JPS59103667A - Fixing of vacuum type blood removing cannula - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention fixes the cannula insertion portion to the organ wall when inserting a blood removal cannula into the atrium wall or blood vessel wall and removing blood under reduced pressure in heart surgery. The present invention relates to a method and a vacuum blood removal cannula used in the method.

Conventionally, when a cannula for blood removal is inserted into an atrium wall, a blood vessel wall, etc. and blood is removed, the cannula insertion part is fixed to the organ wall, as shown in Fig. 1. The collar is inserted into the hole made in the organ tissue wall 11, and the tissue wall around the outer periphery of the cannula (this suture system is sutured continuously along the outer periphery to the 13th station, the so-called "Kinchaff suture"). " or "tobacco suture" is used, and both ends of this suture system 10 are pulled to tighten the tissue wall to the outer periphery of the cannula. In addition, a plurality of flanges 2, 2 as shown in FIG. A cannula with a cannula 2' is also used, but the flange 2' located on the outside of the set W&wall is only used to prevent the cannula insertion part from being inserted too deeply and to fix the suture system to the flange. .

Such conventional cannulae are used only when the blood pressure within the tissue wall is equal to normal venous pressure or atmospheric pressure. In other words, if blood is removed by suction using a sutured cannula until the blood pressure falls below the external pressure, air will be suctioned through the needle hole in the tissue wall during suturing, creating air bubbles in the blood, and these air bubbles will cause fatal emboli. This is because it will occur.

Furthermore, sealing of the tissue wall due to blood coagulation that occurs during the suturing is also unpredictable because a large amount of anticoagulant is administered when such blood removal operation is performed.

With recent advances in medical science, it has become necessary for doctors to remove Okawa's blood by suction, and this has created a demand for blood removal by reducing the internal pressure of the cannula below the external pressure. The present invention satisfies these requirements and is intended to prevent air leakage from the 0-through hole in the wall of the assembly due to the suture needle. To provide a method for easily and reliably fixing a cannula insertion part to an organ wall without a gap by sandwiching an organ wall suture part therebetween and pressing and holding a fixing tool, and to provide a decompression type blood removal cannula suitable for this method. It is something.

That is, in the method of the present invention, the organ hole wall into which the cannula is inserted is held between the flange of the cannula and the pressing portion of the fixing device, and the organ hole wall is held in a depressed state via the fixing device.
This is to secure the cannula to prevent air leakage at the joint.

An embodiment of a cannula suitable for applying the method of the present invention will be described with reference to FIG. 3, which shows a cross-sectional view of the insertion part thereof. A fixture 4 movable along the tubular part 3 of the cannula on the side opposite the insertion tip is mounted on said tubular part G.

The fixture 4 consists of a flange-like pressing part 6 having a shape and size corresponding to the shape and size to abut against the flange, and a fitting part 5 that is fitted into the tubular part 3 and slides. teeth,
It needs to be flexible and have appropriate elasticity so that it can press against the organ wall when it comes into contact with the organ wall and not damage the organ wall. This fixation method using a cannula involves inserting the insertion part 1 of the cannula into the hole wall of the organ, suturing the hole wall inside the cannula with, for example, the suture thread 10 using the previously described method, and then tightening the forceps 4. The organ tissue wall 11 is held in the tubular part of the cannula at a position sufficiently close to the flange so that the organ tissue wall 11 is sandwiched and pressed between the flange 2 and the pressing part 6. The fitting portion 5 is used as a holding portion for the cannula tubular portion.

That is, the outer periphery of the insertion part 5 is wound and tightened with the suture system 10'.

Alternatively, the tubular part is threaded, and the holding part (fitting part) is provided with a female thread that engages with the thread, and the cannula is pressed forward along the thread and stopped at a desired position, and is fixed using the friction of the thread. A guide groove is provided in the axial direction in the tubular part and a lock groove is provided laterally at the tip of the guide groove, while the holding part (
It is also possible to provide a protrusion that slides in the guide groove on the insertion part, advance the protrusion to the tip, press the organ wall, rotate the fixture, and lock the protrusion of the holding part.

FIG. 4 shows another embodiment of the cannula, in which the fixing device is a floating ring-shaped balloon, which consists of a fitting part 5 that fits into the tubular part of the cannula and an annular wall, and the part facing the organ tissue wall is expandable. When fluid is injected from the tube 9 connected to the balloon, it comes into contact with the organ tissue wall and forms a pressing part 6.

The method for fixing the cannula is to insert the cannula into a hole in the organ wall, suture the hole wall using the method described above, bring the fixing device close to the sutured portion, inflate the balloon through the tube 9, and inflate the tissue at the organ sutured portion. When pressing against the wall, the insertion part also strongly presses the tubular part of the cannula due to internal pressure, and acts as a holding part for the tubular part of the cannula.

FIG. 5 shows another example of a cannula, in which the fixture 4 is attached to the periphery 7. It consists of a fitting part 5 which is elastically tightly fitted into the skirt part 8 and the cannula tubular part and also serves as a holding part. After inserting the cannula into the organ wall hole, the hole wall is sutured using the method described above.
As shown by the dotted line in the figure, the skirt portion can be inverted using its flexibility and elasticity, so it does not become an obstacle to suturing. After suturing, when the skirt portion 8 is turned over again to return to its original shape, the peripheral edge portion 7 is pressed against the tissue wall due to the elasticity of the skirt portion to form a pressing portion 6. In this cannula, by connecting the tube 9 to the skirt portion of the fixture, for example, physiological saline is sealed into the skirt portion from the outside, and the presence or absence of a drop in the position of the reel surface of the tube is monitored.
The cannula suture can be checked for leakage, and even if there is a leak, no problem will occur because the physiological saline will permeate through the suture. Furthermore, if a thrombin solution is sealed in place of physiological saline, even if there is a leak at the suture, the clotting action of thrombin will clot the blood in the leak area and occlude it. be. The fixing device used in the method of the present invention needs to have appropriate flexibility and elasticity so as to press the organ wall sufficiently and not to damage it. For example, it can be molded using soft vinyl chloride resin or silicone rubber, or it can be molded using urethane rubber or the like as a closed-cell sponge, an open-cell sponge molded product with an airtight surface, or the like.

According to the method of the present invention, the sutured tissue wall is sandwiched between the flange of the cannula and the fixing device, and the sutured tissue wall is pressed and held, so that airtightness is maintained in conjunction with the flexibility and elasticity of the tissue wall, and no gaps are created and no force is applied. There is no risk of air bubbles being mixed into the blood during vacuum blood removal using the vacuum cleaner. In addition, the holding operation of the fixing device provided on the cannula used in the present invention is extremely easy, does not require a high level of skill, and can be carried out in a short time. The cannula can be fixed in almost the same amount of time as other systems.

[Brief explanation of drawings]

FIGS. 1 and 2 are longitudinal sectional views showing a conventional method of suturing a cannula to an organ wall, and FIGS. It is a front view. 1... Cannula insertion part. 2.2'... collar part, 3... tubular part. 4...Fixing tool, 5...Fitting insertion part. 6... Pressing part, 7... Peripheral part. 8...Skirt part. 9...Tube. 10, TO'...suture system. 11... Organ tissue wall. Figure 1 Figure 2
Figure 1υ Figure 5

Claims (1)

[Scope of Claims] 1. In a method for inserting and fixing an insertion part of a cannula with a flange into a wall hole of an organ, a tubular part provided in series with the flange of the insertion part and connected to the insertion part; To the FaM wall of a decompression blood removal cannula, the hole wall of the organ is held between the collar and the suppressing part using a fixture having a pressing part covered on the outer periphery of the cannula. fixing method. 2. A cannula having a flange in the insertion portion, and a pressing portion having a flexible and elastic shape and having a shape capable of abutting against the flange, on the tubular outer peripheral portion on the opposite side of the flange and the insertion portion; 1. A decompression blood removal cannula, characterized in that it is equipped with a fixing device comprising a holding part that maintains the pressed state of the pressing part.