WO2005107607A1 - 外科用処置具 - Google Patents
外科用処置具 Download PDFInfo
- Publication number
- WO2005107607A1 WO2005107607A1 PCT/JP2005/008484 JP2005008484W WO2005107607A1 WO 2005107607 A1 WO2005107607 A1 WO 2005107607A1 JP 2005008484 W JP2005008484 W JP 2005008484W WO 2005107607 A1 WO2005107607 A1 WO 2005107607A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- needle
- holding
- opening
- treatment tool
- distal end
- Prior art date
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- 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
- A61B17/062—Needle manipulators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
-
- 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
- A61B17/0493—Protective devices for suturing, i.e. for protecting the patient's organs or the operator
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1135—End-to-side connections, e.g. T- or Y-connections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
- A61B17/282—Jaws
- A61B2017/2825—Inserts of different material in jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2902—Details of shaft characterized by features of the actuating rod
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2913—Handles transmission of forces to actuating rod or piston cams or guiding means
Definitions
- the present invention relates to a surgical treatment tool for operating a needle or the like at the time of suturing a blood vessel or ureter of a heart or suturing a tissue in a body cavity.
- a suturing operation of suturing a tissue by operating a curved needle with a thread or the like has been performed.
- a surgical treatment tool for performing a suturing operation for example, a treatment section is provided at a distal end of an insertion section. Then, when suturing the anastomotic port, the operator pays close attention to finely manipulate the needles at the treatment section of the surgical treatment instrument and sew the needles one by one. For this reason, suturing work in surgical operations is a factor that lengthens the operation time
- US Pat. No. 5,810,877 discloses a surgical treatment tool for holding a needle such as a suture needle when performing anastomosis or suturing of a cardiovascular or ureter.
- This surgical treatment device includes a treatment portion having a so-called pinch forceps structure, and holds the needle by grasping.
- US Patent No. 5,951,575 discloses a needle holder which is intended to improve usability. With this needle holder, when suturing a blood vessel, an organ, or the like, it is possible to perform piercing by actively powering the needle in accordance with the curvature of the curved needle while holding the curved needle.
- US Patent No. 6,322,578 discloses a grasping forceps used for various uses in a body cavity, such as tissue deployment and thread manipulation.
- the surgeon grasps the base end side of the needle with the needle holder and moves the needle tip to a predetermined position of the organ. Thereafter, the surgeon performs an operation of actively moving the needle to insert the needle. Then, the needle tip inserted at a predetermined position of the organ passes through the organ and projects again from the surface force of the organ.
- the surgeon grasps the needle tip protruding from the organ with a needle holder or grasping forceps, performs an operation at hand, and removes the needle with the organ force. This completes the stitch of one stitch.
- the surgeon When the surgeon removes the needle with a needle holder, the surgeon once grasps the base end of the needle and releases the closed state. Thereafter, the surgeon moves the needle holder from the base end to the needle tip, grasps the needle tip with the needle holder, and removes the needle.
- the operator when the operator removes the needle with the grasping forceps, the operator operates the needle holder with one hand to insert the needle. Thereafter, the operator operates the grasping forceps with the other hand to grasp the needle tip and withdraw the needle. In this way, the needle is inserted with the needle holder, and the needle is withdrawn with the grasping forceps. By doing so, the needle can be smoothly extracted and the suturing can be performed in a shorter time than in a case where the needle is inserted and extracted using a needle holder.
- a suturing needle 33 which is a curved needle inserted into a first luminal organ 31 and a second luminal organ 32 is Let's consider the technique of extracting.
- the operator first introduces the grasping forceps 34 into the body cavity via the trocar 36 inserted into the patient body wall 35. In this state, the range of operation of the grasping forceps 34 is restricted except for the direction in which the grasping forceps 34 advances and retreats with respect to the trocar 36.
- Reference numeral 37 denotes a suture portion
- reference numeral 38 denotes a suture
- reference numeral 39 denotes a suture opening.
- the surgeon grasps the needle tip 33a with the grasping forceps 34 introduced through the trocar 36.
- the suturing needle 33 is extracted by moving the grasping forceps 34 so as to be pulled out from the patient body wall 35 as shown by an arrow A, for example.
- a tensile force acts on the luminal organ 32 from the suturing needle 33 as shown by an arrow B in FIG. 3, and it may be difficult to easily extract the suturing needle 33. There is.
- the present invention has been made in view of the above circumstances, and it is possible to easily hold a needle in an arbitrary posture without changing the posture, and to smoothly perform a suturing operation under an endoscope. It is an object of the present invention to provide a surgical treatment tool having excellent properties.
- the treatment section connected to the distal end of the insertion section is provided with a needle holding means having an elastic body capable of holding a needle by being punctured.
- FIG. 1 is a view for explaining a state in which a grasping forceps is introduced into a body cavity via a trocar
- FIG. Fig. 3 illustrates a state in which a grasping forceps is pulled out of a body cavity by a bow.
- FIG. 3 is a diagram showing a state in which a suturing needle force pulled out by a grasping forceps also exerts a pulling force on a luminal organ
- FIG. 4 is a perspective view showing a schematic configuration of a surgical treatment tool according to the first embodiment.
- FIG. 5 is an explanatory view showing a needle holding force and a needle transfer operation to a needle holding unit.
- FIG. 6 An explanatory view of a needle holding unit holding a needle in a blood vessel
- ⁇ 8 This is a diagram showing the needle moving operation by the surgical treatment tool, in which the needle is rotated in accordance with the force of moving the insertion portion and also receiving the body tissue force at the penetrating position.
- FIG. 9 is a perspective view showing a schematic configuration of a surgical treatment tool according to a second embodiment.
- FIG. 10 is a longitudinal sectional view illustrating the configuration of a surgical treatment tool.
- FIG. 11 is a perspective view showing a schematic configuration of a surgical treatment tool according to a third embodiment.
- FIG. 12 is a longitudinal sectional view illustrating the configuration of a treatment section.
- FIG. 14 is a perspective view showing a schematic configuration of a surgical treatment tool according to a fourth embodiment.
- FIG. 15 is a longitudinal cross-sectional view illustrating the configuration of an operation unit.
- FIG. 16 is a longitudinal cross-sectional view illustrating a configuration of a treatment section.
- FIG. 19 is a perspective view illustrating a configuration of a treatment section of a surgical treatment tool according to a fifth embodiment.
- FIG. 20 is a perspective view illustrating a configuration of a treatment section of the surgical treatment tool according to the sixth embodiment.
- FIG. 21 is a longitudinal sectional view for explaining a configuration of a treatment section of a surgical treatment tool according to a seventh embodiment.
- FIG. 22 is a longitudinal sectional view illustrating the configuration of a surgical treatment tool according to an eighth embodiment.
- FIG. 23 is a perspective view illustrating the configuration of a treatment section.
- FIG. 25 A perspective view illustrating the configuration of the treatment section of the surgical treatment tool according to the ninth embodiment.
- ⁇ 26 A perspective view illustrating the configuration of the treatment section of the surgical treatment tool according to the tenth embodiment
- FIG. 27 A longitudinal cross-sectional view illustrating a configuration of a treatment section of a surgical treatment tool according to an eleventh embodiment.
- FIG. 30 is a view for explaining the configuration of the opening / closing operation unit at the operation start position and the base end side of the insertion unit
- FIG. 31 is a diagram illustrating the configuration of the distal end side of the insertion section and the holding section when the opening / closing operation section is at the operation start position
- FIG. 32 is a view for explaining an open state of the holding section when the opening / closing operation section is moved to the maximum pushing position.
- FIG. 33 is a view showing a state in which the needle tip is grasped by the holding portion and the needle is started to be extracted.
- FIG. 34 is a view showing a state in which the insertion portion has been moved to the patient's body wall side and the proximal end side of the suture needle has been removed from the first luminal organ forceps.
- FIG. 35 is a view showing a state in which the insertion portion has been further moved toward the patient's body wall and the proximal end side of the suture needle has reached the second luminal organ.
- FIG. 36 The insertion portion is further moved to the patient's body wall side, the suture needle is also pulled out of the second luminal organ force, and the suture is placed on the first luminal organ and the second luminal organ.
- FIG. 37 is a view for explaining a holding portion characteristic of the opening / closing member.
- FIG. 38 is a view for explaining an operation of a holding portion having an opening / closing member provided with a rod having a spherical portion.
- FIG. 39 is a view for explaining another operation of the holding portion having the opening / closing member provided with a rod having a spherical portion.
- reference numeral 1 denotes, for example, a curved needle (refer to reference numeral 6 in FIG. 5; hereinafter abbreviated as a needle) for suturing, which will be described later, for example, during anastomosis or suturing of a cardiovascular or ureter.
- a needle for suturing, which will be described later, for example, during anastomosis or suturing of a cardiovascular or ureter.
- This is a medical treatment tool.
- the surgical treatment tool 1 includes an operation unit 2 for an operator to hold and operate with one hand.
- An insertion section 3 is continuously provided on the distal end side of the operation section 2.
- a treatment section 4 which is a main part is continuously provided on the distal end side of the insertion section 3.
- the operation unit 2 and the insertion unit 3 are integrally formed of, for example, a stainless steel bar.
- the outer diameter of the insertion section 3 is smaller than that of the operation section 2.
- the insertion portion 3 is formed to have a thickness that can be inserted into a trocar used for an operation under an endoscope.
- the surgical treatment tool 1 can be used in any of an operation under an endoscope and an operation by laparotomy or the like, so-called open operation.
- the operation section 2 and the insertion section 3 may be formed of so-called engineering plastics such as, for example, polycarbonate and PEEK. Also, the outer diameter of the operation section 2 and the outer diameter of the insertion section 3 may be formed to be equal. Further, it is preferable that the operation unit 2 is processed to prevent slippage. Examples of the non-slip processing include knurl processing, sand blast processing, and the like.
- a needle holding section 5 as a needle holding means constituting the treatment section 4 is fixed by welding, for example.
- the needle holder 5 is formed by forming an elastic body such as silicon rubber into a tapered substantially conical shape, for example.
- the needle 6 is held by the insertion of the needle 6 into the needle holding part 5, that is, the insertion of the needle 6 into the elastic body.
- the shape of the needle holding portion 5 is not limited to a tapered and substantially conical shape.
- Various shapes such as a substantially spherical shape, a substantially cylindrical shape, a substantially polygonal pyramid shape, and a substantially polygonal column shape are set. It is possible.
- various materials such as fluororubber, polychlorinated vinyl, and polyurethane can be set. By appropriately selecting the material and setting the hardness of the needle holder 5 appropriately, the elastic force is changed, and the needle holder 5 holds the pierced needle 6 with the optimum holding force. It becomes possible to do.
- the operator grasps the operation unit 2 with one hand and changes the position of the treatment unit 4, thereby lifting or pushing the tissue in the surgical field. It is possible to perform operations such as
- the operator operates the needle holder 10 with one hand and sutures the blood vessel 7 while operating the surgical treatment tool 1 with the other hand.
- the surgeon inserts the tip of the needle 6 held by the needle holder 10 into the needle holding section 5 from an arbitrary direction.
- the needle 6 can be delivered to the surgical treatment tool 1.
- the needle holding part 5 is inserted into the opening of the blood vessel 7 and the needle 6 is inserted.
- the needle holder 5 is pressed against the inner wall of the blood vessel 7 near the insertion point. This makes it possible to simultaneously support the blood vessel 7 and receive the needle 6 with the surgical instrument 1.
- the supporting and receiving operations can be performed simultaneously at the same time.
- the needle 6 held by the needle holder 5 is rotatable about a shaft 8 passing through a point of insertion into the needle holder 5. Therefore, when removing the needle 6 penetrated through the blood vessel 7 using the surgical treatment tool 1, the needle 6 can be passively rotated according to the force received from the blood vessel 7. For example, as shown in FIG. 8, when the needle holder 5 is moved forward and backward in the direction shown by arrow C in the figure, the needle 6 Rotate around arrow 8 in the direction of arrow D in the figure.
- the surgical treatment tool according to the present embodiment has a configuration in which the needle is inserted into the needle holding unit and held.
- the treatment section which does not require opening and closing operations for holding the needle, such as a needle holder having a pinch forceps structure, can be stably arranged at a desired position, and needle delivery can be performed. Can be easily performed.
- fine work such as suturing a thin tube such as a cardiovascular or ureter, the operability of handing over a needle is remarkably improved.
- a needle can be inserted into the needle holder from various directions irrespective of the posture of the surgical treatment tool. Therefore, the operability at the time of delivery of the needle from the needle holder or the like is further improved, and it is particularly effective in an operation under an endoscope where the posture that the surgical treatment tool 1 can take is limited. .
- a needle holding portion is arranged behind the insertion point of the needle, thereby simultaneously holding the tissue and receiving the needle. It can be done with one instrument. Therefore, a series of operations up to the insertion of the needle into the tissue and removal of the needle can be performed quickly, and the number of treatment tools to be used is reduced. Therefore, in an operation performed under an endoscope, the number of ports for providing an opening in a patient for inserting a treatment tool can be reduced, and a more invasive operation can be realized.
- the needle tip is buried in the needle holding unit. For this reason, it is possible to prevent the needle tip from injuring the tissue, and to prevent the needle tip from contacting another surgical instrument and causing the malfunction.
- the present embodiment is different from the first embodiment described above in that it has a function of variably adjusting the holding force of the needle by the needle holding unit. Therefore, the same components are denoted by the same reference numerals and description thereof is omitted.
- the operation unit 2 has a configuration in which a handle unit 42 having a built-in link mechanism unit 40 is provided.
- the handle portion 42 is formed by connecting a pair of handle portion halves 42a and 42b with screws 41.
- a slide bearing 43 that penetrates and supports the base end of a rod 46 described later is disposed at the distal end of the handle 42.
- a base end of a hollow outer cylinder 44 constituting the insertion section 3 is fitted to the inner periphery of the sliding bearing 43.
- the handle portion 42, the sliding bearing portion 43, and the outer cylinder 44 are fastened and fixed by screws 45a, 45b, 45c arranged on the same circumference at intervals of 120 degrees, for example.
- a screw portion 47 is formed at the base of a rod 46 that penetrates through the sliding bearing portion 43 and is exposed in the handle portion 42. Nuts 48a and 48b are screwed into the screw portion 47. This restricts the movement of the rod 46 toward the distal end.
- the distal end of the joint 49 is screwed into the proximal end of the screw portion 47.
- One end of an arm 51 is rotatably connected to a base end of the joint 49 via a pin 50.
- an opening 52 is formed at the joint between the handle half halves 42a and 42b.
- the other end of the arm 51 is exposed to the outside through the opening 52.
- a free end of a lever 53 is rotatably connected to the other end of the arm 51 via a pin 54.
- the fixed end of the lever 53 is swingably supported via a pin 55 buried in the base end of the handle half 42a, 42b.
- the operating section 2 is provided with a link mechanism section 40 for moving the rod 46 forward and backward in the outer cylinder 44 by the operation of the lever 53 falling and standing on the handle section 42.
- a sliding bearing portion 56 that penetrates and supports the rod 46 is fixed to a distal end portion of the outer cylinder 44 by a screw 57.
- the rod 46 that penetrates the sliding bearing 56 and is exposed to the treatment section 4 A screw portion 58 is provided at the tip.
- a cap 59 is screwed into the screw portion 58.
- a needle holding portion 60 which is a force needle holding means made of a substantially cylindrical elastic body, is sandwiched.
- the needle holder 60 is made of an elastic member made of, for example, silicone rubber, fluorine rubber, polyvinyl chloride, or polyurethane.
- the adjustment of the holding force on the needle holding unit 60 is usually performed after the delivery of the needle 6 and the like. For this reason, the workability at the time of delivery and the like of the needle 6 to the surgical treatment tool 1 is maintained satisfactorily with the force of the needle holder 10.
- the holding force of the needle inserted into the needle holding section is increased by the compression of the needle holding section. By doing so, it is possible to achieve a more effective needle holding operation.
- the configuration of the treatment section 4 is different from the above-described first embodiment.
- the same reference numerals are given to other similar configurations, and description thereof will be omitted.
- the needle holding section 100 as the needle holding means provided in the treatment section 4 includes a tip cap 101 and an elastic body 10 covered on the surface thereof. 2 is configured.
- the distal end cap 101 is connected to the distal end of the insertion section 3 via a connector 104.
- a recess 106 is opened at the tip of the insertion section 3, and the base of the connector 104 is fitted into the recess 106.
- a screw 105 that penetrates the recess 106 from the side of the insertion section 3 is screwed into the base of the connector 104. As a result, the connector 104 is connected and held to the inlet 3. It is.
- a screw hole penetrating in the axial direction is provided at the center of the connector 104.
- a screw portion 103 protruding from the base of the tip cap 101 is screwed into this screw hole.
- the tip cap 101 is connected to the connector 104 by the screwing of the screw portion 103, the edge of the elastic body 102 is sandwiched between the tip cap 101 and the connector 104. As a result, the elastic body 102 is held on the surface of the tip cap 101.
- the elastic body 102 is formed of a flexible member in which a plurality of holes 107 having a smaller diameter than the diameter of the needle 6 are arranged in a mesh. As shown in FIG. 13, when the needle 6 is inserted into the hole 107, the needle 6 is held by the elastic restoring force (contracting force) of the hole 107.
- the elasticity deteriorated due to the configuration in which the distal end cap and the elastic body can be easily removed by the connector force. There is an effect that the body can be easily exchanged and the cost can be reduced.
- FIGS. 14 to 18 illustrate a fourth embodiment of the present invention.
- the present embodiment is different from the above-described first embodiment in that a point force having a function of variably adjusting the holding force of the needle by the needle holding unit is added.
- a point force having a function of variably adjusting the holding force of the needle by the needle holding unit is added.
- the same reference numerals are given to other similar components, and description thereof is omitted.
- the operation section 2 is configured to have a handle section 122 having a link mechanism section 120 therein.
- the handle part 122 is formed by connecting a pair of handles ⁇ half bodies 122a, 122b with force screws 121.
- a sliding bearing 123 that penetrates and supports a base end of a rod 126 described later is provided at a distal end of the node barrel.
- a base portion of a hollow outer cylinder 124 constituting the insertion portion 3 is fitted on the inner periphery of the sliding bearing portion 123.
- the handle portion 122, the sliding bearing portion 123, and the outer cylinder 124 are fastened and fixed by, for example, screws 125a, 125b, and 125c arranged at 120-degree intervals on the same circumference.
- a screw portion 127 is provided at the base of a rod 126 that passes through the sliding bearing portion 123 and is exposed in the handle portion 122.
- Rod 126 is screwed into thread 127
- the nuts 128a and 128b restrict movement toward the distal end.
- the distal end of the joint 129 is screwed to the proximal end of the screw portion 127.
- the base end of 129 is rotatably connected via a force pin 130 at one end of an arm 131 constituting a link mechanism 120.
- an opening 132 is formed at the joint between the handle portion halves 122a and 122b.
- the other end of the arm 131 is exposed to the outside through the opening 132.
- An intermediate portion of a lever 133 is rotatably connected to the other end of the arm 131 via a pin 134.
- Fixed end force of lever 133 Pin 13 buried at base end of handle half 122a, 122b
- the operating section 2 is provided with a link mechanism section 120 for moving the rod 126 forward and backward in the outer cylinder 124 by raising and lowering the lever 133 with respect to the handle section 122.
- a connector 136 is fixed to a distal end portion of the outer cylinder 124 by screws 137.
- a screw hole is provided at the center of the connector 136 so as to pass through the connector 136 in the axial direction. Through this screw hole, it is connected to a sliding bearing 138 that supports the rod 126 through it.
- a screw portion 139 having a through hole protrudes from the sliding bearing portion 138.
- the sliding bearing portion 138 is connected to the connector 136 by screwing the screw portion 139 into a screw hole of the connector 136.
- a thread portion 141 is provided at the tip of the rod 126 that penetrates the sliding bearing portion 138 and is exposed to the treatment section 4 side.
- a tip pusher 142 is screwed into the screw portion 141.
- the distal end pusher 142 is covered with an elastic body 140 constituting a needle holding portion 143 as a needle holding means.
- the edge of the elastic body 140 is sandwiched between the sliding bearing portion 138 and the connector 136 when the sliding bearing portion 138 and the connector 136 are connected by screwing the screw portion 139. It is. As a result, the elastic body 140 is held on the surface of the tip pusher 142.
- the elastic body 140 is formed of an elastic member, and a plurality of holes 144 through which the needle 6 can be inserted are arranged in a mesh.
- the material of the elastic body 140 for example, silicon Rubber, fluororubber, polychlorinated rubber, or polyurethane is preferably used.
- the lever 133 is operated to fall down by an operator holding the operation unit 2. Then, the rod 126 is moved to the distal end side together with the joint 129 via the arm 131. Thereby, the distal end pusher 142 is moved to the distal end side.
- the elastic body 140 covering the distal end pusher 142 is pulled to the distal end side.
- the hole 144 of the elastic body 140 is elastically deformed by the tension caused by the pulling. This increases the holding force of the needle 6 by the needle holding section 143 as shown in FIG.
- the elastic body 140 is elastically deformed by the link mechanism section 120 provided in the operation section 2 and the tip pusher 142 interlocking with the link mechanism section 120, and the holding force of the needle 6 is maintained.
- a needle holding force adjustment mechanism that variably adjusts the distance is realized.
- the adjustment of the holding force of the needle holding section 143 is usually performed after the delivery of the needle 6 and the like. For this reason, the operability when delivering the needle 6 to the surgical treatment tool 1 and the like with the force of the needle holder 10 is maintained satisfactorily.
- the holding force of the needle inserted into the hole by pulling the needle holding portion can be increased.
- the needle holding operation can be performed more reliably, it is effective.
- the present embodiment is different from the first embodiment in that a plurality of cut portions are provided in the needle holding unit.
- Other similar configurations are denoted by the same reference numerals and description thereof is omitted.
- the needle holding section 5 constituting the treatment section 4 is provided with, for example, a plurality of cutouts 162 along its circumferential direction and longitudinal axis direction.
- needle holding section 5 can of course hold needle 6 even by being punctured into a portion other than cut section 162.
- the present embodiment is different from the first embodiment in that the needle holder is covered with an adhesive layer.
- the same reference numerals are given to other similar configurations, and description thereof will be omitted.
- an adhesive layer 201 is formed on the surface of the needle holding section 5 constituting the treatment section 4.
- the needle 6 is transferred from the needle holder 10 to the surgical treatment tool 1, the needle 6 is brought into contact with the adhesive layer 201.
- Needle holder 5 can of course hold needle 6 even when the needle 6 is inserted.
- the present embodiment is different from the above-described first embodiment in that a needle holding portion is configured by incorporating a magnet in an elastic body.
- a needle holding portion is configured by incorporating a magnet in an elastic body.
- the needle holding unit 220 as a needle holding unit is configured to include, for example, a magnet 221 having a tapered substantially conical shape, and an elastic body 224 welded and fixed to the surface thereof.
- the elastic body 224 for example, silicone rubber, fluorine rubber, polychlorinated bead, or polyurethane is preferably used.
- a screw hole 223 is provided at the base of the magnet 221, and a screw portion 222 that also projects the leading end force of the insertion portion 3 is screwed into the screw hole 223.
- the needle holding section 220 is connected to the insertion section 3.
- the needle at the position apart from the needle holding unit can also be attracted to the magnet of the treatment unit 4. Therefore, for example, there is an effect that the operation for re-holding the needle dropped into the body can be easily performed.
- the configuration of a part of the operation unit and the configuration of the treatment unit are different from the above-described third embodiment.
- the same reference numerals are given to other similar configurations, and description thereof will be omitted.
- the link mechanism section 40 is used for operation of a forceps structure section described later, instead of the use for elastically deforming the needle holding section 60.
- a panel 252 for biasing the joint 49 toward the distal end side is provided in the handle portion 42.
- a fixed holding piece 241 is connected to the distal end of the insertion section 3. More specifically, the fixed holding piece 241 has a substantially cylindrical base portion 241a.
- the base 241 a is fitted to the outer cylinder 44 of the insertion section 3 and is fixed to the insertion section 3 by screws 242, thereby being connected to the insertion section 3.
- a distal end of a rod 46 penetrating the outer cylinder 44 is inserted into the center of the base 241a connected to the insertion portion 3 so as to be able to advance and retreat in the longitudinal axis direction.
- a holding surface portion 243 for holding a needle or the like is formed on the distal end side of the base portion 241a.
- the holding surface portion 243 is formed of a substantially ring-shaped member having a through hole 244 opened at the center.
- the holding surface portion 243 is provided along a surface substantially coincident with a surface including the direction of the longitudinal axis of the rod 46 and the axis of the pin 50.
- the elastic body 245 constituting the needle holder 5 is filled in the holding surface portion 243 from the back side of the holding surface portion 243 to the through hole 244.
- the fixed holding piece 241 has a distal end near the connecting portion between the base 241a and the holding surface 243.
- a recess 241b is provided.
- the base 247b of the movable holding piece 247 is provided in the recess 241b.
- a pin 246 parallel to the pin 50 is supported in the concave portion 241b.
- the base 247b of the movable holding piece 247 is supported by the pin 246.
- the distal end of the rod 46 is rotatably connected to the proximal end of the base 247 via a pin 248 parallel to the pin 246.
- a clamping surface 249 facing the clamping surface 243 is formed on the distal end side of the base 247b of the movable clamping piece 247.
- the holding surface portion 249 is formed of a substantially ring-shaped member having a through hole 250 opened at the center.
- the elastic body 251 constituting the needle holding section 5 is filled in the through hole 250 from the back side of the holding surface section 249 to 250 mm.
- the material forming the elastic bodies 245 and 251 silicon rubber, fluoro rubber, polychlorinated rubber, polyurethane or the like is suitably used.
- anti-slip processing is performed on opposing surfaces of the holding surface portion 243 and the holding surface portion 249.
- non-slip processing electric discharge machining, knurling, fine diamond spraying on metal plating, and the like are suitably applied.
- the needle in addition to the effect substantially similar to the effect obtained in the first embodiment described above, by adding a forceps function to the surgical treatment tool 1, the needle can be held by the needle holding unit 5.
- the needle and other tissues can be held by opening and closing the holding surface portion 249, and the number of times of changing the treatment tool during the operation can be reduced.
- the present embodiment differs from the first embodiment in that an opening for water absorption is formed in the treatment section.
- the same reference numerals are given to other similar components, and description thereof will be omitted.
- the needle holder 5 has, for example, a substantially cylindrical shape.
- the elastic body 262 is provided.
- An opening 263 of a water supply conduit communicating with a suction pump (not shown) is opened at the tip.
- the material forming the elastic body 262 for example, silicon rubber, fluoro rubber, polychlorinated vinyl, polyurethane, or the like is suitably used.
- the surgical treatment tool 1 can suction liquid such as bodily fluid or dirt near the opening 263 by the operation of the water supply pump communicating with the water supply conduit.
- the number of treatment instruments to be used can be reduced.
- the number of ports opened to a patient for inserting a treatment tool can be reduced, thereby achieving an effect of realizing a less invasive operation.
- a point force at which a blower opening is formed in the treatment section is different from the first embodiment described above.
- the same reference numerals are given to other similar configurations, and description thereof will be omitted.
- the needle holding section 5 has, for example, an elastic body 267 having a substantially cylindrical shape.
- An opening 268 of a blower passage communicating with a blower device (not shown) is opened at the tip.
- a material constituting the elastic body 267 for example, silicon rubber, fluorine rubber, polyvinyl chloride, polyurethane, or the like is suitably used.
- the surgical treatment tool 1 can remove liquid such as bodily fluid and dirt near the opening 268 by the operation of the blower device communicating with the blower passage.
- the score of the treatment tool to be used can be reduced.
- the number of ports opened to a patient for inserting a treatment tool can be reduced, and an effect of realizing a less invasive operation can be achieved.
- the configuration of the needle holding section is mainly different from that of the first embodiment described above. different.
- the same reference numerals are given to other similar configurations, and description thereof will be omitted.
- a stepped protrusion 324 having a plurality of steps formed around the tip of the insertion portion 3 is protruded.
- a needle holding section 320 serving as a needle holding means constituting the treatment section 4 is fitted and supported by the stepped projection 324. Note that, for example, a configuration may be employed in which the needle holding section 320 is provided on the stepped projection 324 by insert molding.
- needle holding section 320 has a two-layer structure including outer layer 321 and an inner layer 322 made of an elastic body.
- the elastic member of the inner layer 322 is configured to be softer than the elastic member of the outer layer 321.
- various materials such as, for example, silicone rubber, fluoro rubber, polychlorinated vinyl, or polyurethane can be suitably applied.
- the needle 6 held by the needle holding portion 320 rotates in the direction of arrow D around the rotation axis 8 in the drawing, and the outer layer 321 and the inner layer Due to the relative hardness difference with respect to the outer layer 321, the rocking operation in the direction of the arrow E in the figure with the insertion point 323 into the outer layer 321 as a fulcrum becomes possible.
- the surgical treatment tool 1 mainly includes an operation unit 2, an insertion unit 3, and a grip unit 404.
- the operation unit 2 also serves as a part to be gripped by the operator.
- the insertion section 3 is provided to extend from one end of the operation section 2.
- the grip portion 404 is provided so that the distal end portion of the bent insertion portion 3 also extends.
- the operation unit 2 mainly includes an operation unit main body 421 and operation buttons 422.
- the operation button 422 is an opening / closing operation unit, and is arranged at a distal end portion of a side peripheral surface of the operation unit main body 421.
- the grip portion 404 mainly includes a holding portion main body 441 and an opening / closing member 442.
- the holding portion main body 441 is a first holding member and has a step.
- the opening / closing member 442 is a second holding member.
- the operation section main body 421 is formed of a rigid member, for example, a resin member.
- the operation button 422 is formed of a resin member that is hard and slidable.
- the holding portion main body 441 and the opening / closing member 442 are formed of a metal member such as stainless steel.
- the operation unit 2 will be described with reference to FIGS. 29 and 30.
- the operation section main body 421 constituting the operation section 2 is provided with an operation section internal space 423.
- a button arrangement hole 424 communicating with the operation unit internal space 423 is formed on the side surface of the operation unit main body 421.
- the central axis of the button arrangement hole 424 is substantially orthogonal to the longitudinal axis direction of the operation unit main body 421.
- a stepped hole 425 communicating with the operation section internal space 423 is formed in the center of the tip side surface of the operation section main body 421.
- the stepped hole 425 is composed of a small hole 425a and a large hole 425b.
- the central axis of the small-diameter hole 425a and the central axis of the large-diameter hole 425b are coaxial and substantially coincide with the longitudinal axis direction of the operation unit body 421.
- the operation unit main body 421 is composed of, for example, a cylindrical member having a base end opening, and a lid member for closing the base end opening.
- the tubular member and the lid member are integrally fixed by a fixing means such as bonding or heat welding.
- An operation button 422 is disposed in the button arrangement hole 424 from the operation unit internal space 423 side so as to be able to advance and retreat.
- the operation button 422 advances and retreats in a direction orthogonal to the longitudinal axis direction of the operation section main body 421.
- the operation button 422 includes a button body 422a, a retaining portion 422b, and a convex portion 422d having a pressing surface 422c.
- the button body 422a is solid and has a cross-sectional shape of, for example, an ellipse.
- the retaining portion 422b projects a predetermined amount from the side surface of the button body 422a.
- the pressing surface 422c is inclined at a predetermined angle.
- a recess 422e is provided on the end face of the button body 422a. The recess 422e is provided in consideration of the operability of the operator's finger holding the operation unit 2.
- the side surface of the button body 422a is a sliding surface.
- the retaining portion 422b comes into contact with the inner peripheral surface 421a of the operation portion main body 421. This prevents the operation button 422 from dropping out of the operation section main body 421.
- the inclination angle of the pressing surface 422c provided on the protrusion 422d and the amount of protrusion of the protrusion 422d are set in consideration of the amount of movement of the opening / closing force transmitting member 432 described later.
- the base end of the insertion portion main body 431 constituting the insertion portion 3 is integrally fixed to the large-diameter hole 425b of the stepped hole 425 by, for example, bonding.
- the insertion portion main body 431 is made of, for example, stainless steel and has a pipe shape.
- a transmission rod 432 serving as an opening / closing transmission member is provided through the small-diameter hole 425a of the stepped hole 425.
- the transmission rod 432 is made of, for example, stainless steel and has a round bar shape.
- the transmission rod 432 is slidably (also referred to as retractable) with respect to the inner hole of the insertion portion main body 431.
- the inner diameter of the small hole 425a and the inner diameter of the inner hole of the insertion portion main body 431 are substantially the same.
- An operation force transmission block (hereinafter, abbreviated as a transmission block) 433 is fixed to the base of the transmission rod 432.
- the transmission block 433 has an inclined surface 433a.
- the inclined surface 433a is configured to make surface contact with the pressing surface 422c of the operation button 422.
- the outer diameter of the transmission block 433 is larger than the outer diameter of the transmission rod 432 by a predetermined dimension.
- a block urging coil panel (hereinafter abbreviated as “coil panel”) 434 is arranged in a compressed state between the transmission block 433 and the inner end surface 421b of the operation section main body 421.
- the coil panel 434 has an urging force for moving the transmission block 433 to a position indicated by a broken line.
- the protrusion amount of the convex portion 422d of the operation portion main body 421 is set in a state where the retaining portion 422b is in contact with the inner peripheral surface 421a.
- the pressing surface 422c and the inclined surface 433a are set so as to make surface contact.
- the transmission block 433 is urged by the urging force of the coil panel 434 to move to the position shown by the broken line.
- the pressing surface 422c is arranged on the inclined surface 433a of the transmission block 433 in a surface-contact state, so that further movement to the base end surface side is restricted!
- the position of the operation button 422 in this state is referred to as an operation start position.
- the movement of the operation button 422 in the direction of the arrow F is stopped, and the movement of the transmission block 433 in the direction of the arrow G is stopped. That is, when the retaining portion 422b of the operation button 422 comes into contact with the side surface 433b of the transmission block 433, the transmission rod 432 moves to the maximum with respect to the distal end side of the insertion portion main body 431.
- the insertion section 3 is configured by an insertion section main body 431 in which a transmission rod 432 is slidably inserted.
- the distal end portion of the insertion portion main body 431 is provided with an insertion portion distal end portion 435 having a second axis.
- the second axis of the insertion portion distal end portion 435 is configured to bend at an angle ⁇ ⁇ ⁇ , for example, in the range of 90 ° to 140 ° with respect to the central axis in the longitudinal direction, which is the first axis.
- a rotating groove 435a is provided on the inner peripheral surface of the distal end of the insertion portion distal end 435.
- the rotation groove portion 435a is rotatably fitted into a convex portion 441c, which is a rotation holding portion described later, provided on the holding portion main body 441.
- the transmission surface 432a comes into contact with a receiving surface 443b of a receiving member 443 described later, which is a first contact surface fixed to the opening / closing member 442.
- the gripping portion 404 is composed of a holding portion main body 441, an opening / closing member 442, a receiving member 443, and a holding biasing panel (hereinafter abbreviated as holding panel) 444.
- the holding portion main body 441 is a stepped tubular member.
- the holding portion main body 441 is configured by sequentially connecting a small-diameter portion 441a, a large-diameter portion 441b, and a convex portion 441c from the tip side.
- a through hole 441d is formed in the small diameter portion 44la.
- the tip side of the small diameter part 441a is a grip It is configured.
- the large-diameter portion 441b and the convex portion 441c are provided with a hole 441e in which the depth of the base end surface force is set to a predetermined size.
- the rotatable holding portion main body 441 is extended from the distal end portion 435 of the insertion portion at a predetermined angle by fitting the convex portion 441c of the holding portion main body 441 into the rotation groove 435a.
- the opening / closing member 442 includes a shaft portion 442a and a flange portion 442b.
- the shaft portion 442a is formed to have a predetermined length, and is disposed so as to be slidable with respect to the through hole 441d.
- the flange 442b is provided at the tip of the shaft 442a.
- the flange portion 442b is a grip portion, and the outer diameter of the flange portion 442b and the outer diameter of the small diameter portion 441a are substantially the same.
- the flange 442b has a circular shape.
- the flange portion 442b is not limited to a circular shape as long as it can hold the needle. That is, the flange portion 442b has another shape as long as it has a portion extending in the radial direction with respect to the axis of the shaft portion 442a, such as an elliptical shape or a polygonal shape having a concave portion in part. May be.
- the receiving member 443 includes a cylindrical portion 443a and a conical portion 443c having a receiving surface 443b.
- the cylindrical portion 443a is slidably disposed with respect to the hole 441e.
- the receiving surface 443b is formed at a predetermined inclination angle so that the transmission surface 432a comes into contact with the receiving surface 443b.
- the receiving member 443 is integrally fixed to the base end of the shaft portion 442a by bonding or the like.
- the holding panel 444 is a coil panel having a predetermined urging force.
- the holding panel 444 is arranged in a compressed state between the bottom surface 441f of the hole 441e and the distal end surface of the receiving member 443.
- the receiving member 443 is moved in a direction in which the opening force of the hole 441e is also pushed out by the urging force of the holding panel 444.
- the base flat portion 442c of the flange portion 442b comes into contact with and is in close contact with the front flat portion 44lg of the holding portion main body 441.
- the convex portion 441c is arranged rotatably with respect to the rotating groove 435a. Accordingly, when the base flat portion 442c and the front flat portion 441g are in close contact with each other, the grip portion 404 is By receiving the external force, the insertion portion can easily and passively rotate with respect to the insertion portion distal end portion 435 as shown by the arrow H.
- the grip portion 404 includes a holding portion main body 441, an opening / closing operation member 442, a receiving member 443, and a holding panel 444.
- the proximal flat portion 442c of the flange portion 442b is in close contact with the distal flat portion 441g of the holding portion main body 441.
- a state is established in which a slight gap is formed between the receiving surface 443b, which is the first position, and the transmitting surface 432a.
- this arrangement position state is made to correspond to the operation start position of the operation button 422. That is, the length of the transmission rod 432 is set such that a slight gap is formed between the transmission surface 432a and the receiving surface 443b when the operation button 422 is located at the operation start position. .
- the transmission surface 432a moves while sliding on the receiving surface 443b.
- the cylindrical portion 443a of the receiving member 443 moves so as to be gradually pushed in the direction of the arrow J in the hole 441e against the urging force of the holding panel 444.
- the proximal flat portion 442c and the distal flat portion 441g that have been in close contact with each other are gradually separated from each other.
- the user releases his / her finger from the operation button 422 to release the pressed state.
- the urging force of the coil panel 434 causes the transmission block 433 to move toward the base end face in the direction opposite to the arrow G direction.
- the transmission rod 432 moves in the direction opposite to the arrow G direction, and the transmission surface 432a is returned to the original position.
- the receiving member 443 is moved in the direction opposite to the arrow F by the urging force of the holding panel 444. This allows the operation
- the operation button 422 is moved in the direction opposite to the arrow F direction, and is again arranged at the operation start position.
- the receiving member 443 is moved in a direction opposite to the direction of the arrow J, and the base flat portion 442c shown in FIG.
- the surgical instrument 1 removes the suture needle 453 that is a curved needle inserted into the first luminal organ 451 and the second luminal organ 452 by a needle holder (not shown).
- the insertion section main body 431 of the surgical treatment instrument 1 is previously introduced into the body cavity via a trocar 456 inserted into the patient's body wall 455.
- the grasping portion 404 is moved toward the tip of the suture needle 453 protruding from the second hollow organ 452.
- the operation button 422 is pushed and operated.
- the base flat portion 442c of the opening / closing member 442 constituting the grip portion 404 and the flat end portion 44lg of the holding portion main body 441 are separated from each other.
- the distal end portion 453a of the suture needle 453 is disposed between the proximal flat surface portion 442c and the distal flat surface portion 441g.
- the distal end portion 453a of the suture needle 453 is disposed between the proximal flat surface portion 442c and the distal flat surface portion 441g. After confirmation, gradually release the pressed state of operation button 422. As a result, the proximal flat portion 442c and the distal flat portion 441g gradually close. Then, as shown in FIG. 33, the distal end portion 453a of the suture needle 453 is gripped by the grip portion 404.
- Reference numeral 458 denotes a stitched portion sewn with a suture 457.
- Reference numeral 459 denotes an anastomotic opening formed by cutting with a scalpel or scissors.
- the surgical treatment tool 1 is pulled back so that the insertion portion main body 431 is removed from the body cavity as shown by the arrow K, Perform operations such as tilting the insertion section main body 431 within the range.
- the grasping portion 404 in the state of grasping the suture needle 453 passively rotates around the second axis with respect to the insertion portion distal end portion 435. As a result, the trajectory of the suture needle 453 is gradually changed, and the first luminal organ 451 and And from the second luminal organ 452.
- the suture needle 453 is extracted from the first hollow organ 451. Thereafter, the suture needle 453 is moved with respect to the second hollow organ 452 as shown in FIG. Finally, as shown in FIG. 36, the suturing needle 453 is withdrawn from the second luminal organ 452, completing one needle for suturing the anastomotic opening 459. Then, the insertion of the suture needle 453 is performed using a holding needle device (not shown), and the removal of the suture needle 453 using the surgical treatment tool 1 is repeated.
- the holding portion main body constituting the holding portion is provided so as to be easily and passively rotatable with respect to the distal end portion of the insertion portion. Further, in a state where the base end flat portion of the opening and closing operation member and the front end flat portion of the holding portion main body are closed by the biasing force of the holding panel, the holding portion main body, the opening / closing operation member, the receiving member, and the holding panel
- the holding portion constituted by is configured to be rotatable by receiving an external force.
- a pull-up operation is performed to remove the intra-cavity force of the surgical treatment tool without complicatedly operating the surgical treatment tool.
- the suturing needle can extract the force of the luminal organs and the like.
- the configuration of the grip 404A is not limited to the above-described embodiment.
- the opening / closing member 442 disposed on the holding unit main body 441 is configured as shown in Fig. 37 to configure the grip 404A. You can do it.
- a rod portion 442d having a spherical portion 442e is provided on the tip side surface of the flange portion 442b.
- the flange portion 442b has a base end flat portion 442c that is in close contact with the front end flat portion 44lg of the holding portion main body 441.
- Other configurations are the same as those of the twelfth embodiment described above, and the same members are denoted by the same reference numerals and description thereof is omitted.
- a rod portion 442d having a spherical portion 442e is provided on the distal end surface side of the flange portion 442b. Therefore, by hooking the suture 457 on the spherical portion 442e in the body cavity, the thread trimming, which is the operation of moving the thread, can be easily performed without grasping the thread. In addition, by providing the spherical portion 442e at the tip of the rod portion 442d, it is possible to prevent the luminal organs from being damaged when the yarn is moved.
- a rod portion 442d having a spherical portion 442e is provided on the distal end surface side of the flange portion 442b with a force S.
- the rod portion 442d can be inserted from the anastomosis port 459, and for example, the first hollow organ 451 can be lifted. This makes it possible to easily deploy the visual field without grasping the luminal organs.
- the spherical portion 442e at the tip of the rod portion 442d, it is possible to prevent the luminal organs from being damaged when performing visual field development.
- the holding portion is constituted by the opening / closing operation member having the rod portion having the spherical portion and the holding portion main body, the holding portion is moved without gripping the treatment target site or the like, and the thread is moved. Operation of organs and organs can be performed easily and safely. This further improves the operability of the surgical treatment instrument in the body cavity.
Landscapes
- 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)
- Ophthalmology & Optometry (AREA)
- Surgical Instruments (AREA)
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP05739135.1A EP1762188B1 (en) | 2004-05-11 | 2005-05-10 | Surgical operation instrument |
US11/403,037 US20060184183A1 (en) | 2004-05-11 | 2006-04-12 | Surgical instrument |
US12/273,739 US8894668B2 (en) | 2004-05-11 | 2008-11-19 | Surgical instrument |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2004-141513 | 2004-05-11 | ||
JP2004141513A JP4594644B2 (ja) | 2004-05-11 | 2004-05-11 | 外科用処置具 |
JP2005-054020 | 2005-02-28 | ||
JP2005054020A JP4832773B2 (ja) | 2005-02-28 | 2005-02-28 | 外科用処置具 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/403,037 Continuation US20060184183A1 (en) | 2004-05-11 | 2006-04-12 | Surgical instrument |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2005107607A1 true WO2005107607A1 (ja) | 2005-11-17 |
Family
ID=35320007
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP2005/008484 WO2005107607A1 (ja) | 2004-05-11 | 2005-05-10 | 外科用処置具 |
Country Status (3)
Country | Link |
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US (2) | US20060184183A1 (ja) |
EP (2) | EP1762188B1 (ja) |
WO (1) | WO2005107607A1 (ja) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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EP1955663A3 (en) * | 2004-03-31 | 2008-10-15 | Glengowan B.V. | Surgical instrument and method |
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CA2671030C (en) | 2006-11-30 | 2013-10-08 | Wilson-Cook Medical, Inc. | Visceral anchors for purse-string closure of perforations |
US20090005795A1 (en) * | 2007-06-28 | 2009-01-01 | Brandon Giap | Surgical needle docking device and method |
US20080082168A1 (en) * | 2007-07-31 | 2008-04-03 | Marc Peterman | Surgical scaffold to enhance fibrous tissue response |
US7879049B2 (en) * | 2007-08-17 | 2011-02-01 | Wilson-Cook Medical Inc. | Device to open and close a bodily wall |
AU2008304583B2 (en) * | 2007-09-25 | 2012-03-29 | Cook Medical Technologies Llc | Medical devices, systems, and methods for using tissue anchors |
WO2009082596A1 (en) * | 2007-12-18 | 2009-07-02 | Wilson-Cook Medical, Inc. | Device and method for placement of tissue anchors |
CA2747172C (en) * | 2008-12-05 | 2015-04-14 | Vihar C. Surti | Tissue anchors for purse-string closure of perforations |
EP2413809B1 (en) * | 2009-04-03 | 2014-10-08 | Cook Medical Technologies LLC | Medical devices for rapid deployment and fixation of tissue anchors |
JP5619137B2 (ja) | 2009-04-03 | 2014-11-05 | クック メディカル テクノロジーズ エルエルシーCook Medical Technologies Llc | 組織アンカー、及び組織アンカーの迅速な配備のための医療デバイス |
WO2010127084A1 (en) * | 2009-05-01 | 2010-11-04 | Wilson-Cook Medical, Inc. | Medical systems, devices and methods for suturing perforations |
WO2021158922A1 (en) * | 2020-02-07 | 2021-08-12 | Children's Medical Center Corporation | Intracorporeal suture tying |
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- 2005-05-10 EP EP14184237.7A patent/EP2837336B1/en not_active Expired - Fee Related
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Also Published As
Publication number | Publication date |
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EP2837336A3 (en) | 2015-06-03 |
EP2837336B1 (en) | 2018-01-10 |
EP1762188A1 (en) | 2007-03-14 |
US8894668B2 (en) | 2014-11-25 |
EP1762188A4 (en) | 2014-03-26 |
EP2837336A2 (en) | 2015-02-18 |
US20060184183A1 (en) | 2006-08-17 |
US20090076527A1 (en) | 2009-03-19 |
EP1762188B1 (en) | 2017-02-22 |
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