WO2017199392A1 - Medical stapler system - Google Patents

Medical stapler system Download PDF

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Publication number
WO2017199392A1
WO2017199392A1 PCT/JP2016/064861 JP2016064861W WO2017199392A1 WO 2017199392 A1 WO2017199392 A1 WO 2017199392A1 JP 2016064861 W JP2016064861 W JP 2016064861W WO 2017199392 A1 WO2017199392 A1 WO 2017199392A1
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WO
WIPO (PCT)
Prior art keywords
staple
medical stapler
angle
gripping member
needle
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Application number
PCT/JP2016/064861
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French (fr)
Japanese (ja)
Inventor
岡部　洋
熊田　嘉之
契介 釣本
香由 木村
雅之 小林
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.)
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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/JP2016/064861 priority Critical patent/WO2017199392A1/en
Priority to JP2018518017A priority patent/JPWO2017199392A1/en
Publication of WO2017199392A1 publication Critical patent/WO2017199392A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps

Definitions

  • the present invention relates to a medical stapler system.
  • a medical stapler is known as a treatment tool for simultaneously suturing and cutting tissue (see, for example, Patent Document 1).
  • This medical stapler includes a large number of staples, a mechanism for ejecting the staples, and an anvil for deforming the ejected staples in a pair of jaws that grip tissue.
  • the anvil is provided with an anvil pocket having a predetermined concave curved surface shape at a position facing the staple that is punched out, and the punched staple is bent in accordance with the concave curved surface shape of the anvil pocket to embrace the tissue. It is made to be bent and stitched. That is, the staple punched out from the jaw is guided to slide along the concave curved surface of the anvil pocket after being bent in a predetermined direction by being buckled and deformed from the state where it hits the concave curved surface of the anvil pocket. It is plastically deformed into a curved shape at the time of final stitching.
  • Patent Document 1 since the medical stapler of Patent Document 1 is accompanied by buckling deformation at the start of bending of the staple, a large amount of force is required to drive out the staple. The number of staples to be driven out in one stitching operation is large, and the burden on the operating operator is great.
  • the present invention has been made in view of the circumstances described above, and provides a medical stapler system that can reduce the amount of force required to deform a staple and reduce the burden on an operator. It is aimed.
  • One aspect of the present invention includes a medical stapler and staples driven out by the medical stapler.
  • the medical stapler is provided so as to be openable and closable with respect to each other.
  • a gripping member; and a second gripping member wherein the first gripping member includes a storage portion for storing the staple, and an ejection hole for injecting the staple stored in the storage portion, and the second grip A member is disposed at a position facing the ejection hole, and an anvil portion having a curved surface that curves the staple needle portion of the ejected staple in a predetermined direction, and the needle portion of the staple is the needle portion At a position where the tip of the needle abuts against the curved surface of the anvil portion, a first angle formed by a tangential plane on the outer edge side in the bending direction and a tangential plane on the curved surface, a tangential plane on the inner edge side in the bending direction, and the A second angle formed between the tangent plane of the face, said
  • the medical stapler system 1 includes a medical stapler 2 and staples 3 attached to the medical stapler 2.
  • the medical stapler 2 includes a first gripping member (first jaw) 5, a second gripping member (second jaw) 6, and a second gripping member 6 that are swingable around the swinging shaft 4.
  • a swing mechanism 7 that swings around the swing shaft 4 with respect to the first gripping member 5 and an injection cutting mechanism 8 that ejects the staple 3 and cuts the tissue A are provided.
  • the first gripping member 5 and the second gripping member 6 are shown in FIG. 2 by swinging the second gripping member 6 about the swinging shaft 4 with respect to the first gripping member 5 by the swing mechanism 7. Thus, they are moved relative to each other between an open state that is open to each other and a closed state that is closed to each other and grips the tissue A therebetween as shown in FIG.
  • the first gripping member 5 accommodates the plurality of staples 3 in, for example, two rows (only one row is shown in the figure) on the gripping surface (first contact surface 5a) that grips the tissue A in the first gripping member 5.
  • a holder 10 capable of accommodating a staple cassette (accommodating section) 9 is provided.
  • the first gripping member 5 has a first contact surface 5a that is brought into close contact with one surface of the tissue A sandwiched between the first gripping member 6 and the second gripping member 6 in a state where the staple cassette 9 is accommodated in the holder 10.
  • An ejection hole 5b that opens to the contact surface 5a and ejects the staple 3 is provided.
  • the staple 3 includes a linear base portion 3a and a single needle portion 3b extending from one end of the base portion 3a in a direction perpendicular to the longitudinal direction of the base portion 3a. It has an asymmetric shape.
  • the needle portion 3b is formed in a shape that smoothly curves in a direction closer to the other end of the base portion 3a as the distance from the base portion 3a increases in a plane including the base portion 3a.
  • the needle portion 3 b includes an outer edge 3 d and an inner edge 3 e that are curved in the same direction, and the outer edge 3 d and the inner edge 3 e are arranged on the outer sides each having a continuous curvature. It is constituted by a convex curved surface, for example, a single arc surface.
  • the needle tip 3c of the needle portion 3b is formed in a sharp shape that is easy to pierce the tissue A at a position where the outer edge 3d and the inner edge 3e intersect.
  • the base portions 3 a of all the staples 3 are arranged in a straight line for each row, and the base portions 3 a and the needle portions 3 b of all the staples 3 are on the same plane. They are arranged at intervals so as to be arranged above.
  • the staple 3 in each injection hole 5b is arranged with the needle portion 3b facing the side close to the opening of the injection hole 5b.
  • FIG. 1 to 3 schematically show an example in which three staples 3 are arranged in each row. Accordingly, the ejection holes 5b for ejecting the staples 3 are also arranged in a line for each row in a state where the staple cassette 9 is accommodated in the holder 10.
  • the anvil part 11 includes a groove part 11 a that is disposed at a position facing each injection hole 5 b provided in the first gripping member 5 when the anvil part 11 is disposed in the closed state. In the example shown in FIGS. 1 to 3, three grooves 11 a are provided at positions facing the three injection holes 5 b for each row.
  • Each groove portion 11a has a groove width dimension in which a single staple 3 can be inserted, and as shown in FIG. 5 or FIG. 6, a groove bottom that abuts the needle tip 3c of the staple 3 ejected from the ejection hole 5b. 11b.
  • the groove bottom 11 b includes a flat surface and an arc surface that smoothly connects to the flat surface.
  • the groove bottom 11 b is configured by a concave curved surface that is smoothly curved so as to be deepest at a midway position in the longitudinal direction of the groove 11 a.
  • the groove bottom 11b shown in FIG. 6 is composed of two curved surfaces having different curvatures in the longitudinal direction of the groove 11a.
  • the two curved surfaces are smoothly connected so as to share the tangent plane at the connection position of the two curved surfaces. Further, when comparing each of the two curved surfaces, the curvature at the position where the needle tip 3c of the staple 3 abuts first is in contact with the other curvature (the outer edge 3d of the needle portion 3b is in contact with the curvature of the needle portion 3b).
  • the curvature is set to be smaller than the curvature at the position at which it is to occur.
  • the angle (first angle) formed between the tangent plane and the tangent plane of the curved surface constituting the groove bottom 11b is less than 53.5 °, and the curved surface on the inner edge 3e side of the needle portion 3b at the same position is connected.
  • the angle (second angle) formed between the flat surface and the tangent plane of the curved surface constituting the groove bottom 11b is set to be larger than the first angle and less than 90 °.
  • FIG. 4 is a reference example in which the first angle is 53.5 ° and the second angle is 90 °.
  • the first angle is preferably 43.5 ° or less as shown in FIG. 5, and more preferably 28.5 ° or less as shown in FIG. 6.
  • the second angle is preferably 80 ° or less as shown in FIG. 5, and more preferably 65 ° or less as shown in FIG.
  • the swing mechanism 7 includes a linear first elongated hole 7a provided in the first holding member 5 and a linear first elongated hole provided in the second holding member 6 and inclined so as to intersect the first elongated hole 7a.
  • An opening / closing driving force transmission member 7d that pushes and pulls in a direction along 7a.
  • the slider member 7c When the slider member 7c is pressed against the distal end side of the first gripping member 5 by the opening / closing driving force transmission member 7d, the slider member 7c is moved along the first long hole 7a and the second long hole 7b. The crossing position of the long hole 7a and the second long hole 7b changes. As a result, the second gripping member 6 is swung about the swinging shaft 4 toward the open state with respect to the first gripping member 5.
  • the injection cutting mechanism 8 includes a slider 8a that is linearly movable along the arrangement direction of the staples 3 in the staple cassette 9 in the holder 10 of the first gripping member 5, and a shaft that applies a pressing force to the slider 8a. 8b.
  • the slider 8a is disposed in the gap between the slope 8c that applies a radiant power in the direction in which the staple 3 is ejected from the ejection hole 5b to the base portion 3a of the staple 3, and the first contact surface 5a and the second contact surface 6a.
  • the cutter 8d that cuts the tissue A gripped between the first contact surface 5a and the second contact surface 6a is fixed by the movement of the slider 8a.
  • the base portion 3a of the staple 3 on the most proximal side rides on the slope 8c, receives the radiation output from the slope 8c, and is ejected from the ejection hole 5b. It has come to be. Since the staple 3 is arranged with the needle tip 3c facing the opening side of the ejection hole 5b, the staple 3 ejected from the ejection hole 5b is located outward of the ejection hole 5b from the needle tip 3c side of the needle portion 3b. The tissue A that has been ejected and is gripped between the first gripping member 5 and the second gripping member 6 is penetrated in the thickness direction by the needle portion 3b.
  • the needle tip 3c of the needle portion 3b of the staple 3 penetrating the tissue A abuts against the groove bottom 11b of the groove portion 11a of the anvil portion 11 of the second gripping member 6. Since the needle tip 3c of the staple 3 is curved so as to fall toward the other end of the base portion 3a, an external force is received from the groove bottom 11b of the anvil portion 11 in the direction of increasing the curvature.
  • the needle tip 3c of the needle portion 3b slides and moves along the groove bottom 11b of the anvil portion 11, is bent so as to be folded back, and is allowed to puncture the tissue A again. It has become. Thereby, the needle 3b of the staple 3 is bent so as to embrace the tissue A, and the tissue A can be appropriately sutured.
  • the cutter 8d is disposed with the cutting edge facing the distal end side of the first gripping member 5, and the staple A is ejected by moving the slider 8a toward the distal end side, and the tissue A after being stitched by the staple 3 is removed. Cutting is performed in the vicinity of the stitching position by the staple 3.
  • the slider member 7c is moved to the distal end side of the first gripping member 5 via the opening / closing driving force transmission member 7d of the swing mechanism 7. Apply driving force to move. Then, the slider member 7 c moves to the tip side along the first long hole 7 a provided in the first gripping member 5. Since the slider member 7c also penetrates the second elongated hole 7b provided in the second gripping member 6, the second elongated hole 7b is moved so as to change the penetrating position in the second elongated hole 7b. As a result, as shown in FIG. 2, the second gripping member 6 provided with the second elongated hole 7 b swings about the swing shaft 4 with respect to the first gripping member 5, and the first gripping member 5 And the 2nd holding member 6 will be in the open state opened mutually.
  • the tissue A to be sutured is disposed between the first contact surface 5a and the second contact surface 6a of the first gripping member 5 and the second gripping member 6, and is swung.
  • a driving force for moving the slider member 7 c to the proximal end side of the first gripping member 5 is applied via the opening / closing driving force transmission member 7 d of the mechanism 7.
  • the second gripping member 6 swings about the swinging shaft 4 with respect to the first gripping member 5 and is in a closed state in which the second gripping member 6 is closed to each other as shown in FIG.
  • the tissue A is gripped between the first contact surface 5 a of the second gripper 5 and the second contact surface 6 a of the second gripping member 6.
  • a pressing force is applied to the shaft 8 b of the injection cutting mechanism 8.
  • the slider 8a is pushed out to the distal end side, and as shown in FIG. 4, the base portion 3a rides on the slope 8c from the most proximal staple 3 and is ejected from the ejection hole 5b.
  • the staple 3 arranged with the needle tip 3c of the needle portion 3b facing the opening side of the ejection hole 5b is gripped between the first gripping member 5 and the second gripping member 6 when ejected from the ejection hole 5b.
  • the formed tissue A is penetrated in the thickness direction by the needle portion 3b.
  • the needle portion 3b penetrating the tissue A is As shown in FIG. 5, the needle tip 3c is abutted against the groove bottom 11b by being inserted into the groove 11a.
  • the outer edge 3d of the needle portion 3b is connected to the groove bottom 11b at the initial contact position between the needle tip 3c of the staple 3 and the groove bottom 11b of the groove portion 11a. Since the relative angle is less than 53.5 ° and the inner edge 3e of the needle portion 3b contacts the groove bottom 11b at a relative angle of less than 90 °, the needle portion 3b can be bent with a relatively small amount of force. .
  • the deformation amount of the needle portion 3 b does not increase unless a large amount of deformation force is initially applied. That is, as in the case of the reference example of FIG. 4, the outer edge 3d of the needle portion 3b makes a relative angle of 53.5 ° with the groove bottom 11b, and the inner edge 3e of the needle portion 3b has a relative angle of 90 ° with the groove bottom.
  • the bending of the needle portion 3b is not started unless a large amount of deformation force (buckling load) for buckling the needle portion 3b is applied.
  • the outer edge 3d of the needle 3b has a relative angle of less than 53.5 ° with the groove bottom 11b.
  • the inner edge 3e of the needle portion 3b satisfies the condition of a relative angle of less than 90 ° with the groove bottom 11b, the amount of deformation force for starting the bending can be reduced.
  • the outer edge 3d of the needle portion 3b such as the staple 3 described in FIG. 5 forms a relative angle of 43.5 ° or less with the groove bottom 11b, and the inner edge 3e of the needle portion 3b has an angle of 80 ° or less with the groove bottom 11b.
  • the curve is as shown by symbol B in FIG. 7, and the outer edge 3d of the needle portion 3b is 28.5 ° with the groove bottom 11b as in the staple 3 described in FIG.
  • a curve as indicated by reference C in FIG. 7 is obtained.
  • the needle portion 3b can be continuously curved without being given a force amount equal to or greater than the buckling load of the needle portion 3b, that is, within a range of the force amount equal to or less than the buckling load. it can.
  • an external force applied by the slope 8c acts on the needle tip 3c that has abutted against the groove bottom 11b in a direction orthogonal to the second contact surface 6a at the contact position, but the outer edge 3d of the needle portion 3b is applied to the needle tip 3c.
  • the second contact surface 6a is in contact with the groove bottom 11b at a shallow angle, and the inner edge 3e of the needle portion 3b is at an angle of less than 90 °
  • the reaction force received from the second contact surface 6a A moment in the direction of bending the portion 3b is generated, and the needle tip 3c slides on the groove bottom 11b.
  • the load received by the needle portion 3b is equal to or less than the buckling load, and the needle portion 3b is bent from the beginning of contact without buckling, so that an increase in deformation force due to buckling can be prevented.
  • the needle portion 3b is guided to bend by the shape of the groove bottom 11b, is bent so as to be folded back to the tissue A side, and is punctured into the tissue A again. Thereby, the tissue A can be firmly sutured by the staple 3.
  • the cutter 8 d provided on the slider 8 a cuts the tissue A adjacent to the portion stitched by the staple 3. Accordingly, the operation of pushing the shaft 8b toward the distal end side sequentially repeats the stitching and cutting of the tissue A, and the tissue A that has been properly sutured by the staple 3 can be separated.
  • the staple 3 starts to bend without buckling. Therefore, the amount of force required when the tissue A is sutured can be reduced. Even in the suturing operation in which the staples 3 are sequentially bent, there is an advantage that the burden on the doctor can be greatly reduced.
  • the case where three staples 3 are arranged in two rows is illustrated for ease of illustration and description, but the number of staples 3 and the number of rows per row are arbitrary. Good.
  • the medical stapler 2 that swings the two gripping members 5 and 6 is illustrated, but the medical stapler that deforms a large number of staples 3 at a time like a circular or linear type medical stapler. You may apply to the stapler system 1.
  • FIG. By doing in this way, the force at the time of deform

Abstract

The purpose of the present invention is to reduce burden on an operator by reducing the amount of power required to deform a staple. This medical stapler system (1) includes a medical stapler (2) and staples (3). The medical stapler has a first holding member (5) and a second holding member (6) that are provided to be mutually openable and closable, the first holding member having a housing portion (9) that houses the staples and ejection holes (5b) for ejecting the staples in the housing portion, and the second holding member having an anvil portion (11) which is arranged in a position facing the ejection holes and has curved surfaces for bending a needle portion (7b) of each ejected staple in a predetermined direction. The needle portion of the staple has, at a position at which a needle tip of the needle portion abuts the curved surface, a first angle between a tangent of an outer edge in a bending direction and a tangent of the curved surface and a second angle between a tangent of an inner edge in the bending direction and the tangent of the curved surface which are set to angles to start the needle portion to bend under a load at or less than a buckling load.

Description

医療用ステープラシステムMedical stapler system
　本発明は、医療用ステープラシステムに関するものである。 The present invention relates to a medical stapler system.
　組織の縫合と切断とを同時に行う処置具として医療用ステープラが知られている（例えば、特許文献１参照。）。
　この医療用ステープラは、組織を把持する一対のジョーの内部に、多数のステープルと該ステープルを打ち出す機構と、打ち出されたステープルを変形させるアンビルとを備えている。 A medical stapler is known as a treatment tool for simultaneously suturing and cutting tissue (see, for example, Patent Document 1).
This medical stapler includes a large number of staples, a mechanism for ejecting the staples, and an anvil for deforming the ejected staples in a pair of jaws that grip tissue.
　アンビルには、打ち出されてくるステープルに対向する位置に、所定の凹曲面形状のアンビルポケットが備えられ、打ち出されたステープルをアンビルポケットの凹曲面形状に倣って湾曲させることにより、組織を抱き込むように湾曲させて、縫合するようになっている。すなわち、ジョーから打ち出されたステープルは、アンビルポケットの凹曲面に突き当たった状態から座屈変形させられることによって所定の方向に湾曲された後に、アンビルポケットの凹曲面に倣って滑るように案内されて最終的な縫合時の湾曲形状に塑性変形させられる。 The anvil is provided with an anvil pocket having a predetermined concave curved surface shape at a position facing the staple that is punched out, and the punched staple is bent in accordance with the concave curved surface shape of the anvil pocket to embrace the tissue. It is made to be bent and stitched. That is, the staple punched out from the jaw is guided to slide along the concave curved surface of the anvil pocket after being bent in a predetermined direction by being buckled and deformed from the state where it hits the concave curved surface of the anvil pocket. It is plastically deformed into a curved shape at the time of final stitching.
特許第５３２９９５６号公報Japanese Patent No. 5329956
　しかしながら、特許文献１の医療用ステープラでは、ステープルの湾曲開始時に座屈変形を伴うため、ステープルを打ち出すために大きな力量が必要である。１回の縫合作業で打ち出すステープルの数は多数であり、操作する術者にかかる負担は大きい。
　本発明は上述した事情に鑑みてなされたものであって、ステープルを変形させるのに必要な力量を低減して、術者にかかる負担を軽減することができる医療用ステープラシステムを提供することを目的としている。 However, since the medical stapler of Patent Document 1 is accompanied by buckling deformation at the start of bending of the staple, a large amount of force is required to drive out the staple. The number of staples to be driven out in one stitching operation is large, and the burden on the operating operator is great.
The present invention has been made in view of the circumstances described above, and provides a medical stapler system that can reduce the amount of force required to deform a staple and reduce the burden on an operator. It is aimed.
　本発明の一態様は、医療用ステープラと、該医療用ステープラにより打ち出されるステープルとを備え、前記医療用ステープラが、相互に開閉可能に設けられ、閉状態において間に組織を把持可能な第１把持部材と第２把持部材とを備え、前記第１把持部材が、前記ステープルを収容する収容部と、該収容部に収容されている前記ステープルを射出する射出孔とを備え、前記第２把持部材が、前記射出孔に対向する位置に配置され、射出された前記ステープルの針部を所定の方向に湾曲させる曲面を有するアンビル部と、を備え、前記ステープルの前記針部は、該針部の針先が前記アンビル部の前記曲面に突き当たる位置において、湾曲方向の外縁側の接平面と前記曲面の接平面とのなす第１角度と、前記湾曲方向の内縁側の接平面と前記曲面の接平面とのなす第２角度とが、前記針部を座屈荷重以下の荷重で湾曲開始させる角度に設定されている医療用ステープラシステムである。 One aspect of the present invention includes a medical stapler and staples driven out by the medical stapler. The medical stapler is provided so as to be openable and closable with respect to each other. A gripping member; and a second gripping member, wherein the first gripping member includes a storage portion for storing the staple, and an ejection hole for injecting the staple stored in the storage portion, and the second grip A member is disposed at a position facing the ejection hole, and an anvil portion having a curved surface that curves the staple needle portion of the ejected staple in a predetermined direction, and the needle portion of the staple is the needle portion At a position where the tip of the needle abuts against the curved surface of the anvil portion, a first angle formed by a tangential plane on the outer edge side in the bending direction and a tangential plane on the curved surface, a tangential plane on the inner edge side in the bending direction, and the A second angle formed between the tangent plane of the face, said needle portion is a medical stapler system is set to an angle which starts curved buckling load following load.
　本発明によれば、ステープルを変形させるのに必要な力量を低減して、術者にかかる負担を軽減することができるという効果を奏する。 According to the present invention, there is an effect that it is possible to reduce the amount of force required to deform the staple and to reduce the burden on the operator.
本発明の一実施形態に係る医療用ステープラシステムを示す縦断面図である。It is a longitudinal section showing a medical stapler system concerning one embodiment of the present invention. 図１の医療用ステープラシステムにより組織を把持する前の開状態を示す縦断面図である。It is a longitudinal cross-sectional view which shows the open state before hold | gripping a structure | tissue with the medical stapler system of FIG. 図１の医療用ステープラシステムにより組織を把持した閉状態を示す縦断面図である。It is a longitudinal cross-sectional view which shows the closed state which hold | gripped the structure | tissue by the medical stapler system of FIG. ステープルとアンビル部の溝底との関係を示す参考例を示す縦断面図である。It is a longitudinal cross-sectional view which shows the reference example which shows the relationship between a staple and the groove bottom of an anvil part. 図１の医療用ステープラシステムにおけるステープルとアンビル部の溝底との関係の一例を示す縦断面図である。It is a longitudinal cross-sectional view which shows an example of the relationship between the staple in the medical stapler system of FIG. 1, and the groove bottom of an anvil part. 図１の医療用ステープラシステムにおけるステープルとアンビル部の溝底との関係の他の例を示す縦断面図である。It is a longitudinal cross-sectional view which shows the other example of the relationship between the staple in the medical stapler system of FIG. 1, and the groove bottom of an anvil part. 図４から図６のステープルとアンビル部の溝底との関係における変形量と変形力量との関係を示すグラフである。7 is a graph showing the relationship between the amount of deformation and the amount of deformation force in the relationship between the staple of FIGS. 4 to 6 and the groove bottom of the anvil portion.
　本発明の一実施形態に係る医療用ステープラシステム１について、図面を参照して以下に説明する。
　本実施形態に係る医療用ステープラシステム１は、図１に示されるように、医療用ステープラ２と、該医療用ステープラ２に装着されるステープル３とを備えている。 A medical stapler system 1 according to an embodiment of the present invention will be described below with reference to the drawings.
As shown in FIG. 1, the medical stapler system 1 according to the present embodiment includes a medical stapler 2 and staples 3 attached to the medical stapler 2.
　医療用ステープラ２は、揺動軸４回りに相互に揺動可能に設けられた第１把持部材（第１ジョー）５および第２把持部材（第２ジョー）６と、第２把持部材６を第１把持部材５に対して揺動軸４回りに揺動させる揺動機構７と、ステープル３を射出するとともに組織Ａを切断する射出切断機構８とを備えている。 The medical stapler 2 includes a first gripping member (first jaw) 5, a second gripping member (second jaw) 6, and a second gripping member 6 that are swingable around the swinging shaft 4. A swing mechanism 7 that swings around the swing shaft 4 with respect to the first gripping member 5 and an injection cutting mechanism 8 that ejects the staple 3 and cuts the tissue A are provided.
　第１把持部材５と第２把持部材６とは、揺動機構７によって第２把持部材６を第１把持部材５に対して揺動軸４回りに揺動させることで、図２に示されるように相互に開いた開状態と、図３に示されるように相互に閉じられて間に組織Ａを把持する閉状態との間で相対的に移動させられるようになっている。 The first gripping member 5 and the second gripping member 6 are shown in FIG. 2 by swinging the second gripping member 6 about the swinging shaft 4 with respect to the first gripping member 5 by the swing mechanism 7. Thus, they are moved relative to each other between an open state that is open to each other and a closed state that is closed to each other and grips the tissue A therebetween as shown in FIG.
　第１把持部材５は、複数のステープル３を、例えば、第１把持部材５における組織Ａを把持する把持面（第１接触面５ａ）において２列（図では１列のみ表示）に並べて収容するステープルカセット（収容部）９を収容可能なホルダ１０を備えている。第１把持部材５は、ステープルカセット９がホルダ１０に収容された状態において、第２把持部材６との間に挟まれた組織Ａの一面に密着させられる第１接触面５ａと、該第１接触面５ａに開口し、ステープル３を射出させる射出孔５ｂとが設けられている。 The first gripping member 5 accommodates the plurality of staples 3 in, for example, two rows (only one row is shown in the figure) on the gripping surface (first contact surface 5a) that grips the tissue A in the first gripping member 5. A holder 10 capable of accommodating a staple cassette (accommodating section) 9 is provided. The first gripping member 5 has a first contact surface 5a that is brought into close contact with one surface of the tissue A sandwiched between the first gripping member 6 and the second gripping member 6 in a state where the staple cassette 9 is accommodated in the holder 10. An ejection hole 5b that opens to the contact surface 5a and ejects the staple 3 is provided.
　ステープル３は、例えば、図５に示されるように、直線状のベース部３ａと、該ベース部３ａの一端からベース部３ａの長尺方向に直交する方向に延びる単一の針部３ｂとを有する非対称形状を有している。針部３ｂは、ベース部３ａを含む平面内において、ベース部３ａから離れるに従ってベース部３ａの他端に近接する方向に滑らかに湾曲する形状に形成されている。 For example, as shown in FIG. 5, the staple 3 includes a linear base portion 3a and a single needle portion 3b extending from one end of the base portion 3a in a direction perpendicular to the longitudinal direction of the base portion 3a. It has an asymmetric shape. The needle portion 3b is formed in a shape that smoothly curves in a direction closer to the other end of the base portion 3a as the distance from the base portion 3a increases in a plane including the base portion 3a.
　さらに詳細には、針部３ｂは、図５に示されるように、同一方向に湾曲する外縁３ｄと内縁３ｅとを備え、外縁３ｄおよび内縁３ｅが、それぞれ連続的な曲率で構成された外側に凸の曲面、例えば、単一の円弧面により構成されている。
　針部３ｂの針先３ｃは、外縁３ｄと内縁３ｅとが交差する位置に、組織Ａに刺さり易い鋭利な形状に形成されている。 More specifically, as shown in FIG. 5, the needle portion 3 b includes an outer edge 3 d and an inner edge 3 e that are curved in the same direction, and the outer edge 3 d and the inner edge 3 e are arranged on the outer sides each having a continuous curvature. It is constituted by a convex curved surface, for example, a single arc surface.
The needle tip 3c of the needle portion 3b is formed in a sharp shape that is easy to pierce the tissue A at a position where the outer edge 3d and the inner edge 3e intersect.
　そして、複数のステープル３は、ステープルカセット９内において、列毎に、全てのステープル３のベース部３ａが一直線上に配列され、かつ、全てのステープル３のベース部３ａおよび針部３ｂが同一平面上に配置されるように間隔をあけて配列されている。各射出孔５ｂ内のステープル３は、針部３ｂを射出孔５ｂの開口に近い側に向けて配置されている。 In the plurality of staples 3, in the staple cassette 9, the base portions 3 a of all the staples 3 are arranged in a straight line for each row, and the base portions 3 a and the needle portions 3 b of all the staples 3 are on the same plane. They are arranged at intervals so as to be arranged above. The staple 3 in each injection hole 5b is arranged with the needle portion 3b facing the side close to the opening of the injection hole 5b.
　図１から図３は、列毎に３個のステープル３が、配列された例を模式的に示している。これにより、ステープルカセット９がホルダ１０内に収容された状態で、ステープル３を射出させる射出孔５ｂも列毎に一列に並んで配置されるようになっている。 1 to 3 schematically show an example in which three staples 3 are arranged in each row. Accordingly, the ejection holes 5b for ejecting the staples 3 are also arranged in a line for each row in a state where the staple cassette 9 is accommodated in the holder 10.
　第２把持部材６は、閉状態に配置されたときに、第１把持部材５との間に挟まれた組織Ａの他面に密着させられる第２接触面６ａと、該第２接触面６ａに設けられ、射出孔５ｂから射出された各ステープル３を所定の方向に湾曲させる溝を複数備えるアンビル部１１とを備えている。
　アンビル部１１は、閉状態に配置されたときに、第１把持部材５に設けられた各射出孔５ｂに対向する位置に配置される溝部１１ａを備えている。図１から図３に示す例では、列毎に３個の射出孔５ｂに対向する位置に３個の溝部１１ａを備えている。 When the second gripping member 6 is disposed in the closed state, the second contact surface 6a is brought into close contact with the other surface of the tissue A sandwiched between the first gripping member 5 and the second contact surface 6a. And an anvil portion 11 having a plurality of grooves for bending each staple 3 ejected from the ejection hole 5b in a predetermined direction.
The anvil part 11 includes a groove part 11 a that is disposed at a position facing each injection hole 5 b provided in the first gripping member 5 when the anvil part 11 is disposed in the closed state. In the example shown in FIGS. 1 to 3, three grooves 11 a are provided at positions facing the three injection holes 5 b for each row.
　各溝部１１ａは、単一のステープル３を挿入可能な溝幅寸法を有するとともに、図５または図６に示されるように、射出孔５ｂから射出されたステープル３の針先３ｃを突き当てる溝底１１ｂを有している。図５に示す例では、溝底１１ｂは、平坦面と該平坦面に滑らかに接続する円弧面とを備えている。図６に示す例では、溝底１１ｂは、溝部１１ａ長手方向の途中位置において最も深くなるように滑らかに湾曲する凹状の曲面により構成されている。 Each groove portion 11a has a groove width dimension in which a single staple 3 can be inserted, and as shown in FIG. 5 or FIG. 6, a groove bottom that abuts the needle tip 3c of the staple 3 ejected from the ejection hole 5b. 11b. In the example illustrated in FIG. 5, the groove bottom 11 b includes a flat surface and an arc surface that smoothly connects to the flat surface. In the example shown in FIG. 6, the groove bottom 11 b is configured by a concave curved surface that is smoothly curved so as to be deepest at a midway position in the longitudinal direction of the groove 11 a.
　図６に示される溝底１１ｂは、溝部１１ａの長手方向において、連続する曲率の異なる２つの曲面により構成されている。２つの曲面は、当該２つの曲面の接続位置において、接平面を共有するように滑らかに接続されている。また、２つの曲面のそれぞれを比較すると、ステープル３の針先３ｃが最初に突き当たる位置における曲率のほうが、他方の曲率（針部３ｂの湾曲変形が進行するにつれて、針部３ｂの外縁３ｄが接触するようになる位置における曲率）よりも小さく設定されている。 The groove bottom 11b shown in FIG. 6 is composed of two curved surfaces having different curvatures in the longitudinal direction of the groove 11a. The two curved surfaces are smoothly connected so as to share the tangent plane at the connection position of the two curved surfaces. Further, when comparing each of the two curved surfaces, the curvature at the position where the needle tip 3c of the staple 3 abuts first is in contact with the other curvature (the outer edge 3d of the needle portion 3b is in contact with the curvature of the needle portion 3b). The curvature is set to be smaller than the curvature at the position at which it is to occur.
　また、本実施形態に係る医療用ステープラシステム１においては、アンビル部１１の溝底１１ｂにステープル３の針先３ｃが突き当たったときの針先３ｃ位置において、針部３ｂの外縁３ｄ側の曲面の接平面と、溝底１１ｂを構成している曲面の接平面とのなす角度（第１角度）が５３．５°未満であり、かつ、同じ位置における針部３ｂの内縁３ｅ側の曲面の接平面と、溝底１１ｂを構成している曲面の接平面とのなす角度（第２角度）が、第１角度より大きく、かつ、９０°未満となるように設定されている。 Further, in the medical stapler system 1 according to the present embodiment, the curved surface on the outer edge 3d side of the needle portion 3b at the needle tip 3c position when the needle tip 3c of the staple 3 abuts against the groove bottom 11b of the anvil portion 11. The angle (first angle) formed between the tangent plane and the tangent plane of the curved surface constituting the groove bottom 11b is less than 53.5 °, and the curved surface on the inner edge 3e side of the needle portion 3b at the same position is connected. The angle (second angle) formed between the flat surface and the tangent plane of the curved surface constituting the groove bottom 11b is set to be larger than the first angle and less than 90 °.
　図４は第１角度が５３．５°、第２角度が９０°の参考例である。
　第１角度は、図５に示されるように、４３．５°以下であることが好ましく、図６に示されるように、２８．５°以下であることがさらに好ましい。
　また、第２角度は、図５に示されるように、８０°以下であることが好ましく、図６に示されるように、６５°以下であることがさらに好ましい。 FIG. 4 is a reference example in which the first angle is 53.5 ° and the second angle is 90 °.
The first angle is preferably 43.5 ° or less as shown in FIG. 5, and more preferably 28.5 ° or less as shown in FIG. 6.
Further, the second angle is preferably 80 ° or less as shown in FIG. 5, and more preferably 65 ° or less as shown in FIG.
　揺動機構７は、第１把持部材５に設けられた直線状の第１長孔７ａと、第２把持部材６に設けられ、第１長孔７ａに交差するように傾斜した直線状の第２長孔７ｂと、これら第１長孔７ａおよび第２長孔７ｂの交差位置においてこれらの長孔７ａ，７ｂを貫通して配置されるスライダ部材７ｃと、該スライダ部材７ｃを第１長孔７ａに沿う方向に押し引きする開閉駆動力伝達部材７ｄとを備えている。 The swing mechanism 7 includes a linear first elongated hole 7a provided in the first holding member 5 and a linear first elongated hole provided in the second holding member 6 and inclined so as to intersect the first elongated hole 7a. Two elongated holes 7b, a slider member 7c disposed through these elongated holes 7a and 7b at the intersection of the first elongated hole 7a and the second elongated hole 7b, and the slider member 7c as the first elongated hole. An opening / closing driving force transmission member 7d that pushes and pulls in a direction along 7a.
　開閉駆動力伝達部材７ｄによってスライダ部材７ｃを第１把持部材５の先端側に押圧すると、スライダ部材７ｃが、第１長孔７ａおよび第２長孔７ｂに沿って移動させられることにより、第１長孔７ａと第２長孔７ｂとの交差位置が変化する。これにより、第１把持部材５に対して第２把持部材６が揺動軸４回りに開状態に向かって揺動させられるようになっている。 When the slider member 7c is pressed against the distal end side of the first gripping member 5 by the opening / closing driving force transmission member 7d, the slider member 7c is moved along the first long hole 7a and the second long hole 7b. The crossing position of the long hole 7a and the second long hole 7b changes. As a result, the second gripping member 6 is swung about the swinging shaft 4 toward the open state with respect to the first gripping member 5.
　逆に、開閉駆動力伝達部材７ｄによってスライダ部材７ｃを第１把持部材５の基端側に牽引すると、スライダ部材７ｃが、第１長孔７ａおよび第２長孔７ｂに沿って移動させられ、第１把持部材５に対して第２把持部材６が揺動軸４回りに閉状態に向かって揺動させられるようになっている。 Conversely, when the slider member 7c is pulled toward the proximal end side of the first gripping member 5 by the opening / closing driving force transmission member 7d, the slider member 7c is moved along the first long hole 7a and the second long hole 7b. The second gripping member 6 is swung around the swing shaft 4 toward the closed state with respect to the first gripping member 5.
　射出切断機構８は、第１把持部材５のホルダ１０内において、ステープルカセット９におけるステープル３の配列方向に沿って直線移動可能に設けられたスライダ８ａと、該スライダ８ａに押圧力を印加するシャフト８ｂとを備えている。スライダ８ａには、ステープル３のベース部３ａに対してステープル３を射出孔５ｂから射出させる方向の射出力を作用させるスロープ８ｃと、第１接触面５ａと第２接触面６ａとの隙間に配置され、スライダ８ａの移動によって、第１接触面５ａと第２接触面６ａとの間に把持した組織Ａを切断するカッター８ｄとが固定されている。 The injection cutting mechanism 8 includes a slider 8a that is linearly movable along the arrangement direction of the staples 3 in the staple cassette 9 in the holder 10 of the first gripping member 5, and a shaft that applies a pressing force to the slider 8a. 8b. The slider 8a is disposed in the gap between the slope 8c that applies a radiant power in the direction in which the staple 3 is ejected from the ejection hole 5b to the base portion 3a of the staple 3, and the first contact surface 5a and the second contact surface 6a. The cutter 8d that cuts the tissue A gripped between the first contact surface 5a and the second contact surface 6a is fixed by the movement of the slider 8a.
　シャフト８ｂに押圧力を印加することにより、スライダ８ａを先端側に押し出すと、最も基端側のステープル３のベース部３ａがスロープ８ｃに乗り上げてスロープ８ｃから射出力を受け、射出孔５ｂから射出されるようになっている。ステープル３は針先３ｃを射出孔５ｂの開口側に向けて配置されているので、射出孔５ｂから射出されるステープル３は、針部３ｂの針先３ｃ側から、射出孔５ｂの外方に射出され、第１把持部材５と第２把持部材６との間に把持されている組織Ａを針部３ｂによって厚さ方向に貫通するようになっている。 When the slider 8a is pushed to the distal end side by applying a pressing force to the shaft 8b, the base portion 3a of the staple 3 on the most proximal side rides on the slope 8c, receives the radiation output from the slope 8c, and is ejected from the ejection hole 5b. It has come to be. Since the staple 3 is arranged with the needle tip 3c facing the opening side of the ejection hole 5b, the staple 3 ejected from the ejection hole 5b is located outward of the ejection hole 5b from the needle tip 3c side of the needle portion 3b. The tissue A that has been ejected and is gripped between the first gripping member 5 and the second gripping member 6 is penetrated in the thickness direction by the needle portion 3b.
　そして、スライダ８ａをさらに先端側に押圧すると、組織Ａを貫通したステープル３の針部３ｂの針先３ｃが第２把持部材６のアンビル部１１の溝部１１ａの溝底１１ｂに突き当たる。ステープル３の針先３ｃは、ベース部３ａの他端に向かって倒れるように湾曲しているので、アンビル部１１の溝底１１ｂから湾曲を強める方向に外力を受けるようになっている。 When the slider 8a is further pressed toward the distal end side, the needle tip 3c of the needle portion 3b of the staple 3 penetrating the tissue A abuts against the groove bottom 11b of the groove portion 11a of the anvil portion 11 of the second gripping member 6. Since the needle tip 3c of the staple 3 is curved so as to fall toward the other end of the base portion 3a, an external force is received from the groove bottom 11b of the anvil portion 11 in the direction of increasing the curvature.
　そして、ステープル３がさらに射出されていくと、針部３ｂの針先３ｃは、アンビル部１１の溝底１１ｂを滑って移動し、大きく湾曲されて折り返され、組織Ａに再度穿刺させられるようになっている。これにより、ステープル３の針部３ｂが組織Ａを抱き込むように湾曲させられて、組織Ａを適正に縫合することができるようになっている。 Then, as the staple 3 is further ejected, the needle tip 3c of the needle portion 3b slides and moves along the groove bottom 11b of the anvil portion 11, is bent so as to be folded back, and is allowed to puncture the tissue A again. It has become. Thereby, the needle 3b of the staple 3 is bent so as to embrace the tissue A, and the tissue A can be appropriately sutured.
　また、カッター８ｄは刃先を第１把持部材５の先端側に向けて配置されており、スライダ８ａが先端側に移動することでステープル３が射出され、ステープル３によって縫合された後の組織Ａをステープル３による縫合位置近傍において切断するようになっている。 The cutter 8d is disposed with the cutting edge facing the distal end side of the first gripping member 5, and the staple A is ejected by moving the slider 8a toward the distal end side, and the tissue A after being stitched by the staple 3 is removed. Cutting is performed in the vicinity of the stitching position by the staple 3.
　このように構成された本実施形態に係る医療用ステープラシステム１の作用について以下に説明する。
　本実施形態に係る医療用ステープラシステム１を用いて組織Ａを縫合および切断するには、揺動機構７の開閉駆動力伝達部材７ｄを介してスライダ部材７ｃを第１把持部材５の先端側に移動させる駆動力を加える。すると、スライダ部材７ｃが第１把持部材５に設けられた第１長孔７ａに沿って先端側に移動する。スライダ部材７ｃは、第２把持部材６に設けられた第２長孔７ｂをも貫通しているので、第２長孔７ｂにおける貫通位置を変化させるように、第２長孔７ｂを移動させる。これにより、図２に示されるように、第２長孔７ｂが設けられている第２把持部材６が第１把持部材５に対して揺動軸４回りに揺動し、第１把持部材５および第２把持部材６が相互に開かれた開状態となる。 The operation of the medical stapler system 1 according to this embodiment configured as described above will be described below.
In order to sew and cut the tissue A using the medical stapler system 1 according to the present embodiment, the slider member 7c is moved to the distal end side of the first gripping member 5 via the opening / closing driving force transmission member 7d of the swing mechanism 7. Apply driving force to move. Then, the slider member 7 c moves to the tip side along the first long hole 7 a provided in the first gripping member 5. Since the slider member 7c also penetrates the second elongated hole 7b provided in the second gripping member 6, the second elongated hole 7b is moved so as to change the penetrating position in the second elongated hole 7b. As a result, as shown in FIG. 2, the second gripping member 6 provided with the second elongated hole 7 b swings about the swing shaft 4 with respect to the first gripping member 5, and the first gripping member 5 And the 2nd holding member 6 will be in the open state opened mutually.
　この状態で、図２に示されるように、第１把持部材５と第２把持部材６の第１接触面５ａと第２接触面６ａとの間に、縫合したい組織Ａを配置し、揺動機構７の開閉駆動力伝達部材７ｄを介してスライダ部材７ｃを第１把持部材５の基端側に移動させる駆動力を加える。これにより、第２把持部材６が第１把持部材５に対して、揺動軸４回りに揺動して、図３に示されるように、相互に閉じられた閉状態となり、第１把持部材５の第１接触面５ａと第２把持部材６の第２接触面６ａとの間に組織Ａが把持される。 In this state, as shown in FIG. 2, the tissue A to be sutured is disposed between the first contact surface 5a and the second contact surface 6a of the first gripping member 5 and the second gripping member 6, and is swung. A driving force for moving the slider member 7 c to the proximal end side of the first gripping member 5 is applied via the opening / closing driving force transmission member 7 d of the mechanism 7. As a result, the second gripping member 6 swings about the swinging shaft 4 with respect to the first gripping member 5 and is in a closed state in which the second gripping member 6 is closed to each other as shown in FIG. The tissue A is gripped between the first contact surface 5 a of the second gripper 5 and the second contact surface 6 a of the second gripping member 6.
　次に、射出切断機構８のシャフト８ｂに押圧力を印加する。これにより、スライダ８ａを先端側に押し出して、図４に示されるように、最も基端側のステープル３から、ベース部３ａをスロープ８ｃに乗り上げてさせて射出孔５ｂから射出させる。針部３ｂの針先３ｃを射出孔５ｂの開口側に向けて配置されているステープル３は、射出孔５ｂから射出されると、第１把持部材５と第２把持部材６との間に把持されている組織Ａを針部３ｂによって厚さ方向に貫通する。 Next, a pressing force is applied to the shaft 8 b of the injection cutting mechanism 8. As a result, the slider 8a is pushed out to the distal end side, and as shown in FIG. 4, the base portion 3a rides on the slope 8c from the most proximal staple 3 and is ejected from the ejection hole 5b. The staple 3 arranged with the needle tip 3c of the needle portion 3b facing the opening side of the ejection hole 5b is gripped between the first gripping member 5 and the second gripping member 6 when ejected from the ejection hole 5b. The formed tissue A is penetrated in the thickness direction by the needle portion 3b.
　組織Ａの他面に接触している第２接触面６ａには、組織Ａを挟んで射出孔５ｂに対向する位置に溝部１１ａが設けられているので、組織Ａを貫通した針部３ｂは、図５に示されるように、溝部１１ａに挿入されて、針先３ｃが溝底１１ｂに突き当たる。
　この場合において、本実施形態に係る医療用ステープラシステム１によれば、ステープル３の針先３ｃと溝部１１ａの溝底１１ｂとの最初の接触位置において、針部３ｂの外縁３ｄが溝底１１ｂと５３．５°未満の相対角度をなすとともに、針部３ｂの内縁３ｅが溝底１１ｂと９０°未満の相対角度をなして接触するので、比較的小さい力量によって針部３ｂを湾曲させることができる。 Since the groove portion 11a is provided in the second contact surface 6a that is in contact with the other surface of the tissue A at a position facing the injection hole 5b across the tissue A, the needle portion 3b penetrating the tissue A is As shown in FIG. 5, the needle tip 3c is abutted against the groove bottom 11b by being inserted into the groove 11a.
In this case, according to the medical stapler system 1 according to the present embodiment, the outer edge 3d of the needle portion 3b is connected to the groove bottom 11b at the initial contact position between the needle tip 3c of the staple 3 and the groove bottom 11b of the groove portion 11a. Since the relative angle is less than 53.5 ° and the inner edge 3e of the needle portion 3b contacts the groove bottom 11b at a relative angle of less than 90 °, the needle portion 3b can be bent with a relatively small amount of force. .
　例えば、図４の参考例の場合、図７に符号Ａで示されるように、初期に大きな変形力量を加えなければ、針部３ｂの変形量が大きくならない。すなわち、図４の参考例の場合のように、針部３ｂの外縁３ｄが溝底１１ｂと５３．５°の相対角度をなすとともに、針部３ｂの内縁３ｅが溝底と９０°の相対角度をなして接触する場合には、針部３ｂを座屈させるための大きな変形力量（座屈荷重）を加えなければ針部３ｂの湾曲が開始されない。 For example, in the case of the reference example of FIG. 4, as indicated by the symbol A in FIG. 7, the deformation amount of the needle portion 3 b does not increase unless a large amount of deformation force is initially applied. That is, as in the case of the reference example of FIG. 4, the outer edge 3d of the needle portion 3b makes a relative angle of 53.5 ° with the groove bottom 11b, and the inner edge 3e of the needle portion 3b has a relative angle of 90 ° with the groove bottom. When the contact is made, the bending of the needle portion 3b is not started unless a large amount of deformation force (buckling load) for buckling the needle portion 3b is applied.
　これに対し、上述したような、ステープル３の針先３ｃと溝部１１ａの溝底１１ｂとの最初の接触位置において、針部３ｂの外縁３ｄが溝底１１ｂと５３．５°未満の相対角度をなすとともに、針部３ｂの内縁３ｅが溝底１１ｂと９０°未満の相対角度という条件を満たすことにより、湾曲を開始するための変形力量を低減することができる。
　特に、図５において説明したステープル３のような針部３ｂの外縁３ｄが溝底１１ｂと４３．５°以下の相対角度をなすとともに、針部３ｂの内縁３ｅが溝底１１ｂと８０°以下の相対角度をなして接触する場合は図７の符号Ｂで示されるような曲線となり、また、図６において説明したステープル３のような、針部３ｂの外縁３ｄが溝底１１ｂと２８．５°以下の相対角度をなすとともに、針部３ｂの内縁３ｅが溝底１１ｂと６５°以下の相対角度をなして接触する場合は、図７の符号Ｃで示されるような曲線となる。このように、針部３ｂに対して当該針部３ｂの座屈荷重以上の力量を与えることなく、つまり、座屈荷重以下の力量の範囲内で、漸次増加する変形力量によって湾曲させ続けることができる。 On the other hand, at the initial contact position between the needle tip 3c of the staple 3 and the groove bottom 11b of the groove 11a as described above, the outer edge 3d of the needle 3b has a relative angle of less than 53.5 ° with the groove bottom 11b. In addition, when the inner edge 3e of the needle portion 3b satisfies the condition of a relative angle of less than 90 ° with the groove bottom 11b, the amount of deformation force for starting the bending can be reduced.
In particular, the outer edge 3d of the needle portion 3b such as the staple 3 described in FIG. 5 forms a relative angle of 43.5 ° or less with the groove bottom 11b, and the inner edge 3e of the needle portion 3b has an angle of 80 ° or less with the groove bottom 11b. When the contact is made at a relative angle, the curve is as shown by symbol B in FIG. 7, and the outer edge 3d of the needle portion 3b is 28.5 ° with the groove bottom 11b as in the staple 3 described in FIG. When the following relative angles are formed and the inner edge 3e of the needle portion 3b is in contact with the groove bottom 11b at a relative angle of 65 ° or less, a curve as indicated by reference C in FIG. 7 is obtained. In this way, the needle portion 3b can be continuously curved without being given a force amount equal to or greater than the buckling load of the needle portion 3b, that is, within a range of the force amount equal to or less than the buckling load. it can.
　すなわち、溝底１１ｂに突き当たった針先３ｃには、接触位置において第２接触面６ａに直交する方向にスロープ８ｃによって付与された外力が作用するが、針先３ｃにおいて針部３ｂの外縁３ｄが、溝底１１ｂに対して浅い角度で接触し、かつ、第２接触面６ａと針部３ｂの内縁３ｅが９０°未満の角度となっているので、第２接触面６ａから受ける反力によって針部３ｂを湾曲させる方向のモーメントを生じ、針先３ｃが溝底１１ｂを滑る。その結果、針部３ｂに受ける荷重は座屈荷重以下となり、針部３ｂは座屈することなく接触当初から湾曲させられるので、座屈による変形力量の増大を防止することができる。 That is, an external force applied by the slope 8c acts on the needle tip 3c that has abutted against the groove bottom 11b in a direction orthogonal to the second contact surface 6a at the contact position, but the outer edge 3d of the needle portion 3b is applied to the needle tip 3c. Since the second contact surface 6a is in contact with the groove bottom 11b at a shallow angle, and the inner edge 3e of the needle portion 3b is at an angle of less than 90 °, the reaction force received from the second contact surface 6a A moment in the direction of bending the portion 3b is generated, and the needle tip 3c slides on the groove bottom 11b. As a result, the load received by the needle portion 3b is equal to or less than the buckling load, and the needle portion 3b is bent from the beginning of contact without buckling, so that an increase in deformation force due to buckling can be prevented.
　そして、針部３ｂは、溝底１１ｂの形状によって湾曲を案内されて、組織Ａ側に折り返されるように湾曲させられて、再度組織Ａに穿刺させられる。これにより、ステープル３によって組織Ａをしっかりと縫合することができる。 The needle portion 3b is guided to bend by the shape of the groove bottom 11b, is bent so as to be folded back to the tissue A side, and is punctured into the tissue A again. Thereby, the tissue A can be firmly sutured by the staple 3.
　次いで、ステープル３を射出する動作に連動して、スライダ８ａに設けられているカッター８ｄが、ステープル３によって縫合された部分に近接する組織Ａを切断していく。これにより、シャフト８ｂを先端側に向けて押し出す操作によって、組織Ａの縫合と切断とが順次繰り返され、ステープル３によって適正に縫合された状態の組織Ａを切り離すことができる。 Next, in conjunction with the operation of ejecting the staple 3, the cutter 8 d provided on the slider 8 a cuts the tissue A adjacent to the portion stitched by the staple 3. Accordingly, the operation of pushing the shaft 8b toward the distal end side sequentially repeats the stitching and cutting of the tissue A, and the tissue A that has been properly sutured by the staple 3 can be separated.
　このように、本実施形態に係る医療用ステープラシステム１によれば、ステープル３が座屈することなく湾曲を開始するので、組織Ａを縫合する際に必要な力量を低減することができ、多数のステープル３について順次湾曲させていく縫合作業においても、医師にかかる負担を大幅に軽減することができるという利点がある。 As described above, according to the medical stapler system 1 according to the present embodiment, the staple 3 starts to bend without buckling. Therefore, the amount of force required when the tissue A is sutured can be reduced. Even in the suturing operation in which the staples 3 are sequentially bent, there is an advantage that the burden on the doctor can be greatly reduced.
　なお、本実施形態においては、図示および説明を簡易にするために、３個のステープル３が２列に配列されている場合を例示したが、列毎のステープル３の数および列数は任意でよい。
　また、２つの把持部材５，６を揺動させる方式の医療用ステープラ２を例示したが、サーキュラタイプあるいはリニアタイプの医療用ステープラのように、多数のステープル３を一度に変形させる方式の医療用ステープラシステム１に適用してもよい。このようにすることで、多数のステープル３を一度に変形させる際の力量を大幅に低減して、医師にかかる負担の軽減効果を向上することができる。 In the present embodiment, the case where three staples 3 are arranged in two rows is illustrated for ease of illustration and description, but the number of staples 3 and the number of rows per row are arbitrary. Good.
The medical stapler 2 that swings the two gripping members 5 and 6 is illustrated, but the medical stapler that deforms a large number of staples 3 at a time like a circular or linear type medical stapler. You may apply to the stapler system 1. FIG. By doing in this way, the force at the time of deform | transforming many staples 3 at a time can be reduced significantly, and the reduction effect of a doctor's burden can be improved.
　１　医療用ステープラシステム
　２　医療用ステープラ
　３　ステープル
　３ｂ　針部
　３ｃ　針先
　３ｄ　外縁
　３ｅ　内縁
　５　第１把持部材
　５ｂ　射出孔
　６　第２把持部材
　９　ステープルカセット（収容部）
　１１　アンビル部
　Ａ　組織 DESCRIPTION OF SYMBOLS 1 Medical stapler system 2 Medical stapler 3 Staple 3b Needle part 3c Needle tip 3d Outer edge 3e Inner edge 5 1st holding member 5b Injection hole 6 2nd holding member 9 Staple cassette (accommodating part)
11 Anvil Department A Organization

Claims (5)

  1. 　医療用ステープラと、該医療用ステープラにより打ち出されるステープルとを備え、
    　前記医療用ステープラが、相互に開閉可能に設けられ、閉状態において間に組織を把持可能な第１把持部材と第２把持部材とを備え、
    　前記第１把持部材が、前記ステープルを収容する収容部と、該収容部に収容されている前記ステープルを射出する射出孔とを備え、
    　前記第２把持部材が、前記射出孔に対向する位置に配置され、射出された前記ステープルの針部を所定の方向に湾曲させる曲面を有するアンビル部と、を備え、
    　前記ステープルの前記針部は、該針部の針先が前記アンビル部の前記曲面に突き当たる位置において、湾曲方向の外縁側の接平面と前記曲面の接平面とのなす第１角度と、前記湾曲方向の内縁側の接平面と前記曲面の接平面とのなす第２角度とが、前記針部を座屈荷重以下の荷重で湾曲開始させる角度に設定されている医療用ステープラシステム。     Comprising a medical stapler and staples driven out by the medical stapler;
    The medical stapler is provided so as to be openable and closable with each other, and includes a first gripping member and a second gripping member that can grip tissue in the closed state,
    The first gripping member includes a storage unit that stores the staples, and an injection hole that injects the staples stored in the storage unit,
    The second gripping member is disposed at a position facing the ejection hole, and includes an anvil portion having a curved surface that curves the needle portion of the ejected staple in a predetermined direction,
    The staple portion of the staple has a first angle formed by a tangential plane on an outer edge side in a bending direction and a tangential plane of the curved surface at a position where a needle tip of the staple portion abuts on the curved surface of the anvil portion, and the curved portion. A medical stapler system in which a second angle formed by a tangential plane on the inner edge side of the direction and a tangential plane of the curved surface is set to an angle at which the needle portion starts to bend with a load equal to or less than a buckling load.
  2. 　前記針部の前記外縁が、連続的な曲率で構成された外側に凸の曲面からなる請求項１に記載の医療用ステープラシステム。 The medical stapler system according to claim 1, wherein the outer edge of the needle portion is formed of an outwardly convex curved surface having a continuous curvature.
  3. 　前記第１角度が５３．５°未満であり、
    　前記第２角度が９０°未満である請求項１または請求項２に記載の医療用ステープラシステム。     The first angle is less than 53.5 °;
    The medical stapler system according to claim 1 or 2, wherein the second angle is less than 90 °.
  4. 　前記第１角度が、４３．５°以下であり、
    　前記第２角度が８０°以下である請求項３に記載の医療用ステープラシステム。     The first angle is 43.5 ° or less;
    The medical stapler system according to claim 3, wherein the second angle is 80 ° or less.
  5. 　前記第１角度が、２８．５°以下であり、
    　前記第２角度が６５°以下である請求項３に記載の医療用ステープラシステム。     The first angle is 28.5 degrees or less;
    The medical stapler system according to claim 3, wherein the second angle is 65 ° or less.
PCT/JP2016/064861 2016-05-19 2016-05-19 Medical stapler system WO2017199392A1 (en)

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Publication number Priority date Publication date Assignee Title
US10881400B2 (en) 2016-11-18 2021-01-05 Olympus Corporation Medical stapler system

Citations (1)

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Publication number Priority date Publication date Assignee Title
JP2011056277A (en) * 2000-10-20 2011-03-24 Tyco Healthcare Group Lp Directionally biased staple and anvil assembly for forming the staple

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US9867613B2 (en) * 2013-12-19 2018-01-16 Covidien Lp Surgical staples and end effectors for deploying the same
US10542988B2 (en) * 2014-04-16 2020-01-28 Ethicon Llc End effector comprising an anvil including projections extending therefrom

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2011056277A (en) * 2000-10-20 2011-03-24 Tyco Healthcare Group Lp Directionally biased staple and anvil assembly for forming the staple

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10881400B2 (en) 2016-11-18 2021-01-05 Olympus Corporation Medical stapler system

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