KR100289263B1 - 의료용 봉합재 - Google Patents
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- KR100289263B1 KR100289263B1 KR1019960707422A KR19960707422A KR100289263B1 KR 100289263 B1 KR100289263 B1 KR 100289263B1 KR 1019960707422 A KR1019960707422 A KR 1019960707422A KR 19960707422 A KR19960707422 A KR 19960707422A KR 100289263 B1 KR100289263 B1 KR 100289263B1
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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Abstract
스테이플라인을 가지는 자동봉합기에 장착되어서 사용되는 의료용 봉합재이다. 이 봉합재는 봉합용의 실을 사용하여 시트형태를 이루는 봉합재료를 봉합실을 사용하여 선단이 폐색된 주머니형태로 봉합되어서 이룬다. 봉합재의 주체가 되는 재료에는, 펠트와 같은 부직포, 직포, 니트지 등, 어느 정도의 유연성, 신축성을 가지는 것이 사용되고, 특히 폴리글리콜산과 같은 생체흡수성 고분자나, 생체조직의 일부, 예를들면 심낭막(心囊膜) 등의 장기보호막이 사용된다.
이 봉합재는, 선단이 폐색된 주머니형태로 봉합된 것이기 때문에, 자동봉합기 삽입시에 삽입방향으로 수축함으로써 치우침이 발생하는 것이 방지된다.
Description
생체조직에 생긴 병소(病巢)의 절제는, 이과적 수술에 의하는 것이 일반적이나, 환자에 대한 부담의 경감 등을 목적으로 내시경하에서의 수술 등이 시술 되도록 되어오고 있다.
예를 들면, 자동봉합기를 사용한 절제술 등은 그 일예이다. 자동봉합기는 뚫린 구멍에서 생체내에 도입된어, 환부를 절제하는 동시에 절제부위의 봉합을 행하는 것이며, 이것을 사용하는 것으로 환부의 절개가 불필요하게 된다는 이점이 있다. 따라서 상기 자동봉합기는 선단에 생체조직의 절제부위를 끼워 넣는 봉합기구부를 가지며, 또한 이 봉합기구부에는 봉합을 위한 복수의 스테이플라인이나 생체조직을 절단하기 위한 나이프 등의 절단기구가 설치되어 있다.
물론, 외과적 수술에 있어서도 상기 자동봉합기의 사용은 봉합, 절개시간의 단축이나, 시술의 간편화에 유리하다.
그런데 폐, 기관지, 간장, 소화관 등의 취약한 조직에 대하여 상술한 자동봉합기로 시술하는 경우, 스테이플에 의한 봉합만으로는 조직의 단열의 껍질이 있고, 또 예를들면 폐의 수술에 있어서는 공기누출이 발생할 우려가 있다. 상기 공기누출은 환자에 있어서 치명적이며, 이것을 확실히 방지하는 것이 요망된다.
그래서 종래는 상기 자동봉합기에 봉합재를 장착하여 놓고, 이것을 생체 조직의 절제부위에 스테이플로 봉합한다는 것이 행하여지고 있다.
이 경우, 봉합재를 자동봉합기에 장착가능하게 하고, 확실히 환부에 도달시키기 위해서는 어떠한 연구가 필요하며, 예를 들면 펠트형태의 봉합재에 신축성을 가지는 니트지를 겹치고, 이들을 가봉사로 양측 가장자리에 따라 꿔매서 통형태로 한 것이 제안되고 있다.
그렇지만, 신축성을 가지는 니트지를 봉합용의 실에 의해 꿔매서 자동봉합기에의 장착을 가능하게 한 봉합재로는, 자동봉합기를 생체내에 삽입하여 환부에 도입할 때에, 삽입방향에서 수축하고 자동봉합기의 기단측에 치우친다든지, 자동봉합기의 주위에서 회전하는, 즉 비틀어지는 등의 불편이 발생하고 있었다.
봉합재에 치우침이나 회전이 생기면, 정확한 처치가 어렵고 특히 내시경하와 같은 한정된 시야에서의 시술시에, 큰 문제가 된다.
본 발명은, 생체조직의 절제부위 등에 봉합되는 의료용 봉합재에 관하여 특히 자동봉합기에 장착하여 사용되는 의료용 봉합재에 관한 것이다.
도 1은 본 발명을 적용한 봉합재의 일예를 나타내는 개략사시도이다.
도 2는 상시 봉합재가 사용되는 자동봉합기의 일예를 나타내는 개략사시도이다.
도 3은 상기 봉합재가 사용되는 자동봉합기의 봉합기구부의 요부 개략평면도이다.
도 4는 봉합재의 상기 자동봉합기에의 장착상태를 나타내는 개략사시도이다.
도 5는 상기 자동봉합기에 의한 봉합조작상태를 나타내는 개략사시도이다.
도 6은 봉합처치의 종료상태를 나타내는 개략사시도이다.
도 7은 본 발명을 적용한 봉합재의 다른 예를 나타내는 개략사시도이다.
* 도면의 주요부분에 대한 부호의 설명
1. 의료용 봉합재 2. 주봉합재
3. 꿔매는 실 13. 스테이플라인
11. 샤프트
그래서 본 발명은, 이와같은 실정을 감안하여 제안된 것이며, 자동봉합기의 삽입시에 치우침이나 회전에 의한 불편이 발생하지 않고, 예를들면 폐의 수술에 사용한 경우에 공기누출을 확실히 방지하는 것이 가능한 의료용 봉합재를 제공하는 것을 목적으로 한다.
상술한 목적을 달성하기 위해, 본 발명의 의료용 봉합재는 봉합용의 실을 사용하여 시트형태를 이루는 봉합재료가 선단이 폐색된 주머니형태로 봉합되어 이루고, 스테이플라인을 가지는 자동봉합기에 장착된다.
본 발명의 봉합재에 있어서, 그 주체가 되는 봉합재료에는 펠트와 같은 부직포나 직포, 니트지 등, 어느정도의 유연성, 신축성을 가지는 것이라면 임의의 형태의 것이 사용될 수 있고, 그 재질도 공지의 것에서 어느 것이나 사용될 수 있으나, 시술후를 고려하면 폴리글리콜산과 같은 생체흡수성 고분자나, 생체 조직의 일부, 예를 들면 심낭막(心囊膜) 등의 장기보호막을 사용하는 것이 요망된다.
상술한 봉합재료는, 예를들면 1장의 포형태의 것을 봉합용의 실에 의해 주머니형태로 봉합하여도 좋고, 복수매 예를들면 2장의 봉합재료를 주머니형태로 봉합하도록 하여도 좋다. 후자의 경우 2장의 봉합재료는 동일한 재료라도 좋고, 별도의 재료라도 좋다, 또 2장의 봉합재료중의 한편은 반드시 봉합재료가 아니라도 좋고, 예를들면 통상의 니트지 등도 사용가능하다.
본 발명의 봉합재는, 선단이 폐색된 주머니형태로 봉합된 것이기 때문에, 자동봉합기 삽입시에 삽입방향으로 수축함으로써 치우침이 발생하지 않는다.
또 특히, 1장 혹은 복수매의 봉합재로를 주머니형태로 봉합한 봉합내는, 전둘레에 걸쳐 봉합재료만에 의해 구성되기 때문에, 부주의로 회전(트위스트)하였다고 하여도 문제는 없다.
이하, 본 발명을 적용한 구체적인 실시예에 대하여, 도면을 참조하면서 상세히 설명한다.
실시예 1
본 실시예의 의료용 봉합재(1)는, 도 1에 나타내는 바와같이 예를들면 흡수성폴리글리콜산의 펠트(예를들면, 군제주식회사제, 상품명 네오벨 등)로 되는 1장의 주봉합재(2)를 봉합용실을 사용하여 선단이 폐색된 주머니형태로 봉합하여서 이루는 것이며, 극히 심플한 구성을 가지는 것이다.
여기서, 주봉합재(2)에는 상기 흡수성폴리글리콜산과 같은 생체흡수성 고분자외에, 종래 봉합재로써 사용되고 있는 것에서 어느 것이나 사용가능하다. 예를들면 심낭막 등의 장기보호막과 같은 생체조직의 일부를 사용하는 것도 가능하다.
상기 주봉합재(2)는, 후술하는 자동봉합기의 장착부위의 길이와 거의 같은 길이를 가지면, 2개로 접는 것으로 하여 폭방향 한쪽 가장자리에 따라서 봉합용의 실인 꿔매는 실(3)에 의해 봉합되어 있다.
상기 꿔매는 실(3)은 뽑아내기 쉬운 것을 고려하면, 소위 모노필라먼트가 좋고 그재질은 임의이다. 예를들면 생체흡수성폴리머의 실이나, 미끄럼성이 양호한 폴리아미드사(상품명-나일론사) 등이 가장 적절하다. 상술한 구성을 가지는 의료용 봉합재는, 자동봉합기에 장착하여 사용된다. 그래서 다음에 자동봉합기의 구조 및 본 실시예의 의료용 봉합재의 사용방법에 대하여 설명한다.
자동봉합기는, 도 2에 나타내는 바와같이 샤프트(11)의 선단에 개폐자재한 봉합부(12)를 가지고 이루는 것이며, 기단부에는 파지-조작하기 위한 조작부(13)가 설치되어 있다.
상기 봉합부(12)는, 도 3에 나타내는 바와같이 스테이플이 수용된 카트리지나 나이프블레이드가 장전되는 봉합기구부(12a) 및 생체조직을 끼워넣기 위한 턱부(12b)로 되고, 봉합기구부(12a)의 끼워넣는 면에는 복수(본 예에서는, 3열×3열=6열)의 스테이플라인(14)이나 나이프의 주사라인(15)이 면하고 있다.
이 자동봉합기는, 서지보트라고 칭하여지는 어태치먼트를 개재하여 생체내에 도입된다. 즉 먼저 생체에 설치한 뚫인 구멍에 서지보트를 장착하고, 이 서지보트를 통해서 자동봉합기의 샤프트(11)를 생체내에로 삽입한다. 이것에 의해 생체에 설치한 뚫인 구멍의 밀폐가 유지된다.
앞의 의료용 봉합재(1)는, 상기 자동봉합기의 봉합부(12)에 장착하여 사용된다, 도 4는 봉합재(1)를 자동봉합기의 봉합부(12)에 장착한 상태를 나타내는 것으로, 봉합기구부(12a) 및 턱부(12b)에 각각 봉합재(1)가 부착된다.
봉합재(1)의 봉합부(12)에의 장착은, 주머니형태의 봉합재(1)를 봉합부(12)에 씌우는 것으로 원활하게 행할 수 있다.
이 상태에서, 앞에 기술한 바와같이 서지보트를 개재하여 자동봉합기를 생체내에 삽입하여 환부에로 도달시킨다. 이때 자동봉합기에 장착되는 봉합재(1)는, 주머니형태의 것을 폐색된 부분에서 밀어넣는 형태로 되어 있으므로, 수축에 의한 치우침이나 비틀림이 발생하지 않는다.
봉합부(12)를 환부에 도입한 후, 도 5에 나타내는 바와같이 생체조직(20)의 절제부위를 봉합기구부(12a) 및 턱부(12b)에 의해 끼워넣는다. 이것에 의해 상기 절제부위는 주봉합재(2)로 씌워지게 된다.
다음에, 자동봉합기의 조작부(13)에 설치된 조작레버를(13a)를 조작하여 상기 스테이플라인(13)에서 스테이플을 타침한다.
이것에 의해, 생체조직(20)의 절제부위에 따라서 스테이플이 타침되고 봉합처치가 실시되는바, 이때 동시에 봉합부(12)에 장착된 봉합재(1)의 주봉합재(2)가 생체조직(20)의 절제부위에 꽉눌러져서 상기 스테이플에 의해 봉합된다.
상기 주봉합재(2)는 봉합시의 보강재로써 기능하고, 생체조직(20)의 절단부분을 이 주봉합재(2)를 개재하여 봉합하는 것으로 조직의 단열이 방지되고, 예를들면 거대 폐낭포(肺囊胞)의 절제술 등에 있어슨 공기누출이 방지된다.
이어서, 봉합기구부(12a)에 설치된 나이프를 주사라인(15)에 따라서 주사하고, 생체조직(20) 및 주봉합재(2)를 절단한다.
이상에 의해 봉합처치가 완료하는바, 본예의 봉합재(1)를 사용함으로써 봉합조작을 원활히 진행시킬 수 있고, 더구나 확실하게 봉합부위의 보강, 공기누출의 방지를 행할 수 있다. 도 6은 봉합종료상태를 나타내는 것이며, 생체조직(20)의 봉합부위에는 주봉합재(2)가 봉합되고, 봉합상태가 극히 안정한 것으로 되어 있다.
실시예 2
본 실시예의 봉합재(21)는, 도 7에 나타내는 바와같이 2장의 봉합재료(22, 23)를 선단이 폐색하는 주머니형태로 봉합하여 이루는 것이다.
각 봉합재료(22, 23)는, 어느 것이나 선단으로 향해서 차차 폭이 좁아지도록 되는 형태로 되어있고, 꿔매는 실(24, 25)에 의해 양측 가장자리에 따라서 봉합되어 있다. 또 이들 꿔매는 실 (24,25)은, 상기 봉합재료(22, 23)의 형태에 의해 봉합재료(22, 23)의 선단부에 있어서 교차되고, 주머니형태의 봉합을 확실한 것으로 하고 있다.
여기서 봉합재료(22, 23)는 동일재료라도 좋고, 별도의 재료라도 좋다. 구체적으로 본 예에서는 제 1봉합재료(22)를 흡수성폴리글리콜산의 펠트(예를들면 군제주식회사제, 상품명 네오벨 등)에 의해 구성하고, 제 2봉합재료(23)를 별도의 재료에 의해 구성하였다.
이와 같이, 별도의 재료로 구성함으로써 코스트를 삭감할 수 있고, 제조상 유리하다.
또한 본예의 봉합재도, 앞의 실시예 1의 봉합재와 동일하게 자동봉합기에 장착하여 사용되는 것이며, 그 사용방법은 실시예 1의 것과 동일하다.
이상, 본 발명의 구체적인 실시예에 대하여 설명하여 왔으나, 본 발명이 이 실시예에 한정되는 것이 아니고 재질, 형태 등에 있어서 여러가지의 변형이 가능한 것은 말할 필요도 없다.
본 발명의 봉합재에 있어선, 자동봉합기 삽입시에 발생하는 수축에 의한 치우침을 방지할 수 있다. 또 뒤틀림이 발생하였다고 하드라고, 상시 봉합재료가 환부에 맞닿게 된다.
따라서, 본 발명의 봉합재를 사용함으로써 봉합부위의 보강을 확실히 생할 수 있고, 조직의 단열이나 공기누출을 억제하는 것이 가능하다.
Claims (11)
- 스테이플라인을 가지는 자동봉합기에 장착되어서 사용되는 의료용 봉합재이며,시트형태를 이루는 봉합재가, 봉합용의 실에 의해 선단이 폐색된 주머니 형태로 봉합되어서 이루는 의료용 봉합재.
- 제 1항에 있어서,1장의 시트형태를 이루는 봉합재료가, 봉합용의 실에 의해 주머니형태로 봉합되어 있는 것을 특징으로 하는 의료용 봉합재.
- 제 1항에 있어서,복수매의 봉합재료가 봉합용의 실에 의해 주머니형태로 봉합되어 있는 것을 특징으로 하는 의료용 봉합재.
- 제 1항에 있어서,상기 봉합재료와 다른 재료가 주머니형태로 봉합용의 실에 의해 봉합되어 있는 것을 특징으로 하는 의료용 봉합재.
- 제 1항에 있어서,상기 봉합재료가 부직포, 직포, 니트에서 선택되는 적어도 1종으로 이루는 것을 특징으로 하는 의료용 봉합재.
- 제 5항에 있어서,상기 봉합재료가 합성고분자로 이루는 것을 특징으로 하는 의료용 봉합재.
- 제 6항에 있어서,상기 합성고분자가 생체흡수성 고분자인 것을 특징으로 하는 의료용 봉합재.
- 제 7항에 있어서,상기 생체흡수성 고분자가 폴리글리콜산인 것을 특징으로 하는 의료용 봉합재.
- 제 1항에 있어서,상기 봉합재료가 생체조직의 일부로 이루는 것을 특징으로 하는 의료용 봉합재.
- 제 9항에 있어서,상기 생체조직이 장기보호막인 것을 특징으로 하는 의료용 봉합재.
- 제 10항에 있어서,상기 생체조직이 심낭막(心囊膜)인 것을 특징으로 하는 의료용 봉합재.
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JP10983495 | 1995-05-08 | ||
JP95-109834 | 1995-05-08 | ||
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KR1019960707422A KR100289263B1 (ko) | 1995-05-08 | 1996-05-08 | 의료용 봉합재 |
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US (1) | US5843096A (ko) |
EP (1) | EP0770357B1 (ko) |
JP (1) | JP3795100B2 (ko) |
KR (1) | KR100289263B1 (ko) |
AT (1) | ATE230582T1 (ko) |
AU (1) | AU711168B2 (ko) |
CA (1) | CA2194240C (ko) |
DE (1) | DE69625664T2 (ko) |
DK (1) | DK0770357T3 (ko) |
ES (1) | ES2185784T3 (ko) |
WO (1) | WO1996035376A1 (ko) |
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-
1995
- 1995-05-16 JP JP11754195A patent/JP3795100B2/ja not_active Expired - Fee Related
-
1996
- 1996-05-08 AT AT96922672T patent/ATE230582T1/de not_active IP Right Cessation
- 1996-05-08 DE DE69625664T patent/DE69625664T2/de not_active Expired - Lifetime
- 1996-05-08 US US08/765,882 patent/US5843096A/en not_active Expired - Fee Related
- 1996-05-08 WO PCT/JP1996/001219 patent/WO1996035376A1/ja active IP Right Grant
- 1996-05-08 DK DK96922672T patent/DK0770357T3/da active
- 1996-05-08 AU AU56588/96A patent/AU711168B2/en not_active Ceased
- 1996-05-08 ES ES96922672T patent/ES2185784T3/es not_active Expired - Lifetime
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- 1996-05-08 EP EP96922672A patent/EP0770357B1/en not_active Expired - Lifetime
- 1996-05-08 KR KR1019960707422A patent/KR100289263B1/ko not_active IP Right Cessation
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WO1996035376A1 (fr) | 1996-11-14 |
US5843096A (en) | 1998-12-01 |
JP3795100B2 (ja) | 2006-07-12 |
DE69625664T2 (de) | 2003-10-16 |
AU5658896A (en) | 1996-11-29 |
EP0770357B1 (en) | 2003-01-08 |
CA2194240A1 (en) | 1996-11-14 |
CA2194240C (en) | 2007-07-17 |
AU711168B2 (en) | 1999-10-07 |
DE69625664D1 (de) | 2003-02-13 |
DK0770357T3 (da) | 2003-05-05 |
JPH0924050A (ja) | 1997-01-28 |
ES2185784T3 (es) | 2003-05-01 |
EP0770357A4 (en) | 1998-02-11 |
EP0770357A1 (en) | 1997-05-02 |
ATE230582T1 (de) | 2003-01-15 |
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