KR102554820B1 - suturing device - Google Patents

Abstract

A suture device for fixing a suture thread by compressing a fixing member is disclosed. A suturing device according to an embodiment includes a body having an operation handle and a shape that can be grasped by an operator with one hand, a pipe-shaped shaft extending in one direction from the body, and separated from the distal end of the shaft. A cartridge having a structure capable of being coupled, at least a part of the fixing member disposed therein, moving forward or backward along the one direction inside the shaft in conjunction with the operation of the operation handle, the body A pusher having a protruding end in the opposite direction and a hammer and an anvil disposed inside the distal end of the shaft and spaced apart by a predetermined interval, and advancing along the one direction. and a clamper designed to compress the fixing member by reducing the gap between the hammer and the anvil due to pressure by the protruding end.
Representative diagram: Figure 2

Description

suturing device

The present invention relates to a suture device for suturing an incision, etc., and more specifically, to fix a suture string to which a predetermined tension is applied by clamping/crimping a securing member. It relates to a sealing device.

BACKGROUND OF THE INVENTION In a surgical operation in which damaged body tissue is replaced with an artificial structure through an incision in an affected area, the suturing procedure is a great burden on the surgeon as well as the patient. For example, in an operation such as heart valve replacement, each of a plurality of artificial heart valves must be sewn to the body tissue using a suture, and then crossed and fixed while the suture is pulled tight. Not only does it require strength, but it also takes a lot of time. If the time of the suturing procedure is prolonged, the physical and mental energy used by the surgeon increases as well as the physical burden on the patient, so the possibility of side effects accordingly increases.

In addition, minimally-invasive surgical procedures are usefully used in surgical operations. In minimally-invasive surgery, with visual assistance through an endoscope and an external display, the surgeon can use various medical instruments, such as glass, in the body. A grasper, dissector, clip applier, laser, etc. are used according to the surgical procedure. Accordingly, minimally invasive surgery can bring advantages to patients, such as a quick recovery time, hospitalization period and medical cost reduction.

One of the biggest difficulties encountered in such minimally invasive surgery is to suture body tissues inside the body. In the suturing procedure, the surgeon must first pass the end of the suture through another adjacent body tissue. Then, the surgeon pulls the suture and applies tension to the suture so as to effectively bring the body tissues together, and fixes the suture using a knot or the like. Tying a knot in the suture during the procedure is not only difficult to manipulate the suture device due to the limitation of the entry space for the procedure, but also takes a lot of time, and thus corresponds to a task that is considerably burdensome to the surgeon.

Various methods have been proposed to solve the difficulty of crossing and fixing sutures maintaining tension in an operation through a wound incision or tying a knot while maintaining a desired tension in a suture during minimally invasive surgery. One of them is a suturing device developed by LSI Solutions of the United States, for example, a device called a brand name COR-KNOT device (or MINI COR-KNOT device). The COR-KNOT device uses a clamping/crimping instrument to crimp and deform a securing member (aka fastner) through which the suture passes to fix the suture and at the same time cut and remove the excess suture. perform the function of Accordingly, the suture may be fixed in a state in which a predetermined tension is maintained by the compression-deformed fixing member.

Figure 1a is a perspective view schematically showing the schematic configuration of such a COR-KNOT suture device, for convenience of explanation, the suture (S) is shown together. In FIG. 1A, reference numeral 12 is a handle, reference numeral 14 is a lever, reference numeral 16 is a shaft, reference numeral 18 is a compression deformation mechanism or clamper, and reference numeral 22 is a target ), reference numeral 24 denotes a wire snare, reference numeral 26 denotes a curved handle, and reference numeral 32 denotes a fastener. And Figure 1b is a perspective view schematically showing the internal configuration of the compression deformation mechanism 18 corresponding to the distal end of the shaft tube of the COR-KNOT sealing device of Figure 1a, Figure 1c is coupled to the compression deformation mechanism 18 It is a perspective view schematically showing a state in which the ring 26 is inserted. For example, LSI Solutions' US Patent No. 7,235,086 (Patent Document 1), “Crimping instrument with motion limiting feature” discloses an example of such a sealing device and a crimping deformation mechanism provided therewith.

The suture procedure using the COR-KNOT suture device is performed as follows. First, the fixing member 32 is inserted into the distal end of the shaft 16, that is, into the clamper 18. The fixing member 32 has, for example, a cylindrical shape with one end (head) having a larger outer diameter than the body, and the body is inserted into the clamper 18 so that the head is roughly parallel to the distal end of the shaft 16. do. In addition, the surgeon inserts the curved handle 26 through the fixing member 32 and the suture bypass hole in a state where the suture S passing through the body tissue is inserted into the wire noose 24 ( 1c), when pulled outward, a predetermined tension is applied to the fixing member 32 along the wire noose 24 and the suture S passing through the suture through hole. When the lever 14 is pulled with the other hand holding the handle 12 while a predetermined tension is continuously applied to the suture thread S, the pusher moves forward. At this time, the cutting blade coupled to the pusher moves forward. (cutting blade) also moves forward. The protruding end of the forward pusher applies pressure to the clamper so that the clamper is closed, whereby the hammer and anvil of the clamper approach by a predetermined distance and press the fixing member 32 . At the same time, the cutting blade advancing forward together with the pusher at a position opposite to the protruding end of the pusher cuts the excess suture thread passing through the suture through hole. As a result, the remaining suture may be fixed with a predetermined tension applied by the compressively deformed fixing member 32 .

In the sealing device having this configuration, it is important to apply appropriate pressure to deform the fixing member 32, and if the pressure is too great, there is a risk that the fixing member 32 may be damaged. If the fixing member 32 is damaged, since the broken pieces remain inside the body, in severe cases, the patient's life may be threatened. In Patent Document 1, the shape (profile) of the hammer and the anvil is utilized so that the pressure applied to the fixing member 32 can be adjusted. That is, in a state in which the fixing member 32 is not completely compressed, the lower profile of the hammer and the upper profile of the anvil contact each other (ie, one or more cooperative stops (reference numbers 46A and 46B of FIG.8 of Patent Document 1) , 46C and 46D), it is prevented that excessive pressure is applied to the fixing member 32 disposed therebetween.

According to this conventional suturing device, the surgeon has to insert the fixing member 32 into the inside through the distal end of the shaft 16 having a diameter of 4 mm or 5 mm every time the surgeon performs suturing, and the fixing member 32 has a diameter of 2 mm or less and is Since it is fairly small, it is not only unwieldy but also easy to drop. In addition, after inserting the fixing member 32, the curved handle 26 must pass through the fine hole formed in the fixing member 32 and the suture thread through hole together, which is also a precision for the curved handle 26. ask for manipulation

In addition, controlling the degree (size) of compression only by the contacting profile of the hammer and the anvil causes a problem in that the function cannot be properly performed if the hammer and the anvil do not contact exactly at the preset position. That is, when force is applied to either the hammer or the anvil forward and/or backward or shifted from side to side, the hammer and the anvil do not come into contact with each other in the correct position, so that excessive pressure is applied to the fixing member 32. there is.

In addition, in the existing suturing device, the blade for cutting is coupled to the pusher on the opposite side (lower side of the shaft) of the protruding end of the pusher (disposed on the upper side of the shaft) (the suture is cut at the suture through-hole portion on the lower side of the shaft). ), structurally only a part (proximal part) of the blade for cutting is supported by the pusher. As a result, the cutting blade also advances as the pusher advances, but the distal portion of the cutting blade that is not supported by the pusher swings up and down, making it difficult to advance accurately in the direction in which the pusher advances. In this case, a problem may arise that the suture is not cut or is cut at an undesirable location.

One problem to be solved by the present invention is that the operator can place the fixing member at the distal end of the suture device without directly handling the fixing member, which has a fairly small size, and also provides a curved handle to the fixing member and the suture through hole. It is to provide a sealing device that does not require an operation to be inserted into a fine hole.

Another problem to be solved by the present invention is to provide a sealing device capable of preventing an unnecessary pressing force from being applied to a fixing member even when the hammer and the anvil do not accurately contact each other.

Another problem to be solved by the present invention is to provide a sealing device capable of preventing a cutting blade moving forward with a pusher from shaking.

One embodiment of the present invention for solving the above problems is a suture device for fixing a suture thread by compressing a fixing member, comprising: a body having an operation handle and having a shape that an operator can grip with one hand; A pipe-shaped shaft extending in one direction from the body, a cartridge having a structure that can be detachably coupled to the distal end of the shaft, and at least a part of the fixing member disposed therein; A pusher having a protruding end in the opposite direction of the body and a hammer disposed inside the distal end of the shaft and spaced apart by a predetermined interval by interlocking with each other to advance or retreat along the one direction inside the shaft ( and a clamper having a hammer and an anvil, and designed to compress the fixing member by reducing a distance between the hammer and the anvil due to pressure from the protruding end of the pusher advancing along the one direction.

According to one aspect of the embodiment, the cartridge has at least a portion of the fixing member disposed therein to be coupled to the distal end of the shaft, and a first through hole into which the fixing member can be inserted is the shaft. A case formed at the opposite end coupled to the case, a snare member disposed outside the direction in which the first through hole of the case is located, a connection line penetrating the fixing member, and one end connected to the snare member, and the case It is coupled to the second through hole formed on the outer circumferential surface to be detachable from the case, and includes a pulling member to which the other end of the connection line is coupled through the second through hole.

According to another aspect of the embodiment, at a position corresponding to the protruding end, a cutting blade coupled to the distal portion of the pusher to advance or retreat inside the shaft in conjunction with the movement of the pusher may be further included. .

In this case, the hammer and the anvil may be disposed opposite to each other so as not to overlap with the second through hole, and the cutting blade may be disposed to overlap with the second through hole. And the protruding end and the blade for cutting are disposed orthogonally to each other, and the protruding end is connected to a first member for pressing the hammer of the clamper by the pusher advanced by manipulation of the operation handle, and the first member. It includes a second member coupled to support at least a portion of the lower surface of the cutting blade in the longitudinal direction.

According to the embodiment of the present invention described above, since the disposable cartridge having the fixing member disposed therein and having a pulling member connected to the snare member is used, the fixing member must be inserted before the procedure or the curved handle ( coupling ring) through the fixing member and the suture through-hole. Therefore, the accuracy and convenience of the procedure are improved.

And since the degree of compression of the fixing member is determined by the thickness of the distal end of the pusher, it is possible to prevent the fixing member from being compressed too much or too little.

Also, since the cutting member disposed to be orthogonal to the pusher is supported in the longitudinal direction by the pusher, it is possible to prevent a phenomenon in which the cutting blade that advances does not cut the suture thread or cuts the suture at an undesired position.

Figure 1a is a perspective view schematically showing the schematic configuration of such a COR-KNOT suture device.
Figure 1b is a perspective view schematically showing the internal configuration of the compression deformation mechanism corresponding to the distal end of the shaft tube of the COR-KNOT sealing device of Figure 1a.
1C is a perspective view schematically showing a state in which a coupling ring is inserted into a compression deformation mechanism.
Figure 2 is a perspective view schematically showing a schematic configuration of a sealing device according to an embodiment of the present invention.
Figure 3a is a perspective view schematically showing the schematic configuration of the cartridge of the sealing device of Figure 2;
Figure 3b is a cross-sectional view taken in the vertical direction along the dotted line in Figure 3a.
Figure 4a is a perspective view schematically showing the internal configuration of the distal end of the shaft to which the cartridge is mounted in the sealing device of Figure 2.
Figure 4b is a cross-sectional view taken in the vertical direction along the dotted line in Figure 4a, before ((a)) and after ((b)) compression of the clamp.
Figure 4c is a perspective view schematically showing the shape of the clamp in Figure 4b.
Figure 5a is a front view schematically showing the configuration of the pusher of the closure device.
Figure 5b is a plan view and a rear view showing an enlarged dotted line rectangular portion of Figure 5a.

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings. Terms and words used in this specification are terms selected in consideration of functions in the embodiments, and the meanings of the terms may vary depending on the intention or practice of the invention. Therefore, the terms used in the embodiments to be described later, when specifically defined in the present specification, follow the definition, and when there is no specific definition, they should be interpreted as meanings generally recognized by those skilled in the art.

An embodiment of the present invention to be described later is an improved device for the purpose of operator's convenience and surgical accuracy of the existing COR-KNOT suture device. Therefore, hereinafter, the embodiment of the present invention will be described in detail, focusing on the differences from the COR-KNOT sealing device. Therefore, in relation to the configuration and operation of the suturing device, matters not described in detail in the embodiments of the present invention are the same as those related to the COR-KNOT suturing device, except for configurations or functions that are essentially excluded from the application. may be applied appropriately.

Figure 2 is a perspective view schematically showing a schematic configuration of the sealing device 100 according to an embodiment of the present invention. Figure 3a is a perspective view schematically showing the schematic configuration of the cartridge of the sealing device of Figure 2 Figure 3b is a cross-sectional view taken in the vertical direction along the dotted line in Figure 3a. Figure 4a is a perspective view schematically showing the internal configuration of the distal end of the shaft to which the cartridge is mounted in the sealing device of Figure 2, Figure 4b is a cross-sectional view taken in the vertical direction along the dotted line in Figure 4a, the clamp is compressed Before (A) and after compression (B), Figure 4c is a perspective view schematically showing the shape of the clamp in Figure 4b. And Figure 5a is a front view schematically showing the configuration of the pusher 142 of the suturing device 100, Figure 5b is an enlarged portion (dotted line rectangular portion of 5a) including the protruding end of each pusher 142 Shown are a top view and a back view.

As shown in Figure 2, the closure device 100 includes at least a body 110, a shaft 120 and a cartridge 130 in appearance.

The body 110 has a shape that an operator can hold with one hand, and the shape or structure of the body 100 shown in FIG. 2 is exemplary. According to this embodiment, there is no particular limitation on the shape or structure of the body 110, and the operator can operate the operating handle 112 using one or more fingers while holding the suture device 100 with one hand. A structure that exists is sufficient. Depending on the embodiment, a predetermined friction member 114 may be additionally provided at the part where the operator's palm touches so that the operator can firmly grip the body 110 and prevent it from slipping during operation. The friction member 114 is sufficient to have a material and/or shape capable of increasing frictional force with the palm, and there is no particular limitation on its specific implementation form.

The operating handle 112 is a means by which the operator can operate the suturing device 100 using one or more fingers while holding the body 110 . The shape or structure of the operating handle 112 shown in FIG. 2 is also exemplary. When the operator applies a predetermined force to the operating handle 112 with a finger or the like and drives it (eg, pulling the operating handle 112 in the direction of the friction member 114), the shaft 120 is provided in conjunction with this The pusher 142 moves forward. Conversely, when the force applied to the operating handle 112 is removed, the pusher 142 retracts and returns to its original position.

According to the present embodiment, there is no particular limitation on a specific method for implementing a mechanism in which the pusher 142 advances or retreats in conjunction with the manipulation of the operating handle 112 . For example, in the conventional COR-KNOT suturing device shown in FIGS. 1A to 1C, the pusher may be configured to move forward or backward in association with the operation handle 14 (see FIG. 1A). Alternatively, one end of the operation handle 112 (the end inserted into the body 110 as a part of the operation handle 112) is directly or indirectly connected to the proximal end of the pusher 142 inside the body 110. Since they are connected (coupled) to each other, if the structure interlocks with the operation of the operating handle 112, it may be implemented in a different way from the existing COR-KNOT suture device.

The shaft 120 is a pipe-shaped member extending from the body 110 in one direction. Inside the shaft 120, at least a pusher 142 is provided so as to be movable along the longitudinal direction (advancing toward the distal end or retracting in the opposite direction). That is, the shaft 120 functions as a pipe in which the pusher 142 is installed to be movable. According to this embodiment, there is no particular limitation on the size of the length, outer diameter, inner diameter, etc. of the shaft 120, while having a length and outer diameter sufficient to perform a suturing procedure inside the body through endoscopic surgery, etc. The inner diameter may be as long as the pusher 142 can be disposed.

According to one embodiment, the distal end 120a of the shaft 120 may have a smaller outer diameter than the other portions (see FIG. 3B ). This is to prevent irregularities from occurring at the connection portion even when the cartridge 130 is inserted into the distal end 120a of the shaft 120 and mounted, and according to this, the outer diameter of the case 131 of the mounted cartridge 130 is It may be the same as the outer diameter of the shaft 120 (see FIG. 2).

The cartridge 130 is a disposable consumable that can be detachably coupled to the distal end of the shaft 120 and is used by being coupled to the shaft 120 during a suturing procedure. 3A and 3B, the cartridge 130 includes a case 131, a fixing member 132, a snare member 133, a pulling member 134, and a connecting line 135. .

The case 131 has a structure that can be detachably coupled to the distal end 120a of the shaft in appearance. More specifically, the case 131 is generally cylindrical in shape with substantially the same diameter as the shaft 120, and the profile of the end (proximal end) opposite to the direction (distal end) in which the snare member 133 is disposed is , has a shape corresponding to the profile of the distal end of the shaft 120. For example, the proximal end of the case 131 and the distal end of the shaft 120 may have concave and convex profiles corresponding to each other, or may have protrusions and grooves. As a result, the cartridge 130 mounted on the distal end 120a of the shaft is not only tightly coupled to the distal end of the shaft 120, but also easily or unintentionally due to friction during the suturing procedure, the distal end of the shaft ( 120a) can be prevented from being separated.

The case 131 has a cylindrical shape with an empty inside, and at least a part of the fixing member 132 is disposed therein. And the remaining part of the case 131 where the fixing member 132 is not disposed is an empty space, and when the case 131 is inserted into the distal end 120a of the shaft, including the clamper 146, the pusher 142 Corresponds to the space in which at least a part of the protruding end 142a and the cutting blade 144 of ) is disposed. In an embodiment such as that shown in FIGS. 3A and 4A , a portion of the pulling member 134 may also be disposed in the empty space.

A first through hole into which the fixing member 132 can be inserted is formed at the distal end of the case 131 (in the direction opposite to the direction in which the shaft 120 is inserted). The first through hole preferably has a shape in which the head portion 132b of the fixing member 132 is seated and the body portion 132a can be inserted into the case 131 . 3A, 3B, and 4B show a shape in which the fixing member 132 is inserted through the first through hole, and only the body portion 132a of the fixing member 132 is inside the case 131. , the head portion 132b of the fixing member 132 is arranged parallel to a plane corresponding to the distal end of the case 131.

A second through hole is formed on the outer circumferential surface of the case 131 (the outer circumferential surface corresponding to the upper side in FIGS. 3A and 3B , etc.). The second through hole allows at least the connection line 135 connected to the snare member 133 to be connected to the pulling member 134 located outside the case 131 . In this case, the entire pulling member 134 is installed on the outer circumferential surface of the case 131, and only the connecting line 135 passes through the second through hole so that the other end thereof is connected/coupled to the pulling member 134. On the other hand, in the embodiment as shown in FIGS. 3A and 3B, the second through hole is so that a part of the pulling member 134 is inserted into the case 131 and stably seated in the case 131 as a whole. , may have a predetermined size or more.

The fixing member 132 is for fixing the suture instead of the knot. More specifically, the fixing member 132 is a tubular member through which a suture can pass through, and when compressed by the clamper 146, fixes the suture penetrating therein so as not to move. Therefore, since the fixing member 132 can be compressed by a predetermined force and is inserted into the body, it is preferable to be formed of a material harmless to the human body.

For example, the fixing member 132 may be LSI Solutions' COR-KNOT FASTNER product (see https://www.lsisolutions.com/products/1/cor-knot-device/), but is not limited thereto. . In this case, the fixing member 132 may include a body portion 132a having a cylindrical shape as a whole and a header portion 132b having a larger diameter than the body portion 132a. According to this, the body part 132a is disposed inside the case 131, but the header part 132b is inserted through the first through hole formed at the distal end of the case 131, so that the fixing member 132 can be prevented from being completely inserted into the case 131 (see (a) of FIG. 4b). In this state, when a predetermined force (compression force in a symmetrical direction) is applied to the fixing member 132, the fixing member 132 is compressed by the clamper 146, and the suture penetrating the inside thereof is like a knot. It is fixed as if forming (see (b) in FIG. 4b).

The snare member 133 disposed outside the case 131 where the first through hole is located is formed of a circular or elliptical wire. During a suture procedure, a suture that needs to be fixed may be inserted into a circular or elliptical wire. According to this embodiment, there is no particular limitation on the material of the snare member 133, and the same material as the snare member (wire snare, see FIG. 1c) used in the existing COR-KNOT sealing device may be used.

The snare member 133 is connected or coupled to one end 135b of the connection line 135 passing through the first through hole and the fixing member 132 . And the other end 135b of the connection line 135 is connected or coupled to the pulling member 134 through the second through hole. That is, the connection line 135 is disposed to pass through the inside of the case 131 and the inside of the fixing member 132, and one end 135b is connected to the snare member 133 through the first through hole, and the other end ( 135a) is connected to the pulling member 134 through the second through hole. According to this, when the pulling member 134 is moved away from the case 131, the snare member 133 and the suture inserted therein are separated from the first through hole, the fixing member 132, and the inside and outside of the case 131. It can be pulled through the second through hole. As a result, by adjusting the pulling force of the pulling member 134, the suture can be pulled with a predetermined tension applied.

The pulling member 134 is a means for pulling the snare member 133 so that a predetermined tension can be applied by pulling the suture thread. To this end, one end 135a of the connection line 135 is connected or coupled to the pulling member 134 . The pulling member 134 can be pulled by the operator to the outside of the case 131 by holding the suture device 100 with a non-holding hand, and there is no particular limitation on its shape, material, or placement position. For example, as shown in FIGS. 3A and 3B, the pulling member 134 has a shape with a smaller diameter toward the bottom so as to be inserted into the second through hole, or a case ( 131) may be attached. However, in the latter case, it is preferable that the pulling member 134 is coupled to the case 131 in a way that the operator can easily separate it with one hand.

The pusher 142 is a rod-shaped structure, all or part of which is disposed inside the shaft 120, and moves forward or backward along the length direction of the shaft 120 in association with the operation (movement) of the operation handle 112. do. For example, when the operation handle 112 is pulled toward the friction member 114, the pusher 142 advances along the length of the shaft 120, and when the pulled operation handle 112 is restored to its original position, the pusher 142 ) may be retracted along the length direction of the shaft 120. To this end, the proximal end of the pusher 142 is directly or indirectly connected to the operating handle 112. In this embodiment, there is no particular limitation on the mechanism for interlocking the operation of the pusher 142 and the operating handle 112. .

A protruding end 142a is provided at a distal end of the pusher 142, that is, at an end opposite to the direction in which the body 110 is present. The protruding end 142a is a part of the pusher 142, and as the pusher 142 moves forward, it contacts the clamper 146, more precisely, the inclined back surface of the hammer 146a of the clamper 146 to move the hammer 146a. pressurize As a result, the hammer 146a moves upward, that is, in the direction where the anvil 146b is located, and the distance between the hammer 146a and the anvil 146b is shortened. As a result, the fixing member 132 disposed between the hammer 146a and the anvil 146b can be compressed and deformed.

According to an embodiment of the present invention, the protruding end 142a of the pusher may include a first member 142c and a second member 142b. The first member 142c and the second member 142b are integrally formed or formed as separate members so that all or part of the second member 142b is bonded to the first member 142c. may be continued

The first member 142c has a portion (distal end) in contact with the clamper 146, and the distal end is formed of a member having a predetermined thickness. That is, according to an embodiment of the present invention, by appropriately setting the thickness of the distal end of the first member 142c that presses the rear surface of the hammer 146a, the distance the hammer 146a moves in the direction of the anvil 146b, That is, the clamper 146 may compress the fixing member 132 with an appropriate strength. According to this embodiment of the present invention, since the thickness of the distal end of the first member 142c can be appropriately determined through trial and error, the fixing member 132 is compressed or compressed too much by the clamper 146. There is little room for a problem in which the suture is not fixed because the suture is not properly fixed.

The second member 142b serves to support the cutting blade 144 in the longitudinal direction. To this end, the second member 142b may have a smaller width than the first member 142c and be attached to the first member 142c. According to this, the blade 144 for cutting is one side of the blade 144 for cutting by the thickness of the second member 142b as well as at the proximal end (a 'c'-shaped structure rotated 90 degrees counterclockwise). Since the edge can be supported long, shaking of the cutting blade 144 advancing/retracting corresponding to the advancement/retraction of the pusher 142, especially the sharp-edged distal end of the cutting blade 144, can be minimized. can As a result, the cutting of the suture thread by the moving blade 144 for cutting can be reliably performed at the correct position.

The blade 144 for cutting is for cutting the suture thread by advancing in conjunction with the advancement of the pusher 142, and the distal end functions as a blade for cutting the suture thread. According to this embodiment, the blade 144 for cutting, the protruding end 142a of the pusher 142 so that one edge of the blade 144 for cutting can be long supported by the thickness of the second member (142b). ) can be arranged in a direction perpendicular to According to this, since the cutting blade 144 is disposed at a position overlapping the second through hole of the cartridge 130, it is possible to cut the suture between the fixing member 132 and the second through hole.

The clamper 146 disposed at the most distal end of the shaft 120 is for compressing the fixing member 132 . To this end, the clamper 146 includes a hammer 146a and an anvil 146b spaced apart at predetermined intervals. However, the clamper 146 is formed of an elastic material and/or structure, and when a predetermined force is applied, the gap between the hammer 146a and the anvil 146b may become narrower or wider. For example, as shown in FIG. 4C, the clamper 146 is shaped like a pair of tongs in which two leg parts (ie, a hammer 146a and an anvil 146b) separated from one body are spaced apart at predetermined intervals. may be a rescue. However, the distance between the hammer 146a and the anvil 146b must be larger than the diameter of the fixing member 132 so that the fixing member 132 can be disposed therebetween.

The inner surfaces of the hammer 146a and the anvil 146b may each have a concavo-convex structure having a predetermined profile. According to this embodiment, there is no particular limitation on the specific shape of the concavo-convex structure. However, when the distance between the hammer 146a and the anvil 146b is narrowed, a protrusion capable of compressing the fixing member 132 disposed therebetween with a predetermined force and a structure corresponding thereto are formed on the hammer 146a, respectively. ) and the anvil 146b are sufficient.

According to the embodiment of the present invention, the clamper 146 is disposed so that the hammer 146a and the anvil 146b do not overlap with the second through hole 131a of the cartridge 130. More specifically, in the embodiment shown in FIG. 4B, the hammer 146a is located on the lower side, the anvil 146b is located on the upper side, and the second through hole 131a is located in the frontward direction.

Next, a suturing procedure using the suturing device 100 according to the above-described embodiment of the present invention will be described.

First, the cartridge 130 is inserted into the distal end of the shaft 16. Accordingly, the fixing member 132 disposed inside the cartridge 130 is disposed between the hammer 146a and the anvil 146b of the clamper 146 . Here, the fixing member 132 has a body portion 132a disposed inside the case 131 such that the head portion 132b is aligned with the distal end of the case 131 of the cartridge 130. Then, the operator inserts a suture (not shown) passed through the body tissue into the snare member 133, and then pulls the pulling member 134 upward using the hand not holding the body 110. As a result, the suture along with the snare member 133 passes through the first through hole, the fixing member 132, and the second through hole, and a predetermined tension is applied to the suture. When the operation handle 112 is pulled using the finger of the hand holding the body 110 in a state where a predetermined tension is continuously applied to the suture thread, the pusher 142 moves forward. The cutting blade 144 is also moved forward. The protruding end 142a of the forwardly advanced pusher 142 applies pressure to the hammer 146a of the clamper 146 to move it toward the anvil 146b so that the clamper 146 is closed by a preset size. As a result, the hammer 146a and the anvil 146b of the clamper 146 come close to each other by a predetermined interval to compress the fixing member 132 . At the same time, the cutting blade 144 moving forward together with the pusher at a position orthogonal to the protruding end of the pusher 142 (ie, upper side) cuts the suture between the fixing member 132 and the second through hole. do. As a result, the remaining suture may be fixed with a predetermined tension applied by the compression-deformed fixing member 132 .

Although the present invention has been described in detail with preferred embodiments, the present invention is not limited to the above-described embodiments, and various modifications may be made by those skilled in the art within the scope of the technical idea of the present invention. possible.

The present invention can be used in the medical device related industry.

Claims (5)

A suture device for fixing a suture thread by compressing a fixing member,
a body having an operation handle and having a shape that an operator can hold with one hand;
a pipe-shaped shaft extending in one direction from the body;
a cartridge having a structure detachably coupled to the distal end of the shaft and having at least a portion of the fixing member disposed therein;
a pusher which advances or retreats along the one direction inside the shaft in conjunction with the operation of the operation handle, and has a protruding end in the opposite direction of the body; and
A hammer and an anvil are disposed inside the distal end of the shaft and are spaced apart from each other by a predetermined interval, and the hammer and the anvil are pressed by the protruding end of the pusher advancing along the one direction. And a clamper designed to compress the fixing member as the interval of is reduced,
the cartridge,
a case in which at least a portion of the fixing member is disposed and coupled to a distal end of the shaft, and a first through hole into which the fixing member is inserted is formed at an opposite end coupled to the shaft;
a snare member disposed outside a direction in which the first through hole of the case is located;
a connecting line passing through the fixing member, one end of which is connected to the snare member; and
A sealing device comprising a pulling member coupled to a second through hole formed on an outer circumferential surface of the case to be detachable from the case, and the other end of the connection line being coupled through the second through hole. delete According to claim 1,
At a position corresponding to the protruding end, the sealing device characterized in that it further comprises a cutting blade coupled to the distal portion of the pusher to advance or retreat inside the shaft in conjunction with the movement of the pusher. According to claim 3,
The hammer and the anvil are disposed at opposite positions so as not to overlap with the second through hole, and the cutting blade is disposed to overlap with the second through hole. According to claim 4,
The protruding end and the cutting blade are disposed perpendicular to each other,
The protruding end is coupled to a first member for pressing the hammer of the clamper by the pusher advanced by the operation of the operating handle, and coupled to the first member to support at least a portion of the lower surface of the cutting blade in the longitudinal direction A sealing device comprising a second member.

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