WO2020175479A1 - Manipulateur d'aiguille automatique - Google Patents

Manipulateur d'aiguille automatique Download PDF

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Publication number
WO2020175479A1
WO2020175479A1 PCT/JP2020/007502 JP2020007502W WO2020175479A1 WO 2020175479 A1 WO2020175479 A1 WO 2020175479A1 JP 2020007502 W JP2020007502 W JP 2020007502W WO 2020175479 A1 WO2020175479 A1 WO 2020175479A1
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WO
WIPO (PCT)
Prior art keywords
needle
jaw
threaded
wire
automatic
Prior art date
Application number
PCT/JP2020/007502
Other languages
English (en)
Japanese (ja)
Inventor
龍 中楯
正俊 江藤
誠 橋爪
明夫 森田
Original Assignee
国立大学法人九州大学
学校法人日本医科大学
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 国立大学法人九州大学, 学校法人日本医科大学 filed Critical 国立大学法人九州大学
Priority to JP2021502275A priority Critical patent/JP7429392B2/ja
Publication of WO2020175479A1 publication Critical patent/WO2020175479A1/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
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators

Definitions

  • the present disclosure relates to an automatic needle handling device.
  • Patent Document 1 discloses, as a needle-moving device for suturing an object, a device in which two jaw elements extending from a main body part are provided with a fixing means and a releasing means for fixing a needle, respectively. Has been done. In this device, the needle is passed between the two jaw elements using the fixing means and the opening means to perform suturing of the object.
  • Patent Document 1 Japanese Patent Application Laid-Open No. 7-1515/33
  • the present disclosure has been made in view of the above, and an object thereof is to provide an automatic needle handling device capable of performing continuous suturing with a simpler operation.
  • an automatic needle handling device includes a needle support portion and a needle receiving portion, and an object is disposed between the needle support portion and the needle receiving portion.
  • An automatic needle handling device for moving a needle by passing a needle with a thread from the needle support section to the needle receiving section in a retracted state, wherein an object is arranged between the needle supporting section and the needle receiving section.
  • An intermediate plate having a slit through which the threaded needle can pass along the needle movement direction, the intermediate plate having the slit along the needle movement direction after the needle receiving portion receives the threaded needle; It is possible to separate from the needle receiving portion.
  • the threaded needle is delivered from the needle support section to the needle receiving section while the object is arranged between the needle support section and the intermediate plate, The needle is inserted into the object.
  • the intermediate plate can be separated from the needle receiving portion along the needle movement direction. Therefore, the intermediate plate can be used to promote the movement of the threaded needle with respect to the object arranged between the needle support portion and the intermediate plate, and the needle can be appropriately moved to the object. ..
  • the threaded needle can be inserted into the target object while the target object is separated from the needle receiving section on the side receiving the threaded needle, so that the target object can be inserted on the needle receiving section side. Since it is also possible to prevent bite, the work of removing the object from the needle receiving portion does not occur, and continuous suturing of the object can be performed more easily.
  • the threaded needle when the threaded needle is allowed to be delivered from the needle receiving section to the needle supporting section, the threaded needle is continuously delivered between the needle receiving section and the needle supporting section. This makes it possible to perform continuous suturing on the object with a simpler operation.
  • the intermediate plate can be separated from the needle support portion along the needle movement direction. Therefore, by using the intermediate plate, the movement of the threaded needle with respect to the object arranged between the needle receiving portion and the intermediate plate can be promoted, and the needle can be moved appropriately with respect to the object. Also, since the intermediate plate is provided, the object is separated from the needle support on the side receiving the threaded needle. ⁇ 0 2020/175 479 3 ⁇ (: 17 2020 /007502
  • the needle supporting portion, the needle receiving portion, and the intermediate plate are respectively attached to one end sides of three mutually different shafts extending in the same direction, and the other of each of the three shafts.
  • a mode may be provided which is provided on the end side and has an operation unit that can move the relative positions of the needle support unit, the needle receiving unit, and the intermediate plate by individually moving the three shafts.
  • the needle support part, the needle receiving part, and the intermediate plate are attached to one end side of each of the three shafts, and the three shafts are individually moved in the operation part on the other end side.
  • the length of the shaft and the like can be used to favorably use the automatic needle handling device even when suturing an object at a location away from the operation portion.
  • the threaded needle has a notch on a side surface thereof, and the needle support section or the needle receiving section includes a passage section in which the threaded needle is movable along the needle movement direction, A locking portion movable in a direction crossing the passage portion so as to enter the passage portion; and when the threaded needle moves to a predetermined position of the passage portion, It is possible to adopt a mode in which movement of the threaded needle is regulated by locking the locking portion with the notch of the threaded needle.
  • the notch provided on the side surface of the threaded needle restricts the movement of the threaded needle by engaging the locking portion with the notch. It is possible to prevent the threaded needle from moving while holding the threaded needle in the needle receiving section. Also, by locking and unlocking the locking part, it is possible to easily switch between the movable state and the restricted state of the threaded needle, so that the threaded needle in the needle support part or needle receiving part Delivery can be done smoothly.
  • the locking portion is a wire extending along the needle supporting portion having the passage portion or a supporting member supporting the needle receiving portion, and the passage portion side of the wire. ⁇ 2020/175479 4 boxes (:171? 2020/007502
  • the locking portion is attached to the notch of the threaded needle.
  • a mode in which the movement of the threaded needle is regulated by locking can be adopted.
  • the locking portion is configured by the wire, and the locking and unlocking of the locking portion is switched by operating the wire, whereby the needle support portion or the needle receiver having the passage portion is provided. It is possible to prevent an increase in size due to the provision of the locking portion for the portion. Further, by using the wire extending along the support member as the locking portion, it is possible to operate the locking portion even at a position separated from the needle supporting portion or the needle receiving portion by adjusting the length of the wire. Therefore, when performing suturing of the target portion, it is not necessary to perform the locking operation at a position close to the target portion.
  • the wire may be housed inside a pipe provided along the support member and movable along the / ⁇ ip.
  • an automatic needle handling device capable of performing continuous suturing by a simpler operation.
  • Fig. 1 is a perspective view of an automatic needle handling device.
  • FIG. 2 is a perspective view of a needle movement portion and a shaft portion of an automatic needle movement device.
  • FIG. 3 is an exploded perspective view of a hand movement portion and a shaft portion of the automatic hand movement device.
  • FIG. 4 Fig. 4 (3) and Fig. 4 (10) are diagrams for explaining the threaded needle used in the automatic needle handling device.
  • FIG. 5 Fig. 5 (3) and Fig. 5 (13) are views for explaining the hand movement section of the automatic hand movement device.
  • FIG. 6 is a diagram for explaining a hand movement section of the automatic hand movement device. ⁇ 0 2020/175479 5 ?01/1?2020/007502
  • Fig. 7 (3) to Fig. 7 (6) are diagrams for explaining the hand movement operation of the automatic hand movement device.
  • Fig. 8 Fig. 8 ( 3 ) to Fig. 8 ( ⁇ 0 are diagrams for explaining the hand movement operation of the automatic hand movement device.
  • FIG. 9 is a view for explaining an operation unit of the automatic needle handling device.
  • FIG. 10 is a partially exploded perspective view illustrating an operating portion of the automatic needle handling device.
  • FIG. 11 Fig. 11 (3) to Fig. 11 ( ⁇ ) are diagrams for explaining an automatic needle handling device having no intermediate plate.
  • FIG. 1 is a perspective view of an automatic needle handling device 1 according to an embodiment of the present disclosure.
  • the automatic needle handling device 1 according to the present embodiment is used when suturing a target tissue or the like using a medical threaded needle.
  • the target tissue includes, for example, the deep brain region, and the automatic needle driving device 1 is used when suturing the deep brain tissue via the inside of the nasal cavity.
  • the tissue to be sutured is not limited to the above.
  • the automatic needle handling device 1 is used in brain surgery, otolaryngology, or ophthalmology, but the area used is not limited to these.
  • An automatic hand-moving device 1 shown in Fig. 1 includes a hand-moving part 2 for performing a hand-moving operation of a threaded needle, an operating part 3 held by an operator, and a shaft provided between the hand-moving part 2 and the operating part 3. And part 4.
  • the shaft portion 4 extends in one direction (X direction in FIG. 1), and the hand operating portion 2 is provided on one end side and the operating portion 3 is provided on the other end side.
  • the operator can grasp the operation part 3 and operate the handle 5 provided on the operation part 3 in the directions of arrows 1 to 1 with respect to the case 6 of the operation part 3 in the automatic needle operation device 1. Move the needle with thread 9 attached to 2. Below, the needle handling section 2 and the shaft section 4 are explained. ⁇ 2020/175479 6 ⁇ (: 171-1? 2020/007502
  • the operation unit 3 will be described later.
  • Fig. 2 is a partially enlarged view of the hand movement unit 2 and the shaft unit 4 continuous with the hand movement unit 2
  • Fig. 3 is an exploded perspective view of the hand movement unit 2 and the shaft unit 4.
  • the hand movement unit 2 is configured to include a pair of jaws 20 and an intermediate plate 30 provided between the pair of jaws 20.
  • the jaw 20 is composed of a first jaw 21 and a second jaw 22.
  • the shaft portion 4 includes a first shaft 41, a second shaft 42 and a third shaft 43.
  • the first jaw 21 is attached to one end of the first shaft 41.
  • the second jaw 22 is attached to one end of the second shaft 42.
  • the intermediate plate 30 is attached to one end of the third shuffle 43. That is, the first shaft 41 functions as a support member for the first jaw 21.
  • the second shaft 42 functions as a support member for the second jaw 22.
  • the third shaft 43 functions as a support member for the intermediate plate 30.
  • the first jaw 21 and the second jaw _22 perform the needle movement by passing the threaded needle 9 between them. Therefore, both the first jaw 21 and the second jaw 22 are adapted to support the needle prior to passing the needle against the object and the needle support after passing the needle against the object. It has a function as a needle receiving part to support. In other words, in the automatic needle handling device 1, not only the delivery of the needle from the needle support part to the needle reception part, but also the delivery of the needle from the needle reception part to the needle support part is performed. Specifically, in this embodiment, it is assumed that the second jaw 22 is the needle supporting portion and the first jaw 21 is the needle receiving portion.
  • passing the needle from the second jaw 22 to the first jaw _ 2 1 corresponds to passing the needle from the needle supporting portion to the needle receiving portion, and from the first jaw-2 1 to the second jaw _ 2 2
  • the delivery of the needle to the needle corresponds to the delivery of the needle from the needle receiving portion to the needle supporting portion. The specific procedure will be described later.
  • the outer diameter and inner diameter of the first shaft 41, the second shaft 42, and the third shaft 43 are smaller in this order. That is, the outer diameter of the second shaft 42 is slightly smaller than the inner diameter of the first shaft 41, and the outer diameter of the third shaft 43 is slightly smaller than the inner diameter of the second shaft 42. .. In addition, the first ⁇ 2020/175479 7 ⁇ (: 171-1?2020/007502
  • the shaft 41, the second shaft 42, and the third shaft 43 are arranged coaxially with respect to the axis 8 (see Fig. 2). That is, the second shaft 42 enters inside the first shaft 41, and the second shaft 42 can move along the eight directions (X direction) of the axis. Also, the third shaft 4 3 is inserted inside the second shaft 4 2, and the third shaft 4 3 can move along the axial direction (X direction). As a result, the first shaft 41, the second shaft 42, and the third shaft 43 can change their relative positions in the axial direction (X direction). Therefore, the first jaw 2 1, the second jaw 2 2, and the intermediate plate 30 attached to each of the first shaft 41, the second shaft 42, and the third shaft 43 are also in the eight axial directions (X direction).
  • the relative position can be changed along. That is, the distance between the first jaw 21 and the second jaw 22 can be changed along the eight directions of the axis (X direction).
  • the intermediate plate 30 is movable between the first jaw 21 and the second jaw _ 22 along the eight axial directions (X direction).
  • the first shaft 41 is fixed to the case 6 of the operation part 3. Therefore, the above movement is realized by changing the relative positions of the second shaft 43 and the third shaft 43 with respect to the first shaft 41.
  • the first jaw 21, the second jaw 22 and the intermediate plate 30 are oriented in the same direction with respect to the axis 8 of the first shaft 41, the second shaft 42 and the third shaft 43 (Fig. 2 and the upper (+) side in Fig. 3).
  • the protruding direction of the first jaw 21, the second jaw 22 and the intermediate plate 30 with respect to the axis is fixed, and the first jaw 21 moves along the axis in the protruding direction.
  • the first shaft 4 1 is provided with a slit 4 11 extending in the eight directions of the axis.
  • the third shaft 43 is also provided with a slit 431 extending in the eight directions of the axis.
  • the slit 431 is provided to avoid interference with a guide tube extending along the second shaft 42. This point will be described later.
  • the intermediate plate 30 is provided between the first jaw _ 21 and the second jaw _ 22 and is arranged in a direction intersecting the eight directions of the axis (specifically, a direction orthogonal to each other).
  • the intermediate plate 30 has a slit 31 through which the threaded needle 9 can pass. If the threaded needle 9 is carried on the axis 8, the slit 31 is provided on the axis 8. The width of the slit 3 1 is slightly larger than the needle portion of the threaded needle 9, and the threaded needle 9 can pass through the inside of the slit 3 1. Further, the slit 31 is opened upward (the direction away from the axis 8; the + direction), and the thread of the threaded needle 9 can pass through the opening.
  • Fig. 4 shows an enlarged view of the vicinity of the threaded needle 9 used in the automatic needle handling device 1.
  • Fig. 4 (a) is a front view of the threaded needle
  • Fig. 4 (b) is a top view of the threaded needle.
  • 4(a) and 4(b) show the coordinate system based on the direction in which the threaded needle 9 is attached to the automatic needle handling device 1.
  • the threaded needle 9 is a medical threaded needle, and includes a straight needle 9 1 and a thread 9 2.
  • the straight needle 91 is a linear needle, and both ends thereof are stalk ends. Therefore, the object can be inserted from both ends of the straight needle 91.
  • the thread 9 2 is fixed to the center of the straight needle 9 1.
  • Straight needle 9 1 has two notches on the side 9 3 b are provided.
  • the notch 9 3 Each of the 93 ⁇ is provided at a position close to both ends of the straight needle 91 so as to face each other with the axial center (longitudinal direction) interposed therebetween. Also, the notch 9 3 9 3 swallows have 9 straight needles
  • the 93 ⁇ is used to support the straight needle 9 1 by a pair of jaws _ 2 0, a first jaw _ 2 1 and a second jaw _ 2 2.
  • the straight needle 91 of the threaded needle 9 has, for example, an outer diameter of ⁇ . Yes, with a length of 4. Can be used. However, the size is not limited to this.
  • FIGS. 5 and 6 explain the internal structure around the first jaw 21 and the second jaw 22.
  • 5(b) and 6 schematically show the inside of the periphery of the first jaw 21 and the second jaw 22 as well.
  • 2020/175479 9 ⁇ (: 171-1? 2020/007502
  • the first jaw 2 1 is provided with a first passage portion 2 11 which is a through hole extending in eight axial directions (X direction).
  • the first passage 2 11 corresponds to the outer diameter of the straight needle 9 1.
  • a first guide tube 2 12 is provided in the first jaw 21 and the first shaft 41.
  • the first guide pipe 2 12 is a pipe extending from the operating portion 3 and extends from the operating portion 3 to the first jo _ 2 1 in the eight axes in the first shaft 4 1. Furthermore, in the vicinity of the end on the first jaw _ 21 side, the extension direction is bent 90° in the eight axial directions (X direction) and in the protruding direction (ten direction) of the first jaw 21.
  • Parts 2 1 3 are provided.
  • the end 2 1 2 3 on the first jaw 21 side of the first guide tube 2 1 2 is opened in the projecting direction of the first jaw 2 1 1 via the bent portion 2 1 3 as described above.
  • a first wire passage 2 1 4 is provided continuously from the end portion 2 1 2 3 and extending in the projecting direction (ten directions) of the first jaw _ 2 1.
  • the first wire passage 2 14 is open at the upper end of the first jaw 21.
  • the first guide pipe 2 12 can be composed of, for example, a stainless tube or the like.
  • a first wire 2 15 is kneaded into the first guide tube 2 12 and the first wire passage 2 14.
  • the 1st wire 2 15 is longer than the 1st guide tube 2 1 2, and the end (not shown) on the operation part 3 side of the 1st guide tube 2 12 and the 1st jo _ 2 1 side.
  • the first wire 2 1 5 is kneaded into the first guide tube 2 1 2 with both ends of the first wire 2 1 5 protruding from both ends 2 1 2 3. Further, on the first jaw 21 side, the first wire 2 15 protruding from the first guide tube 2 12 extends upward along the first wire passage 2 1 4.
  • the diameter of the first wire 2 15 is slightly smaller than the inner diameter of the first guide tube 2 12 and the first wire 2 15 is shaved in the extending direction of the first guide tube 2 1 2 Sliding is possible for one guide pipe 2 1 2.
  • the first wire 2 15 can be made of a metal material that does not easily bend, such as a superelastic 1 ⁇ 1 ⁇ alloy. When the first wire 2 15 made of such a material is used, the first wire 2 15 is smoothly slid in the first guide tube 2 1 2 having the bent portion 2 1 3 as described above. be able to. ⁇ 2020/175479 10 ⁇ (: 171-1? 2020/007502
  • first guide tube 2 1 2 and first wire passage 2 1 4 completely overlap with the first passage portion 2 1 1 1 when the automatic needle handling device 1 is viewed from above (10 directions). It is not a position, but a position where only part of it overlaps.
  • first guide tube 2 12 extends parallel to the axis 8 at a position slightly displaced from the axis.
  • first wire passage 2 14 extends upward (from the extending direction of the first jaw 21) from the position where the first guide pipe 2 12 extends, it is provided at a position where it does not overlap the axis 8. ..
  • first wire passage 2 14 communicates with the first passage portion 2 1 1.
  • the first passage portion 21 A first wire passage 2 1 4 is provided at a position overlapping with 1.
  • the first wire 2 1 5 makes the side face of the first passage portion 2 1 1 into the first side. It is possible to pass in the direction orthogonal to the one passage portion 211.
  • the first wire 2 1 5 is connected to the first passage portion 2 1 By passing through the side surface of 1, the first wire 2 15 can restrict the movement of the straight needle 91 and support the threaded needle 9.
  • Fig. 5 (3), Fig. 5 (slung) and Fig. 6 show a state in which the threaded needle 9 is supported by the first jaw 21.
  • the threaded needle 9 is in a state of being inserted into the first passage portion 2 11 of the first jaw 21, and the cutout portion 9 3 3 of the straight needle 9 1 is aligned with the first passage portion 2 1 1. It is in a state where it is provided at a position where it overlaps with the first wire passageway 2 14.
  • This state is a state in which the straight needle 91 of the threaded needle 9 is arranged at a predetermined position in the first passage portion 211. Note that the direction of the straight needle 91 is controlled so that the notch 9333 extends in the vertical direction (direction).
  • the first wire 2 1 5 is arranged along the first guide pipe 2 1 2 so that the protruding length from the end 2 1 2 3 of the first guide pipe 2 1 2 becomes large. Sliding the first wire section 2 1 1 and the first wire path 2 1 4 at the position where they overlap. ⁇ 2020/175479 1 1 ⁇ (: 171-1? 2020 /007502
  • the threaded needle 9 is supported by the first jaw 21.
  • the first wire 2 15 is locked to the notch 9 3 3 provided in the straight needle 91 of the threaded needle 9 to move the threaded needle 9. It functions as a locking part that regulates.
  • the first wire 215 is not connected to the first passage portion 211.
  • the first passage portion 2 1 is provided so that the first wire 2 15 can pass only when the notch 9 3 3 provided in the straight needle 9 1 overlaps with the first wire passage 2 1 4.
  • the above configuration can be realized by designing the sizes of the first wire passage 2 1 4, the first wire 2 15 and the notch 9 3 3.
  • the second jaw 22 is also provided with the same configuration. That is, the second jaw 22 is provided with the second passage portion 2 21 which is a through hole extending in the eight directions of the axis (X direction).
  • a second guide pipe 2 22 is provided in the second jaw 22 and the second shaft 42.
  • the second guide pipe 22 22 extends in the second shaft 42 from the operating portion 3 to the second jaw 22 in the eight axial directions, and near the end on the second jaw 22 side.
  • Is provided with a bent portion 2 23 which is bent by 90° in the extending direction from the eight axial directions (X direction) and in the protruding direction (ten direction) of the second jaw 22. ⁇ 2020/175479 12 boxes (: 171-1?2020/007502
  • a second wire passage 2 2 4 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 3 2 side end that is continuous, and extends in the protruding direction of the second jaw 2 2 (ten directions). Is provided.
  • the second wire passage 2 2 4 opens at the upper end of the second jaw 2 2.
  • the second guide tube 2222 can be made of, for example, a stainless tube.
  • the second wire 2 25 is kneaded into the second guide pipe 2 2 2 and the second wire passage 2 2 4.
  • the second wire 2 25 is longer than the second guide pipe 2 22, and the end of the second guide pipe 2 22 on the side of the operating portion 3 (not shown) and the end on the side of the second jaw 2 2 2
  • the ends of the second wires 2 25 are projected into both the parts 2 2 2 3 and are inserted into the second guide pipe 2 2 2.
  • the second wire 2 25 protruding from the second guide tube 22 2 extends upward along the second wire passage 2 24.
  • the diameter of the second wire 2 25 is slightly smaller than the inner diameter of the second guide tube 2 22, and the second wire 2 25 is shaved in the extending direction of the second guide tube 2 2 2 2 It is possible to slide on the guide tube 2 2 2.
  • the second wire 225 can also be made of a metal material such as superelasticity 1 ⁇ ! I-chome I alloy that does not easily bend.
  • the above-mentioned second guide tube 2 2 2 and second wire passage 2 2 4 completely overlap the second passage portion 2 2 1 when the automatic needle handling device 1 is viewed from above (10 directions). It is not a position, but a position where only part of it overlaps. This point is the same as the first guide tube 2 1 2 and the first wire passage 2 1 4. However, the side opposite to the side where the first guide pipe 2 1 2 and the first wire passage 2 1 4 are deviated from the extending direction of the first passage portion 2 1 1 and the second passage portion 2 2 1. Is off. For example, when the second passage portion 2 21 extends along the axis, the second guide tube 2 22 extends parallel to the axis 8 at a position slightly displaced from the axis. ..
  • the second wire passage 2 24 extends upward (the protruding direction of the second jaw 22) from the position where the second guide pipe 2 22 extends, it is provided at a position where it does not overlap the axis 8. To be However, a part of the second wire passage 2 24 communicates with the second passage portion 2 21. That is, when the automatic needle handling device 1 is viewed from above (10 directions), the second passage ⁇ 2020/175479 13 ⁇ (: 171-1? 2020/007502
  • a second wire passage 2 2 4 is provided at a position overlapping with the second passage portion 2 2 1 on the side surface of 2 2 1 (in the case of the automatic needle handling device 1, the side surface on the _ side).
  • the 2nd wire 2 25 slides in the 2nd guide tube 2 2 2 and the 2nd wire passage 2 2 4 above, the 2nd wire 2 25 is the side surface of the 2nd passage part 2 2 1. Is allowed to pass in the direction orthogonal to the second passage portion 2 21.
  • the second wire 2 25 is attached to the side surface of the second passage portion 2 2 1. By passing it, this second wire 2 25 can restrict the movement of the straight needle 91 and support the threaded needle 9. This point is the same as the case where the first wire 2 15 restricts the movement of the straight needle 9 1. That is, the threaded needle 9 is in a state of being inserted into the second passage portion 2 21 of the second jaw 22, and the cutout portion 9 3 of the straight needle 9 1 of the threaded needle 9 has the second passage.
  • the second wire 2 25 is slid in a state in which the path portion 2 21 and the second wire passage 2 24 are provided at a position where they overlap with each other.
  • the second wire 2 25 passes through the position where the passage portion 2 21 and the second wire passage 2 24 overlap.
  • the notch 9 3 provided in the straight needle 9 1 overlaps with the second wire passage 2 24, the second wire 2 2 5 It is possible to move up to the second wire passage 2 2 4 in an orthogonal state.
  • FIG. 6 shows a state in which the second wire 2 25 can be moved to the upper second wire passage 2 24.
  • the second wire 2 25 extends vertically so as to fill the notch 9 3 of the straight needle 91, the movement of the straight needle 9 1 along the second passage 2 2 1 is restricted. Has been done. Therefore, the threaded needle 9 is supported by the second jaw 22. Thus, in the second jaw 22, the second wire 2 25 is locked to the notch 9 3 provided in the straight needle 91 of the threaded needle 9 and the needle 9 of the threaded needle 9 is locked. It functions as a locking part that regulates movement.
  • the second guide pipe 2 2 2 may interfere with the shaft 4 3. Therefore, by providing the slit 431 to the third shaft 43, it is possible to prevent interference between the second guide pipe 222 and the third shaft 43 (see Fig. 6). ..
  • the length of the shaft portion 4 of the automatic needle handling device 1 is not particularly limited as long as it is long enough to reach the tissue to be the target of using the automatic needle handling device 1, and the automatic needle handling device 1 may be used. It can be appropriately selected according to the physique of the patient having the tissue to be used, the positional relationship between the tissue to be sutured and the operator of the automatic needle handling device 1, and the like.
  • the length of the shaft portion 4 is, for example, 1 6 It can be a degree.
  • the cross-sectional shapes of the first shaft 41, the second shaft 42, and the third shaft of the shaft portion 4 are not particularly limited as long as they can be inserted into each other as described above.
  • the cross section can be circular as described above.
  • the outer diameter of the shaft portion 4 (first shaft 41) is not particularly limited as long as it is an outer diameter that can reach the tissue to be the target of using the automatic needle handling device 1. 1 can be appropriately selected according to the physique and the like of a patient or the like having a target tissue.
  • the outer diameter of the shaft portion 4 is, for example, It can be a degree.
  • the protruding length (length in the direction) of 30 is, for example, 2.5. It is considered as a degree. Further, the length of the first jaw 21 and the second jaw 22 (thickness of the shaft portion 4 in the extending direction: length along the X direction) is, for example, 2 It is considered as a degree. Further, the thickness of the intermediate plate 30 (thickness in the extending direction of the shaft portion 4: length along the X direction) is, for example,: It is considered as a degree. In addition, the inner diameters of the first passage portion 2 11 provided in the first jaw 21 and the second passage portion 2 21 provided in the second jaw 22 are set in the extending direction of the passage portion (the longitudinal direction of the shaft portion 4).
  • the straight needle 91 When the straight needle 91 is inserted along the (X-axis direction), the straight needle 91 can be inserted, and the straight needle 91 is in a direction different from the eight axial directions (X direction) in the passage portion.
  • the size is such that it does not move. ⁇ 2020/175 479 15 ⁇ (:171? 2020 /007502
  • first wire 2 15 and the second wire 2 25 have an outer diameter of about 0.2, for example.
  • first guide pipe 2 12 and the second guide pipe 2 22 which accommodate these wires have inner diameters such that the wires can move inside.
  • a hand movement method using the automatic hand movement device 1 will be described.
  • the needle 9 with the thread is transferred between the first jaw 2 1 and the second jaw _ 22 to perform the hand movement.
  • Fig. 7 shows the procedure for passing the threaded needle 9 from the second jaw 22 to the first jaw 21.
  • the threaded needle 9 from the first jaw 21 to the second jaw 22 is shown. Shows the delivery procedure.
  • the threaded needle 9 is moved along the axial direction of the automatic needle handling device 1. That is, the direction of movement of the threaded needle 9 corresponds to the eight axial directions.
  • the hand movement by the automatic hand movement device 1 is performed by the operator operating the operation unit 3.
  • FIGS. 7 and 8 the hand movement in the hand movement unit 2 by the operation of the operation unit 3 will be described.
  • the movement of the second jo _ 22 and the intermediate plate 30 with respect to the first jo _ 2 1 will be mainly described, but the movement of the second jo _ 22 and the intermediate plate 30 will be described below. As described above, it is realized by the movement of the second shaft 4 2 and the third shaft 4 3 with respect to the first shaft 4 1.
  • the second jaw 22 functions as a needle supporting portion
  • the first jaw 21 functions as a needle receiving portion.
  • the threaded needle 9 is held on the side of the second jaw 22 as shown in Fig. 7(a). This state is the initial state. In the initial state, the second wire 2 25 is locked in the notch 9 3 of the straight needle 9 1 of the threaded needle 9 3 in the second passage 2 2 1 of the second jaw 22. Therefore, the threaded needle 9 is fixed to the second jaw _ 2 2.
  • the object ⁇ to be sewn is provided between the second jaw 22 and the intermediate plate 30.
  • the intermediate plate 30 is moved close to the first jaw 21 to secure a wide distance between the second jaw 22 and the intermediate plate 30 for arranging the object ⁇ .
  • they can be separated by about 0.501 01.
  • the second jaw 22 is retracted to be separated from the first jaw _ 21 and the intermediate plate 30.
  • the straight needle 91 of the threaded needle 9 is held by the first jaw 21, only the second jaw 22 is retracted.
  • the threaded needle 9 continues to be inserted into the object ⁇ on the first jo _ 21 side.
  • the object ⁇ is in a state where the straight needle 91 is inserted near the intermediate plate 30.
  • the intermediate plate 30 moves, it moves in a direction away from the first jaw 21.
  • the straight needle 91 which had been partially inserted as the object ⁇ , is further moving in the penetrating direction.
  • the thread 92 attached to the straight needle 91 also passes through the insertion hole of the straight needle 91.
  • the thread 92 can pass through the slit 3 1 of the intermediate plate 30, so that the first jaw 2 can be moved more than the intermediate plate 30.
  • the thread 92 is movable to the 1st side.
  • the intermediate plate 30 is prevented from hindering the movement of the yarn 92. It should be noted that the second jo_22 and the intermediate plate 30 may be moved at the same time. Even in this case, as shown in Fig. 7 ( ⁇ ) and Fig. 7 (), the straight needle 9 1 moves with respect to the object ⁇ along with the movement of the second jaw _ 22 and the intermediate plate 30. Become.
  • the second jaw 22 functions as the needle support portion
  • the first jaw 21 functions as the needle receiving portion
  • the needle 9 with the thread is received from the needle receiving portion to the needle supporting portion.
  • FIG. 8 (3) it is assumed that the threaded needle 9 is held on the first jaw 21 side.
  • This state is the initial state.
  • This state is the same as the state shown in Fig. 7 ( ⁇ ).
  • the first wire 2 15 is locked in the notch 9 3 3 of the straight needle 9 1 of the threaded needle 9 in the first passage portion 2 1 1 of the first jaw 21. Therefore, the threaded needle 9 is fixed to the first jaw _ 2 1.
  • the object ⁇ to be sewn is provided between the first jaw 21 and the intermediate plate 30.
  • the intermediate plate 30 is moved close to the second jaw 22 to secure a wide distance between the first jaw _ 21 and the intermediate plate 30 for arranging the object ⁇ . ⁇ 2020/175 479 18 ⁇ (:171? 2020 /007502
  • the second jaw 22 and the intermediate plate 30 can be separated by, for example, about 0.5.
  • the second jaw 22 and the intermediate plate 30 are moved to the 1st jo _ 2 1 side.
  • the object ⁇ moves to the first jaw _ 21 side.
  • the intermediate plate 30 moves to such an extent that the slit 3 1 of the intermediate plate 30 moves to the extent that the straight needle 91 of the threaded needle 9 moves, the object ⁇ moves along with the movement of the intermediate plate 30.
  • the threaded needle 9 is inserted into the object ⁇ .
  • the tip of the threaded needle 9 on the second jaw _2 2 side penetrates the object 0 and then enters the second passage portion 2 21 of the second jaw 22.
  • the threaded needle 9 moves to a predetermined position in the second passage portion 2 21 of the second jaw 22 according to the movement amount of the second jaw 22.
  • the second jaw 22 is retracted to separate the second jaw 22 from the intermediate plate 30.
  • the straight needle 91 of the threaded needle 9 is held by the second jaw 22, the straight needle 91 also retracts as the second jaw 22 retracts.
  • the object ⁇ is restricted by the intermediate plate 30 so as not to move together with the straight needle 91, so that the straight needle 91 which moves together with the second jaw 22 is ⁇ 2020/175 479 19 ⁇ (:171? 2020 /007502
  • the thread 9 2 attached to the straight needle 9 1 also passes through the insertion hole of the straight needle 9 1. Since the thread 92 can pass through the slit 31 of the intermediate plate 30, the thread 92 can be moved toward the second jaw 22 side of the intermediate plate 30. That is, the intermediate plate 30 is prevented from hindering the movement of the yarn 92.
  • the intermediate plate 30 does not move, but in this case as well, the intermediate plate 30 moves in the direction in which it is relatively separated from the second jaw 22. It can be said that
  • the object ⁇ penetrated by the straight needle 91 is removed from between the first jaw 21 and the intermediate plate 30.
  • the thread 92 passes through the insertion hole of the object ⁇ .
  • the straight needle 91 is moved once to the object ⁇ .
  • the state shown in Fig. 8 (is the same as the state shown in Fig. 7 (a). That is, after the state shown in Fig. 8 ( ⁇ 0 is reached, the series of steps shown in Fig. 7 ( 2 It is possible to carry out the movement from the jo _ 2 2 to the first jo _ 2 1.
  • the operation unit 3 of the automatic needle handling device 1 will be described with reference to Figs. 9 and 10.
  • the operation related to the hand movement in the hand movement portion 2 of the automatic hand movement device 1 is performed by the operation of the operator in the operation portion 3.
  • the operator once moves the handle 5 with respect to the case 6, so that the series of operations shown in FIG. It is possible to execute the series of operations shown.
  • Fig. 9 is a view showing a state in which the lid portion 63 which is a part of the case 6 of the operation portion 3 is removed
  • Fig. 10 is an exploded perspective view of each component inside the operation portion 3. Is. In FIG. 10, the handle 5, the case 6, and the gear 10 1 and the spring 10 2 attached to the handle 5 are not shown.
  • a main body 100 is provided inside the operation unit 3 (see FIG. 10).
  • Figure 9 ⁇ 2020/175 479 20 ⁇ (:171? 2020 /007502
  • the handle 5 is rotatably attached to the main body 100 around the fulcrum.
  • the gear 5 01 of the handle 5 and the gears of the ratchet 1 0 3, 10 4 are rotated.
  • the rotation is transmitted to 1043.
  • the handle 5 can be returned to its original position by a spring 102 mounted inside the case 6.
  • Cam 1 05, 1 06 are set to rotate 90 degrees.
  • it consists of a pair of ratchets 103 and 104, a pair of panels 107 and 108, and a pair of fasteners 1 09 and 110. Due to the structure, the cams 1 05 and 1 06 are designed not to rotate.
  • cam grooves are dug on the inner surface of the cam 105, respectively.
  • two cam grooves 1 1 1 3, 1 1 1 1 each have been dug on the inside surface of cam 1 06 (Fig. 10 shows cam groove 1 1 1 3 3, 1 1 1 Only 13 are shown). In other words, these four cam grooves realize four cam movements.
  • the protrusion 1 12 provided on the main body 100 can serve as a cam follower along the outer cam groove of the two cam grooves provided on the cam 105.
  • the protrusion 1 12 is interlockable with the first locking member fixed end 1 13 to which the end portion of the first wire 2 15 on the side of the operation portion 3 is attached.
  • the first locking member fixed end 1 13 moves up and down.
  • the first wire 2 15 can be pushed and pulled with respect to the first guide tube 2 12. That is, the motion given to the protrusions 11 12 ⁇ 2020/175479 21 ⁇ (: 171-1?2020/007502
  • the amount of protrusion of the first wire 2 15 from the first guide tube 2 12 in the first jaw 21 can be changed.
  • the protrusion 1 14 can serve as a cam follower along the cam groove inside the cam 105.
  • the protrusion 1 14 can be interlocked with the third shaft fixture 1 15 to which the end of the third shaft 4 3 on the side of the operation portion 3 is attached.
  • two protrusions are also provided on the back surface of the main body 100, which is not shown in Fig. 10, and the operation of the same mechanism as the above-mentioned protrusions 1 1 2 and 1 1 4 is performed.
  • the two protrusions on the back surface are attached to the end of the second wire 2 2 5 on the operation part 3 side according to the motion pattern of the two cam grooves 1 1 1 3, 1 1 1 1.
  • it is responsible for the vertical movement of the second locking member fixed end 1 16 and the forward/backward movement of the second shaft fixing tool 1 17 to which the end of the second shaft 4 2 on the operation portion 3 side is attached.
  • a change in the relative position of the first jaw 21, the second jaw 22 and the intermediate plate 30 (the second jaw _ 2 2 and the intermediate plate 3) can be performed by an operation input simply by grasping the handle 5. 0 movement), the movement of the threaded needle 9 including the straight needle 91 in the first jaw 2 1 and the second jaw _ 2 2 is controlled and released in cooperation with each other, and one needle movement is completed.
  • the operation unit 3 is provided with a needle attachment/detachment switch 118.
  • the needle attaching/detaching switch 1 18 controls the movement of the first wire 2 15 separately from the mechanism by the cams 10 5 and 10 6 described above. Specifically, when the needle attaching/detaching switch 1 18 is rotated, the claw 1 19 that operates in conjunction with the needle attaching/detaching switch 1 18 pushes down the first locking member fixing end 1 1 3 downward. Therefore, the first wire 2 15 can be moved to the first guide tube 2 12 side in the first jaw 21 regardless of the state of the cams 10 5 and 10 6. Therefore, the restriction on the movement of the straight needle 91 is released. This allows the needle to be removed from the first jaw _ 21 while the straight needle 91 is held on the first jaw 21 side. ⁇ 2020/175 479 22 ⁇ (:171? 2020 /007502
  • the configuration example of the operation unit 3 described above is an example of a mechanism that utilizes the rotation of the cams 105 and 106.
  • the operation unit 3 may be configured without using a cam, or may be configured using a cam mechanism other than the above.
  • the operation unit 3 may be configured to electrically perform shaft movement control and the like.
  • the material of the above-mentioned automatic needle handling device 1 is not particularly limited as long as it does not affect the tissue to which the automatic needle handling device 1 is used.
  • stainless steel or titanium alloy is used. Can be used.
  • a material that can be washed, disinfected, or sterilized which is commonly used as a material for surgical instruments, can be used.
  • the automatic needle handling device 1 in the state where the object ⁇ is arranged between the second jaw 22 as the needle support portion and the intermediate plate 30, Since the needle 9 with thread is transferred from the needle support portion (second jaw 22) to the first jaw _ 2 1 as the needle receiving portion, the needle 9 with thread is inserted into the object ⁇ . R. At this time, after the needle receiving portion (first jaw 21) receives the threaded needle 9, the intermediate plate 30 can be separated from the needle receiving portion (first jaw 21) along the needle movement direction. It is said to be Noh.
  • the intermediate plate 30 to promote the movement of the threaded needle 9 with respect to the object ⁇ arranged between the needle support portion (2nd jo _ 22) and the intermediate plate 30. It is possible to move the object ⁇ appropriately. Further, since the intermediate plate 30 is provided, the threaded needle 9 is inserted into the object ⁇ while the object ⁇ is separated from the needle receiving portion (first jaw 21) on the side receiving the threaded needle 9. Since it is also prevented that the object ⁇ bites into the needle receiving part (1st jaw _ 2 1) side, work such as removal of the object ⁇ from the needle receiving part (1st jaw 21) is performed. Therefore, continuous suturing of the object ⁇ can be performed more easily.
  • the second jaw 22 holding the threaded needle 9 is moved to the first jaw _ 21 side.
  • the threaded needle 9 is inserted into the object ⁇ .
  • the tip of the threaded needle 9 penetrates the object ⁇ and then enters the first passage portion 2 1 1 of the first jaw 21. Since the threaded needle 9 moves while being held by the second jaw 22, depending on the amount of movement of the second jaw _ 2 2, it reaches the predetermined position in the first passage portion 2 1 1 of the first jaw 2 1.
  • the needle with thread 9 moves. In this state, assume that the jaw holding the threaded needle 9 is changed from the second jaw 22 to the first jaw _ 21. It is assumed that the threaded needle 9 itself is transferred from the second jaw 22 to the first jaw _ 21 in the same manner as the automatic needle handling device 1.
  • the second jaw 22 is retracted to be separated from the first jaw 21.
  • the straight needle 91 of the threaded needle 9 is held by the first jaw 21, only the second jaw 22 is retracted.
  • the threaded needle 9 continues to be inserted into the object ⁇ on the first jo _ 21 side.
  • the object ⁇ is in a state where the straight needle 91 is inserted.
  • the straight needle 91 does not penetrate the object ⁇ , the straight needle 91 needs to penetrate the object ⁇ .
  • the automatic needle handling device 1 described in the present embodiment uses the intermediate plate 30 to penetrate the straight needle 91 with respect to the object ⁇ , as described with reference to FIGS. 7 and 8. Since the passage is performed smoothly, there is no need to move the object ⁇ around the object ⁇ , and continuous stitching can be performed easily.
  • the threaded needle 9 can also be delivered from the one jaw 2 1) to the needle support portion (the second jaw 22). With such a configuration, it is possible to continue the delivery of the threaded needle 9 between the needle receiving portion (first jaw 21) and the needle supporting portion (second jaw 22), The continuous suturing of the object 0 can be performed by a simpler operation. Further, after the needle support portion (2nd jaw _ 2 2) receives the threaded needle 9, the intermediate plate 30 can be separated from the needle support portion (2nd jaw 22) along the needle movement direction. Has been done. Therefore, the intermediate plate 30 can be used to promote the movement of the threaded needle 9 with respect to the object ⁇ arranged between the needle receiving portion (first jo _ 21) and the intermediate plate 30.
  • the needle 9 with thread is inserted into the object ⁇ while the object ⁇ is separated from the needle support portion (the second jaw 22) on the side receiving the needle 9 with thread. Since the insertion is performed, it is also possible to prevent the object ⁇ from digging into the needle support part (2nd jaw 22) side, so that it is possible to remove the object ⁇ from the needle support part (2nd jaw 22). No work is required, and continuous suturing of the object ⁇ can be performed more easily. The above effect is as described with reference to FIG.
  • the needle support portion is the second jaw _22, and the needle receiving portion is the second jaw.
  • the needle support portion can be treated as the 1st jaw _ 2 1 and the needle support portion can be treated as the 2nd jaw 2 2.
  • the second shaft 42 and the first shaft extending in the same direction are used. ⁇ 2020/175 479 25 ⁇ (:171? 2020 /007502
  • the needle support part (2nd jaw 2 2), needle receiving part (1st jaw 2 1) and intermediate plate 30 to one end side of each of the shaft 41 and the 3rd shaft 43.
  • the needle handling device 1 can be suitably used. Therefore, the automatic needle handling device 1 can also be used for suturing in a deep brain region as described above.
  • the movement of the threaded needle 9 is regulated by locking the first wire 2 15 and the second wire 2 25 as locking portions with respect to the 9 3 sill.
  • the threaded needle 9 moves when the threaded needle 9 is held in the needle supporting portion (second jaw 22) or the needle receiving portion (first jaw 21). You can prevent this.
  • by locking and unlocking the locking part it is possible to easily switch between the movable state of the threaded needle 9 and the restricted state of movement, so that the needle support part (2nd jaw 22) or needle receiving part It is possible to smoothly transfer the needle 9 with a thread to the part (first jaw 21).
  • the locking portion is provided on the shaft as a supporting member for supporting the needle supporting portion (second jaw 22) having the passage portion or the needle receiving portion (first jaw 21).
  • a wire extending along the wire is operated at the end opposite to the passage-side end.
  • the second wires 2 25 are housed inside the first guide pipe 2 1 2 and the second guide pipe 2 2 2 which are pipes provided along the shaft as a supporting member, and are connected to the pipes. As described above, the wire is accommodated inside the pipe and moved along the pipe so that the direction of movement of the wire along the support member is regulated by the pipe. It becomes possible. Therefore, it is possible to more accurately control the operation of the locking portion using the wire.
  • the holding and releasing of the threaded needle 9 on the first jaw _ 2 1 and the second jaw _ 2 2 can be switched only by operating the operating portion 3. Therefore, operability is enhanced. Also, as with the automatic needle handling device 1, the threaded needle 9 is delivered (one-time movement) between the first jaw _ 2 1 and the second jaw 2 2 by only one operation of the handle 5. With the configuration, the operability by the operator is further enhanced, and continuous suturing can be performed by a simpler operation.
  • each part constituting the automatic needle handling device 1 can be appropriately changed.
  • the locking portion is a wire
  • the locking portion may be made of a member different from the wire.
  • the different member it is possible to use, for example, a plate-shaped member or the like.
  • the locking part in the operating part 3 as in the automatic needle handling device 1, the operability for the operator can be improved, but the operation of the locking part and its control are improved.
  • the place where it is performed is not limited to the operation unit 3, and various changes can be made.
  • it may be configured such that one or both of the needle supporting portion and the needle receiving portion are not provided with the locking portion. In that case, some mechanism for supporting the needle may be separately provided in the needle supporting portion and the needle receiving portion.
  • the shape of the automatic hand-moving device 1 having a shaft for performing the hand-moving operation
  • the shape of the automatic hand-moving device is not limited to the above.
  • the shape of the needle handling device is changed appropriately depending on the location of the object ⁇ and its shape.
  • the shape of the threaded needle is also changed according to the object ⁇ , and for example, threaded needle having an arc-shaped curve may be used for suturing. Since the direction of movement of the needle also changes depending on the shape of the needle, etc., the shape and mechanism of the automatic hand movement device will be designed accordingly.
  • the configuration using the intermediate plate between the needle supporting portion and the needle receiving portion described in the above embodiment should be applied to all needle moving devices regardless of the shape of the threaded needle used in the automatic needle moving device and the method of moving the needle. You can
  • the automatic needle handling device 1 described in the above embodiment is capable of delivering the threaded needle 9 from either the first jaw _ 2 1 or the second jaw 22 2 as a starting point, that is, a so-called bidirectional movement.
  • the structure in which the intermediate plate described in the above embodiment is provided can be applied to an automatic hand movement device in which the movement direction is limited to one direction.

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  • 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

L'invention concerne un manipulateur d'aiguille automatique 1, ayant une seconde mâchoire 22 en tant que partie support d'aiguille et une première mâchoire 21 en tant que partie réception d'aiguille, une manipulation d'aiguille étant effectuée par le transfert d'une aiguille attachée à un fil 9 de la partie support d'aiguille à la partie réception d'aiguille tandis qu'une pièce O est disposée entre la partie support d'aiguille et la partie réception d'aiguille. Le manipulateur d'aiguille automatique 1 a une plaque intermédiaire 30 qui est disposée entre la pièce O et la partie réception d'aiguille et qui a une fente à travers laquelle l'aiguille attachée au fil 9 peut passer dans la direction de manipulation d'aiguille lorsque la pièce est disposée entre la partie support d'aiguille et la partie réception d'aiguille. La plaque intermédiaire 30 est configurée pour pouvoir s'éloigner de la partie réception d'aiguille dans la direction de manipulation d'aiguille après que la partie réception d'aiguille a reçu l'aiguille 9 attachée à un fil.
PCT/JP2020/007502 2019-02-28 2020-02-25 Manipulateur d'aiguille automatique WO2020175479A1 (fr)

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JP2019-035931 2019-02-28

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6056771A (en) * 1995-06-02 2000-05-02 United States Surgical Corporation Radiused tip surgical needles and surgical incision members
JP2011509121A (ja) * 2008-01-03 2011-03-24 ウィルソン−クック・メディカル・インコーポレーテッド 内視鏡を使用して穴を縫合するための医療装置、器具及び方法
US20180235604A1 (en) * 2017-02-22 2018-08-23 Boston Scientific Scimed, Inc. Suture based closure device

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6056771A (en) * 1995-06-02 2000-05-02 United States Surgical Corporation Radiused tip surgical needles and surgical incision members
JP2011509121A (ja) * 2008-01-03 2011-03-24 ウィルソン−クック・メディカル・インコーポレーテッド 内視鏡を使用して穴を縫合するための医療装置、器具及び方法
US20180235604A1 (en) * 2017-02-22 2018-08-23 Boston Scientific Scimed, Inc. Suture based closure device

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JPWO2020175479A1 (fr) 2020-09-03

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