JP2951659B1 - Automatic suture device for biological tissue resection - Google Patents

Automatic suture device for biological tissue resection

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Publication number
JP2951659B1
JP2951659B1 JP10285419A JP28541998A JP2951659B1 JP 2951659 B1 JP2951659 B1 JP 2951659B1 JP 10285419 A JP10285419 A JP 10285419A JP 28541998 A JP28541998 A JP 28541998A JP 2951659 B1 JP2951659 B1 JP 2951659B1
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JP
Japan
Prior art keywords
staple
holding
suturing
living tissue
tumor
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.)
Expired - Fee Related
Application number
JP10285419A
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Japanese (ja)
Other versions
JP2000107190A (en
Inventor
素子 岩渕
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Individual
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Individual
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Priority to JP10285419A priority Critical patent/JP2951659B1/en
Application granted granted Critical
Publication of JP2951659B1 publication Critical patent/JP2951659B1/en
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads

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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

【要約】 【課題】 １回の挟持操作で小切片の切り取りを可能と
する縫合を行なうことが出来る縫合器を提供する。 【解決手段】人体の生体組織から生検用小切片を切除す
るために腫瘍を含む小切片の外周部分を縫合する縫合器
であって、生体組織中に存在する腫瘍を囲むように包囲
して該生体組織を挟持する開閉可能な上下一対の挟持部
材と、その挟持部材の一方に装着するステープルと、該
ステープルを他方の挟持部材側に打ち出して生体組織を
縫合するステープル打ち出し部材からなり、前記上下一
対の挟持部材における挟持部が環状に形成され、腫瘍を
含む生検用小切片の外周を一動作で縫合する。A suturing device is provided that can perform suturing that enables small pieces to be cut out by a single clamping operation. Kind Code: A1 A suturing device for suturing an outer peripheral portion of a small section containing a tumor in order to resect a small section for biopsy from a living body tissue of a human body, wherein the suturing device surrounds a tumor existing in the living body tissue. A pair of openable and closable holding members for holding the living tissue, a staple attached to one of the holding members, and a staple driving member for driving the staple toward the other holding member and suturing the living tissue, The holding portion of the pair of upper and lower holding members is formed in an annular shape, and the outer circumference of the small biopsy section containing the tumor is sutured in one operation.

Description

【発明の詳細な説明】DETAILED DESCRIPTION OF THE INVENTION

【０００１】[0001]

【発明の属する技術分野】本発明は人体の生体組織切除
用自動縫合器に関し、詳しくは生体組織から生検のため
の小切片を切り取る時に、該小切片の外側周囲（人体側
に残る生体組織）をステープルで縫合する縫合器に関す
る。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an automatic suturing device for excision of a living tissue from a human body, and more particularly, to a method of cutting a small biopsy biopsy from a living tissue. ) With a staple.

【０００２】[0002]

【従来の技術】人体の内臓を病理学的に調べる生検は、
腫瘍等が含まれた部位の生体組織の小切片を切り取って
行なわれるが、その小切片の切除に当たっては人体側に
残る生体組織の切り取り部の外周はステープルで縫合す
るようになっている。その小切片の切り取りに際して使
用される縫合器は数多く提案されているが、それらは何
れもハンドルの先部に上下方向に開閉する一対の直線棒
状の挟持部が設けられ、その一方の挟持部にステープル
を収容したカートリッジが着脱可能に装着され、挟持部
で生体組織を挟持後、ハンドル部に設けられた操作子を
操作することでカートリッジのステープルが打ち出され
て挟持する生体組織を縫合するように構成されている。
例えば、特開平１０−１９５号公報等が挙げられる。2. Description of the Related Art A biopsy for pathologically examining the internal organs of a human body is known as
A small section of a living tissue at a site containing a tumor or the like is cut out. When the small section is cut off, the outer periphery of the cut portion of the living tissue remaining on the human body side is stapled with staples. A number of suturing devices used for cutting the small pieces have been proposed, but each of them has a pair of straight bar-shaped holding portions that open and close in the vertical direction at the tip of the handle, and one of the holding portions is provided on one of the holding portions. The cartridge containing the staples is detachably mounted, and after holding the living tissue by the holding portion, the staples of the cartridge are punched out by operating the operation element provided on the handle portion so that the living tissue to be held is sutured. It is configured.
For example, Japanese Patent Application Laid-Open No. H10-195 is mentioned.

【０００３】しかし、上記した従来の縫合器は生体組織
を挟持する挟持部が直線棒状に形成されているため、生
体組織から小切片を切り取るためにはその切除しようと
する小切片の周りを数回の操作で囲むことに成る。即
ち、小切片の切り取りを平面略Ｖ字形状に行う場合は、
縫合器による挟持を小切片の左側と右側から一度づつ行
なう合計二回、平面略台形状に行う場合は前記左右から
の縫合をその先端を交叉させずに行ない、三回目に前記
二回の縫合を結ぶように行なうことになる。However, in the above-described conventional suturing device, the holding portion for holding the living tissue is formed in a straight rod shape. It will be surrounded by multiple operations. That is, when cutting small pieces into a substantially V-shaped plane,
When holding the small section once from the left and right sides of the small section once, a total of two times, and when performing a substantially trapezoidal plane, perform the stitching from the left and right without crossing the tip, and perform the second stitching for the third time Will be connected.

【０００４】[0004]

【発明が解決しようとする課題】従って、上記した従来
の縫合器で生体組織から生検のための小切片を切除しよ
うとした場合は、少なくとも縫合器を２回以上操作しな
ければ切り取ろうとする腫瘍部分の外側を縫合すること
ができないものであり、その為に切除作業に手数を要
し、取り出しに時間が掛かるといった不便さを有する。
そして、その小切片の位置が深部の場合、胸腔内操作が
困難になるため前記開口部の大きさも大きくなるという
問題点を有する。Therefore, when a small section for biopsy is to be cut from a living tissue with the above-mentioned conventional suturing device, the suturing device must be cut at least twice or more. Since the outside of the tumor cannot be sutured, it requires a lot of time for the resection operation, and it takes a long time to remove the tumor.
When the position of the small section is deep, there is a problem in that the intrathoracic operation becomes difficult, and the size of the opening becomes large.

【０００５】更に、生体組織を縫合するステープルは一
回の縫合毎にカートリッジを交換して行ない、しかも２
回、３回の操作でＶ形或いは台形等に区画するため、ス
テープルが重なり合ったり、又、不要な部分にステープ
ルが打ち込まれるという問題点を有する。本発明は上記
した従来の技術が有する問題点に鑑みてなされたもの
で、その目的とするところは、１回のステープル打ち出
し操作で小切片の切り取りを可能とする縫合を行なうこ
とが出来る縫合器を提供することにある。更に、本発明
の他の目的は腫瘍部分の検査などを容易に行なうことが
できる機能を備えた縫合器を提供することにある。Further, staples for suturing living tissues are performed by exchanging a cartridge for each suturing operation.
There are problems in that staples are overlapped or staples are driven into unnecessary portions because they are divided into V-shaped or trapezoidal shapes by three or three operations. SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned problems of the related art, and an object of the present invention is to provide a suturing device capable of performing a suturing operation capable of cutting small pieces by a single staple driving operation. Is to provide. Still another object of the present invention is to provide a suture instrument having a function of easily examining a tumor part or the like.

【０００６】[0006]

【課題を解決するための手段】上記の課題を達成するた
めに本発明が講じた技術的手段は、人体の生体組織から
生検用小切片を切除するために腫瘍を含む小切片の外周
部分を縫合する縫合器であって、生体組織中に存在する
腫瘍を囲むように包囲して該生体組織を挟持する開閉可
能な上下一対の挟持部材と、その挟持部材の一方に装着
するステープルとそのステープルを打ち出す打ち出し爪
を備えたカートリッジと、該ステープルを他方の挟持部
材側に打ち出して生体組織を縫合するステープル打ち出
し部材からなり、前記ステープル打ち出し部材の操作で
打ち出されるステープルが区画する縫合形状が少なくと
も腫瘍部分を取り囲む形状とし、腫瘍を含む生検用小切
片の外周を一動作で縫合することを特徴とする。上記ス
テープルが区画する縫合形状が少なくとも腫瘍部分を取
り囲む形状としては、周囲が閉塞された環状（Ｏ形）だ
けでなく、周囲の一部が切り欠かれたＶ形、Ｕ形、Ｃ形
等でもよいものである。SUMMARY OF THE INVENTION In order to achieve the above object, the present invention has been made to solve the above-mentioned problem by providing an outer peripheral portion of a small section containing a tumor for removing a small biopsy section from a living body tissue of a human body. A pair of openable and closable upper and lower sandwiching members for surrounding the tumor present in the living tissue and sandwiching the living tissue, and a staple attached to one of the sandwiching members, and A cartridge provided with a launching claw for launching staples, a staple launching member for launching the staple to the other holding member side and suturing a living tissue, and a staple launched by operation of the staple launching member has at least a stitching shape defining a staple. It is characterized in that it has a shape surrounding a tumor portion, and the outer periphery of a small biopsy section containing the tumor is sutured in one operation. As the shape in which the staples define the suture shape surrounding at least the tumor portion, not only the closed shape of the periphery (O shape), but also the V shape, the U shape, the C shape, etc. Good thing.

【０００７】上記一方の挟持部材に装着するステープル
のカートリッジは、合成樹脂材で成形した環状（Ｏ形）
或いはＶ形、Ｕ形、Ｃ形等のステープル収容部と、ステ
ープル収容部の外側に取付用柄部が連設され、その取付
用柄部を挟持部材の一方のグリップ部に差し込み又は嵌
め込みによって装着固定し得るように構成されている。
そして、環状等のステープル収容部にはステープルが２
列又は３列互い違いに配列されて平面略Ｖ字形或いは平
面Ｕ字形に配置され、更にそのステープルを打ち出す打
ち出し爪が装備されている。 又、上記カートリッジに
セットされるステープルは、肺の生体組織の縫合におい
ては肺は外周縁の厚さが薄く、外周縁から内方に入るに
従い次第に厚くなるため、縫合部位の手前側と先端側
（奥側）でステープルの針脚に長短差を付けると共に、
ステープルの幅に広狭差を付けるようにする。即ち、手
前側には針脚の長さが短く且つ幅の広いステープルを配
置し、先端側（奥側）の湾曲部には針脚が長く且つより
曲線的に縫合できるように幅の狭いステープルを配置
し、それにより確実に縫合し得るようにする。尚、本発
明の一動作で腫瘍部分を囲む形状に縫合する場合は、針
脚の長さよりもステープルの幅に広狭差を付けることが
重要である。The staple cartridge to be mounted on the one holding member is an annular (O-shaped) formed of a synthetic resin material.
Alternatively, a V-shaped, U-shaped, C-shaped, etc. staple accommodating portion and a mounting handle portion are continuously provided outside the staple accommodating portion, and the mounting handle portion is inserted or fitted into one grip portion of the holding member. It is configured to be fixed.
Then, the staple is accommodated in the staple accommodating portion such as an annular shape.
A row or three rows are alternately arranged and are arranged in a substantially V-shaped plane or a U-shaped plane, and are further provided with a punching claw for punching the staple. In addition, the staples set in the cartridge are such that, when suturing living tissue of the lung, the lung has a thin outer peripheral edge and gradually becomes thicker as it enters from the outer peripheral edge. At the (back side), make a difference between the length of the staple and the length of the staple,
Make the width of the staple wide and narrow. That is, a staple having a short length of the needle leg and a wide width is disposed on the front side, and a staple having a narrow width so that the needle leg is long and can be stitched more curvedly on the curved portion on the distal end side (rear side). To ensure that sutures can be sutured. When suturing in a shape surrounding a tumor portion in one operation of the present invention, it is important to make the width of the staple wider or narrower than the length of the needle leg.

【０００８】上記ステープルの針脚の先端を受け止める
挟持部材の環状等の挟持部は、その開口部が開放された
ままでもよいが、その開口部を閉塞してもよく、その閉
鎖する底板部材は透明、不透明の何れでもよい。The holding portion, such as an annular portion, of the holding member for receiving the tip of the needle leg of the staple may have its opening kept open, or the opening may be closed, and the closed bottom plate member may be closed. It may be either transparent or opaque.

【０００９】上記手段によれば、生体組織を挟持する開
閉可能な上下一対の挟持部材における一方の挟持部と他
方の挟持部材に装着するステープル及び打ち出し爪を内
蔵したカートリッジが、生体組織中に存在する腫瘍部分
を囲む環状（Ｏ形）、Ｖ形、Ｕ形、Ｃ形等に形成されて
いることで、前記腫瘍部分を含む小切片の縫合を平面略
Ｖ字形、平面略Ｕ字形、平面略Ｃ字形等に一動作で行な
うことができる。又、挟持部が上記したように環状をな
しているため、生体組織を挟持部材で挟むことで硬いシ
コリ状の腫瘍部分の検出を縫合器で行なうことが可能と
なる。そして、一番下側に位置する挟持部材の挟持部
（生体組織の下側に位置する挟持部材）の開口部が底板
で閉鎖された場合は、生体組織中に腫瘍が存在すれば該
腫瘍は底板で支えられるため上側の挟持部材に装着され
るカートリッジの環状部内で上方に盛り上がり、腫瘍の
探索を視覚によって容易に行なうことが可能となる。According to the above means, there is provided a cartridge having a built-in staple and a punching claw mounted on one of the upper and lower holding members for holding and holding the living tissue and the other holding member. Is formed in an annular shape (O-shape), V-shape, U-shape, C-shape or the like surrounding the tumor portion to be sewn. It can be performed in one operation such as C-shape. In addition, since the holding portion is formed in an annular shape as described above, it is possible to detect a hard, slimy tumor portion by using a suture device by holding the living tissue between the holding members. Then, when the opening of the holding portion of the holding member located at the lowermost side (the holding member located at the lower side of the living tissue) is closed by the bottom plate, the tumor is located in the living tissue if it exists. Because it is supported by the bottom plate, it rises upward in the annular portion of the cartridge mounted on the upper holding member, and it is possible to easily search for a tumor visually.

【００１０】[0010]

【発明の実施の形態】以下、本発明の実施の形態を図面
に基づいて説明する。図１は本発明に係る生体組織切除
用自動縫合器の外観図で、該縫合器Ａは生体組織を挟持
するステンレス材で構成した開閉可能な上下一対の挟持
部材１，２と、その一方（上側）の挟持部材１に対して
着脱自在に装着するステープル及び打ち出し爪を収容し
たカートリッジ３と、前記カートリッジ３に収容された
ステープルを打ち出すステープル打ち出し部材４とで構
成され、挟持部材１に対して下側の挟持部材２とステー
プル打ち出し部材４がピン５で鋏状に組み立てられ開閉
可能に構成されている。Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is an external view of an automatic suturing device for resection of a living tissue according to the present invention. The suturing device A includes a pair of openable and closable holding members 1 and 2 made of stainless steel for holding a living tissue. A staple and a staple ejecting member 4 for ejecting staples contained in the cartridge 3 and a cartridge 3 containing a staple and a punching claw detachably attached to the holding member 1 (upper side). The lower holding member 2 and the staple driving member 4 are assembled in a scissors shape with pins 5 and are configured to be openable and closable.

【００１１】上側の挟持部材１は、後述するカートリッ
ジの取付用柄部を連結固定又は開放する連結固定手段を
内蔵するグリップ１ａの先に、下側の挟持部材２及びス
テープル打ち出し部材４を鋏状に交叉させて開閉可能に
軸支する支持杆１ｂが固着突設され、グリップ１ａの先
端にカートリッジ３の取付用柄部の差込口６が開設され
ている。尚、グリップ１ａの内部に内蔵する連結固定手
段はカートリッジ３の取付用柄部を差込口から差し込む
ことで自動的に連結固定される自動ロックタイプ（解除
は手動）、或いは連結固定及び解除を手動操作で行なう
手動タイプの何れでもよい。The upper holding member 1 is provided with a lower holding member 2 and a staple driving member 4 at the tip of a grip 1a having a connecting / fixing means for connecting / fixing a mounting handle portion of a cartridge described later. A support rod 1b, which is rotatably supported so as to be able to open and close, is fixedly protruded, and an insertion port 6 of a mounting handle portion of the cartridge 3 is opened at the tip of the grip 1a. The connecting and fixing means built into the grip 1a is an automatic lock type (cancellation is manually released) which is automatically connected and fixed by inserting the mounting handle portion of the cartridge 3 from the insertion port, or a connection fixing and releasing. Any of a manual type performed by a manual operation may be used.

【００１２】前記挟持部材１と対を成す下側の挟持部材
２は、柄部２ａとその柄部２ａの先端に接続固定した環
状の挟持部２ｂとで構成され、挟持部２ｂは平面略卵形
に形成されて径の大きい側方が柄部２ａに接続されてい
る。又、環状の挟持部２ｂの上面には前記した上側の挟
持部材１に装着されるカートリッジ３から打ち出される
ステープルの脚先端を受け止め且つ内側への折り曲げを
スムーズに行なわしめる受け凹部７がカートリッジ３に
収容されるステープルに対応させて凹設されている。更
に、環状の挟持部２ｂはその内側の開口を開放させたま
までもよいが、挟持部２ｂの開口下側を底板８で閉鎖し
てもよい。尚、該底板８は縫合した生体組織（小切
片））をメス等で切り取るときの刃先を受ける受け材と
なるため、それによって切断されることの無い材料、例
えば金属板（ステンレス板）が有効である。The lower holding member 2 which forms a pair with the holding member 1 is composed of a handle 2a and an annular holding portion 2b connected and fixed to the tip of the handle 2a. The side having a large diameter formed in a shape is connected to the handle 2a. A receiving recess 7 is formed on the upper surface of the annular holding portion 2b to receive the tip of the leg of the staple ejected from the cartridge 3 mounted on the upper holding member 1 and to smoothly bend inward. It is recessed corresponding to the staple to be accommodated. Furthermore, the opening of the inside of the annular holding portion 2b may be left open, but the lower side of the opening of the holding portion 2b may be closed by the bottom plate 8. In addition, since the bottom plate 8 is a receiving material for receiving the cutting edge when the sutured living tissue (small section) is cut with a scalpel or the like, a material that is not cut by the cutting edge, for example, a metal plate (stainless plate) is effective. It is.

【００１３】前記した上側の挟持部材１に装着されるカ
ートリッジ３は、合成樹脂材で成形した取付用柄部３ａ
と、その取付用柄部３ａの先端に一体に接続固定された
環状のステープル収容ケース３ｂと、そのステープル収
容ケース３ｂ内に収容される複数列（図面では３列）の
ステープル９と、該ステープル９を押し出す打ち出し爪
１０とで構成され、ステープル収容ケース３ｂの平面形
状は前記した挟持部材２における挟持部２ｂの平面形状
と同一の形状に形成されている。尚、カートリッジ３の
平面形状における最大幅の寸法（挟持部材の挟持部の横
幅と同じ）は、本縫合器を体内に差し入れるために切開
する切り口の大きさに影響を与えるため、より切り口を
小さくするためには最大幅部分に配置するステープルの
列を最少の２列にする。The cartridge 3 mounted on the upper holding member 1 includes a mounting handle 3a formed of a synthetic resin material.
An annular staple accommodating case 3b integrally connected and fixed to the tip of the mounting handle 3a; a plurality of (three in the drawing) staples 9 accommodated in the staple accommodating case 3b; The staple storage case 3b has the same planar shape as the holding portion 2b of the holding member 2 described above. In addition, since the dimension of the maximum width in the planar shape of the cartridge 3 (same as the width of the holding portion of the holding member) affects the size of an incision to be made to insert the suture instrument into the body, the incision is made larger. In order to reduce the size, the number of staples arranged in the maximum width portion is reduced to a minimum of two.

【００１４】カートリッジ３における取付用柄部３ａの
後部には前記した挟持部材１におけるグリップ１ａ内の
連結固定手段に対して係脱する係合部（図示省略）が設
けられている。ステープル収容ケース３ｂに内蔵される
ステープル９は、該収容ケース３ａの後側の略１／３を
除いた部分に３列配置収容し、その収容する全体のステ
ープル９は線径及び幅が同一のものでもよいが、縫合の
対象となる生体組織の厚さが外周縁は薄く内方に至るに
したがって厚くなる肺組織にあってはその３列のステー
プル９は前半部と後半部で針脚の長さとステープルの幅
を変えると効果的である。特に収容ケース３ｂの前半部
は略Ｖ字形に湾曲しているため後半部の直線部に比べて
漏れが生じ易く、その為例えば前半部（Ｌ１）に針脚が
長く且つ幅が狭いステープル９ａを密に配置し、後半部
（Ｌ２）には針脚が短く且つ幅が広いステープル９ｂを
配置する。尚、３列に配置されるステープル９は夫々ス
テープル収容ケース３ｂに上下方向に貫通して開設した
独立の孔１１に収容されている。尚、ステープルの配置
は針脚の長さが同じで幅が上記のように広狭差のあるス
テープルを配置しても効果的である。At the rear of the mounting handle 3a of the cartridge 3, there is provided an engaging portion (not shown) for engaging and disengaging from the connecting and fixing means in the grip 1a of the holding member 1. The staples 9 incorporated in the staple accommodating case 3b are arranged and accommodated in three rows except for approximately one third at the rear side of the accommodating case 3a, and the entire staples 9 accommodated therein have the same wire diameter and width. However, in lung tissue in which the thickness of the living tissue to be sutured is such that the outer peripheral edge is thinner and thicker as it goes inward, the three rows of staples 9 have needle legs in the first half and the second half. Changing the length and width of the staples is effective. In particular, the front half of the housing case 3b is curved in a substantially V-shape, so that leakage tends to occur as compared with the straight part of the rear half. The staples 9b are arranged densely, and the staples 9b having short and wide needle legs are arranged in the rear half (L2). The staples 9 arranged in three rows are respectively housed in independent holes 11 which are opened through the staple housing case 3b in the vertical direction. The staples are also effective even if staples having the same length and the wide and narrow difference as described above are arranged.

【００１５】又、ステープル収容ケース３ｂには孔１１
内に収容されたステープル９を押し出す打ち出し爪１０
が上下摺動可能に取付けられている。打ち出し爪１０
は、ステープル収容ケース３ｂ内に収容された３列のス
テープル９に対応する３個の爪枠１０ａ、１０ｂ、１０
ｃで構成され、爪枠１０ａは外側列のステープルを、爪
枠１０ｂは中間列のステープルを、爪枠１０ｃは内側列
のステープルを受け持ち、その３個の爪枠は爪枠１０ａ
を一番下にしてその上に爪枠１０ｂ、更にその上に爪枠
１０ｃが順次積み重ねられて取付けてある。即ち、爪枠
１０ａの上縁にはその上に積層配置される爪枠１０ｂ及
び爪枠１０ｃの爪部が貫通するスリット１２ａ、１２ｂ
が２列形成され、爪枠１０ｂの上縁にはその上に積層配
置される爪枠１０ｃの爪部が貫通するスリット１２ｃが
形成されており、これにより後述する打ち出し部材４の
下降押圧により各爪枠１０ａ、１０ｂ、１０ｃが下動し
て孔１１に収容されているステープル９を押し出すよう
になつている。尚、爪枠１０ａ、１０ｂに形成するスリ
ット１２ａ、１２ｂ、１２ｃは図示した爪部に対応した
独立形態に限定されず、周方向に連続した溝としてもよ
いものである。１３はステープル収容ケース３ｂの上側
に嵌合セットされる打ち出し爪１０が搬送中等の振動で
不用意に動いてステープル９を押し出すといったことを
防止するカバーである。The staple accommodating case 3b has holes 11 therein.
Claw 10 for pushing out staple 9 housed inside
Are slidably mounted vertically. Launch nail 10
Are three claw frames 10a, 10b, 10 corresponding to three rows of staples 9 stored in the staple storage case 3b.
c, the claw frame 10a is for staples in the outer row, the claw frame 10b is for staples in the middle row, the claw frame 10c is for staples in the inner row, and the three claw frames are the claw frames 10a.
Is at the bottom, and the claw frame 10b is further stacked thereon, and the claw frame 10c is further stacked and mounted thereon. That is, the slits 12a, 12b through which the claw portions of the claw frame 10b and the claw frame 10c stacked on the upper edge of the claw frame 10a are passed.
Are formed in two rows, and a slit 12c is formed in the upper edge of the claw frame 10b, through which the claw portion of the claw frame 10c stacked thereover penetrates. The claw frames 10a, 10b, and 10c move downward to push out the staples 9 stored in the holes 11. The slits 12a, 12b, 12c formed in the claw frames 10a, 10b are not limited to the independent forms corresponding to the illustrated claw portions, but may be grooves continuous in the circumferential direction. Reference numeral 13 denotes a cover that prevents the ejection claw 10 fitted and set on the upper side of the staple accommodating case 3b from inadvertently moving and extruding the staple 9 due to vibration during conveyance or the like.

【００１６】上記したカートリッジ３のステープル９を
打ち出す打ち出し部材４は、柄部４ａと、その柄部４ａ
の先部に上下揺動可能に支持した環状の押圧部材４ｂと
で構成され、柄部４ａの中程が前記した挟持部材１と挟
持部材２とを鋏状に組み立てるピン５を利用して同軸で
開閉可能に取付けられ、柄部４ａを開く（挟持部材１の
グリップ１ａから離れる方向の動き）ことで押圧部材４
ｂがカートリッジ３から離れ、逆に柄部４ａを閉じる
（挟持部材１のグリップ１ａに近づける方向の動き）と
押圧部材４ｂがカートリッジ３に当接し前記した打ち出
し爪１０を押圧する。そして、押圧部材４ｂは柄部４ａ
に軸１３で上下揺動可能に支持されているため、カート
リッジ３の上面に当接する押圧部材４ｂは柄部４ａの閉
じ動作により押圧部材４ｂの下面全面が当接した状態で
下方に平行移動され、打ち出し爪１０を均等に押圧する
ため、全てのステープルに均等な力が作用し確実な縫合
が行なわれる。尚、打ち出し部材４の閉じ状態を保持す
るロック機構を装備するかは任意である。The ejection member 4 for ejecting the staples 9 of the cartridge 3 includes a handle 4a and the handle 4a.
And a ring-shaped pressing member 4b supported at the tip of the shaft so as to be vertically swingable. The middle of the handle 4a is coaxial using the pin 5 for assembling the holding member 1 and the holding member 2 in the form of scissors. The handle 4a is opened (moves in the direction away from the grip 1a of the holding member 1) to open and close the handle 4a.
When the b moves away from the cartridge 3 and the handle 4a is closed (movement in the direction of approaching the grip 1a of the holding member 1), the pressing member 4b comes into contact with the cartridge 3 and presses the above-described embossing claw 10. And the pressing member 4b is a handle 4a.
The pressing member 4b, which is in contact with the upper surface of the cartridge 3, is translated downward by the closing operation of the handle 4a in a state in which the entire lower surface of the pressing member 4b is in contact. Since the pushing claws 10 are evenly pressed, an equal force acts on all the staples, and a reliable stitch is performed. It should be noted that it is optional to provide a lock mechanism for holding the ejection member 4 closed.

【００１７】次に以上の如く構成した縫合器の使用を図
９乃至図１３に基づいて説明すると、先ず挟持部材１に
カートリッジ３を装着固定して準備を完了する。この時
カートリッジ３に装着されているカバー１３は外し、他
の手段でステープルが打ち出されないようにしてある。
以上の状態で図９に示すように開胸または開腹した切開
部から生体組織Ｂを把持鉗子１４で挟んで引き出し、次
に図１０及び図１１に示すようにその生体組織Ｂを挟持
部材１に装着したカートリッジ３と挟持部材２の挟持部
２ｂとで挟みながら腫瘍部分を探し出す。この時、生体
組織中に腫瘍等があると挟持部２ｂの底板８上に支えら
れるため該腫瘍部分は環状のカートリッジ３の中で上方
に突出し、それにより挟持部材１，２で挟んだ時の感触
に加えて視覚によって容易に認識することができる。そ
して、腫瘍部分が見つかった場合はその腫瘍が悪性か良
性かを調べるために該腫瘍を含んだ部分を小切片として
切り取るが、図１２に示すように当該部分を挟持部材１
のカートリッジ３と挟持部材２で挟持し、その状態で打
ち出し部材４を閉じる。この打ち出し部材４の閉動によ
り押圧部材４ｂが下動され、カートリッジ３に装備され
た打ち出し爪１０を押圧しステープル９を押し出し、生
体組織Ｂを縫合する。小切片の周囲の縫合が完了した後
は挟持部材２の挟持部２ｂ、カートリッジ３、打ち出し
部材４の積層状態でその内周縁に沿ってメスを入れるこ
とで小切片を切り離すことが出来る。この時、挟持部材
２の挟持部２ｂの開口は底板８で閉鎖されているため、
メスの先端が挟持部２ｂを突き抜ける心配が無く、従っ
て切断時他の生体組織を傷つける危険がなくなる。尚、
上記縫合で区画された内側部分（小切片）の切断（切
開）を電気メスで行なうことを考慮して、その場合挟持
する生体組織を焼き切らないようにするために、電気メ
スと接触する挟持部材２の挟持部２ｂ、打ち出し部材４
の押圧部４ｂの内側面、及び底板８の内表面は絶縁処理
を施すとよい。Next, the use of the suturing device constructed as described above will be described with reference to FIGS. 9 to 13. First, the cartridge 3 is mounted and fixed on the holding member 1, and the preparation is completed. At this time, the cover 13 attached to the cartridge 3 is removed to prevent staples from being ejected by other means.
In the above state, the living tissue B is gripped by the grasping forceps 14 and pulled out from the incised portion where the thoracotomy or laparotomy is performed as shown in FIG. 9, and then the biological tissue B is inserted into the holding member 1 as shown in FIGS. 10 and 11. The tumor portion is searched for while being sandwiched between the mounted cartridge 3 and the holding portion 2b of the holding member 2. At this time, if there is a tumor or the like in the living tissue, the tumor portion protrudes upward in the annular cartridge 3 because it is supported on the bottom plate 8 of the holding portion 2b, thereby causing the tumor portion to be sandwiched between the holding members 1 and 2. In addition to feel, it can be easily recognized visually. Then, when a tumor portion is found, a portion containing the tumor is cut out as a small piece in order to check whether the tumor is malignant or benign, but as shown in FIG.
The ejection member 4 is closed in this state. Due to the closing movement of the ejection member 4, the pressing member 4b is moved downward, and the ejection claw 10 provided on the cartridge 3 is pushed to push out the staple 9, thereby suturing the living tissue B. After the suturing around the small piece is completed, the small piece can be cut off by inserting a scalpel along the inner peripheral edge of the holding portion 2b of the holding member 2, the cartridge 3, and the punching member 4 in a stacked state. At this time, since the opening of the holding portion 2b of the holding member 2 is closed by the bottom plate 8,
There is no fear that the tip of the scalpel penetrates the holding portion 2b, and therefore there is no danger of damaging other living tissues at the time of cutting. still,
Considering that the inner part (small section) partitioned by the above-mentioned suture is cut (cut) with an electric knife, in this case, in order to prevent the living tissue to be clamped from being burnt off, the clamping is performed in contact with the electric knife. Nipping portion 2b of member 2, launching member 4
The inner surface of the pressing portion 4b and the inner surface of the bottom plate 8 may be subjected to insulation treatment.

【００１８】[0018]

【発明の効果】本発明の生体組織切除用自動縫合器は請
求項１に記載の構成により、生体組織から小切片を切り
取る時の縫合を一回の操作で確実に行なうことができ
る。従って、従来装置に比べて縫合作業に要する時間を
大幅に短縮することができると共に、開胸または開腹し
た切開部からの縫合器の差し込みも切り取ろうとする部
分に対して真っ直ぐ挿入して操作するため切開の幅は従
来装置を使用する場合の切開幅に比べて小さくすること
が出来る。即ち、小切片が深部に位置する場合でも小開
胸手術の適用が可能となり、従来のように切開の幅を大
きくする必要が無い。又、請求項２に記載の構成により
簡単に使用することが出来る縫合器を提供できる。更
に、請求項３に記載の構成により、湾曲部のある縫合に
おいても止血及び空気漏れ防止を確実に行なうことがで
きる縫合器を構成することが出来る。又、請求項４に記
載の構成により、生体組織中に存在する腫瘍の探索を容
易に行なうことが出来ると共に、縫合後の切断時他臓器
に傷を付ける危険が無く、且つ切断した小切片を受け止
める受け皿として働くため、悪性細胞が胸腔内または腹
腔内に散布することを防止できる。According to the automatic suturing device for resection of living tissue of the present invention, the suture for cutting a small section from the living tissue can be reliably performed by a single operation. Therefore, the time required for the suturing operation can be significantly reduced as compared with the conventional device, and the insertion of the suturing device from the incised part with the thoracotomy or laparotomy can be performed by inserting it straight into the part to be cut. The width of the incision can be made smaller than the width of the incision when the conventional device is used. That is, even when the small slice is located at a deep portion, the small thoracotomy operation can be applied, and it is not necessary to increase the width of the incision as in the related art. Further, a suturing device that can be easily used can be provided by the configuration described in claim 2. Further, according to the configuration of the third aspect, it is possible to configure a suturing device that can reliably perform hemostasis and prevent air leakage even in a suture having a curved portion. Further, according to the configuration of claim 4, it is possible to easily search for a tumor present in the living tissue, and there is no risk of damaging other organs at the time of cutting after suturing, and the cut small section can be used. Since it acts as a receiving tray, it can prevent malignant cells from being spread into the thoracic cavity or the abdominal cavity.

【図面の簡単な説明】[Brief description of the drawings]

【図１】 本発明に係る自動縫合器の実施の一例を示す
正面図である。FIG. 1 is a front view showing an example of an embodiment of an automatic suturing device according to the present invention.

【図２】 図１の平面図である。FIG. 2 is a plan view of FIG.

【図３】 分解斜視図である。FIG. 3 is an exploded perspective view.

【図４】 カートリッジの構造を示す分解斜視図であ
る。FIG. 4 is an exploded perspective view showing the structure of the cartridge.

【図５】 カートリッジを装備した挟持部材に対して下
側の挟持部材を開いた状態を示す斜視図である。FIG. 5 is a perspective view showing a state in which a lower holding member is opened with respect to a holding member equipped with a cartridge.

【図６】 図５における打ち出し部材の上下動を示す斜
視図である。FIG. 6 is a perspective view showing vertical movement of a launching member in FIG. 5;

【図７】 カートリッジにおけるステープルの配置を示
し、（ィ）は平面図、（ロ）は前半部（Ｌ１）の範囲に
収容されたステープルを示す断面図、（ハ）は後半部
（Ｌ２）の範囲に収容されたステープルを示す断面図で
ある。FIGS. 7A and 7B show the arrangement of staples in a cartridge, wherein FIG. 7A is a plan view, FIG. 7B is a cross-sectional view showing staples accommodated in the range of the first half (L1), and FIG. It is sectional drawing which shows the staple accommodated in the range.

【図８】 生体組織を縫合する状態を示す拡大断面図で
ある。FIG. 8 is an enlarged sectional view showing a state where a living tissue is sutured.

【図９】 生体組織を把持鉗子で挟んで引き出し縫合器
で挟む状態を示す説明図である。FIG. 9 is an explanatory view showing a state in which a living tissue is sandwiched by grasping forceps and sandwiched by a pull-out suture device.

【図１０】 下側の挟持部材を閉じて生体組織を挟む状
態を示す同説明図である。FIG. 10 is an explanatory view showing a state in which a living tissue is sandwiched by closing a lower sandwiching member.

【図１１】 生体組織を縫合器で挟んで腫瘍の探索をす
る状態を示す同説明図である。FIG. 11 is an explanatory diagram showing a state in which a living tissue is sandwiched by a suturing device to search for a tumor.

【図１２】 縫合のために打ち出し部材を閉じる状態を
示す同説明図である。FIG. 12 is an explanatory view showing a state in which the launching member is closed for suturing.

【図１３】 縫合状態を示す同説明図である。FIG. 13 is an explanatory view showing a suturing state.

【符号の説明】[Explanation of symbols]

Ａ…縫合器 Ｂ…生体組織 １…上側の挟持部材 ２…下側の挟持部材 ３…カートリッジ ４…打ち出し部材 ８…底板 ９…ステープル １０…打ち出し爪 A: suturing device B: living tissue 1 ... upper holding member 2 ... lower holding member 3 ... cartridge 4 ... ejection member 8 ... bottom plate 9 ... staple 10 ... ejection nail

Claims (4)

(57)【特許請求の範囲】(57) [Claims] 【請求項１】 人体の生体組織から生検用小切片を切除
するために腫瘍を含む小切片の外周部分を縫合する縫合
器であって、生体組織中に存在する腫瘍を囲むように包
囲して該生体組織を挟持する開閉可能な上下一対の挟持
部材と、その挟持部材の一方に装着するステープルと、
該ステープルを他方の挟持部材側に打ち出して生体組織
を縫合するステープル打ち出し部材からなり、前記ステ
ープル打ち出し部材の操作で打ち出されるステープルが
区画する縫合形状が少なくとも腫瘍部分を取り囲む形状
とし、腫瘍を含む生検用小切片の外周を一動作で縫合す
ることを特徴とする生体組織切除用自動縫合器。1. A suturing device for suturing an outer peripheral portion of a small section containing a tumor in order to resect the small section for biopsy from a living body tissue of a human body, wherein the suturing device surrounds the tumor existing in the living body tissue. A pair of openable and closable holding members for holding the living tissue, and a staple attached to one of the holding members,
A staple driving member for driving the staple toward the other holding member and suturing the living tissue, wherein the staple driven by the operation of the staple driving member defines a stitching shape that surrounds at least a tumor portion; An automatic suturing device for resection of living tissue, wherein the outer periphery of a small section for examination is sutured in one operation. 【請求項２】 上記一方の挟持部材に装着するステープ
ルが、樹脂製ケースにステープルとそのステープルを打
ち出す打ち出し爪を備えたカートリッジタイプである請
求項１記載の生体組織切除用自動縫合器。2. The automatic suturing device according to claim 1, wherein the staple mounted on the one holding member is a cartridge type having a staple and a driving claw for driving the staple in a resin case. 【請求項３】 上記カートリッジにセットされるステー
プルは、縫合部位の手前側に位置するステープルは針脚
が短く且つ幅広とし、先端湾曲部に位置するステープル
は針脚が長く且つ幅狭いことを特徴とする請求項２記載
の生体組織切除用自動縫合器。3. The staple set in the cartridge has a staple located on the near side of a suturing portion having a short and wide needle leg, and a staple located on a distal end curved portion has a long and narrow needle leg. The automatic suturing device for resection of living tissue according to claim 2, wherein 【請求項４】 上記ステープルの針脚を受ける挟持部材
の環状を呈した挟持部が底板で閉塞されていることを特
徴とする請求項１乃至３の何れかに記載の生体組織切除
用自動縫合器。4. The automatic suture for resection of living tissue according to claim 1, wherein an annular holding portion of the holding member for receiving the needle leg of the staple is closed by a bottom plate. vessel.
JP10285419A 1998-10-07 1998-10-07 Automatic suture device for biological tissue resection Expired - Fee Related JP2951659B1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP10285419A JP2951659B1 (en) 1998-10-07 1998-10-07 Automatic suture device for biological tissue resection

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP10285419A JP2951659B1 (en) 1998-10-07 1998-10-07 Automatic suture device for biological tissue resection

Publications (2)

Publication Number Publication Date
JP2951659B1 true JP2951659B1 (en) 1999-09-20
JP2000107190A JP2000107190A (en) 2000-04-18

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Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7401721B2 (en) * 2005-08-15 2008-07-22 Tyco Healthcare Group Lp Surgical stapling instruments including a cartridge having multiple staple sizes
US8579178B2 (en) 2005-08-15 2013-11-12 Covidien Lp Surgical stapling instruments including a cartridge having multiple staples sizes
JP6214409B2 (en) * 2014-01-27 2017-10-18 大日本印刷株式会社 Tissue excision cradle
CN104188703B (en) * 2014-09-17 2016-01-27 武汉大学 A kind of storage bag forming stapler

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