WO2017145337A1 - Needle holder and suture set - Google Patents

Needle holder and suture set Download PDF

Info

Publication number
WO2017145337A1
WO2017145337A1 PCT/JP2016/055685 JP2016055685W WO2017145337A1 WO 2017145337 A1 WO2017145337 A1 WO 2017145337A1 JP 2016055685 W JP2016055685 W JP 2016055685W WO 2017145337 A1 WO2017145337 A1 WO 2017145337A1
Authority
WO
WIPO (PCT)
Prior art keywords
gripping member
gripping
needle
curved needle
insertion tube
Prior art date
Application number
PCT/JP2016/055685
Other languages
French (fr)
Japanese (ja)
Inventor
明宏 島津
Original Assignee
オリンパス株式会社
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by オリンパス株式会社 filed Critical オリンパス株式会社
Priority to PCT/JP2016/055685 priority Critical patent/WO2017145337A1/en
Publication of WO2017145337A1 publication Critical patent/WO2017145337A1/en

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—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

Definitions

  • the present invention relates to a needle holder and a suture set.
  • Patent Document 1 discloses a medical manipulator that can hold a curved needle.
  • Patent Document 2 discloses that a concave portion for preventing rotation of the gripped curved needle is provided at an edge portion in the width direction of the gripping surface.
  • Patent Literature 3 discloses a needle holder having a flexible insertion portion that can be inserted into a treatment instrument channel of a flexible endoscope.
  • JP 2012-50691 A JP 2011-200404 A JP 2009-247888 A
  • An object of the present invention is to provide a needle holder and a suturing set in which the curved needle is unlikely to rotate or shift even when the gripping force is small.
  • a long insertion tube portion a first gripping member rotatably connected to the distal end portion of the insertion tube portion, and a first connection member coupled to the distal end portion of the insertion tube portion.
  • Two gripping members the first gripping member has a first gripping surface, and the second gripping member extends from the distal end of the second gripping surface to the proximal end of the second gripping surface. It has a groove part, The said groove part is a needle holder characterized by being wider than said 1st holding surface in the direction orthogonal to the central axis of the said insertion part pipe
  • the second gripping member may have a protrusion protruding from the tip of the second gripping surface toward the first gripping member.
  • the protrusion may have a recess into which the tip of the first gripping member enters.
  • the curved needle gripped by the first gripping member and the second gripping member has a first contact portion and a first contact portion spaced apart from each other along a center line extending in the arc direction of the curved needle on the surface of the curved needle.
  • Two contact portions are supported by a boundary portion between the second gripping member and the groove portion, and between the first contact portion and the second contact portion in the center line direction of the curved needle on the surface of the curved needle.
  • the third contact portion located at the first gripping surface is supported by the first gripping surface, and a part between the first contact portion and the second contact portion enters the groove portion, whereby the longitudinal axis of the groove portion is
  • the posture of the curved needle may be constrained so that the center line of the curved needle exists in a plane that is orthogonal and orthogonal to the second gripping surface.
  • the present invention it is possible to provide a needle holder and a suturing set in which the curved needle is unlikely to rotate or shift even when the gripping force is small.
  • FIG. 3 is an example of a cross-sectional view taken along line AA in FIG. 2. It is an enlarged view of the treatment part in a needle holder. It is a top view of the 2nd holding member in a treatment part. It is a front view of the treatment part in the state which grasped the curved needle. It is a side view which shows the structure of the modification of the embodiment. It is a side view which shows the structure of the other modification of the embodiment. It is the figure seen from the B direction of FIG. It is a side view which shows the modification of the operation part of the needle holder of this invention.
  • FIG. 1 is an overall view showing a state in which the needle holder of the present embodiment grips a curved needle.
  • FIG. 2 is a plan view of the curved needle.
  • FIG. 3 is an example of a cross-sectional view taken along line AA in FIG.
  • FIG. 4 is an enlarged view of a treatment portion in the needle holder.
  • FIG. 5 is a plan view of the second gripping member in the treatment section.
  • FIG. 6 is a front view of the treatment section in a state where the curved needle is gripped.
  • the suturing set 1 of this embodiment includes a curved needle 10 and a needle holder 20.
  • the curved needle 10 has an arc shape having a predetermined curvature.
  • the curved needle 10 includes a needle tip 11 that can be inserted into tissue, a needle tip 12 that is connected to a suture thread, and a needle tip 11 and a needle tip so as to connect the needle tip 11 and the needle tip 12.
  • a needle body portion 13 disposed between the portion 12 and the needle portion 13.
  • the needle main body 13 has a first flat portion 14 and a second flat portion 15.
  • the first flat portion 14 is formed on the inner peripheral side of the needle main body portion 13 (side closer to the center of curvature O1 of the curved needle 10) in a cross section orthogonal to the center line Z1 extending along the arc of the curved needle 10.
  • the second flat portion 15 is formed on the outer peripheral side of the needle main body portion 13 (the side far from the center of curvature O1 of the curved needle 10) in a cross section orthogonal to the center line Z1 extending along the arc of the curved needle 10. Yes.
  • the needle holder 20 includes a long insertion tube portion 21 having flexibility, a treatment portion 22 disposed at a distal end 21 a of the insertion tube portion 21, and a proximal end of the insertion tube portion 21. And an traction member 34 disposed inside the insertion tube section 21 and connected to the operation section 31 and the treatment section 22.
  • the treatment unit 22 includes a first gripping member 23 and a second gripping member 26 for gripping the curved needle 10, and the first gripping member 23 is a second gripping member.
  • a connecting portion 28 and a connecting shaft 29 are provided for connecting the first gripping member 23 and the second gripping member 26 so as to be capable of opening and closing with respect to 26.
  • the first gripping member 23 is coupled to the distal end 21 a of the insertion tube portion 21 via the connection portion 28 and the coupling shaft 29.
  • a proximal end 23 b of the first gripping member 23 is connected to a distal end 34 a of the pulling member 34.
  • the first gripping member 23 has a connecting hole portion 23 c for connecting to the connecting portion 28 via the connecting shaft 29 between the distal end 23 a and the base end 23 b of the first gripping member 23.
  • the surface of the first gripping member 23 that faces the second gripping member 26 has a first gripping surface 25 that can contact the curved needle 10.
  • the first gripping surface 25 is a surface that is substantially parallel to a second gripping surface 27 (described later) of the second gripping member 26 in a state where the curved needle 10 is gripped by the first gripping member 23 and the second gripping member 26. is there.
  • the second gripping member 26 is coupled to the distal end 21 a of the insertion tube portion 21 via the connection portion 28 in the direction of the central axis Y ⁇ b> 1 of the insertion tube portion 21.
  • the second gripping member 26 and the connection portion 28 are integrally formed.
  • the second gripping member 26 has a groove portion 30 and a second gripping surface 27 directed to the first gripping member 23 side.
  • the second holding member 26 extends linearly along the center line Y1 of the insertion tube portion 21 from the distal end to the proximal end.
  • the width w2 of the groove portion 30 is equal to or greater than the width w1 of the first gripping surface 25 when viewed from the direction of the center line Y1 of the insertion tube portion 21.
  • the width w ⁇ b> 2 of the groove portion 30 is wider than the width w ⁇ b> 1 of the first gripping surface 25 when viewed from the direction of the center line Y ⁇ b> 1 of the insertion tube portion 21.
  • the second gripping surface 27 has boundary portions 30 a and 30 b with the groove portion 30.
  • the groove part 30 has the separated wall surface used as the width
  • the boundary portions 30a and 30b are groove edges extending in the longitudinal axis direction of the groove portion 30 at a position where the second gripping surface 27 and the groove portion 30 intersect, and the edges may be corner portions.
  • a round shape may be applied instead of a shape with a chamfered corner or a corner.
  • the first gripping member 23 is closed in a state where the outer peripheral side of the needle main body 13 is supported by the boundary portions 30 a and 30 b, the first gripping member 23 is moved to the inner peripheral side of the needle main body 13 of the curved needle 10. Touch.
  • the inner peripheral side of the needle main body 13 of the curved needle 10 is viewed from the distal end 26a of the second gripping member 26 toward the base end 26b of the second gripping member 26, the above two locations (first contact portion A1). , Second contact portion A2) is supported by the first gripping surface 25 of the first gripping member 23 at two locations (third contact portion, positions indicated by reference numerals A3 and A4 in FIG. 6).
  • the connecting portion 28 has a connecting hole portion 28 a for connecting with the connecting shaft 29.
  • a central axis Y2 (see FIG. 4) of the connecting shaft 29 connected to the connecting portion 28 extends in a direction orthogonal to the central line Y1 of the insertion tube portion 21. Since the first gripping member 23 and the second gripping member 26 are connected by the connecting hole portions 23c and 28a and the connecting shaft 29, the first gripping member 23 is orthogonal to the center line Y1 of the insertion tube portion 21.
  • a straight line extending in the direction can be rotated about the rotation axis Y2 with the rotation axis Y2 (the center line Y2 of the connecting shaft 29). Thereby, the first gripping member 23 can open and close with respect to the second gripping member 26.
  • the treatment portion 22 in this embodiment is a treatment in which the first gripping member 23 opens and closes with respect to the second gripping member 26 that is coupled to the distal end 21 a of the insertion tube portion 21 via the connection portion 28 and the coupling shaft 29. Part 22.
  • the operation unit 31 includes an operation unit main body 32, a slider 33, and a ratchet mechanism mechanism (not shown) that restricts the slider 33 from moving toward the distal end side with respect to the operation unit main body 32. And a release button 35 for the ratchet mechanism.
  • the distal end 32 a of the operation portion main body 32 is fixed to the proximal end 21 b of the insertion tube portion 21.
  • the slider 33 is coupled to the operation unit main body 32 so as to be movable back and forth in the long axis direction of the operation unit main body 32. Further, the slider 33 is connected to the base end 34 b of the pulling member 34.
  • the pulling member 34 can be moved along the center line Y ⁇ b> 1 of the insertion tube portion 21 by moving the slider 33 forward and backward along the operation portion main body 32.
  • the traction member 34 can be pulled toward the operation unit 31 by moving the slider 33 toward the proximal end along the operation unit main body 32.
  • the slider 33 can restrict the movement of the slider 33 toward the distal end side by a ratchet mechanism at a desired position. For this reason, the slider 33 can be locked in a state where the slider 33 is pulling the pulling member 34, and the state where the pulling member 34 is pulled can be maintained.
  • the pulling member 34 transmits an operation force amount for performing the opening / closing operation of the first gripping member 23 with respect to the second gripping member 26 from the operation unit 31 to the first gripping member 23. It is a member.
  • the distal end 34 a of the pulling member 34 is connected to the proximal end 23 b of the first gripping member 23.
  • a base end 34 b of the pulling member 34 is connected to the slider 33 of the operation unit 31.
  • the suturing set 1 and the needle holder 20 of this embodiment will be described.
  • the tissue in the body is sutured using the suture set 1 of the present embodiment
  • the curved needle 10 introduced to the vicinity of the site to be sutured is grasped using the needle holder 20 as shown in FIGS. To do.
  • the curved needle 10 When the curved needle 10 is sandwiched between the first gripping member 23 and the second gripping member 26, a part of the curved needle 10 enters the inside of the groove portion 30.
  • the curved needle 10 is most stably gripped with the inner peripheral side of the needle main body 13 in contact with the first gripping surface 25 and the outer peripheral side of the needle main body 13 in contact with the second gripping surface 27. At this time, a part of the inner peripheral side of the needle main body 13 is located in the groove 30.
  • the first gripping member 23 is in contact with the inner peripheral side of the needle main body 13.
  • the tissue can be sutured.
  • the inner peripheral side of the needle main body 13 is in contact with the first gripping surface 25, and the outer peripheral side of the needle main body 13 is in contact with the second gripping surface 27.
  • the posture of the curved needle 10 is stabilized. For this reason, the curved needle 10 sandwiched between the first gripping member 23 and the second gripping member 26 is unlikely to rotate or shift.
  • FIG. 7 is a side view showing the treatment portion 22 in the needle holder 20 of the present modification.
  • the first gripping member 23 in the present modification has a first gripping surface 25 ⁇ / b> A having a configuration different from that of the first gripping surface 25 disclosed in the above embodiment.
  • the first gripping surface 25A in this modified example is curved in the vicinity of the distal end 23a of the first gripping member 23 so as to gradually approach the second gripping member 26 side from the proximal end 23b of the first gripping member 23 toward the distal end 23a. is doing.
  • the first gripping surface 25A of the present modified example moves the curved needle 10 toward the distal end side of the treatment portion 22 by the gripping force in a state where the curved needle 10 is gripped by the first gripping member 23 and the second gripping member 26.
  • the curved needle 10 can be reliably grasped by the first grasping member 23 and the second grasping member 26.
  • FIG. 8 is a side view showing the treatment portion 22 in the needle holder 20 of the present modification.
  • FIG. 9 is a view showing the treatment portion 22 in the needle holder 20 of the present modified example from the direction C of FIG.
  • the second gripping member 26 in this modification has a protrusion 36 that protrudes from the tip 27 a of the second gripping surface 27 toward the first gripping surface 25.
  • the protruding portion 36 moves to the distal end side of the treatment section 22 and the first gripping member 23 and the second gripping member 36
  • the curved needle 10 can be supported so that the curved needle 10 does not fall out from between the gripping member 26.
  • the surface of the curved needle 10 is directed toward the proximal end of the second gripping member 26 in the protrusion 36 as the amount of force for closing the first gripping member 23 and the second gripping member 26 increases. It is strongly pressed against the abutting surface 36b (see FIG. 8). The surface of the curved needle 10 is pressed from three different directions toward the center line Z1 of the curved needle 10 by the first gripping surface 25, the second gripping surface 27, and the abutting surface 36b. For this reason, as the amount of force for closing the first gripping member 23 and the second gripping member 26 increases, the curved needle 10 is less likely to be displaced.
  • the curved needle 10 since the first gripping surface 25, the second gripping surface 27, and the abutting surface 36b surround the curved needle 10, the amount of force for closing the first gripping member 23 and the second gripping member 26 is small. However, the curved needle 10 is not easily displaced.
  • the protrusion 36 in this modification has a recess 36a into which the tip 23a of the first gripping member 23 enters. Since the depression 36 a is provided in the protrusion 36, the first holding member 23 and the second holding member 26 allow the curved needle 10 having a diameter smaller than the distance from the second holding surface 27 to the protruding end of the protrusion 36 to be It can be gripped.
  • the second gripping member 26 disclosed in each of the above embodiments may have a shape (slit shape) in which the groove 30 penetrates at least a part of the second gripping surface 27.
  • the needle holder 20 disclosed in the above embodiments may be a surgical needle holder in which the insertion tube portion and the pulling member are hard members.
  • the operation part of the needle holder 20 disclosed in each of the above embodiments may be a curl linen type as shown in FIG. For example, as illustrated in FIG.
  • the operation unit 51 includes a pair of handles (a fixed handle 52 and a movable handle 53) that can be opened and closed, and a fixing mechanism (not shown) that fixes the movable handle 53. .
  • the movable handle 53 is connected to the fixed handle 52 so as to be rotatable about a predetermined opening / closing axis 53a with respect to the fixed handle 52. Further, the movable handle 53 is connected to the base end 34 b of the pulling member 34. By opening and closing the movable handle 53 with respect to the fixed handle 52, the traction member 34 can be moved along the central axis Y1 of the insertion tube portion 21.
  • the needle holder 20 disclosed in each of the above embodiments may be a double-open needle holder in which the second gripping member 26 is rotatably connected to the connection portion 28 in the same manner as the first gripping member 23.
  • the cross section AA of the needle main body portion of the curved needle 10 of the suturing set 1 disclosed in the above embodiments is a flat surface on both the inner peripheral side and the outer peripheral side of the needle main body portion 13 as shown in FIG. It may be a D-cut shape having a D-cut oval shape having a flat surface on either the inner peripheral side or the outer peripheral side, or a polygonal shape.
  • the present invention can be used for a medical instrument for suturing a tissue.

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)
  • Surgical Instruments (AREA)

Abstract

This needle holder (20) is provided with: an elongated insertion tube section (21); a first gripping member (23) having a first gripping surface (25) extending in the direction of the center axis of the insertion tube section (21), the first gripping member (23) being connected to the front end of the insertion tube section (21) so as to be capable of pivoting about a pivot axis which is a straight line extending in the direction perpendicular to the center axis of the insertion tube section (21); and a second gripping member (26) having a groove (28) which is wider than the first gripping surface (25) in the direction perpendicular to the center axis and which is long in the direction of the center axis, the second gripping member (26) also having a second gripping surface (27) connecting to an opening end of the groove (28) and facing the first gripping member (23), the second gripping member (26) being connected to the front end of the insertion tube section (21).

Description

持針器及び縫合セットNeedle holder and suture set
　本発明は、持針器及び縫合セットに関する。 The present invention relates to a needle holder and a suture set.
　従来、体内の組織を縫合するための曲針を把持する器具が知られている。たとえば、曲針を把持可能な医療用マニピュレータが特許文献１に開示されている。
　また、曲針を把持可能な外科用処置具において、把持された曲針の回転を防止するための凹部を把持面の幅方向の縁部に設けることが特許文献２に開示されている。
　また、軟性内視鏡の処置具チャンネルに挿通可能な可撓性を有する挿入部を備えた持針器が特許文献３に開示されている。 2. Description of the Related Art Conventionally, an instrument for grasping a curved needle for suturing a body tissue is known. For example, Patent Document 1 discloses a medical manipulator that can hold a curved needle.
Further, in a surgical treatment instrument capable of gripping a curved needle, Patent Document 2 discloses that a concave portion for preventing rotation of the gripped curved needle is provided at an edge portion in the width direction of the gripping surface.
Further, Patent Literature 3 discloses a needle holder having a flexible insertion portion that can be inserted into a treatment instrument channel of a flexible endoscope.
特開２０１２－５０６９１号公報JP 2012-50691 A 特開２０１１－２００４０４号公報JP 2011-200404 A 特開２００９－２４７８８８号公報JP 2009-247888 A
　持針器によって曲針を把持して組織を穿刺する際に、把持力量が不足すると、曲針が回転したりずれたりすることがある。たとえば、軟性内視鏡の処置具チャンネルに挿入されて使用される持針器は、操作用の軟性ワイヤを通じて一対の把持部材へ把持力量を伝達するため、操作力量の損失が大きく、把持力量が不足することで曲針の回転やずれが起こりがちである。
　本発明は、把持力量が小さくても曲針の回転やずれが起こりにくい持針器及び縫合セットを提供することを目的とする。 When grasping a curved needle with a needle holder and puncturing tissue, if the amount of grasping force is insufficient, the curved needle may rotate or shift. For example, a needle holder that is used by being inserted into a treatment instrument channel of a flexible endoscope transmits a gripping force amount to a pair of gripping members through a soft wire for operation. The shortage tends to cause rotation and displacement of the curved needle.
An object of the present invention is to provide a needle holder and a suturing set in which the curved needle is unlikely to rotate or shift even when the gripping force is small.
　本発明の第一の態様は、長尺の挿入管部と、前記挿入管部の先端部に回動可能に連結された第一把持部材と、前記挿入管部の先端部に連結された第二把持部材と、を備え、前記第一把持部材は、第一把持面を有し、前記第二把持部材は、第二把持面と、前記第二把持面の先端から基端へ向かって延びる溝部を有し、前記溝部は、前記挿入部管の中心軸に対して直交する方向において前記第一把持面よりも幅が広いことを特徴とする、持針器である。 According to a first aspect of the present invention, there is provided a long insertion tube portion, a first gripping member rotatably connected to the distal end portion of the insertion tube portion, and a first connection member coupled to the distal end portion of the insertion tube portion. Two gripping members, the first gripping member has a first gripping surface, and the second gripping member extends from the distal end of the second gripping surface to the proximal end of the second gripping surface. It has a groove part, The said groove part is a needle holder characterized by being wider than said 1st holding surface in the direction orthogonal to the central axis of the said insertion part pipe | tube.
　前記第二把持部材は、前記第二把持面の先端から前記第一把持部材側へ突出する突起部を有していてもよい。 The second gripping member may have a protrusion protruding from the tip of the second gripping surface toward the first gripping member.
　前記突起部は、前記第一把持部材の先端が入り込む窪みを有していてもよい。 The protrusion may have a recess into which the tip of the first gripping member enters.
　前記第一把持部材と前記第二把持部材とによって把持された曲針は、前記曲針の表面のうち前記曲針の弧の方向に延びる中心線に沿って互いに離間する第一接触部及び第二接触部が、前記第二把持部材と前記溝部との境界部によって支持され、前記曲針の表面のうち前記曲針の中心線方向において前記第一接触部と前記第二接触部との間に位置する第三接触部は、前記第一把持面によって支持され、前記第一接触部と前記第二接触部との間の一部が前記溝部へ進入することによって、前記溝部の長手軸に直交するとともに前記第二把持面に直交する面内に前記曲針の中心線が存するように前記曲針の姿勢が拘束されてもよい。 The curved needle gripped by the first gripping member and the second gripping member has a first contact portion and a first contact portion spaced apart from each other along a center line extending in the arc direction of the curved needle on the surface of the curved needle. Two contact portions are supported by a boundary portion between the second gripping member and the groove portion, and between the first contact portion and the second contact portion in the center line direction of the curved needle on the surface of the curved needle. The third contact portion located at the first gripping surface is supported by the first gripping surface, and a part between the first contact portion and the second contact portion enters the groove portion, whereby the longitudinal axis of the groove portion is The posture of the curved needle may be constrained so that the center line of the curved needle exists in a plane that is orthogonal and orthogonal to the second gripping surface.
　本発明によれば、把持力量が小さくても曲針の回転やずれが起こりにくい持針器及び縫合セットを提供することができる。 According to the present invention, it is possible to provide a needle holder and a suturing set in which the curved needle is unlikely to rotate or shift even when the gripping force is small.
本発明の一実施形態の持針器が曲針を把持した状態を示す全体図である。It is a general view which shows the state which the needle holder of one Embodiment of this invention hold | gripped the curved needle. 曲針の平面図である。It is a top view of a curved needle. 図２のＡ－Ａ線における断面図の一例である。FIG. 3 is an example of a cross-sectional view taken along line AA in FIG. 2. 持針器における処置部の拡大図である。It is an enlarged view of the treatment part in a needle holder. 処置部における第二把持部材の平面図である。It is a top view of the 2nd holding member in a treatment part. 曲針を把持した状態における処置部の正面図である。It is a front view of the treatment part in the state which grasped the curved needle. 同実施形態の変形例の構成を示す側面図である。It is a side view which shows the structure of the modification of the embodiment. 同実施形態の他の変形例の構成を示す側面図である。It is a side view which shows the structure of the other modification of the embodiment. 図８のＢ方向から見た図である。It is the figure seen from the B direction of FIG. 本発明の持針器の操作部の変形例を示す側視図である。It is a side view which shows the modification of the operation part of the needle holder of this invention.
　本発明の一実施形態について説明する。図１は、本実施形態の持針器が曲針を把持した状態を示す全体図である。図２は、曲針の平面図である。図３は、図２のＡ－Ａ線における断面図の一例である。図４は、持針器における処置部の拡大図である。図５は、処置部における第二把持部材の平面図である。図６は、曲針を把持した状態における処置部の正面図である。 An embodiment of the present invention will be described. FIG. 1 is an overall view showing a state in which the needle holder of the present embodiment grips a curved needle. FIG. 2 is a plan view of the curved needle. FIG. 3 is an example of a cross-sectional view taken along line AA in FIG. FIG. 4 is an enlarged view of a treatment portion in the needle holder. FIG. 5 is a plan view of the second gripping member in the treatment section. FIG. 6 is a front view of the treatment section in a state where the curved needle is gripped.
　図１，図２，及び図６に示すように、本実施形態の縫合セット１は、曲針１０と持針器２０とを有している。
　図２及び図３に示すように、曲針１０は、所定の曲率を有する弧状をなしている。曲針１０は、組織に刺入可能な針先部１１と、縫合糸と連結される針元部１２と、針先部１１と針元部１２とを繋ぐように針先部１１と針元部１２との間に配された針本体部１３とを有している。 As shown in FIGS. 1, 2, and 6, the suturing set 1 of this embodiment includes a curved needle 10 and a needle holder 20.
As shown in FIGS. 2 and 3, the curved needle 10 has an arc shape having a predetermined curvature. The curved needle 10 includes a needle tip 11 that can be inserted into tissue, a needle tip 12 that is connected to a suture thread, and a needle tip 11 and a needle tip so as to connect the needle tip 11 and the needle tip 12. A needle body portion 13 disposed between the portion 12 and the needle portion 13.
　本実施形態では、針本体部１３は、第一平坦部１４と、第二平坦部１５とを有している。
　第一平坦部１４は、曲針１０の弧に沿って延びる中心線Ｚ１に対して直交する断面において、針本体部１３の内周側（曲針１０の曲率中心Ｏ１に近い側）に形成されている。
　第二平坦部１５は、曲針１０の弧に沿って延びる中心線Ｚ１に対して直交する断面において、針本体部１３の外周側（曲針１０の曲率中心Ｏ１から遠い側）に形成されている。 In the present embodiment, the needle main body 13 has a first flat portion 14 and a second flat portion 15.
The first flat portion 14 is formed on the inner peripheral side of the needle main body portion 13 (side closer to the center of curvature O1 of the curved needle 10) in a cross section orthogonal to the center line Z1 extending along the arc of the curved needle 10. ing.
The second flat portion 15 is formed on the outer peripheral side of the needle main body portion 13 (the side far from the center of curvature O1 of the curved needle 10) in a cross section orthogonal to the center line Z1 extending along the arc of the curved needle 10. Yes.
　図１に示すように、持針器２０は、可撓性を有する長尺の挿入管部２１と、挿入管部２１の先端２１ａに配された処置部２２と、挿入管部２１の基端２１ｂに配された操作部３１と、挿入管部２１の内部に配され操作部３１及び処置部２２に接続された牽引部材３４と、を備えている。 As shown in FIG. 1, the needle holder 20 includes a long insertion tube portion 21 having flexibility, a treatment portion 22 disposed at a distal end 21 a of the insertion tube portion 21, and a proximal end of the insertion tube portion 21. And an traction member 34 disposed inside the insertion tube section 21 and connected to the operation section 31 and the treatment section 22.
　図１，図４，及び図６に示すように、処置部２２は、曲針１０を把持するための第一把持部材２３及び第二把持部材２６と、第一把持部材２３が第二把持部材２６に対して開閉動作可能となるように第一把持部材２３と第二把持部材２６とを連結する接続部２８および連結軸２９とを備えている。 As shown in FIGS. 1, 4, and 6, the treatment unit 22 includes a first gripping member 23 and a second gripping member 26 for gripping the curved needle 10, and the first gripping member 23 is a second gripping member. A connecting portion 28 and a connecting shaft 29 are provided for connecting the first gripping member 23 and the second gripping member 26 so as to be capable of opening and closing with respect to 26.
　第一把持部材２３は、接続部２８および連結軸２９を介して挿入管部２１の先端２１ａに連結されている。第一把持部材２３の基端２３ｂは、牽引部材３４の先端３４ａに接続されている。第一把持部材２３は、連結軸２９を介して接続部２８に連結するための連結孔部２３ｃを、第一把持部材２３の先端２３ａと基端２３ｂとの間に有している。第一把持部材２３において第二把持部材２６に向けられた面は、曲針１０に接触可能な第一把持面２５を有している。第一把持面２５は、第一把持部材２３と第二把持部材２６とによって曲針１０が把持された状態で第二把持部材２６の第二把持面２７（後述）と略平行となる面である。 The first gripping member 23 is coupled to the distal end 21 a of the insertion tube portion 21 via the connection portion 28 and the coupling shaft 29. A proximal end 23 b of the first gripping member 23 is connected to a distal end 34 a of the pulling member 34. The first gripping member 23 has a connecting hole portion 23 c for connecting to the connecting portion 28 via the connecting shaft 29 between the distal end 23 a and the base end 23 b of the first gripping member 23. The surface of the first gripping member 23 that faces the second gripping member 26 has a first gripping surface 25 that can contact the curved needle 10. The first gripping surface 25 is a surface that is substantially parallel to a second gripping surface 27 (described later) of the second gripping member 26 in a state where the curved needle 10 is gripped by the first gripping member 23 and the second gripping member 26. is there.
　図４から図６までに示すように、第二把持部材２６は、挿入管部２１の中心軸Ｙ１方向に、接続部２８を介して挿入管部２１の先端２１ａに連結されている。本実施形態では、第二把持部材２６と接続部２８とは一体成型されている。第二把持部材２６は、溝部３０と、第一把持部材２３側に向けられた第二把持面２７とを有している。
第二把持部材２６の先端から基端へ向かって、挿入管部２１の中心線Ｙ１に沿って直線状に延びている。溝部３０の幅ｗ２は、挿入管部２１の中心線Ｙ１方向からみたときに、第一把持面２５の幅ｗ１以上である。本実施形態では、溝部３０の幅ｗ２は、挿入管部２１の中心線Ｙ１方向からみたときに、第一把持面２５の幅ｗ１よりも広い。第二把持面２７は、溝部３０との境界部３０ａ、３０ｂを有している。溝部３０は、幅ｗ２となる離間した壁面を有する。溝部３０と第二把持面２７との境界部３０ａ，３０ｂに曲針１０の針本体部１３が接することによって、曲針１０の針本体部１３の外周側は、互いに離間する２ヶ所（第一接触部Ａ１，第二接触部Ａ２）において、境界部３０ａ，３０ｂによって支持される。本実施形態では、境界部３０ａ，３０ｂは、第二把持面２７と溝部３０とが交わる位置で溝部３０の長手軸方向に延びた溝の縁であり、その縁が角部であっても良いし、角部を面取りした形状や角部に代えてラウンド形状を施していても良い。 As shown in FIGS. 4 to 6, the second gripping member 26 is coupled to the distal end 21 a of the insertion tube portion 21 via the connection portion 28 in the direction of the central axis Y <b> 1 of the insertion tube portion 21. In the present embodiment, the second gripping member 26 and the connection portion 28 are integrally formed. The second gripping member 26 has a groove portion 30 and a second gripping surface 27 directed to the first gripping member 23 side.
The second holding member 26 extends linearly along the center line Y1 of the insertion tube portion 21 from the distal end to the proximal end. The width w2 of the groove portion 30 is equal to or greater than the width w1 of the first gripping surface 25 when viewed from the direction of the center line Y1 of the insertion tube portion 21. In the present embodiment, the width w <b> 2 of the groove portion 30 is wider than the width w <b> 1 of the first gripping surface 25 when viewed from the direction of the center line Y <b> 1 of the insertion tube portion 21. The second gripping surface 27 has boundary portions 30 a and 30 b with the groove portion 30. The groove part 30 has the separated wall surface used as the width | variety w2. When the needle main body 13 of the curved needle 10 comes into contact with the boundary portions 30a and 30b between the groove 30 and the second gripping surface 27, the outer peripheral side of the needle main body 13 of the curved needle 10 is separated from each other at two locations (first In the contact part A1, the second contact part A2), it is supported by the boundary parts 30a, 30b. In the present embodiment, the boundary portions 30a and 30b are groove edges extending in the longitudinal axis direction of the groove portion 30 at a position where the second gripping surface 27 and the groove portion 30 intersect, and the edges may be corner portions. However, a round shape may be applied instead of a shape with a chamfered corner or a corner.
　また、針本体部１３の外周側が境界部３０ａ，３０ｂによって支持されている状態で第一把持部材２３が閉じられると、第一把持部材２３が曲針１０の針本体部１３の内周側に接する。曲針１０の針本体部１３の内周側は、第二把持部材２６の先端２６ａから第二把持部材２６の基端２６ｂへ向かって見たときに、上記の２ヶ所（第一接触部Ａ１，第二接触部Ａ２）の間の２か所（第三接触部、図６において符号Ａ３，Ａ４で示される位置）において第一把持部材２３の第一把持面２５によって支持される。この状態において、第一接触部Ａ１と第二接触部Ａ２との間の一部が溝部３０へ進入することによって、溝部３０の長手軸に直交するとともに第二把持面２７に直交する面内に曲針１０の中心線Ｚ１が存するように、曲針１０の姿勢が拘束される。このとき、図６に示すように第一把持面２５の幅ｗ１は、溝部３０の幅ｗ２の間に位置する。 Further, when the first gripping member 23 is closed in a state where the outer peripheral side of the needle main body 13 is supported by the boundary portions 30 a and 30 b, the first gripping member 23 is moved to the inner peripheral side of the needle main body 13 of the curved needle 10. Touch. When the inner peripheral side of the needle main body 13 of the curved needle 10 is viewed from the distal end 26a of the second gripping member 26 toward the base end 26b of the second gripping member 26, the above two locations (first contact portion A1). , Second contact portion A2) is supported by the first gripping surface 25 of the first gripping member 23 at two locations (third contact portion, positions indicated by reference numerals A3 and A4 in FIG. 6). In this state, when a part between the first contact portion A1 and the second contact portion A2 enters the groove portion 30, it is in a plane perpendicular to the longitudinal axis of the groove portion 30 and perpendicular to the second gripping surface 27. The posture of the curved needle 10 is restrained so that the center line Z1 of the curved needle 10 exists. At this time, as shown in FIG. 6, the width w <b> 1 of the first gripping surface 25 is located between the width w <b> 2 of the groove 30.
　接続部２８は、連結軸２９と連結するための連結孔部２８ａを有している。接続部２８に連結された連結軸２９の中心軸Ｙ２（図４参照）は、挿入管部２１の中心線Ｙ１に対して直交する方向に延びている。第一把持部材２３と第二把持部材２６とが連結孔部２３ｃ，２８ａおよび連結軸２９によって連結されているので、第一把持部材２３は、挿入管部２１の中心線Ｙ１に対して直交する方向に延びる直線を回動軸Ｙ２（連結軸２９の中心線Ｙ２）として、この回動軸Ｙ２回りに回動可能である。これにより、第一把持部材２３は、第二把持部材２６に対して開閉動作することができる。すなわち、本実施形態における処置部２２は、挿入管部２１の先端２１ａに接続部２８と連結軸２９を介して連結された第二把持部材２６に対して第一把持部材２３が開閉動作する処置部２２である。 The connecting portion 28 has a connecting hole portion 28 a for connecting with the connecting shaft 29. A central axis Y2 (see FIG. 4) of the connecting shaft 29 connected to the connecting portion 28 extends in a direction orthogonal to the central line Y1 of the insertion tube portion 21. Since the first gripping member 23 and the second gripping member 26 are connected by the connecting hole portions 23c and 28a and the connecting shaft 29, the first gripping member 23 is orthogonal to the center line Y1 of the insertion tube portion 21. A straight line extending in the direction can be rotated about the rotation axis Y2 with the rotation axis Y2 (the center line Y2 of the connecting shaft 29). Thereby, the first gripping member 23 can open and close with respect to the second gripping member 26. That is, the treatment portion 22 in this embodiment is a treatment in which the first gripping member 23 opens and closes with respect to the second gripping member 26 that is coupled to the distal end 21 a of the insertion tube portion 21 via the connection portion 28 and the coupling shaft 29. Part 22.
　図１に示すように、操作部３１は、操作部本体３２と、スライダ３３と、スライダ３３が操作部本体３２に対して遠位端側へ移動するのを制限するラチェット機構機構（不図示）と、ラチェット機構の解除ボタン３５とを有している。操作部本体３２の先端３２ａは、挿入管部２１の基端２１ｂに固定されている。スライダ３３は、操作部本体３２に対して操作部本体３２の長軸方向に進退可能に連結に連結されている。さらに、スライダ３３は、牽引部材３４の基端３４ｂに連結されている。操作部本体３２に沿ってスライダ３３を進退動作させることによって、牽引部材３４を挿入管部２１の中心線Ｙ１に沿って移動させることができる。本実施形態では、スライダ３３を操作部本体３２に沿って基端側へ移動させることによって、牽引部材３４を操作部３１側へと牽引することができる。スライダ３３は、所望の位置でラチェット機構によりスライダ３３の遠位端側への移動を制限できる。このため、スライダ３３が牽引部材３４を牽引している状態でスライダ３３をロックして、牽引部材３４が牽引された状態を維持できる。 As shown in FIG. 1, the operation unit 31 includes an operation unit main body 32, a slider 33, and a ratchet mechanism mechanism (not shown) that restricts the slider 33 from moving toward the distal end side with respect to the operation unit main body 32. And a release button 35 for the ratchet mechanism. The distal end 32 a of the operation portion main body 32 is fixed to the proximal end 21 b of the insertion tube portion 21. The slider 33 is coupled to the operation unit main body 32 so as to be movable back and forth in the long axis direction of the operation unit main body 32. Further, the slider 33 is connected to the base end 34 b of the pulling member 34. The pulling member 34 can be moved along the center line Y <b> 1 of the insertion tube portion 21 by moving the slider 33 forward and backward along the operation portion main body 32. In the present embodiment, the traction member 34 can be pulled toward the operation unit 31 by moving the slider 33 toward the proximal end along the operation unit main body 32. The slider 33 can restrict the movement of the slider 33 toward the distal end side by a ratchet mechanism at a desired position. For this reason, the slider 33 can be locked in a state where the slider 33 is pulling the pulling member 34, and the state where the pulling member 34 is pulled can be maintained.
　図１及び図４に示すように、牽引部材３４は、第二把持部材２６に対する第一把持部材２３の開閉動作を行なうための操作力量を操作部３１から第一把持部材２３へと伝達するための部材である。牽引部材３４の先端３４ａは、第一把持部材２３の基端２３ｂに接続されている。牽引部材３４の基端３４ｂは、操作部３１のスライダ３３に接続されている。
牽引部材３４が操作部３１側へ牽引されることによって、第二把持部材２６と第一把持部材２３が閉じる方向に移動する。牽引部材３４が操作部３１側へ牽引されることによって、第一把持部材２３と第二把持部材２６とによる曲針１０の把持力量が生じる。 As shown in FIGS. 1 and 4, the pulling member 34 transmits an operation force amount for performing the opening / closing operation of the first gripping member 23 with respect to the second gripping member 26 from the operation unit 31 to the first gripping member 23. It is a member. The distal end 34 a of the pulling member 34 is connected to the proximal end 23 b of the first gripping member 23. A base end 34 b of the pulling member 34 is connected to the slider 33 of the operation unit 31.
When the pulling member 34 is pulled toward the operation unit 31, the second gripping member 26 and the first gripping member 23 move in the closing direction. By pulling the pulling member 34 toward the operation unit 31, a gripping force amount of the curved needle 10 by the first gripping member 23 and the second gripping member 26 is generated.
　本実施形態の縫合セット１及び持針器２０の作用について説明する。
　本実施形態の縫合セット１を用いて体内の組織を縫合する場合には、縫合対象部位近傍まで導入された曲針１０を、図１及び図６に示すように持針器２０を用いて把持する。 The operation of the suturing set 1 and the needle holder 20 of this embodiment will be described.
When the tissue in the body is sutured using the suture set 1 of the present embodiment, the curved needle 10 introduced to the vicinity of the site to be sutured is grasped using the needle holder 20 as shown in FIGS. To do.
　曲針１０が第一把持部材２３と第二把持部材２６とによって挟まれると、曲針１０の一部が溝部３０の内部に進入する。曲針１０は、針本体部１３の内周側が第一把持面２５に接し、針本体部１３の外周側が第二把持面２７に接した状態で、最も安定して把持される。このとき、針本体部１３の内周側の一部が溝部３０内に位置する。そして、針本体部１３の外周側のうち、曲針１０の中心線Ｚ１に沿った方向において互いに離間する２ヶ所が、第二把持面２７と溝部３０との境界をなす２つの境界部３０ａ，３０ｂに対して線接触する。また、このとき、第一把持部材２３は、針本体部１３の内周側に接している。 When the curved needle 10 is sandwiched between the first gripping member 23 and the second gripping member 26, a part of the curved needle 10 enters the inside of the groove portion 30. The curved needle 10 is most stably gripped with the inner peripheral side of the needle main body 13 in contact with the first gripping surface 25 and the outer peripheral side of the needle main body 13 in contact with the second gripping surface 27. At this time, a part of the inner peripheral side of the needle main body 13 is located in the groove 30. Two of the outer peripheral sides of the needle main body 13, which are separated from each other in the direction along the center line Z <b> 1 of the curved needle 10, form the boundary between the second gripping surface 27 and the groove 30. Line contact is made with respect to 30b. At this time, the first gripping member 23 is in contact with the inner peripheral side of the needle main body 13.
　針本体部１３の内周側が第一把持面２５に接し、針本体部１３の外周側が第二把持面２７に接した状態において、操作者がスライダ３３をさらに牽引して固定することにより、曲針１０が回転したりずれたりすることがないように、第一把持部材２３と第二把持部材２６とによって曲針１０が把持した状態で維持される。 When the inner peripheral side of the needle main body 13 is in contact with the first gripping surface 25 and the outer peripheral side of the needle main body 13 is in contact with the second gripping surface 27, the operator further pulls and fixes the slider 33, The bent needle 10 is held by the first gripping member 23 and the second gripping member 26 so that the needle 10 does not rotate or shift.
　第一把持部材２３と第二把持部材２６とによって曲針１０が把持された状態で、操作部３１を用いて挿入管部２１を進退させたり回転させたりすることによって、曲針１０を用いて組織を縫合することができる。 Using the curved needle 10 by moving the insertion tube portion 21 forward and backward using the operation unit 31 in a state where the curved needle 10 is gripped by the first gripping member 23 and the second gripping member 26. The tissue can be sutured.
　以上に説明したように、本実施形態の縫合セット１によれば、針本体部１３の内周側が第一把持面２５に接し、針本体部１３の外周側が第二把持面２７に接した状態で、曲針１０の姿勢が安定する。このため、第一把持部材２３と第二把持部材２６との間に挟まれた曲針１０が回転したりずれたりしにくくなる。 As described above, according to the suturing set 1 of the present embodiment, the inner peripheral side of the needle main body 13 is in contact with the first gripping surface 25, and the outer peripheral side of the needle main body 13 is in contact with the second gripping surface 27. Thus, the posture of the curved needle 10 is stabilized. For this reason, the curved needle 10 sandwiched between the first gripping member 23 and the second gripping member 26 is unlikely to rotate or shift.
（変形例１）
　上記実施形態の変形例について説明する。図７は、本変形例の持針器２０における処置部２２を示す側面図である。
　図７に示すように、本変形例における第一把持部材２３は、上記実施形態に開示された第一把持面２５とは構成が異なる第一把持面２５Ａを有している。
　本変形例における第一把持面２５Ａは、第一把持部材２３の先端２３ａ近傍において、第一把持部材２３の基端２３ｂから先端２３ａ側へ行くに従って漸次第二把持部材２６側に近づくように湾曲している。本変形例の第一把持面２５Ａは、第一把持部材２３と第二把持部材２６とによって曲針１０が把持された状態において、把持力により曲針１０が処置部２２の先端側に移動するのを制限する。これにより、本変形例では、牽引部材３４の牽引力が強くても第一把持部材２３と第二把持部材２６とによって確実に曲針１０を把持することができる。 (Modification 1)
A modification of the above embodiment will be described. FIG. 7 is a side view showing the treatment portion 22 in the needle holder 20 of the present modification.
As shown in FIG. 7, the first gripping member 23 in the present modification has a first gripping surface 25 </ b> A having a configuration different from that of the first gripping surface 25 disclosed in the above embodiment.
The first gripping surface 25A in this modified example is curved in the vicinity of the distal end 23a of the first gripping member 23 so as to gradually approach the second gripping member 26 side from the proximal end 23b of the first gripping member 23 toward the distal end 23a. is doing. The first gripping surface 25A of the present modified example moves the curved needle 10 toward the distal end side of the treatment portion 22 by the gripping force in a state where the curved needle 10 is gripped by the first gripping member 23 and the second gripping member 26. To limit. Thereby, in this modification, even if the traction force of the traction member 34 is strong, the curved needle 10 can be reliably grasped by the first grasping member 23 and the second grasping member 26.
（変形例２）
　上記実施形態の他の変形例について説明する。図８は、本変形例の持針器２０における処置部２２を示す側面図である。図９は、本変形例の持針器２０における処置部２２を図１０のＣ方向から示す図である。 (Modification 2)
Another modification of the above embodiment will be described. FIG. 8 is a side view showing the treatment portion 22 in the needle holder 20 of the present modification. FIG. 9 is a view showing the treatment portion 22 in the needle holder 20 of the present modified example from the direction C of FIG.
　図８及び図９に示すように、本変形例における第二把持部材２６は、第二把持面２７の先端２７ａから第一把持面２５側へ突出する突起部３６を有している。 As shown in FIGS. 8 and 9, the second gripping member 26 in this modification has a protrusion 36 that protrudes from the tip 27 a of the second gripping surface 27 toward the first gripping surface 25.
　突起部３６は、第一把持部材２３と第二把持部材２６とによって曲針１０が把持された状態において、処置部２２の先端側に曲針１０が移動して第一把持部材２３と第二把持部材２６との間から曲針１０が抜け落ちてしまうことがないように、曲針１０を支持することができる。 In the state where the curved needle 10 is gripped by the first gripping member 23 and the second gripping member 26, the protruding portion 36 moves to the distal end side of the treatment section 22 and the first gripping member 23 and the second gripping member 36 The curved needle 10 can be supported so that the curved needle 10 does not fall out from between the gripping member 26.
　本変形例では、曲針１０の表面は、第一把持部材２３と第二把持部材２６とを閉じようとする力量が大きくなるに従って、突起部３６のうち第二把持部材２６の基端へ向く当て付け面３６ｂ（図８参照）に強く押し付けられる。曲針１０の表面は、第一把持面２５，第二把持面２７，及び当て付け面３６ｂによって、互いに異なる３方向から曲針１０の中心線Ｚ１方向へと押圧される。このため、第一把持部材２３と第二把持部材２６とを閉じようとする力量が大きくなるに従って曲針１０の位置ずれが起こりにくくなる。また、第一把持面２５，第二把持面２７，及び当て付け面３６ｂが曲針１０を囲んでいるので、第一把持部材２３と第二把持部材２６とを閉じようとする力量が小さい状態でも、曲針１０がずれにくい。 In this modification, the surface of the curved needle 10 is directed toward the proximal end of the second gripping member 26 in the protrusion 36 as the amount of force for closing the first gripping member 23 and the second gripping member 26 increases. It is strongly pressed against the abutting surface 36b (see FIG. 8). The surface of the curved needle 10 is pressed from three different directions toward the center line Z1 of the curved needle 10 by the first gripping surface 25, the second gripping surface 27, and the abutting surface 36b. For this reason, as the amount of force for closing the first gripping member 23 and the second gripping member 26 increases, the curved needle 10 is less likely to be displaced. In addition, since the first gripping surface 25, the second gripping surface 27, and the abutting surface 36b surround the curved needle 10, the amount of force for closing the first gripping member 23 and the second gripping member 26 is small. However, the curved needle 10 is not easily displaced.
　また、本変形例における突起部３６は、第一把持部材２３の先端２３ａが入り込む窪み３６ａを有していている。窪み３６ａが突起部３６に設けられていることにより、第二把持面２７から突起部３６の突出端までの距離よりも直径が小さな曲針１０を第一把持部材２３及び第二把持部材２６によって把持することができる。 Further, the protrusion 36 in this modification has a recess 36a into which the tip 23a of the first gripping member 23 enters. Since the depression 36 a is provided in the protrusion 36, the first holding member 23 and the second holding member 26 allow the curved needle 10 having a diameter smaller than the distance from the second holding surface 27 to the protruding end of the protrusion 36 to be It can be gripped.
　以上、本発明の実施形態について図面を参照して詳述したが、具体的な構成はこの実施形態に限られるものではなく、本発明の要旨を逸脱しない範囲の設計変更等も含まれる。
　例えば、上記各実施形態で開示された第二把持部材２６は、溝部３０が第二把持面２７に対して少なくとも一部が貫通した形状（スリット形状）でもよい。
　例えば、上記各実施形態で開示された持針器２０は、挿入管部や牽引部材が硬質部材である外科用の持針器でもよい。
　また、上記各実施形態に開示された持針器２０の操作部は、図１０に示すようなカールライネル型でもよい。
　例えば、図１０に示すように、操作部５１は、開閉動作可能な一対のハンドル（固定ハンドル５２及び可動ハンドル５３）と、可動ハンドル５３を固定する固定機構（不図示）とを有している。可動ハンドル５３は、固定ハンドル５２に対して所定の開閉軸５３ａを中心として回動可能となるように固定ハンドル５２に連結されている。さらに、可動ハンドル５３は、牽引部材３４の基端３４ｂに連結されている。固定ハンドル５２に対して可動ハンドル５３を開閉動作させることによって、挿入管部２１の中心軸Ｙ１に沿って牽引部材３４を移動させることができる。
　また、上記各実施形態に開示された持針器２０は、第二把持部材２６が第一把持部材２３と同様に、接続部２８に対して回転自在に連結されている両開きの持針器でもよい。
　また、上記各実施形態に開示された縫合セット１の曲針１０の針本体部の断面Ａ－Ａは、図２に示すような針本体部１３の内周側と外周側の両方に平坦面を有するＤカット形状でも、内周側と外周側のどちらか一方に平坦面を有するDカットの楕円形状でも、多角形でもよい。 As mentioned above, although embodiment of this invention was explained in full detail with reference to drawings, the concrete structure is not restricted to this embodiment, The design change etc. of the range which does not deviate from the summary of this invention are included.
For example, the second gripping member 26 disclosed in each of the above embodiments may have a shape (slit shape) in which the groove 30 penetrates at least a part of the second gripping surface 27.
For example, the needle holder 20 disclosed in the above embodiments may be a surgical needle holder in which the insertion tube portion and the pulling member are hard members.
Moreover, the operation part of the needle holder 20 disclosed in each of the above embodiments may be a curl linen type as shown in FIG.
For example, as illustrated in FIG. 10, the operation unit 51 includes a pair of handles (a fixed handle 52 and a movable handle 53) that can be opened and closed, and a fixing mechanism (not shown) that fixes the movable handle 53. . The movable handle 53 is connected to the fixed handle 52 so as to be rotatable about a predetermined opening / closing axis 53a with respect to the fixed handle 52. Further, the movable handle 53 is connected to the base end 34 b of the pulling member 34. By opening and closing the movable handle 53 with respect to the fixed handle 52, the traction member 34 can be moved along the central axis Y1 of the insertion tube portion 21.
Further, the needle holder 20 disclosed in each of the above embodiments may be a double-open needle holder in which the second gripping member 26 is rotatably connected to the connection portion 28 in the same manner as the first gripping member 23. Good.
Further, the cross section AA of the needle main body portion of the curved needle 10 of the suturing set 1 disclosed in the above embodiments is a flat surface on both the inner peripheral side and the outer peripheral side of the needle main body portion 13 as shown in FIG. It may be a D-cut shape having a D-cut oval shape having a flat surface on either the inner peripheral side or the outer peripheral side, or a polygonal shape.
　本発明は、組織の縫合を行うための医療器具に利用可能である。 The present invention can be used for a medical instrument for suturing a tissue.
１　縫合セット
１０　曲針
１１　針先部
１２　針元部
１３　針本体部
１４　第一平坦部
１５　第二平坦部
２０　持針器
２１　挿入管部
２２　処置部
２３　第一把持部材
２３ｃ　第一把持部材の連結孔部
２５，２５Ａ　第一把持面
２６　第二把持部材
２７　第二把持面
２８　接続部
２８ａ　接続部の連結孔部
２９　連結軸
３０　溝部
３０ａ，３０ｂ　境界部
３１、５１　操作部
３２　操作部本体
３３　スライダ
３４　牽引部材
３５　解除ボタン
３６　突起部
３６ａ　窪み
３６ｂ　当て付け面
５２　固定ハンドル
５３　可動ハンドル DESCRIPTION OF SYMBOLS 1 Suture set 10 Bending needle 11 Needle tip part 12 Needle part 13 Needle main part 14 First flat part 15 Second flat part 20 Needle holder 21 Insertion tube part 22 Treatment part 23 First gripping member 23c of the first gripping member Connecting hole portions 25, 25A First gripping surface 26 Second gripping member 27 Second gripping surface 28 Connection portion 28a Connection hole portion 29 of connecting portion Connection shaft 30 Groove portions 30a, 30b Boundary portions 31, 51 Operation portion 32 Operation portion main body 33 Slider 34 Pulling member 35 Release button 36 Protrusion 36a Depression 36b Abutting surface 52 Fixed handle 53 Movable handle

Claims (5)

  1. 　長尺の挿入管部と、
    　前記挿入管部の先端部に回動可能に連結された第一把持部材と、
    　前記挿入管部の先端部に連結された第二把持部材と、
    　を備え、
    　前記第一把持部材は、第一把持面を有し、
    　前記第二把持部材は、第二把持面と溝部を有し、
    　前記溝部は、前記挿入部管の中心軸に対して直交する方向において前記第一把持面よりも幅が広いことを特徴とする、
    　持針器。     A long insertion tube,
    A first gripping member rotatably connected to the distal end portion of the insertion tube portion;
    A second gripping member connected to the distal end portion of the insertion tube portion;
    With
    The first gripping member has a first gripping surface,
    The second gripping member has a second gripping surface and a groove,
    The groove is wider than the first gripping surface in a direction perpendicular to the central axis of the insertion tube.
    Needle holder.
  2. 　前記第二把持部材は、前記第二把持面の先端から前記第一把持部材側へ突出する突起部を有している、請求項１に記載の持針器。 The needle holder according to claim 1, wherein the second gripping member has a protrusion that protrudes from the tip of the second gripping surface toward the first gripping member.
  3. 　前記突起部は、前記第一把持部材の先端が入り込む窪みを有している、請求項１又は請求項２に記載の持針器。 The needle holder according to claim 1 or 2, wherein the protrusion has a recess into which a tip of the first gripping member enters.
  4. 　前記第一把持部材と前記第二把持部材とによって把持された曲針は、
    　前記曲針の表面のうち前記曲針の弧の方向に延びる中心線に沿って互いに離間する第一接触部及び第二接触部が、前記第二把持部材と前記溝部との境界部によって支持され、
    　前記曲針の表面のうち前記曲針の中心線方向において前記第一接触部と前記第二接触部との間に位置する第三接触部は、前記第一把持面によって支持され、
    　前記第一接触部と前記第二接触部との間の一部が前記溝部へ進入することによって、前記溝部の長手軸に直交するとともに前記第二把持面に直交する面内に前記曲針の中心線が存するように前記曲針の姿勢が拘束される
    ことを特徴とする、請求項１～３のいずれか一項に記載の持針器。     The curved needle gripped by the first gripping member and the second gripping member is
    A first contact portion and a second contact portion that are separated from each other along a center line extending in the arc direction of the curved needle on the surface of the curved needle are supported by a boundary portion between the second gripping member and the groove portion. ,
    A third contact portion located between the first contact portion and the second contact portion in the centerline direction of the curved needle among the surfaces of the curved needle is supported by the first gripping surface,
    When a part between the first contact portion and the second contact portion enters the groove portion, the curved needle is placed in a plane perpendicular to the longitudinal axis of the groove portion and perpendicular to the second gripping surface. The needle holder according to any one of claims 1 to 3, wherein a posture of the curved needle is constrained so that a center line exists.
  5. 　請求項１～３のいずれか一項に記載の持針器と、
    　前記第一把持部材と前記第二把持部材とによって把持される曲針と、
    を備えた縫合セット。     A needle holder according to any one of claims 1 to 3,
    A curved needle gripped by the first gripping member and the second gripping member;
    Suture set with.
PCT/JP2016/055685 2016-02-25 2016-02-25 Needle holder and suture set WO2017145337A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2016/055685 WO2017145337A1 (en) 2016-02-25 2016-02-25 Needle holder and suture set

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2016/055685 WO2017145337A1 (en) 2016-02-25 2016-02-25 Needle holder and suture set

Publications (1)

Publication Number Publication Date
WO2017145337A1 true WO2017145337A1 (en) 2017-08-31

Family

ID=59685003

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2016/055685 WO2017145337A1 (en) 2016-02-25 2016-02-25 Needle holder and suture set

Country Status (1)

Country Link
WO (1) WO2017145337A1 (en)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019180867A1 (en) * 2018-03-22 2019-09-26 オリンパス株式会社 Needle carrier and method of using same
WO2021079461A1 (en) * 2019-10-24 2021-04-29 オリンパス株式会社 Needle carrier for endoscope and method for manipulating suture needle
WO2021176636A1 (en) * 2020-03-05 2021-09-10 オリンパス株式会社 Needle holder for endoscope, and endoscopic suturing method
CN114343753A (en) * 2020-10-13 2022-04-15 奥林巴斯株式会社 Traction tool, traction system, suture thread traction method, and suture method
US12004738B2 (en) 2020-09-16 2024-06-11 Olympus Corporation Needle holder and method of using same

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5601575A (en) * 1994-09-02 1997-02-11 Ethicon Endo-Surgery, Inc. Needle driving device
US5951587A (en) * 1997-10-09 1999-09-14 Ethicon-Endo-Surgery, Inc. Needle holder with suture filament grasping abilities
US20020120282A1 (en) * 1999-12-20 2002-08-29 Kilpela Thomas S. Multiple lumen crimp
JP2009247888A (en) * 2008-04-10 2009-10-29 Olympus Medical Systems Corp Medical treatment system

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5601575A (en) * 1994-09-02 1997-02-11 Ethicon Endo-Surgery, Inc. Needle driving device
US5951587A (en) * 1997-10-09 1999-09-14 Ethicon-Endo-Surgery, Inc. Needle holder with suture filament grasping abilities
US20020120282A1 (en) * 1999-12-20 2002-08-29 Kilpela Thomas S. Multiple lumen crimp
JP2009247888A (en) * 2008-04-10 2009-10-29 Olympus Medical Systems Corp Medical treatment system

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019180867A1 (en) * 2018-03-22 2019-09-26 オリンパス株式会社 Needle carrier and method of using same
CN111867488A (en) * 2018-03-22 2020-10-30 奥林巴斯株式会社 Needle holder and method of use thereof
JPWO2019180867A1 (en) * 2018-03-22 2021-03-11 オリンパス株式会社 Needle holder and how to use it
CN114302683A (en) * 2019-10-24 2022-04-08 奥林巴斯株式会社 Needle holder for endoscope and method for operating suture needle
JPWO2021079461A1 (en) * 2019-10-24 2021-04-29
WO2021079461A1 (en) * 2019-10-24 2021-04-29 オリンパス株式会社 Needle carrier for endoscope and method for manipulating suture needle
JP7233562B2 (en) 2019-10-24 2023-03-06 オリンパス株式会社 Needle holder for endoscope and operation method of suture needle
CN114302683B (en) * 2019-10-24 2024-04-26 奥林巴斯株式会社 Needle holder for endoscope and method for operating suture needle
WO2021176636A1 (en) * 2020-03-05 2021-09-10 オリンパス株式会社 Needle holder for endoscope, and endoscopic suturing method
JP7349553B2 (en) 2020-03-05 2023-09-22 オリンパス株式会社 Endoscope needle holder
US12004738B2 (en) 2020-09-16 2024-06-11 Olympus Corporation Needle holder and method of using same
CN114343753A (en) * 2020-10-13 2022-04-15 奥林巴斯株式会社 Traction tool, traction system, suture thread traction method, and suture method
CN114343753B (en) * 2020-10-13 2024-03-29 奥林巴斯株式会社 Traction device, traction system, suture traction method and suture method

Similar Documents

Publication Publication Date Title
US10835220B2 (en) Self-articulating joint for a minimally invasive surgical apparatus
US7896900B2 (en) Medical instrument for grasping an object, in particular needle holder
WO2017145337A1 (en) Needle holder and suture set
US11911020B2 (en) Needle holder for endoscope, suture set, and suture system
WO2012042920A1 (en) Therapeutic instrument
JP6184639B2 (en) Suture device
JP2004154164A (en) Multi-degree-of-freedom type treating instrument
JP5328421B2 (en) forceps
US20090198098A1 (en) Endoscope treatment instrument
JP6622151B2 (en) Gripper, needle holder and attachment
US20070016249A1 (en) Suture device
JPWO2018163410A1 (en) Guide wire grasper
US11311305B2 (en) Surgical instruments with coupling members to effect multiple pivot axes
JP2014518653A (en) Surgical forceps
JP6408024B2 (en) Medical treatment tool
JP5266358B2 (en) Needle holder
JP5695835B2 (en) Surgical instrument
JP2018061672A (en) Indwelling clip
WO2017119080A1 (en) Endoscopy treatment instrument
JP7468725B2 (en) forceps
JP5103609B2 (en) Needle holder
JP2007054249A (en) Needle-holding tool
JP5751554B2 (en) Surgical instruments
JP2004016661A (en) Surgery tool

Legal Events

Date Code Title Description
NENP Non-entry into the national phase

Ref country code: DE

121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 16891494

Country of ref document: EP

Kind code of ref document: A1

122 Ep: pct application non-entry in european phase

Ref document number: 16891494

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: JP