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WO2016072017A1 - Matériau de liaison pour tissu biologique et procédé de liaison pour tissu biologique - Google Patents

Matériau de liaison pour tissu biologique et procédé de liaison pour tissu biologique Download PDF

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Publication number
WO2016072017A1
WO2016072017A1 PCT/JP2014/079593 JP2014079593W WO2016072017A1 WO 2016072017 A1 WO2016072017 A1 WO 2016072017A1 JP 2014079593 W JP2014079593 W JP 2014079593W WO 2016072017 A1 WO2016072017 A1 WO 2016072017A1
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WO
WIPO (PCT)
Prior art keywords
biological tissue
porous body
biological
bonding material
living
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/JP2014/079593
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English (en)
Japanese (ja)
Inventor
井上　晃
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Corp
Original Assignee
Olympus Corp
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 Olympus Corp filed Critical Olympus Corp
Priority to PCT/JP2014/079593 priority Critical patent/WO2016072017A1/fr
Publication of WO2016072017A1 publication Critical patent/WO2016072017A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses

Definitions

  • the present invention relates to a biological tissue bonding material and a biological tissue bonding method.
  • an energy treatment tool that joins living tissues using energy such as high frequency, heat, and ultrasonic waves is known (see, for example, Patent Document 1).
  • the energy treatment tool locally heats the living tissue by applying energy to the living tissue, denatures the protein, and simultaneously removes moisture from the living tissue, thereby achieving bonding between the living tissues.
  • a medical stapler that mechanically joins living tissues using staples
  • such an energy treatment device has an advantage that no foreign matter is left in the living body.
  • power is unstable.
  • Patent Document 1 a moisture permeation preventing member is disposed at a joint from which moisture has been removed by supplying energy, and the joint is protected from moisture of surrounding tissues by the moisture permeation prevention member, thereby maintaining the joining force at the joint. I am trying.
  • the present invention has been made in view of the above-described circumstances, and provides a living tissue bonding material and a living tissue bonding method capable of increasing the bonding force between living tissues in bonding of living tissues using energy. With the goal.
  • a first aspect of the present invention includes a porous body made of a biocompatible material, and the porous body opens to a surface hole formed on an outer surface and an inner surface of the surface hole. Is a biological tissue bonding material having pores having small pore diameters.
  • the biological tissue bonding material described above is disposed between two overlapping biological tissues, and the two biological tissues with the biological tissue bonding material disposed therebetween are stacked.
  • a biological tissue joining comprising: a pressurizing step for pressurizing in a direction; and an energy supplying step for joining the two living tissues by supplying energy to the two living tissues in a pressurized state by the pressurizing step Is the method.
  • the bonding force between living tissues can be increased in the bonding of living tissues using energy.
  • FIG. 2 is another scanning electron micrograph of the biological tissue bonding material of FIG.
  • FIG. 2 is another scanning electron micrograph of the biological tissue bonding material of FIG.
  • FIG. 2 shows the energy treatment tool used in the biological tissue joining method using the biological tissue joining material of FIG.
  • FIG. 2 shows the process of arrange
  • the biological tissue bonding material 1 includes a plate-like porous body 2 made of a biocompatible material, as shown in FIG.
  • the porous body 2 is formed from a biopolymer or a synthetic polymer.
  • the biopolymer collagen, gelatin, chitosan, cellulose, polysaccharides or derivatives thereof are preferably used.
  • the synthetic polymer polylactic acid, glycolic acid or polyethylene glycol is preferably used.
  • the porous body 2 may be formed of a bioabsorbable material that is decomposed and absorbed over time in the living body.
  • FIG. 1 shows a porous body 2 made of a collagen sponge as an example.
  • the porous body 2 has a large number of surface holes 3 opening on the outer surface and a smaller diameter than the surface holes 3, and a large number opening on the inner surface of the surface hole 3.
  • Pores 4. 2 and 3 are enlarged views of the surface of the porous body 2 made of collagen sponge.
  • the pore diameters of the surface hole 3 and the pore 4 are dimensions that cause capillary action on the liquid contained in the living tissue.
  • the inner diameter of a thin tube capable of sucking physiological saline by capillary action is 0.01 ⁇ m to several mm. Since the composition of the liquid contained in the living tissue approximates the composition of physiological saline, the pore diameters of the surface hole 3 and the pore 4 may be 0.01 ⁇ m to several mm.
  • the pore diameter of the surface hole 3 is several hundred ⁇ m, and the pore diameter of the pore 4 is preferably 0.01 ⁇ m to several ⁇ m.
  • the suction force of the liquid due to capillary action is inversely proportional to the hole diameter, and the smaller the hole diameter, the greater the suction force.
  • the pore diameter of the pore 4 is 0.01 ⁇ m to several ⁇ m, a strong suction force is exerted on the surface of the living tissue that has entered the surface hole 3, and the surface of the living tissue is made to be the inner surface of the surface hole 3.
  • the living tissue can enter the pores 4.
  • the specific surface area per unit weight of the porous body 2 is 0.1 m 2 / g or more and 500 m 2 / g or less.
  • the biological tissue bonding material 1 is used when bonding a biological tissue using the energy treatment tool 5.
  • the energy treatment device 5 includes an elongated cylindrical sheath 6, an openable and closable upper jaw 7 a and lower jaw 7 b provided at the distal end of the sheath 6, and the upper jaw 7 a and lower jaw. 7b and a flat plate 8 provided so as to be able to project and retract.
  • the living tissue H1 and the living tissue H2 are sandwiched between the upper jaw 7a and the lower jaw 7b, and the upper jaw 7a and the lower jaw 7b are closed so that the outer sides of the living tissues H1 and H2 are closed. Hold it.
  • the plate 8 on which the biological tissue bonding material 1 is placed is projected from between the upper jaw 7a and the lower jaw 7b, and the plate 8 is interposed between the biological tissue H1 and the biological tissue H2. Is inserted, the biological tissue bonding material 1 is disposed between the biological tissue H1 and the biological tissue H2, and the plate 8 is retracted into the sheath 6 (arrangement step).
  • the living tissues H1 and H2 which are overlapped via the living tissue bonding material 1 by holding the living tissues H1 and H2 with a stronger force by the upper jaw 7a and the lower jaw 7b. Are pressed in the stacking direction (pressurizing step).
  • the flexible biological tissues H1 and H2 pressed against the outer surface of the porous body 2 are deformed along the outer surface shape of the porous body 2 and enter the surface hole 3, and further from the surface hole 3. Enter the inside of the hole 4.
  • the state in which the biological tissues H1, H2 are pressurized by the upper jaw 7a and the lower jaw 7b until the entry of the biological tissues H1, H2 into the surface holes 3 and the pores 4 is stabilized for a predetermined time, preferably Is maintained for 0.1 to 30 seconds (maintenance step). Since the time for the living tissues H1 and H2 to enter the surface holes 3 and the pores 4 is ensured by the maintaining step, the anchor effect between the porous body 2 and the living tissues H1 and H2 is further enhanced, The joining force between the tissues H1 and H2 can be further increased.
  • vibration may be applied to the biological tissues H1, H2 in a pressurized state to promote the penetration of the biological tissues H1, H2 into the surface hole 3.
  • the vibration may be given by shaking the hand holding the sheath 6 or may be given by ultrasonically vibrating the jaws 7a and 7b. Since the penetration of the living tissues H1 and H2 into the surface holes 3 and the pores 4 is promoted by the vibration of the living tissues H1 and H2, the anchor effect between the porous body 2 and the living tissues H1 and H2 is further increased. This can increase the bonding force between the living tissues H1 and H2.
  • the jaws 7a, 7b supply the biological tissues H1, H2.
  • Supply of energy for example, high frequency, heat, or ultrasonic waves
  • the living tissues H1 and H2 when the temperature rises due to the supply of energy, the extracellular matrix contained in the living tissues H1 and H2 dissolves and exudes from the surface of the living tissues H1 and H2, and further energy is supplied.
  • the living tissues H1 and H2 are solidified by protein denaturation and moisture evaporation.
  • the biological tissues H1 and H2 are fixed to the porous body 2 using the extracellular matrix as an adhesive while maintaining the shape of the surface holes 3 and pores 4, and the biological tissues H1 and H2 are bonded to each other. Bonding is performed via the porous body 2.
  • the porous body 2 is in a state in which the concavo-convex shape of the surfaces of the biological tissues H1 and H2 meshes with the concavo-convex structure of the porous body 2 formed by the surface holes 3 and the pores 4. 2 and the living tissues H1 and H2 are fixed.
  • the anchor effect which is a mechanical coupling
  • the living tissues H1 and H2 can be strongly bonded to each other through the porous body 2, and a high bonding force sufficient for practical use can be exhibited even in the bonding of thick living tissues such as the large intestine and the small intestine. There is an advantage that can be.
  • the porous body 2 is formed from a biopolymer or a synthetic polymer.
  • the porous body 2 is formed from a biocompatible ceramic. May be.
  • FIG. 8 shows the surface of a porous body 2 made of apatite as an example of the porous body 2 made of ceramic.
  • FIG. 9 is an enlarged view of the inner surface of the surface hole 3 of FIG. Even when the porous body 2 made of ceramic is used, the same high bonding force as that of the porous body 2 made of biopolymer or synthetic polymer can be obtained by the anchor effect by the surface holes 3 and the pores 4. .
  • the biological tissue joining material 1 provided only with the porous body 2 was demonstrated, in addition to the porous body 2, the biological tissue joining material 1 is biocompatible which hardens
  • An adhesive for example, a liquid containing an extracellular matrix such as collagen or elastin may be included.
  • the surface hole 3 may be formed penetrating in the thickness direction of the plate-like porous body 2.
  • the pores 4 are formed in a direction crossing the longitudinal direction of the surface holes 3 as shown in FIG.
  • the biological tissue H1 that has entered the surface hole 3 from one side of the porous body 2 and the biological tissue H2 that has entered the surface hole 3 from the other side are formed inside the porous body 2.
  • the porous body 2 is disposed closer to the thickness direction.
  • the porous body 2 is formed of a biopolymer or a synthetic polymer, the porous body 2 is dissolved or softened by supplying energy and is compressed and deformed according to the pressure from the jaws 7a and 7b.
  • the distance between the living tissue H1 and the living tissue H2 is further reduced.
  • the living tissue H1 and the living tissue H2 are partially bonded directly via an extracellular matrix or an adhesive, and the bonding force between the living tissues H1 and H2 Can be further enhanced.
  • the porous body 2 is plate-shaped, but instead, it may be granular as shown in FIG.
  • FIG. 11 shows a porous bead made of apatite as an example of the granular porous body 2.
  • the same high bonding force as that of the plate-like porous body 2 can be obtained due to the anchor effect by the surface holes and pores.
  • the biological tissue bonding material including the granular porous body 2 is used, for example, in the energy treatment device 5 in which a plurality of discharge ports 9 are formed on both upper and lower surfaces of the plate 8 as shown in FIG.
  • the plurality of discharge ports 9 are connected to a bonding material supply unit (not shown) such as a syringe through passages (not shown) formed inside the plate 8 and the sheath 6.
  • the biological tissue bonding material is supplied into the passage from the bonding material supply unit, and is disposed between the biological tissues H1 and H2 by being discharged from the discharge port 9 of the plate 8 inserted between the biological tissues.
  • the granular porous body 2 may be dispersed in the adhesive described above. By doing in this way, high fluidity

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Transplantation (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Medicinal Chemistry (AREA)
  • Physics & Mathematics (AREA)
  • Dermatology (AREA)
  • Plasma & Fusion (AREA)
  • Epidemiology (AREA)
  • Otolaryngology (AREA)
  • Chemical & Material Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Materials For Medical Uses (AREA)

Abstract

L'invention concerne un matériau de liaison pour un tissu biologique (1), qui est pourvu d'un corps poreux (2) comprenant un matériau biocompatible. Le corps poreux (2) comprend des trous de surface (3) qui sont formés dans sa surface externe, et des pores (4) qui s'ouvrent sur la surface interne des trous de surface (3) et qui ont un diamètre de trou plus petit que celui des trous de surface (3).
PCT/JP2014/079593 2014-11-07 2014-11-07 Matériau de liaison pour tissu biologique et procédé de liaison pour tissu biologique Ceased WO2016072017A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2014/079593 WO2016072017A1 (fr) 2014-11-07 2014-11-07 Matériau de liaison pour tissu biologique et procédé de liaison pour tissu biologique

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2014/079593 WO2016072017A1 (fr) 2014-11-07 2014-11-07 Matériau de liaison pour tissu biologique et procédé de liaison pour tissu biologique

Publications (1)

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WO2016072017A1 true WO2016072017A1 (fr) 2016-05-12

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019188657A1 (fr) * 2018-03-28 2019-10-03 テルモ株式会社 Dispositif médical

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2001523483A (ja) * 1997-11-14 2001-11-27 ボーンテック コーポレーション 生分解性ポリマースカフォード
JP2009160302A (ja) * 2008-01-09 2009-07-23 National Institute For Materials Science 複合多孔質足場材
JP2010115412A (ja) * 2008-11-14 2010-05-27 Kobe Univ 組織再生用の材料
JP5123435B2 (ja) * 2009-08-11 2013-01-23 オリンパスメディカルシステムズ株式会社 治療用処置具、治療用処置装置および治療処置方法

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2001523483A (ja) * 1997-11-14 2001-11-27 ボーンテック コーポレーション 生分解性ポリマースカフォード
JP2009160302A (ja) * 2008-01-09 2009-07-23 National Institute For Materials Science 複合多孔質足場材
JP2010115412A (ja) * 2008-11-14 2010-05-27 Kobe Univ 組織再生用の材料
JP5123435B2 (ja) * 2009-08-11 2013-01-23 オリンパスメディカルシステムズ株式会社 治療用処置具、治療用処置装置および治療処置方法

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019188657A1 (fr) * 2018-03-28 2019-10-03 テルモ株式会社 Dispositif médical

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