WO2017145337A1 - Porte-aiguille et ensemble de suture - Google Patents

Porte-aiguille et ensemble de suture Download PDF

Info

Publication number
WO2017145337A1
WO2017145337A1 PCT/JP2016/055685 JP2016055685W WO2017145337A1 WO 2017145337 A1 WO2017145337 A1 WO 2017145337A1 JP 2016055685 W JP2016055685 W JP 2016055685W WO 2017145337 A1 WO2017145337 A1 WO 2017145337A1
Authority
WO
WIPO (PCT)
Prior art keywords
gripping member
gripping
needle
curved needle
insertion tube
Prior art date
Application number
PCT/JP2016/055685
Other languages
English (en)
Japanese (ja)
Inventor
明宏 島津
Original Assignee
オリンパス株式会社
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 オリンパス株式会社 filed Critical オリンパス株式会社
Priority to PCT/JP2016/055685 priority Critical patent/WO2017145337A1/fr
Publication of WO2017145337A1 publication Critical patent/WO2017145337A1/fr

Links

Images

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
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators

Definitions

  • the present invention relates to a needle holder and a suture set.
  • Patent Document 1 discloses a medical manipulator that can hold a curved needle.
  • Patent Document 2 discloses that a concave portion for preventing rotation of the gripped curved needle is provided at an edge portion in the width direction of the gripping surface.
  • Patent Literature 3 discloses a needle holder having a flexible insertion portion that can be inserted into a treatment instrument channel of a flexible endoscope.
  • JP 2012-50691 A JP 2011-200404 A JP 2009-247888 A
  • An object of the present invention is to provide a needle holder and a suturing set in which the curved needle is unlikely to rotate or shift even when the gripping force is small.
  • a long insertion tube portion a first gripping member rotatably connected to the distal end portion of the insertion tube portion, and a first connection member coupled to the distal end portion of the insertion tube portion.
  • Two gripping members the first gripping member has a first gripping surface, and the second gripping member extends from the distal end of the second gripping surface to the proximal end of the second gripping surface. It has a groove part, The said groove part is a needle holder characterized by being wider than said 1st holding surface in the direction orthogonal to the central axis of the said insertion part pipe
  • the second gripping member may have a protrusion protruding from the tip of the second gripping surface toward the first gripping member.
  • the protrusion may have a recess into which the tip of the first gripping member enters.
  • the curved needle gripped by the first gripping member and the second gripping member has a first contact portion and a first contact portion spaced apart from each other along a center line extending in the arc direction of the curved needle on the surface of the curved needle.
  • Two contact portions are supported by a boundary portion between the second gripping member and the groove portion, and between the first contact portion and the second contact portion in the center line direction of the curved needle on the surface of the curved needle.
  • the third contact portion located at the first gripping surface is supported by the first gripping surface, and a part between the first contact portion and the second contact portion enters the groove portion, whereby the longitudinal axis of the groove portion is
  • the posture of the curved needle may be constrained so that the center line of the curved needle exists in a plane that is orthogonal and orthogonal to the second gripping surface.
  • the present invention it is possible to provide a needle holder and a suturing set in which the curved needle is unlikely to rotate or shift even when the gripping force is small.
  • FIG. 3 is an example of a cross-sectional view taken along line AA in FIG. 2. It is an enlarged view of the treatment part in a needle holder. It is a top view of the 2nd holding member in a treatment part. It is a front view of the treatment part in the state which grasped the curved needle. It is a side view which shows the structure of the modification of the embodiment. It is a side view which shows the structure of the other modification of the embodiment. It is the figure seen from the B direction of FIG. It is a side view which shows the modification of the operation part of the needle holder of this invention.
  • FIG. 1 is an overall view showing a state in which the needle holder of the present embodiment grips a curved needle.
  • FIG. 2 is a plan view of the curved needle.
  • FIG. 3 is an example of a cross-sectional view taken along line AA in FIG.
  • FIG. 4 is an enlarged view of a treatment portion in the needle holder.
  • FIG. 5 is a plan view of the second gripping member in the treatment section.
  • FIG. 6 is a front view of the treatment section in a state where the curved needle is gripped.
  • the suturing set 1 of this embodiment includes a curved needle 10 and a needle holder 20.
  • the curved needle 10 has an arc shape having a predetermined curvature.
  • the curved needle 10 includes a needle tip 11 that can be inserted into tissue, a needle tip 12 that is connected to a suture thread, and a needle tip 11 and a needle tip so as to connect the needle tip 11 and the needle tip 12.
  • a needle body portion 13 disposed between the portion 12 and the needle portion 13.
  • the needle main body 13 has a first flat portion 14 and a second flat portion 15.
  • the first flat portion 14 is formed on the inner peripheral side of the needle main body portion 13 (side closer to the center of curvature O1 of the curved needle 10) in a cross section orthogonal to the center line Z1 extending along the arc of the curved needle 10.
  • the second flat portion 15 is formed on the outer peripheral side of the needle main body portion 13 (the side far from the center of curvature O1 of the curved needle 10) in a cross section orthogonal to the center line Z1 extending along the arc of the curved needle 10. Yes.
  • the needle holder 20 includes a long insertion tube portion 21 having flexibility, a treatment portion 22 disposed at a distal end 21 a of the insertion tube portion 21, and a proximal end of the insertion tube portion 21. And an traction member 34 disposed inside the insertion tube section 21 and connected to the operation section 31 and the treatment section 22.
  • the treatment unit 22 includes a first gripping member 23 and a second gripping member 26 for gripping the curved needle 10, and the first gripping member 23 is a second gripping member.
  • a connecting portion 28 and a connecting shaft 29 are provided for connecting the first gripping member 23 and the second gripping member 26 so as to be capable of opening and closing with respect to 26.
  • the first gripping member 23 is coupled to the distal end 21 a of the insertion tube portion 21 via the connection portion 28 and the coupling shaft 29.
  • a proximal end 23 b of the first gripping member 23 is connected to a distal end 34 a of the pulling member 34.
  • the first gripping member 23 has a connecting hole portion 23 c for connecting to the connecting portion 28 via the connecting shaft 29 between the distal end 23 a and the base end 23 b of the first gripping member 23.
  • the surface of the first gripping member 23 that faces the second gripping member 26 has a first gripping surface 25 that can contact the curved needle 10.
  • the first gripping surface 25 is a surface that is substantially parallel to a second gripping surface 27 (described later) of the second gripping member 26 in a state where the curved needle 10 is gripped by the first gripping member 23 and the second gripping member 26. is there.
  • the second gripping member 26 is coupled to the distal end 21 a of the insertion tube portion 21 via the connection portion 28 in the direction of the central axis Y ⁇ b> 1 of the insertion tube portion 21.
  • the second gripping member 26 and the connection portion 28 are integrally formed.
  • the second gripping member 26 has a groove portion 30 and a second gripping surface 27 directed to the first gripping member 23 side.
  • the second holding member 26 extends linearly along the center line Y1 of the insertion tube portion 21 from the distal end to the proximal end.
  • the width w2 of the groove portion 30 is equal to or greater than the width w1 of the first gripping surface 25 when viewed from the direction of the center line Y1 of the insertion tube portion 21.
  • the width w ⁇ b> 2 of the groove portion 30 is wider than the width w ⁇ b> 1 of the first gripping surface 25 when viewed from the direction of the center line Y ⁇ b> 1 of the insertion tube portion 21.
  • the second gripping surface 27 has boundary portions 30 a and 30 b with the groove portion 30.
  • the groove part 30 has the separated wall surface used as the width
  • the boundary portions 30a and 30b are groove edges extending in the longitudinal axis direction of the groove portion 30 at a position where the second gripping surface 27 and the groove portion 30 intersect, and the edges may be corner portions.
  • a round shape may be applied instead of a shape with a chamfered corner or a corner.
  • the first gripping member 23 is closed in a state where the outer peripheral side of the needle main body 13 is supported by the boundary portions 30 a and 30 b, the first gripping member 23 is moved to the inner peripheral side of the needle main body 13 of the curved needle 10. Touch.
  • the inner peripheral side of the needle main body 13 of the curved needle 10 is viewed from the distal end 26a of the second gripping member 26 toward the base end 26b of the second gripping member 26, the above two locations (first contact portion A1). , Second contact portion A2) is supported by the first gripping surface 25 of the first gripping member 23 at two locations (third contact portion, positions indicated by reference numerals A3 and A4 in FIG. 6).
  • the connecting portion 28 has a connecting hole portion 28 a for connecting with the connecting shaft 29.
  • a central axis Y2 (see FIG. 4) of the connecting shaft 29 connected to the connecting portion 28 extends in a direction orthogonal to the central line Y1 of the insertion tube portion 21. Since the first gripping member 23 and the second gripping member 26 are connected by the connecting hole portions 23c and 28a and the connecting shaft 29, the first gripping member 23 is orthogonal to the center line Y1 of the insertion tube portion 21.
  • a straight line extending in the direction can be rotated about the rotation axis Y2 with the rotation axis Y2 (the center line Y2 of the connecting shaft 29). Thereby, the first gripping member 23 can open and close with respect to the second gripping member 26.
  • the treatment portion 22 in this embodiment is a treatment in which the first gripping member 23 opens and closes with respect to the second gripping member 26 that is coupled to the distal end 21 a of the insertion tube portion 21 via the connection portion 28 and the coupling shaft 29. Part 22.
  • the operation unit 31 includes an operation unit main body 32, a slider 33, and a ratchet mechanism mechanism (not shown) that restricts the slider 33 from moving toward the distal end side with respect to the operation unit main body 32. And a release button 35 for the ratchet mechanism.
  • the distal end 32 a of the operation portion main body 32 is fixed to the proximal end 21 b of the insertion tube portion 21.
  • the slider 33 is coupled to the operation unit main body 32 so as to be movable back and forth in the long axis direction of the operation unit main body 32. Further, the slider 33 is connected to the base end 34 b of the pulling member 34.
  • the pulling member 34 can be moved along the center line Y ⁇ b> 1 of the insertion tube portion 21 by moving the slider 33 forward and backward along the operation portion main body 32.
  • the traction member 34 can be pulled toward the operation unit 31 by moving the slider 33 toward the proximal end along the operation unit main body 32.
  • the slider 33 can restrict the movement of the slider 33 toward the distal end side by a ratchet mechanism at a desired position. For this reason, the slider 33 can be locked in a state where the slider 33 is pulling the pulling member 34, and the state where the pulling member 34 is pulled can be maintained.
  • the pulling member 34 transmits an operation force amount for performing the opening / closing operation of the first gripping member 23 with respect to the second gripping member 26 from the operation unit 31 to the first gripping member 23. It is a member.
  • the distal end 34 a of the pulling member 34 is connected to the proximal end 23 b of the first gripping member 23.
  • a base end 34 b of the pulling member 34 is connected to the slider 33 of the operation unit 31.
  • the suturing set 1 and the needle holder 20 of this embodiment will be described.
  • the tissue in the body is sutured using the suture set 1 of the present embodiment
  • the curved needle 10 introduced to the vicinity of the site to be sutured is grasped using the needle holder 20 as shown in FIGS. To do.
  • the curved needle 10 When the curved needle 10 is sandwiched between the first gripping member 23 and the second gripping member 26, a part of the curved needle 10 enters the inside of the groove portion 30.
  • the curved needle 10 is most stably gripped with the inner peripheral side of the needle main body 13 in contact with the first gripping surface 25 and the outer peripheral side of the needle main body 13 in contact with the second gripping surface 27. At this time, a part of the inner peripheral side of the needle main body 13 is located in the groove 30.
  • the first gripping member 23 is in contact with the inner peripheral side of the needle main body 13.
  • the tissue can be sutured.
  • the inner peripheral side of the needle main body 13 is in contact with the first gripping surface 25, and the outer peripheral side of the needle main body 13 is in contact with the second gripping surface 27.
  • the posture of the curved needle 10 is stabilized. For this reason, the curved needle 10 sandwiched between the first gripping member 23 and the second gripping member 26 is unlikely to rotate or shift.
  • FIG. 7 is a side view showing the treatment portion 22 in the needle holder 20 of the present modification.
  • the first gripping member 23 in the present modification has a first gripping surface 25 ⁇ / b> A having a configuration different from that of the first gripping surface 25 disclosed in the above embodiment.
  • the first gripping surface 25A in this modified example is curved in the vicinity of the distal end 23a of the first gripping member 23 so as to gradually approach the second gripping member 26 side from the proximal end 23b of the first gripping member 23 toward the distal end 23a. is doing.
  • the first gripping surface 25A of the present modified example moves the curved needle 10 toward the distal end side of the treatment portion 22 by the gripping force in a state where the curved needle 10 is gripped by the first gripping member 23 and the second gripping member 26.
  • the curved needle 10 can be reliably grasped by the first grasping member 23 and the second grasping member 26.
  • FIG. 8 is a side view showing the treatment portion 22 in the needle holder 20 of the present modification.
  • FIG. 9 is a view showing the treatment portion 22 in the needle holder 20 of the present modified example from the direction C of FIG.
  • the second gripping member 26 in this modification has a protrusion 36 that protrudes from the tip 27 a of the second gripping surface 27 toward the first gripping surface 25.
  • the protruding portion 36 moves to the distal end side of the treatment section 22 and the first gripping member 23 and the second gripping member 36
  • the curved needle 10 can be supported so that the curved needle 10 does not fall out from between the gripping member 26.
  • the surface of the curved needle 10 is directed toward the proximal end of the second gripping member 26 in the protrusion 36 as the amount of force for closing the first gripping member 23 and the second gripping member 26 increases. It is strongly pressed against the abutting surface 36b (see FIG. 8). The surface of the curved needle 10 is pressed from three different directions toward the center line Z1 of the curved needle 10 by the first gripping surface 25, the second gripping surface 27, and the abutting surface 36b. For this reason, as the amount of force for closing the first gripping member 23 and the second gripping member 26 increases, the curved needle 10 is less likely to be displaced.
  • the curved needle 10 since the first gripping surface 25, the second gripping surface 27, and the abutting surface 36b surround the curved needle 10, the amount of force for closing the first gripping member 23 and the second gripping member 26 is small. However, the curved needle 10 is not easily displaced.
  • the protrusion 36 in this modification has a recess 36a into which the tip 23a of the first gripping member 23 enters. Since the depression 36 a is provided in the protrusion 36, the first holding member 23 and the second holding member 26 allow the curved needle 10 having a diameter smaller than the distance from the second holding surface 27 to the protruding end of the protrusion 36 to be It can be gripped.
  • the second gripping member 26 disclosed in each of the above embodiments may have a shape (slit shape) in which the groove 30 penetrates at least a part of the second gripping surface 27.
  • the needle holder 20 disclosed in the above embodiments may be a surgical needle holder in which the insertion tube portion and the pulling member are hard members.
  • the operation part of the needle holder 20 disclosed in each of the above embodiments may be a curl linen type as shown in FIG. For example, as illustrated in FIG.
  • the operation unit 51 includes a pair of handles (a fixed handle 52 and a movable handle 53) that can be opened and closed, and a fixing mechanism (not shown) that fixes the movable handle 53. .
  • the movable handle 53 is connected to the fixed handle 52 so as to be rotatable about a predetermined opening / closing axis 53a with respect to the fixed handle 52. Further, the movable handle 53 is connected to the base end 34 b of the pulling member 34. By opening and closing the movable handle 53 with respect to the fixed handle 52, the traction member 34 can be moved along the central axis Y1 of the insertion tube portion 21.
  • the needle holder 20 disclosed in each of the above embodiments may be a double-open needle holder in which the second gripping member 26 is rotatably connected to the connection portion 28 in the same manner as the first gripping member 23.
  • the cross section AA of the needle main body portion of the curved needle 10 of the suturing set 1 disclosed in the above embodiments is a flat surface on both the inner peripheral side and the outer peripheral side of the needle main body portion 13 as shown in FIG. It may be a D-cut shape having a D-cut oval shape having a flat surface on either the inner peripheral side or the outer peripheral side, or a polygonal shape.
  • the present invention can be used for a medical instrument for suturing a tissue.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un porte-aiguille (20) comportant : une section de tube d'insertion allongée (21) ; un premier élément de préhension (23) présentant une première surface de préhension (25) s'étendant dans la direction de l'axe central de la section de tube d'insertion (21), le premier élément de préhension (23) étant relié à l'extrémité avant de la section de tube d'insertion (21) de façon à pouvoir pivoter autour d'un axe de pivotement qui est une ligne droite s'étendant dans la direction perpendiculaire à l'axe central de la section de tube d'insertion (21) ; et un second élément de préhension (26) présentant une rainure (28) qui est plus large que la première surface de préhension (25) dans la direction perpendiculaire à l'axe central et qui est longue dans la direction de l'axe central, le second élément de préhension (26) présentant également une seconde surface de préhension (27) reliant une extrémité d'ouverture de la rainure (28) et faisant face au premier élément de préhension (23), le second élément de préhension (26) étant relié à l'extrémité avant de la section de tube d'insertion (21).
PCT/JP2016/055685 2016-02-25 2016-02-25 Porte-aiguille et ensemble de suture WO2017145337A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2016/055685 WO2017145337A1 (fr) 2016-02-25 2016-02-25 Porte-aiguille et ensemble de suture

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2016/055685 WO2017145337A1 (fr) 2016-02-25 2016-02-25 Porte-aiguille et ensemble de suture

Publications (1)

Publication Number Publication Date
WO2017145337A1 true WO2017145337A1 (fr) 2017-08-31

Family

ID=59685003

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2016/055685 WO2017145337A1 (fr) 2016-02-25 2016-02-25 Porte-aiguille et ensemble de suture

Country Status (1)

Country Link
WO (1) WO2017145337A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019180867A1 (fr) * 2018-03-22 2019-09-26 オリンパス株式会社 Porte-aiguille et son procédé d'utilisation
JPWO2021079461A1 (fr) * 2019-10-24 2021-04-29
WO2021176636A1 (fr) * 2020-03-05 2021-09-10 オリンパス株式会社 Porte-aiguille pour endoscope, et procédé de suture endoscopique
CN114343753A (zh) * 2020-10-13 2022-04-15 奥林巴斯株式会社 牵引器具、牵引系统、缝合线的牵引方法以及缝合方法

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5601575A (en) * 1994-09-02 1997-02-11 Ethicon Endo-Surgery, Inc. Needle driving device
US5951587A (en) * 1997-10-09 1999-09-14 Ethicon-Endo-Surgery, Inc. Needle holder with suture filament grasping abilities
US20020120282A1 (en) * 1999-12-20 2002-08-29 Kilpela Thomas S. Multiple lumen crimp
JP2009247888A (ja) * 2008-04-10 2009-10-29 Olympus Medical Systems Corp 治療システム

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5601575A (en) * 1994-09-02 1997-02-11 Ethicon Endo-Surgery, Inc. Needle driving device
US5951587A (en) * 1997-10-09 1999-09-14 Ethicon-Endo-Surgery, Inc. Needle holder with suture filament grasping abilities
US20020120282A1 (en) * 1999-12-20 2002-08-29 Kilpela Thomas S. Multiple lumen crimp
JP2009247888A (ja) * 2008-04-10 2009-10-29 Olympus Medical Systems Corp 治療システム

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019180867A1 (fr) * 2018-03-22 2019-09-26 オリンパス株式会社 Porte-aiguille et son procédé d'utilisation
CN111867488A (zh) * 2018-03-22 2020-10-30 奥林巴斯株式会社 持针器及其使用方法
JPWO2019180867A1 (ja) * 2018-03-22 2021-03-11 オリンパス株式会社 持針器およびその使用方法
JPWO2021079461A1 (fr) * 2019-10-24 2021-04-29
WO2021079461A1 (fr) * 2019-10-24 2021-04-29 オリンパス株式会社 Porte-aiguille pour endoscope et procédé de manipulation d'aiguille de suture
CN114302683A (zh) * 2019-10-24 2022-04-08 奥林巴斯株式会社 内窥镜用持针器及缝合针的操作方法
JP7233562B2 (ja) 2019-10-24 2023-03-06 オリンパス株式会社 内視鏡用持針器および縫合針の操作方法
CN114302683B (zh) * 2019-10-24 2024-04-26 奥林巴斯株式会社 内窥镜用持针器及缝合针的操作方法
WO2021176636A1 (fr) * 2020-03-05 2021-09-10 オリンパス株式会社 Porte-aiguille pour endoscope, et procédé de suture endoscopique
JP7349553B2 (ja) 2020-03-05 2023-09-22 オリンパス株式会社 内視鏡用持針器
CN114343753A (zh) * 2020-10-13 2022-04-15 奥林巴斯株式会社 牵引器具、牵引系统、缝合线的牵引方法以及缝合方法
CN114343753B (zh) * 2020-10-13 2024-03-29 奥林巴斯株式会社 牵引器具、牵引系统、缝合线的牵引方法以及缝合方法

Similar Documents

Publication Publication Date Title
US10835220B2 (en) Self-articulating joint for a minimally invasive surgical apparatus
US7896900B2 (en) Medical instrument for grasping an object, in particular needle holder
WO2017145337A1 (fr) Porte-aiguille et ensemble de suture
US11911020B2 (en) Needle holder for endoscope, suture set, and suture system
WO2012042920A1 (fr) Instrument thérapeutique
JP6184639B2 (ja) 縫合器
JP2004154164A (ja) 多自由度型処置具
JP5328421B2 (ja) 鉗子
US20090198098A1 (en) Endoscope treatment instrument
JP6622151B2 (ja) 把持器、持針器及びアタッチメント
US20070016249A1 (en) Suture device
JPWO2018163410A1 (ja) ガイドワイヤ把持具
US11311305B2 (en) Surgical instruments with coupling members to effect multiple pivot axes
JP2014518653A (ja) 外科用鉗子
JP5266358B2 (ja) 持針器
JP3884046B2 (ja) 外科用器具
JP5695835B2 (ja) 外科用処置具
JP2018061672A (ja) 留置用クリップ
WO2017119080A1 (fr) Instrument de traitement endoscopique
JP7468725B2 (ja) 鉗子
JP5103609B2 (ja) 持針器
JP2007054249A (ja) 持針器
JP5751554B2 (ja) 手術用器具
JP2004016661A (ja) 外科用処置具

Legal Events

Date Code Title Description
NENP Non-entry into the national phase

Ref country code: DE

121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 16891494

Country of ref document: EP

Kind code of ref document: A1

122 Ep: pct application non-entry in european phase

Ref document number: 16891494

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: JP