KR20110007244A - 자동봉합장치용 봉합보강재 - Google Patents
자동봉합장치용 봉합보강재 Download PDFInfo
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- KR20110007244A KR20110007244A KR1020107027307A KR20107027307A KR20110007244A KR 20110007244 A KR20110007244 A KR 20110007244A KR 1020107027307 A KR1020107027307 A KR 1020107027307A KR 20107027307 A KR20107027307 A KR 20107027307A KR 20110007244 A KR20110007244 A KR 20110007244A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L17/00—Materials for surgical sutures or for ligaturing blood vessels ; Materials for prostheses or catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—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
- A61B17/07207—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 the staples being applied sequentially
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0483—Hand-held instruments for holding sutures
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—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
- A61B17/07292—Reinforcements for staple line, e.g. pledgets
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
- A61B2017/0477—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery with pre-tied sutures
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- Details Of Garments (AREA)
- Lining Or Joining Of Plastics Or The Like (AREA)
Abstract
본 발명은, 외과수술 등에 널리 사용되는 자동봉합장치에 적합하게 채용할 수 있는 관형의 봉합보강재에 관한 것으로, 관형상화에 있어서의 생산성을 증대시키고, 실 제거조작을 용이하게 한 것이다. 종래의 임시 접착에 의한 벗겨짐, 전부 바느질에 의한 생산성의 저하와 숙련의 문제, 시트형 재료의 종류, 바느질 피치에 의하여 실이 부드럽게 빠지기 어려운 문제를 해결하는 것에 그 목적이 있다. 구체적으로는, 시트형 재료의 양단부를 봉합하고, 관형으로 형성한 자동봉합장치용 봉합보강재의 구성으로서, 그 바느질 방법은 1개의 실로 구성된는 자사루핑 스티치로 하여 바느질 끝에서의 실 끝단을 적절히 연장한 것을 특징이라고 하는 자동봉합장치용 봉합보강재에 관한 것이다.
Description
본 발명은 외과수술 등에 널리 사용되는 자동봉합장치의 이용에 적합한 관형(tubular) 봉합보강재에 관한 것으로, 보다 구체적으로 관 형상화가 용이하여 생산성이 증대되고, 실 제거조작이 용이한 관형 봉합보강재에 관한 것이다.
종래, 다수의 스테이플을 포함한 스테이플러 타입의 자동봉합장치는 조직의 봉합에 사용되고 있지만, 폐 등으로의 적용에 있어서는 봉합된 부분으로부터 공기가 누설되는 문제가 있고, 또한 연약 조직에 적용될 경우에는 조직의 손상, 찢어짐 등의 문제가 발생하였다.
이러한 문제에 대하여 본 출원인은 공기누설의 방지, 보강을 목적으로 하여 스테이플 부분에 장착해서 사용하는 관형 봉합보강재에 대하여 이미 몇 개의 출원을 한바 있다(예를 들면 일본 실용신안등록 제2604025호 공보, 일본특허 제3136392호 공보, 일본특허 제3237749호 공보, 일본특허 제3237750호 공보, 일본 특개평 9-24050호 공보, 일본 특개평 9-308635호 공보, 일본 특허공개 제2000-157622호 공보, 일본 특허공개 제2000-316963호 공보, 일본 특허공개 제2001-70433호 공보).
또한 다른 출원인에 의한 관형 봉합보강재에 관련되는 출원으로서, 일본특허 제3040930호 공보, 일본 특개평 8-299427호 공보 등도 있다.
전술한 출원에는 예를 들면 생체 내 분해흡수성 소재로 이루어지는 부직포, 또는 필름 등의 시트(sheet)형 재료를 관형으로 형성한 구성, 또는 생체 내 분해흡수성 소재로 이루어지는 부직포와 신축성 편지(編地)를 조합시켜서 관형으로 형성한 구성 등이 개시되어 있다. 이와 같은 관형상화는 적층된 시트형 재료의 양단부(양쪽 가장자리부)를 가볍게 임시 접착하는 방법, 적층된 시트형 재료의 양단부를 거칠게 임시로 꿰매는 방법이 예시되어 있다. 구체적으로 적층된 시트형 재료의 표면과 이면을 교대로 홈질(running stitch)하여 봉합하는 방법이 예시되어 있다.
이와 같이 시트형 재료를 임시 접착 또는 임시로 꿰매는 것은 봉합보강재가 장착된 자동봉합장치에 의해 환부를 봉합해 병변부(病變部)를 정상조직부에서 분리한 후, 병변부를 체외로 제거할 때, 병변부와 함께 꺼내는 보강재의 부분과, 체내에 남는 보강재 부분을 분리하기 쉽도록 하기 위함이다.
그러나, 이러한 임시 접착에 의해 제작되는 관형 봉합보강재에서는 시트형 재료가 분리되기 쉽고, 홈질에 의해 제작되는 관형 봉합보강재에서는 바느질의 숙련과 시간을 필요로 하며, 시트형 재료의 종류, 바느질 피치 등에 좌우되어 실을 부드럽게 제거하기에 어려운 문제가 있었다.
본 발명은 이러한 문제를 해결하기 위한 것으로, 고도의 기술을 필요로 하지 않고 제작할 수 있고, 또한 보강재의 소재나 바느질 피치에 관계없이 보강재로부터의 실이 매우 부드럽게 제거될 수 있는 새로운 자동봉합장치용 봉합보강재를 제공하는데 있다.
이와 같은 본 발명의 특징은 이하의 구성을 갖는다.
항목 1. 시트형 재료의 양단부를 봉제하여 관형으로 한 자동봉합장치용 봉합 보강재로서, 그 바느질 방법은 1개의 실로 구성되는 자사루핑스티치(intralooping stitch)(체인스티치: chain stitch)로 하고, 바느질 끝에서의 실 끝단을 적절히 연장한 것을 특징으로 하는 자동봉합장치용 봉합보강재.
항목 2. 선단부를 끝이 가는 모양 또는 자루모양으로 봉제하여 이루어지는 항목 1 기재의 자동봉합장치용 봉합보강재.
항목 3. 상기 시트형 재료의 적어도 일부는 생체 내 분해흡수성 소재로 이루어지는 편물, 직물, 부직포 및 필름 중 선택되는 적어도 하나를 이용하는 것을 특징으로 하는 항목 1 또는 항목 2에 기재의 자동봉합장치용 봉합보강재.
항목 4. 상기 시트형 재료와 신축성을 갖는 편물지 또는 직물지를 일체화하여 관형으로 형성하는 항목 1 기재의 자동봉합장치용 봉합보강재.
항목 5. 관형을 구성하는 시트형 재료의 바느질 끝 측단부에 손잡이부를 구비한 항목 1 내지 4 중 어느 하나의 기재의 자동봉합장치용 봉합보강재.
항목 6. 바느질 끝에서 연장된 실 끝단 끼리를 링형태로 연결하는 항목 1 내지 4 중 어느 하나의 기재의 자동봉합장치용 봉합보강재.
항목 7. 연장된 실 끝단의 루프에 스토퍼를 관통시켜 빠짐방지를 도모한 항목 1 내지 4 중 어느 하나의 기재의 자동봉합장치용 봉합보강재.
항목 8. 연장된 실 끝단을 그 실의 끝단에 연속하는 앞 루프에 관통시켜 빠짐 방지를 도모한 항목 1 내지 4 중 어느 하나의 기재의 자동봉합장치용 봉합보강재.
항목 9. 바느질 끝 측의 하나의 루프를 그 직전의 루프에 묶어 빠짐 방지를 도모한 항목 1 내지 4 중 어느 하나의 기재의 자동봉합장치용 봉합보강재.
항목 10. 시트형 재료의 양단부를 봉합해 관형으로 한 자동봉합장치용 봉합보강재의 제조방법으로서, 1개의 실로 구성되는 체인 스티치에 의해 상기 시트형 재료의 양단부를 봉제해서 관형으로 하고, 바느질 끝에서의 실 끝단을 적절히 연장하는 것을 특징으로 하는 자동봉합장치용 봉합보강재의 제조방법.
항목 11. 스테이플 내장 카트리지부와 스테이플수용홈을 갖는 프레임부를 구비한 자동봉합장치로서, 상기 카트리지부 및/또는 상기 프레임부에 항목 1 내지 9중 어느 하나의 기재의 자동봉합장치용 봉합보강재를 장착되는 자동봉합장치.
본 발명의 봉합보강재는 기존의 재봉틀 등을 이용하여 솔기의 형성을 용이하게 할 수 있는 특징을 갖는다. 그 때문에 숙련을 필요로 하는 않고 관형 봉합보강재를 제조하는 것을 할 수 있고, 생산성을 증대시키고, 품질의 편차도 발생시키지 않는다. 또한 종래의 솔기에 비하여 제거성이 뛰어나고, 수술 후의 시트형 재료의 분리조작을 부드럽게 실행할 수 있다. 또한 자동봉합장치에의 장착 작업성의 개선하고, 조작 중의 풀림을 방지하는 기능도 함께 제공한 것이다.
도1은 본 발명을 구성하는 바느질 방법의 모식도.
도2는 본 발명을 구성하는 바느질 방법의 모식도.
도3은 본 발명을 구성하는 바느질 방법의 모식도.
도4는 본 발명을 구성하는 바느질 방법의 모식도.
도5는 본 발명을 구성하는 바느질 방법의 모식도.
도6은 본 발명을 구성하는 바느질 방법의 모식도.
도7은 본 발명을 구성하는 바느질 방법의 모식도
도8은 본 발명의 구성을 예시한 사시도.
도9는 본 발명의 다른 구성을 예시한 사시도.
도10은 본 발명의 봉합보강재를 장착한 자동봉합장치의 정면도.
도11은 도10에서의 본 발명의 봉합보강재를 자동봉합장치에 장착하는 상태를 나타낸 일부확대 정면도.
도12는 본 발명의 다른 구성을 예시한 사시도.
도13은 본 발명에 따른 실의 끝단 빠짐방지의 예시 사시도.
도14는 본 발명에 따른 실의 끝단 빠짐방지의 다른 예시 사시도.
도15는 본 발명에 따른 실의 끝단 빠짐방지의 또 다른 예시 사시도.
도16은 본 발명의 손잡이부를 구비한 구성을 예시한 사시도.
도2는 본 발명을 구성하는 바느질 방법의 모식도.
도3은 본 발명을 구성하는 바느질 방법의 모식도.
도4는 본 발명을 구성하는 바느질 방법의 모식도.
도5는 본 발명을 구성하는 바느질 방법의 모식도.
도6은 본 발명을 구성하는 바느질 방법의 모식도.
도7은 본 발명을 구성하는 바느질 방법의 모식도
도8은 본 발명의 구성을 예시한 사시도.
도9는 본 발명의 다른 구성을 예시한 사시도.
도10은 본 발명의 봉합보강재를 장착한 자동봉합장치의 정면도.
도11은 도10에서의 본 발명의 봉합보강재를 자동봉합장치에 장착하는 상태를 나타낸 일부확대 정면도.
도12는 본 발명의 다른 구성을 예시한 사시도.
도13은 본 발명에 따른 실의 끝단 빠짐방지의 예시 사시도.
도14는 본 발명에 따른 실의 끝단 빠짐방지의 다른 예시 사시도.
도15는 본 발명에 따른 실의 끝단 빠짐방지의 또 다른 예시 사시도.
도16은 본 발명의 손잡이부를 구비한 구성을 예시한 사시도.
이하 본 발명을 상세하게 설명한다.
본 발명을 구성하는 시트형 재료는 폴리아미드(polyamide), 폴리에스테르(polyester), 실리콘, 불소수지(fluororesin) 등 생체 내에서의 비흡수성 재료, 및 폴리글리콜산(polyglycolic acid), 폴리유산(polyactic acid), 글리콜산(glycolic acid)과 유산(lactic acid)의 공중합체(copolymer), 유산과 카프로락톤(caprolacton)의 공중합체, 글리콜산(glycolic acid)과 카프로락톤(caprolacton)의 공중합체 또는 그의 혼합물, 폴리파라디옥사논(polyparadioxanone), 폴리카프로락톤(polycaprolactone), 키틴(chitin), 동물조직 등 생체 내의 분해흡수성 재료로부터 적절히 선택되어 제조된다. 상기 시트형 재료의 형태로는 상기 생체 내 비흡수성 재료, 및/또는 생체 내 분해흡수성 재료로부터 이루어진다, 편물, 직물, 부직포, 필름, 시트, 스펀지 시트 등을 예시할 수 있다.
특히 바람직한 재료로는 유연성, 통풍성, 강성, 두께, 흡혈성, 스테이플 라인의 형성성, 가수분해성 등에 있어서 뛰어나고, 폴리글리콜산을 재료로 한 부직포를 예시할 수 있다. 이러한 부직포는 니들펀칭(needle punching)법, 멜트블로운(meltblown)법 등과 같은 적절한 방법에 의해 제조될 수 있다.
본 발명의 봉합보강재는 1장의 시트형 재료를 둥글게 포개어 그 양단부를 봉제하거나, 또는 2장의 시트형 재료를 적층하여 그 양단부를 봉제해서 관형으로 형성한다. 2장의 시트형 재료를 적층히여 관형으로 형성할 경우, 그 중 1장의 시트형 재료는 신축성을 갖는 시트형 재료로 이루어질 수 있다. 여기에서 신축성을 갖는 시트형 재료로는 그 조직 속에, 고무실, 폴리우레탄계 탄성실, 권축(crimp)가공 실, 부피가공실 등이 적절히 짜거나(interknit) 엮어(interweave), 세로 및/또는 가로방향에 신축성을 갖는 편물지 또는 직물지가 적절하다. 이와 같이 신축성 생지로 조합시킨 봉합보강재의 경우, 자동봉합장치로의 장착, 장착 후의 조절(위치 수정)조작 등을 실행하기 용이하기 때문이다.
또한 이러한 신축성 시트형 재료의 편직 또는 조직에 대해서 특별히 한정되지 않지만, 재단 작업, 관형재의 형성시, 봉제작업의 용이성, 형태 안정성 등의 면에서 폴리우레탄 실에 나일론 실을 커버링(covering)하여 얻은 신축성 실을 사용하고, 날실 조직에 제공한 파워네트 생지가 바람직한 것으로서 예시할 수 있다.
상기 시트형 재료의 관형상화는 1장의 시트형 재료를 사용하는 경우, 봉합장치의 외주 사이즈에 맞춰 재단된 생지를 둥글게 포개어 그 양단부를 봉제함으로써 구현될 수 있다. 또한 2장의 시트형 재료를 사용할 경우에는, 두 시트형 재료를 적층하여 그 양단부끼리를 봉제함으로써 구형될 수 있다.
또한, 본 발명에 있어서 「관형 」의 용어는 시트형 재료의 양단부가 일체화해서 접합하는 것을 나타내고, 원통모양, 각기둥모양, 평면모양 어느 쪽의 형태로 이루어질 수 있다.
이러한 봉제는 양단을 평행하게 봉제하는 방법, 선단부의 끝이 가늘게 되도록 봉제하는 방법, 선단부를 자루 모양으로 되도록 연속해서 봉제하는 방법 등을 들 수 있고, 임의로 선택할 수 있다. 또한 선단부의 끝을 가늘게 하거나, 자루모양이면 봉합장치로의 장착이 용이한 이점이 있다.
이러한 봉제에 사용되는 재봉실은 보통 의류 등의 봉제에 사용될 수 있는 것을 그대로 사용할 수 있지만, 특히 의료용도로 말하는 특수성에서 잘못하여 체내에 케이스가 잔류하게 경우를 생각하여 수술용의 봉합실, 예를 들면 폴리글리콜산, 글리콜 산/유산의 공중합체, 유산/카프로락톤의 공중합체 등에 의한 생체 내 분해흡수성의 봉합실이 바람직하다.
본 발명은 그 바느질 방법에 있어서, 1개의 실로 구성되는 체인 스티치(자사루핑 스티치)로 한 것을 특징으로 한다. 이러한 1개의 실로 구성된 체인 스티치로서는 1개의 실 만으로 루프를 형성한 솔기이다.
본 발명의 바느질 방법의 구체적인 예를 도1 내지 도7에서 나타내고 있지만, 이에 한정되는 것은 아니다. 또한 하기에서 사용할 수 있는 「바늘측 」이라는 것은 적층된 시트형 재료에 바늘을 찌르는 측, 즉 도면의 상측을 의미하고, 「후측 」이라는 것은 적층된 시트형 재료에 바늘을 찌르는 측과 반대측, 즉 도면의 하측을 의미한다. 또한 도1 내지 도6에서는 적층된 시트형 재료를 생략하고 있다.
도1은 바늘측으로부터 시트형 재료로 루프(3)가 관통하고, 시트형 재료의 후측에서 자사루핑(intralooping)되는 예이다. 또한 본 발명에서 자사루핑이라는 것은 실 하나의 루프가 같은 실의 다른 루프를 관통하는 것을 의미한다.
도2는 바늘측으로부터 시트형 재료 안으로 루프(3)가 들어가고, 시트형 재료 일부를 통해 바늘측에 나타나고, 다음 바늘 관통점에서 자사루핑되는 예이다. 이하, 「시트형 재료의 일부를 통해 바늘측에서 나타남」이라고 하는 것은 적층된 시트형 재료의 끝을 돌아서 바늘측에 루프가 보이는 경우나, 시트형 재료를 관통해서 루프가 바늘측에 보이는 경우 등을 포함한다.
도3은 바늘측으로부터 시트형 재료로 루프(3)가 관통하고, 조금 전진해서 시트형 재료를 통해 바늘측에 나타난 다음, 바늘 관통점에서 시트형 재료의 바늘측에서 자사루핑하는 예이다.
도4는 바늘측으로부터 시트형 재료 안으로 루프(3)가 들어가고, 그 시트형 재료의 일부를 통해 바늘측에 나타나고, 스티치 형성 선상(꿰맨 자리 선상)의 다음 바늘관통 점에서 자사루핑하는 예이다.
도5는 도1에 있어서의 봉제 방법의 변형으로 지그재그 모양을 형성한 것이다.
도6은 루프(3)가 바늘측에서 시트형 재료의 이면으로 관통하고, 약간 후퇴하여 시트형 재료를 통해 바늘측에 나타난 것이다. 이 실은 다음 루프가 시트형 재료를 관통하여 자사루핑하는 예이다.
도7은 루프(3)가 시트형 재료의 바늘측에 이미 지나가 있는 루프와, 시트형 재료를 관통하고 이 관통한 루프를 시트형 재료의 단부를 돌아 다음 바늘 관통점까지 연장된 예시다.
또한 각 도면에서, 도면부호 1은 바느질 시작의 실 끝단, 도면부호 2는 바느질 끝의 실 끝단을 나타낸다. 또한 도1에서 도면부호 3은 루프, 도면부호 7은 겉솔기, 도면부호 8은 안솔기를 나타낸다.
이상의 예는 어느 쪽 1개의 실에서 구성되는 루핑스티치이며, 바느질 끝의 실 끝단(2)을 길게 늘어뜨림으로써 형성된 루프로부터 실이 제거되어 저항없이 솔기가 풀리는 봉제방법이다. 이러한 봉제방법은 손바느질에 의해 실행될 수 있지만, 시판되는 재봉틀을 이용하여 실행할 수 있으며, 이 경우 매우 효율적으로 봉제할 수 있다.
실의 끝단은 병변부와 함께 꺼내는 보강재 부분(예를 들면 파워네트 생지)과, 체내에 잔존시키는 보강재 부분(예를 들면 생체 내 분해흡수성 재료)를 분리하기 쉽도록 하기 위하여 적절한 길이로 연장하는 것이 바람직하다. 또한 연장된 바느질 끝의 실 끝단 끼리가 고리형태로 연결될 수 있다. 또한,바느질 시작의 실 끝단을 시트형 재료(예를 들면 파워네트 생지옷감)에 결합시켜 일체화하고, 연장된 양단의 바느질 끝의 실 끝단 끼리를 서로 묶어 고리형태로 연결할 수 있다. 이 경우 뽑기 조작이 매우 용이해서 수술 후에 시트형 재료(예를 들면 파워네트 생지)를 재봉실과 함께 제거하기에 용이하다.
또한 부주위로 보강재로부터 실이 풀리는 것을 방지하기 위하여 바느질 끝 실 끝단의 루프에 스토퍼를 구비하거나, 바느질 끝의 실 끝단에 연속하는 앞 루프에 상기 실의 끝단을 관통시키거나, 바느질 끝 측의 루프를 그 직전의 루프에 관통시켜 1회 결합한 매듭에 의해 고정할 수 있다.
본 발명의 봉합보강재가 적용되는 자동봉합장치로서는 미국 SURGICAL사 제품의 MULTIFIRE GIA80, MULTIFIRE GIA60, MULTIFIRE GIA50, 및 MULTIFIRE GIA90P, Ethicon Endo-Surgery사 제품의 PROXIMATE LINEAR CUTTER 55mm 및 PROXIMATE LINEAR CUTTER 75mm, 미국 SURGICAL사 제품의 ENDO GIA(2)30, ENDO GIA(2)45, ENDO GIA(2)60, 및 Ethicon Endo-Surgery사 제품의 ENDOPATH END CUTTER ETS EZ45 ENDOPATH END CUTTER ETS EZ45 등을 예시할 수 있다.
본 발명의 봉합보강재의 봉합장치로의 적용은 스테이플 내장 카트리지부와 스테이플수용홈을 갖는 프레임부의 일측 또는 양측에 둘러싸(장착하여) 실행된다.
이 경우 관형 봉합보강재를 자동봉합장치에 용이하게 장착할 수 있도록 관형 봉합보강재를 구성하는 시트형 재료의 바느질 끝 측단부를 연장하여 구비하고 손잡이부를 형성할 수 있다.
이하, 본 발명의 봉합보강재에 대하여 예시한 도면을 참조하여 설명하지만, 본 발명은 이에 한정되는 것은 아니다.
실시예1
도8 및 도9는 각각 도1에 나타내는 바느질 방법에 의해 형성된 본 발명의 봉합보강재이고, 도8은 생체 내 분해흡수성의 부직포(5)와 신축성을 갖는 파워네트생지(8)를 적층시키고, 그 양단을 페가사스 회사제품의 DH형 고리봉제 재봉틀에 의해 봉제해서 얻은 관형의 봉합보강재(4)이다. 또한 도9는 상기한 1장의 부직포(5)를 둥글게 하고, 그 단부끼리 포개어 상기와 동일한 재봉틀로 고리형태로 봉제하여 선단부가 폐쇄된 자루모양의 관형 봉합보강재(4)이다.
또한 도면에는 나타내지 않았지만, 도8의 변형예로서, 선단부를 가늘게 하도록 끝을 가늘게 하는 봉제도 본 발명의 하나의 형태로서 예시할 수 있다.
또한 어떠한 예에 있어서도, 바느질 끝의 실 끝단(2)은 빼내기 용이하게 하기 위하여 적당히 연장하여 구비된다.
이와 같이 얻어진 봉합보강재(4)는 도10에 나타낸 자동봉합장치(10)의 스테이플을 포함한 카트리지부(11)와 프레임부(12)에 각각 도11의 확대도에 나타낸 바와 같이 장착해서 사용한다. 또한 이러한 장착에 있어 연장된 바느질 끝의 실 끝단(2)이 앞쪽, 즉 자동봉합장치(10)의 손잡이 측에 위치하도록 장착한다.
실시예2
도12에는 다른 구성 예를 나타낸 것이다. 이러한 구성은 도8과 같이 생체 내 분해흡수성의 부직포(5)와 신축성을 갖는 파워네트생지(6)를 적층시키고, 양단을 봉제해서 얻은 관형 봉합보강재의 구성이며, 바느질 시작의 실 끝단(1)을 파워네트 생지(6)에 결합시켜 일체화하고, 양단의 바느질 끝의 실 끝단(2) 상호 간을 서로 연결하여 고리형상(바퀴형상)으로 한 것이다.
상기 구성에 있어서 바느질 끝의 실 끝단(2)이 고리형상이므로 다루기 쉽고, 제거조작도 용이하게 이루어진다. 또한 파워네트생지(6)에 바느질 시작의 실 끝단(1)이 결합하여, 수술 후에 해당부분을 재봉실과 함께 꺼내기 쉬운 이점이 있다.
실시예3
도13 및 도14에는 바느질 끝의 실 끝단(2)의 빠짐방지를 위한 구성 예를 나타낸 것이다.
도13은 바느질 끝의 실 끝단(2)의 루프(3)에 스토퍼(9)를 관통시킨 것이다. 이러한 스토퍼(9)는 실, 가늘게 절단한 생지, 필름 등이나, 또는 섬유 이외의 재료에 의한 것이어도 무방하다. 관통시키기 쉽고, 잡아 빼기 쉬운 강도를 갖는 것이 적절히 선택되어 사용되는 것이 바람직하다.
도14는 바느질 끝의 실 끝단(2)에서 끝을 잇는 앞 루프(3)에 상기 실의 끝단을 관통시킴으로써 빠짐 방지를 도모한 것이다. 그 조작은 도14의 ① 내지 ④의 순서에 따라 이루어지고, 바느질 끝의 실 끝단(2)을 앞 루프(3)에 관통하고, 최종적으로 실의 끝단(2)을 길게 늘어뜨리고 고정되어 이루어진다.
이와 같은 빠짐 방지수단은, 실의 끝단(2)에 부주의하게 텐션이 걸리고, 실이 보강재로부터 분리되는 것을 방지하는 것이다. 따라서, 소정의 봉합 처리가 완료한 후, 스토퍼를 제거하거나, 앞 루프(3)에 관통시킨 실의 끝단을 원래로 되돌리거나, 잡아당김으로써 실의 빼기를 실행한다.
또한 도15에는 다른 빠짐 방지수단을 예시한다.
이러한 구성은 바느질 끝 측의 루프(3)를 그의 직전의 루프에 관통시키고, 1회 연결하는 매듭(15)에 의해 고정한 것으로, 이에 따라 루프(3)의 빠짐을 방지한다. 즉 이러한 구성에 의하면, 특히 카트리지부, 프레임부에 장착할 때에 부가되는 장력에 의해 생기는 솔기의 풀림을 방지할 수 있다. 또한 봉합 조작 완료 후, 실의 끝단을 잡아당겨 생체 내 분해흡수성의 부직포(5)의 테두리가 찢어지고, 계속해서 솔기가 풀려가기 위해서 재봉실과 함께 파워네트생지(6)를 용이하게 뽑아낼 수 있다.
또한 이러한 빠짐 방지수단은, 상기 예시한 것 외, 예를 들면 시트형 재료에 접착제를 도포해서 실의 끝단을 시트형 재료에 임시 접착하거나, 점착테이프를 붙여서 실의 끝단을 시트형 재료에 임시 고정하는 등 그 방법은 다양이다.
실시예4
도16에는 관형 봉합보강재의 자동봉합장치로의 장착조작을 용이하게 하기 위한 구성, 즉 관형 봉합보강재를 구성하는 시트형 재료의 바느질 끝 측단부를 연장하고, 손잡이부(14)를 구비한 구성을 나타낸 것이다. 본 예에서는 파워네트생지(6)의 바느질 끝 단부를 볼록한 모양으로 재단하여 손잡이부(14)로 형성한 것으로, 해당부를 움켜쥐어서 잡아당김으로써 관형 봉합보강재를 자동봉합장치에 용이하게 장착할 수 있다.
이러한 손잡이부(14)는 조작성을 감안하여 임의인 형상, 치수로 설정하는 것이 바람직하다. 또한 재단에 의한 방법 이외, 임의의 방법에 의해 파워네트생지(6)에 손잡이부를 구비할 수도 있다. 예를 들면 천, 필름 등의 다른 재료를 접착, 봉제 등으로 손잡이부를 구비할 수 있다. 또한 이를 생체 내 분해흡수성의 부직포 (5)측에 구비하여도 좋고, 양쪽에 구비할 수도 있다.
도면 중의 부호에서, 도1 내지 도16 중, 1:바느질 시작의 실 끝단, 2:바느질 끝의 실 끝단, 3:루프, 4:관형 봉합보강재, 5:생체 내 분해흡수성 부직포, 6:파워네트생지, 7:겉솔기, 8:안솔기, 9:스토퍼, 10:자동봉합장치, 11:카트리지부, 12:프레임부, 13:매듭, 14:손잡이부, 15:매듭을 나타낸다.
Claims (8)
- 시트형 재료의 양단부를 봉제하여 관형으로 형성한 자동봉합장치용 봉합보강재로서, 그 바느질 방법은 1개의 실로 구성되는 자사루핑 스티치로 하여 바느질 끝에서의 실 끝단을 연장하고, 앞 루프를 그 앞의 루프로부터 떼어내고, 연장된 실 끝단을 해당 실 끝단에 연속하는 앞 루프에 관통시켜 풀림방지가 되도록 하는 것을 특징으로 하는
자동봉합장치용 봉합보강재.
- 제1항에 있어서,
선단부를 끝이 가는 모양 또는 자루모양으로 봉제하여 이루어지는
자동봉합장치용 봉합보강재.
- 제1항 또는 제2항에 있어서,
상기 시트형 재료의 적어도 일부는 생체 내 분해흡수성 소재로 이루어지는 편물, 직물, 부직포 및 필름 중 선택되는 적어도 하나를 이용하는 것을 특징으로 하는
자동봉합장치용 봉합보강재.
- 제1항에 있어서,
상기 시트형 재료와 신축성을 갖는 편물지 또는 직물지를 일체화하여 관형으로 형성하는
자동봉합장치용 봉합보강재.
- 제1항 또는 제2항에 있어서,
상기 바느질 끝 측의 하나의 루프를 그 직전의 루프에 묶어 빠짐을 방지하도록 한
자동봉합장치용 봉합보강재.
- 시트형 재료의 양단부를 봉합해 관형으로 형성한 자동봉합장치용 봉합보강재의 제조방법으로서, 1개의 실로 구성되는 자사루핑 스티치에 의해 상기 시트형 재료의 양단부를 봉제해서 관형으로 하고, 바느질 끝에서의 실 끝단을 연장하고, 앞 루프를 그 앞의 루프로부터 떼어내고, 연장된 실 끝단을 해당 실 끝단에 연속하는 앞 루프에 관통시켜 풀림 방지가 되도록 하는 것을 특징으로 하는
자동봉합장치용 봉합보강재의 제조방법.
- 스테이플 내장 카트리지부와 스테이플 수용 홈을 갖는 프레임부를 구비한 자동봉합장치로서, 상기 카트리지부, 상기 프레임부, 또는 상기 카트리지부 및 상기 프레임부에 제1항 또는 제2항에 기재된 자동봉합장치용 봉합보강재가 장착되는 자동봉합장치.
- 제6항에 있어서, 바느질 끝측의 루프의 하나를 그 직전의 루프에 묶어 풀림 방지가 되도록 하는 자동 봉합기용 봉합보강재의 제법.
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- 2004-07-16 WO PCT/JP2004/010566 patent/WO2005007208A1/ja active Application Filing
- 2004-07-16 AT AT04747929T patent/ATE482656T1/de active
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EP1647286A4 (en) | 2007-05-02 |
US8177797B2 (en) | 2012-05-15 |
KR101136114B1 (ko) | 2012-04-17 |
PT1647286E (pt) | 2010-11-30 |
JP4675237B2 (ja) | 2011-04-20 |
JP5241802B2 (ja) | 2013-07-17 |
TWI300354B (ko) | 2008-09-01 |
KR20060033913A (ko) | 2006-04-20 |
DE602004029366D1 (de) | 2010-11-11 |
EP1647286A1 (en) | 2006-04-19 |
EP1647286B1 (en) | 2010-09-29 |
US20070049953A2 (en) | 2007-03-01 |
HK1088567A1 (en) | 2006-11-10 |
WO2005007208A1 (ja) | 2005-01-27 |
JP2011078799A (ja) | 2011-04-21 |
ES2350912T3 (es) | 2011-01-28 |
JPWO2005007208A1 (ja) | 2006-08-31 |
US20060178683A1 (en) | 2006-08-10 |
CN100444905C (zh) | 2008-12-24 |
ATE482656T1 (de) | 2010-10-15 |
TW200507885A (en) | 2005-03-01 |
CN1822865A (zh) | 2006-08-23 |
DK1647286T3 (da) | 2010-11-29 |
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