WO2021002272A1 - Tissue ligation device, suture thread fixing member, and method for producing tissue ligation device - Google Patents

Tissue ligation device, suture thread fixing member, and method for producing tissue ligation device Download PDF

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Publication number
WO2021002272A1
WO2021002272A1 PCT/JP2020/025038 JP2020025038W WO2021002272A1 WO 2021002272 A1 WO2021002272 A1 WO 2021002272A1 JP 2020025038 W JP2020025038 W JP 2020025038W WO 2021002272 A1 WO2021002272 A1 WO 2021002272A1
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Prior art keywords
suture
fixing
fixing portion
tissue
end side
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PCT/JP2020/025038
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French (fr)
Japanese (ja)
Inventor
稔 小野
一郎 佐久間
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国立大学法人東京大学
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Publication of WO2021002272A1 publication Critical patent/WO2021002272A1/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
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis

Definitions

  • the present invention relates to medical technology, and relates to a tissue ligating device, a suture fixing member, and a method for manufacturing a tissue ligating device.
  • suturing and ligating tissue is very important in many procedures, but it is a difficult procedure that requires skill.
  • various procedures such as surgery have been carried out using an endoscope, a laparoscope, a thoracoscope and the like.
  • endoscope a laparoscope
  • a thoracoscope a thoracoscope
  • a particularly difficult task in suturing and ligating is to tie a suture to form a knot. If the knot of the suture is loosened, the suture and ligature may be released, causing complications.
  • one of the objects of the present invention is to provide a tissue ligating device, a suture fixing member, and a method for manufacturing a tissue ligating device that facilitates the fixation of sutures.
  • the suture having the first end and the second end, the first fixing portion fixing the first end side of the suture, and the second fixing connected to the first fixing portion. It is provided with a second fixing portion for fixing the second end side of the suture after the tissue is ligated with the suture, and the first end side of the suture provides the first fixing portion.
  • a device for tissue ligation is provided that penetrates and projects the first end of the suture from the first fixation.
  • the first end of the suture may protrude from the first fixing portion so that the first end side of the suture is sandwiched between the tweezers.
  • the tissue ligation device described above may further include a suture needle connected to the second end of the suture.
  • the second fixing portion may include a support portion connected to the first fixing portion and a grip portion connected to the support portion.
  • the second end side of the suture is inserted between the support portion and the grip portion, and the support portion and the grip portion are joined.
  • the second end side of the suture may be fixed to the second fixing portion.
  • the support portion and the grip portion may be substantially parallel before fixing the second end side of the suture.
  • the above-mentioned tissue ligation device may further include a guide end connected to the grip, and the guide end may be inclined so as to move away from the support in the direction opposite to the grip.
  • the first fixing portion may include an upper portion to which the supporting portion of the second fixing portion is connected, and the upper portion may be inclined so as to be away from the supporting portion with respect to the supporting portion.
  • the suture fixing member for fixing the suture having the first end and the second end, and the first fixing portion for fixing the first end side of the suture
  • a second fixing portion connected to the first fixing portion, the second fixing portion is provided with a second fixing portion for fixing the second end side of the suture after the tissue is ligated by the suture.
  • the first fixing portion may include an upper portion, both side portions, and a bottom portion to which the second fixing portion is connected, and a groove may be provided from the bottom portion to the upper portion side.
  • both sides may be substantially parallel.
  • the groove may include an introduction portion having a width capable of introducing the suture from the bottom and a holding portion for holding the suture introduced from the introduction portion.
  • the introduction portion may be narrowed by sandwiching both side portions of the first fixing portion.
  • the groove may further include a narrowed portion having a width that the suture held in the holding portion cannot enter from the holding portion.
  • the narrowed portion may be narrowed by sandwiching both side portions of the first fixing portion.
  • a suture having a first end and a second end is prepared, and a first fixing portion for fixing the first end side of the suture is connected to the first fixing portion.
  • a suture fixing member including a second fixing portion for fixing the second end side of the suture after the tissue is ligated with the suture is prepared.
  • the first end side of the suture is set to the first fixing part so that the first end side of the suture penetrates the first fixing part of the suture fixing member and the first end of the suture protrudes from the first fixing part.
  • the first end side of the suture is set so as to sandwich the first end side of the suture with tweezers and the first end of the suture protrudes from the first fixing portion. 1 It may be fixed to a fixed portion.
  • the first fixing portion includes an upper part, both side parts, and a bottom part to which the second fixing part is connected, and a groove is provided from the bottom part to the upper part side for fixing. It may further include threading the suture through the groove prior to doing so.
  • both sides of the first fixing portion may be substantially parallel before the first end side of the suture is fixed to the first fixing portion.
  • the groove is introduced from an introduction portion having a width that allows the suture to be introduced from the bottom before the first end side of the suture is fixed to the first fixing portion, and an introduction portion.
  • the suture may be introduced from the introduction portion of the groove to the holding portion by providing a holding portion for holding the suture and passing the suture through the groove.
  • both sides of the first fixing portion may be sandwiched to narrow the introduction portion of the groove.
  • the groove may further include a stenotic portion having a width that the suture held in the holding portion cannot enter from the holding portion.
  • both sides of the first fixing portion may be sandwiched to narrow the narrowed portion.
  • tissue ligating device a suture fixing member, and a method for manufacturing a tissue ligating device that facilitates fixation of a suture.
  • FIG. 1 It is a schematic perspective view which shows the use method of the tissue ligation device which concerns on embodiment. It is a schematic perspective view which shows the use method of the tissue ligation device which concerns on embodiment. It is a schematic front view which shows the suture thread fixing member before fixing the 1st end side of the suture thread which concerns on embodiment. It is a schematic perspective view which shows the suture thread fixing member before fixing the 1st end side of the suture thread which concerns on embodiment.
  • the tissue ligation device includes a suture thread 10 having a first end 11 and a second end 12, and a suture thread fixing member 20 for fixing the suture thread 10. .
  • the suture thread fixing member 20 has a first fixing portion 30 that fixes the first end 11 side of the suture thread 10 and a second fixing portion 30 that is connected to the first fixing portion 30.
  • the portion 40 includes a second fixing portion 40 for fixing the second end 12 side of the suture 10 after the tissue is ligated by the suture 10.
  • the tissue ligation device according to the embodiment is used for tissue ligation.
  • the tissue refers to a tissue constituting the body such as a human or an animal, and refers to an organ, a blood vessel, a muscle, a skin, or the like, but is not particularly limited.
  • the tissue ligation device according to the embodiment is made of, for example, biocompatible stainless steel, but the material of the tissue ligation device according to the embodiment is not limited to this.
  • the suture 10 is made of, for example, polypropylene, but is not limited thereto.
  • the first end 11 side of the suture thread 10 penetrates the first fixing portion 30 of the suture thread fixing member 20, and the suture thread 10
  • the first end 11 projects from the first fixing portion 30 of the suture thread fixing member 20.
  • the first end 11 of the suture thread 10 protrudes from the first fixing portion 30 of the suture thread fixing member 20 so that the first end 11 side of the suture thread 10 is sandwiched between the tweezers.
  • the length of the suture thread 10 protruding from the first fixing portion 30 of the suture thread fixing member 20 on the first end 11 side is not particularly limited.
  • the length of the suture thread 10 protruding from the first fixing portion 30 of the suture thread fixing member 20 on the second end 12 side is not particularly limited.
  • the tissue ligation device according to the embodiment further includes a suture needle 50 connected to the second end 12 of the suture thread 10, as shown in FIG.
  • the second fixing portion 40 of the suture thread fixing member 20 has a support portion 41 connected to the first fixing portion 30 and a grip portion 42 connected to the support portion 41. Be prepared.
  • the support portion 41 is connected to the first fixing portion 30 at the bottom.
  • the grip portion 42 is connected above the support portion 41 via the folded portion 43.
  • the folded-back portion 43 is folded back in a hairpin shape.
  • the suture thread fixing member 20 may include a plurality of grip portions 42.
  • the suture fixing member 20 includes two grips 42 symmetrically with respect to the support 41.
  • the second end side of the suture 10 is inserted into the groove between the support 41 and the grip 42 and passed through, as shown in FIGS. 4 to 6.
  • the support portion 41 and the grip portion 42 are crimped by the tweezers 60 or the like, the support portion 41 and the grip portion 42 are crimped, and the support portion 41 and the grip portion 42 are joined to form the second end side of the suture thread 10. It is fixed between the support portion 41 and the grip portion 42 of the second fixing portion 40 of the suture thread fixing member 20. This forms a suture loop.
  • the second end side is not limited to the vicinity of the second end, and may be any place of the suture thread 10 as long as it is on the opposite side of the first end with respect to the suture thread fixing member 20.
  • the suture thread fixing member 20 may further include a guide end 44 connected to the grip 42.
  • the guide end 44 is inclined so as to move away from the support 41, for example, in the direction opposite to the grip 42. This makes it easy to insert the suture thread 10 into the groove between the support portion 41 and the grip portion 42.
  • the first fixing portion 30 of the suture thread fixing member 20 includes, for example, an upper portion 31 to which the supporting portion 41 of the second fixing portion 40 is connected so that the shoulder of the upper portion 31 moves away from the supporting portion 41 with respect to the supporting portion 41. It is inclined to. This also facilitates inserting the suture thread 10 into the groove between the support portion 41 and the grip portion 42.
  • the tissue 70 to be sutured and ligated is sewn with the suture needle 50 and the suture thread 10.
  • the suture thread fixing member 20 since the suture thread fixing member 20 is wider than the suture thread 10, the suture thread fixing member 20 stays on the tissue 70 even when the suture thread 10 is pulled. Therefore, the first end 11 of the suture 10 is prevented from passing through the tissue 70.
  • the second end 12 side of the suture thread 10 is formed into a groove between the support portion 41 and the grip portion 42 of the suture thread fixing member 20. Pass through. After that, as shown in FIG.
  • the support portion 41 and the grip portion 42 are joined by a tweezers 60 or the like, and the second end side of the suture thread 10 is attached to the support portion 41 of the second fixing portion 40 of the suture thread fixing member 20. It is fixed between the grip portion 42 and the grip portion 42. This prevents the second end 12 of the suture 10 from passing through the tissue 70.
  • the suture thread fixing member 20 is tilted on the tissue 70, or the suture thread fixing member 20 If is buried in the fat on the tissue 70, as it is, the second end 12 side of the suture 10 is placed between the support portion and the grip portion of the second fixing portion 40 of the suture fixing member 20. It can be difficult to thread through the ditch. Further, before passing the second end 12 side of the suture thread 10 through the groove between the support portion 41 and the grip portion 42 of the second fixing portion 40 of the suture thread fixing member 20, the second fixing of the suture thread fixing member 20 is performed.
  • the suture thread fixing member 20 When the suture thread fixing member 20 is raised or moved by sandwiching the suture thread fixing member 20 with a chisel or the like so that the suture thread 10 can be easily passed through the groove between the support portion 41 and the grip portion 42 of the portion 40, the suture thread is raised or moved.
  • the groove between the support portion 41 and the grip portion 42 of the second fixing portion 40 may be closed by the above.
  • the suture thread fixing member 20 can be made upright or appropriately moved with respect to the tissue without closing the groove between the support portion 41 and the grip portion 42 of the second fixing portion 40 by sandwiching the suture thread fixing member 20 with a ligature or the like. Is easy. Therefore, it is easy to pass the second end 12 side of the suture thread 10 through the groove between the support portion 41 and the grip portion 42 of the second fixing portion 40 of the suture thread fixing member 20.
  • the instrument that sandwiches the first end 11 of the suture thread 10 is not limited to tweezers, and may be forceps or the like, and is not particularly limited.
  • the suture thread After fixing the second end 12 side of the suture thread 10 between the support portion 41 and the grip portion 42 of the second fixing portion 40 of the suture thread fixing member 20, the suture thread does not form a loop of the suture thread 10.
  • the first end 11 side and the second end 12 side of 10 may be cut from the suture thread fixing member 20 and removed from the body.
  • the suture thread fixing member 20 before fixing the first end 11 side of the suture thread 10 is prepared.
  • the first fixing portion 30 has the first end 11 side of the suture thread 10 penetrating the first fixing portion 30, and the suture thread 10 The first end 11 is configured to protrude from the first fixing portion 30.
  • the first fixing portion 30 includes, for example, an upper portion 31 to which the support portion 41 of the second fixing portion 40 is connected, and both side portions 32. It includes a bottom 33. Both side portions 32 of the first fixing portion 30 may be substantially parallel.
  • a groove 35 is provided from the bottom 33 to the upper 31 side of the first fixing portion 30.
  • the groove 35 is located at the center with respect to both side portions 32, for example.
  • the groove 35 has an introduction portion 36, a holding portion 37 communicating with the introduction portion 36, and a narrowed portion 38 communicating with the holding portion 37 from the bottom 33 side.
  • the introduction portion 36 of the groove 35 has a width that allows the suture thread 10 to be introduced from the bottom portion 33 to the holding portion 37.
  • the width of the introduction portion 36 of the groove 35 is, for example, narrower than the width of the unpressurized suture, but equal to or greater than the width that the pressurized suture can take.
  • the holding portion 37 of the groove 35 holds the suture thread 10 introduced from the introducing portion 36. At least a part of the cross-sectional shape of the holding portion 37 is substantially the same as, for example, at least a part of the cross-sectional shape of the suture thread 10.
  • the width of the holding portion 37 of the groove 35 is, for example, substantially the same as the width of the suture 10 under no pressure.
  • the narrowed portion 38 of the groove 35 has a width that the suture held in the holding portion 37 cannot be inserted.
  • the width of the narrowed portion 38 of the groove 35 is narrower than the width that the pressurized suture can take.
  • the width of the narrowed portion 38 of the groove 35 is narrowed.
  • the width of the holding portion 37 also narrows, and the first end 11 side of the suture 10 is fixed by the inner wall of the holding portion 37.
  • the suture is sutured so that the first end 11 side of the suture thread 10 penetrates the first fixing portion 30 of the suture thread fixing member 20 and the first end 11 of the suture thread 10 protrudes from the first fixing portion 30.
  • the first end 11 side of the thread 10 is fixed to the first fixing portion 30, and the tissue ligation device according to the embodiment is manufactured.
  • the suture thread fixing member 20 can be made upright with respect to the tissue or moved as appropriate without closing the groove between the support portion 41 and the grip portion 42 of the second fixing portion 40. It is easy to make it.

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Abstract

This tissue ligation device is provided with: a suture thread 10 having a first end and a second end; and a suture thread fixing member 20 for fixing the suture thread 10. The suture thread fixing member 20 is provided with: a first fixing part 30 for fixing the first end side of the suture thread 10; and a second fixing part 40 which is connected to the first fixing part 30 and is for fixing the second end side of the suture thread 10 after ligation of a tissue with the suture thread 10.

Description

組織結紮用デバイス、縫合糸固定部材、組織結紮用デバイスの製造方法Manufacturing method of tissue ligation device, suture fixing member, tissue ligation device
　本発明は医療技術に関し、組織結紮用デバイス、縫合糸固定部材、及び組織結紮用デバイスの製造方法に関する。 The present invention relates to medical technology, and relates to a tissue ligating device, a suture fixing member, and a method for manufacturing a tissue ligating device.
　医療分野において、組織を縫合、結紮することは、多くの手技において非常に重要であるが、熟練を要する難度の高い処置である。近年、患者の負担を軽減するために、内視鏡や腹腔鏡、胸腔鏡等を用いて手術等の各種手技を行うことが進められている。しかし、鏡視下では、縫合糸や縫合針等を長い鉗子等で把持して操作する必要があり、縫合、結紮等の難度はさらに高くなっている。縫合、結紮において、特に困難なのは、縫合糸を結んで結び目を形成することである。縫合糸の結び目が緩むと、縫合、結紮が解除されて合併症を引き起こす場合がある。 In the medical field, suturing and ligating tissue is very important in many procedures, but it is a difficult procedure that requires skill. In recent years, in order to reduce the burden on patients, various procedures such as surgery have been carried out using an endoscope, a laparoscope, a thoracoscope and the like. However, under a microscope, it is necessary to grip the suture, the suture needle, or the like with a long forceps or the like for operation, and the difficulty of suturing, ligating, or the like is further increased. A particularly difficult task in suturing and ligating is to tie a suture to form a knot. If the knot of the suture is loosened, the suture and ligature may be released, causing complications.
　これに対し、縫合糸の一端を縫合糸固定部材に固定した組織結紮用デバイスが提案されている（例えば、特許文献１から３参照。）。縫合糸固定部材は縫合糸より大きいため、縫合糸で組織を縫合、結紮する際に、縫合糸固定部材は組織上に保持される。また、縫合、結紮後、縫合糸固定部材で縫合糸の他端側を挟み込むことにより、縫合糸の他端を縫合糸固定部材に固定することが可能である。これにより、縫合糸の他端側が組織を抜けることが防止される。 On the other hand, a tissue ligation device in which one end of the suture is fixed to the suture fixing member has been proposed (see, for example, Patent Documents 1 to 3). Since the suture fixing member is larger than the suture, the suture fixing member is held on the tissue when the tissue is sutured and ligated with the suture. Further, after suturing and ligating, the other end of the suture can be fixed to the suture fixing member by sandwiching the other end side of the suture with the suture fixing member. This prevents the other end of the suture from coming out of the tissue.
特許６０６１６２３号公報Japanese Patent No. 6061623 特許６２６６０４８号公報Japanese Patent No. 6266048 特許６４１０４７３号公報Japanese Patent No. 6410473
　しかし、本発明者らは、鋭意研究の末、例えば組織上において縫合糸固定部材が倒れていると、縫合、結紮後に、縫合糸固定部材の溝や穴に縫合糸の他端側を通すことが困難であり、縫合糸の他端を固定することが依然として困難であることを見出した。そこで、本発明は、縫合糸の固定を容易にする組織結紮用デバイス、縫合糸固定部材、及び組織結紮用デバイスの製造方法を提供することを目的の一つとする。 However, after diligent research, for example, when the suture fixing member has fallen on the tissue, the present inventors pass the other end side of the suture through the groove or hole of the suture fixing member after suturing and ligating. It was found that it was difficult and it was still difficult to fix the other end of the suture. Therefore, one of the objects of the present invention is to provide a tissue ligating device, a suture fixing member, and a method for manufacturing a tissue ligating device that facilitates the fixation of sutures.
　本発明の態様によれば、第１端と第２端を有する縫合糸と、縫合糸の第１端側を固定している第１固定部と、第１固定部に接続された第２固定部であって、縫合糸による組織の結紮が行われた後に、縫合糸の第２端側を固定するための第２固定部と、を備え、縫合糸の第１端側が第１固定部を貫通しており、縫合糸の第１端が第１固定部から突出している、組織結紮用デバイスが提供される。 According to the aspect of the present invention, the suture having the first end and the second end, the first fixing portion fixing the first end side of the suture, and the second fixing connected to the first fixing portion. It is provided with a second fixing portion for fixing the second end side of the suture after the tissue is ligated with the suture, and the first end side of the suture provides the first fixing portion. A device for tissue ligation is provided that penetrates and projects the first end of the suture from the first fixation.
　上記の組織結紮用デバイスにおいて、縫合糸の第１端側を鑷子で挟めるよう、縫合糸の第１端が第１固定部から突出していてもよい。 In the above-mentioned tissue ligation device, the first end of the suture may protrude from the first fixing portion so that the first end side of the suture is sandwiched between the tweezers.
　上記の組織結紮用デバイスが、縫合糸の第２端に接続された縫合針をさらに備えていてもよい。 The tissue ligation device described above may further include a suture needle connected to the second end of the suture.
　上記の組織結紮用デバイスにおいて、第２固定部が、第１固定部に接続された支持部と、支持部に接続された把持部と、を備えていてもよい。 In the above-mentioned tissue ligation device, the second fixing portion may include a support portion connected to the first fixing portion and a grip portion connected to the support portion.
　上記の組織結紮用デバイスにおいて、縫合糸による組織の結紮が行われた後に、縫合糸の第２端側が、支持部と把持部との間に入れられ、支持部と把持部が接合されることにより、縫合糸の第２端側が第２固定部に固定されてもよい。 In the above-mentioned tissue ligation device, after the tissue is ligated with the suture, the second end side of the suture is inserted between the support portion and the grip portion, and the support portion and the grip portion are joined. The second end side of the suture may be fixed to the second fixing portion.
　上記の組織結紮用デバイスにおいて、縫合糸の第２端側を固定する前に、支持部と把持部が略平行であってもよい。 In the above-mentioned tissue ligation device, the support portion and the grip portion may be substantially parallel before fixing the second end side of the suture.
　上記の組織結紮用デバイスが、把持部に接続されたガイド端部をさらに備え、ガイド端部が、把持部に対して反対方向に向けて、支持部から遠ざかるように傾斜していてもよい。 The above-mentioned tissue ligation device may further include a guide end connected to the grip, and the guide end may be inclined so as to move away from the support in the direction opposite to the grip.
　上記の組織結紮用デバイスにおいて、第１固定部が、第２固定部の支持部が接続された上部を備え、上部が支持部に対して支持部から遠ざかるように傾斜していてもよい。 In the above-mentioned tissue ligation device, the first fixing portion may include an upper portion to which the supporting portion of the second fixing portion is connected, and the upper portion may be inclined so as to be away from the supporting portion with respect to the supporting portion.
　本発明の態様によれば、第１端と第２端を有する縫合糸を固定するための縫合糸固定部材であって、縫合糸の第１端側を固定するための第１固定部と、第１固定部に接続された第２固定部であって、縫合糸による組織の結紮が行われた後に、縫合糸の第２端側を固定するための第２固定部と、を備え、第１固定部が、縫合糸の第１端側を固定する際に、縫合糸の第１端側が当該第１固定部を貫通し、縫合糸の第１端が当該第１固定部から突出するよう、構成されている、縫合糸固定部材が提供される。 According to the aspect of the present invention, the suture fixing member for fixing the suture having the first end and the second end, and the first fixing portion for fixing the first end side of the suture, A second fixing portion connected to the first fixing portion, the second fixing portion is provided with a second fixing portion for fixing the second end side of the suture after the tissue is ligated by the suture. When the 1 fixing portion fixes the first end side of the suture, the first end side of the suture penetrates the first fixing portion and the first end of the suture protrudes from the first fixing portion. , A suture fixing member is provided.
　上記の縫合糸固定部材において、第１固定部が、第２固定部が接続された上部、両側部、及び底部を備え、底部から上部側に向けて溝が設けられていてもよい。 In the above-mentioned suture thread fixing member, the first fixing portion may include an upper portion, both side portions, and a bottom portion to which the second fixing portion is connected, and a groove may be provided from the bottom portion to the upper portion side.
　上記の縫合糸固定部材において、両側部が略平行であってもよい。 In the above suture thread fixing member, both sides may be substantially parallel.
　上記の縫合糸固定部材において、溝が、縫合糸を底部から導入可能な幅を有する導入部と、導入部から導入された縫合糸を保持する保持部と、を備えていてもよい。 In the suture fixing member described above, the groove may include an introduction portion having a width capable of introducing the suture from the bottom and a holding portion for holding the suture introduced from the introduction portion.
　上記の縫合糸固定部材において、第１固定部の両側部を挟み込むことより導入部が狭められることができてもよい。 In the suture fixing member described above, the introduction portion may be narrowed by sandwiching both side portions of the first fixing portion.
　上記の縫合糸固定部材において、溝が、保持部に保持された縫合糸が、保持部から入れない幅を有する狭窄部をさらに備えていてもよい。 In the suture fixing member described above, the groove may further include a narrowed portion having a width that the suture held in the holding portion cannot enter from the holding portion.
　上記の縫合糸固定部材において、第１固定部の両側部を挟み込むことより狭窄部が狭まることができてもよい。 In the suture fixing member described above, the narrowed portion may be narrowed by sandwiching both side portions of the first fixing portion.
　本発明の態様によれば、第１端と第２端を有する縫合糸を用意することと、縫合糸の第１端側を固定するための第１固定部と、第１固定部に接続された第２固定部であって、縫合糸による組織の結紮が行われた後に、縫合糸の第２端側を固定するための第２固定部と、を備える縫合糸固定部材を用意することと、縫合糸の第１端側が縫合糸固定部材の第１固定部を貫通し、縫合糸の第１端が第１固定部から突出するよう、縫合糸の第１端側を第１固定部に固定することと、を含む、組織結紮用デバイスの製造方法が提供される。 According to the aspect of the present invention, a suture having a first end and a second end is prepared, and a first fixing portion for fixing the first end side of the suture is connected to the first fixing portion. A suture fixing member including a second fixing portion for fixing the second end side of the suture after the tissue is ligated with the suture is prepared. , The first end side of the suture is set to the first fixing part so that the first end side of the suture penetrates the first fixing part of the suture fixing member and the first end of the suture protrudes from the first fixing part. Methods of making a device for tissue ligation, including immobilization, are provided.
　上記の組織結紮用デバイスの製造方法において、縫合糸の第１端側を鑷子で挟めるように、縫合糸の第１端が第１固定部から突出するよう、縫合糸の第１端側を第１固定部に固定してもよい。 In the above method for manufacturing a tissue ligation device, the first end side of the suture is set so as to sandwich the first end side of the suture with tweezers and the first end of the suture protrudes from the first fixing portion. 1 It may be fixed to a fixed portion.
　上記の組織結紮用デバイスの製造方法において、第１固定部が、第２固定部が接続された上部、両側部、及び底部を備え、底部から上部側に向けて溝が設けられており、固定することの前に、溝に縫合糸を通すことをさらに含んでいてもよい。 In the above method for manufacturing a tissue ligation device, the first fixing portion includes an upper part, both side parts, and a bottom part to which the second fixing part is connected, and a groove is provided from the bottom part to the upper part side for fixing. It may further include threading the suture through the groove prior to doing so.
　上記の組織結紮用デバイスの製造方法において、縫合糸の第１端側が第１固定部に固定される前に、第１固定部の両側部が略平行であってもよい。 In the above method for manufacturing a tissue ligation device, both sides of the first fixing portion may be substantially parallel before the first end side of the suture is fixed to the first fixing portion.
　上記の組織結紮用デバイスの製造方法において、溝が、縫合糸の第１端側が第１固定部に固定される前に縫合糸を底部から導入可能な幅を有する導入部と、導入部から導入された縫合糸を保持する保持部と、を備え、溝に縫合糸を通すことにおいて、縫合糸を、溝の導入部から保持部に導入してもよい。 In the above method for manufacturing a tissue ligation device, the groove is introduced from an introduction portion having a width that allows the suture to be introduced from the bottom before the first end side of the suture is fixed to the first fixing portion, and an introduction portion. The suture may be introduced from the introduction portion of the groove to the holding portion by providing a holding portion for holding the suture and passing the suture through the groove.
　上記の組織結紮用デバイスの製造方法において、固定することにおいて、第１固定部の両側部を挟み込み、溝の導入部を狭めてもよい。 In the above method for manufacturing a tissue ligation device, in fixing, both sides of the first fixing portion may be sandwiched to narrow the introduction portion of the groove.
　上記の組織結紮用デバイスの製造方法において、溝が、保持部に保持された縫合糸が、保持部から入れない幅を有する狭窄部をさらに備えていてもよい。 In the method for manufacturing a tissue ligation device described above, the groove may further include a stenotic portion having a width that the suture held in the holding portion cannot enter from the holding portion.
　上記の組織結紮用デバイスの製造方法において、固定することにおいて、第１固定部の両側部を挟み込み、狭窄部を狭めてもよい。 In the method for manufacturing a tissue ligation device described above, in fixing, both sides of the first fixing portion may be sandwiched to narrow the narrowed portion.
　本発明によれば、縫合糸の固定を容易にする組織結紮用デバイス、縫合糸固定部材、及び組織結紮用デバイスの製造方法を提供可能である。 According to the present invention, it is possible to provide a tissue ligating device, a suture fixing member, and a method for manufacturing a tissue ligating device that facilitates fixation of a suture.
実施形態に係る組織結紮用デバイスを示す模式的斜視図である。It is a schematic perspective view which shows the device for tissue ligation which concerns on embodiment. 実施形態に係る組織結紮用デバイスを示す模式的正面図である。It is a schematic front view which shows the device for tissue ligation which concerns on embodiment. 実施形態に係る組織結紮用デバイスを示す模式的斜視図である。It is a schematic perspective view which shows the device for tissue ligation which concerns on embodiment. 実施形態に係る組織結紮用デバイスを示す模式的正面図である。It is a schematic front view which shows the device for tissue ligation which concerns on embodiment. 実施形態に係る組織結紮用デバイスを示す模式的正面図である。It is a schematic front view which shows the device for tissue ligation which concerns on embodiment. 実施形態に係る組織結紮用デバイスを示す模式的正面図である。It is a schematic front view which shows the device for tissue ligation which concerns on embodiment. 実施形態に係る組織結紮用デバイスの使用方法を示す模式的斜視図である。It is a schematic perspective view which shows the use method of the tissue ligation device which concerns on embodiment. 実施形態に係る組織結紮用デバイスの使用方法を示す模式的斜視図である。It is a schematic perspective view which shows the use method of the tissue ligation device which concerns on embodiment. 実施形態に係る組織結紮用デバイスの使用方法を示す模式的斜視図である。It is a schematic perspective view which shows the use method of the tissue ligation device which concerns on embodiment. 実施形態に係る組織結紮用デバイスの使用方法を示す模式的斜視図である。It is a schematic perspective view which shows the use method of the tissue ligation device which concerns on embodiment. 実施形態に係る縫合糸の第１端側を固定する前の縫合糸固定部材を示す模式的正面図である。It is a schematic front view which shows the suture thread fixing member before fixing the 1st end side of the suture thread which concerns on embodiment. 実施形態に係る縫合糸の第１端側を固定する前の縫合糸固定部材を示す模式的斜視図である。It is a schematic perspective view which shows the suture thread fixing member before fixing the 1st end side of the suture thread which concerns on embodiment.
　以下に本発明の実施の形態を説明する。以下の図面の記載において、同一又は類似の部分には同一又は類似の符号で表している。ただし、図面は模式的なものである。したがって、具体的な寸法等は以下の説明を照らし合わせて判断するべきものである。また、図面相互間においても互いの寸法の関係や比率が異なる部分が含まれていることはもちろんである。 An embodiment of the present invention will be described below. In the description of the drawings below, the same or similar parts are represented by the same or similar reference numerals. However, the drawings are schematic. Therefore, the specific dimensions and the like should be determined in light of the following explanations. In addition, it goes without saying that the drawings include parts having different dimensional relationships and ratios from each other.
　実施形態に係る組織結紮用デバイスは、図１に示すように、第１端１１と第２端１２を有する縫合糸１０と、縫合糸１０を固定するための縫合糸固定部材２０と、を備える。図２及び図３に示すように、縫合糸固定部材２０は、縫合糸１０の第１端１１側を固定している第１固定部３０と、第１固定部３０に接続された第２固定部４０であって、縫合糸１０による組織の結紮が行われた後に、縫合糸１０の第２端１２側を固定するための第２固定部４０と、を備える。 As shown in FIG. 1, the tissue ligation device according to the embodiment includes a suture thread 10 having a first end 11 and a second end 12, and a suture thread fixing member 20 for fixing the suture thread 10. .. As shown in FIGS. 2 and 3, the suture thread fixing member 20 has a first fixing portion 30 that fixes the first end 11 side of the suture thread 10 and a second fixing portion 30 that is connected to the first fixing portion 30. The portion 40 includes a second fixing portion 40 for fixing the second end 12 side of the suture 10 after the tissue is ligated by the suture 10.
　実施形態に係る組織結紮用デバイスは、組織の結紮に用いられる。本開示において、組織とは、例えばヒト又は動物等の体を構成する組織を指し、臓器、血管、筋肉、及び皮膚等を指すが、特に限定されない。実施形態に係る組織結紮用デバイスは、例えば、生体適合性ステンレスからなるが、実施形態に係る組織結紮用デバイスの材料は、これに限定されない。縫合糸１０は、例えば、ポリプロピレンからなるが、これに限定されない。 The tissue ligation device according to the embodiment is used for tissue ligation. In the present disclosure, the tissue refers to a tissue constituting the body such as a human or an animal, and refers to an organ, a blood vessel, a muscle, a skin, or the like, but is not particularly limited. The tissue ligation device according to the embodiment is made of, for example, biocompatible stainless steel, but the material of the tissue ligation device according to the embodiment is not limited to this. The suture 10 is made of, for example, polypropylene, but is not limited thereto.
　図１及び図３に示すように、実施形態に係る組織結紮用デバイスにおいて、縫合糸１０の第１端１１側が縫合糸固定部材２０の第１固定部３０を貫通しており、縫合糸１０の第１端１１が縫合糸固定部材２０の第１固定部３０から突出している。例えば、縫合糸１０の第１端１１側を鑷子で挟めるよう、縫合糸１０の第１端１１が縫合糸固定部材２０の第１固定部３０から突出している。しかし、縫合糸固定部材２０の第１固定部３０から突出している縫合糸１０の第１端１１側の長さは、特に限定されない。 As shown in FIGS. 1 and 3, in the tissue ligation device according to the embodiment, the first end 11 side of the suture thread 10 penetrates the first fixing portion 30 of the suture thread fixing member 20, and the suture thread 10 The first end 11 projects from the first fixing portion 30 of the suture thread fixing member 20. For example, the first end 11 of the suture thread 10 protrudes from the first fixing portion 30 of the suture thread fixing member 20 so that the first end 11 side of the suture thread 10 is sandwiched between the tweezers. However, the length of the suture thread 10 protruding from the first fixing portion 30 of the suture thread fixing member 20 on the first end 11 side is not particularly limited.
　縫合糸固定部材２０の第１固定部３０から突出している縫合糸１０の第２端１２側の長さは、特に限定されない。実施形態に係る組織結紮用デバイスは、図１に示すように、縫合糸１０の第２端１２に接続された縫合針５０をさらに備える。 The length of the suture thread 10 protruding from the first fixing portion 30 of the suture thread fixing member 20 on the second end 12 side is not particularly limited. The tissue ligation device according to the embodiment further includes a suture needle 50 connected to the second end 12 of the suture thread 10, as shown in FIG.
　図２及び図３に示すように、縫合糸固定部材２０の第２固定部４０は、第１固定部３０に接続された支持部４１と、支持部４１に接続された把持部４２と、を備える。支持部４１は、下方において、第１固定部３０に接続されている。把持部４２は、折り返し部４３を介して、支持部４１の上方に接続される。折り返し部４３は、ヘアピン状に折り返している。縫合糸固定部材２０は、把持部４２を複数備えていてもよい。例えば、縫合糸固定部材２０は、支持部４１に関して対称に２つの把持部４２を備える。 As shown in FIGS. 2 and 3, the second fixing portion 40 of the suture thread fixing member 20 has a support portion 41 connected to the first fixing portion 30 and a grip portion 42 connected to the support portion 41. Be prepared. The support portion 41 is connected to the first fixing portion 30 at the bottom. The grip portion 42 is connected above the support portion 41 via the folded portion 43. The folded-back portion 43 is folded back in a hairpin shape. The suture thread fixing member 20 may include a plurality of grip portions 42. For example, the suture fixing member 20 includes two grips 42 symmetrically with respect to the support 41.
　縫合糸１０による組織の結紮が行われた後、図４から図６に示すように、縫合糸１０の第２端側が、支持部４１と把持部４２との間の溝に入れられ、通される。その後、鑷子６０等により、支持部４１と把持部４２をかしめ、支持部４１と把持部４２を圧着させ、支持部４１と把持部４２が接合することにより、縫合糸１０の第２端側が、縫合糸固定部材２０の第２固定部４０の支持部４１と把持部４２の間に固定される。これにより、縫合糸のループが形成される。なお、第２端側とは、第２端の近傍に限定されず、縫合糸固定部材２０に関して第１端の反対側であれば、縫合糸１０の任意の場所でよい。 After the tissue is ligated with the suture 10, the second end side of the suture 10 is inserted into the groove between the support 41 and the grip 42 and passed through, as shown in FIGS. 4 to 6. To. After that, the support portion 41 and the grip portion 42 are crimped by the tweezers 60 or the like, the support portion 41 and the grip portion 42 are crimped, and the support portion 41 and the grip portion 42 are joined to form the second end side of the suture thread 10. It is fixed between the support portion 41 and the grip portion 42 of the second fixing portion 40 of the suture thread fixing member 20. This forms a suture loop. The second end side is not limited to the vicinity of the second end, and may be any place of the suture thread 10 as long as it is on the opposite side of the first end with respect to the suture thread fixing member 20.
　図２及び図３に示すように、縫合糸１０の第２端側を固定する前に、縫合糸固定部材２０の第２固定部４０の支持部４１と把持部４２が略平行であってもよい。縫合糸固定部材２０は、把持部４２に接続されたガイド端部４４をさらに備えていてもよい。ガイド端部４４は、例えば、把持部４２に対して反対方向に向けて、支持部４１から遠ざかるように傾斜している。これにより、支持部４１と把持部４２の間の溝に縫合糸１０を入れることが容易になる。縫合糸固定部材２０の第１固定部３０は、例えば、第２固定部４０の支持部４１が接続された上部３１を備え、上部３１の肩が支持部４１に対して支持部４１から遠ざかるように傾斜している。これによっても、支持部４１と把持部４２の間の溝に縫合糸１０を入れることが容易になる。 As shown in FIGS. 2 and 3, even if the support portion 41 and the grip portion 42 of the second fixing portion 40 of the suture thread fixing member 20 are substantially parallel to each other before fixing the second end side of the suture thread 10. Good. The suture thread fixing member 20 may further include a guide end 44 connected to the grip 42. The guide end 44 is inclined so as to move away from the support 41, for example, in the direction opposite to the grip 42. This makes it easy to insert the suture thread 10 into the groove between the support portion 41 and the grip portion 42. The first fixing portion 30 of the suture thread fixing member 20 includes, for example, an upper portion 31 to which the supporting portion 41 of the second fixing portion 40 is connected so that the shoulder of the upper portion 31 moves away from the supporting portion 41 with respect to the supporting portion 41. It is inclined to. This also facilitates inserting the suture thread 10 into the groove between the support portion 41 and the grip portion 42.
　次に、実施形態に係る組織結紮用デバイスの使用方法を説明する。図７に示すように、縫合、結紮する組織７０を縫合針５０及び縫合糸１０で縫っていく。図８に示すように、縫合糸固定部材２０は縫合糸１０より幅広であるため、縫合糸１０を引いても、縫合糸固定部材２０は、組織７０上に留まる。そのため、縫合糸１０の第１端１１が、組織７０を通り抜けることが防止される。組織７０を縫合し、縫合糸１０を引き絞った後、図９に示すように、縫合糸１０の第２端１２側を、縫合糸固定部材２０の支持部４１と把持部４２の間の溝に通す。その後、図１０に示すように、鑷子６０等により、支持部４１と把持部４２を接合し、縫合糸１０の第２端側を、縫合糸固定部材２０の第２固定部４０の支持部４１と把持部４２の間に固定する。これにより、縫合糸１０の第２端１２が、組織７０を通り抜けることが防止される。 Next, a method of using the tissue ligation device according to the embodiment will be described. As shown in FIG. 7, the tissue 70 to be sutured and ligated is sewn with the suture needle 50 and the suture thread 10. As shown in FIG. 8, since the suture thread fixing member 20 is wider than the suture thread 10, the suture thread fixing member 20 stays on the tissue 70 even when the suture thread 10 is pulled. Therefore, the first end 11 of the suture 10 is prevented from passing through the tissue 70. After the tissue 70 is sutured and the suture thread 10 is squeezed, as shown in FIG. 9, the second end 12 side of the suture thread 10 is formed into a groove between the support portion 41 and the grip portion 42 of the suture thread fixing member 20. Pass through. After that, as shown in FIG. 10, the support portion 41 and the grip portion 42 are joined by a tweezers 60 or the like, and the second end side of the suture thread 10 is attached to the support portion 41 of the second fixing portion 40 of the suture thread fixing member 20. It is fixed between the grip portion 42 and the grip portion 42. This prevents the second end 12 of the suture 10 from passing through the tissue 70.
　ここで、縫合糸１０の第２端１２側を、縫合糸固定部材２０の第２固定部４０に固定する際、縫合糸固定部材２０が組織７０上で倒れていたり、あるいは縫合糸固定部材２０が組織７０上の脂肪内に埋もれていたりしていた場合、そのままでは、縫合糸１０の第２端１２側を、縫合糸固定部材２０の第２固定部４０の支持部と把持部の間の溝に通すことが困難になり得る。また、縫合糸１０の第２端１２側を、縫合糸固定部材２０の第２固定部４０の支持部４１と把持部４２の間の溝に通す前に、縫合糸固定部材２０の第２固定部４０の支持部４１と把持部４２の間の溝に縫合糸１０を通しやすいように、鑷子等で縫合糸固定部材２０を挟んで、縫合糸固定部材２０を起こしたり、動かしたりすると、鑷子等で第２固定部４０の支持部４１と把持部４２の間の溝が塞がれ得る。 Here, when the second end 12 side of the suture thread 10 is fixed to the second fixing portion 40 of the suture thread fixing member 20, the suture thread fixing member 20 is tilted on the tissue 70, or the suture thread fixing member 20 If is buried in the fat on the tissue 70, as it is, the second end 12 side of the suture 10 is placed between the support portion and the grip portion of the second fixing portion 40 of the suture fixing member 20. It can be difficult to thread through the ditch. Further, before passing the second end 12 side of the suture thread 10 through the groove between the support portion 41 and the grip portion 42 of the second fixing portion 40 of the suture thread fixing member 20, the second fixing of the suture thread fixing member 20 is performed. When the suture thread fixing member 20 is raised or moved by sandwiching the suture thread fixing member 20 with a chisel or the like so that the suture thread 10 can be easily passed through the groove between the support portion 41 and the grip portion 42 of the portion 40, the suture thread is raised or moved. The groove between the support portion 41 and the grip portion 42 of the second fixing portion 40 may be closed by the above.
　これに対し、実施形態に係る組織結紮用デバイスにおいては、縫合糸１０の第１端１１が縫合糸固定部材２０の第１固定部３０から突出しているため、縫合糸１０の第１端１１側を鑷子等で挟むことにより、第２固定部４０の支持部４１と把持部４２の間の溝を塞ぐことなく、縫合糸固定部材２０を組織に対して直立させたり、適宜移動させたりすることが容易である。そのため、縫合糸１０の第２端１２側を、縫合糸固定部材２０の第２固定部４０の支持部４１と把持部４２の間の溝に通すことが容易である。なお、縫合糸１０の第１端１１を挟む器具は鑷子に限定されず、鉗子等であってもよく、特に限定されない。 On the other hand, in the tissue ligation device according to the embodiment, since the first end 11 of the suture thread 10 protrudes from the first fixing portion 30 of the suture thread fixing member 20, the first end 11 side of the suture thread 10 The suture thread fixing member 20 can be made upright or appropriately moved with respect to the tissue without closing the groove between the support portion 41 and the grip portion 42 of the second fixing portion 40 by sandwiching the suture thread fixing member 20 with a ligature or the like. Is easy. Therefore, it is easy to pass the second end 12 side of the suture thread 10 through the groove between the support portion 41 and the grip portion 42 of the second fixing portion 40 of the suture thread fixing member 20. The instrument that sandwiches the first end 11 of the suture thread 10 is not limited to tweezers, and may be forceps or the like, and is not particularly limited.
　縫合糸１０の第２端１２側を、縫合糸固定部材２０の第２固定部４０の支持部４１と把持部４２の間に固定した後、縫合糸１０のループを形成していない、縫合糸１０の第１端１１側と第２端１２側は、縫合糸固定部材２０から切断し、体外に除去してもよい。 After fixing the second end 12 side of the suture thread 10 between the support portion 41 and the grip portion 42 of the second fixing portion 40 of the suture thread fixing member 20, the suture thread does not form a loop of the suture thread 10. The first end 11 side and the second end 12 side of 10 may be cut from the suture thread fixing member 20 and removed from the body.
　次に、実施形態に係る組織結紮用デバイスの製造方法を説明する。図１１及び図１２に示すように、縫合糸１０の第１端１１側を固定する前の縫合糸固定部材２０を用意する。縫合糸１０の第１端１１側を固定する前の縫合糸固定部材２０は、第１固定部３０が、縫合糸１０の第１端１１側が第１固定部３０を貫通し、縫合糸１０の第１端１１が第１固定部３０から突出するよう、構成されている。 Next, a method for manufacturing the tissue ligation device according to the embodiment will be described. As shown in FIGS. 11 and 12, the suture thread fixing member 20 before fixing the first end 11 side of the suture thread 10 is prepared. In the suture fixing member 20 before fixing the first end 11 side of the suture thread 10, the first fixing portion 30 has the first end 11 side of the suture thread 10 penetrating the first fixing portion 30, and the suture thread 10 The first end 11 is configured to protrude from the first fixing portion 30.
　縫合糸の第１端側を固定する前の縫合糸固定部材２０において、第１固定部３０が、例えば、第２固定部４０の支持部４１が接続された上部３１と、両側部３２と、底部３３と、を備える。第１固定部３０の両側部３２は、略平行であってもよい。 In the suture fixing member 20 before fixing the first end side of the suture, the first fixing portion 30 includes, for example, an upper portion 31 to which the support portion 41 of the second fixing portion 40 is connected, and both side portions 32. It includes a bottom 33. Both side portions 32 of the first fixing portion 30 may be substantially parallel.
　縫合糸の第１端側を固定する前の縫合糸固定部材２０において、例えば、第１固定部３０の底部３３から上部３１側に向けて溝３５が設けられている。溝３５は、例えば、両側部３２に対して中心に位置する。溝３５は、底部３３側から、導入部３６と、導入部３６に連通する保持部３７と、保持部３７に連通する狭窄部３８と、を有する。 In the suture fixing member 20 before fixing the first end side of the suture, for example, a groove 35 is provided from the bottom 33 to the upper 31 side of the first fixing portion 30. The groove 35 is located at the center with respect to both side portions 32, for example. The groove 35 has an introduction portion 36, a holding portion 37 communicating with the introduction portion 36, and a narrowed portion 38 communicating with the holding portion 37 from the bottom 33 side.
　溝３５の導入部３６は、縫合糸１０を底部３３から保持部３７に導入可能な幅を有する。溝３５の導入部３６の幅は、例えば、圧力を加えられていない縫合糸の幅より狭いが、圧力を加えられた縫合糸がとり得る幅と同じ以上である。 The introduction portion 36 of the groove 35 has a width that allows the suture thread 10 to be introduced from the bottom portion 33 to the holding portion 37. The width of the introduction portion 36 of the groove 35 is, for example, narrower than the width of the unpressurized suture, but equal to or greater than the width that the pressurized suture can take.
　溝３５の保持部３７は、導入部３６から導入された縫合糸１０を保持する。保持部３７の断面形状の少なくとも一部は、例えば、縫合糸１０の断面形状の少なくとも一部と略同一である。溝３５の保持部３７の幅は、例えば、圧力を加えられていない縫合糸１０の幅と略同一である。 The holding portion 37 of the groove 35 holds the suture thread 10 introduced from the introducing portion 36. At least a part of the cross-sectional shape of the holding portion 37 is substantially the same as, for example, at least a part of the cross-sectional shape of the suture thread 10. The width of the holding portion 37 of the groove 35 is, for example, substantially the same as the width of the suture 10 under no pressure.
　溝３５の狭窄部３８は、保持部３７に保持された縫合糸が入れない幅を有する。溝３５の狭窄部３８の幅は、圧力を加えられた縫合糸がとり得る幅よりも狭い。 The narrowed portion 38 of the groove 35 has a width that the suture held in the holding portion 37 cannot be inserted. The width of the narrowed portion 38 of the groove 35 is narrower than the width that the pressurized suture can take.
　溝３５に縫合糸を入れる際には、溝３５の導入部３６から溝３５の保持部３７に、縫合糸１０の第１端１１側を入れる。その際、例えば縫合糸１０の第１端１１側を鑷子で挟めるよう、縫合糸１０の第１端１１が第１固定部３０から突出するようにする。縫合糸１０の第１端１１側が、第１固定部３０の溝３５の保持部３７に導入された後、第１固定部３０の両側部３２を挟み込む。これにより、溝３５の導入部３６の幅が狭められ、縫合糸が第１固定部３０の溝３５から出ることができなくなる。また、第１固定部３０の両側部３２を挟み込む際に、溝３５の狭窄部３８の幅が狭められる。狭窄部３８の幅が狭まることにより、保持部３７の幅も狭まり、縫合糸１０の第１端１１側が保持部３７の内壁で固定される。このようにして、縫合糸１０の第１端１１側が縫合糸固定部材２０の第１固定部３０を貫通し、縫合糸１０の第１端１１が第１固定部３０から突出するように、縫合糸１０の第１端１１側が第１固定部３０に固定され、実施形態に係る組織結紮用デバイスが製造される。 When inserting the suture into the groove 35, insert the first end 11 side of the suture 10 from the introduction portion 36 of the groove 35 into the holding portion 37 of the groove 35. At that time, for example, the first end 11 of the suture 10 is made to protrude from the first fixing portion 30 so that the first end 11 side of the suture 10 is sandwiched between the tweezers. After the first end 11 side of the suture thread 10 is introduced into the holding portion 37 of the groove 35 of the first fixing portion 30, both side portions 32 of the first fixing portion 30 are sandwiched. As a result, the width of the introduction portion 36 of the groove 35 is narrowed, and the suture cannot come out of the groove 35 of the first fixing portion 30. Further, when sandwiching both side portions 32 of the first fixing portion 30, the width of the narrowed portion 38 of the groove 35 is narrowed. As the width of the narrowed portion 38 narrows, the width of the holding portion 37 also narrows, and the first end 11 side of the suture 10 is fixed by the inner wall of the holding portion 37. In this way, the suture is sutured so that the first end 11 side of the suture thread 10 penetrates the first fixing portion 30 of the suture thread fixing member 20 and the first end 11 of the suture thread 10 protrudes from the first fixing portion 30. The first end 11 side of the thread 10 is fixed to the first fixing portion 30, and the tissue ligation device according to the embodiment is manufactured.
　以上説明した実施形態に係る製造方法により製造された組織結紮用デバイスにおいては、縫合糸１０の第１端１１が縫合糸固定部材２０の第１固定部３０から突出しているため、縫合糸１０の第１端１１を鑷子等で挟むことにより、第２固定部４０の支持部４１と把持部４２の間の溝を塞ぐことなく、縫合糸固定部材２０を組織に対して直立させたり、適宜移動させたりすることが容易である。 In the tissue ligation device manufactured by the manufacturing method according to the embodiment described above, since the first end 11 of the suture thread 10 protrudes from the first fixing portion 30 of the suture thread fixing member 20, the suture thread 10 By sandwiching the first end 11 with a ligature or the like, the suture thread fixing member 20 can be made upright with respect to the tissue or moved as appropriate without closing the groove between the support portion 41 and the grip portion 42 of the second fixing portion 40. It is easy to make it.
　１０・・・縫合糸、１１・・・第１端、１２・・・第２端、２０・・・縫合糸固定部材、３０・・・第１固定部、３１・・・上部、３２・・・両側部、３３・・・底部、３５・・・溝、３６・・・導入部、３７・・・保持部、３８・・・狭窄部、４０・・・第２固定部、４１・・・支持部、４２・・・把持部、４３・・・折り返し部部、４４・・・ガイド端部、５０・・・縫合針、６０・・・鑷子、７０・・・組織
  10 ... Suture, 11 ... 1st end, 12 ... 2nd end, 20 ... Suture fixing member, 30 ... 1st fixing part, 31 ... Upper part, 32 ... -Both sides, 33 ... bottom, 35 ... groove, 36 ... introduction part, 37 ... holding part, 38 ... constricted part, 40 ... second fixing part, 41 ... Support part, 42 ... Grip part, 43 ... Folded part, 44 ... Guide end, 50 ... Suture needle, 60 ... Tweezers, 70 ... Tissue

Claims (23)

  1. 　第１端と第２端を有する縫合糸と、
    　前記縫合糸の前記第１端側を固定している第１固定部と、
    　前記第１固定部に接続された第２固定部であって、前記縫合糸による組織の結紮が行われた後に、前記縫合糸の前記第２端側を固定するための第２固定部と、
    　を備え、
    　前記縫合糸の前記第１端側が前記第１固定部を貫通しており、
    　前記縫合糸の前記第１端が前記第１固定部から突出している、
    　組織結紮用デバイス。     A suture having a first end and a second end,
    A first fixing portion that fixes the first end side of the suture, and
    A second fixing portion connected to the first fixing portion, which is a second fixing portion for fixing the second end side of the suture after the tissue is ligated by the suture.
    With
    The first end side of the suture penetrates the first fixing portion.
    The first end of the suture protrudes from the first fixing portion.
    Device for tissue ligation.
  2. 　前記縫合糸の前記第１端側を鑷子で挟めるよう、前記縫合糸の前記第１端が前記第１固定部から突出している、請求項１に記載の組織結紮用デバイス。 The tissue ligation device according to claim 1, wherein the first end of the suture protrudes from the first fixing portion so that the first end side of the suture is sandwiched between tweezers.
  3. 　前記縫合糸の第２端に接続された縫合針をさらに備える、請求項１又は２に記載の組織結紮用デバイス。 The tissue ligation device according to claim 1 or 2, further comprising a suture needle connected to the second end of the suture.
  4. 　前記第２固定部が、
    　前記第１固定部に接続された支持部と、
    　前記支持部に接続された把持部と、
    　を備える、請求項１から３のいずれか１項に記載の組織結紮用デバイス。     The second fixing portion
    A support portion connected to the first fixing portion and
    A grip portion connected to the support portion and
    The tissue ligation device according to any one of claims 1 to 3, wherein the device comprises.
  5. 　前記縫合糸による組織の結紮が行われた後に、前記縫合糸の前記第２端側が、前記支持部と前記把持部との間に入れられ、前記支持部と前記把持部が接合されることにより、前記縫合糸の前記第２端側が前記第２固定部に固定される、請求項４に記載の組織結紮用デバイス。 After the tissue is ligated with the suture, the second end side of the suture is inserted between the support portion and the grip portion, and the support portion and the grip portion are joined to each other. The tissue ligation device according to claim 4, wherein the second end side of the suture is fixed to the second fixing portion.
  6. 　前記縫合糸の前記第２端側を固定する前に、前記支持部と前記把持部が略平行である、請求項４又は５に記載の組織結紮用デバイス。 The tissue ligation device according to claim 4 or 5, wherein the support portion and the grip portion are substantially parallel to each other before fixing the second end side of the suture.
  7. 　前記把持部に接続されたガイド端部をさらに備え、
    　前記ガイド端部が、前記把持部に対して反対方向に向けて、前記支持部から遠ざかるように傾斜している、請求項４から６のいずれか１項に記載の組織結紮用デバイス。     Further provided with a guide end connected to the grip
    The tissue ligation device according to any one of claims 4 to 6, wherein the guide end portion is inclined so as to move away from the support portion in a direction opposite to the grip portion.
  8. 　前記第１固定部が、前記第２固定部の前記支持部が接続された上部を備え、前記上部が前記支持部に対して前記支持部から遠ざかるように傾斜している、請求項４から７のいずれか１項に記載の組織結紮用デバイス。 Claims 4 to 7 wherein the first fixing portion includes an upper portion to which the support portion of the second fixing portion is connected, and the upper portion is inclined so as to move away from the support portion with respect to the support portion. The device for tissue ligation according to any one of the above.
  9. 　第１端と第２端を有する縫合糸を固定するための縫合糸固定部材であって、
    　前記縫合糸の前記第１端側を固定するための第１固定部と、
    　前記第１固定部に接続された第２固定部であって、前記縫合糸による組織の結紮が行われた後に、前記縫合糸の前記第２端側を固定するための第２固定部と、
    　を備え、
    　前記第１固定部が、前記縫合糸の前記第１端側を固定する際に、
    　前記縫合糸の前記第１端側が当該第１固定部を貫通し、
    　前記縫合糸の前記第１端が当該第１固定部から突出するよう、
    　構成されている、
    　縫合糸固定部材。     A suture fixing member for fixing a suture having a first end and a second end.
    A first fixing portion for fixing the first end side of the suture, and
    A second fixing portion connected to the first fixing portion, which is a second fixing portion for fixing the second end side of the suture after the tissue is ligated by the suture.
    With
    When the first fixing portion fixes the first end side of the suture,
    The first end side of the suture penetrates the first fixing portion,
    So that the first end of the suture protrudes from the first fixing portion.
    It is configured,
    Suture fixing member.
  10. 　前記第１固定部が、前記第２固定部が接続された上部、両側部、及び底部を備え、
    　前記底部から前記上部側に向けて溝が設けられている、
    　請求項９に記載の縫合糸固定部材。     The first fixing portion comprises a top, both sides, and a bottom to which the second fixing portion is connected.
    A groove is provided from the bottom to the top.
    The suture thread fixing member according to claim 9.
  11. 　前記両側部が略平行である、請求項１０に記載の縫合糸固定部材。 The suture thread fixing member according to claim 10, wherein both side portions are substantially parallel.
  12. 　前記溝が、
    　前記縫合糸を前記底部から導入可能な幅を有する導入部と、
    　前記導入部から導入された前記縫合糸を保持する保持部と、
    　を備える、
    　請求項１０又は１１に記載の縫合糸固定部材。     The groove
    An introduction portion having a width at which the suture can be introduced from the bottom portion,
    A holding portion for holding the suture introduced from the introduction portion, and a holding portion.
    To prepare
    The suture fixing member according to claim 10 or 11.
  13. 　前記第１固定部の前記両側部を挟み込むことより、前記導入部の幅が狭められることができる、請求項１２に記載の縫合糸固定部材。 The suture thread fixing member according to claim 12, wherein the width of the introduction portion can be narrowed by sandwiching both side portions of the first fixing portion.
  14. 　前記溝が、前記保持部に保持された前記縫合糸が、前記保持部から入れない幅を有する狭窄部をさらに備える、請求項１２又は１３に記載の縫合糸固定部材。 The suture thread fixing member according to claim 12 or 13, wherein the groove further includes a narrowed portion having a width that the suture thread held in the holding portion cannot enter from the holding portion.
  15. 　前記第１固定部の前記両側部を挟み込むことより前記狭窄部が狭まることができる、請求項１４に記載の縫合糸固定部材。 The suture thread fixing member according to claim 14, wherein the narrowed portion can be narrowed by sandwiching both side portions of the first fixing portion.
  16. 　第１端と第２端を有する縫合糸を用意することと、
    　前記縫合糸の前記第１端側を固定するための第１固定部と、前記第１固定部に接続された第２固定部であって、前記縫合糸による組織の結紮が行われた後に、前記縫合糸の前記第２端側を固定するための第２固定部と、を備える縫合糸固定部材を用意することと、
    　前記縫合糸の前記第１端側が前記縫合糸固定部材の前記第１固定部を貫通し、前記縫合糸の前記第１端が前記第１固定部から突出するよう、前記縫合糸の前記第１端側を前記第１固定部に固定することと、
    　を含む、組織結紮用デバイスの製造方法。     To prepare a suture having a first end and a second end,
    A first fixing portion for fixing the first end side of the suture and a second fixing portion connected to the first fixing portion, after the tissue is ligated by the suture. To prepare a suture thread fixing member including a second fixing portion for fixing the second end side of the suture thread, and
    The first end of the suture so that the first end side of the suture penetrates the first fixing portion of the suture fixing member and the first end of the suture protrudes from the first fixing portion. Fixing the end side to the first fixing part and
    A method for manufacturing a device for tissue ligation, including.
  17. 　前記縫合糸の前記第１端側を鑷子で挟めるように、前記縫合糸の前記第１端が前記第１固定部から突出するよう、前記縫合糸の前記第１端側を前記第１固定部に固定する、請求項１６に記載の組織結紮用デバイスの製造方法。 The first fixing portion of the suture so that the first end side of the suture protrudes from the first fixing portion so that the first end side of the suture is sandwiched between the tweezers. The method for manufacturing a tissue ligation device according to claim 16, which is fixed to the device.
  18. 　前記第１固定部が、前記第２固定部が接続された上部、両側部、及び底部を備え、
    　前記底部から前記上部側に向けて溝が設けられており、
    　前記固定することの前に、前記溝に前記縫合糸を通すことをさらに含む、
    　請求項１７に記載の組織結紮用デバイスの製造方法。     The first fixing portion comprises a top, both sides, and a bottom to which the second fixing portion is connected.
    A groove is provided from the bottom to the top.
    Further comprising passing the suture through the groove prior to the fixation.
    The method for manufacturing a tissue ligation device according to claim 17.
  19. 　前記縫合糸の前記第１端側が前記第１固定部に固定される前に、前記両側部が略平行である、請求項１８に記載の組織結紮用デバイスの製造方法。 The method for manufacturing a tissue ligation device according to claim 18, wherein both sides of the suture are substantially parallel before the first end side of the suture is fixed to the first fixing portion.
  20. 　前記溝が、
    　前記縫合糸の前記第１端側が前記第１固定部に固定される前に前記縫合糸を前記底部から導入可能な幅を有する導入部と、
    　前記導入部から導入された前記縫合糸を保持する保持部と、
    　を備え、
    　前記溝に前記縫合糸を通すことにおいて、前記縫合糸を、前記溝の前記導入部から前記保持部に導入する、
    　請求項１８又は１９に記載の組織結紮用デバイスの製造方法。     The groove
    An introduction portion having a width at which the suture can be introduced from the bottom portion before the first end side of the suture is fixed to the first fixing portion.
    A holding portion for holding the suture introduced from the introduction portion, and a holding portion.
    With
    By passing the suture through the groove, the suture is introduced from the introduction portion of the groove to the holding portion.
    The method for manufacturing a tissue ligating device according to claim 18 or 19.
  21. 　前記固定することにおいて、前記第１固定部の前記両側部を挟み込み、前記溝の前記導入部を狭める、請求項２０に記載の組織結紮用デバイスの製造方法。 The method for manufacturing a tissue ligation device according to claim 20, wherein in the fixing, both side portions of the first fixing portion are sandwiched and the introduction portion of the groove is narrowed.
  22. 　前記溝が、前記保持部に保持された前記縫合糸が、前記保持部から入れない幅を有する狭窄部をさらに備える、請求項２０又は２１に記載の組織結紮用デバイスの製造方法。 The method for manufacturing a tissue ligating device according to claim 20 or 21, wherein the groove further includes a narrowed portion having a width that the suture held in the holding portion cannot enter from the holding portion.
  23. 　前記固定することにおいて、前記第１固定部の前記両側部を挟み込み、前記狭窄部を狭める、請求項２２に記載の組織結紮用デバイスの製造方法。
          The method for manufacturing a tissue ligation device according to claim 22, wherein in fixing, both side portions of the first fixing portion are sandwiched and the narrowed portion is narrowed.
PCT/JP2020/025038 2019-07-04 2020-06-25 Tissue ligation device, suture thread fixing member, and method for producing tissue ligation device WO2021002272A1 (en)

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Citations (4)

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US6015428A (en) * 1997-06-03 2000-01-18 Anthony C. Pagedas Integrally formed suture and suture lock
US20030093091A1 (en) * 2000-04-05 2003-05-15 Anthony Paolitto Surgical suturing clamp
JP2015223296A (en) * 2014-05-27 2015-12-14 国立大学法人 東京大学 Tissue ligation device
JP2016104297A (en) * 2016-03-01 2016-06-09 オリンパス株式会社 Tissue ligation device

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JP6266048B2 (en) * 2010-11-30 2018-01-24 オリンパス株式会社 Organization ligation device
JP6061623B2 (en) * 2012-11-01 2017-01-18 オリンパス株式会社 Knotting thread fastener and ligating device

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US6015428A (en) * 1997-06-03 2000-01-18 Anthony C. Pagedas Integrally formed suture and suture lock
US20030093091A1 (en) * 2000-04-05 2003-05-15 Anthony Paolitto Surgical suturing clamp
JP2015223296A (en) * 2014-05-27 2015-12-14 国立大学法人 東京大学 Tissue ligation device
JP2016104297A (en) * 2016-03-01 2016-06-09 オリンパス株式会社 Tissue ligation device

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