JPH09248307A - Suture cutting appliance for intracardiac suture operation - Google Patents
Suture cutting appliance for intracardiac suture operationInfo
- Publication number
- JPH09248307A JPH09248307A JP6078496A JP6078496A JPH09248307A JP H09248307 A JPH09248307 A JP H09248307A JP 6078496 A JP6078496 A JP 6078496A JP 6078496 A JP6078496 A JP 6078496A JP H09248307 A JPH09248307 A JP H09248307A
- Authority
- JP
- Japan
- Prior art keywords
- suture
- intracardiac
- hub
- side hole
- outer tube
- 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.)
- Granted
Links
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- Surgical Instruments (AREA)
Abstract
Description
【0001】[0001]
【発明の属する技術分野】本発明は、心腔内縫合手術用
縫合糸を切断するための器具に関する。より詳しくは、
例えば心房中隔欠損(ASD)、心室中隔欠損(VS
D)や動脈管開存(PDA)等を直接縫合閉鎖するため
の手術を行う場合、心臓カテーテル手技で末梢血管から
手術部位に心腔内縫合手術用器具等の縫合装置を挿入し
て行うが、この様な縫合手術に用いた縫合糸を体内にお
いて切断するのに好適な心腔内縫合手術用縫合糸切断器
具に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an instrument for cutting a suture thread for intracardiac suture. More specifically,
For example, atrial septal defect (ASD), ventricular septal defect (VS
D) or an operation for directly suturing and closing a patent ductus arteriosus (PDA) or the like is performed by inserting a suturing device such as an intracardiac suture surgical instrument into a surgical site from a peripheral blood vessel by a cardiac catheterization procedure. The present invention relates to a suture thread cutting instrument for intracardiac suture surgery, which is suitable for cutting the suture thread used in such suture surgery in the body.
【0002】[0002]
【従来の技術】先天性心疾患の一つであるASDの治療
方法としては、一般に、外科的手術が主である。しかし
ながら、外科的手術においては、当然のことながら疾患
部分の治療そのものだけでなく、開胸術(または開腹
術)を伴うものであり、患者への負担が大きい。増して
や小児患者の場合、その負担は非常に大きいものとな
る。そこで、近年、非手術的方法として、心臓カテーテ
ルを経血管的に心腔内に挿入して心房中隔欠損を閉塞す
る方法が開発されている。この方法は経皮経管腔カテー
テル法として知られており、キングとミルによって19
76年に初めて臨床成功例が報告されている。キング等
による方法は、左房用と右房用の2枚の円盤状の傘を、
中心のワイヤーと同軸の2層のカテーテルからなる挿入
用具で心房に到らせ、心房中隔を挟んで合体させること
により心房中隔欠損を閉鎖するものである。2. Description of the Related Art As a method for treating ASD, which is one of the congenital heart diseases, surgical operation is generally the main method. However, the surgical operation naturally involves not only the treatment of the diseased part itself but also a thoracotomy (or laparotomy), which imposes a heavy burden on the patient. The burden is even greater for pediatric patients. Therefore, in recent years, as a non-surgical method, a method of inserting a cardiac catheter transvascularly into the heart chamber to occlude the atrial septal defect has been developed. This method is known as percutaneous transluminal catheterization and is described by King and Mill in 19
The first clinical success was reported in 1976. The method by King et al. Is using two disc-shaped umbrellas for the left and right chambers.
The atrial septal defect is closed by reaching the atrium with an insertion tool consisting of a two-layer catheter coaxial with the central wire and sandwiching the atrial septum.
【0003】しかしながら、この方法は非常に太い挿入
用具と硬い傘を用いているため、ほとんどの小児、特に
就学前の小児には全く使用できないものであった。そこ
で、ラシュキントは装置の小型化に努め、1977年に
鉤付きの1枚傘式閉鎖栓を考案し、小児での臨床成功例
を報告している。しかしながら、この方法も、閉塞栓が
鉤付きのため意図しない部分に引っ掛かることがあり、
そのため、心内で一度開傘すると、位置を変えることも
回収することも出来ず緊急手術をしなければならないと
いう欠点を有していた。そこで、このような欠点を解消
するものとして、ラシュキントは2枚の傘を一体化した
閉鎖栓を開発しており、これは、動脈管開存の閉鎖に広
く臨床応用されてきている。[0003] However, this method uses very thick insertion tools and a hard umbrella and cannot be used for most children, especially preschool children. Therefore, Raskind made an effort to miniaturize the device, devised a single umbrella closure plug with a hook in 1977, and reported a clinical success case in children. However, also in this method, the obstruction plug may catch on an unintended part because of a hook,
Therefore, there is a drawback in that once the umbrella is opened in the heart, the position cannot be changed and the collection cannot be performed, and an emergency operation must be performed. Therefore, as a solution to such a drawback, Rashkint has developed a closure plug that integrates two umbrellas, and this has been widely clinically applied to the closure of the patent ductus arteriosus.
【0004】一方、ロックはラシュキントの開発した一
体型の2枚の傘式閉鎖栓の8本のステンレス鋼の骨の各
々の中間にコイルスプリングを追加して、2つの傘が薄
い心房中隔をしっかり挿むようにした蛤式中隔傘を開発
し特許出願している(特開平5−297130号公
報)。この閉鎖栓は、2枚の傘が互いに重なり合うよう
に密着することで、薄い心房中隔にしっかりと固定され
るようにしたもので、その形が二枚貝である蛤に似てい
ることから、蛤式中隔傘と呼ばれている。この方法は1
1フレンチのロングシースを大腿静脈から挿入するもの
であり、体重8Kg以上の患者であれば使用することが
できるので、心房中隔欠損の経皮経管腔カテーテル法で
閉塞する方法として、初めて広く臨床応用されている。On the other hand, Locke added a coil spring in the middle of each of the eight stainless steel bones of the two umbrella closures developed by Raschint to allow the two umbrellas to form a thin atrial septum. A claw-type septum umbrella that can be firmly inserted has been developed and applied for a patent (Japanese Patent Laid-Open No. 5-297130). This closure plug is designed to be firmly fixed to the thin atrial septum by closely adhering two umbrellas so that they overlap each other. Since its shape resembles a clam that is a bivalve, it is a clam. It is called a shika septum umbrella. This method is 1
A 1-French long sheath is inserted through the femoral vein and can be used by patients with a body weight of 8 kg or more. Therefore, it is the first method widely used for percutaneous transluminal catheterization of atrial septal defect. Clinically applied.
【0005】しかしながら、何れにしてもこれらの閉鎖
栓を使用するものは、様々な形態をしたASDに対して
画一的な形状の閉鎖栓を使用するものであり、欠損孔の
閉鎖にはその2倍の大きさの閉鎖栓が必要なので、適応
が限定され、比較的小さな中心部の欠損孔しか閉鎖出来
ないという欠点を有しており、また、心内に残した閉鎖
栓の長期的な観測データが無いために、その使用に対す
る懸念の残るものであった。本発明者等は如上の事情に
鑑み、従来技術の課題を解決するものとして、特に様々
な形態をしたASDに適応するのに好適な心腔内縫合手
術用カテーテル組立体をすでに提案している(特願平7
−269916号)。このものは、先端に縫合糸捕捉手
段を備え基端に操作用部材を備えた捕捉カテーテルと、
この捕捉カテーテルを出し入れ自在に挿着することがで
きる第1シースと、この第1シースを出し入れ自在に挿
着することができ、先端に穿刺針を備えるとともに基端
部に止血弁を備えた穿刺カテーテルと、この穿刺カテー
テルを出し入れ自在に挿着することができ、基端部に止
血弁を備えた第2シースからなるもので、第2シースに
挿着された穿刺カテーテルの先端と第2シースの先端が
一致するようにした時に、穿刺カテーテルの先端部に設
けられた側孔と第2シースの先端部に設けられた側孔が
重なり、この重なった側孔から第1シースを露出するこ
とができるようになっている。[0005] However, in any case, those using these closure plugs use a uniform closure plug for various forms of ASD. The necessity of double the size of the closure plug limits the adaptation, has the disadvantage that only a relatively small central hole can be closed, and the long-term The lack of observational data left concerns about its use. In view of the above circumstances, the present inventors have already proposed a catheter assembly for endocardial suturing surgery suitable for adapting to various forms of ASD as a solution to the problems of the prior art. (Japanese Patent Application No. 7
-269916). This is a capture catheter having a suture capture means at the distal end and an operating member at the proximal end,
A first sheath through which the capture catheter can be freely inserted and removed, and a puncture having a first needle that can be freely inserted and removed and a puncture needle at the distal end and a hemostatic valve at the proximal end A second sheath having a proximal end portion provided with a hemostasis valve, the distal end of the puncture catheter inserted into the second sheath, and a second sheath; When the tip of the second sheath coincides, the side hole provided at the tip of the puncture catheter and the side hole provided at the tip of the second sheath overlap, and the first sheath is exposed from the overlapped side hole. Is available.
【0006】このような非手術的に欠損口を閉鎖する器
具は、簡単かつ正確に欠損口を閉鎖することができると
いう利点を有するものであるが、糸を結んだ後できるだ
け糸の結び目近くで糸を切断しょうとすると、心腔内で
糸を切断しなければならないため、糸の切断に非常な熟
練を要するものであった。そこで、体内で糸を切断する
ための器具が必要になり、特公平5−60934号公報
において、先端部に切断刃部を設けた内チューブと切断
刃部押し当て部を設けた外チューブからなり、外チュー
ブに押し当てた糸を軸方向に移動させた内チューブの切
断刃部で切断するようにした糸切断装置が提案されてい
る。[0006] Such a non-surgical device for closing a defect opening has an advantage that the defect opening can be closed easily and accurately. However, after the thread is tied, it should be as close as possible to the knot of the thread. When attempting to cut a thread, the thread must be cut in the heart chamber, which requires a great deal of skill to cut the thread. Therefore, an instrument for cutting the thread in the body is required. In Japanese Patent Publication No. 5-60934, an inner tube having a cutting blade portion at the tip and an outer tube having a cutting blade pressing portion are provided. A thread cutting device has been proposed in which the thread pressed against the outer tube is cut by the cutting blade portion of the inner tube that is moved in the axial direction.
【0007】[0007]
【発明が解決しようとする課題】しかしながら、上記の
糸切断装置は、外チューブに切断刃部押し当て部が設
けられているとはいえ、軸方向に移動する切断刃部が内
チューブの先端に設けられているため、誤って組織を損
傷する虞がある。内チューブの軸方向に力がかかるの
で、切断器具の位置にぶれが生じ、所望の位置で正確に
糸を切断するのが難しい。切断器具の全長もしくはそ
れ以上に渡って、糸を内チューブの内側に通す必要があ
るので、その操作自体に非常な手間を要するものであ
り、従って、例えば腰の弱い(フレキシビリティの非常
に高い)糸の場合には、適当な案内具が無ければ内チュ
ーブ内側の途中で引っ掛かってしまう虞があった。本発
明は如上の事情に鑑みてなされたもので、心腔内におい
て、医療用の縫合糸を簡単かつ確実に切断することので
きる器具(心腔内縫合手術用縫合糸切断器具)を提供す
ることを目的とする。However, in the above-mentioned yarn cutting device, although the outer tube is provided with the cutting blade pressing portion, the axially movable cutting blade is provided at the tip of the inner tube. Since it is provided, there is a risk of accidentally damaging the tissue. Since a force is applied in the axial direction of the inner tube, the position of the cutting instrument is shaken, and it is difficult to cut the thread accurately at a desired position. Since it is necessary to pass the thread inside the inner tube over the entire length or more of the cutting instrument, the operation itself requires a great deal of labor, and thus, for example, a weak waist (very high flexibility) ) In the case of a thread, there is a risk that it may be caught in the inner tube inside without an appropriate guide tool. The present invention has been made in view of the above circumstances, and provides a device (suture thread cutting device for intracardiac suture surgery) that can easily and reliably cut a medical suture in a heart chamber. The purpose is to
【0008】[0008]
【課題を解決するための手段】本発明は、上記の課題を
解決するために、基端にハブを備え先端部に側孔を有す
る外管と、該外管の基端のハブから回動自在に挿着され
た、基端にハブを備え先端に側孔を有する内管から構成
されてなり、内管の外径が外管の内径より僅かに小さく
形成されており、内管の側孔が該内管を回転させた時に
外管の側孔と少なくとも一部重なることができるように
位置決めされてなる心腔内縫合手術用縫合糸切断器具を
採用している。ここで外管の側孔の縁と内管の側孔の縁
は、糸が容易に切断できるように鋭利に噛み合うように
なっているのがよい。In order to solve the above problems, the present invention provides an outer tube having a hub at its proximal end and a side hole at its distal end, and a rotation from the hub at the proximal end of the outer tube. It is made up of an inner tube that is freely inserted and has a hub at the base end and a side hole at the tip, and the outer diameter of the inner tube is slightly smaller than the inner diameter of the outer tube. A suture cutting instrument for intracardiac suture surgery is employed in which the hole is positioned so as to at least partially overlap the side hole of the outer tube when the inner tube is rotated. Here, it is preferable that the edge of the side hole of the outer tube and the edge of the side hole of the inner tube engage with each other sharply so that the thread can be easily cut.
【0009】[0009]
【発明の実施の形態】次に本発明の実施例について図面
に基づいて説明する。図1は本発明の一実施例を示す側
面図であり、図2は図1の断面図である。また、図3は
縫合糸を図1に示す器具の先端から側孔に通した時の説
明図であり、図4は図1に示す器具を所望の切断位置ま
で進めたときの説明図、図5は図4において内管を僅か
に回転させた状態を示す側孔部分の拡大図、図6は糸を
切断する直前の状態を示す側孔部分の拡大図である。図
1および図2に示すように、本発明の心腔内縫合手術用
縫合糸切断器具は、基端にハブ2を備えた外管1と、こ
の外管1の基端のハブ2から回動自在に挿着された基端
にハブ4を備えた内管3から構成されてなり、内管3の
外径は外管1の内径より僅かに小さく形成されている。
そして、外管1も内管3もそれぞれ先端に側孔11、3
1を有しており、内管3を回転させた時に側孔11と3
1が一部重なることができるように位置決めされてい
る。DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Next, embodiments of the present invention will be described with reference to the drawings. 1 is a side view showing an embodiment of the present invention, and FIG. 2 is a sectional view of FIG. FIG. 3 is an explanatory view when the suture thread is passed through the side hole from the tip of the instrument shown in FIG. 1, and FIG. 4 is an explanatory view when the instrument shown in FIG. 1 is advanced to a desired cutting position. 5 is an enlarged view of the side hole portion showing a state in which the inner pipe is slightly rotated in FIG. 4, and FIG. 6 is an enlarged view of the side hole portion immediately before cutting the thread. As shown in FIGS. 1 and 2, the suture cutting instrument for intracardiac suture surgery according to the present invention includes an outer tube 1 having a hub 2 at a proximal end and a hub 2 at the proximal end of the outer tube 1. It is composed of an inner tube 3 having a hub 4 at a base end movably inserted therein, and an outer diameter of the inner tube 3 is formed to be slightly smaller than an inner diameter of the outer tube 1.
Then, the outer tube 1 and the inner tube 3 have side holes 11 and 3 respectively at their tips.
1 has side holes 11 and 3 when the inner tube 3 is rotated.
1 are positioned so that they can partially overlap.
【0010】内管3のハブ4の内腔41には、他の医療
用具と接続可能なようにテーパーが設けられており、内
管3と外管1の間には隙間(クリアランス)が設けられ
ている。この隙間は、縫合糸の切断性能を考慮した場
合、内管3を回転させるのに差し支えない限り、出来る
だけ小さい方が好ましい。縫合糸の切断性能を更に良く
するために、外管1の側孔11の縁部と内管3の側孔3
1の縁部に鋭利な刃物状の加工を施すなど、側孔11と
側孔31が鋭利に噛み合うようにしてもよい。The inner lumen 41 of the hub 4 of the inner tube 3 is provided with a taper so that it can be connected to other medical devices, and a clearance is provided between the inner tube 3 and the outer tube 1. Has been. In consideration of the cutting performance of the suture thread, this gap is preferably as small as possible as long as the inner tube 3 can be rotated. In order to further improve the cutting performance of the suture, the edge portion of the side hole 11 of the outer tube 1 and the side hole 3 of the inner tube 3
The side hole 11 and the side hole 31 may be sharply engaged with each other by, for example, processing a sharp edge on the edge portion of 1.
【0011】外管1と内管3の形成材料は、切断性能お
よびトルク伝達性を考慮した場合、ステンレス鋼等の金
属が好ましいが、側孔11、31のエッジで縫合糸が切
断でき、かつ内管3を回転させる際、手元(基端)のト
ルクが先端に十分伝わるのであればこれに限定されるも
のではなく、硬質の合成樹脂、例えばポリサルホン等も
採用可能である。また、チューブ材料としてポリアミド
11や高密度ポリエチレンを採用し、切断性能を良くす
るために側孔11、31の縁部のみに金属性材料を使用
したり、必要ならばトルク伝達性を良くするために内管
3を補強するなどしてもよい。また、内管ハブ4や外管
ハブ2の形成材料は、一般に、医療用として用いられる
樹脂や金属であれば特に限定されるものではない。The material for forming the outer tube 1 and the inner tube 3 is preferably metal such as stainless steel in consideration of cutting performance and torque transmissibility, but sutures can be cut at the edges of the side holes 11 and 31, and The present invention is not limited to this as long as the torque at the hand (base end) is sufficiently transmitted to the tip when the inner tube 3 is rotated, and a hard synthetic resin such as polysulfone can be adopted. In addition, polyamide 11 or high-density polyethylene is used as the tube material, and a metallic material is used only at the edges of the side holes 11 and 31 to improve the cutting performance, and if necessary, torque transmission is improved. Alternatively, the inner tube 3 may be reinforced. The material for forming the inner tube hub 4 and the outer tube hub 2 is not particularly limited as long as it is a resin or metal generally used for medical purposes.
【0012】次に、本発明の心腔内縫合手術用縫合糸切
断器具C(以下、単に切断器具という)の使用について
説明する。先ず、既に体内で結ばれその端部が体外に導
出された状態の縫合糸Aを切断器具Cの先端開口5から
内管3に挿入し、図3に示すように、縫合糸Aの端部を
側孔31、11を通して外管1の外側に取り出す。次
に、縫合糸Aの端部を把持したまま切断器具Cを体内に
挿入して、その先端を閉鎖済みの組織Bの近くの所望の
切断位置まで進める(図4参照)。ここで、外管ハブ2
を手などで把持固定して内管ハブ4を回転させると、内
管3が回転して、図5に示すように外管1の側孔11と
内管3の側孔31がずれていき、少しずつ側孔11と3
1の重なり部分が狭くなる。やがて図6に示すように側
孔11と31の重なり部分が殆ど無くなり、2つの側孔
11、31の重なりが無くなる時に、丁度鋏で切るよう
に側孔11と31の縁部により縫合糸Aが切断される。Next, the use of the suture cutting instrument C (hereinafter simply referred to as a cutting instrument) for intracardiac suture surgery of the present invention will be described. First, the suture thread A, which has already been tied in the body and the end portion of which has been led out of the body, is inserted into the inner tube 3 through the tip opening 5 of the cutting instrument C, and as shown in FIG. Is taken out of the outer tube 1 through the side holes 31 and 11. Next, the cutting instrument C is inserted into the body while grasping the end portion of the suture thread A, and the tip thereof is advanced to a desired cutting position near the closed tissue B (see FIG. 4). Here, the outer tube hub 2
When the inner pipe hub 4 is rotated by gripping and fixing the inner pipe 3 with a hand or the like, the inner pipe 3 is rotated and the side hole 11 of the outer pipe 1 and the side hole 31 of the inner pipe 3 are displaced as shown in FIG. , Side holes 11 and 3 little by little
The overlapping part of 1 becomes narrow. When the overlapping portions of the side holes 11 and 31 are almost eliminated as shown in FIG. Is disconnected.
【0013】[0013]
【発明の効果】以上説明してきたことから明らかなよう
に、本発明を採用することにより、心腔内縫合手術終了
後、安全、確実かつ迅速に、心腔内において縫合糸を切
断することができる。As is clear from the above description, by adopting the present invention, it is possible to safely, reliably and promptly cut the suture thread in the intracardiac cavity after completion of the intracardiac suture operation. it can.
【図1】本発明の一実施例を示す側面図である。FIG. 1 is a side view showing an embodiment of the present invention.
【図2】図1の縦断面図である。FIG. 2 is a longitudinal sectional view of FIG.
【図3】縫合糸を図1に示す器具の先端から側孔に通し
た時の説明図である。FIG. 3 is an explanatory diagram when a suture is passed through a side hole from the tip of the device shown in FIG.
【図4】図1に示す器具を所望の切断位置まで進めたと
きの説明図である。FIG. 4 is an explanatory diagram when the instrument shown in FIG. 1 is advanced to a desired cutting position.
【図5】図4において内管を僅かに回転させた状態を示
す側孔部分の拡大図である。FIG. 5 is an enlarged view of a side hole portion showing a state in which the inner pipe is slightly rotated in FIG.
【図6】糸を切断する直前の状態を示す側孔部分の拡大
図である。FIG. 6 is an enlarged view of a side hole portion showing a state immediately before cutting a thread.
1 外管 11 側孔 2 外管ハブ 3 内管 31 側孔 4 内管ハブ A 縫合糸 C 心腔内縫合手術用縫合糸切断器具 1 Outer Tube 11 Side Hole 2 Outer Tube Hub 3 Inner Tube 31 Side Hole 4 Inner Tube Hub A Suture Thread C Suture Cutting Device for Intracardiac Suture Operation
Claims (2)
外管と、該外管の基端のハブから回動自在に挿着され
た、基端にハブを備え先端に側孔を有する内管から構成
されてなり、内管の外径が外管の内径より僅かに小さく
形成されており、内管の側孔が該内管を回転させた時に
外管の側孔と少なくとも一部重なることができるように
位置決めされてなる心腔内縫合手術用縫合糸切断器具。1. An outer tube having a hub at a base end and a side hole at a tip end, and a hub at a base end rotatably inserted from a hub at a base end of the outer tube and a side hole at a tip. The inner diameter of the inner tube is slightly smaller than the inner diameter of the outer tube, and the side hole of the inner tube is at least the side hole of the outer tube when the inner tube is rotated. A suture cutting instrument for intracardiac suture surgery, which is positioned so that it can partially overlap.
に噛み合うようになっている請求項1に記載の心腔内縫
合手術用縫合糸切断器具。2. The suture cutting instrument for intracardiac suture according to claim 1, wherein the edge of the side hole of the outer tube and the edge of the side hole of the inner tube are engaged with each other sharply.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP06078496A JP3859257B2 (en) | 1996-03-18 | 1996-03-18 | Suture cutting device for intracardiac suture surgery |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP06078496A JP3859257B2 (en) | 1996-03-18 | 1996-03-18 | Suture cutting device for intracardiac suture surgery |
Publications (2)
Publication Number | Publication Date |
---|---|
JPH09248307A true JPH09248307A (en) | 1997-09-22 |
JP3859257B2 JP3859257B2 (en) | 2006-12-20 |
Family
ID=13152274
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP06078496A Expired - Fee Related JP3859257B2 (en) | 1996-03-18 | 1996-03-18 | Suture cutting device for intracardiac suture surgery |
Country Status (1)
Country | Link |
---|---|
JP (1) | JP3859257B2 (en) |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2008546454A (en) * | 2005-06-20 | 2008-12-25 | スーチュラ,インコーポレイテッド | Method and apparatus for knotting sutures |
JP2022023968A (en) * | 2016-07-14 | 2022-02-08 | ストライカー・ユーロピアン・ホールディングス・I,リミテッド・ライアビリティ・カンパニー | Cutting assembly for surgical instrument with clog reducing tip |
JP2022519000A (en) * | 2018-07-12 | 2022-03-18 | バルテック・カーディオ・リミテッド | Annuloplasty system and locking tools for it |
-
1996
- 1996-03-18 JP JP06078496A patent/JP3859257B2/en not_active Expired - Fee Related
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2008546454A (en) * | 2005-06-20 | 2008-12-25 | スーチュラ,インコーポレイテッド | Method and apparatus for knotting sutures |
JP2022023968A (en) * | 2016-07-14 | 2022-02-08 | ストライカー・ユーロピアン・ホールディングス・I,リミテッド・ライアビリティ・カンパニー | Cutting assembly for surgical instrument with clog reducing tip |
CN114271899A (en) * | 2016-07-14 | 2022-04-05 | 史赛克欧洲运营有限责任公司 | Cutting assembly for surgical instrument having occlusion-reducing tip |
US11766274B2 (en) | 2016-07-14 | 2023-09-26 | Stryker European Operations Holdings Llc | Cutting assembly for surgical instrument with clog-reducing hub |
JP2022519000A (en) * | 2018-07-12 | 2022-03-18 | バルテック・カーディオ・リミテッド | Annuloplasty system and locking tools for it |
US11890191B2 (en) | 2018-07-12 | 2024-02-06 | Edwards Lifesciences Innovation (Israel) Ltd. | Fastener and techniques therefor |
Also Published As
Publication number | Publication date |
---|---|
JP3859257B2 (en) | 2006-12-20 |
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