KR20200069540A - Motorizing surgical auto-stith device - Google Patents

Abstract

The present invention relates to a medical automatic suturing device for suturing a tissue by forming a continuous stitch at a predetermined interval and a predetermined tension and depth while moving along a movement direction set by a user along a suture object. The medical automatic suturing device includes a patch graft covering both ends of a ruptured rotator cuff; a moving body that sutures the patch graft using suture while moving the patch graft; a transfer unit for transferring the moving body; a suturing condition setting unit for setting a suturing condition; and a control unit for controlling the transfer of the transfer unit and the moving body according to the suturing condition set by the suturing condition setting unit. Accordingly, the present invention implements an automatic suturing device for arthroscopic surgery.

Description

Automated surgical auto-stith device

The present invention relates to a medical automatic suture device, and more specifically, a medical automatic suture that sutures tissue by forming a continuous stitch at regular intervals, constant tension and depth while moving along a moving direction set by a user along a suture target. It is about the device.

When the rotator cuff tears forming the shoulder joint due to a disease or disease, a suture operation is needed to suture the rotator cuff tear.

For the suture operation, as shown in FIG. 1, a patch graft is used, and a method of closing the rupture site by one stitch is used. In the case of such a suture operation, the suture time is very long, and a lot of effort is required by the doctor.

Therefore, in order to solve this discomfort, various types of medical sutures have been proposed in recent years, and as an example of such a suture, a medical stapler (Surgical Stapler) has the advantage of suturing the affected area quickly and easily.

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

In addition, the following <Patent Document 2> discloses a sealing device using a medical suture. A suture is attached to a needle that alternately reciprocates between two jaws.

It is hung so that the affected area is closed by the needle's round trip.

United States Published Patent US 2016/0174985 (2016.06.23. Published, Applicant-Ethicon Endo-Surgery) US registered patent US 8,968,339 (2015.03.03. registered, patent holder-Covidien LP)

However, the above general medical sealing devices and prior arts have the advantage of conveniently implementing the sealing, but the sealing is performed only at a predetermined interval and depth, and the sealing is automatically performed according to the sealing direction or the sealing interval and depth are determined. There is a disadvantage that can not be arbitrarily set.

In particular, the length of the patch graft (patch graft) used according to the rupture site during shoulder surgery may be different depending on the length of the rupture, and it is necessary to vary the sealing interval or depth depending on the rupture condition. The technique has the disadvantage of always sealing only at regular intervals and depths without considering the length or thickness of such patch grafts.

In addition, when the automatic sealing device is used, it is used in blood, body fluids, and physiological saline. In the related art, a problem that may occur when sealing with blood, body fluids, physiological saline, etc. There is a disadvantage in that it is difficult for a doctor to accurately recognize or if a foreign substance enters the automatic sealing device, a method for solving the problem is not presented.

Therefore, the present invention has been proposed to solve various problems arising from the general sealing device and the prior art as described above, while moving along the moving direction set by the user along the sealing object, and continuously at regular intervals, constant tension, and depth. An object of the present invention is to provide a medical automatic sealing device for forming a stitch and sealing the tissue.

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

Another object of the present invention, when using the automatic sealing device to the human body, to improve the problems, such as the difficulty of securing the field of view, which may occur due to blood, body fluids, physiological saline, or failure of the automatic sealing device due to the introduction of foreign matter It is to provide a medical automatic sealing device.

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

In the moving body, a needle for transporting the suture while reciprocating through the patch graft; Needle drive unit for reciprocating the needle; A hook which is installed at a position opposite to the needle and hooks the suture transported by the needle while reciprocating depending on the reciprocating displacement of the needle to form a stitch; It includes a hook drive for reciprocating the hook.

In the above, the mobile body is waterproofed to prevent the liquid containing blood or physiological saline from entering the mobile body.

In the above, the outer cover of the medical sealing device including the moving body and the transfer part, the blood or liquid containing physiological saline further comprises an outer shell to prevent penetration into the interior of the medical sealing device,

The outer shell is characterized in that it uses at least one of transparent plastic or transparent rubber (soft PVC) or polyvinyl alcohol (PVA)-based synthetic fibers that are visible inside.

In the above, the sealing condition setting unit is characterized by setting the sealing interval, the sealing direction, and the sealing depth as the sealing condition.

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

In the above, the direction setting unit includes 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 spacing of the moving body according to the direction and interval 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 by controlling the driving portion to control the depth of the suture.

In addition, the automatic sealing device for medical use according to the present invention is a display unit for displaying a sealing image output from the control unit on the screen; Built in the moving body further comprises a photographing device for photographing the lower suture state of the patch graft during sealing,

The control unit is characterized in that it controls the image display to display the suture image obtained from the photographing device on the display unit.

In addition, the automatic sealing device for medical use according to the present invention further includes a medical suction unit that sucks body fluid, blood or physiological saline in conjunction with the control unit,

The medical suction device is a probe mounted inside the automatic medical sealing device; A suction container that regulates the suction power and sucks and stores body fluids or blood or physiological saline; It characterized in that it comprises a connecting portion for transmitting a suction operation signal to the suction container according to the control signal of the control unit, and connecting the probe and the suction container.

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

1 is an exemplary view of suture during general shoulder surgery,
2 is a block diagram of a medical automatic sealing device according to the present invention,
Figure 3 is an embodiment of the control and driving unit for sealing the patch graft with both ends of the rotator cuff ruptured according to the present invention,
Figures 4a and 4b is an illustration of an automatic sealing of the portion of the patch graft overlapping the rotator cuff end in the present invention.

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

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

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

The moving body 20 includes a needle 21 for transporting the suture 3 while reciprocating through the patch graft 10, a needle driving unit 22 for reciprocating the needle 21, and the needle ( The hook 23, which is installed at a position opposite to the 21) and is dependent on the reciprocating displacement of the needle 21 and forms a stitch by hooking the suture 3 conveyed by the needle 21 while reciprocating. ) Includes a hook driving unit 24 that reciprocates.

In addition, the inside of the moving body 20 is built-in a photographing device 80 for photographing the lower sealing state of the patch graft 10 during sealing and transmitting it to the control unit 30. It is preferable that the imaging device 80 uses a subminiature camera.

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

The control unit 30 controls the direction and spacing of the moving body 20 according to the direction and spacing set by the sealing condition setting unit 40, and the sealing 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 sealing depth, and when the suction function is input by the suction manipulation unit 44, the medical suction machine 90 is controlled to achieve a suction function. It is desirable to control.

The medical suction device 90 is a probe 91 mounted inside the automatic sealing device for medical use, and controls the suction container 93 and the control unit 30 to control and absorb suction and store body fluid or blood or physiological saline. It includes a connection portion 92 for transmitting a suction operation signal to the suction container 93 in accordance with the signal, and connecting the probe 91 and the suction container 93.

In addition, the automatic sealing device for medical use according to the present invention wraps the outside of the medical sealing device including the moving body 20 and the transfer part 50, so that the liquid containing blood or physiological saline penetrates into the medical sealing device. The outer cover 70 is further prevented from being formed, and the outer cover 70 is 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 preferred. Here, the outer cover 70 can be used by covering the medical automatic sealing device as a cover, and it is preferable to dispose of it after being manufactured as a disposable, and it is preferable to replace it with a new one when foreign substances are introduced during use.

Even in the case of using transparent plastic, it is preferable to use a soft material to promote convenience in replacement use.

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

First, a doctor for shoulder joint arthroscopic surgery sets the sealing conditions to suture a ruptured rotator cuff.

Here, the sealing conditions include a sealing interval, a sealing direction, and a sealing depth.

The doctor sets the sealing interval, the sealing direction, and the sealing depth by using a key or button or dial for condition setting. It is preferable to set the sealing interval, the sealing direction, and the sealing depth according to the thickness or depth of the patch graft 10 used, and the state of the rotator cuff tearing.

When the sealing interval is set, the interval setting unit 41 transmits the interval setting value to the control unit 30. When the sealing direction is set, the direction setting unit 42 transmits the direction setting value to the control unit 30. When the sealing depth is set, the depth setting unit 43 transmits the sealing depth setting value to the control unit 30.

The control unit 30 extracts a control value according to each set value stored in the internal memory when each set value (interval set value, direction set value, depth set value) is input. 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. It is assumed that the initialization of the set value is set to the most basic interval and depth.

Subsequently, the operator (doctor) covers the mobile body 20 with the epithelium 70 to prevent foreign substances from entering the inside of the medical automatic sealing device.

Here, the outer sheath 70 uses at least one of transparent plastic or transparent rubber (soft PVC) or polyvinyl alcohol (PVA)-based synthetic fibers that are visible inside, and is made of soft, so that the upper device 51 and the lower device 52 ) Is used as a way to wrap the outside. It is preferable that the outer cover 70 is made of a disposable and is disposed of after use, and if it is determined that foreign matter has penetrated into the inside of the medical sealing device through the naked eye during use, it is preferable to replace it with a new one.

In practice, the automatic sealing device for medical use according to the present invention is waterproof, so that it is possible to prevent to some extent that foreign substances are introduced into the medical sealing device, but the actual automatic sealing device for medical use is in a liquid such as blood, body fluid, or physiological saline. Since it is used in the waterproof treatment as described above, it may be difficult to completely block foreign substances from entering the medical automatic sealing device. Therefore, to compensate for this waterproofing, and to visually identify that foreign substances are introduced into the medical automatic sealing device, the outer cover 70 is added to further improve the waterproofing function.

On the other hand, in the state in which the patch graft 10, which is the sealing target, is located between the upper device 51 and the lower device 52 of the moving body 20, the driving command is given using the driving button. Here, although not shown in the drawings, a driving button is provided for a suture driving command.

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

Here, the sealing direction includes a left sealing direction for automatic sealing while moving from the current position to the left, and a right sealing direction for automatic sealing while moving to the right from the current position.

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 in the left or right direction from the current position according to the direction control value using a rack-pinion gear method or a transfer device using a separate motor gear or the like. At the same time, the transfer unit 50 adjusts the moving speed of the moving body 20 according to the gap control value. Here, the moving speed becomes the interval. That is, when the moving speed is fast, the stitching interval of the stitch is wide, and when the moving speed is slow, the stitching interval of the stitch is narrow.

While transferring the moving body 20 through the transfer unit 50 in the same manner as described above, the control unit 30 controls the needle driving unit 22 and the hook driving unit 24 built in the transfer body 20 to seal. Depth is controlled.

Here, since the moving body 20 is operated within the actual human body joint, blood or articular cavity in the shoulder joint is widened, and physiological saline injected to secure a view of the arthroscopy makes contact. Therefore, blood or physiological saline flows into the moving body 20, which may damage the moving body 20. Therefore, in order to solve this problem, in the present invention, the moving body 20 is waterproofed to prevent blood or physiological saline from flowing into the moving body 20 during sealing.

Meanwhile, the needle driving unit 22 adjusts the depth during reciprocation of the needle 21 according to the applied depth control value. In this state in which the depth is adjusted, the needle 21 reciprocates on the patch graft 10 using the suture 3, and the hook driving unit 23 located at the bottom of the patch graft 10 hooks By operating (23), a stitch is automatically formed to suture.

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

Among the components constituting the sealing device, the needle driving unit 22 includes a needle driving motor, a driving gear, a Geneva driver, a slider, first and second sliding guides, a slider driver, and the like, and moves the needle 21 up and down. It is a trigger.

In addition, the hook driving unit 24 is provided with a hook driving motor, a driving gear, a camshaft, a cam, a hook slider, a hook slider holder, a spring, etc., and is an element that allows the hook to move horizontally.

In the state in which the automatic sealing device 1 is placed in a predetermined position of the patch graft 10 to be sealed, the needle driving motor and hook driving motor described above are electrically controlled, and the needle 21 and the hook 23 By performing the operation to form a stitch by the suture (3) to seal the patch graft (10). The driving force of the needle drive motor is transmitted to the Geneva driver through the drive gear and the slider driver rotating integrally therewith. 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 is also reciprocated up and down 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 which rotates integrally with the camshaft reciprocates the hook slider in the front-rear direction according to its rotational position.

On the other hand, the 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 moves integrally in the front-rear direction.

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

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

When automatically sealing the rotator cuff ruptured as described above, the sealing state or the location of the rotator cuff and the patch graft 10 at the top of the patch graft 10 is well visible from above, but the patch graft 10 It is hard to see from the bottom. Therefore, in order to compensate for this drawback, in the present invention, the imaging device 80 using a miniature camera is embedded in a predetermined position (preferably, a predetermined position of the lower device 52) of the moving body 20, and the lower suture is automatically sealed. 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 lower suture state in real time. The rotator cuff suture is a method in which the patch kraft 10 and the tattered tendon (rotator cuff) overlap so that the stitch can be optimized only by confirming that the needle is well in the overlapped area. Therefore, in the past, there was a problem in that the doctor checks the suture state only when the rotator cuff suture is completed, and if the suture is not performed well, the suture must be re-supplied. Therefore, there is an advantage that the suture can be completed while modifying the suture at any time during the suture.

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

For example, the medical suction machine 90 is coupled through the connecting portion 92 mounted by the transfer device 50 of the automatic medical suture device, and the suture image is checked through the display unit 60 when the suture is checked, thereby securing the field of view by body fluid or blood. If it is difficult, the suction function is input through the suction manipulation unit 44. Here, the suction force can be adjusted when the suction function is input.

When the suction function is input, the control unit 30 transmits a control signal to the suction container 93 through the connection unit 92 to control the medical suction device 90 to achieve a 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 the body fluid or the fluid according to the suction force in the probe 91 connected to the suction container 93 by the suction function performed in this way Blood or physiological saline is aspirated and sent to the aspiration container 93. Here, the suction device 90 adopts a known general medical suction device and uses it as it is. Since the specific technical configuration or operation is the same as a general medical suction device, a detailed description will be omitted.

Thus, by removing the foreign matter by using the suction function during the sealing, it is possible to always secure the optimal field of view during the sealing, thereby improving the accuracy of the sealing.

The invention made by the present inventors has been described above in detail according to the above-described embodiments, but the present invention is not limited to the above-described embodiments and can be changed in various ways without departing from the gist thereof. It is obvious to those who have it.

1: Medical automatic sealing device
2: Rotator cuff (tendon)
3: suture
10: patch graft
20: moving body
21: Needle
22: Needle drive
23; hook
24: hook drive
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: envelope
80: photographing device
90: suction

Claims (10)

As an automatic suture device for arthroscopic surgery,
A moving body that sutures the patch graft using a suture while moving the patch graft covering both ends of the ruptured cuff;
A transfer unit for transferring the moving body;
A sealing condition setting unit for setting a sealing condition; And
Automatic control device for medical sealing, characterized in that it comprises a control unit for controlling the transfer of the transfer unit and the moving body according to the sealing conditions set by the sealing condition setting unit.
The method according to claim 1, The moving body is a needle for transporting the suture while reciprocating through the patch graft; Needle drive unit for reciprocating the needle; A hook which is installed at a position opposite to the needle and hooks the suture transported by the needle while reciprocating depending on the reciprocating displacement of the needle to form a stitch; Automated suture device for medical treatment, characterized in that it comprises a hook drive for reciprocating the hook.
In claim 1 or 2, wherein the mobile body is waterproof medical automatic sealing device characterized in that to prevent blood or physiological saline or liquid from entering the mobile body.
The method according to claim 1, The sealing condition setting unit automatic sealing device for medical treatment, characterized in that for setting at least one or more of the sealing interval, the sealing direction, the sealing depth.
The method according to claim 1, The sealing condition setting unit interval setting unit for setting the sealing interval; A direction setting unit for setting a sealing direction; A depth setting unit for setting the sealing depth; Automatic sealing device for medical use, characterized in that it comprises at least one or more of the suction operation unit for inputting the suction operation function.
The method according to claim 5, The direction setting unit Medical sealing device, characterized in that it comprises a left direction setting to move the moving body to the left and the right direction setting to move the moving body to the right.
The method according to claim 1, The control unit controls the direction and spacing of the moving body according to the direction and spacing set by the sealing condition setting unit, the needle driving unit and the hook according to the sealing depth set by the sealing condition setting unit Automatic sealing device for medical treatment, characterized in that to control the driving unit to control the sealing depth.
The method according to claim 1, further comprising an outer shell surrounding the outside of the medical suture device including the moving body and the transfer unit, preventing the liquid containing blood or physiological saline from penetrating into the medical suture device,
The outer shell is a transparent plastic or transparent rubber (soft PVC) or polyvinyl alcohol (PVA)-based synthetic fibers visible inside the medical sealing device characterized in that it is formed using at least one of the synthetic fibers.
The method according to claim 1, Display unit for displaying a suture image output from the control unit on the screen; Built in the moving body further comprises a photographing device for photographing the lower suture state of the patch graft during sealing,
The control unit controls the image display so that the display unit displays the suture image obtained from the imaging device.
In claim 1, further comprising a medical suction unit (suction unit) for sucking the body fluid, blood or physiological saline in conjunction with the control unit,
The medical suction device is a probe mounted inside the automatic medical sealing device; A suction container that regulates the suction power and sucks and stores body fluids or blood or physiological saline; Automatic sealing device for medical use, characterized in that it comprises a connecting portion for transmitting a suction operation signal to the suction container according to the control signal of the control unit, and connecting the probe and the suction container.

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