WO2003065903A1 - Instrument de suture a usage biologique - Google Patents

Instrument de suture a usage biologique Download PDF

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Publication number
WO2003065903A1
WO2003065903A1 PCT/JP2003/000627 JP0300627W WO03065903A1 WO 2003065903 A1 WO2003065903 A1 WO 2003065903A1 JP 0300627 W JP0300627 W JP 0300627W WO 03065903 A1 WO03065903 A1 WO 03065903A1
Authority
WO
WIPO (PCT)
Prior art keywords
suture
puncture needle
outer cylinder
tip
movable
Prior art date
Application number
PCT/JP2003/000627
Other languages
English (en)
Japanese (ja)
Inventor
Jiro Kanie
Original Assignee
Jiro Kanie
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Jiro Kanie filed Critical Jiro Kanie
Priority to AU2003203378A priority Critical patent/AU2003203378A1/en
Publication of WO2003065903A1 publication Critical patent/WO2003065903A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0485—Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0482—Needle or suture guides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0472—Multiple-needled, e.g. double-needled, instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B2017/06052—Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/061—Needles, e.g. needle tip configurations hollow or tubular

Definitions

  • the present invention relates to a suturing tool for a living body used for suturing a plurality of scheduled suturing sites separated from each other in a living body with a suture, and particularly to a technique for improving the usability thereof.
  • a gastrostoma is to be endoscopically constructed in a patient as a living body.
  • a through-hole is formed through the patient's abdominal wall and stomach wall prior to the construction of the gastrostomy, and the abdominal wall and stomach wall are punctured with a puncture needle to form the through-hole.
  • a puncture needle Prior to the puncture with the puncture needle, it is common practice to suture the abdominal wall and the stomach wall with a suture in order to temporarily fix the movable stomach wall to the abdominal wall.
  • Fixing member to fix It is configured to include.
  • the stylet has at its distal end an annular member made of an elastic material that can be stored in the internal passage of the suture grasping puncture needle.
  • the annular member is used for inserting a suture such that the central axis of the suture insertion puncture needle or an extension thereof passes through the inside of the annular member when the annular member protrudes from the tip of the suture grasping puncture needle. It is configured to extend toward the puncture needle.
  • the conventional medical device is used as follows.
  • the stylet and the annular member are inserted into the suture grasping needle from the rear end thereof.
  • the annular member is projected from the distal end of the suture grasping puncture needle.
  • the suture is inserted into the suture insertion needle from the rear end thereof, and as a result, a part of the suture is exposed from the distal end of the suture insertion needle.
  • the suture is captured by the annular member, and thereafter, until the suture reaches the tip of the suture grasping puncture needle, that is, the suture is grasped by the suture grasping puncture needle. Until the stylet is retracted within the suture grasping needle.
  • the The suture thus obtained is gripped at its distal end by the suture grasping puncture needle, and the distal end of the suture grasping puncture needle is sharp.
  • the present invention provides a living body suturing instrument of the type in which a suture inserted into the body is captured in the body and pulled out of the body, and has improved usability. This was done as an issue.
  • a hollow fixed puncture needle having a sharp tip held by the holder, wherein the suture is passed through an internal passageway thereof, and
  • a hollow outer cylinder which is held by the holder in a lateral direction along with the fixed puncture needle and has a non-sharp tip, wherein the suture is passed through and used in an internal passage thereof;
  • a movable puncture needle and a suture traction tool which are selectively removably inserted into the internal passage of the outer cylinder;
  • the movable puncture needle has a sharp tip, and when the movable puncture needle is inserted into the outer cylinder from the rear end thereof and reaches the advance limit, the sharp tip projects from the tip of the outer cylinder.
  • the suture traction tool has, at its tip, an elastically deformable snare, which in a free state extends radially outward from the suture traction tool, and the suture is elastically deformed with the snare.
  • the thread retractor When the thread retractor is inserted into the outer cylinder from the rear end thereof and reaches the advance limit, the snare projects from the front end of the outer cylinder and returns to the free state, whereby the A living body suture tool wherein the snare is positioned at a planned capturing position where a portion exposed from the tip of the fixed puncture needle is scheduled to be captured.
  • the inner passage of the outer cylinder functions as a passage through which a suture is inserted, a function as a passage through which a movable puncture needle is inserted, and a suture traction tool is inserted. It functions as a passage.
  • the tip of the movable puncture needle protruding from the distal end of the outer cylinder despite the tip of the outer cylinder is not sharp.
  • the sharpness fulfills the function of puncturing the living body.
  • the suture traction tool when the suture traction tool is inserted into the outer tube in place of the movable puncture needle, the portion of the suture exposed from the tip of the fixed puncture needle is the suture traction bow I. If the suture traction tool is retracted within the outer tube after being captured by the snare at the tip of the device, the suture enters the outer tube through the blunt tip of the outer tube and then is sutured. It is pulled by a thread pulling tool.
  • the suture tool when the suture inserted into the body is captured in the body and pulled out of the body, the suture does not have to pass through a sharp part. Therefore, according to the suturing tool, it is not indispensable to perform the suturing of the living body with care not to cut the suture, and as a result, a suturing tool with improved usability is provided.
  • the “plurality of scheduled sutures separated from each other” is, for example, a plurality of planned sutures arranged in a plane along the surface of each planned suture, It is possible to have a plurality of scheduled suture portions arranged in a stack along the thickness direction of the position.
  • fixed puncture needle is “fixed” to distinguish it from a movable puncture needle that is relatively movable with respect to the outer cylinder from the viewpoint of the force that can move relative to the outer cylinder. It is assumed that the term is attached.
  • both the internal passage of the fixed puncture needle and the internal passage of the outer cylinder are used as suture passages.
  • the traveling directions of the suture are opposite to each other between the two internal passages.
  • the operator using the suture tool receives the reaction force generated by the movable puncture needle and the fixed puncture needle together. Therefore, the worker punctures the living body Therefore, it is necessary to operate the suture tool with a large force.
  • the suturing tool when the movable puncture needle is at the advance limit, the position of the tip of the movable puncture needle and the position of the tip of the fixed puncture needle are shifted from each other in the direction in which they extend. ing.
  • the operator who wants to puncture the living body using the suturing tool can fix the required operating force required to act on the suturing tool at each time with the position of the tip of the movable puncture needle. It is easier to reduce the puncture needle than in the case where the positions of the tips of the puncture needles coincide with each other in the direction in which they extend.
  • the suturing tool according to any one of the above (1) to (3) When the suturing tool according to any one of the above (1) to (3) is used, the parallelism of the puncture needles is maintained during the operation of puncturing the living body with the fixed puncture needle and the movable puncture needle. It is desirable to be done.
  • the living body is punctured by the movable puncture needle while being inserted into the outer cylinder.
  • the outer cylinder also functions as an element that withstands the reaction force from the living body.
  • the ability to withstand the reaction force from the living body is more improved by using the outer cylinder than by using the movable puncture needle alone. Can be improved more easily than if they were received at This means that This means that the form of the puncture needle and the outer cylinder can be easily held, and that the parallelism between the movable puncture needle and the fixed puncture needle can also be easily held.
  • the function of maintaining the distance between the holder force movable puncture needle and the fixed puncture needle and the function of maintaining the parallelism between the two are provided.
  • the form of the movable puncture needle and the outer cylinder can be easily held, and the movable puncture needle
  • the parallelism with the fixed puncture needle can be easily maintained. Therefore, the holder does not have to be so strongly required to perform the function of maintaining the parallelism between the movable puncture needle and the fixed puncture needle.
  • the holder holds the fixed puncture needle and the outer cylinder in parallel with each other and at one position.
  • the holder can be easily downsized and the structure can be simplified as compared with a case where the holder holds the fixed puncture needle and the outer cylinder at a plurality of positions.
  • a guide member for guiding a selected one of the movable puncture needle and the suture traction tool into the internal passage of the outer cylinder is provided at a rear end of the outer cylinder;
  • the living body suture tool according to any one of (1) to (4), which has a hole.
  • the movable puncture needle And the selected suture traction tool is inserted into the outer cylinder from its rear end.
  • a guide member for guiding a selected one of the movable puncture needle and the suture torsion I into the internal passage of the outer cylinder is provided at the rear end of the outer cylinder.
  • the guide member has an insertion hole that opens at the rear end of the outer cylinder and has a larger diameter than the internal passage of the outer cylinder, a tapered tapered hole that extends from the insertion hole toward the distal end of the outer cylinder. have.
  • this suture tool when the selected one of the movable puncture needle and the suture traction tool is inserted into the outer cylinder from the rear end thereof, first, the larger than the inner passage of the outer cylinder. Since it is inserted into the insertion hole of the diameter, the work for the insertion can be simplified more easily than in the case where it is inserted into the internal passage of the outer cylinder from the beginning.
  • the selected one of the movable puncture needle and the suture traction tool is inserted into the tapered hole after being inserted into the insertion hole, and is movable by the slope of the tapered hole.
  • the tip of the selected one of the puncture needle and the suture traction tool is automatically guided toward the internal passage of the outer cylinder.
  • the living body includes a patient, the plurality of scheduled suturing sites include two overlapping portions of the patient's abdomen and the stomach wall, and the living body suturing device fixes the stomach wall to the abdomen.
  • the biological suture according to any one of (1) to (5), which functions as a stomach wall fixing device.
  • the movable puncture needle is inserted into the outer cylinder from its rear end to the advance limit.
  • a puncture needle insertion step
  • the main body including the fixed puncture needle and the outer cylinder is held by the holder together with the movable puncture needle.
  • An advancing step toward the living body by puncturing the living body with the fixed puncture needle and the movable puncture needle;
  • a method for using a living body suture tool comprising: '
  • FIG. 1 is a front sectional view showing a main body 10 of a gastric wall fixing device according to an embodiment of the present invention.
  • FIG. 2 is a front sectional view showing the movable puncture needle 80 in the gastric wall fixing device.
  • FIG. 3 is a front sectional view showing the main body 10 of FIG. 1 with the movable puncture needle 80 of FIG. 2 inserted therein.
  • FIG. 4 is a front sectional view showing the suture traction tool 100 in the gastric wall fixing device.
  • FIG. 5 is a front sectional view showing the main body portion 100 of FIG. 1 in a state where the suture traction tool 100 of FIG. 4 is inserted.
  • FIG. 6 is a flowchart showing a method of using the gastric wall fixing device.
  • FIG. 7 is a front sectional view for explaining S2 in FIG.
  • FIG. 8 is another front sectional view for explaining S3 in FIG.
  • FIG. 9 is a front sectional view for explaining S4 in FIG.
  • FIG. 10 is another front sectional view for explaining S4 of FIG.
  • FIG. 11 is a front sectional view for explaining S5 in FIG.
  • FIG. 12 is a front sectional view for explaining S6 of FIG.
  • FIG. 13 is another front sectional view for explaining S6 of FIG.
  • FIG. 14 is a front sectional view for explaining S7 of FIG.
  • FIG. 15 is another front sectional view for explaining S7 of FIG.
  • FIG. 16 is a front cross-sectional view for explaining a state in which the suture 32 in FIG. 15 is ligated at two portions of the suture 32 exposed outside the body.
  • FIG. 1 is a front sectional view showing a main body 10 of a gastric wall fixing device according to an embodiment of the present invention.
  • the main body 10 is configured to include a holder 12, a fixed puncture needle 14, and an outer cylinder 16.
  • the holder 12 is made of synthetic resin, whereas the fixed puncture needle 14 and the outer cylinder 16 are both made of metal.
  • the holder 12 holds the fixed puncture needle 14 and the outer cylinder 16 at a constant distance therebetween. And a function of holding them so as to be parallel to each other. In order to fulfill the function, the holder 12 has a structure for holding the fixed puncture needle 14 and the outer cylinder 16 at one position.
  • each holding position of the holder 12 is substantially the center of the fixed puncture needle 14 and the outer cylinder 16 in the axial direction.
  • the fixed puncture needles 14 and the outer cylinder 16 are closer to the holding positions of the holders 12 than the end positions in the axial direction of the fixed puncture needles 14 and the outer cylinder 16. The relative positional relationship between and can be efficiently maintained.
  • each holding position of the holder 12 is adjustable in the axial direction of the fixed puncture needle 14 and the outer cylinder 16.
  • the tip of the fixed puncture needle 14 is designed to be convenient.
  • the distal end of the fixed puncture needle 14 has a shape in which the cylindrical member is cut in one plane obliquely intersecting the axis thereof.
  • the sharpness of the tip of the fixed puncture needle 14 provides a good function of puncturing the patient's abdominal wall 20 and stomach wall 22 (see FIG. 7).
  • the fixed puncture needle 14 has a hollow structure, and an internal passage 30 extending coaxially therewith is used as a passage through which a suture thread 32 (see FIG. 11) passes.
  • the internal passage 30 is a passage for guiding the suture 32 in one direction from the rear end to the distal end of the fixed puncture needle 14.
  • a hollow block 40 is attached at the rear end of the fixed puncture needle 14.
  • This block 40 is made of a synthetic resin.
  • the block 40 has a stepped hole 46 in which the small-diameter portion 42 and the large-diameter portion 44 are coaxially arranged.
  • the small diameter portion 42 is fitted to the rear end of the fixed puncture needle 14 such that the rear end surface of the fixed puncture needle 14 abuts the shoulder surface 48 (an example of a forward facing surface) of the stepped hole 46. ing.
  • the outer tube 16 also has a hollow structure like the fixed puncture needle 14, and the internal passage 50 extending coaxially therewith is used as a passage through which the suture thread 32 passes.
  • This internal passage 50 is oriented in the opposite direction to the internal passage 30 of the fixed puncture needle 14, that is, the outer cylinder 1 6 is a passage for guiding the suture 32 in one direction from the front end to the rear end.
  • At least a portion of the outer cylinder 16 that comes into contact with the suture thread 32 is not sharp.
  • the portion that bends when the suture thread 32 is inserted into the outer cylinder 16, that is, the tip of the outer cylinder 16 is not sharp.
  • the edge existing at the tip is made not to have an acute angle, and it is desirable that the edge be chamfered on the C plane or the R plane.
  • a hollow guide member 60 is attached to the rear end of the outer cylinder 16.
  • the guide member 60 is made of synthetic material.
  • a stepped hole 66 in which the fitting hole 62 and the guide hole 64 are coaxially arranged penetrates the guide member 60.
  • the fitting hole 62 is fitted to the rear end of the outer cylinder 16 so that the rear end surface of the outer cylinder 16 contacts the shoulder surface 68 (an example of a front surface) of the stepped hole 66. I have.
  • the guide member 60 is non-rotatably attached to the outer cylinder 16. The structure of the guide hole 64 will be described later in detail.
  • FIG. 2 is a front sectional view of the movable puncture needle 80 of the gastric wall fixing device.
  • the movable puncture needle 80 is solid and made of metal.
  • the tip of the movable puncture needle 80 is made sharp, so that the function of puncturing the abdominal wall 20 and the stomach wall 22 of the patient can be performed well.
  • a stopper 84 is attached at the rear end of the movable puncture needle 80.
  • the stopper 84 has a stepped shape and is made of synthetic resin.
  • the stopper 84 is formed on the shoulder surface 86 (an example of a forward facing surface) of the stopper 84 by the guide member 60. By contacting the rear end face, it has a function of defining the advance limit of the movable puncture needle 80 in the outer cylinder 16.
  • stopper 84 is engaged with the guide member 60 so as to be relatively rotatable. This prevents the movable puncture needle 80 from rotating with respect to the outer cylinder 16 at its forward limit.
  • the movable puncture needle 80 is inserted into the outer cylinder 16 from the rear end thereof, and is moved forward. Degrees have been reached. In this state, the tip of the movable puncture needle 80 protrudes from the tip of the outer cylinder 16. The position of the tip of the movable puncture needle 80 and the position of the tip of the fixed puncture needle 14 are displaced from each other in the axial direction.
  • the tip of the movable puncture needle 80 which is sharper than the fixed puncture needle 14 and apparently higher than that of the fixed puncture needle 14 is located forward of the tip of the fixed puncture needle 14, and the movable puncture needle 8 0 comes in contact with the abdominal wall 20 before the fixed puncture needle 14.
  • the apparent rigidity of the movable puncture needle 80 is higher than that of the fixed puncture needle 14 because the movable puncture needle 80 is inserted into the outer cylinder 16 and is supported by the outer cylinder 16. is there.
  • FIG. 4 shows a front cross-sectional view of the suture retraction device 100 of the gastric wall fixing device.
  • the suture traction tool 100 is configured to include a rod 102 and a snare 104 attached to the distal end thereof.
  • the rod 102 is solid and made of metal.
  • the snare 104 is made of an elastic wire as an elastically deformable material.
  • the snare 104 naturally extends from the distal end of the rod 102 radially outward as shown in FIG.
  • the snare 104 is formed of an annular natural wire, which has a good function of hooking a portion of the suture 32 exposed from the distal end of the fixed puncture 14. Well done.
  • the suture traction tool 100 is inserted into the outer cylinder 16 from the rear end thereof.
  • the snare 104 is elastically deformed so as to extend coaxially with the rod 102, and is inserted through the outer cylinder 16 in this state.
  • a stopper 108 made of synthetic resin is attached to the rear end of the suture traction tool 100, similarly to the movable puncture needle 80.
  • the stopper 1108 is positioned on the shoulder surface 110 of the stopper 100 (an example of a forward facing surface). Abut the rear end face of guide member 60 Accordingly, a function of defining the advance limit of the suture traction tool 100 in the outer cylinder 16 is provided.
  • the stopper 108 is engaged with the guide member 60 so as to be relatively rotatable. This prevents the suture traction tool 100 from rotating relative to the outer cylinder 16 at its forward limit.
  • FIG. 5 shows the suture traction tool 100 inserted into the outer cylinder 16 from its rear end and reaching the forward limit.
  • the snare 104 projects from the tip of the outer cylinder 16 and is restored to its natural state.
  • the snare 104 is positioned at a planned capturing position where the portion of the suture 32 exposed from the distal end of the fixed puncture needle 14 is scheduled.
  • the insertion hole 120, the tapered hole 122, and the small-diameter hole 124 are arranged coaxially with the outer cylinder 16 from the rear end to the front end of the outer cylinder 16. .
  • the inlet hole 120 has a larger diameter than the inner passage 50 of the outer cylinder 16, whereas the smaller hole 124 has a smaller diameter than the inlet hole 120. .
  • the tapered hole 122 has a slope whose diameter decreases as it goes from the insertion hole 120 to the small diameter hole 124. Due to the tapered holes 122, the cross section of the internal passage of the guide member 60 gradually decreases as it moves from the rear end to the front end of the outer cylinder 16, and eventually the internal passage 50 of the outer cylinder 16 becomes smaller. Substantially matches the cross section.
  • the diameter of the small-diameter hole 1 24 is substantially equal to the inner diameter of the outer cylinder 16, and there is a step between the small-diameter hole 124 and the hole forming the internal passage 50 of the outer cylinder 16 as much as possible. Not to do so. Thereby, the movable puncture needle 80 and the suture traction tool 100 can be easily inserted into the outer cylinder 16 from the rear end thereof.
  • FIG. 6 is a flowchart showing a method of using the gastric wall fixing device.
  • step SI hereinafter simply referred to as “S 1”, the same applies to other steps
  • the user inserts the movable puncture needle 80 into the outer cylinder 16 from the rear end thereof.
  • the main body 10 with the movable puncture needle 80 is advanced in a direction to vertically approach the abdominal wall 20 of the patient, thereby, as shown in FIG.
  • the abdominal wall 20 and the stomach wall 22 are punctured by 0 and the fixed puncture needle 14.
  • the movable puncture needle 80 comes into contact with and pierces the skin of the abdominal wall 20 first, and the fixed puncture needle 14 comes into contact with the skin of the abdominal wall 20 later. Pierce.
  • the movable puncture needle 80 is removed from the outer cylinder 16.
  • the suture traction tool 100 is inserted into the outer cylinder 16 from the rear end thereof.
  • the snare 104 is elastically deformed so as to be coaxial with the rod 102 when it is in the outer cylinder 16.
  • the planned capturing position is set such that the extension of the axis of the fixed puncture needle 14 passes through the annular space defined by the annular elastic wires constituting the snare 104, and the snare 1 04 is parked at its intended capture position.
  • the suture 32 is inserted into the fixed puncture needle 14 from its rear end. By this insertion, the leading portion of the suture 32 is exposed from the tip of the fixed puncture needle 14 and further passes through the snare 104.
  • the suture traction tool 100 is pulled out of the outer tube 16 and thereby the snare 104
  • the force of the fixed puncture needle 14 of the suture 3 2 The part exposed from the tip is hooked and captured, and in that state, the snare 104 is elastic It is inserted into the outer cylinder 16 with its deformation from the tip.
  • the suture traction tool 100 is retracted within the outer cylinder 16, the suture 32 is pulled from the leading end to the rear end of the outer cylinder 16.
  • the suture traction tool 100 is completely removed from the outer cylinder 16, and the leading part of the suture 32 is exposed from the rear end of the outer cylinder 16, and in this state, the snare 104 is removed.
  • the suture is released from the force, as shown in FIG. 13, the continuous suture 32 enters the body from outside the body via the fixed puncture needle 14, the intragastric space, and the outer cylinder 16.
  • a state where the patient leaves the body is realized. This realization can be performed without displacing the main body 10 relative to the abdominal wall 20 and the stomach wall 22.
  • the main body 10 is retracted together with the suture 32 in a direction away from the patient.
  • the continuous suture 3 2 force 1st through hole as shown in FIG. 15 A state in which the body enters the body from outside the body and exits the body through the body 140, the intragastric space, and the second through hole 142 is realized.
  • two portions of the abdominal wall 20 and the stomach wall 22 that overlap each other constitute an example of the “plural scheduled suture portions” in the above section (1). It is.
  • S 1 in FIG. 6 constitutes an example of the “movable puncture needle insertion step” in the above item (7)
  • S 2 constitutes an example of the “advancing step”
  • S 3 constitutes an example of the "suture traction tool insertion step”
  • S5 constitutes an example of the "suture insertion step”
  • S6 constitutes an example of the "suture insertion step”.
  • S7 constitutes an example of the "retreating process” It is.

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  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
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  • General Health & Medical Sciences (AREA)
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Abstract

L'invention permet d'améliorer les propriétés de manipulation d'un instrument destiné à réparer une paroi de l'estomac, une suture insérée dans le corps étant capturée dans le corps et extraite du corps. Pour ce faire, ledit instrument comprend un support (12), une aiguille de ponction creuse fixe (14) supportée par ce support, la suture (32) étant insérée dans le passage intérieur de cette aiguille, un tube extérieur creux (16) disposé en parallèle par rapport à l'aiguille de ponction fixe et supporté par ledit support, la suture traversant ce tube, une aiguille de ponction mobile (non représentée dans la figure) insérée dans le passage intérieur du tube extérieur de manière sélective et mobile, ainsi qu'un dispositif de traction de suture (100). Lorsque l'aiguille de ponction mobile atteint la limite avant du tube extérieur, son extrémité pointue sort de l'extrémité de ce tube extérieur. Le dispositif de traction de suture comporte un piège élastique déformable au niveau de son extrémité. Lorsque ce dispositif de traction atteint la limite avant du tube extérieur, le piège sort de l'extrémité dudit tube extérieur et capture la suture.
PCT/JP2003/000627 2002-02-04 2003-01-23 Instrument de suture a usage biologique WO2003065903A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2003203378A AU2003203378A1 (en) 2002-02-04 2003-01-23 Suture insrument for biological use

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2002-026203 2002-02-04
JP2002026203A JP3331215B1 (ja) 2002-02-04 2002-02-04 生体用縫合具

Publications (1)

Publication Number Publication Date
WO2003065903A1 true WO2003065903A1 (fr) 2003-08-14

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Application Number Title Priority Date Filing Date
PCT/JP2003/000627 WO2003065903A1 (fr) 2002-02-04 2003-01-23 Instrument de suture a usage biologique

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JP (1) JP3331215B1 (fr)
AU (1) AU2003203378A1 (fr)
WO (1) WO2003065903A1 (fr)

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2007319169A (ja) * 2006-05-30 2007-12-13 Masataka Funada 医療用器具
US8500758B2 (en) 2007-02-20 2013-08-06 Covidien Lp Auxiliary device for a puncture needle
GB2482638B (en) * 2009-05-26 2014-02-12 Piolax Medical Devices Inc Suture device
US8663278B2 (en) 2004-10-06 2014-03-04 Covidien Lp Organ fixing equipment
US8672955B2 (en) 2005-12-26 2014-03-18 Covidien Lp Medical suturing device
US8968343B2 (en) 2008-06-24 2015-03-03 Covidien Lp Puncturing needle assisting tool
US9119893B2 (en) 2010-11-04 2015-09-01 Linvatec Corporation Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone
US9307977B2 (en) 2010-11-04 2016-04-12 Conmed Corporation Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing suture to bone
US9307978B2 (en) 2010-11-04 2016-04-12 Linvatec Corporation Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone
CN110099611A (zh) * 2017-01-31 2019-08-06 日本瑞翁株式会社 缝合装置

Families Citing this family (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060069398A1 (en) * 2003-02-26 2006-03-30 Yutaka Suzuki Medical instrument
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US20100217069A1 (en) * 2005-08-04 2010-08-26 C.R. Bard Inc. Implantable introducer
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JP4566939B2 (ja) * 2006-03-20 2010-10-20 テルモ株式会社 生体用縫合具
US8277463B2 (en) 2006-04-07 2012-10-02 Yutaka Suzuki Medical device and method of fixing internal organ
JP5306184B2 (ja) 2006-05-22 2013-10-02 スカンジウス バイオメディカル， インコーポレイテッド 半月板修復のための方法および装置
US8876842B2 (en) 2006-05-22 2014-11-04 Covidien Lp Meniscal repair device
WO2008033950A2 (fr) 2006-09-13 2008-03-20 C. R. Bard, Inc. Système de soutien urétral
JP4536698B2 (ja) 2006-10-05 2010-09-01 日本シャーウッド株式会社 医療用縫合具
JP5062742B2 (ja) * 2007-08-23 2012-10-31 国立大学法人山口大学 吻合補助器具
US8206280B2 (en) 2007-11-13 2012-06-26 C. R. Bard, Inc. Adjustable tissue support member
US20160213237A1 (en) * 2015-01-23 2016-07-28 Boston Scientific Scimed, Inc. Balloon catheter visualization systems, methods, and devices having pledgets
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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH05161655A (ja) * 1991-12-19 1993-06-29 Olympus Optical Co Ltd 臓器腹壁固定具
JPH0624533B2 (ja) * 1990-12-29 1994-04-06 昌貴 鮒田 医療用器具
WO1994021178A1 (fr) * 1993-03-23 1994-09-29 Goldrath Milton H Dispositif de suture a aiguille de verres
US5562688A (en) * 1994-03-25 1996-10-08 Riza; Erol D. Apparatus facilitating suturing in laparoscopic surgery

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0624533B2 (ja) * 1990-12-29 1994-04-06 昌貴 鮒田 医療用器具
JPH05161655A (ja) * 1991-12-19 1993-06-29 Olympus Optical Co Ltd 臓器腹壁固定具
WO1994021178A1 (fr) * 1993-03-23 1994-09-29 Goldrath Milton H Dispositif de suture a aiguille de verres
US5562688A (en) * 1994-03-25 1996-10-08 Riza; Erol D. Apparatus facilitating suturing in laparoscopic surgery

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US8663278B2 (en) 2004-10-06 2014-03-04 Covidien Lp Organ fixing equipment
US8672955B2 (en) 2005-12-26 2014-03-18 Covidien Lp Medical suturing device
JP2007319169A (ja) * 2006-05-30 2007-12-13 Masataka Funada 医療用器具
US8500758B2 (en) 2007-02-20 2013-08-06 Covidien Lp Auxiliary device for a puncture needle
US8968343B2 (en) 2008-06-24 2015-03-03 Covidien Lp Puncturing needle assisting tool
GB2482638B (en) * 2009-05-26 2014-02-12 Piolax Medical Devices Inc Suture device
US9119893B2 (en) 2010-11-04 2015-09-01 Linvatec Corporation Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone
US9307977B2 (en) 2010-11-04 2016-04-12 Conmed Corporation Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing suture to bone
US9307978B2 (en) 2010-11-04 2016-04-12 Linvatec Corporation Method and apparatus for securing an object to bone, including the provision and use of a novel suture assembly for securing an object to bone
CN110099611A (zh) * 2017-01-31 2019-08-06 日本瑞翁株式会社 缝合装置
CN110099611B (zh) * 2017-01-31 2022-03-11 日本瑞翁株式会社 缝合装置

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