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WO2018037953A1 - Aiguille de suture médicale - Google Patents

Aiguille de suture médicale Download PDF

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Publication number
WO2018037953A1
WO2018037953A1 PCT/JP2017/029249 JP2017029249W WO2018037953A1 WO 2018037953 A1 WO2018037953 A1 WO 2018037953A1 JP 2017029249 W JP2017029249 W JP 2017029249W WO 2018037953 A1 WO2018037953 A1 WO 2018037953A1
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WO
WIPO (PCT)
Prior art keywords
needle
passage
thread
needle mechanism
distal
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/JP2017/029249
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English (en)
Japanese (ja)
Inventor
祥平 鈴木
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Kaneka Corp
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Kaneka Corp
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Filing date
Publication date
Application filed by Kaneka Corp filed Critical Kaneka Corp
Priority to JP2018535607A priority Critical patent/JP6885959B2/ja
Publication of WO2018037953A1 publication Critical patent/WO2018037953A1/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
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods 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

Definitions

  • the present invention relates to a medical suturing needle used in a medical bi-directional suturing apparatus capable of suturing an object with a thread in both directions from the proximal side to the distal side and from the distal side to the proximal side.
  • transsphenoid sinus pituitary tumor excision (TSS; Trans-Sphenoidal Surgery) is often performed.
  • TSS is generally performed in the following procedure. First, the surgeon advances along the patient's nasal septum while peeling the nasal mucosa, and opens the sphenoid bone and opens the dura mater to reach the pituitary gland. Next, the pituitary tumor is removed. Finally, the dura is sutured to rebuild the sphenoid bone and nasal mucosa.
  • dura stitching is performed by passing a thread through each side of the incised dura mater, closing the dura while pulling both ends of the thread, and then fixing and making knots (knots). It was.
  • the method for passing the suture through the dura mater is as follows. First, after passing a suture needle with a suture through one dura mater from the proximal side to the distal side of the dura mater, that is, from the nasal cavity side to the pituitary side, A suture needle with a suture is passed from the distal side to the proximal side, that is, from the pituitary side to the nasal cavity side. At this time, the suture enters the pituitary side from the nasal cavity side and comes out again to the nasal cavity side.
  • the dural suture with TSS is performed manually by the surgeon holding a curved suture needle having a diameter of about 3 mm to 10 mm with a needle holder having a forceps-like tip. .
  • the distance from the operator's hand to the actual suture site is a tens of centimeters away, and the size of the incision is very small because it is about 20 mm at most. Therefore, the surgeon must perform a suturing operation under a microscope or an endoscopic image, and there is a problem that the operation takes a long time. For this reason, a suturing device that can pass sutures in two directions from the distal side to the proximal side of the dura mater and from the proximal side to the distal side has been proposed.
  • Patent Document 1 and corresponding Patent Document 2 when a needle having a cutout for capturing a suture is moved on the side surface and the cutout and the groove of the boom arm housing are aligned, the cutout is captured by the cutout.
  • a threading device is described in which a living tissue can be sutured in both directions by moving the suture thread in the groove of the boom arm housing.
  • Patent Document 5 and corresponding Patent Document 6 describe a suturing tool that can tie a suture thread to a sharp needle at both ends and suture the tissue by reciprocating the needle.
  • Patent Document 7 describes a suturing tool that can sew a tissue by binding a suture to a ferrule and reciprocating the ferrule.
  • Patent Document 8 describes an endoscopic suture machine in which a looper grips a thread loop formed by a needle, and a looper shaft carrying the looper is rotatably arranged in a case.
  • U.S. Patent No. 6,057,051 describes a suturing device in which a suture clasp arm is pivotally connected to a distal mount and the arm pivots about the distal or proximal end of the arm. .
  • the suturing object is fed by hand while the looper is rotated along a multidimensional motion trajectory in order to reciprocate the annulus formed by the needle. Need to do.
  • the purpose is to overlap two biological tissues and stitch the edges, dura stitching in TSS cannot be performed.
  • the suturing device described in Patent Document 9 needs to grasp a tissue part that is a suture target with a suture clasp arm when suturing, and may possibly damage the tissue part. Since the suture cannot be performed unless the two biological tissues are in a position where they can be grasped by the clasp arm, it is necessary to arrange the biological tissues at appropriate positions before the suture.
  • an object of the present invention is to provide a medical suturing needle that can perform a suturing operation easily and that operates safely and minimally invasively to the human body.
  • the medical suturing needle of the present invention that has solved the above-mentioned problems is a medical suturing needle that has a needle mechanism that extends in the perspective direction and has a distal end on the distal side, and the needle mechanism passes through the thread-like object. It has a gist in that it has a passage, an entrance / exit part provided on one side of the passage, and a terminal part provided on the other side of the passage.
  • the needle mechanism preferably has a capturing part that narrows the passage or the entrance / exit part.
  • the needle mechanism has a hollow member and an insertion member that can be moved forward and backward in the axial direction with respect to the hollow member, and a passage, an inlet / outlet portion, and a terminal portion are provided in the hollow member.
  • the inlet / outlet portion is at the distal end of the hollow member and the capture portion is at the proximal end of the passage.
  • the needle mechanism is provided on the inner side of the hollow member having an inclined portion at the distal end, and at least one of a rotational operation around the axis of the hollow member and a movement operation in the axial direction of the hollow member It is preferable to have an insertion member capable of one of the operations, and the entrance / exit part is provided on the proximal side of the inclined part.
  • the capturing part is constituted by a hollow member and an insertion member.
  • the needle mechanism has a hollow shape, and has a needle member in which an inlet / outlet portion is provided at a distal end of the needle member, and an inner cylinder that is provided in the needle member and rotates with respect to the needle member.
  • the inner cylinder member has an opening extending to its distal end.
  • the catch may be a projection that projects inward in the radial direction of the needle mechanism.
  • the needle mechanism is preferably provided with a terminal end proximal to the entrance / exit part.
  • the passage penetrates in a direction perpendicular to the axial direction of the needle mechanism.
  • the passage extends along the axial direction of the needle mechanism.
  • the medical suturing needle of the present invention can form the folded portion of the thread-like object on the distal side of the suture object by a simple operation of passing the thread-like object through the passage of the needle mechanism. It is possible to easily hold the filamentous material on the side. Further, it is safe because there is no need to change the holding position of the needle or to move the needle while keeping the members in close contact with each other as in a conventional suturing apparatus. Furthermore, since it is not necessary to directly grasp the suture object, it is minimally invasive to the human body.
  • the side view of the medical bidirectional suturing device which concerns on this invention is represented.
  • the side view of the medical bidirectional suturing device which concerns on this invention is represented.
  • the side view which expanded the distal side of the medical bidirectional suturing device which concerns on this invention is represented.
  • the side view of the needle mechanism which concerns on Embodiment 1 is represented.
  • the perspective view which expanded the distal side of the needle mechanism shown in FIG. 4 is represented.
  • the side view to which the distal side of the needle mechanism shown in FIG. 4 was expanded is represented.
  • the front view which looked at the needle mechanism shown in FIG. 4 from the distal side is represented.
  • the side view of the inner cylinder member which concerns on Embodiment 1 is represented.
  • the perspective view in the distal side of the needle mechanism which concerns on Embodiment 1 is represented.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 1 is expressed.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 1 is expressed.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 1 is expressed.
  • the side view which expanded the distal side of the needle mechanism which concerns on Embodiment 2 is represented.
  • the side view which expanded the distal side which shows the modification of the needle mechanism shown in FIG. 14 is represented.
  • the side view which expanded the distal side of the needle mechanism which concerns on Embodiment 3 is represented.
  • the perspective view which expanded the distal side of the needle mechanism which concerns on Embodiment 4 is represented.
  • the side view which expanded the distal side of the needle mechanism shown in FIG. 17 is represented.
  • the perspective view which expanded the distal side of the needle mechanism which concerns on Embodiment 5 is represented.
  • the front view which looked at the needle mechanism shown in FIG. 19 from the distal side is represented.
  • the side view which looked at the needle mechanism shown in Drawing 19 from the 1st side is expressed.
  • the side view which looked at the needle mechanism shown in Drawing 19 from the 2nd side is expressed.
  • the side view which expanded the distal side of the hollow member which concerns on Embodiment 6 is represented.
  • the perspective view which expanded the distal side of the hollow member shown in FIG. 23 is represented.
  • the side view which expanded the distal side of the insertion member which concerns on Embodiment 6 is represented.
  • the perspective view which expanded the distal side of the insertion member shown in FIG. 25 is represented.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 6 is expressed.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 6 is expressed.
  • the side view which expanded the distal side of the hollow member which concerns on Embodiment 7 is represented.
  • the perspective view which expanded the distal side of the hollow member shown in FIG. 29 is represented.
  • the side view which expanded the distal side of the insertion member which concerns on Embodiment 7 is represented.
  • the perspective view which expanded the distal side of the insertion member shown in FIG. 31 is represented.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 7 is expressed.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 7 is expressed.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 7 is expressed.
  • the side view which expanded the distal side of the hollow member which concerns on Embodiment 8 is represented.
  • the perspective view which expanded the distal side of the hollow member shown in FIG. 36 is represented.
  • the side view which expanded the distal side of the insertion member which concerns on Embodiment 8 is represented.
  • FIG. 38 The perspective view which expanded the distal side of the insertion member shown in FIG. 38 is represented.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 8 is expressed.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 8 is expressed.
  • the side view which expanded the distal side of the hollow member which concerns on Embodiment 9 is represented.
  • FIG. 43 is an enlarged perspective view of the distal side of the hollow member shown in FIG. 42.
  • the perspective view which expanded the distal side of the insertion member which concerns on Embodiment 9 is represented.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 9 is expressed.
  • the side view (partial sectional view) which expanded the distal side of the needle mechanism concerning Embodiment 9 is expressed.
  • the medical suturing needle is, for example, viewed from the one side to the other side and from the other side to the one side in both directions under a visual inspection, a microscope, and an endoscopic image. It is used as a suture needle of a medical bi-directional suture device that can pass a thread. In the present specification, it may be simply referred to as a “suture needle”.
  • the thread-like material is a suture used for medical purposes, and may be a single yarn or a knitting yarn.
  • the outer diameter can be appropriately selected as long as it is a diameter used for a general suture.
  • the filamentous material may be formed of a degradable material.
  • the length of the filamentous material is desirably long enough not to interfere with the operation, and is preferably 20 cm or more and 200 cm or less.
  • TSS a length that allows a suture to reciprocate from the outside of the body to the dura mater, plus a length sufficient for a doctor to make a knot in the suture outside the patient's body is preferred, and is preferred in TSS.
  • the length of the filamentous material is 70 cm or more and 150 cm or less.
  • FIGS. 1 and 2 are a side view and a side view showing the interior of the suturing device D according to the present invention, respectively, and FIG. 3 shows an enlarged side view of the distal side.
  • the suturing device D has a perspective direction.
  • the proximal side of the device D refers to the direction of the user's hand side
  • the distal side refers to the opposite direction of the proximal side (that is, the direction of the treatment target side).
  • the upper side of the device D refers to the upper side of FIG.
  • the suture needle 1 of the present invention has a needle mechanism 2 that extends in the perspective direction and has a distal end on the distal side.
  • a puncture portion 11 for puncturing a suture object is preferably provided on the distal side of the needle mechanism 2.
  • a thread holding member 30 is provided on the distal side of the suturing device D.
  • the thread-like material holding member 30 is for holding the thread-like material on the distal side of the suturing device D.
  • the suture needle 1 (needle mechanism 2) and the thread-like material holding member 30 are held by a housing 50 formed in a hollow shape.
  • FIG. 1 to 3 show examples in which the needle mechanism 2 has a hollow needle member 10, the invention is not limited to this embodiment.
  • a handle portion 53 that a user holds with a hand may be provided on the proximal side of the housing 50.
  • the device D is provided with an operation portion on the proximal side.
  • the 1st operation part 61 and the 3rd operation part 63 for operating the suture needle 1 and the filamentous material holding member 30, respectively are provided.
  • the suture object 100 is positioned between the suture needle 1 and the filamentous material holding member 30 with the suture needle 1 moved proximally as shown in FIG.
  • the suture needle 1 with the thread 70 is moved in the perspective direction to penetrate the suture object 100, and the thread 70 is held by the thread holding member 30 as appropriate. Do. As a result, the suture object 100 can be sutured from the proximal side to the distal side, or from the distal side to the proximal side.
  • the needle mechanism is a mechanism used to pass a thread-like material through a living tissue such as a dura mater, which is an object to be sutured.
  • the needle mechanism may be composed of one member or may be composed by combining a plurality of members.
  • the needle mechanism according to the present invention has a passage through which the filamentous material passes, an entrance / exit portion provided on one side of the passage, and a terminal portion provided on the other side of the passage. For this reason, by inserting the midway part of the thread-like material into the passage from the entrance / exit part of the needle mechanism and hooking it on the passage or the terminal part, the thread-like substance can be retained in the passage while being folded back in the axial direction of the needle mechanism. .
  • the needle mechanism and the filamentous material are moved more distally than the suture object while the middle part of the filamentous material remains in the passage, by moving only the needle mechanism proximally,
  • the folded portion of the thread-like material can be arranged on the distal side of the suture object.
  • the filamentous material can be easily held on the distal side of the suture target.
  • the suture needle of the present invention can form the folded portion of the thread-like material on the distal side of the suture object by a simple operation of passing the thread-like object through the passage of the needle mechanism, and on the distal side of the suture object. It is possible to easily hold the filamentous material. Further, it is safe because there is no need to change the holding position of the needle or to move the needle while keeping the members in close contact with each other as in a conventional suturing apparatus. Furthermore, since it is not necessary to directly grasp the suture object, it is minimally invasive to the human body.
  • the range of motion of the device is limited.
  • the tip of the needle mechanism is provided on the distal side so that the suturing position can be confirmed.
  • a puncture portion is preferably provided on the distal side of the needle mechanism, and is preferably provided on the distal end portion of the needle mechanism. The puncture portion only needs to be formed so as to have one or a plurality of sharp tips pointed toward the distal side, for example, even if formed so that the cross-sectional area decreases toward the distal side.
  • the puncture portion may have a constant outer diameter.
  • the needle mechanism may be provided with one distal end portion or a plurality of distal end portions. When the needle mechanism is composed of a plurality of members, the puncture part may be provided only on one member, or the puncture part may be provided on the plurality of members.
  • the needle mechanism is preferably arranged so as to be movable in the perspective direction of the device. By moving the needle mechanism from the proximal side to the distal side, the needle mechanism can be pierced into an object to be sutured disposed further to the distal side than the needle mechanism. By moving the needle mechanism that punctures the suture object to the proximal side, the needle mechanism can be removed from the suture object.
  • the needle mechanism extends in the perspective direction, and at least the distal end portion thereof preferably extends in the perspective direction, and more preferably extends in the perspective direction as a whole.
  • the length of the needle mechanism can be set to about 2 cm to 30 cm, which is the distance from the nasal cavity to the pituitary gland, for example, when used for TSS.
  • the needle mechanism may be linear or curved, and may have a combination thereof or a bent portion. Further, the member constituting the needle mechanism may be hollow or solid.
  • the outer diameter of the needle mechanism is not particularly limited as long as it is a diameter used for a general suture needle, but is preferably 0.05 mm or more and 1.5 mm or less, for example.
  • the thickness of the needle member is preferably 0.01 mm or more and 0.5 mm or less, for example.
  • the material of the needle mechanism is preferably biocompatible and strong enough to puncture an object such as a biological tissue, for example, a metal material such as stainless steel or a resin material is preferable. Stainless steel is preferable from the viewpoint of ease.
  • the needle mechanism may be connected to a first operation unit 61 provided on the operator's hand side, for example, the first operation unit 61 via a needle support member 65 connected to the proximal side of the needle mechanism. It may be connected to. Moreover, you may be connected to the 1st operation part 61 through one or more other members.
  • the passage is a portion that appears when viewed from the side of the needle mechanism, and is a portion through which the thread-like material passes. Therefore, for example, a lumen that does not appear on the side surface of the hollow needle mechanism is not defined as a passage in the present invention.
  • the shape of the passage may be, for example, linear, curved, or a combination thereof.
  • the entrance / exit part is a part that functions as an entrance / exit for passing the filamentous material through the passage of the needle mechanism.
  • the entrance / exit part is provided on one side of the passage.
  • the entrance / exit part is preferably the distal end of the needle mechanism (more preferably It is preferably provided at the distal end.
  • the terminal portion is a portion provided on the other side of the passage. For example, when the needle mechanism is moved to the distal side or the proximal side, the thread-like material can be retained in the passage.
  • the size of the passage may be constant, and a wide part or a narrow part may be provided.
  • the length of the passage can be set in a range of 0.1 mm to 100 mm, for example.
  • the size of the passage may be formed so as to increase toward the distal side in the needle mechanism.
  • the size of the passage means the maximum diameter in a cross section perpendicular to the extending direction of the passage, and the length of the passage means a length in the extending direction of the passage.
  • the size of the entrance / exit part and the passage is not particularly limited as long as it has a size that allows the thread-like material to pass therethrough.
  • the entrance / exit part of the needle mechanism In order to prevent excessive deformation and cutting of the thread-like object, the entrance / exit part of the needle mechanism And the size of the passage is preferably larger than the outer diameter of the filamentous material.
  • the size of the entrance / exit portion means the maximum diameter in a cross section perpendicular to the extending direction of the passage.
  • size of an entrance / exit part is not specifically limited, It may be larger than the length of a channel
  • the needle mechanism preferably has a capturing part that narrows at least one of the entrance / exit part, the passage, and the terminal part. More preferably, the needle mechanism has a capture portion that narrows the passage or the entrance / exit portion. Since it becomes easy to hold the thread-like material by the capturing portion, it is possible to suppress the thread-like material from being detached from the needle mechanism during the movement of the needle mechanism.
  • FIG. 1 shows a side view of the needle mechanism 2A
  • FIG. 5 shows an enlarged perspective view of the distal side of the needle mechanism 2A shown in FIG. 4
  • FIG. 6 shows a distant view of the needle mechanism 2A shown in FIG.
  • FIG. 7 shows a front view of the needle mechanism 2A shown in FIG. 4 as viewed from the distal side.
  • the passage 13 is formed in the needle member 10A. It is preferable that the passage 13 extends along the axial direction of the needle mechanism 2A.
  • the passage 13 of the needle member 10 shown in FIGS. 4 to 7 extends along the axial direction of the needle member 10. For this reason, by moving the needle member 10 in the axial direction, the filamentous material 70 located in the passage 13 can be moved in the perspective direction of the needle member 70.
  • the passage 13 preferably passes through the axis C of the needle member 10. Thereby, the filamentous material 70 is stably hold
  • the needle member 10 When the needle member 10 is hollow, a plurality of distal end portions are preferably provided, and in particular, two are preferably provided. In this case, it is more preferable that the distal end portion has a shape that is tapered toward the distal side (so-called twin peak shape). As shown in FIGS. 4 to 6, the outer diameter of the needle member 10 may be constant. In that case, in order to facilitate the insertion of the filament 70 into the passage 13, it is preferable that the size of the passage 13 increases toward the distal side.
  • the passage 13 penetrates in a direction perpendicular to the axial direction of the needle mechanism 2A. As shown in FIGS. 5 to 7, it is more preferable that the passage 13 penetrates in a direction perpendicular to the axial direction of the needle member 10. More preferably, the passage 13 penetrates in a direction perpendicular to the axial direction of the needle member 10 when viewed from the distal side of the needle member 10. Thereby, since the folding
  • a passage 13 is formed in the needle member 10, and an opening is provided on the side surface of the needle member 10.
  • the passage 13 is formed so that there are two distal ends of the needle member 10 and two openings are provided on the side surface of the needle member 10, one opening and the other in the circumferential direction of the needle member 10 are provided. It is preferable that the openings face each other across the axis C of the needle member 10.
  • the opening provided on the side surface of the needle member 10 may be arranged rotationally symmetrically with the major axis direction of the needle member 10 as the central axis.
  • the needle mechanism 2 ⁇ / b> A may be provided with a terminal portion 14 on the proximal side of the entrance / exit portion 12.
  • the needle member 10 may be provided with a terminal portion 14 on the proximal side of the entrance / exit portion 12.
  • the needle mechanism 2A preferably includes the needle member 10A and the inner cylinder member 20 provided inside the needle member.
  • FIG. 8 and 9 show a side view and an enlarged perspective view of the inner cylinder member 20 according to the present invention, respectively, and FIG. 10 shows a perspective view of the distal side of the needle mechanism 2A according to the present invention.
  • 11 to 13 are side views (partially sectional views) of the needle mechanism 2A according to the present invention.
  • the needle mechanism 2 ⁇ / b> A is hollow, the entrance / exit part 12 has a needle member 10 provided at the distal end, and the capturing part 15 is provided inside the needle member 10.
  • the inner cylinder member 20 that rotates with respect to the member 10 is preferable.
  • the inlet / outlet portion 12 or the passage 13 of the needle member 10 is covered with the inner cylinder member 20 and becomes narrower.
  • the thread-like material 70 can be held in the narrow entrance / exit part 12 or the passage 13.
  • the outer diameter of the inner cylinder member 20 only needs to be smaller than the inner diameter of the needle member 10, and can be set to 0.02 mm or more and 1.5 mm or less, for example.
  • the thickness of the inner cylinder member 20 can be set to 0.01 mm or more and 0.5 mm or less, for example.
  • the material of the inner cylinder member 20 is preferably a metal material such as stainless steel or a resin material, and particularly preferably stainless steel from the viewpoint of anti-rust properties and ease of processing.
  • the inner cylinder member 20 preferably has an opening 21 extending to the distal end.
  • an opening 21 is provided on the side portion (outer peripheral surface) of the inner cylinder member 20. Thereby, the thread 70 can be hung on the opening 21 from the distal end of the inner cylinder member 20.
  • the shape and size of the region where the inlet / outlet portion 12 or the passage 13 of the needle member 10 overlaps the opening 21 provided on the side portion of the inner cylinder member 20 is changed.
  • 12, and 13 show states in which the inner cylinder member 20 is rotated by 0 degrees, 40 degrees, and 70 degrees with respect to the needle member 10.
  • the inlet / outlet part 12 or the passage 13 of the needle member 10 and the opening 21 of the inner cylinder member 20 overlap each other.
  • the filament 70 can be guided into the passage 13 from the distal side of the region where the entrance / exit portion 12 or the passage 13 and the opening 21 of the inner cylinder member 20 overlap.
  • the release of the holding of the filament 70 may be performed by reducing the rotation angle by rotating the inner cylinder member 20 in the reverse direction with respect to the needle member 10.
  • the rotation angle is limited to this.
  • the angle may be any angle as long as it is larger than 0 degree and smaller than 180 degrees, and more preferably 30 degrees or more and 90 degrees or less.
  • the inner cylinder member 20 preferably has an opening 21 as shown in FIG. . That is, the opening 21 of the inner cylinder member 20 has a distal region 21A and a proximal region 21B that is connected to the distal region 21A and is more proximal than the distal region 21A.
  • the width of the distal region 21A in the circumferential direction is preferably smaller than the width of the proximal region 21B.
  • the shape of the opening 21 of the inner cylinder member 20 is not particularly limited as long as the thread-like object 70 can be inserted.
  • a polygonal shape such as a triangle or a quadrangle, a circular shape, an elliptical shape, or a combination thereofcan be.
  • the opening 21 has a shape in which a rectangular distal region 21A and a rectangular proximal region 21B are combined.
  • the shape of the opening 21 of the inner cylinder member 20 is preferably a combination of the rectangular distal region 21A and the rectangular proximal region 21B shown in FIG. 9 from the viewpoint of preventing the thread 70 from falling off. . Further, from the viewpoint of ease of processing, it is preferable that the shape is one rectangular shape.
  • the number of openings 21 in the inner cylinder member 20 is preferably 1 or more, and more preferably 2 or more.
  • the number of openings 21 in the inner cylinder member 20 is preferably the same as the number of openings in the needle member 10.
  • the number of the openings 21 of the inner cylinder member 20 may be two in order to provide a region where the opening of the needle member 10 and the opening 21 of the inner cylinder member 20 overlap. preferable.
  • the minimum diameter of the opening 21 of the inner cylinder member 20 is preferably larger than the outer diameter of the thread 70.
  • a fixing portion may be provided on the inner cylinder member 20.
  • a convex portion may be provided on the outer side of the inner cylinder member 20, and a groove that engages with the convex portion of the inner cylinder member 20 may be provided on the inner side of the needle member 10.
  • Embodiment 2 The needle mechanism 2 (2B) according to Embodiment 2 will be described with reference to FIG. 14 shows a side view of the needle mechanism 2B, and FIG. 15 shows a side view showing a modification of the needle mechanism 2B shown in FIG.
  • the needle mechanism 2B is formed in a solid shape and has a needle member 10 (10B) provided with one distal end.
  • An entrance / exit part 12, a passage 13 and a terminal part 14 are provided in the needle member 10.
  • the entrance / exit part 12 shown in FIG. 14 is provided more proximally than the distal end of the needle member 10. In this case, it is preferable that the entrance / exit part 12 is provided in the side part of the needle member 10.
  • the needle member 10 shown in FIG. 14 is provided with one distal end.
  • the passage 13 extends along the radial direction of the needle member 10.
  • the protrusion 16 protrudes toward the proximal side of the needle member 10, but may protrude toward the distal side of the needle member 10.
  • the protrusion 16 preferably protrudes in a direction perpendicular to the extending direction of the passage 13. Since the thread-like object 70 is held at the portion where the protrusion 16 is formed, the thread-like object 70 is prevented from falling off.
  • the protrusion 16 preferably has a size of 1/5 or more of the size of the passage 13, more preferably 1/4 or more, and still more preferably 1/3 or more.
  • the shape of the protrusion 16 can be formed in, for example, a polygonal column shape, a cone shape such as a cone shape or a pyramid shape, a truncated cone shape such as a truncated cone shape or a truncated pyramid shape, a hemispherical shape, or a semi-elliptical spherical shape.
  • the protrusion 16 may be formed in a rounded shape such as a truncated cone shape, a hemispherical shape, a semi-elliptical sphere shape, etc., in order to prevent the threaded material 70 from being damaged by coming into contact with the threaded material 70. preferable.
  • a narrow portion 17 in which the passage 13 is narrowed instead of the protrusion 16 is provided as the capturing portion 15.
  • the narrow portion 17 is provided on the end portion 14 side and the end portion 14 of the passage 13, but the narrow portion 17 is provided on at least one of the entrance / exit portion 12, the passage 13, and the end portion 14. It only has to be done.
  • the narrow portion 17 is formed in a staircase shape in FIG. 15, and the size of the passage 13 is abruptly reduced.
  • the narrow portion 17 is not limited to this, and a taper shape that gradually decreases may be adopted. .
  • the size of the passage 13 in the narrow portion 17 is preferably smaller than the outer diameter of the filament 70. Thereby, it becomes possible to hold the thread-like material 70 firmly with the narrow portion 17, and to prevent the thread-like material 70 from dropping out of the passage 13.
  • the needle member 10 alone can be used as a thread 70 without combining other members. Can be held and released.
  • FIG. 16 shows a side view of the needle mechanism 2C.
  • the needle mechanism 2C is formed in a solid shape and has a needle member 10 (10C) provided with two distal end portions.
  • the entrance / exit part 12 is provided at the distal end of the needle member 10.
  • the passage 13 extends along the axial direction of the needle member 10. Compared to the second embodiment, since the path of the passage 13 can be made longer, the filament 70 is less likely to fall out of the passage 13.
  • the needle member 10 has a distal end portion (puncture portion 11) with an outer diameter that decreases toward the distal end.
  • the passage 13 is formed so as to pass through the axis C of the needle member 10, and the needle member 10 has two distal ends.
  • the capturing part 15 is a protrusion 16 (16 ⁇ / b> A, 16 ⁇ / b> B) that protrudes inward in the radial direction of the passage 13 of the needle member 10.
  • the protrusion 16A provided on the entrance / exit portion 12 side protrudes toward the lower side of the device D
  • the protrusion 16B provided on the terminal end portion 14 side protrudes toward the upper side of the device D.
  • the protrusions 16 are formed in opposite directions. Thereby, the filamentous material 70 can be firmly held.
  • at least one protrusion 16 may be provided in each of the entrance / exit portion 12 and the passage 13.
  • a narrow portion may be provided instead of the protrusion.
  • the needle mechanism 2 (2D) according to the fourth embodiment will be described with reference to FIGS. 17 shows an enlarged perspective view of the distal side of the needle mechanism 2D, and FIG. 18 shows a side view of the needle mechanism 2D shown in FIG.
  • the needle mechanism 2D has a needle member 10 (10D) in which a plurality of passages 13 having shapes extending in different directions are formed.
  • the passage 13 is a combination of a section 13A extending along the axial direction of the needle member 10 and a section 13B extending along a direction perpendicular to the axial direction of the needle member 10. By connecting the section 13B to the proximal end of the section 13A, the sections 13A and 13B are in communication.
  • the entrance / exit part 12 is provided on one side of the section 13B, and the other side of the section 13B is connected to one side of the section 13A.
  • a terminating portion 14 is provided on the other side of the section 13A.
  • the thread 70 By moving the thread 70 from the section 13B of the passage 13 of the needle member 10 to the section 13A, the thread 70 can be held. Further, by moving the thread 70 from the section 13A of the passage 13 of the needle member 10 to the section 13B, the holding of the thread 70 can be released.
  • the thread 70 When moving the needle member 10 hung on the thread 70 to the distal side, the thread 70 can be hooked on the connecting portion of the section 13A and the section 13B. On the other hand, when the needle member 10 is moved to the proximal side, the thread 70 can be hooked on the distal end portion (that is, the end portion 14) of the section 13A.
  • one section 13A and one section 13B are provided, but one or more sections 13A and 13B may be provided.
  • the section 13B was connected to the proximal end of the section 13A, the section 13B may be connected to the distal end of the section 13A.
  • a protrusion or a narrow portion may be provided.
  • the section 13B in which the entrance / exit portion 12 is provided has a risk that the thread-like material 70 may drop out as compared with the section 13A in which the end portion 14 is provided, and thus the protrusion and the narrow portion are provided in the section 13B. It is preferable.
  • the capturing part 15 may be provided in a section where the terminal part 14 is provided.
  • FIGS. 19 represents an enlarged perspective view of the distal side of the needle mechanism 2E according to the present invention
  • FIG. 20 represents a front view of the needle mechanism 2E shown in FIG. 19 viewed from the distal side
  • FIG. FIG. 22 shows side views of the needle mechanism 2E shown in FIG. 19 as viewed from the first side surface and the second side surface.
  • the needle mechanism 2 (2E) is solid and has a needle member 10 (10E) provided with four distal ends.
  • the distal end portion of the needle member 10 has a larger passage toward the distal side.
  • the passage 13 for fastening the thread 70 has four openings 18 as seen from the side.
  • FIG. 5 The needle mechanism 2 (2E) according to the fifth embodiment will be described with reference to FIGS. 19 represents an enlarged perspective view of the distal side of the needle mechanism 2E according to the present invention
  • FIG. 20 represents a front view of the needle mechanism 2E shown in FIG. 19 viewed from the distal side
  • FIG. FIG. 22 shows side views of the needle mechanism
  • the passage 13 of the needle member 10 when viewed from the first side surface, has a certain size on the proximal side of the puncture portion 11.
  • the passage 13 of the needle member 10 when viewed from the second side surface, there is a narrow portion 17 in which the passage 13 is narrow.
  • first side surface and the second side surface are at positions different by 90 degrees when viewed from a direction perpendicular to the axial direction of the needle member 10.
  • the shapes of the openings 18 adjacent to each other in the circumferential direction are different.
  • the shapes of the openings 18 facing each other across the axis C of the needle member 10 are the same.
  • the minimum width of the opening 18A viewed from the first side surface is larger than the minimum width of the opening 18B viewed from the second side surface.
  • the holding strength of the thread 70 can be changed. For example, in the case of suture from the proximal side to the distal side where the thread 70 is difficult to drop from the needle member 10, the thread 70 is hung on the opening 18A visible from the first side surface, and the thread 70 drops from the needle member 10.
  • the strength of holding the filament 70 can be changed in accordance with the stitching direction by using the opening 18B viewed from the second side surface. That is, as shown in FIG. 20, it is preferable that the passage 13 is formed in a cross shape when the needle member 10 is viewed from the distal side.
  • the needle member 10 shown in FIG. 21 can be advanced distally while holding the thread 70 in the opening 18A by hooking the thread 70 on the opening 18A viewed from the first side face.
  • the needle member 10 When the needle member 10 is retracted proximally, the holding of the thread 70 is released.
  • the needle member 10 may be rotated by a predetermined angle about the major axis direction as the central axis before the needle member 10 is advanced.
  • the needle member 10 shown in FIG. 22 can be retracted by holding the thread 70 in the opening 18B by hooking the thread 70 on the proximal opening 18B as viewed from the second side.
  • the filament 70 can be held by contacting the distal end of the proximal opening 18B as viewed from the second side surface. At this time, if the narrow portion 17 is provided in the opening 18 ⁇ / b> B viewed from the second side surface, the thread-like material 70 can be firmly held. Therefore, even if the needle member 10 is retracted, the opening of the needle member 10. It becomes difficult for the thread-like material 70 to come off from 18. Release of the holding of the thread 70 is performed by removing the thread 70 from the side surface of the opening 18 or moving the thread 70 to the distal side of the opening 18. In order to wind the thread 70 around the needle member 10 and strengthen the holding, the needle member 10 may be rotated by a predetermined angle about the major axis direction of the needle member 10 as the central axis before the needle member 10 is retracted.
  • the needle mechanism 2 (2F) according to the sixth embodiment will be described with reference to FIGS.
  • the needle mechanism 2F includes a hollow member 22 (22F) and an insertion member 25 (25F) that is provided on the inner side of the hollow member 22F and can advance and retract in the axial direction with respect to the hollow member 22F.
  • 23 to 24 show a side view and a perspective view of the distal side of the hollow member 22F, respectively.
  • 25 to 26 show a side view and a perspective view showing the distal side of the insertion member 25F, respectively.
  • 27 to 28 are side views (partially sectional views) of the needle mechanism 2F according to the sixth embodiment.
  • the passage 13, the entrance / exit portion 12, and the end portion 14 are provided in the hollow member 22 ⁇ / b> F, the entrance / exit portion 12 is at the distal end of the hollow member 22 ⁇ / b> F, and the capturing portion 15 is the proximal end portion of the passage 13. Is preferred.
  • the needle mechanism 2A having the inner cylinder member 20 holds and releases the filamentous material 70 by rotating the inner cylinder member 20, whereas in the sixth embodiment, the passage 13 of the hollow member 22F. Is different in that the thread-like object 70 is held at the proximal end portion thereof and the holding of the thread-like object 70 is released by the insertion member 25F.
  • the passage 13 of the needle mechanism 2F shown in FIGS. 23 to 24 extends along the axial direction of the hollow member 22F. For this reason, by moving the hollow member 22F in the axial direction, the filament 70 located in the passage 13 can be relatively moved. As shown in FIGS. 23 to 24, the passage 13 preferably passes through the axis C of the hollow member 22F. Thereby, the filamentous material 70 is stably hold
  • the distal end portion of the hollow member 22F be tapered toward the distal side (so-called twin peak shape).
  • twin peak shape As shown in FIGS. 23 to 24, the outer diameter of the hollow member 22F may be constant.
  • the width of the passage 13 increases toward the distal side. Since the width of the passage 13 is narrowed toward the proximal side, the filament 70 is held at the proximal end of the passage 13. That is, in the needle mechanism 2 ⁇ / b> F shown in FIG. 27, the capturing portion 15 is configured by the proximal end portion of the passage 13.
  • the passage 13 penetrates in a direction perpendicular to the axial direction of the hollow member 22F.
  • the shape of the passage is not particularly limited, and the passage may be narrowed by inclining with respect to the axial direction, or may be narrowed by changing the width in a staircase shape.
  • the inclination angle may be changed at a plurality of locations, and the inclination angle may not be constant.
  • the insertion member 25F is provided inside the hollow member 22F.
  • the shape of the insertion member 25F is preferably a solid shape such as a columnar shape or a prismatic shape, or a hollow shape such as a cylindrical shape or a polygonal cylindrical shape, and is solid to increase the strength of the needle mechanism 2F. Is more preferable.
  • the shape of the distal end portion of the insertion member 25F is not particularly limited as long as the filament 70 held by the capturing portion 15 can be pushed out to the distal side. However, as shown in FIGS. A pointed needle shape is preferred. In that case, it is preferable that the tip of the insertion member 25F is located at the outermost side in the radial direction of the insertion member 25F. If the insertion member 25F is a needle shape, the insertion member 25F can be easily punctured into the suture target. When the suture target is punctured with the needle-shaped insertion member 25F, puncture waste is less likely to be generated and dropped from the suture target as compared with the case of puncturing with the twin-peak needle mechanism.
  • the removal of the puncture lint means that the cut portion of the suture target (for example, the dura mater) that is punctured, that is, cut off by the needle mechanism 2F, is completely cut out and detached from the suture target. If the puncture lint falls off near the thread 70 and the needle mechanism 2F, it becomes a factor that hinders the movement of the needle mechanism 2F and the thread 70 during the suturing operation. It is advantageous.
  • an inclined portion 26 may be provided at the distal end portion of the insertion member 25F.
  • the inclined portion 26 only needs to have an inclination angle similar to that of a medical suture needle.
  • the inclined portion 26 is 5 degrees or more, 8 degrees or more, 10 degrees or more, 15 with respect to the axial direction of the hollow member 22G. It is preferable to incline below 20 degrees or below 20 degrees.
  • the hollow member 22F and the insertion member 25F are preferably made of a metal material such as stainless steel or a resin material, like the needle member 10 and the inner cylinder member 20 of the first to fifth embodiments.
  • a method of gripping the thread-like object 70 by the needle mechanism 2F will be described with reference to FIGS.
  • a part of the thread 70 is arranged on the distal side of the needle mechanism 2F, and the needle mechanism 2F is moved to the distal side, so that the thread 70 passes through the entrance / exit part 12. Further, by moving the needle mechanism 2F to the distal side, as shown in FIG. 27, the thread 70 is entered into the passage 13, and the thread 70 is press-fitted toward the end portion 14, so that the passage 13 The filament 70 can be held at the proximal end.
  • the release of the holding of the thread 70 is performed by moving the insertion member 25F to the distal side with respect to the needle mechanism 2F, and moving the thread 70 to the distal side at the tip of the insertion member 25F. This can be done by extruding. At this time, it is preferable not to rotate the insertion member 25F with respect to the hollow member 22F.
  • the needle mechanism 2 is provided on the inside of the hollow member 22 having the inclined portion 23 at the distal end portion, and the shaft of the hollow member 22 is rotated.
  • An insertion member 25 capable of at least one of a rotation operation around the center and a movement operation of the hollow member 22 in the axial direction, and the entrance / exit portion 12 is provided more proximally than the inclined portion 23
  • the inclined portion 23 can be configured in the same manner as the hollow member 22F described in the sixth embodiment.
  • FIGS. 29 to 30 show a side view and a perspective view of the distal side of the hollow member 22G.
  • 31 to 32 are a side view and a perspective view showing the distal side of the insertion member 25 (25G).
  • 33 to 35 are side views (partially sectional views) showing the distal side of the needle mechanism 2G.
  • a groove 24 is provided at the distal end of the hollow member 22G shown in FIGS.
  • the groove part 24 of the hollow member 22G can constitute at least a part of the entrance / exit part 12, the passage 13 and the terminal part 14 for holding the filament 70.
  • the entrance / exit part 12 is provided on the distal side of the groove part 24. Can be provided.
  • the depth of the groove 24 of the hollow member 22G is not particularly limited as long as the depth is equal to or larger than the diameter of the thread 70, but from the viewpoint of ease of processing, strength of the needle mechanism, and ease of holding the thread 70.
  • the radius is preferably equal to or less than the radius of the hollow member 22G.
  • the width of the groove portion 24 of the hollow member 22G is not particularly limited as long as it is equal to or larger than the diameter of the thread 70, but from the viewpoint of ease of processing and the strength of the hollow member 22G, it is twice or more the diameter of the thread 70, or 3 It is preferable that it is twice or more.
  • the depth of the groove portion 24 of the hollow member 22G indicates a length along the radial direction
  • the width of the groove portion 24 indicates a length in a direction perpendicular to the axial direction when the groove portion 24 is viewed from above.
  • the groove 24 is formed by three inner walls of a bottom wall 24A, a distal side wall 24B, and a proximal side wall 24C.
  • the distal side wall 24B and the proximal side wall 24C are preferably formed perpendicular to the axial direction of the needle mechanism 2G as shown in FIG.
  • the proximal side wall 24C is preferably formed higher than the distal side wall 24B.
  • An inclined portion 23 is provided at the distal end of the hollow member 22G.
  • the inclined portion 23 functions as a portion that punctures a suture target.
  • the inclined portion 23 is provided on the distal side of the groove portion 24.
  • the insertion member 25G is provided inside the hollow member 22G, and can perform at least one of a rotation operation around the axis of the hollow member 22G and a movement operation in the axial direction of the hollow member 22G. It is.
  • the passage 13 can be formed in the needle mechanism 2 by moving or rotating the insertion member 25G in the axial direction with respect to the hollow member 22G.
  • path 13 or the entrance / exit part 12 can be narrowed by adjusting the position and rotation angle of the axial direction of the insertion member 25G. That is, in the needle mechanism 2G shown in FIG. 33, the capturing unit 15 is configured by the hollow member 22G and the insertion member 25G.
  • the shape of the insertion member 25G can be configured similarly to the insertion member 25G described in the sixth embodiment, but from the viewpoint of ensuring the strength of the needle mechanism 2G and firmly holding the filament 70,
  • the shape of the insertion member 25G is preferably solid.
  • a method of gripping the thread-like object 70 by the needle mechanism G will be described with reference to FIGS.
  • the insertion member 25G is moved closer to the proximal side than the groove 24 of the hollow member 22G.
  • the distal end of the insertion member 25G and the distal end of the hollow member 22G are arranged so as to face each other across the axis C of the needle mechanism 2G when the needle mechanism 2G is viewed from the distal side. Thereby, it becomes easy to adjust the passage 13 and the entrance / exit part 12 to an appropriate width that can easily hold the filament 70.
  • the thread-like material 70 can be held by sandwiching the thread-like material 70 at three locations, that is, the bottom wall 24A of the groove portion 24, the distal side wall 24B, and the inclined portion 27 of the insertion member 25G.
  • the holding of the filament 70 can be released by moving the insertion member 25G proximally with respect to the hollow member 22G. Furthermore, in order to easily release the holding of the filament 70, the insertion member 25G is moved proximally with respect to the hollow member 22G, and then the insertion member 25G is rotated. As shown in FIG. It is preferable to move the insertion member 25G to the distal side again. Thereby, the filament 70 can be pushed out to the distal side by the inclined portion 26 of the insertion member 25G. Instead of moving the insertion member 25G proximally relative to the hollow member 22G, the insertion member 25G may be rotated and the insertion member 25G moved again to the distal side.
  • the insertion member 25G When the holding of the thread-like material 70 is released by moving the entire suturing apparatus or the like without pushing the thread-like object 70 by the insertion member 25G, the insertion member 25G only holds the thread-like object 70. In that case, the thread-like object 70 can be held only by either one of the rotation operation of the insertion member 25G or the movement operation in the axial direction.
  • FIGS. 36 to 37 respectively show a side view and a perspective view of the distal side of the hollow member 22 (22H).
  • 38 to 39 respectively show a side view and a perspective view of the distal side of the insertion member 25H.
  • 40 to 41 are side views (partially sectional views) showing the distal side of the needle mechanism 2H.
  • an inclined portion 23 is provided at the distal end of the hollow member 22H.
  • the inclined portion 23 of the hollow member 22H functions as a portion that punctures a suture target.
  • the configuration of the inclined portion 23 the configuration described in the seventh embodiment can be employed.
  • a groove 27 is provided at the distal end of the insertion member 25H.
  • the groove portion 27 of the insertion member 25H at least a part of the entrance / exit portion 12, the passage 13 and the terminal portion 14 for holding the filament 70 can be formed.
  • the depth of the groove 27 of the insertion member 25H is not particularly limited as long as the depth is equal to or greater than the diameter of the thread 70, but from the viewpoint of ease of processing, strength of the needle mechanism, and ease of holding the thread 70.
  • the width of the groove 27 of the insertion member 25H is not particularly limited as long as it is equal to or larger than the diameter of the thread 70, but is three times or more the diameter of the thread 70 from the viewpoint of ease of processing and the strength of the needle mechanism, or 5 It is preferably at least twice, preferably at most 8 times, or at most 10 times.
  • the groove portion 27 of the insertion member 25H is formed by three inner walls of a bottom wall 27A, a distal side wall 27B, and a proximal side wall 27C.
  • the distal side wall 27B and the proximal side wall 27C of the groove portion 27 may be formed perpendicular to the axial direction of the needle mechanism 2H as shown in FIG. 38, and are inclined with respect to the axial direction of the needle mechanism 2H. It may be formed.
  • a semi-cylindrical portion 28 is provided closer to the proximal side than the proximal end of the inclined portion 23 of the hollow member 22H.
  • the semi-cylindrical portion 28 is preferably a portion starting from the proximal end of the inclined portion 23 in a side view in which the long axis of the hollow member 22H is in the horizontal direction.
  • the semi-cylindrical portion is preferably linear along the long axis of the hollow member 22H, and may be linear or curved inclined with respect to the axial direction.
  • the passage 13 can be formed in the needle mechanism 2 by exposing the groove portion 27 of the insertion member 25H and the distal portion of the groove portion 27 from the semi-cylindrical portion 28 of the hollow member 22H in the axial direction of the needle mechanism 2H. it can.
  • the exposure means a state in which the groove portion 27 of the insertion member 25H is disposed on the distal side of the proximal end of the semi-cylindrical portion 28, and the distal side wall 27B and the semi-cylindrical portion 28 of the insertion member 25H are arranged. This includes both the case where the proximal side wall 28C faces (FIG. 40) and the case where it does not face (FIG. 41).
  • path 13 or the entrance / exit part 12 can be narrowed by adjusting the position and rotation angle of the axial direction of the insertion member 25H. That is, in the needle mechanism 2H, the capturing part 15 is configured by the hollow member 22H and the insertion member 25H.
  • the insertion member 25H may have a flat portion 29 on the distal side.
  • the flat portion 29 is preferably provided with a groove portion 27. Since the passage 13 is not formed in the needle mechanism 2 by rotating the insertion member 25H with respect to the hollow member 22H, the holding of the thread-like object 70 can be easily released.
  • the thickness of the flat portion 29 is preferably smaller than the maximum outer diameter of the insertion member 25H, more preferably not more than three-quarters of the maximum outer diameter of the insertion member 25H, and more preferably not more than two-thirds. The size is preferred.
  • the thickness of the flat portion 29 may be constant in the axial direction of the insertion member 25H, or may decrease toward the distal end.
  • the flat portion 29 of the insertion member 25H preferably has a length equal to or shorter than the semi-cylindrical portion 28 of the hollow member 22H.
  • the distal side wall 27B of the insertion member 25H and the proximal side wall 28C of the semi-cylindrical portion 28 are surfaces. The insertion member is rotated so that the facing portion is small.
  • the insertion member 25H is moved more proximally than the groove 24 of the hollow member 22H.
  • the distal portion of the insertion member 25H is disposed more distally than the proximal end of the semi-cylindrical portion 28 of the hollow member 22H.
  • the insertion member 25H is hollow so that the height at which the distal portion of the insertion member 25H is exposed from the semi-cylindrical portion 28 is made as low as possible and the thread 70 is easily guided to the semi-cylindrical portion 28.
  • the hollow member 22H is caught by the proximal side wall 28C which is a surface perpendicular to the axial direction at the proximal end of the semi-cylindrical portion 28 of the hollow member 22H.
  • the insertion member 25H is rotated with respect to the hollow member 22H and the height at which the distal portion is exposed from the semi-cylindrical portion 28 is higher than the groove portion of the insertion member 25H, the hollow member 22H and the insertion are inserted.
  • the passage 13 is formed by the member 25H. That is, when the depth direction of the groove portion 24 of the insertion member 25H is rotated so as to be perpendicular to the plane parallel to the axial direction of the semi-cylindrical portion 28, the passage 13 is formed by the hollow member 22H and the insertion member 25H. The When the hollow member 22H is further moved to the distal side, the width of the passage 13 is narrowed. As shown in FIG. 40, the thread-like material 70 is held by sandwiching the thread-like material 70 at two locations, the distal side wall 27B of the groove portion 27 of the insertion member 25H and the proximal side wall 28C of the semi-cylindrical portion 28 of the hollow member 22H. can do.
  • the filamentous material is obtained. 70 is released from the needle mechanism 2H. That is, when the depth direction of the groove portion 24 of the insertion member 25H is rotated so as to be parallel to a plane parallel to the axial direction of the semi-cylindrical portion 28, the thread-like object 70 is released from the needle mechanism 2H.
  • the needle mechanism 2 (2I) according to the ninth embodiment will be described with reference to FIGS.
  • the needle mechanism 2 (2I) has a hollow member 22 (22I) and an insertion member 25 (25I) provided inside the hollow member 22I.
  • the hollow member 22I and the insertion member 25I are provided with groove portions 24 and 27, respectively.
  • 42 to 43 respectively show a side view and a perspective view of the distal side of the hollow member 22I.
  • FIG. 44 shows a perspective view of the distal side of the insertion member 25I.
  • 45 to 47 are enlarged side views (partially sectional views) of the distal side of the needle mechanism 2 (2I) according to the ninth embodiment.
  • an inclined portion 23 is provided at the distal end portion of the hollow member 22I.
  • the inclined part 26 is provided also in the distal end part of the insertion member 25I.
  • the length of the inclined portion 23 of the hollow member 22I and the length of the inclined portion 26 of the insertion member 25I may be the same or different. It suffices that at least one of the inclined portions 23 and 26 functions as a portion that punctures the suture target. 45 to 47, the inclined portion 23 of the hollow member 22I is formed longer in the axial direction than the inclined portion 26 of the insertion member 25I.
  • the inclined portion 23 of the hollow member 22I and the inclined portion 26 of the insertion member 25I may have the same or different inclination angles. These inclination angles may be, for example, 45 degrees or more, 60 degrees or more, 70 degrees or more, and even if they are 85 degrees or less or 80 degrees or less. 45 to 47 show examples in which the inclination angle of the inclined portion 23 is smaller than the inclination angle of the inclined portion 26. FIG.
  • the groove portion is provided in one of the hollow member 22 and the insertion member 25, whereas in the ninth embodiment, the groove portion 24 is provided in both the hollow member 22I and the insertion member 25I. , 27 is different.
  • the proximal side walls (24C, 27C) and the distal side walls (24B, 27B) of the groove portions 24, 27 of the hollow member 22 or the insertion member 25 are arranged with respect to the axial direction of the needle mechanism 2.
  • the ninth embodiment is different in that the side wall forming the groove is formed so as to be inclined with respect to the axial direction of the needle mechanism 2.
  • the depth and width of the groove 24 of the hollow member 22I can be set similarly to the hollow member 22I of the seventh embodiment. Further, the depth and width of the groove 27 of the insertion member 25I can be set similarly to the insertion member 25I of the eighth embodiment.
  • At least one of the distal side wall 24B and the proximal side wall 24C constituting the groove 24 of the hollow member 22I is inclined with respect to the axial direction.
  • at least one of the distal side wall 27B and the proximal side wall 27C of the groove portion 27 of the insertion member 25I is inclined with respect to the axial direction. In this way, by inclining the inner wall of the groove portion of the hollow member 22I or the insertion member 25I, the thread-like material 70 can be easily held and released.
  • one of the distal side wall 24B and the proximal side wall 24C of the groove portion 24 is inclined with respect to the axial direction, and the other is perpendicular to the axial direction.
  • one of the distal side wall 27B and the proximal side wall 27C of the groove portion 27 is inclined with respect to the axial direction and the other is perpendicular to the axial direction.
  • the distal side wall 24B of the groove portion 24 of the hollow member 22I is inclined distally with respect to the axial direction, and the proximal side wall 27C of the groove portion 27 of the insertion member 25I is axial. It is preferable to incline proximally with respect to the direction. In that case, it is preferable that the proximal side wall 24C of the groove part 24 of the hollow member 22I and the distal side wall 27B of the groove part 27 of the insertion member 25I are each formed perpendicular to the axial direction.
  • the filament 70 is sandwiched between the proximal side wall 24C of the groove 24 of the hollow member 22I and the distal side wall 27C of the groove 27 of the insertion member 25I, that is, two side walls formed perpendicular to the axial direction. If held, it is possible to prevent the filamentous material 70 from falling off the needle mechanism 2I.
  • the width of the passage 13 is determined by the distal side wall 24B of the groove part 24 of the hollow member 22I and the proximal side wall 27C of the groove part 27 of the insertion member 25I, that is, two side walls inclined with respect to the axial direction. Becomes narrower inward in the radial direction.
  • the thread-like object 70 is easily pushed outward in the radial direction, and the thread-like object 70 is easily released from the needle mechanism 2I.
  • the axial position and rotation angle of the insertion member 25I with respect to the hollow member 22I the width of the passage 13 and the entrance / exit part 12 can be reduced. That is, also in the needle mechanism 2I, the capturing part 15 is configured by the hollow member 22I and the insertion member 25I.
  • a method for holding and releasing the thread-like material 70 by the needle mechanism 2I will be described with reference to FIGS. It arrange
  • the thread 70 By disposing a part of the thread 70 on the distal side of the needle mechanism 2I and moving the needle mechanism 2I to the distal side, a part of the thread 70 is guided to the inclined portion of the hollow member 22I.
  • the inlet / outlet part 12 constituted by the groove part 24 of the hollow member 22I and the groove part 27 of the insertion member 25 is reached.
  • the filament 70 enters the passage 13 constituted by the groove 24 of the hollow member 22I and the groove 27 of the insertion member 25I.
  • the insertion member 25I is moved proximally with respect to the hollow member 22I.
  • the filament 70 can be held by sandwiching the filament 70 between the proximal side wall 24C of the groove 24 of the hollow member 22I and the distal side wall 27B of the groove 27 of the insertion member 25I.
  • the distal side wall 24B of the inclined groove portion 24 of the hollow member 22I and the groove portion 27 of the insertion member 25I are provided.
  • the width of the passage 13 formed by the proximal side wall 27 ⁇ / b> C is narrowed, and the filament 70 is pushed out of the needle mechanism 2 ⁇ / b> I. In this way, the holding of the thread-like material 70 can be released.
  • the configuration example in which the inlet / outlet portion 12, the passage 13, and the terminal portion 14 are formed in the hollow member 22 is shown.
  • the configuration examples in which the inlet / outlet portion 12, the passage 13, and the terminal portion are formed by the hollow member 22 and the insertion member 25 are shown.
  • the inlet / outlet part 12, the passage 13, and the terminal part 14 may be formed in the insertion member 25.
  • the filamentous material 70 can be held and released.
  • the dural suture with TSS has been described as an example.
  • it can be used at any surgical position such as craniotomy, laparotomy, and thoracotomy, and without being limited to the use of an endoscope or a microscope.
  • the operation unit has been described by taking an operation by a human being such as a doctor as an example.
  • the biological tissue is not limited to membrane tissue such as dura mater, arachnoid membrane, pleura, pericardium, peritoneum, and includes all living tissue such as skin, blood vessel, lung, heart, digestive tract, bone, muscle, etc. be able to.
  • D Bidirectional suture device for medical use 1: Medical suture needles 2, 2A, 2B, 2C, 2D, 2E, 2F, 2G, 2H, 2I: Needle mechanism 10: Needle member 11: Puncture portion 12: Entrance / exit portion 13: Channel 14: Terminal part 15: Capture part 16: Protrusion 17: Narrow part 20: Inner cylinder member 21: Opening of inner cylinder member 22: Hollow member 23: Inclined part 24: Groove part 24: Groove part 24A: Bottom wall, 24B: Distal side wall 24C: proximal side wall 25: insertion member 26: inclined portion 27: groove portion 27A: bottom wall, 27B: distal side wall, 27C: proximal side wall 28: semi-cylindrical portion 28C of the hollow member: proximal side wall 29: inside Flat part 50 of insertion member: casing 61: first operation part 63: third operation part 70: thread-like object 71: folding part 100: suture object

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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

La présente invention concerne une aiguille de suture médicale avec laquelle une opération de suture peut être effectuée avec facilité, et qui est actionnée d'une manière qui est sûre et minimalement invasive vis-à-vis d'un corps humain. Une aiguille de suture médicale comprend un mécanisme d'aiguille 2 qui s'étend dans une direction distale/proximale, une pointe dudit mécanisme d'aiguille 2 étant sur le côté distal, le mécanisme d'aiguille 2 ayant un passage 13 à travers lequel passe un élément filiforme, une section d'entrée/sortie 12 qui est disposée sur un côté du passage 13, et une section de borne qui est disposée sur l'autre côté du passage 13.
PCT/JP2017/029249 2016-08-23 2017-08-14 Aiguille de suture médicale Ceased WO2018037953A1 (fr)

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JP2016-163086 2016-08-23
JP2016163086 2016-08-23

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2019180636A (ja) * 2018-04-05 2019-10-24 国立大学法人広島大学 縫合針及びそれに用いる縫合糸
JP7549399B1 (ja) 2023-09-04 2024-09-11 株式会社テイクウイング 縫合用の器具および縫合用の位置決め器具ならびにシステム
WO2025204841A1 (fr) * 2024-03-28 2025-10-02 ブラザー工業株式会社 Dispositif de ligature

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2013537068A (ja) * 2010-09-10 2013-09-30 ピボット・メディカル，インコーポレーテッド 縫合糸を組織に通すための方法および器具
WO2015179465A1 (fr) * 2014-05-22 2015-11-26 Tensor Surgical, Inc. Méthode et appareil permettant de faire passer un fil de suture au travers d'un tissu
JP2016513575A (ja) * 2013-03-15 2016-05-16 アルファ サイエンティフィック コーポレイションＡｌｐｈａ Ｓｃｉｅｎｔｉｆｉｃ Ｃｏｒｐｏｒａｔｉｏｎ 横係合を備える外科用縫合装置
WO2016168422A1 (fr) * 2015-04-15 2016-10-20 Smith & Nephew, Inc. Dispositif de préhension de suture et son procédé d'utilisation
WO2017163600A1 (fr) * 2016-03-25 2017-09-28 株式会社カネカ Dispositif de suture médicale bidirectionnelle et son procédé de fonctionnement

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2013537068A (ja) * 2010-09-10 2013-09-30 ピボット・メディカル，インコーポレーテッド 縫合糸を組織に通すための方法および器具
JP2016513575A (ja) * 2013-03-15 2016-05-16 アルファ サイエンティフィック コーポレイションＡｌｐｈａ Ｓｃｉｅｎｔｉｆｉｃ Ｃｏｒｐｏｒａｔｉｏｎ 横係合を備える外科用縫合装置
WO2015179465A1 (fr) * 2014-05-22 2015-11-26 Tensor Surgical, Inc. Méthode et appareil permettant de faire passer un fil de suture au travers d'un tissu
WO2016168422A1 (fr) * 2015-04-15 2016-10-20 Smith & Nephew, Inc. Dispositif de préhension de suture et son procédé d'utilisation
WO2017163600A1 (fr) * 2016-03-25 2017-09-28 株式会社カネカ Dispositif de suture médicale bidirectionnelle et son procédé de fonctionnement

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2019180636A (ja) * 2018-04-05 2019-10-24 国立大学法人広島大学 縫合針及びそれに用いる縫合糸
JP7549399B1 (ja) 2023-09-04 2024-09-11 株式会社テイクウイング 縫合用の器具および縫合用の位置決め器具ならびにシステム
WO2025204841A1 (fr) * 2024-03-28 2025-10-02 ブラザー工業株式会社 Dispositif de ligature

Also Published As

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JP6885959B2 (ja) 2021-06-16
JPWO2018037953A1 (ja) 2019-06-20

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