KR102253299B1 - Motorizing surgical auto-stith device - Google Patents

Abstract

A patch graph covering both ends of a ruptured rotator cuff by forming a continuous stitch at regular intervals and a constant tension and depth while moving along the suture object in the direction of movement set by the user. A moving body that sutures the patch graft using suture while moving the patch and patch graft, a transfer part that transfers the moving body, a sealing condition setting part that sets the sealing condition, and a transfer part according to the sealing conditions set by the sealing condition setting part. It implements an automatic suture device for arthroscopic surgery, including a control unit that controls the transfer and movement of the body.

Description

Medical surgical auto-stith device

The present invention relates to an automatic medical suturing device, and more particularly, an automatic medical suturing device for suturing a tissue by forming a continuous stitch at a certain interval and a certain tension and depth while moving in a direction of movement set by a user along a suture object. It is about.

In the event of a rotator cuff rupture that forms the shoulder joint due to a disease or disease, suture surgery is required to suture the rotator cuff rupture site.

For the suture operation, as shown in FIG. 1, a patch graft is used, and a method of suturing the ruptured area by stitch by stitch is used. In the case of such a suture operation, it takes a lot of time to suture and a lot of effort is required by a doctor.

Therefore, in order to solve this discomfort, various types of medical sutures have recently been proposed, and as an example of such a suture, a medical stapler has the advantage of being able to easily and quickly suture the affected area.

The U.S. published patent presented in <Patent Document 1> below is that when the user moves the actuator, the staple thread assembly moves and pushes the staple of the staple cartridge toward the anvil located on the opposite side, and the staple is deformed by being pressed against the anvil. As a result, the affected area is sutured. Such a medical stapler mainly uses a staple made of titanium. Titanium is widely used as a staple material because it does not react with the body's immune system, so it has excellent biocompatibility and excellent corrosion resistance.

In addition, the following <Patent Document 2> discloses a suture device using a medical suture. A suture is applied to the needles that alternately reciprocate between the two jaws.

It is caught and the affected part is sutured by the reciprocation of the needle.

US Patent Publication No. US 2016/0174985 (published on June 23, 2016, Applicant-Ethicon Endo-Surgery) US registered patent US 8,968,339 (registered on Mar. 3, 2015, patentee-Covidien LP)

However, the general medical suture devices and conventional techniques as described above have the advantage of being able to conveniently implement suturing, but suturing is performed only by a predetermined interval and depth, and they are automatically sutured according to the suture direction, or the suture interval and depth are doctored. There is a drawback that cannot be set arbitrarily.

In particular, the length may be different depending on the thickness or degree of rupture of the patch graft used according to the rupture site during shoulder surgery, and it is necessary to vary the suture interval or depth according to the rupture condition. The technology has the disadvantage of not considering the length or thickness of such a patch graft at all, and is always suturing only at a certain interval and depth.

In addition, when using an automatic suture device, it is used in blood, body fluids, and physiological saline. If it is difficult for a doctor to accurately recognize or a foreign substance is introduced into the automatic sealing device, there is a disadvantage that a method to solve it is not suggested at all.

Therefore, the present invention has been proposed to solve the problems occurring in the general sealing device and the prior art as described above, while moving along the direction of movement set by the user along the sealing object, and continuously at a constant interval and a constant tension and depth. It is an object of the present invention to provide an automatic medical suturing device for suturing a tissue by forming a stitch.

Another object of the present invention is to provide an automatic medical suturing device for automatically suturing structures such as tendons in a joint in surgery using an arthroscopy.

Another object of the present invention is to improve problems such as difficulty in securing a field of vision that may occur due to blood, body fluids, physiological saline, etc., or failure of the automatic sealing device due to the inflow of foreign substances when the automatic sealing device is used on the human body. It is to provide a medical automatic suture device.

In order to achieve the above object, a medical automatic suture device according to the present invention includes: a patch graft covering both ends of the ruptured rotator cuff (tendon); A moving body that sutures the patch graft using suture while moving the patch graft; A transfer unit for transferring the moving body; A sealing condition setting unit for setting a sealing condition; And a control unit for controlling the transfer of the transfer unit and the moving body according to the sealing condition set by the sealing condition setting unit.

In the above, the movable body includes a needle passing through the patch graft and transferring the suture while reciprocating; A needle driver for reciprocating the needle; A hook installed at a position opposite to the needle to form a stitch by hanging the suture transferred by the needle while performing reciprocating motion depending on the reciprocating displacement of the needle; It includes a hook driving unit for reciprocating the hook.

In the above, the moving body is waterproofed to prevent a liquid including blood or physiological saline from flowing into the moving body.

In the above, by surrounding the outside of the medical suture device including the moving body and the transfer unit, further comprising a shell for preventing a liquid containing blood or physiological saline from penetrating into the interior of the medical suture device,

The outer shell is characterized by using at least one of transparent plastic or transparent rubber (soft PVC) or polyvinyl alcohol (PVA)-based synthetic fibers that can be seen inside.

In the above, the suture condition setting unit is characterized in that the suture interval, suture direction, and suture depth are set as suture conditions.

In the above, the sealing condition setting unit comprises: an interval setting unit for setting a sealing interval; A direction setting unit for setting a direction of suturing; A depth setting unit for setting a suture depth; It characterized in that it comprises a suction operation unit for inputting a suction operation function.

In the above, the direction setting unit may include a left direction setting for moving the moving body to the left and a right direction setting for moving the moving body to the right.

In the above, the control unit controls the direction and distance of the moving body according to the direction and distance set by the sealing condition setting unit, and the needle driving unit and the hook according to the sealing depth set by the sealing condition setting unit. It is characterized in that the suture depth is controlled by controlling the driving unit.

In addition, the automatic sealing device for medical use according to the present invention includes: a display unit for displaying a sealing image output from the control unit on a screen; It is embedded in the moving body further comprising a photographing device for photographing the state of the lower suture of the patch graft when suturing,

The control unit is characterized in that for controlling the image display to display the sutured image acquired from the photographing device on the display unit.

In addition, the medical automatic sealing device according to the present invention further includes a medical suction unit for sucking bodily fluid, blood, or physiological saline in connection with the control unit,

The medical suction device includes a probe mounted inside the automatic medical sealing device; A suction container for storing body fluids or blood or physiological saline by suctioning and storing body fluids or blood or physiological saline while controlling suction power; And a connection part for transmitting a suction operation signal to the suction container according to a control signal from the control unit and connecting the probe and the suction container.

According to the present invention, there is an effect of automatically suturing a structure within a joint by forming a continuous stitch at a constant interval, a constant tension, and a depth while moving along the direction of movement set by the user along the suture object.

1 is an exemplary view of sutures during general shoulder surgery,
2 is a configuration diagram of an automatic medical suture device according to the present invention,
3 is a configuration diagram of an embodiment of a control and driving unit for sealing both ends of a ruptured rotator cuff and a patch graft according to the present invention;
4A and 4B are exemplary views of automatic suturing of an overlapping portion of the rotator cuff end and the patch graft in the present invention.

Hereinafter, an automatic medical suture device according to a preferred embodiment of the present invention will be described in detail with reference to the accompanying drawings.

2 is a configuration diagram of an automatic medical sealing device 1 according to a preferred embodiment of the present invention, and FIG. 3 is a configuration diagram of an embodiment of a control and driving unit of the automatic medical sealing device 1 according to the present invention.

As shown, the medical automatic suturing device 1 according to the present invention includes a patch graft 10 covering both ends of the ruptured rotator cuff (tendon) 2, and the patch graft 10 A moving body 20 for suturing the patch graft 10 using a suture 3 while moving ), a transfer unit 50 for transferring the moving body 20, and a suturing condition setting unit for setting the sealing condition ( 40), a control unit 30 for controlling the transfer of the transfer unit 50 and the moving body 20 according to the sealing condition set by the sealing condition setting unit 40, and a sealing image output from the control unit 30 A display unit 60 for displaying on the screen and a medical suction unit 90 for sucking bodily fluid, blood, or physiological saline in connection with the control unit 30 are included.

The moving body 20 has a needle 21 for transferring the suture 3 while reciprocating through the patch graft 10, a needle driving part 22 for reciprocating the needle 21, and the needle ( The hook 23, the hook 23, which is installed at a position opposite to the needle 21 and is subjected to the reciprocating displacement of the needle 21 to reciprocate and hang the suture 3 conveyed by the needle 21 to form a stitch. ) And a hook driving unit 24 for reciprocating motion.

In addition, a photographing device 80 that photographs the state of the lower portion of the patch graft 10 and transmits it to the control unit 30 is built into the moving body 20. It is preferable that the photographing apparatus 80 uses a subminiature camera.

In addition, the suture condition setting unit 40 includes an interval setting unit 41 for setting a suture interval, a direction setting unit 42 for setting a sealing direction, a depth setting unit 43 for setting a suture depth, and a suction operation function. It includes a suction operation unit 44 to input.

The control unit 30 controls the direction and the interval of the moving body 20 according to the direction and interval set by the sealing condition setting unit 40, and the sealing is set by the sealing condition setting unit 40. Depending on the depth, the needle driving unit 22 and the hook driving unit 24 are controlled to control the suture depth, and when a suction function is input by the suction operation unit 44, the medical suction unit 90 is controlled so that the suction function is performed. It is desirable to control.

The medical suction device 90 includes a probe 91 mounted inside the automatic medical sealing device, a suction container 93 that adjusts a suction force and sucks and stores bodily fluid or blood or physiological saline, and a control of the control unit 30 It transmits a suction operation signal to the suction vessel 93 according to the signal, and includes a connection portion 92 for connecting the probe 91 and the suction vessel 93.

In addition, the automatic medical sealing device according to the present invention surrounds the outside of the medical sealing device including the moving body 20 and the transfer unit 50, so that a liquid containing blood or physiological saline penetrates into the medical sealing device. It further includes an outer shell 70 to prevent the outer shell 70 from being implemented by using at least one of transparent plastic or transparent rubber (soft PVC) or polyvinyl alcohol (PVA)-based synthetic fibers visible inside. It is desirable. Here, the outer skin 70 may be used by covering the automatic medical sealing device as a cover, and it is preferably made for a single use and disposed of after use, and it is preferable to use a new one if foreign substances are introduced during use.

Even when using transparent plastic, it is desirable to use a soft material to improve convenience in replacement and use.

The operation of the automatic medical suture device according to the present invention configured as described above will be described in detail as follows.

First, the surgeon for the shoulder joint arthroscopic surgery sets the suture condition to suture the ruptured rotator cuff.

Here, the suture conditions include suture interval, suture direction, and suture depth.

The surgeon sets the suture spacing, suture direction, and suture depth using keys, buttons, or dials for setting conditions. It is preferable to set the suture interval, suture direction, and suture depth according to the thickness or depth of the patch graft 10 to be used, and the state of the ruptured rotator cuff.

When the sealing gap is set, the gap setting unit 41 transmits the gap setting value to the control unit 30, and when the sealing direction is set, the direction setting unit 42 transmits the direction setting value to the control unit 30. Then, when the suture depth is set, the depth setting unit 43 transmits the suture depth setting value to the control unit 30.

When each setting value (interval setting value, direction setting value, depth setting value) is input, the control unit 30 extracts a control value according to each setting value stored in the internal memory. Here, it is assumed that the control value according to each setting value is stored in the internal memory in the form of a table. In addition, it is assumed that each set value is initialized when the power of the medical automatic sealing device 1 is turned off and the power is turned on again. Initialization of the setting value is assumed to be set to the most basic interval and depth.

Thereafter, the operator (doctor) puts the upper skin 70 on the moving body 20 in order to prevent foreign substances from flowing into the medical automatic suture device.

Here, the outer shell 70 is made of at least one of transparent plastic or transparent rubber (soft PVC) or polyvinyl alcohol (PVA)-based synthetic fiber with visible inside, and is made of a soft material, and the upper device 51 and the lower device 52 It is used in a way that wraps the outside of ). The outer shell 70 is made for a single use and is preferably disposed of after use, and if it is determined that foreign substances have penetrated into the medical suture device through the naked eye even during use, it is preferable to replace it with a new one.

In fact, the medical automatic sealing device according to the present invention is waterproof, so that foreign substances are prevented from being introduced into the medical sealing device to some extent, but the actual medical automatic sealing device is used in a liquid such as blood, body fluid, or physiological saline. Since it is used in, it may be difficult to completely block foreign substances from entering the medical automatic sealing device only with the above waterproof treatment. Therefore, this waterproofing treatment was supplemented, and the outer skin 70 was added to visually identify that foreign substances were introduced into the medical automatic sealing device, thereby further improving the waterproofing function.

On the other hand, while the patch graft 10 as a suture object is positioned between the upper device 51 and the lower device 52 of the moving body 20, a suture driving command is issued using a driving button. Here, although not shown in the drawing, a driving button is provided for a suture driving command.

When a sealing driving command is input according to the operation of the driving button, the control unit 30 controls the sealing direction by applying a direction control value and an interval control value of the extracted control values to the transfer unit 50.

Here, the suture direction includes a left suture direction in which automatic suture is performed while moving from the current position to the left, and a right suture direction in which automatic suture is performed while moving from the current position to the right.

When the sealing direction control value output according to the setting of the sealing direction is applied to the transfer unit 50, the transfer unit 50 drives the moving body 20 to move the moving body 20.

Here, the transfer unit 50 automatically moves the moving body 20 from the current position to the left or right according to the direction control value using a rack-pinion gear method or a transfer device using a separate motor gear. At the same time, the transfer unit 50 adjusts the moving speed of the moving body 20 according to the interval control value. Here, the speed of movement becomes the interval. That is, when the moving speed is high, the stitching interval of the stitches is wide, and when the moving speed is low, the stitching interval of the stitches is narrow.

While transferring the moving body 20 through the transfer unit 50 in the same manner as described above, the control unit 30 simultaneously controls the needle drive unit 22 and the hook drive unit 24 built in the transfer body 20 to seal Control the depth.

Here, since the moving body 20 is in a state of operation within the actual human joint, blood in the shoulder joint or a physiological saline solution, etc., which is injected to secure the field of view of the arthroscope, come into contact with the blood in the shoulder joint or the joint cavity. Therefore, there is a concern that blood or physiological saline may flow into the moving body 20 and damage the moving body 20. Therefore, in order to solve this problem, in the present invention, the movable body 20 is waterproofed to prevent blood or physiological saline from flowing into the movable body 20 during suturing.

Meanwhile, the needle driving unit 22 adjusts the depth during the reciprocating movement of the needle 21 according to the applied depth control value. In the state where the depth is adjusted in this way, the needle 21 performs a reciprocating motion on the top of the patch graft 10 using the suture 3, and the hook driving unit 23 located under the patch graft 10 is a hook By operating (23), a stitch is automatically formed and sutured.

Here, the process of automatically forming a stitch will be described in more detail with reference to FIGS. 4A and 4B as follows.

Among the constituent parts constituting the sealing device, the needle drive unit 22 includes a needle drive motor, a drive gear, a Geneva driver, a slider, first and second sliding guides, a slider driver, and the like, and performs the vertical movement of the needle 21. It is a triggering factor.

In addition, the hook driving unit 24 includes a hook driving motor, a driving gear, a camshaft, a cam, a hook slider, a hook slider holder, a spring, and the like, and is an element that causes the hook to move horizontally.

In a state in which the automatic sealing device 1 is placed in a predetermined position of the patch graft 10 to be sutured, the needle driving motor and the hook driving motor are electrically controlled, and the needle 21 and the hook 23 The patch graft 10 is sutured by performing the operation to form a stitch by the suture 3. The driving force of the needle drive motor is transmitted to the Geneva driver and the slider driver that rotates integrally with it through the drive gear. The rotational motion of the slider driver is converted into a vertical reciprocating motion of the slider, and the needle 21 fixed to the slider also reciprocates vertically to form a stitch.

In addition, the driving force of the hook driving motor is transmitted to the camshaft through the driving gear. The cam that rotates integrally with the camshaft causes the hook slider to reciprocate in the front-rear direction according to its rotation position.

On the other hand, rotation of the Geneva driver is transmitted to the Geneva gear, and when the Geneva gear rotates, the gear unit rotates on the fixed rack and integrally moves in the front-rear direction.

This process is illustrated in an exemplary diagram as in FIGS. 4A and 4B.

The present invention automatically sutures the suture object by forming a continuous stitch at a certain interval and a certain tension and depth while moving along the direction of movement set by the user along the suture object. In addition, in surgery using arthroscopy, the suture of structures such as the rotator cuff in the joint is automatically performed to shorten the suturing time.

When automatically suturing the ruptured rotator cuff as described above, the suture state or position of the rotator cuff and the patch graft 10 at the top of the patch graft 10 is clearly visible from above, but the patch graft 10 It is hard to see from the lower part of. Therefore, in order to compensate for these shortcomings, in the present invention, the photographing device 80 using a micro-camera is embedded in a predetermined position of the moving body 20 (preferably, a predetermined position of the lower device 52), and the lower suture is performed upon automatic suturing. The state is photographed and transmitted to the control unit 30. The control unit 30 displays the lower suture image transmitted in real time on the screen through the display unit 60 so that the doctor recognizes the state of the lower suture in real time. The rotator cuff suture is a method in which the patch kraft 10 and the tattered tendon (rotator cuff) overlap and suture, and the suture can be optimized only by checking whether the needle fits well in the overlapped area. Therefore, in the past, there was a problem in that the doctor checks the suture state only in the state where the rotator cuff suture is completed, and if the suture is not well, the suture must be re-sutured, but in the present invention, the doctor can check the suture state in real time during the suturing process. Therefore, there is an advantage that the suture can be completed while modifying the suture at any time in the middle of suturing.

On the other hand, as another feature of the present invention, it is possible to perform suturing while removing body fluid or blood that obstructs the visual field while performing automatic suturing.

For example, the medical suction device 90 is coupled through the connection part 92 mounted by the transfer device 50 of the medical automatic sealing device, and the view is secured by bodily fluid or blood while checking the suture image through the display unit 60 when suturing. If it is difficult, the suction function is input through the suction operation unit 44. Here, it is also possible to adjust the suction force when entering the suction function.

When a suction function is input, the controller 30 transmits a control signal to the suction container 93 through the connection part 92 to control the medical suction device 90 to perform the suction function. Here, it is assumed that the suction container 93 is provided with a configuration for performing a suction function. The suction container 93 of the medical suction device 90 performs a suction operation through an internal control device, and by the suction function performed in this way, the body fluid or body fluid or body fluid or fluid from the probe 91 connected to the suction container 93 according to the suction force Blood or physiological saline is sucked and sent to the suction container (93). Here, the suction device 90 adopts and uses a known general medical suction device as it is, and a specific technical configuration or operation is the same as a general medical suction device, and thus a detailed description thereof will be omitted.

By removing foreign substances using the suction function during suturing as described above, it is always possible to secure an optimal field of view during suturing, and thus, the accuracy of suturing can be improved.

Although the invention made by the present inventor has been described in detail according to the above embodiment, the present invention is not limited to the above embodiment, and it is common knowledge in the art that various changes can be made without departing from the gist of the invention. It is self-evident to those who have.

1: Medical automatic sealing device
2: rotator cuff (tendon)
3: suture
10: patch graft
20: moving body
21: needle
22: needle drive unit
23; hook
24: hook driving part
30: control unit
40: condition setting unit
41: interval setting unit
42: direction setting unit
43: depth setting unit
50: transfer unit
60: display
70: outer shell
80: photographing device
90: suction device

Claims (10)

As an automatic suture device for arthroscopic surgery,
A moving body for suturing the patch graft using suture while moving the patch graft covering both ends of the ruptured rotator cuff;
A transfer unit for transferring the moving body;
A sealing condition setting unit for setting a sealing condition; And
And a control unit for controlling the transfer of the transfer unit and the moving body according to the sealing condition set by the sealing condition setting unit,
The suture condition setting unit sets at least one or more of a suture interval, a suture direction, and a suture depth as a suture condition,
The sealing condition setting unit includes an interval setting unit for setting a sealing interval; A direction setting unit for setting a direction of suturing; A depth setting unit for setting a suture depth; Including at least any one or more of the suction operation unit for inputting a suction operation function,
The direction setting unit includes a left direction setting function for moving the moving body to the left and a right direction setting function for moving the moving body to the right,
The movable body includes a needle passing through the patch graft and reciprocating while transferring the suture; A needle driver for reciprocating the needle; A hook installed at a position opposite to the needle to form a stitch by hanging the suture transferred by the needle while performing reciprocating motion depending on the reciprocating displacement of the needle; And a hook driving unit for reciprocating the hook,
The control unit controls the direction and distance of the moving body according to the direction and distance set by the sealing condition setting unit, and controls the needle driving unit and the hook driving unit according to the sealing depth set by the sealing condition setting unit. A medical automatic suture device, characterized in that the suture depth is controlled and the suture object is automatically sutured by forming a continuous stitch at a constant interval and a constant tension and depth while moving in a direction of movement set by the user along the suture object.
delete The medical automatic sealing device according to claim 1, wherein the moving body is waterproofed to prevent blood, physiological saline, or liquid from flowing into the moving body.
delete delete delete delete The method according to claim 1, further comprising an outer shell that surrounds the outside of the medical suture device including the moving body and the transfer unit, and prevents a liquid containing blood or physiological saline from penetrating into the interior of the medical suture device,
The outer skin is a medical automatic sealing device, characterized in that formed by using at least one of transparent plastic or transparent rubber (soft PVC) or polyvinyl alcohol (PVA)-based synthetic fibers that can be seen inside.
The method according to claim 1, Display unit for displaying the stitched image output from the control unit on the screen; It is embedded in the moving body further comprising a photographing device for photographing the state of the lower suture of the patch graft when suturing,
Wherein the control unit controls an image display to display the stitched image acquired from the photographing device on the display unit.
The method according to claim 1, further comprising a medical suction unit (suction unit) for sucking bodily fluid, blood, or physiological saline in connection with the control unit,
The medical suction device includes a probe mounted inside the automatic medical sealing device; A suction container for storing body fluids or blood or physiological saline by suctioning and storing body fluids or blood or physiological saline while controlling suction power; And a connection part for transmitting a suction operation signal to the suction container according to a control signal from the control unit and connecting the probe and the suction container.

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