JPS58175550A - 消化器官の組織体間を吻合するための外科用縫合器具 - Google Patents

消化器官の組織体間を吻合するための外科用縫合器具

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Publication number
JPS58175550A
JPS58175550A JP58027840A JP2784083A JPS58175550A JP S58175550 A JPS58175550 A JP S58175550A JP 58027840 A JP58027840 A JP 58027840A JP 2784083 A JP2784083 A JP 2784083A JP S58175550 A JPS58175550 A JP S58175550A
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JP
Japan
Prior art keywords
staple
support rod
abutment head
surgical suturing
cylindrical
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.)
Pending
Application number
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English (en)
Inventor
ルツアム・イスマイロビツチ・ウトヤミシエフ
ボリス・アンドレ−ビツチ・シミルノフ
ニコライ・ニコラエビツチ・カンシン
イワン・アレキサンドロビツチ・コロルコフ
タトヤナ・ルキヤノブナ・イワノバ
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
FUSESOYUUZUNUI NAUCHINO ISUREDOWAACHIERESUKII I ISUPUITATERUNUI INST MEDEITSUINSUKOI CHIEFUNIKI MIISUTERUSUTOWA ZUDORABOOFURANENIA
VNI I ISUPUITATERUNUI I MEDEIT
Original Assignee
FUSESOYUUZUNUI NAUCHINO ISUREDOWAACHIERESUKII I ISUPUITATERUNUI INST MEDEITSUINSUKOI CHIEFUNIKI MIISUTERUSUTOWA ZUDORABOOFURANENIA
VNI I ISUPUITATERUNUI I MEDEIT
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Filing date
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Application filed by FUSESOYUUZUNUI NAUCHINO ISUREDOWAACHIERESUKII I ISUPUITATERUNUI INST MEDEITSUINSUKOI CHIEFUNIKI MIISUTERUSUTOWA ZUDORABOOFURANENIA, VNI I ISUPUITATERUNUI I MEDEIT filed Critical FUSESOYUUZUNUI NAUCHINO ISUREDOWAACHIERESUKII I ISUPUITATERUNUI INST MEDEITSUINSUKOI CHIEFUNIKI MIISUTERUSUTOWA ZUDORABOOFURANENIA
Publication of JPS58175550A publication Critical patent/JPS58175550A/ja
Pending legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A61B17/1155—Circular staplers comprising a plurality of staples

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

(57)【要約】本公報は電子出願前の出願データであるた
め要約のデータは記録されません。

Description

【発明の詳細な説明】 本発明は医療技術に関し．更に拝しくに．消化器官の組
織体間を吻合するための外科用縫合器具に関する。
消化器官の組織体間全吻合するための従来の外科用縫付
器具は，支持ロッドを備え北部状ステーグルケースと．
筒状ステープルケース内に同軸に配置されたナイフを備
えたプランジャと．ナイフのための支持ワッシャを備え
た当接ヘッドと．筒状ステープルケース内に同軸に配置
され几ステーブル装填部と，ステープルを屈曲させるた
めの溝を備えた雌型と．ナイフを備えたプランジャに動
きを与える駆動部と．筒状ステープルケースの端及び当
接ヘッドの端の間の隙間を調整する装置とを具備してお
り，支持ロッドは筒状ステープルケース金貫通しており
．該支持ロッドの前端は筒状ステープルケースの外方に
延びており．プランジャは支持ロッドの前端に対して移
動可能に該支持ロッドに設けられており，当接ヘッドは
支持ロッドの前端に設けられており．雌型は当接ヘッド
に設けられている。
当接ヘッドの作動部分は円筒状本俸の形状′になしてお
り．該円筒状本体の端部にはステープルを曲げる友めの
覆数個の溝が円周状に配設名れている。また、円筒状本
体の端部にはナイフのための支持ワッシャを融通せしめ
る開口とナイフを受容するための別の開口とが設けられ
ている。
当接ヘッドは特殊なナツトによって支持ロッドの前端に
止着されている。
ステープル装填部は一連のステープル溝からなっており
，これらステープル＃ｌＩは筒状ステープルケースの円
周に沿って配列されており．これらステープル溝の一端
は開口していてステープルを曲げるための溝と向き合っ
ている。
ステープル溝の個数及び配置はステープルを曲げるため
の溝の個数及び配置に従って定められる。
各ステープル溝は鋭利な脚部を備えた１つの二手形金属
ステープルを融通せしめている。
プランジャの作動部分は複数個の舌片に分割された中空
円筒体からなっている。プランジャのフラップの個数及
び配置はステープル装填部のステープル溝の個数及び配
置に従って定められる。プランジャの各舌片の一部は最
初の位置においてステープル装填部のステープル溝内に
延びている。
グラ／ジャの円筒体部分の内側には組織を切開するため
のナイフが装備される。一方、プランジャの円筒部分は
支持ロッドに移動可能に設けられた中空ロッドに止着さ
れており、従って、この円筒部分はステープルケー゛ス
に沿って往復移動をすることができる。
隙間１ｍ！１！置（筒状２テーブルケースの端と当接ヘ
ッドの端との間の縫合隙間として示されている。）は支
持ロッドの軸ＶＣ４合されたナツト會具備している。そ
のナツトは筒状ステープルケースに対して移動可能に取
り付けられている。筒状ステープルケースはナツトの長
手軸周りのナツトの回転音可能ならしめている。
外科用縫合器具には筒状ステープルケースに固着された
固定ハンドルと筒状ステープルケースに枢着された可動
ハンドルとが備えられている。可動ハンドルと固定ハン
ドルとの□間には戻しばねが配置されている。ナイフを
備えたプランジャに動きを与える駆動部は本質的に可動
ハンドルである。
この可動ハンドルはプラ′ンジャの軸部の壽に係合して
いる。
上述した外科用縫合器具は矢のように作動する。
手術の前に、ステーグル装填部にコ字形金属ステープル
が装填される。即ち、１つのステープルはその鋭利な脚
部が当接ヘッドの方を向くように各ステーブル装一部の
ステープル溝内に挿入される。支持ワッシャが当接ヘッ
ドの穴内に配置され。
その後、圧縮リングが当接ヘッド及び筒状ステープルケ
ースに取り付けられる。その後、外科用縫合器具は滅菌
処理されて手術室に運ばれる。
手術の進行中に外科用縫合器具の作動部分が縫合される
べき筒状組織体（例えば人体の肛門のような人体の開口
部）内に挿入される。
隙間調整装置のナツトを反時計方向に回わすと当接ヘッ
ドは筒状ステープルケースから離れる。
縫合部れた筒状組織体の両端は手術において一般に用い
られる縫合ひ鬼゛によって接合される。縫合された筒状
組織体の一端は支持ロッド上の当接ヘッドの周りに縛り
付けられ、縫合された筒状組織体の他端は支持ロッド上
の当接ヘッドを包む。その後、隙間調整装置のナツト會
時計方向に回わすと、当接ヘッドが筒状ステープルケー
スの方に移動して縫合隙間＋ｍ状ステーブルケースの端
と当接ヘッドの端との間の隙間）を形成する。この隙間
は０通常０組織をび−）たりと接合させてコ字形金属ス
テープルによる引張りを避けるように選定される。
可動ハンドルに加えられる圧力により、ナイフを備え友
グランジャが支持ロッドの細部に沿って当接ヘッドの方
に押される。同時に、プランジャの舌片）ぶコ字形金属
ステープルをステープル溝から押し出す。ステープルの
鋭利な脚部が圧縮リングと縫合すべき組織と全貫通した
後、ステープルの脚部はステープルを曲げるための溝に
当接して８字形に曲がり９組織を圧縮リングにしっかり
と固定ゼしめる。同時に、ナイフが弾性基台上で組織を
切開することにより所望の吻合を達成する。
組織の切開時にナイフは弾性基台内に食い込むので１作
動の信頼性が＾まる。
吻合の形成及び縫合は以上のようにして完成する。縫合
の最終段階を経た後、隙間調整装置のナツトを反時計方
向に回わすと、当接ヘッドが筒状ステーグル装填部￥ｉ
されて外科用縫合器Ｊａｌｌは筒状組織から退去せしめ
られる。
公知の外科用縫合器具の欠点は、縫合処置後の当接ヘッ
ドを吻合開口部から退出姑せる処置の複雑さにある。な
ぜなら、ナイフによって形成された開口部の直径は該開
口部を取り囲む円周状ステープル縫合部の直径よりも小
さく、一方、ステープル縫合部の直径は当接ヘッドの外
径よりも小さいからである。当接ヘッドは特に圧縮リン
グで形成された吻合部内を通して退出させることが離か
しい。このため、吻合箇所の組織に更に別の外傷が生じ
ることとなる。
本発明の目的は、いかなる種類の吻合用ステープル（単
針型、二針型等）を用いる場合で６つでも外科用縫合器
具の非外傷性退去を確保し得る。
消化器官の組織体間の吻合を行なうための外科用縫合器
具を提供することにある。
本発明の別の目的は、ステープル及び圧縮による吻合処
理の変化範囲を確保し得る外科用縫合器具を提供するこ
とにある。
本発明の更に別のＩＬ要な目的は、密閉性及び止血性の
吻合を確保し得る外科用縫合器具に提供することにある
。
本発明の更に別のＪ［要な目的は、縫合手術後の縫合部
の無効音減少ざぜることができる。消化器官吻合用縫合
器具を提供することにある。
本発明の主たる目的は、縫合処理の完了時に筒状組織体
内で自動的に吻合開口部よりも小さいサイズの構成部品
に分解することができる当接ヘッドを提供することにあ
る。このような当接ヘッドによれば、各攬のステープル
及び圧縮吻合のための吻合処置の後の外科用縫合器具の
脱退ｒ９組織に外傷を与えることなく行なうことができ
る。また、密閉性及び止血特性の良好な吻合を行なうこ
とができ、更に、縫合処置後の縫合部の無効を減少させ
ることができる。
上６己目的は、支持ロッドを備えた筒状ステープルケー
スと、１！ｉ状ステープルケース内に同軸に配置された
ナイフを備えたプランジャと、ナイフのための支持ワッ
シャを備えた当接ヘッドと、筒状ステープルケース内に
同軸に配置されたステーグル装填部と、ステープルを屈
曲させるための＃を備えた雌型と、ナイフ全備え九プラ
ンジャに動きを与える駆動部と、筒状ステーブルケース
の端及び当接ヘッドの端の間の隙間′１ｒｉｉｌ！ｌ整
する装置とを具備し、支持ロッドは筒状ステーブルケー
スを貫通して該支持ロッドの前端は筒状ステープルケー
スの外方に延び、プランジャは支持ロッドの前端に対し
て移動可能に該支持ロッドに設けられ、当接ヘッドは支
持ロッドの前端に設けられ、雌型は当接ヘッドに設けら
れている。消化器官の組織体間の吻合を行なうための外
科用縫合器具において。
前記当接ヘッドは互いに軸方向に離脱可能な内側部材と
該内側部材を取り囲む外側部材とを備えており、内側部
材は支持ロッドの前端に設けられており、外側部材は相
互に離脱可能な萱からなっており、前記当接ヘッドは更
に、外側部材の台が内側部材から半径方向に離脱しない
ように該内側部材と台との保合面に沿って内側部材と台
とを相互に噛み合わせる装置を備えていることを特徴と
する。消化器官の組織体間の吻合を行なうための外科用
縫合器具により達成される。
この外科用縫合器具の利点は当接ヘッドの独特の構成に
あり、この当接ヘッドは９例えばステープル及び圧縮に
よる攬々の吻合処置の終了後の外科用縫合器具の非外傷
性退出を確保せしめ、また。
縫合部の密閉性及び止血特性を良好ならしめることがで
き、更に、縫合処置後の縫合部の無効を減少せしめるこ
とができる。
当接ヘッドは他の種々の実施態様に有する。例えば、当
接ヘッドは内側部材を単独の部品として有することなし
に作られ得る。この場合、当接ヘッドは支持ロッドの前
端ｔ−取り囲む相互離脱可能な部品からなる外側部材を
含む。そして、当接ヘッドに、外ｌｌ１１部材の構成部
品が支持ロッドの前端部から半径方向に＃ｌｌ脱しない
ように該支持ロッドの前端部と外ｉ＆１ｌＩｓ材の構成
部品との保合面に沿って支持ロッドと外側１部材の構成
部品とを相互に噛み合わせる装置を含む。
内側部材と外側部材の台との相互噛み合せは。
内偵部材に形成した中−擲と、外側部材の台に形成した
キーとの保合により行なうことが好ましい。
支持ロッドはその前端と筒状ステープルケースとの間に
位置する長手方向溝を備えていることが好ましい。この
長手方向溝は板ばねｔ融通せしめるようになっている。
板ばねの一方の端はプランジャに堅固に結合され、板ば
ねの他方の自由端には歯が設けられる。そして、外側部
材の複数個の台のうちの１つには板ばねの歯が係合する
よりに形成された嵌合突起が設けら１する。板ばねの歯
と台の嵌合突起との係合により、複数個の台の軸方向移
動が可能となる。
離脱可能な複数個の台を一時的に相互連結せしめる装置
（はぞとほぞ溝）を設けることが好ましい。
離脱可能な台に耳部を設け、内側部材にはひもを通す開
口倉設けて当接ヘッドの分解時に外側部材の台と外科用
縫合器具とを相互連結状態に維持することができるよう
にすることが好ましい。
筒状ステーブルケースの漏面及び該端ｍｖｃ対向する当
接ヘッドの端面に圧縮リングを他〈装着することが同様
に好ましい。
以−ド１図面ｔ＃照して本発明の詳細な説明する。
なお、以下の説明において９図面中の同一の構成要素に
は同一の参照符号が付されている。
消化器官の構成物量ｔ−接合するための外科用縫合器具
（第１図）は、支持ロッド２を備えた筒状ステープルケ
ースｌと、ナイフ５°を備えたプランジャ４と、ナイフ
５用の支持ワッシャ７會備えた当接ヘッド６と、ステー
ブル装填部８と、ステーブルｌｌ′に屈曲させるための
溝１０に−備えたＳ型９と’ｔ−ｘ備しており、支持ロ
ッド２は尚状ステーブルケースｌｔ−買通しており、支
持ロッド２の前端３は筒状ステープルケースｌの外方に
延びている。ナイフ５は筒状ステーブルケースｌ内に同
軸に配置されている。支持ワッシャ７は支持ロッド２の
前端３に設けられている。゛ステープルＩｉＩ填部８は
筒状ステープルケースｌ内に同軸に配置されている。雌
ａ！１９は当接ヘッド６に設けられている。
外科用縫合器Ｘに更にナイフ５を備えているプランジャ
４に動きを与える駆動１１ｓ１２と、筒状ステープルケ
ース１の端１５と当接ヘッド６の端１６との間の隙間ｔ
−ｎ＊するための装置１３と會具備している。
筒状ステープルケースｌに止着されたアーム１７には固
定ハンドル１８と戻しばね２０を備えた可動ハンドル１
９とが設けられる。可動ノーンドル１９は軸２１を介し
てアーム１７に枢着されている。
筒状ステープルケースｌの端２２には開口２４を備えた
突起２３が設けられている。突起２３の側面にはピン２
６が止着されている。
支持ロッド２の前端３及び柄部２７にはねじが形成され
ている。
支持ロッド２はその前端３と筒状ステープルケースｌと
の間に作られた長手方向溝２８を具備している。
プランジャ４は本質的に中空のシリンダ２９を具備して
いる。このシリンダ２９は複数個の舌片３０に分割され
ており、且つ、中空ロッド３１Ｃ）端に止着されている
。中空ロッド３１の他端には二叉部３２が形成されてお
り、この二叉部３２Ｆｉプランジャ４を可動ハンドル１
９の端３３に係合さゼるようになっている。
プランジャ４の中空シリンダ２９Ｋｔ！鋭利な端縁３４
を備えた筒状中空ナイフ５が設置されている。
プランジャ４は筒状ステープルケースｌ内に同軸に配置
式れており、支持ロッド２は中空ロッド３１内に配置さ
れている。
当接ヘッド６は軸方間に離脱可能な２つの部材。
即ち、内側部材３５と外側部材とからなっている。
外９１１ｔ！！５材は内側部材３５を取り１んでおり、
且つ。
相互に離脱可能な台（３６，３７，３８及び３９）から
なっている（第２図）。
当接ヘッド６は、外１１１１部材の台３６．３７．３８
゜３９が半径方向ＶＣ！′位しないように内ａｍ材３５
と外側部材の台３６．３７．３８．３９とをそれらの係
合面に沿って相互に噛み合せる装置を備えている。
この相互噛合Ｊ＃ｒ装置は６内情部材３５の本体に形成
されたキー＃１Ｉ４０，４１．４２．４３と、これらの
キー１１１４０，４１，４２．４３に係合するΦ−４４
゜４５．４６．４７とからなる。キー４４．４５．４６
．４７は外側部材の台３６．３７，３８．３９に形成さ
れている。
外側部材には、離脱可能な台３６．３７．３８．３９を
一時的に連結して一体構造を形成するための装置が備え
られている。
すなわち、台３６，３７．３８には、当接ヘッド６が支
持ロッド２に設けられたときに台３７．３８゜３９の穴
（はぞ穴１５１．５２．５３に嵌まる突起（はぞ）４Ｂ
、４９．５０が備えられている。
支持ロッド２の長手方向溝２８　（第１図）は板ばね５
４を融：Ｉ！Ｂせしめるように形成場れている。
板はね５４の一方の端はプランジャ４に堅固に結合され
ており、板はね５４の他方の自由端には歯５７が備えら
れている。
外側部材の台３６　（第３図）にＦｉ嵌合突起５８が備
えらルている。この嵌合突起５８は、歯５７と嵌合突起
５８とによって形成される保合組体によって台３６．３
７，３８．３９の軸方向移動が許容されるようなやり方
で歯５７に係合するようになっている。
当接ヘッド６の内側部材３５Ｆｉｄ内側部材３５の長手
軸の周りに回転可能に取り付けられるナット５９１ｒ融
通ぜしめる役割を果す。ナツト５９には円周溝６０が形
成されている。との円周溝６０はピン６１の先端に係合
しており、このピン６１により、ナツト５９けその長手
軸方向に変位しないように止めらｎている。台３６．３
７．３８．３９（第２図）にはナイフ５を受容する円周
溝６２（第３図）が備えられており、且つ１弾性支持ワ
ッシャ７ｔＭ通せしめるよりに形成された穴６３が備え
られている。
・肩４図ｆｒ＃照すると一、ｍ脱可能な台３６．３７゜
３８、３９　　を台３９＆：を第４図には示されていな
い）には耳部６４が備えられており、内側部材３５には
ひも６６を通す開口６５が備えられている。ひも５ＳＦ
ｉ外側部材の台３６．３７，３８．３９及び外科用縫合
器具を当接ヘッド６０分解時に相互連結状態に保つため
のものである。
ステープルを曲げるための溝１０（第１図）は当接ヘッ
ド６の外側円周に沿っている雌型９に沿って、平面方向
に見食場合にほぼ円を描くように一定ピッチ間隔で配列
されている。
ステープル装填部８は筒状ステ７プルケース１内に同軸
に配置されており、このステーブル！Ｉ横部８は筒状ス
テープルケース１の円周に沿って配列された一連の長手
方向のステープル＄６７からなっている。このステープ
ル溝６７の個数及び配置は当接ヘッド６に形成されるス
テープル屈曲用の溝１０の個数及び配置に対応している
。各ステープル１１１６７はコ字形金属ステープル１１
とプランジャ４の舌片３０とを収容する。したがって。
舌片３０の個数及び配置はステープル＃Ｉ６７の個数及
び配置、並びに、ステープル屈曲用の溝１０の個数及び
配置に対応している。
プラ、ンジャ４に動きを与える駆動部１２は筒状ステー
プルケースｌのアーム１７に枢着された可動ハンドル１
９を本質的に具備している。この可動ハンドル１９０端
３３はプランジャ４の中空１ツド３１の二叉ｓ３２と係
合している。
筒状ステ１−プルケースｌの端１５とａｍヘッド６の端
１６との間の隙間１４を調整する装置１３はナツト６８
である。このナツト６８はナツト６８の長手方向軸の周
りに回転可能に筒状ステープルケースｌに取り付けられ
ている。
ナツト６８は支持ロッド２の柄部２７に蝶合されている
。
ナラ、トロ８には円周溝６９が設けられておｏｌこの円
周溝６９はナツト６８の長手軸方向の変位を防止する定
めのピン２６の端が係合するように形成されている。
外科用縫合器具（第１図、第２図及び第４−〉には弾性
圧縮リング７０が備えられている。弾性圧縮リング７０
は筒状ステープルケースｌの端面１５と当接ヘッド６の
端面１．６とに弛〈装着されていて互いに対向している
。断面で示されているように０弾性圧縮リング７０はコ
字形状ｔ−なしているので筒状ステープルケースｌ及び
当接ヘッド６に定置させておくことができる。
上記外科用縫合器具の作用は以下の通りである。
使用のための準備： 各ステープル溝６７にはコ字形金属ステープルが適合し
ている。このステープルには、ステープルの鋭利な脚部
が雌型９の方に向くように特殊な鉗子が用いられている
。
台３６は、キー４４（第２図）がキー溝４０内に適合す
るようなやり方で当接ヘッド６の内側部材３５の上に装
着される。台３６は概ねナツト６８（１１１図）の方向
に動かせば動く。久いで１台３７のキー４５がキー溝４
０内に適合するように台３７が装着される。この場合１
台３１エナツト６８　（第１図）の方向に全範囲にわた
って前進せしめられ、ついには台３６の突起４８に突き
当る。
次に１台３８のキー４６がキー＄４２（第２図）内に適
合するように台３８が装着される。その後。
台３８はナラ）６８（、ｉｌ１図）の方向に前進せしめ
られて台３７の突起４９に突き轟る。
その後９台３９のキー４７が中−＄４３（ＪＩ２図）内
に適合するように台３９が装着され、その後９台３９は
概ねナツト６８　（第１図）の方向に全範囲にわ逢って
前進ぜしめられて台３８の突起５０に突き当る。
支持ワッシャ７＃−１当接ヘツド６の穴６３内に挿入さ
れる。
筒状スジ−プルケースｌの端及び当接ヘッド６の端には
圧縮リング７０が適合せし７められる。
当接ヘッド６は支持ロッド２の前端３上に置かれ、その
後、ナツト５９を時計方向に回わすことにより適所に位
置決めされる。耳部６４（ＪＥＢ図）内の開口及び内側
部材３５の開口６５にはひも６６が通され、谷開口のそ
ばでひも６６の結び目７１が作られる。こうして、全て
の台３６．３７゜３８．３９はひも６６によって外科用
縫合・具′に連結される。
組立後、外科用縫合器具には滅１処理が施こされる。
使用方法： 外科用縫合器具（第１図及び第３図）は中空組織体１例
えば直場内に肛門から挿入される。
ナット６８′ｆｒ反時針方向に囲わすことにより。
支持ロッド２は筒状ステープルケースＩＫ沿って前進ぜ
しめられ、これにより、当接ヘッド６は筒状ステープル
ケース１から遠ざけられる。
巾着縫合が中空組織体（７２）の両端部（４３図）Ｋ施
こされ９次いで、支持ロッド２の周りに結紮される。
ナツト６８　（第１図）の反時計方向回転により。
当接ヘッド６が筒状ステープルケースｌに近づいて縫合
隙間１４　（筒状ステープルｆ、の端１５と当接ヘッド
６の端１６との間の隙間）金形゛成する。
次に、ｏＪ動ハンドル１９が押されて軸２１の回りに回
わされる。その動きは可動ハンドル１９の端ｊ３ｔ−介
して中空ロッド３１の二叉部３２に伝達され、これによ
り、ナイフ５ｔ−備えたプランジャ４及び板ばね５４が
当接ヘッド６の方向に延ばされる。
プランジャ４の作動中にグランジャ４の舌片３０がステ
ープル１１’ｉス？−プル＃１Ｉ６７　（７４３図）の
外に押し出す。ステープル１１はステープルの鋭利な脚
部が圧縮リング７０及び縫合すぺ自器官組織を貫通した
後、雌型９のステープル屈曲用＄１１０に当って止まり
、引き続き８字状に―けられて器官組織を圧縮リング７
０にしっかりと結合させる。
同時に、鋭利な端縁３４を備えたナイフ５４弾性支持ワ
ッシャ７に対し器官組織を押圧し、ａ盲組織を貫通して
器官組織に円形開口を形成せしめる。
この段階で歯５７を備えた板ばね５４（５１１３図）が
台３６゛の突起５８に係合する。
ナツト６８の回転により当接ヘッド６が筒状ステープル
ケースｌから離される。しかし０台３６は嵌合突起５８
によって板ばね５４に係合せしめられているので、その
位置に維持される。そして。
＃ＮＡｆＩ！ヘッド６の内側部材３５は筒状ステープル
ケースｌから離される。
台３６との結合により９台３７，３８．３９もまたキー
４４．４５，４６．４７がキー溝４０．４１．４２．４
３に保合している間中突起４８，４９，５０　（４４２
図）によって台３６に係合した状態でその位置に線片さ
れる。
＊　−４４，４５，４６，４７カ内１１ｍ材３５　ノ＊
−溝４０、４１．４２．４３から離れると直ちに０台３
６゜３７．３８．３９はひも６６につながれて分離状態
になり、ひも６６によって外科用縫合器具に取り付けら
れた輪（ｇａｒｌａｎｄ　＋　となる。　このような輪
はナイフで予め切開された小さな開口から吻合に支障を
来たすことなく容易に取り除かれる。
以上により１手術後の縫合部の無効及びそれによる死亡
を減少させることができる。
以上１本発明の好ましい実施例について説明したが９％
許請求の範囲及び精神から逸脱しない限りにおいて種々
の変更を加え得ることは当業者にとって明らかであろう
。
【図面の簡単な説明】
第１図は消化器官の組織体間の吻合を行なうための外科
用縫合器具を示す概略部分縦断面図、８２図は第１図中
の■−厘線に沿った外科用縫合器具の横断面図、第３図
は吻合前の外科用縫合器具の当接ヘッドの拡大縦断面図
　＠４図は外科用縫合器具の当接ヘッドを示す部分側面
図である。 ｌ・・・筒状ステーブルケース ２・・・支持ロッド ３・・・支持ロッドの前端 ４・・・プランジャ ５・・・ナイフ ６・・・当接ヘッド ７・・・支持ワッシャ ８・・・ステープル装填部 ９・・・雌型 ｌＯ・・・ステープル屈曲用壽 １１・・・ステーブル １２・・・ナイフ金偏えたプランジャに勧きｔ与える躯
動部１３・・・筒状ステープルケース及び当接ヘッド間
の隙間を調整する手段 １４・・・ケース及びヘッド間の隙間 １５・・・ケースの端 １６・・・ヘッドの端 ２８・・・支持ロッドの長手方向溝 ３５・・・当接ヘッドの内側部材 ３６、３７．３８．３９・・・外側部材の台４０、４１
．４２．４３・・・キー溝 ４４、４５．４６．４７・・・キー ４８．４９．５０・・・はぞ。 ５１、５２．５３・・・はぞ穴 ５４・・・板ばね ５５・・・板ばねの端 ５６・・・板ばねの自由端 ５７・・・板はねの歯 ５８・・・嵌合突起 ６４・・・耳部 ６５・・・内ｍ部材の開口 ６６・・・ひも ７０・・・圧縮リング 特許出−人 ブセソジ、ズニー　ナウチノーイスレト５＜チルスキー
　イイスピタテルニー　インステイテ、−ト　　メデイ
ツイニスコイテヒニキ ｔ＃許出顧代理人 弁理士　背　水　　　朗 弁理士　！２ｉｍ　　和　之 弁理士　中　山　恭　介 弁理士　　山　　口　　昭　　之 第１頁の続き ／ＥＪ ンシン ソ連国モスクワ・ウリツア・マ ラヤ・フイレブスカヤ絽りワル− チーラ１０ ０発　明　者　イワシ・アレキサンドロピッチ・コロル
コフ ソ連国モスクワ・ウリツア・ポ リャルナヤ５２コルプス２クワル チーラ１７４ ０発　明　者　タトヤナ・ルキャノブナ・イヮノバ ソ連国モスクワ・ウリツア・ポ リャルナヤ５２コルプス３クワル チーラ４０８

Claims (1)

  1. 【特許請求の範囲】 １、支持ロッド（２）を備えた筒状ステープルケ−Ｘ（
    １）ト、ｉｌ状ステープルケース（１）内に同軸に配置
    されたナイフ（５）を備えたプランジャ（４）と、ナイ
    フ（５）のための支持プツシ中（７）を備えた当接ヘッ
    ド（６）と、筒状ステープルケース（１）内に同軸に配
    置されたステープル装填部（８）と。 ステープル（１１）を屈曲させるための溝（１０）を備
    えた雌截（９）と、ナイフ（５）ｔ″備えたプランジャ
    （４）に動きを与える駆動部（１２）と、筒状ステープ
    ルケース（１）の端（１５）及び当接ヘッド（６）の端
    （１６）の間の隙間（１４）ｔ−調整する装置（１３）
    とを具備し、支持ロッド（２）は筒状ステープルケース
    （１）ｔ−貫通して該支持ロッド（２）の前端（３）は
    筒状ステープルケース（１）の外方に延び、プランジャ
    （４）は支持ロッド（２）の前端（３）に対して移動可
    能に該支持ロッド（２）に設けられ、当接ヘッド（６）
    は支持ロッド（２）の前端（３）に設けられ。 雌ＩＤ９）は当接ヘッド（６）に設けられている。消化
    器官の組織体間の吻合を行なうための外科用縫合器具に
    おいて。 前記当接ヘッド（６）は互いに軸方向に離脱可能な内側
    部材（３５）と該内側部材（３５）を取り囲む外側部材
    とを備えており、内側部材（３５）は支持ロッド（２）
    の前端（３）に設けられており、外側部材は相互に離脱
    可能な台（３６，３７，３８，３９）からなっており、
    前記当接ヘッド（６）は更に、外側部材の台（３６，３
    ７，３８，３９）が内側部材（３５）から半径方向に離
    脱しないように該内側部材（３５）と台（３６，３７，
    ３８，３９）との保合面に沿って内側部材（３５）と台
    （３６，３７，３８，３９）　とを相互に噛み合わせる
    装置を備えていることを特徴とする。 消化器官の組織体間の吻合を行なうための外科用縫合器
    具。 ２、内側部材（３５）と外側部材の台（３６，３７゜３
    ８．３９１　　と會噛み合わす装置は、内側部材（３５
    ）に形成されたキー溝（４０，４１，４２，４３）と０
    台（３６，３７，３８，３９）に形成され且つキー溝（
    ４０゜４１、４２．４３）に係合するキー（４４，４５
    ，４６，４７）とからなりている％ｆｆ−求の範囲第１
    項記載の外科用縫合器具。 ３、　支持ロッド（２）には支持ロッド（２）の前端（
    ３）と筒状ステープルケース（１）との間に位置する長
    手方向溝（２８）が設けられており、該長平方向溝（２
    ８）は板ばね（５４）を融通せしめるようになっており
    、板ばね（５４）の一方の端はプランジャ（４）に堅固
    に結合されており、板ばね（５４）の他方の自由端（５
    ６）には歯（５７）が設けられており。 前記外側部材の台（３６，３７，３８，３９）のうちの
    １つにＦｉ歯（５７）と保合可能な嵌合突起（５８）が
    設けられており、該嵌合突起（５８）と−（５７）との
    保合によって台１３６．３７．３８．３！ｊ）の軸方向
    の移動が可能となっていることｔ特徴とする特許請求の
    範囲＠１１項記載外科用縫合器具。 ４、離脱可能な台＋３６．３７．３８．３９）を一時的
    に相互連結せしめるためのほぞ（４ｇ、　４９．５０）
    とほぞ穴（５１，５２，５３３が台（３６，３７，３８
    ，３９）間に設けられていることｔ−特徴とする特許請
    求の範囲第３項記載の外科用縫合器具。 ５、離脱可能な台（３６，３７，３８，３９）　Ｋは耳
    部（６４）が設けられており、内側部材（３５）には。 当接ヘッド（６）の分解時に外科用縫合器具と外側部材
    の台＋３６．３７．３８．３９１　とｆｔ相互連結状態
    に保つためのひも（６６）を通す開口（６５）が設けら
    れていることを特徴とする％ｆｆ１ｉ１！求の範囲第１
    項から第４項までのいずれか１つに記載の外科用縫合器
    具。 ６、筒状ステープルケース（１）の端面（１５）　（’
    置端ｄｉ　（１５）に対向する当接ヘッド（６）の□端
    面とにそれぞれ圧縮リング（７０）が弛〈装着されてい
    ることを特徴とする請求 外科用縫合器具。
JP58027840A 1982-02-23 1983-02-23 消化器官の組織体間を吻合するための外科用縫合器具 Pending JPS58175550A (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SU823400255A SU1114405A1 (ru) 1982-02-23 1982-02-23 Хирургический сшивающий аппарат дл наложени компрессионных анастомозов на органы пищеварительного тракта
SU3400255 1982-02-23

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Publication Number Publication Date
JPS58175550A true JPS58175550A (ja) 1983-10-14

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JP58027840A Pending JPS58175550A (ja) 1982-02-23 1983-02-23 消化器官の組織体間を吻合するための外科用縫合器具

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US (1) US4505272A (ja)
JP (1) JPS58175550A (ja)
CA (1) CA1192467A (ja)
SU (1) SU1114405A1 (ja)

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CA1192467A (en) 1985-08-27
US4505272A (en) 1985-03-19

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