stopping member and coupled to the thread stopping member. In particular, when the thread stopping means deforms the thread stopping member by ultrasonic vibration energy, the suturing work can be performed more quickly.
【０００９】[0009]
【実施例】以下、図面を参照しつつ本発明の実施例につ
いて説明する。図１は本発明の一実施例に係る医療用縫
合器１を示している。図１の（ｂ）に示すように、本実
施例の縫合器１は、体内に挿入可能な筒状のシース５
と、シース５内に進退自在に挿通された中空の超音波プ
ローブ６とから縫合器本体が構成されている。超音波プ
ローブ６は、図示しない超音波振動子と超音波駆動回路
とに接続されている。また、シース５の先端部には開口
１０が形成され、この開口１０を通じてシース５の先端
部内に縫合体２０をセットできるようになっている。Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 shows a medical suturing device 1 according to an embodiment of the present invention. As shown in FIG. 1B, the suturing device 1 according to the present embodiment has a tubular sheath 5 that can be inserted into the body.
The main body of the suturing device is composed of the hollow ultrasonic probe 6 that is inserted into the sheath 5 so as to be retractable. The ultrasonic probe 6 is connected to an ultrasonic transducer and an ultrasonic drive circuit (not shown). An opening 10 is formed at the tip of the sheath 5, and the suture body 20 can be set in the tip of the sheath 5 through the opening 10.
【００１０】すなわち、図１の（ａ）に示すように、前
記縫合体２０は、断面がＵ字形状を成す樹脂製の糸止め
部材４と、この糸止め部材４に接続固定された縫合糸２
と、縫合糸２の先端に設けられた縫合針３とから構成さ
れている。そして、縫合体２０は、糸止め部材４をシー
ス５の開口を通じてシース５の先端部内に嵌め込み固定
することによって、シース５に着脱自在にセットすれる
ようになっている。この場合、シース５の開口１０は、
シース５の先端側上面を切り欠いて形成されているとと
もに、シース５にセットされた糸止め部材４を超音波プ
ローブ６によって前方に押し出した際に糸止め部材４が
開口１０の先端側から突出できるようにシース５の先端
を大きく切り欠いて形成されているものである。That is, as shown in FIG. 1A, the suture body 20 comprises a resin thread stopper member 4 having a U-shaped cross section, and a suture thread connected and fixed to the thread stopper member 4. Two
And a suture needle 3 provided at the tip of the suture thread 2. The suture body 20 is detachably set on the sheath 5 by fitting and fixing the thread stopper member 4 into the distal end portion of the sheath 5 through the opening of the sheath 5. In this case, the opening 10 of the sheath 5 is
The upper surface of the sheath 5 on the distal end side is cut out, and when the suture fix member 4 set in the sheath 5 is pushed forward by the ultrasonic probe 6, the suture stop member 4 projects from the distal end side of the opening 10. The distal end of the sheath 5 is formed so as to be greatly cut out so that the sheath 5 can be formed.
【００１１】本実施例で使用される縫合糸２は、生体吸
収性の樹脂によって形成することが好ましいが、非吸収
性のものであっても構わない。また、縫合糸２は、モノ
フィラメント（単線）とマルチフィラメント（複線）と
を使い分けることができる。この場合、モノフィラメン
トは、引張強度の大きい素材からなるコアと、溶着性の
良好な素材からなるクラッドとの２層構造を成すものが
好適である。また、マルチフィラメントは、糸を編んで
形成したもの、或いは、糸を撚って形成したものが好適
である。このようにすることで、糸止め部材４内に縫合
糸２を締め込んでこれら両者を結合させる（後述する）
際に、糸止め部材４が縫合糸２の編み目や撚り目に食い
込んで結合強度が増し、糸止め部材４から縫合糸２が滑
り抜けにくくなる。また、この場合、マルチフィラメン
トは、異なる素材を組み合わせて成るものであっても良
い。The suture thread 2 used in this embodiment is preferably made of a bioabsorbable resin, but may be non-absorbable. Further, as the suture thread 2, a monofilament (single wire) and a multifilament (double wire) can be properly used. In this case, it is preferable that the monofilament has a two-layer structure including a core made of a material having high tensile strength and a clad made of a material having good weldability. Further, the multifilament is preferably formed by knitting yarn or twisted. By doing so, the suture thread 2 is tightened in the thread stopping member 4 to join them together (described later).
At this time, the thread stopper member 4 digs into the stitches or twists of the suture thread 2 to increase the bonding strength, and the suture thread 2 does not easily slip out of the thread stopper member 4. Further, in this case, the multifilament may be formed by combining different materials.
【００１２】なお、縫合糸２の先端に設けられる縫合針
３は、直線状のものや、湾曲状のもの、或いは、直線状
のもので、その先端部が湾曲した形状のものなど、縫合
部位によって適宜選択して使用する。The suturing needle 3 provided at the tip of the suture thread 2 has a straight shape, a curved shape, or a linear shape with a curved tip portion, and the sutured portion. Depending on the case, it is selected appropriately and used.
【００１３】次に、上記構成の縫合器１を用いて生体組
織の縫合を行なう場合について図２を参照しつつ説明す
る。まず、シース５に縫合体２０をセットする。この作
業は、シース５内の超音波プローブ６を手元側に若干引
き込んで、シース５の先端部内に糸止め部材４を収容可
能な空間を形成し、この空間内に糸止め部材４を開口１
０を通じてセットすることによって行なう。Next, a case where a living tissue is sutured using the suturing device 1 having the above-described configuration will be described with reference to FIG. First, the suture body 20 is set on the sheath 5. In this work, the ultrasonic probe 6 in the sheath 5 is slightly pulled toward the hand side to form a space in the distal end portion of the sheath 5 in which the thread stopper member 4 can be accommodated, and the thread stopper member 4 is opened in this space 1.
By setting through 0.
【００１４】次に、縫合体２０がセットされたシース５
を図示しないトラカールを介して体腔内に挿入する。そ
して、別のルートで体腔内に挿入した持針器（図示せ
ず）で縫合針３を保持しながら縫合すべき生体組織３０
に縫合針３を刺し通し、生体組織３０から抜け出た縫合
糸２を糸止め部材４のＵ字溝４ａ内に引き込む（図２の
（ａ）の状態）。Next, the sheath 5 in which the suture body 20 is set
Is inserted into the body cavity through a trocar (not shown). Then, the living tissue 30 to be sutured while holding the suture needle 3 with a needle holder (not shown) inserted into the body cavity through another route.
The suture needle 3 is pierced through the suture, and the suture thread 2 that has come out of the living tissue 30 is drawn into the U-shaped groove 4a of the thread stopping member 4 (state (a) of FIG. 2).
【００１５】この状態で、今度は、図２の（ｂ）に示す
ように、鉗子３２を用いて縫合糸２を引張り、その引張
力で組織同志を接合させながら、超音波プローブ６をシ
ース５内で前進させて糸止め部材４に押し付けた状態
で、シース５の先端を組織３０の縫合部位に押し付け
る。そして、この状態で、超音波プローブ６からの超音
波を糸止め部材４に伝達する。これによって、糸止め部
材４は、超音波プローブ６からの超音波によってその内
部が発熱して軟化するとともに、超音波プローブ６の押
圧力によって容易に変形して縫合糸２を締め込む。この
時、糸止め部材４の変形とともに縫合糸２を引張りなが
ら超音波プローブ６によって糸止め部材４を組織３０側
に押し出してシース５を手元側に引き戻す（図２の
（ｃ）の状態）と、糸止め部材４が開口１０（シース
５）の先端から抜け出て組織３０の縫合部に圧接すると
ともに、組織３０に対する縫合強度が増大する。In this state, this time, as shown in FIG. 2B, the suture thread 2 is pulled by using the forceps 32, and the ultrasonic probe 6 is inserted into the sheath 5 while joining the tissues by the pulling force. The tip of the sheath 5 is pressed against the sutured site of the tissue 30 while being advanced inside and being pressed against the thread fixing member 4. Then, in this state, the ultrasonic wave from the ultrasonic probe 6 is transmitted to the thread stopper member 4. As a result, the inside of the suture fix member 4 is heated and softened by the ultrasonic waves from the ultrasonic probe 6, and is easily deformed by the pressing force of the ultrasonic probe 6 to tighten the suture 2. At this time, while the suture thread 4 is deformed and the suture thread 2 is pulled, the suture thread 4 is pushed out to the tissue 30 side by the ultrasonic probe 6 and the sheath 5 is pulled back to the proximal side (the state of FIG. 2C). The suture fix member 4 comes out of the tip of the opening 10 (sheath 5) and comes into pressure contact with the suture portion of the tissue 30, and the suture strength for the tissue 30 increases.
【００１６】その後、縫合糸２と糸止め部材４とをこの
状態で体内に留置する。この時、余分な縫合糸２をハサ
ミ鉗子で切り取って縫合針３とともに回収する。これに
よって、組織の縫合が完了する。After that, the suture thread 2 and the thread stopping member 4 are left in the body in this state. At this time, the excess suture thread 2 is cut off with scissors and collected together with the suture needle 3. This completes the suturing of the tissue.
【００１７】以上説明したように、本実施例の医療用縫
合器１によれば、糸止め部材４に形成されたＵ字溝４ａ
によって縫合糸２を糸止め部材４内に容易に引き込むこ
とができるとともに、縫合糸２をＵ字溝４ａ内に引き込
んだ状態で、糸止め部材４を超音波によって変形させて
縫合糸２を締め込むことができるため、糸止めを確実、
容易、且つ迅速に形成することができる。As described above, according to the medical suturing device 1 of this embodiment, the U-shaped groove 4a formed in the thread fixing member 4 is formed.
The suture thread 2 can be easily pulled into the thread stopping member 4 by the use of the suture thread 2 while the suture thread 2 is pulled into the U-shaped groove 4a, and the suture thread 2 is deformed by ultrasonic waves to tighten the suture thread 2. Since it can be inserted, the thread is securely fastened.
It can be formed easily and quickly.
【００１８】また、超音波によって糸止め部材４を変形
させて縫合糸２を締め込み結合させるため、縫合糸２同
志を接合して糸止めする場合や、熱によって縫合糸２と
糸止め部材４とを圧着する場合に比べて縫合強度が大き
い。したがって、その後の外力によって縫合状態が緩ま
ったり、糸止め部材４と縫合糸２との結合状態が解除さ
れてしまうといったことがない。In addition, since the suture thread 2 is deformed by ultrasonic waves and the suture thread 2 is tightened and coupled, the suture thread 2 and the suture thread 2 are joined and thread-fastened, or the suture thread 2 and the thread stop member 4 are heated. The suture strength is greater than that when crimping and. Therefore, the sutured state is not loosened by the subsequent external force, and the coupled state between the suture fix member 4 and the suture thread 2 is not released.
【００１９】また、超音波プローブ６と糸止め部材４と
がシース５内に保持された状態で超音波プローブ６によ
る糸止め部材４の変形を行なうため、縫合作業を容易か
つ確実に行なうことができる。Further, since the ultrasonic probe 6 is deformed by the ultrasonic probe 6 while the ultrasonic probe 6 and the thread fixing member 4 are held in the sheath 5, the suturing work can be performed easily and surely. it can.
【００２０】また、本実施例の医療用縫合器１では、糸
止め部材４を縫合組織３０に押し付けた状態で縫合糸２
によって成された組織間接合の接合力を保持させること
ができるため、つまり、糸止め部材４を縫合組織３０に
押し付けた状態で糸止めを行なえるため、糸止め強度が
大きく、したがって縫合強度が大きい確実な縫合作業を
行なうことができる。Further, in the medical suturing device 1 of the present embodiment, the suture thread 2 with the thread stopping member 4 being pressed against the suture tissue 30 is used.
Since the joining force of the inter-tissue joining performed by the above can be maintained, that is, the thread fastening can be performed while the thread fastening member 4 is pressed against the suture tissue 30, the thread fastening strength is large and therefore the suture strength is increased. A large and reliable suturing operation can be performed.
【００２１】図３は糸止め部材４の変形例を示すもので
ある。すなわち、図３の（ａ）に示す糸止め部材４ａは
Ｖ字形状を有し、図３の（ｂ）に示す糸止め部材４ｂは
Ｓ字形状を有し、図３の（ｃ）に示す糸止め部材４ｃは
Ｗ字形状を有し、図３の（ｄ）に示す糸止め部材４ｄは
Ｚ字形状を有し、図３の（ｅ）に示す糸止め部材４ｅは
Ｘ字形状を有し、図３の（ｆ）に示す糸止め部材４ｆは
Ｈ字形状を有している。いずれの場合も、縫合糸２を容
易に引き込むことが可能な溝３５を１つもしくは複数個
有している。FIG. 3 shows a modification of the thread fixing member 4. That is, the thread stopping member 4a shown in FIG. 3 (a) has a V shape, the thread stopping member 4b shown in FIG. 3 (b) has an S shape, and is shown in FIG. 3 (c). The thread stopper 4c has a W shape, the thread stopper 4d shown in FIG. 3D has a Z shape, and the thread stopper 4e shown in FIG. 3E has an X shape. The thread stopper member 4f shown in FIG. 3 (f) has an H shape. In any case, one or a plurality of grooves 35 are provided so that the suture thread 2 can be pulled in easily.
【００２２】このような構成によれば、縫合したい組織
・手技に応じて、組織を縫った縫合糸２をいずれかの溝
３５に引き込むことができる。つまり、縫合糸２を引き
込むべき溝３５を選択できる。このように、縫合糸２を
都合の良い溝３５に引き込むことができれば、縫合をス
ムーズに進めることができる。With such a structure, the suture thread 2 sewn with the tissue can be drawn into any of the grooves 35 depending on the tissue / procedure to be sutured. That is, the groove 35 into which the suture thread 2 should be drawn can be selected. Thus, if the suture thread 2 can be drawn into the convenient groove 35, the suture can be smoothly advanced.
【００２３】また、図３の（ｇ）に示す糸止め部材４ｇ
はラッパ形状に形成されている。このような構成では、
組織を縫った縫合糸２を縫合針３とともに広い開口部３
８から糸止め部材４ｇ内に挿入して狭い開口部３９から
引き出す。Further, the thread stopping member 4g shown in FIG.
Is shaped like a trumpet. In such a configuration,
A wide opening 3 with a suture needle 3
8 to be inserted into the thread stopping member 4g and pulled out from the narrow opening 39.
【００２４】このラッパ形状の糸止め部材４ｇは、その
中に縫合糸２を完全に挿入することができるため、糸止
め部材４ｇを変形させて縫合糸２を締め込む際に縫合糸
２が糸止め部材４ｇから外れてしまうことがない。した
がって、縫合糸２の締め込みが行ない易い。また、広い
開口部３８を有するため、糸止め部材４ｇに対して縫合
糸２を通し易い。Since the suture thread 2 can be completely inserted into the trumpet-shaped thread stopping member 4g, the suture thread 2 is threaded when the suture thread 2 is tightened by deforming the thread stopping member 4g. It does not come off from the stopper member 4g. Therefore, the suture thread 2 can be easily tightened. Further, since the wide opening 38 is provided, the suture thread 2 can be easily passed through the thread stopper member 4g.
【００２５】また、図４の（ａ）に示す糸止め部材４０
は、縫合糸２を挿通可能な径の異なる複数の穴４０ａ，
４０ｂ，４０ｃと、縫った縫合糸２を係止可能な大きさ
の異なる複数の溝３５ａ，３５ｂ，３５ｃとを有してい
る。つまり、縫合糸２の太さに応じて挿通すべき穴４０
ａ，４０ｂ，４０ｃと係止させるべき溝３５ａ，３５
ｂ，３５ｃとを選択することができるように形成されて
いる。Further, the thread stopping member 40 shown in FIG.
Is a plurality of holes 40a having different diameters through which the suture thread 2 can be inserted,
It has 40b, 40c and a plurality of grooves 35a, 35b, 35c of different sizes capable of locking the sewn suture thread 2. That is, the hole 40 to be inserted depending on the thickness of the suture thread 2.
Grooves 35a, 35 to be engaged with a, 40b, 40c
It is formed so that b and 35c can be selected.
【００２６】この構成では、縫合糸２を糸止め部材４０
のいずれかの穴４０ａ，４０ｂ，４０ｃ内に挿通した状
態で結び目４１を形成して糸止め部材４０に縫合糸２を
固定する。そして、この固定状態で、組織を縫った縫合
糸２をいずれかの溝３５ａ，３５ｂ，３５ｃに係止させ
て仮止めを行なう。その後、糸止め部材４０を超音波に
よって変形させ、糸止め部材４０と縫合糸２とを結合す
る。In this structure, the suture thread 2 is fixed to the thread stopping member 40.
The knot 41 is formed in a state of being inserted into any one of the holes 40a, 40b, 40c, and the suture thread 2 is fixed to the thread stopping member 40. Then, in this fixed state, the suture thread 2 sewn with the tissue is locked in any of the grooves 35a, 35b, 35c for temporary fixing. After that, the thread stopping member 40 is deformed by ultrasonic waves, and the thread stopping member 40 and the suture thread 2 are coupled.
【００２７】すなわち、この構成によれば、溝３５ａ，
３５ｂ，３５ｃに縫合糸２を係止させることにより縫合
糸２が仮止めされるため、鉗子によって溝３５ａ，３５
ｂ，３５ｃ内に縫合糸２を引き込んだ後に鉗子を縫合糸
２から離しても、糸止め部材４０を変形させて縫合糸２
を締め込む際に、縫合糸２が溝３５ａ，３５ｂ，３５ｃ
から外れたり、縫合糸２による縫合状態が緩んだりする
ことがない。That is, according to this structure, the grooves 35a,
Since the suture thread 2 is temporarily fixed by engaging the suture thread 35 with the grooves 35a, 35c,
Even if the forceps are released from the suture thread 2 after the suture thread 2 is drawn into the b and 35c, the suture thread 2 is deformed by deforming the thread stopper member 40.
When tightening the suture, the suture thread 2 is cut into the grooves 35a, 35b, 35c.
And the sutured state of the suture 2 does not loosen.
【００２８】図４の（ｂ）に示す糸止め部材４５は、２
本の棒４５ａ，４５ｂから成り、これら２本の棒４５
ａ，４５ｂはヒンジ４６によって互いに回動自在に連結
されている。この構成では、縫合糸２によって組織を縫
った後、この縫った縫合糸２を２つの棒４５ａ，４５ｂ
の間に配置させた状態で棒４５ａ，４５ｂを閉じる。こ
の状態で、超音波により糸止め部材４５を変形させて、
縫合糸２を締め付け固定する。The thread stopper member 45 shown in FIG.
It consists of two rods 45a and 45b, and these two rods 45
The a and 45b are rotatably connected to each other by a hinge 46. In this configuration, after the tissue is sewn with the suture thread 2, the sewn suture thread 2 is attached to the two rods 45a and 45b.
The rods 45a and 45b are closed with the rods 45a and 45b placed between them. In this state, the thread fixing member 45 is deformed by ultrasonic waves,
Tighten and fix the suture thread 2.
【００２９】図４の（ｃ）に示す糸止め部材５０は、縫
合糸２が接続固定される第１の部材５１と、この第１の
部材５１に形成された突起５３と係合可能な係合孔５４
を有する第２の部材５２とから構成されている。この構
成では、縫合糸２によって組織を縫った後、この縫った
縫合糸２を２つの部材５１，５２間に配置させた状態
で、突起５３を係合孔５４に係合させることによって２
つの部材５１，５２を合体させれば、縫合糸２が締め付
け固定される。無論、この状態で糸止め部材５０を超音
波によって変形させれば、縫合強度が向上する。The thread stopper member 50 shown in FIG. 4 (c) is engaged with the first member 51 to which the suture thread 2 is connected and fixed, and the projection 53 formed on the first member 51. Aperture 54
And a second member 52 having In this configuration, after the tissue is sewn with the suture thread 2, the protrusion 53 is engaged with the engagement hole 54 in a state in which the sewn suture thread 2 is placed between the two members 51 and 52.
When the two members 51 and 52 are united, the suture thread 2 is clamped and fixed. Needless to say, if the thread fixing member 50 is deformed by ultrasonic waves in this state, the suture strength is improved.
【００３０】図４の（ｄ）に示す糸止め部材５５は棒状
部材５５ａを備えている。この構成では、縫合糸２によ
って組織を縫った後、この縫った縫合糸２を棒状部材５
５ａに巻き付けた状態で、超音波により縫合糸２と棒状
部材５５ａとを溶着させる。The thread stopping member 55 shown in FIG. 4D has a rod-shaped member 55a. In this configuration, after the tissue is sewn with the suture thread 2, the sewn suture thread 2 is attached to the rod-shaped member 5.
The suture thread 2 and the rod-shaped member 55a are welded to each other by ultrasonic waves while being wound around the 5a.
【００３１】図５の（ｂ）に示す糸止め部材６０は、筒
状に形成されており、縫合糸２を通すための小径の穴６
１を有している。なお、図５の（ａ）は糸止め部材６０
を有する縫合体２０を示している。この構成では、縫合
糸２を糸止め部材６０の小径の穴６１内に挿通した状態
で結び目６３を形成して糸止め部材６０に縫合糸２を固
定する。The thread stopping member 60 shown in FIG. 5 (b) is formed in a tubular shape and has a small diameter hole 6 for passing the suture thread 2.
One. Note that FIG. 5A shows the thread stopper member 60.
2 shows a suture body 20 having In this configuration, the knot 63 is formed in a state where the suture thread 2 is inserted into the small diameter hole 61 of the thread stopping member 60, and the suture thread 2 is fixed to the thread stopping member 60.
【００３２】図６は、糸止め部材６０を有する縫合体２
０と図１に示した縫合器本体とを用いて生体組織の縫合
を行なう様子を示したものである。すなわち、まず初め
に、開口１０を通じてシース５の先端部内に糸止め部材
６０をセットする。その後、糸止め部材６０がセットさ
れたシース５を図示しないトラカールを介して体腔内に
挿入する。そして、持針器（図示せず）で縫合針３を保
持しながら縫合すべき生体組織３０に縫合針３を刺し通
し、生体組織３０から抜け出た縫合糸２を糸止め部材６
０の内孔に引き込む（図６の（ａ）の状態）。FIG. 6 shows a suture body 2 having a thread fixing member 60.
Fig. 2 shows a state in which a living tissue is sutured using 0 and the suturing device main body shown in Fig. 1. That is, first, the thread stopper member 60 is set in the distal end portion of the sheath 5 through the opening 10. Then, the sheath 5 with the thread fixing member 60 set therein is inserted into the body cavity through a trocar (not shown). Then, while holding the suture needle 3 with a needle holder (not shown), the suture needle 3 is pierced through the living tissue 30 to be sutured, and the suture thread 2 that has come out of the living tissue 30 is fixed with the thread stopper member 6
0 (in the state of FIG. 6A).
【００３３】この状態で、今度は、鉗子３２を用いて縫
合糸２を引張り、その引張力で組織同志を接合させなが
ら、超音波プローブ６をシース５内で前進させて糸止め
部材６０に押し付けた状態で、シース５の先端を組織３
０の縫合部位に押し付ける。そして、この状態で、超音
波プローブ６からの超音波を糸止め部材６０に伝達す
る。これによって、糸止め部材６０は、超音波プローブ
６からの超音波によってその内部が発熱して軟化すると
ともに、超音波プローブ６の押圧力によって容易に変形
して縫合糸２を締め込む。この時、糸止め部材６０の変
形とともに縫合糸２を引張りながら超音波プローブ６に
よって糸止め部材６０を組織３０側に押し出してシース
５を手元側に引き戻すと、糸止め部材６０が開口１０
（シース５）の先端から抜け出て組織３０の縫合部に圧
接するとともに、組織３０に対する縫合強度が増大する
（図６の（ｂ）参照）。In this state, this time, the suture thread 2 is pulled by using the forceps 32, and while the tissue is joined by the pulling force, the ultrasonic probe 6 is advanced in the sheath 5 and pressed against the thread stopping member 60. The sheath 5 with the tip of the tissue 5
Press on the 0 stitched site. Then, in this state, the ultrasonic wave from the ultrasonic probe 6 is transmitted to the thread stopper member 60. As a result, the inside of the thread stopper member 60 is heated by the ultrasonic waves from the ultrasonic probe 6 to be softened, and the suture thread 2 is easily deformed by the pressing force of the ultrasonic probe 6 to tighten the suture thread 2. At this time, when the suture thread 2 is pulled along with the deformation of the suture stop member 60, the suture stop member 60 is pushed out to the tissue 30 side by the ultrasonic probe 6 and the sheath 5 is pulled back to the proximal side, so that the suture stop member 60 is opened.
While coming out of the distal end of the (sheath 5) and being pressed against the sutured portion of the tissue 30, the suture strength with respect to the tissue 30 increases (see (b) of FIG. 6).
【００３４】その後、縫合糸２と糸止め部材６０とをこ
の状態で体内に留置する。この時、余分な縫合糸２をハ
サミ鉗子６９（図６の（ｂ）参照）で切り取って縫合針
３とともに回収する。これによって、組織の縫合が完了
する。After that, the suture thread 2 and the thread stopping member 60 are left in the body in this state. At this time, the excess suture thread 2 is cut with scissors forceps 69 (see FIG. 6B) and collected together with the suture needle 3. This completes the suturing of the tissue.
【００３５】その後、別の組織部位を縫合する場合に
は、ハサミ鉗子６９によって切り取った縫合糸２を別に
用意した糸止め部材６０の小径の穴６１に通して（図６
の（ｃ）参照）、再度、結び目６３を形成すれば良い
（図６の（ｄ）参照）。Thereafter, when suturing another tissue site, the suture thread 2 cut with scissors forceps 69 is passed through a small diameter hole 61 of a thread stopping member 60 prepared separately (see FIG. 6).
(See (c)), and the knot 63 may be formed again (see (d) in FIG. 6).
【００３６】このような構成の糸止め部材６０では、こ
れを複数個用意しておくだけで、１本の縫合糸２を複数
箇所の縫合に繰り返し使用できるため、経済的である。
また、糸止め部材６０は、筒状に形成されており、その
中に縫合糸２を完全に挿入することができるため、糸止
め部材６０を変形させて縫合糸２を締め込む際に縫合糸
２が糸止め部材６０から外れてしまうことがない。The thread stopper member 60 having such a structure is economical because one suture thread 2 can be repeatedly used for suturing at a plurality of locations by merely preparing a plurality of thread stop members 60.
Further, since the suture fix member 60 is formed in a tubular shape and the suture thread 2 can be completely inserted therein, when the suture suture 2 is tightened by deforming the suture fix member 60. 2 does not come off from the thread fixing member 60.
【００３７】図７は糸止め部材６０の変形例を示すもの
である。図７の（ａ）の糸止め部材６０ａは縫合糸２を
挿通可能な径の異なる複数の穴６１ａ，６１ｂ，６１ｃ
を有している。この構成では、縫合に適した太さの縫合
糸２を選択した後、選択した縫合糸２の太さに対応した
径の穴６１ａ，６１ｂ，６１ｃに縫合糸２を通す。その
後、縫合糸２の末端に結び目６３を作成する。各種の太
さの縫合糸２を使用できるため便利である。FIG. 7 shows a modification of the thread fixing member 60. The thread stopper member 60a of FIG. 7A has a plurality of holes 61a, 61b, 61c having different diameters through which the suture thread 2 can be inserted.
have. In this configuration, after the suture thread 2 having a thickness suitable for suturing is selected, the suture thread 2 is passed through the holes 61a, 61b, 61c having a diameter corresponding to the thickness of the selected suture thread 2. Then, a knot 63 is created at the end of the suture thread 2. This is convenient because sutures 2 of various thicknesses can be used.
【００３８】図７の（ｂ）の糸止め部材６０ｂは口広で
先細りの溝７０を有している。この構成では、縫合に適
した太さの縫合糸２を選択した後、選択した縫合糸２の
太さに対応した深さまで、縫合糸２を溝７０に嵌め込
む。縫合糸２の末端に結び目６３を作らなくて良いため
縫合作業が楽になる。The thread stopper member 60b shown in FIG. 7B has a wide and tapered groove 70. In this configuration, after the suture thread 2 having a thickness suitable for suturing is selected, the suture thread 2 is fitted into the groove 70 to a depth corresponding to the thickness of the selected suture thread 2. Since the knot 63 need not be formed at the end of the suture thread 2, the suturing work is facilitated.
【００３９】図７の（ｃ）の糸止め部材６０ｃは幅の異
なる複数の溝７３ａ，７３ｂ，７３ｃを有している。こ
の構成では、縫合糸２の太さに応じて嵌め込むべき溝７
３ａ，７３ｂ，７３ｃを選択できるので、便利である。The thread stopper 60c shown in FIG. 7C has a plurality of grooves 73a, 73b, 73c having different widths. In this configuration, the groove 7 to be fitted according to the thickness of the suture thread 2
3a, 73b, 73c can be selected, which is convenient.
【００４０】図７の（ｄ）の糸止め部材６０ｄは鉤状に
突出する突起部７５を有している。この構成では、縫合
に適した縫合糸２を選択した後、突起部７５に縫合糸２
を結び付ける。The thread stopper member 60d shown in FIG. 7 (d) has a protrusion 75 protruding like a hook. In this configuration, after the suture thread 2 suitable for suturing is selected, the suture thread 2 is attached to the protrusion 75.
Tie together.
【００４１】図７の（ｅ）の糸止め部材６０ｅには孔７
７を有する突出部７６が形成されている。この構成で
は、縫合に適した縫合糸２を選択した後、孔７７に縫合
糸２を結び付ける。A hole 7 is formed in the thread stopping member 60e shown in FIG.
A protrusion 76 having 7 is formed. In this configuration, after the suture thread 2 suitable for suturing is selected, the suture thread 2 is tied to the hole 77.
【００４２】なお、以上説明してきた実施例では、糸止
め部材を変形させて縫合糸を締め込むことによって縫合
糸と糸止め部材との結合を行なっているが、接着、溶
着、圧着等によって両者を結合させることができること
は言うまでもない、また、上記実施例では、超音波によ
って糸止め部材を変形させているが、レーザ、ヒータ、
電磁波、電気、振動、化学反応等によっても糸止め部材
を変形させることができることは言うまでもない。In the embodiment described above, the suture thread and the thread stopping member are joined by deforming the thread stopping member and tightening the suture thread. Needless to say, it is possible to connect the thread fixing member with the ultrasonic wave in the above-mentioned embodiment.
It goes without saying that the thread fixing member can be deformed by electromagnetic waves, electricity, vibration, chemical reaction, and the like.
【００４３】なお、以上説明してきた態様により、以下
の項で示す各種の構成が得られる。 １．縫合糸が接続固定されて成り、前記縫合糸の一部を
収容可能な少なくとも１つの収容部を有する糸止め部材
と、手術部位に挿入可能で且つ前記糸止め部材を着脱自
在にセット可能なシースと、前記シース内に配設され且
つ前記シース内にセットされた前記糸止め部材を変形さ
せることによって糸止め部材の前記収容部内に収容され
た縫合糸を締め付け固定する糸止め手段とを具備したこ
とを特徴とする医療用縫合器。The configurations described above can provide various configurations shown in the following sections. 1. A suture thread is connected and fixed, and has a thread stopper member having at least one accommodating portion capable of accommodating a part of the suture thread, and a sheath that can be inserted into a surgical site and can be detachably set. And a thread stopper means for clamping and fixing the suture thread accommodated in the accommodating portion of the thread stopper member by deforming the thread stopper member arranged in the sheath and set in the sheath. A medical suturing device characterized by the above.
【００４４】２．前記糸止め手段は、超音波振動エネル
ギによって前記糸止め部材を変形させることを特徴とす
る第１項に記載の医療用縫合器。この第２項の構成によ
れば、縫合糸と糸止め部材との固定を迅速に行うことが
できる。この場合、超音波振動エネルギーは、糸止め部
材の内部を発熱させるとともに、糸止め部材同志の接触
面を溶着させる作用を有している。2. The suture device for medical use according to claim 1, wherein the suture fixer deforms the suture fix member by ultrasonic vibration energy. According to the configuration of the second item, the suture thread and the thread stopping member can be quickly fixed. In this case, the ultrasonic vibration energy has the effect of heating the inside of the thread stopping member and welding the contact surfaces of the thread stopping members.
【００４５】３．前記縫合糸が前記糸止め部材に着脱自
在に接続固定されていることを特徴とする第１項に記載
の医療用縫合器。この第３項の構成によれば、縫合糸を
術中に繰り返し使用することができる。 ４．前記糸止め部材の前記収容部は縫合糸を係止可能で
あることを特徴とする第１項に記載の医療用縫合器。3. 2. The medical suturing device according to claim 1, wherein the suture thread is detachably connected and fixed to the thread stopping member. According to the configuration of the third item, the suture thread can be repeatedly used during the operation. 4. The medical suturing device according to claim 1, wherein the accommodating portion of the thread stopper member is capable of locking a suture thread.
【００４６】[0046]
【発明の効果】以上説明したように、本発明の医療用縫
合器によれば、簡単な縫合作業によって十分な縫合強度
を得ることができる。すなわち、本発明の医療用縫合器
は、糸止め部材に形成された収容部によって縫合糸を糸
止め部材内に容易に引き込むことができるとともに、縫
合糸を収容部内に引き込んだ状態で、糸止め部材を変形
させて縫合糸を締め込むことができるため、糸止めを確
実、容易、且つ迅速に形成することができる。As described above, according to the medical suturing device of the present invention, sufficient suturing strength can be obtained by a simple suturing operation. That is, in the medical suturing device of the present invention, the suture can be easily pulled into the thread stopper by the accommodating portion formed in the thread stopper, and the suture can be stopped in the accommodating portion while the suture is retracted. Since the member can be deformed and the suture thread can be tightened, the thread stopper can be formed reliably, easily and quickly.
【００４７】また、糸止め部材を変形させて縫合糸を締
め込み結合させるため、縫合糸同志を接合して糸止めす
る場合や、熱によって縫合糸と糸止め部材とを圧着する
場合に比べて縫合強度が大きい。したがって、その後の
外力によって縫合状態が緩まったり、糸止め部材と縫合
糸との結合状態が解除されてしまうといったことがな
い。Further, since the suture thread is deformed and the suture thread is tightened and coupled, compared to the case where suture threads are joined and thread-fastened, and the case where the suture thread and the thread stop member are pressure-bonded by heat. High suture strength. Therefore, the sutured state is not loosened by the subsequent external force, and the coupled state between the suture thread and the suture thread is not released.
【００４８】また、糸止め手段と糸止め部材とをシース
内に保持した状態で糸止め手段による糸止め部材の変形
を行なわしめることができるため、縫合作業を容易かつ
確実に行なうことができる。Further, since the thread fixing member can be deformed by the thread fixing means while the thread fixing means and the thread fixing member are held in the sheath, the suturing work can be performed easily and surely.
【図１】（ａ）は本発明の一実施例に係る医療用縫合器
を構成する縫合体の構成図、（ｂ）は医療用縫合器の要
部を示す平面図、（ｃ）は医療用縫合器の要部を示す側
断面図である。1A is a configuration diagram of a suture body that constitutes a medical suture device according to an embodiment of the present invention, FIG. 1B is a plan view showing a main part of the medical suture device, and FIG. It is a side sectional view showing the important section of the suture instrument for medical use.
【図２】図１の医療用縫合器を用いて縫合作業を行なう
様子を示す図である。FIG. 2 is a diagram showing a state in which a suturing operation is performed using the medical suturing device of FIG.
【図３】縫合体を構成する糸止め部材の変形例を示す図
である。FIG. 3 is a view showing a modified example of the thread stopper member that constitutes the suture body.
【図４】縫合体を構成する糸止め部材の変形例を示す図
である。FIG. 4 is a view showing a modified example of the thread stopper member that constitutes the suture body.
【図５】縫合体を構成する糸止め部材の変形例を示す図
である。FIG. 5 is a view showing a modified example of the thread stopper member that constitutes the suture body.
【図６】図５の縫合体を用いて縫合作業を行なう様子を
示す図である。FIG. 6 is a diagram showing a state in which a suturing operation is performed using the suture body shown in FIG.
【図７】図５の糸止め部材の変形例を示す図である。FIG. 7 is a view showing a modified example of the thread stopper member of FIG.
【符号の説明】 １…医療用縫合器、２…縫合糸、３…縫合針、４…糸止
め部材、４ａ…収容溝（収容部）、５…シース、６…超
音波プローブ（糸止め手段）。[Explanation of Codes] 1 ... Medical suturing device, 2 ... Suture thread, 3 ... Suture needle, 4 ... Thread stopping member, 4a ... Housing groove (housing portion), 5 ... Sheath, 6 ... Ultrasonic probe (thread stopping means) ).
Claims (1)
糸の一部を収容可能な少なくとも１つの収容部を有する
糸止め部材と、 手術部位に挿入可能で且つ前記糸止め部材を着脱自在に
セット可能なシースと、 前記シース内に配設され、前記シース内にセットされた
前記糸止め部材を変形させることによって糸止め部材の
前記収容部内に収容された縫合糸を締め付け固定する糸
止め手段と、 を具備したことを特徴とする医療用縫合器。1. A suture thread is connected and fixed, and has a thread stopper member having at least one accommodating portion capable of accommodating a part of the suture thread; and a thread stopper member that can be inserted into a surgical site and is detachable. And a suture that is disposed in the sheath and deforms the suture stopper member set in the sheath to tighten and fix the suture thread accommodated in the accommodating portion of the suture stopper member. A suture instrument for medical use, comprising:
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP28674894A JP3587571B2 (en) | 1994-11-21 | 1994-11-21 | Medical suture device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP28674894A JP3587571B2 (en) | 1994-11-21 | 1994-11-21 | Medical suture device |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH08140982A true JPH08140982A (en) | 1996-06-04 |
| JP3587571B2 JP3587571B2 (en) | 2004-11-10 |
Family
ID=17708530
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP28674894A Expired - Fee Related JP3587571B2 (en) | 1994-11-21 | 1994-11-21 | Medical suture device |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP3587571B2 (en) |
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