技術分野
本発明は、内視鏡下外科手術等に適した外科手術用結紮方法とその装置に関する。
発明の背景
従来の技術
従来の内視鏡下における外科手術において、糸を迅速確実に結紮することができる外科手術用結紮方法とその装置が種々に提案されてきたが、構造や取り扱いが複雑で、高価なばかりでなく熟練を要するものが少なくなかった。
発明が解決しようとする課題
そこで本発明は、簡単な原理で迅速確実に結紮することができる外科手術用結紮方法と構造が簡素で使用が容易な外科手術用結紮装置を提供しようとするものである。
発明の開示
本発明は、請求項１に記載のように、結紮しようとする糸の一端側を保持して糸巻軸を中心に回転体を回転することにより、一又は複数の糸通し溝を有する糸巻軸の周囲に糸を卷回し、糸の自由端側を糸の一端側を保持する回転体側から糸通し溝に通すことにより巻糸の下を潜らせ、回転体から糸巻軸を外すと共に、巻糸を糸巻軸から外し、糸の一端側と自由端側との間に結び目を形成する外科手術用結紮方法を提供するものである。
本発明によれば、糸通し溝を有する糸巻軸の周囲に糸を卷回する作業を、回転体を回転することにより容易且つ迅速に行うことができる。また、回転体から糸巻軸を外すことにより、容易に巻糸を糸巻軸から外して結び目を形成することができる。
この場合、糸を卷回した後に、糸巻軸の回りから巻いた糸を軽快に取り外し易いように緩く巻き付けることが好ましいから、糸の自由端側を軽く持って巻き糸に緩い張りを持たせて回転体を回転することが好ましい。
また、糸巻軸は回転体と一体に回転しても、回転体のみが糸巻軸の回りで回転しても、糸巻軸の回りに糸を巻くことができる。
また、本発明は、請求項２に記載のように、請求項１に記載の外科手術用結紮方法において、糸の一端側と自由端側との間に一重の結び目を形成した後に、更に回転体を回転して糸の一端側と自由端側との間に二重目の結び目を形成し、これら結紮を繰り返すことにより真結び若しくは逆結びの多重結びを容易に形成する外科手術用結紮方法を提供するものである。
また、本発明は、請求項３に記載のように、請求項２に記載の外科手術用結紮方法において、糸の一端側と自由端側との間に一重の結び目を形成した後に、回転体を逆方向に回転して、糸の一端側と自由端側との間に二重目の結び目を形成することによって、真結びの多重結びを容易に形成する外科手術用結紮方法を提供するものである。
また、本発明は、請求項４に記載のように、請求項１乃至３のいずれかに記載の外科手術用結紮方法において、糸巻軸の周囲に糸を卷回し、糸の自由端を糸通し溝に通した後に、糸巻軸を糸通し溝が回転体方向に避退する方向に引き抜いて、糸巻軸から結び目を容易に離脱させ、糸の一端側と自由端側との間に結び目を形成することができる外科手術用結紮方法を提供するものである。
この場合、糸巻軸には糸外し方向に僅かの傾斜を付けて巻き糸を外すときに滑りやすくすることも可能であり、また、巻き糸を回転体側から糸巻軸の先端方向に傾斜の大きな螺旋を巻くように巻き付ければ、糸巻軸を回転体側に引き抜くときに巻き糸に緩みができて糸巻軸から巻き糸を軽快に外し易くなる。
また、本発明は、請求項５に記載のように、請求項１乃至４のいずれかに記載の外科手術用結紮方法において、回転体を糸巻軸と一体に回転することにより糸通し溝を有する糸巻軸の周囲に糸を容易に確実に卷回するようになした外科手術用結紮方法を提供するものである。
また、本発明は、請求項６に記載のように、請求項１乃至５のいずれかに記載の外科手術用結紮方法において、回転体と相対するように位置する当て板に糸巻軸の先端部を当てて閉鎖し、回転体と当て板部との間の糸巻軸に糸を外れないように確実に巻き、糸通し溝に糸の自由端を通した後に糸巻軸の先端部を開放して巻き糸を外して結紮を形成する外科手術用結紮方法を提供するものである。
また、本発明は、請求項７に記載のように、請求項６に記載の外科手術用結紮方法において、糸巻後に糸巻軸を当て板部を貫通して回転体とは反対方向の当て板部方向に引き抜いて糸巻軸を回転体から開放して糸を通した巻き糸を外して、糸巻軸を施術者が回転体方向又は当て板部方向の左右どちらかに引き抜いて結紮を形成するようにしてなる外科手術用結紮方法を提供するものである。
また、本発明は、請求項８に記載のように、請求項１乃至７のいずれかに記載の外科手術用結紮方法において、回転体をガイドバーに回転可能に支持せしめ且つガイドバーに沿って移動し、必要に応じて回転体と糸巻軸との相対移動をして自在に円滑に結紮を形成するようにしてなる外科手術用結紮方法を提供するものである。
また、本発明は、請求項９に記載のように、請求項１乃至８のいずれかに記載の外科手術用結紮方法において、回転体に糸巻軸の糸通し溝に連続する糸連通溝を設けて、糸の一端を保持する回転体の回転に伴なって糸巻軸の周囲に糸を卷回した後の自由端側を、回転体の後方から糸送り棒により回転体の糸連通溝と糸巻軸の糸通し溝を通して糸巻軸の先端から外部に導き、糸の自由端側を保持し、糸巻軸と糸送り棒を引き抜き、糸の一端部側と自由端側を持って引っ張ることによって糸の自由端側に針がない場合でも糸巻軸の糸通し溝を容易に潜らせて結紮を形成することができる外科手術用結紮方法を提供するものである。
また、本発明は、請求項１０に記載のように、請求項１乃至９のいずれかに記載の外科手術用結紮方法において、回転体に設けた糸保持手段により糸の一端部側を自在に把持して糸巻軸に糸を巻き付けることができるようにしてなる外科手術用結紮方法を提供するものである。
また、請求項１１に記載のように、本発明に係る外科手術用結紮装置によれば、回転体から離脱可能に軸方向に一又は複数の糸通し溝を有する糸巻軸と、糸の一端を保持して糸巻軸を中心に回転する回転体とからなる構成を有することにより、結紮しようとする糸の一端を保持して糸巻軸を中心に回転する回転体によって、糸通し溝を有する糸巻軸の周囲に糸を卷回することができ、糸の自由端を糸の一端側を保持する回転体側から糸通し溝に通すことにより巻糸の下を潜らせてから、回転体から糸通し溝を有する糸巻軸を離脱して巻糸を糸巻軸から外せば、糸の一端側と自由端側との間に一重の結び目ができ、次いで、回転体を逆方向に回転して真結びを、同方向に回転して逆結びを結紮することができ、これら結紮を繰り返すことにより多重結紮が簡単にできる。
また、本発明は、請求項１２に記載のように、請求項１１に記載の外科手術用結紮装置において、回転体に対して糸巻軸を糸通し溝が回転体方向に避退する方向に引き抜き可能に設けてなる構成を有することにより、糸巻軸の周囲に糸を卷回し、糸の自由端を糸通し溝に通した後に、糸巻軸を糸通し溝が回転体方向に避退する方向に引き抜くことができるから、巻糸を糸巻軸から円滑に外すことができる。
また、本発明は、請求項１３に記載のように、請求項１１又は１２に記載の外科手術用結紮装置において、回転体が糸巻軸と一体に回転するようになした構成を有することにより、回転体の回転に伴なって一体に回転する糸通し溝が視認することができるから、施術者が糸通し溝の見やすい位置で巻き糸の状態と糸巻数を確認して糸通しができる。
また、ボス孔を有する回転体とキー軸状又はスプライン軸状の糸巻軸の関係でスライド自在に構成して、糸巻軸に糸通し溝を１個又は複数条に設けることができると共に、回転体と糸巻軸をスライド可能且つ一体に回転可能に構成にすることができる。
また、本発明は、請求項１４に記載のように、請求項１１、１２又は１３に記載の外科手術用結紮装置において、回転体と相対して糸巻軸を開放可能に閉鎖する当て板部を設けてなる構成を有することにより、回転体と当て板部との間の糸巻軸に外れることなく容易且つ確実に糸を巻くことができると共に、糸巻後に糸巻軸を当て板部から開放して糸を通した巻き糸を容易に外して結び目を作ることができる。
また、本発明は、請求項１５に記載のように、請求項１１乃至１４のいずれかに記載の外科手術用結紮装置において、糸巻軸が貫通して引き抜き可能に当て板部を設けた構成を有することにより、糸巻軸を当て板部方向に引き抜くことにより、糸巻後に糸巻軸を回転体から開放して糸を通した巻き糸を容易に外して結紮を作ることができる。
この場合、当て板部を回転体と同じように糸の一端部を保持して回転可能に構成して、施術者が回転体と当て板部のいずれかを選択して使用することができるようにすることができる。
また、本発明は、請求項１６に記載のように、請求項１１乃至１５のいずれかに記載の外科手術用結紮装置において、糸巻軸の軸方向に沿って回転体を回転可能且つ移動可能に支持するガイドバーを設けた構成を有することにより、回転体をガイドバーに沿って回転可能に支持し且つ移動することができると共に、必要に応じて回転体と糸巻軸との相対移動を可能にすることができ、結紮を容易且つ確実に作ることができる。
また、本発明は、請求項１７に記載のように、請求項１６に記載の外科手術用結紮装置において、当て板部をガイドバーに設けた構成を有することにより、必要に応じて当て板部に対して回転体と糸巻軸とをガイドバーに沿って移動し、結紮を容易に作ることができる。
また、本発明は、請求項１８に記載のように、請求項１１乃至１７のいずれかに記載の外科手術用結紮装置において、回転体に糸巻軸の糸通し溝に連続する糸連通溝を設けると共に、糸通し溝を貫通する糸送り棒を設けた構成を有することにより、糸の一端を保持する回転体の回転に伴なって糸巻軸の周囲に糸を卷回した後の自由端側を、回転体の後方から糸送り棒により回転体の糸連通溝と糸巻軸の糸通し溝を通して糸巻軸の先端から外部に導き、糸の一端部を保持せしめ、糸送り棒を引き抜くと共に糸巻軸から巻き糸を離脱し、糸の一端部側と自由端側を持って引っ張ることによって針のない糸に結び目を作ることができる。
また、本発明は、請求項１９に記載のように、請求項１４乃至１８のいずれかに記載の外科手術用結紮装置において、当て板部に糸巻軸の糸通し溝に連続する糸連通溝を設けると共に、当該糸連通溝を貫通する糸送り棒を設けた構成を有することにより、糸送り棒により当て板部の糸連通溝を貫通して糸の自由端側を当て板部の外側に位置する糸巻軸の先端部から引き出して、糸の一端部を保持せしめ、糸送り棒を引き抜くと共に糸巻軸から巻き糸を離脱し、糸の一端部側と自由端側を持って引っ張ることによって針のない糸に結び目を作ることができる。
また、本発明は、請求項２０に記載のように、請求項１１乃至１９のいずれかに記載の外科手術用結紮装置において、回転体に糸を把持可能に保持する糸保持部材を設けてなる構成を有することにより、糸保持部材により糸の一端部側の任意の位置を随時に把持して回転体に保持せしめることができ、糸の長さや結紮物等に対応して糸の長さを調整して適宜に結紮を作ることができる。
発明の実施の形態
以下図示する実施例により本発明の実施の態様を説明する。
図１乃至図３の実施例において、１は軸方向に糸通し溝２を有する糸巻軸で、糸巻軸１を中心に回転する回転体３と一体に設けてある。回転体３の糸巻軸１側の回転外周部には結紮すべき糸１０の一端部を固定する糸固定部４が設けてある。回転体３は糸巻軸１の軸方向に沿って設けたガイドバー５上において、移動自在且つ回転自在に設けてある。
なお、回転体３はガイドバー５上を糸巻軸１の軸方向に沿って移動可能又は移動自在に設けた軸受部材に回転可能又は回転自在に軸受けされた構成にすることも可能である。
なお、上記において、回転体３がガイドバー５上を移動可能とは、例えば、回転体３の回転時にストッパー等により移動を拘束されており、拘束を解除して始めて移動可能になる構成であり、回転可能とは、例えば、移動時には回転を拘束されているとか、回転時に回転数をクリック機構により１回毎にストップするとか、３以上回転しないように拘束するというような構成を意味している。
ガイドバー５の先端部には、糸巻軸１の先端部を開放可能に閉鎖する当て板部６が設けてあり、図示の実施例では、図２に記載のように、回転体３を回転操作軸部７で回転操作するときに、糸巻軸１の先端部を当て板部６に押し当てて、回転体３を糸巻軸１の先端部が当て板部６から離れないように回転すると、糸巻軸１の周囲に糸１０が確実の巻き付くように構成してある。
図２に記載のように、回転体３を必要な回数回転して、糸１０を糸通し溝２の上を１乃至３，４回通るように巻き付けてから、例えば、結紮物１２を縫った後の針１１で、糸通し溝２を回転体３側から当て板部６側に向かって糸１０を先端部から潜らせ、図３に記載のように、回転体３と共に糸巻軸１を当て板部６から離れる方向に移動して、糸巻軸１の開放した先端部から糸１０を外すと、糸１０の一端部側４と自由端側１１との間に結紮物１２を縛る一重目の結び目２０ができ上がることとなる。
次いで、回転体３を逆転して、同様に、糸１０を糸通し溝２の上を１乃至３，４回通るように巻き付けてから、針１１で糸通し溝２を回転体３側から当て板部６側に向かって糸１０を潜らせ、回転体３と共に糸巻軸１を当て板部６から離れる方向に移動して、糸巻軸１から糸１０を外すと、糸１０の一端部側４と自由端側１１との間に結紮物１２を縛る二重目の結び目が本結びででき上がることとなる。これを繰り返すことによって多重結びが確実にできることとなる。なお、回転体３を、前回と同じ方向に回転して結び目を作ると逆結びとなる。
図４及び図５に記載の実施例の場合、回転体３に対して糸巻軸１を回転体方向に避退する方向に引き抜き可能に設けてある。従って、図４に記載のように、糸巻軸１に糸を巻き付けて、糸１０の先端部を糸通し溝２に潜らせた後で、回転体３を移動することなく、糸巻軸１のみを軸受孔８に沿って回転体３内に引き抜けば、図５に記載の如く、卷回した糸１０が糸巻軸１から外れて、結び目２０ができ上がることとなる。
図６に記載の実施例の場合、当て板部６に軸受孔９を設けて、糸巻軸１を当て板部６を貫通して引き抜き可能に構成して、巻き糸を取り外して結び目を作ることができるように構成してある。なお、この場合、当て板部６に代えて回転体３と同じものをガイドバー５上に設け、糸巻軸１を施術者が自由に選択していずれの方向からも挿通し、いずれかの回転体を使用して結紮することができるように構成することも可能である。
また、図４乃至図６の実施例において、糸巻軸１が軸受孔８，９に回転自在に嵌合している場合には、回転体３のみを回転して糸巻軸１の周囲に糸を卷回することができる構成であるが、回転体３と糸巻軸１を一体に回転する構成にすることも可能である。
図７の実施例の場合、回転体３の軸受孔８に、糸巻軸１の糸通し溝２に嵌合するキー部１３が設けてあり、糸巻軸１は回転体方向に引き抜き可能であると同時に、回転体３と一体に回転するように構成してある。
図８のａの実施例の場合、回転体３の軸受孔８に対して複数の糸通し溝２を有する糸巻軸１が回転自在に貫通する構成であるが、ｂの実施例では、回転体３の軸受孔がボス孔であるのに対して複数の糸通し溝２を有する糸巻軸１がスプライン軸として一体に回転するように貫通する構成である。
図９及び図１０の実施例では、多数の細線材１４を等間隔に配置して複数の糸通し溝２を有する糸巻軸１を構成したもので、図１０のａの場合は、回転体３に対して糸巻軸１が回転自在に嵌合するのに対して、ｂの場合は、軸受孔８が細線材１４の間に嵌合するボス孔状の突起部１５を具備し、糸巻軸１と一体に回転する構成である。２７は細線材を内側で固定する内蓋状の内フレーム体である。
なお、図９及び図１０の実施例では、糸巻軸１を細線材１４から構成することにより、軸受孔８に嵌合する軸に弾力性を付与することができると共に軽量化が計れるが、図１１のように、中空パイプ状又は中実状の細線材１６を束ねた形状の複数の糸通し溝２を有する糸巻軸１を構成することも可能である。
また、図では省略してあるが、糸巻軸１の外周には、糸の開放と糸巻軸１の引き抜きを阻害しない滑り止め程度の巻き糸案内用の微細又は微少突起又は凹部を必要に応じて設けることも可能である。
図１２乃至１４に記載の実施例の場合、回転体３及び操作軸部７に糸巻軸１の糸通し溝２に連続する糸連通溝１７を設けると共に、糸通し溝２を貫通する糸送り棒１８を設けた構成からなり、糸１０の一端部４を保持する回転体３の回転に伴なって糸巻軸１の周囲に糸を卷回した後の自由端側１９を、回転体３とは別に糸送り棒１８の先端に設けた鉗子２１等により把持して、回転体３の後方の操作軸７から糸連通溝１７と糸巻軸１の糸通し溝２を通して、図１２に記載のように糸巻軸１の先端から外部に導き、別の鉗子２２で把持せしめて放し、糸巻軸１と共に糸通し棒１８を回転体３側に引き抜き、図１３に記載のように、糸の一端部側４と自由端側１９を持って引っ張ることによって結び目２０を作ることができる。
また、図１３に記載のように、当て板部６に糸巻軸１の糸通し溝２に連続する糸連通溝２３を設けることによって、図１２に記載のように回転体３の後方から糸通し溝２を貫通する糸送り棒１８を当て板部６の外側まで導くことができ、糸送り棒１８の鉗子２１等から他の鉗子２２等に糸の自由端側１９を容易に受渡しすることができる。
図１５及び図１６の実施例の場合は、回転体３に糸１０を把持して固定することができる糸保持部材２４を設けてあり、糸保持部材２４の把持部２５により随時に糸１０の一端部側を把持して回転体３に保持せしめることができる。図示の実施例では、フック状の把持部２５により糸１０を引っ掛けて、回転体３の裏側から操作部２６によって引っ張ることにより、糸１０を回転体３に固定することができるように構成してあるが、鉗子のようなもので把持する構成にすることも勿論可能である。その後、針１１を切り離して糸１０を糸巻軸１に巻掛けて、糸の自由端側を糸通し溝２を通して、糸巻軸１から外して結び目を作ることができる。
上記の本発明に係る外科手術用結紮装置の実施例に基づく説明から明白なように、本発明は、以下のような外科手術用結紮方法を実施の形態に包含するものである。
（実施形態１） 結紮しようとする糸１０の一端側４を保持して糸巻軸１を中心に回転する回転体３により、糸通し溝２を有する糸巻軸１の周囲に糸１０を卷回し、糸の自由端側１１，１９を糸の一端側４を保持する回転体３側から糸通し溝２に通すことにより巻糸の下を潜らせ、次いで、回転体３から糸通し溝２を有する糸巻軸１を離脱し、巻糸を糸巻軸１から外し、糸の一端側４と自由端側１１，１９との間に結び目２０を形成する外科手術用結紮方法。
（実施形態２） 実施形態１に記載の外科手術用結紮方法において、糸の一端側と自由端側との間に一重の結び目を形成した後に、回転体を回転して糸の一端側と自由端側との間に次の二重目の結び目を形成し、これを繰り返すことにより多重結びを形成する外科手術用結紮方法。
（実施形態３） 実施形態２に記載の外科手術用結紮方法において、糸の一端側と自由端側との間に一重の結び目を形成した後に、回転体を逆方向に回転して糸の一端側と自由端側との間に次の二重目の結び目を形成し、真結びの多重結びを形成する外科手術用結紮方法。
（実施形態４） 実施形態１乃至３のいずれかに記載の外科手術用結紮方法において、糸巻軸の周囲に糸を卷回し、糸の自由端を糸通し溝に通した後に、糸巻軸１を糸通し溝２が回転体３方向に避退する方向に引き抜いて、糸巻軸１から結び目２０を離脱し、糸の一端側と自由端側との間に結び目を形成する外科手術用結紮方法。
（実施形態５） 実施形態１乃至４のいずれかに記載の外科手術用結紮方法において、回転体３を糸巻軸１と一体に回転することにより糸通し溝２を有する糸巻軸１の周囲に糸１０を卷回するようになした外科手術用結紮方法。
（実施形態６） 実施形態１乃至５のいずれかに記載の外科手術用結紮方法において、回転体３と相対して糸巻軸１の先端部を当て板部６で閉鎖し、回転体３と当て板部６との間の糸巻軸１に糸１０を巻き、糸通し溝２に糸の自由端１１、１９を通した後に糸巻軸１の先端部を当て板部から開放して巻き糸を外して結紮を形成する外科手術用結紮方法。
（実施形態７） 実施形態６に記載の外科手術用結紮方法において、糸巻軸１の周囲に結び目２０を成形後に、糸巻軸１を当て板部６を貫通して当て板部６方向に引き抜いて糸巻軸１を回転体から開放して結び目２０を糸巻軸１から離脱して結紮を形成するようにしてなる外科手術用結紮方法。
（実施形態８） 実施形態１乃至７のいずれかに記載の外科手術用結紮方法において、回転体３をガイドバー５に回転可能に支持し且つガイドバー５に沿って移動し、必要に応じて回転体３と糸巻軸１との相対移動をするようにして結紮を形成してなる外科手術用結紮方法。
（実施形態９） 実施形態１乃至８のいずれかに記載の外科手術用結紮方法において、回転体３に糸巻軸１の糸通し溝２に連続する糸連通溝１７を設けて、糸の一端４を保持する回転体３の回転に伴なって糸巻軸１の周囲に糸１０を卷回した後の自由端側１９を、回転体３の後方から糸送り棒１８により回転体の糸連通溝１７と糸巻軸の糸通し溝２を通して糸巻軸１の先端から外部に導き、自由端側１９を鉗子等により保持せしめ、糸巻軸１と糸送り棒１８を引き抜き、糸の一端部側４と自由端側１９を持って引っ張ることによって結紮を形成する外科手術用結紮方法。
（実施形態１０） 実施形態１乃至９のいずれかに記載の外科手術用結紮方法において、回転体３に設けた糸保持手段２４，２５，２６により糸１０の一端部側４を任意の位置で随時に自在に把持して回転するようにしてなる外科手術用結紮方法。
【図面の簡単な説明】
図１
本発明装置の一実施例の要部の概略説明図。
図２
その要部の使用態様説明図。
図３
その要部の使用態様説明図。
図４
本発明装置の他の実施例の要部の概略使用態様説明図。
図５
その要部の使用態様説明図。
図６
本発明装置の他の実施例の要部の概略使用態様説明図。
図７
本発明装置の他の実施例の要部の概略使用態様説明図。
図８
その要部の実施形態の断面説明図。
図９
本発明装置の他の実施例の要部の概略使用態様説明図。
図１０
その要部の実施形態の断面説明図。
図１１
本発明装置の他の実施例の要部の概略説明図。
図１２
本発明装置の他の実施例の要部の概略使用態様説明図。
図１３
その要部の概略使用態様説明図。
図１４
その要部の一実施形態の断面説明図。
図１５
本発明装置の他の実施例の要部の概略使用態様説明図。
図１６
その要部の概略使用態様説明図。TECHNICAL FIELD The present invention relates to a surgical ligation method and apparatus suitable for endoscopic surgery and the like.
2. Description of the Related Art In a conventional surgical operation under an endoscope, various surgical ligating methods and devices capable of quickly and reliably ligating a thread have been proposed, but the structure and handling are complicated. Many of them are not only expensive but also require skill.
SUMMARY OF THE INVENTION Accordingly, an object of the present invention is to provide a surgical ligating method that can be ligated quickly and reliably by a simple principle, and a surgical ligating apparatus that has a simple structure and is easy to use. is there.
DISCLOSURE OF THE INVENTION As described in claim 1, the present invention has one or a plurality of threading grooves by holding one end of a thread to be ligated and rotating a rotating body about a spool axis. The yarn is wound around the winding shaft, the free end of the yarn is passed through the threading groove from the rotating body holding one end of the yarn, and the thread is sunk under the wound yarn. An object of the present invention is to provide a surgical ligating method in which a winding thread is removed from a bobbin shaft and a knot is formed between one end side and a free end side of the thread.
ADVANTAGE OF THE INVENTION According to this invention, the operation | work which winds a yarn around the thread winding shaft which has a threading groove | channel can be performed easily and quickly by rotating a rotating body. Further, by removing the bobbin from the rotating body, the bobbin can be easily removed from the bobbin to form a knot.
In this case, after winding the yarn, it is preferable to loosely wind the yarn wound around the winding axis so that the yarn can be easily removed lightly. Preferably, the rotating body is rotated.
In addition, the yarn can be wound around the bobbin shaft even if the bobbin shaft rotates integrally with the rotating body or only the rotatable body rotates around the bobbin shaft.
According to a second aspect of the present invention, in the method for ligating a surgical operation according to the first aspect, a single knot is formed between one end and a free end of the thread, and then further rotated. A surgical ligating method in which the body is rotated to form a double knot between one end and the free end of the thread, and these ligations are repeated to easily form a true knot or a reverse knot. Is provided.
According to a third aspect of the present invention, in the method for ligating a surgical operation according to the second aspect, after forming a single knot between one end and the free end of the thread, the rotating body is formed. By providing a double knot between one end of the thread and the free end of the thread, thereby easily forming a true knot multiple knot. It is.
According to a fourth aspect of the present invention, in the surgical ligating method according to any one of the first to third aspects, a thread is wound around a bobbin and a free end of the thread is threaded. After passing through the groove, pull out the bobbin shaft in the direction in which the threading groove retracts toward the rotating body, easily remove the knot from the bobbin shaft, and form a knot between one end side and the free end side of the yarn. And a surgical ligating method.
In this case, it is also possible to make the spool slightly slippery in the direction of thread removal to make it easier to slip when removing the spool. Is wound so that the wound thread can be loosened when the thread winding shaft is pulled out toward the rotating body, and the wound thread can be easily removed from the thread winding shaft.
According to a fifth aspect of the present invention, there is provided the ligation method for surgical operation according to any one of the first to fourth aspects, wherein the rotating body is integrally rotated with the bobbin shaft to have a threading groove. An object of the present invention is to provide a ligating method for a surgical operation in which a thread is easily and reliably wound around a thread winding shaft.
According to a sixth aspect of the present invention, in the surgical ligating method according to any one of the first to fifth aspects, the distal end portion of the bobbin shaft is attached to the abutment plate located opposite to the rotating body. , Close the thread around the bobbin axis between the rotating body and the caul plate so that the thread does not come off, pass the free end of the thread through the threading groove, and open the tip of the bobbin axis. An object of the present invention is to provide a surgical ligating method for removing a winding thread and forming a ligature.
According to a seventh aspect of the present invention, in the surgical ligating method according to the sixth aspect, after the bobbin is wound, the bobbin shaft passes through the abutment plate, and the abutment plate in the opposite direction to the rotating body. Direction to release the wound shaft from the rotating body, remove the wound yarn through which the thread has passed, and pull out the wound shaft in the direction of the rotating body or in the direction of the backing plate to form a ligature. It is an object of the present invention to provide a surgical ligation method.
Further, according to the present invention, in the surgical ligating method according to any one of claims 1 to 7, the rotator is rotatably supported by the guide bar and is arranged along the guide bar. It is an object of the present invention to provide a ligating method for a surgical operation in which the ligature is moved and, as required, the rotator and the bobbin shaft are relatively moved to form a ligature freely and smoothly.
According to a ninth aspect of the present invention, in the surgical ligating method according to any one of the first to eighth aspects, the rotating body is provided with a thread communication groove that is continuous with the threading groove of the bobbin shaft. Then, the free end side after the yarn is wound around the winding shaft with the rotation of the rotating body that holds one end of the yarn is moved from the back of the rotating body to the thread communication groove of the rotating body by the yarn feed rod and the bobbin. The thread is guided from the end of the bobbin shaft through the threading groove of the shaft to the outside, holding the free end side of the yarn, pulling out the bobbin shaft and the yarn feed rod, and pulling the one end side and the free end side of the yarn and pulling the yarn. An object of the present invention is to provide a ligating method for a surgical operation in which a ligature can be easily formed by threading a threading groove of a bobbin even when a needle is not provided on a free end side.
According to a tenth aspect of the present invention, in the surgical ligating method according to any one of the first to ninth aspects, one end of the thread is freely moved by the thread holding means provided on the rotating body. An object of the present invention is to provide a ligating method for a surgical operation in which a thread can be gripped and wound around a thread winding shaft.
According to the eleventh aspect of the present invention, according to the surgical ligating apparatus of the present invention, a spool having one or more threading grooves in the axial direction so as to be detachable from the rotating body, and one end of the thread. A rotating body that holds and rotates around the bobbin axis, the bobbin shaft having a threading groove by the rotating body that holds one end of the thread to be ligated and rotates around the bobbin axis The thread can be wound around the thread, and the free end of the thread is passed through the threading groove from the rotating body holding one end of the thread so as to dive under the wound thread, and then the rotating body is threaded into the threading groove. If the bobbin is removed from the bobbin by removing the bobbin having a knot, a single knot is formed between one end of the yarn and the free end, and then the rotating body is rotated in the opposite direction to form a true knot, By rotating in the same direction, the reverse knot can be ligated, and by repeating these ligations Heavy ligature can be easy.
According to a twelfth aspect of the present invention, in the surgical ligating device according to the eleventh aspect, the thread winding shaft is pulled out of the rotating body in a direction in which the threading groove retracts in the direction of the rotating body. By having a configuration provided so that it can be provided, the yarn is wound around the yarn winding shaft, and after the free end of the yarn is passed through the threading groove, the yarn winding shaft is moved in the direction in which the threading groove retreats toward the rotating body. Since the yarn can be pulled out, the wound yarn can be smoothly removed from the yarn winding shaft.
According to a thirteenth aspect of the present invention, in the surgical ligating apparatus according to the eleventh or twelfth aspect, the rotating body integrally rotates with the bobbin shaft. Since the threading groove which rotates integrally with the rotation of the rotating body can be visually recognized, the practitioner can check the state of the wound thread and the number of windings at a position where the threading groove is easy to see, and perform threading.
In addition, the rotary member having the boss hole and the key shaft or the spline shaft can be configured to be slidable in relation to each other so that one or a plurality of threading grooves can be provided in the bobbin shaft. And the bobbin shaft can be configured to be slidable and integrally rotatable.
According to the present invention, as described in claim 14, in the surgical ligating device according to claim 11, 12, or 13, the abutment plate portion that opensably closes the bobbin shaft relative to the rotating body is provided. With this configuration, the yarn can be wound easily and reliably without coming off the bobbin shaft between the rotating body and the backing plate portion. The knot can be made by easily removing the wound thread passing through.
According to a fifteenth aspect of the present invention, in the surgical ligating device according to any one of the eleventh to fourteenth aspects, a configuration is provided in which the bobbin shaft is provided so as to be able to be pulled out therefrom. With this configuration, by pulling out the bobbin shaft in the direction of the backing plate portion, the bobbin shaft can be released from the rotating body after the bobbin winding, and the bobbin thread that has passed through the bobbin can be easily removed to form a ligature.
In this case, the backing plate portion is configured to be rotatable while holding one end of the thread in the same manner as the rotating body, so that the practitioner can select and use either the rotating body or the backing plate portion. Can be
According to a twelfth aspect of the present invention, in the surgical ligating device according to any one of the eleventh to fifteenth aspects, the rotating body is rotatable and movable along the axial direction of the bobbin axis. By having a configuration in which the guide bar for supporting is provided, the rotating body can be rotatably supported and moved along the guide bar, and the relative movement between the rotating body and the bobbin shaft can be performed as necessary. Ligatures can be easily and reliably made.
In addition, according to the present invention, in the surgical ligating device according to the sixteenth aspect, the ligating device according to the sixteenth aspect has a configuration in which the reliance plate portion is provided on the guide bar, so that the reliance plate portion is provided as necessary. By moving the rotating body and the bobbin shaft along the guide bar, the ligature can be easily formed.
Further, according to the present invention, as in claim 18, in the surgical ligating device according to any one of claims 11 to 17, the rotating body is provided with a thread communication groove continuous with the threading groove of the bobbin shaft. In addition, by having a configuration in which a thread feed rod penetrating through the threading groove is provided, the free end side after the thread is wound around the thread winding shaft with the rotation of the rotating body holding one end of the thread. From the back of the rotating body, the yarn feed rod guides the outside of the bobbin from the tip of the bobbin through the thread communication groove of the rotatable body and the threading groove of the bobbin, holds one end of the yarn, pulls out the bobbin and pulls out the bobbin from the bobbin The knot can be tied to the needleless thread by releasing the wound thread and pulling on one end side and the free end side of the thread.
According to a ninth aspect of the present invention, in the surgical ligating device according to any one of the fourteenth to eighteenth aspects, a thread communication groove that is continuous with the threading groove of the bobbin shaft is provided in the abutment plate. In addition to having the configuration in which the thread feed rod is provided to penetrate the thread communication groove, the free end side of the thread penetrates the thread communication groove of the backing plate portion by the thread feed bar and is positioned outside the backing plate portion. The needle is pulled out from the end of the winding shaft to hold one end of the yarn. You can tie a knot with no thread.
According to a twentieth aspect of the present invention, in the surgical ligating apparatus according to any one of the eleventh to nineteenth aspects, a thread holding member is provided on the rotating body so that the thread can be gripped. By having the configuration, an arbitrary position on one end side of the yarn can be held at any time by the yarn holding member and held on the rotating body, and the length of the yarn can be adjusted according to the length of the yarn or the ligature. The ligation can be made appropriately by adjustment.
Embodiments of the Invention Embodiments of the present invention will be described below with reference to examples shown in the drawings.
In the embodiment shown in FIGS. 1 to 3, reference numeral 1 denotes a bobbin shaft having a threading groove 2 in the axial direction, which is provided integrally with a rotating body 3 which rotates about the bobbin shaft 1. A thread fixing portion 4 for fixing one end of a thread 10 to be ligated is provided on a rotation outer peripheral portion of the rotating body 3 on the side of the bobbin shaft 1. The rotating body 3 is movably and rotatably provided on a guide bar 5 provided along the axial direction of the bobbin shaft 1.
In addition, the rotating body 3 may be configured to be rotatably or rotatably supported by a bearing member which is movable or movably provided on the guide bar 5 along the axial direction of the bobbin shaft 1.
In the above description, the phrase “the rotating body 3 can move on the guide bar 5” means that, for example, the movement is restricted by a stopper or the like when the rotating body 3 rotates, and the rotating body 3 becomes movable only after the restriction is released. The rotatable means, for example, a configuration in which the rotation is restricted when moving, the number of rotations is stopped by the click mechanism during rotation once each time, or a configuration in which the rotation is restricted not to rotate more than three times. I have.
At the distal end of the guide bar 5, a backing plate 6 for opening and closing the distal end of the bobbin shaft 1 is provided. In the illustrated embodiment, as shown in FIG. When the rotating operation is performed by the shaft portion 7, the tip of the bobbin shaft 1 is pressed against the backing plate portion 6, and the rotating body 3 is rotated so that the front end portion of the bobbin shaft 1 does not separate from the backing plate portion 6. The yarn 10 is configured to be securely wound around the shaft 1.
As shown in FIG. 2, the rotating body 3 is rotated a required number of times, and the thread 10 is wound around the threading groove 2 one to three or four times, and then, for example, the ligature 12 is sewn. With the needle 11 later, the thread 10 is sunk from the tip end of the threading groove 2 from the rotating body 3 side to the backing plate section 6 side, and the bobbin shaft 1 is applied together with the rotating body 3 as shown in FIG. When the yarn 10 is moved away from the plate portion 6 and the yarn 10 is removed from the open end of the yarn winding shaft 1, the first ligature 12 that binds the ligature 12 between the one end 4 and the free end 11 of the yarn 10 is formed. The knot 20 is completed.
Next, the rotating body 3 is reversed and the thread 10 is similarly wound around the threading groove 2 one to three or four times, and then the needle 11 is applied to the threading groove 2 from the rotating body 3 side. When the yarn 10 is sunk toward the plate portion 6, the bobbin shaft 1 is moved together with the rotating body 3 in a direction away from the contact plate portion 6, and the yarn 10 is removed from the bobbin shaft 1. A double knot for tying the ligature 12 between the free end side 11 and the free end side 11 is formed by the main knot. By repeating this, multiple knots can be surely performed. Note that when the rotator 3 is rotated in the same direction as the previous time to form a knot, the knot is reversed.
In the case of the embodiment shown in FIGS. 4 and 5, the bobbin winding shaft 1 is provided so as to be able to be pulled out in the direction of retracting in the direction of the rotating body with respect to the rotating body 3. Therefore, as shown in FIG. 4, after the yarn is wound around the yarn winding shaft 1 and the leading end of the yarn 10 is sunk into the threading groove 2, only the yarn winding shaft 1 is moved without moving the rotating body 3. When the yarn 10 is pulled out into the rotating body 3 along the bearing hole 8, the wound yarn 10 comes off the yarn winding shaft 1 as shown in FIG. 5, and the knot 20 is completed.
In the case of the embodiment shown in FIG. 6, a bearing hole 9 is provided in the backing plate portion 6, the bobbin shaft 1 is configured to be able to be pulled out through the backing plate portion 6, and the winding yarn is removed to form a knot. It is configured to be able to. In this case, the same thing as the rotating body 3 is provided on the guide bar 5 instead of the backing plate section 6, and the practitioner freely selects the bobbin shaft 1 and inserts the bobbin shaft 1 from any direction. It is also possible to configure so that it can be ligated using a body.
In the embodiment of FIGS. 4 to 6, when the bobbin 1 is rotatably fitted in the bearing holes 8 and 9, only the rotating body 3 is rotated to put the yarn around the bobbin 1. Although it is a configuration that can be wound, it is also possible to adopt a configuration in which the rotating body 3 and the bobbin shaft 1 are integrally rotated.
In the case of the embodiment of FIG. 7, a key portion 13 that fits into the threading groove 2 of the bobbin 1 is provided in the bearing hole 8 of the rotating body 3, and the bobbin 1 can be pulled out in the direction of the rotating body. At the same time, it is configured to rotate integrally with the rotating body 3.
In the embodiment shown in FIG. 8A, the bobbin shaft 1 having a plurality of threading grooves 2 is rotatably penetrated through the bearing hole 8 of the rotating body 3, but in the embodiment shown in FIG. 3 is a boss hole, whereas a bobbin shaft 1 having a plurality of threading grooves 2 is penetrated so as to rotate integrally as a spline shaft.
In the embodiment of FIGS. 9 and 10, a large number of fine wires 14 are arranged at equal intervals to constitute a bobbin shaft 1 having a plurality of threading grooves 2. In the case of FIG. In the case of b, the bobbin shaft 1 is provided with a boss-hole-shaped projection 15 that fits between the fine wires 14, while the bobbin shaft 1 is rotatably fitted to the bobbin shaft 1. It is configured to rotate integrally with the camera. Reference numeral 27 denotes an inner frame body having an inner lid shape for fixing the thin wire material inside.
In the embodiment shown in FIGS. 9 and 10, by forming the bobbin shaft 1 from the thin wire material 14, elasticity can be given to the shaft fitted into the bearing hole 8 and the weight can be reduced. As shown in FIG. 11, it is also possible to configure the bobbin shaft 1 having a plurality of threading grooves 2 in a shape obtained by bundling hollow pipe-shaped or solid fine wires 16.
Although not shown in the drawing, fine or minute projections or recesses for winding thread guide, which do not hinder the opening of the thread and the pulling out of the thread winding shaft 1, are provided on the outer periphery of the thread winding shaft 1 as necessary. It is also possible to provide.
In the case of the embodiment shown in FIGS. 12 to 14, the rotary body 3 and the operating shaft 7 are provided with a thread communication groove 17 which is continuous with the threading groove 2 of the thread winding shaft 1, and a thread feed rod penetrating the threading groove 2. The free end side 19 after winding the yarn around the winding shaft 1 with the rotation of the rotating body 3 holding the one end 4 of the yarn 10 is referred to as the rotating body 3. Separately, it is gripped by forceps 21 or the like provided at the tip of the thread feed rod 18 and passes through the thread communication groove 17 and the thread thread groove 2 of the thread winding shaft 1 from the operation shaft 7 behind the rotating body 3 as shown in FIG. The thread guide shaft 18 is guided to the outside from the tip of the bobbin shaft 1, held by another forceps 22 and released, and the threading rod 18 together with the bobbin shaft 1 is pulled out to the rotating body 3 side. As shown in FIG. The knot 20 can be made by pulling the free end side 19 of the knot.
Further, as shown in FIG. 13, by providing the threading groove 23 continuous with the threading groove 2 of the thread winding shaft 1 in the backing plate portion 6 as shown in FIG. The thread feed rod 18 penetrating the groove 2 can be guided to the outside of the backing plate portion 6, and the free end side 19 of the thread can be easily transferred from the forceps 21 or the like of the thread feed rod 18 to another forceps 22 or the like. it can.
In the case of the embodiment shown in FIGS. 15 and 16, a thread holding member 24 capable of gripping and fixing the thread 10 is provided on the rotating body 3, and the thread 10 One end side can be gripped and held by the rotating body 3. In the illustrated embodiment, the yarn 10 can be fixed to the rotating body 3 by hooking the yarn 10 by the hook-shaped gripping portion 25 and pulling the yarn 10 from the back side of the rotating body 3 by the operation section 26. However, it is of course possible to adopt a configuration in which it is gripped with something like forceps. Thereafter, the needle 11 is cut off, the yarn 10 is wound around the bobbin 1, and the free end side of the yarn is removed from the bobbin 1 through the threading groove 2 to form a knot.
As is clear from the above description of the embodiment of the surgical ligating apparatus according to the present invention, the present invention includes the following surgical ligating method in the embodiment.
(Embodiment 1) The thread 10 is wound around a spool 1 having a threading groove 2 by a rotating body 3 that rotates around the spool 1 while holding one end 4 of the thread 10 to be ligated. The free end sides 11 and 19 of the yarn are passed under the winding thread 2 from the side of the rotating body 3 holding the one end side 4 of the thread to dive under the winding thread, and then the threading groove 2 is provided from the rotating body 3 A surgical ligation method in which the bobbin shaft 1 is detached, the bobbin is removed from the bobbin shaft 1, and a knot 20 is formed between one end 4 of the yarn and the free ends 11 and 19.
(Embodiment 2) In the ligation method for a surgical operation according to Embodiment 1, after forming a single knot between one end side and a free end side of a thread, the rotating body is rotated to freely contact one end side of the thread. A surgical ligating method in which a next double knot is formed between the end side and the knot is formed repeatedly to form a multiple knot.
(Embodiment 3) In the surgical ligating method according to Embodiment 2, after forming a single knot between one end side and a free end side of the thread, the rotating body is rotated in the opposite direction to rotate the one end of the thread. A surgical ligating method that forms the next double knot between the side and the free end to form a true knot multiple knot.
(Embodiment 4) In the surgical ligating method according to any one of Embodiments 1 to 3, after winding a thread around a bobbin shaft and passing a free end of the thread through a threading groove, the bobbin shaft 1 is removed. A surgical ligation method in which the threading groove 2 is pulled out in the direction of retreating in the direction of the rotating body 3, the knot 20 is detached from the bobbin shaft 1, and a knot is formed between one end and the free end of the thread.
(Embodiment 5) In the surgical ligation method according to any one of Embodiments 1 to 4, the rotating body 3 is rotated integrally with the bobbin shaft 1 so that a thread is wound around the bobbin shaft 1 having the threading groove 2. A ligation method for surgical operation in which 10 is wound.
(Embodiment 6) In the surgical ligation method according to any one of Embodiments 1 to 5, the distal end portion of the bobbin shaft 1 is closed with a backing plate portion 6 so as to face the rotating body 3, and is brought into contact with the rotating body 3. The yarn 10 is wound around the winding shaft 1 between the plate portion 6 and the free ends 11, 19 of the yarn are passed through the threading groove 2, and then the leading end of the winding shaft 1 is released from the contact plate portion to remove the wound yarn. Surgical ligation method for forming a ligature.
(Embodiment 7) In the surgical ligating method described in Embodiment 6, after forming the knot 20 around the bobbin shaft 1, the bobbin shaft 1 is passed through the backing plate portion 6 and pulled out in the direction of the backing plate portion 6. A ligation method for a surgical operation in which the bobbin shaft 1 is released from the rotating body and the knot 20 is separated from the bobbin shaft 1 to form a ligature.
(Eighth Embodiment) In the surgical ligation method according to any one of the first to seventh embodiments, the rotating body 3 is rotatably supported on the guide bar 5 and is moved along the guide bar 5, and is moved as necessary. A ligation method for a surgical operation, wherein a ligature is formed by moving the rotating body 3 and the bobbin shaft 1 relatively.
(Embodiment 9) In the surgical ligation method according to any one of Embodiments 1 to 8, a thread communication groove 17 that is continuous with the threading groove 2 of the bobbin shaft 1 is provided in the rotating body 3 so that one end 4 of the thread is provided. The free end side 19 after the yarn 10 is wound around the yarn winding shaft 1 with the rotation of the rotating body 3 holding the rotating body 3, is threaded from the rear of the rotating body 3 by the yarn feed rod 18 to the thread communication groove 17 of the rotating body. Through the threading groove 2 of the bobbin shaft to the outside from the tip of the bobbin shaft 1, the free end 19 is held by forceps or the like, the bobbin shaft 1 and the yarn feed rod 18 are pulled out, and the one end side 4 of the yarn and the free end A surgical ligation method wherein the ligation is formed by pulling on the side 19.
(Embodiment 10) In the surgical ligation method according to any one of Embodiments 1 to 9, the one end side 4 of the thread 10 is set at an arbitrary position by the thread holding means 24, 25, 26 provided on the rotating body 3. A surgical ligating method that can be freely held and rotated at any time.
[Brief description of the drawings]
FIG.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a schematic explanatory view of a main part of an embodiment of the present invention.
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FIG. 9 is a schematic explanatory view of a main part of another embodiment of the device of the present invention in use.
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FIG. 9 is a schematic explanatory view of a main part of another embodiment of the device of the present invention in use.
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FIG. 9 is a schematic explanatory view of a main part of another embodiment of the device of the present invention in use.
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Sectional explanatory drawing of embodiment of the principal part.
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FIG. 9 is a schematic explanatory view of a main part of another embodiment of the device of the present invention in use.
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Sectional explanatory drawing of embodiment of the principal part.
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FIG. 7 is a schematic explanatory view of a main part of another embodiment of the device of the present invention.
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FIG. 9 is a schematic explanatory view of a main part of another embodiment of the device of the present invention in use.
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FIG.
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Sectional explanatory drawing of one Embodiment of the principal part.
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FIG. 9 is a schematic explanatory view of a main part of another embodiment of the device of the present invention in use.
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