JP3136392B2 - Suture prosthesis - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a suture prosthesis suitable for use in an automatic suturing device in a surgical operation or the like.

[0002]

2. Description of the Related Art Conventionally, a stapler-type automatic suturing device in which a large number of staples are embedded is often used for surgical operations such as resection of a tubular organ, anastomosis, and the like. The problem of air leakage from the part and application to soft tissue may cause problems such as tissue damage and rupture.

[0003] The present invention relates to a novel suture prosthesis for a new automatic suturing device, which is easy to mount and align, prevents misalignment after mounting, and has an easy cutting operation with a cutter. Materials.

[0004]

SUMMARY OF THE INVENTION The present invention provides a suturing prosthesis made of a tubular body.

Another object of the present invention is to provide a suture prosthesis in which the opening at one end is made narrower than the opening at the other end.

Further, the present invention relates to a tubular suture prosthesis (hereinafter referred to as a first invention) in which a cloth-like body made of a biodegradable and absorbable material and a knitted or woven fabric having elasticity are integrated at both ends thereof. )I will provide a.

[0007] The present invention also provides a tubular suture prosthesis (hereinafter referred to as a second invention) formed of a cloth-like body made of a biodegradable and absorbable material.

The present invention relates to a suturing prosthesis material formed in a tubular shape. In the first invention, an elastic material is used as a part of the constituent material, so that the material can be attached to an automatic suturing device by the elasticity. The prosthetic material can be easily and surely cut because the position of the prosthesis material is not displaced because the adhesion after mounting is increased and the prosthetic material is cut at the same time as the cutting of the affected part.

Further, in the second invention, since the whole is a cloth-like body made of a biodegradable and absorbable material, the operation of removing the non-degradable substance after the operation is unnecessary. Accidents such as foreign substances remaining in the body can also be prevented.

The term "cylindrical" means that both ends of the cloth-like body or both ends of the knitted or woven fabric having elasticity are integrated with the cloth-like body. May be used.

On the other hand, the biodegradable and absorbable material of the present invention used for a part or all of the suture prosthesis has a feature that it does not remain as a foreign substance in the body for a long period of time.

The stretchable knitted or woven fabric of the first invention has a structure in which, for example, rubber yarn, polyurethane-based elastic yarn, crimped, bulky processed yarn and the like are appropriately knitted and interwoven, and is vertically and horizontally woven. It has elasticity in the direction, and its structure is not particularly limited.However, in terms of easiness of sewing and sewing at the time of cutting and integration, and furthermore, in terms of form stability and the like, for example, a nylon yarn is covered with a polyurethane yarn. A power net fabric knitted into a warp knit with the yarn obtained by ringing can be exemplified as a particularly suitable example.

On the other hand, cloths made of biodegradable and absorbable materials include polyglycolic acid, polylactic acid, copolymers or mixtures of both, and also medical materials such as paradioxanone, polycaprolactone, and chitin. Knitted fabrics, woven fabrics, non-woven fabrics, films, etc., of the material applied as the material can be exemplified, but in particular, aspects such as flexibility, air permeability, appropriate waist, thickness, blood absorbency, ease of staple passage, decomposability, etc. Japanese Patent Publication No. Hei 5-18579, which was previously invented by the present applicant,
Knitting and weaving using polyglycolic acid disclosed in JP-A-79586 as a material, and a nonwoven fabric produced by needle punching a woven fabric can be exemplified as suitable materials. In addition, such a nonwoven fabric has poor elasticity.

In the first aspect of the present invention, when the stretchable knit or woven fabric is integrated with the cloth-like body, the two cut into the required sizes (preferably the same size for integration work). Lay the cloth together and the ends (both ears)
Are integrated by, for example, sewing or bonding. As particularly preferred means of integration, a coarse-pitch sewn stitch that can easily separate the two after surgery can be exemplified, and the thread ends thereof are extended to an appropriate length in order to facilitate the separation operation. It is desirable to put out. Examples of the sewing thread include a sewing thread for sewing clothing, a medical suture, and the like.
It is composed of any of non-biodegradable and absorbable materials such as polyester, vinylon, cotton and silk and the above-mentioned biodegradable and absorbable materials. In consideration of the possibility that the suture is caught and remains in the body, it is preferable that the suture be made of the same material as the biodegradable and absorbable material of the present invention. Further, it is important to achieve the above-mentioned purpose that the inner diameter of the tube formed by the integration is equal to or smaller than the outer diameter of the suturing device to be applied. Therefore, the size, shape, It is desired that the sewing means and the like for integration match this purpose.

According to the second aspect of the present invention, the tubular body made of the biodegradable and absorbable material is formed into a tubular shape in accordance with a desired size, that is, the size of the staple embedding portion of the automatic suture instrument to be applied. The cloth-shaped body cut to the size is joined by an arbitrary method such as suturing or bonding. For example, it is advantageous in terms of workability after a suturing operation to be described later that rough sewn or temporary bonding is used. Therefore, it is particularly preferable. However, a knitted fabric knitted in a high-density tubular shape may be used as a suture prosthetic material so as to be suitable for the use.

An automatic suturing device to which the prosthetic material of the present invention is applied is an AUTOSUTURE MUL manufactured by UNITED STATE SURGICAL.
TIFIRE GIA 80, 60 TYPE (brand name), ETHICON endo SUR
GERY's PROXIMATE LINEAR CUTTER 75, 55 TYPE (trade name), etc. can be used as an example. When applying to these, simply attach the cartridge to the frame with the staple built-in cartridge and the frame with the staple receiving groove. It can be performed.

The cloth-like material is made of a non-biodegradable and absorbable material such as nylon, polyester, vinylon, cotton, silk, etc., polyglycolic acid, polylactic acid, a copolymer or mixture of polylactic acid and polyglycolic acid, paradioxanone, It is composed of at least one selected from the group consisting of biodegradable and absorbable materials such as polycaprolactone and chitin. The cloth body may be any of a woven fabric, a knitted fabric, a nonwoven fabric, and a film.

[0018]

DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be described below with reference to the drawings.

Embodiment 1 FIG. 1 shows a suturing prosthesis of the present invention. The prosthetic material is obtained by unifying a nonwoven fabric (3) made of a biodegradable and absorbable material and a power net fabric (4) at both ears by sewing and sewing (5) and (6). Both ends (7), (7) are extended.

The nonwoven fabric (3) was prepared by knitting 12 filament, 33 denier polyglycolic acid yarns with an 18 gauge circular knitting machine at a basis weight of 45 g / m ² and lightly needle punching in the wale direction. These were alternately stacked so that the course direction and the wale direction were orthogonal to each other, and the whole was needle-punched to be integrated. The power net fabric (4) uses a 280 denier polyurethane yarn and a 70 denier, 24 filament nylon yarn, and uses a 48 gauge warp knitting machine so that the mixing ratio becomes 15:85. It is knitted. A specific example of the sewing thread is a polyglycolic acid suture having a size of 4-0.

Such nonwoven fabric (3), power net fabric (4)
Are cut to a size of 80 × 25 mm and overlapped, and the inner side 2 mm from the side edge is sewn by hand stitching at a sewing pitch of 10 mm by hand stitching (5), (6), and the tubular suture prosthesis material of the present invention ( Construct 1). The thread ends (7) are each 8c
m. In addition, a suture prosthesis material (2) was obtained according to the same specifications as described above except that a cloth having a size of 80 × 20 mm was used.

FIG. 2 shows a double staple (2 rows × 2 rows staple embedding) type in which the suture prostheses (1) and (2) of the present invention configured as described above are conventionally used. Frame part with staple receiving groove of automatic suture device (8)
(10) and a use state in which the cartridge is mounted on the staple-containing cartridge section (9), respectively. In addition, (11) in FIG.
Indicates a staple fastening handle, and (12) indicates a cutter. FIG. 3 is a sectional view taken along the line AA in FIG. 2, but the power net fabric (4) is stretched and mounted.

As shown in FIGS. 3 and 4, the suturing prosthesis of the present invention, which is mounted as described above, has an affected part interposed between the frame part (10) and the staple-containing cartridge part (9) at the time of surgery. By tightening the handle (11), the body tissue is sandwiched between the nonwoven fabrics (3) and (3) of the suture prosthesis attached to the frame part (10) and the cartridge part (9), and the staple (15) is used. Both are fixed integrally. Then, by operating a cutter (12), the lesion (13) is separated into a normal tissue part (14) that is not the other part, and the thread end (7) of the sewn suture is pulled to leave the body tissue. (14) and the part which is not separated and cut off, the cut part (13) is a power net cloth (4) which is an elastic cloth
Remove with the body.

FIG. 7 shows another suture prosthesis of the present invention.
The prosthetic material is a nonwoven fabric made of a biodegradable and absorbable material
From both ends of (3) and (3 ') to the center, both ears are sewn together (5) and (6), and the other end is narrowed to narrow the opening at the end. . Further, both ends (7) and (7) of the sewing thread are extended. When this suture prosthesis material is used in the frame portion (10) and the cartridge portion (9) of the double-staple type automatic suturing device (8) shown in FIG. When inserting the cartridge (10) and the cartridge part (9) into the body, there is no turning over or displacement. Also, when the suture prosthesis is attached, it is easy to attach the suture prosthesis, and there is no possibility that the suture prosthesis is shifted or the end is turned up.

As shown in FIG. 8, by providing the knot (20), it is possible to prevent the seam from being released and the non-woven fabric (3) from separating from the power net fabric (4) during mounting. Also, when cutting with a cutter in the direction of the arrow, the seam is not loosened and can be cut easily.

As shown in FIG. 9, by providing a cut (21) or a perforation (22) at the center of the nonwoven fabric (3), a cutter can be operated along the cut and the perforation from the direction of the arrow. Can be easily cut. As another means for facilitating the cutting, it is also possible to temporarily stitch the portion, form a weak portion such as an adhesive, or make the portion like paper by resin processing or hot pressing to make it easier to cut.

As shown in FIG. 10, the suture prosthesis of the present invention
When bringing the automatic suturing device (8) equipped with (1) and (2) to the cutting site, put the protective cap (23) on the frame (10) and the cartridge (9) together. In addition, it is possible to prevent the suture prostheses (1) and (2) after being mounted from being turned up or out of position.

This protective cap (23) is made of a bag-like tubular body made of knitted / woven fabric, non-woven fabric, plastic film or the like.

The shape is preferably matched to the shape of the tip of the automatic suture instrument.

Similar results can be obtained by using a sewing thread made of polyester instead of the sewing thread.

Embodiment 2 FIG. 5 shows a suturing prosthesis according to a second invention. This suture prosthesis
(2 ') is a nonwoven fabric made of the same polyglycolic acid as above
(3 '), and both ends are integrated by sewing with thread (4'). Further, as shown in FIG. 6, only the staple action peripheral portion (17) may be a nonwoven fabric made of polyglycolic acid, and another inexpensive material (18) may be temporarily bonded to the nonwoven fabric with an adhesive (19).

These suture prostheses of the second invention can be used in the same manner as the suture prosthesis of the first invention shown in the first embodiment.

The present invention has a feature of preventing air leakage from a resection portion or tearing of soft tissue, particularly in an operation using a staple-type automatic suturing device. The extension facilitates attachment and correction operations to automatic suturing devices of various sizes, and once attached, there is no displacement due to the contraction force, and cutting operation after fixing to staples Has a feature that it can be easily cut because of tension. In addition, there is also economical efficiency that requires less expensive biodegradable and absorbent materials. In addition, when a sewing thread having elasticity is applied, it can be combined with a low elasticity fabric.

[Brief description of the drawings]

FIG. 1 is a perspective view showing a suturing prosthesis of the present invention.

FIG. 2 is a front view showing a state in which the suture prosthesis material of FIG. 1 is mounted on an automatic suturing device.

FIG. 3 is a sectional view taken along line AA in FIG. 2;

FIG. 4 is a perspective view showing a state in which the suture prosthesis material of FIG.

FIG. 5 shows a suture prosthesis made entirely of a bioabsorbable material.

FIG. 6 shows a suture prosthesis in which only the stapling peripheral edge is made of a bioabsorbable material.

FIG. 7 shows another configuration example of the present invention, and shows a suture prosthesis material in which one end is sewn and narrowed.

FIG. 8 is a perspective view showing another example of the suture prosthesis of the present invention.

FIG. 9 is a perspective view showing another example of the suture prosthesis of the present invention.

FIG. 10 is a perspective view showing an example in which a protective cap is used when using the suture prosthesis of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Suture prosthesis material 2 Suture prosthesis material 3 Nonwoven fabric 3 'nonwoven fabric 4 Power net cloth 5 Gull stitch 6 Gull stitch 7 End of thread 8 Automatic suturer 9 Cartridge part 10 Frame part 11 Staple fastening handle 12 Cutter 13 Lesion 14 Normal tissue Portion 15 Staple 17 Peripheral edge of staple action 18 Material 19 Adhesive 20 Knot 21 Notch 22 Perforation 23 Protective cap

──────────────────────────────────────────────────続 き Continuation of the front page (72) Inventor Satoshi Hashimoto 1 at 38, Nishibaba, Aono-cho, Ayabe-shi, Kyoto Inside the Gunze Co., Ltd. Medical Materials Center (56) References JP-A-5-76586 (JP, A JP-A-63-95041 (JP, A) JP-A-7-33342 (JP, U) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61L 17/00-17/12

Claims (10)

(57) [Claims] 1. A suture prosthesis for an automatic suturing device, wherein the cloth body is formed into a tubular shape. 2. The suture prosthesis according to claim 1, wherein the opening at one end is made narrower than the opening at the other end. 3. The tubular suture prosthesis according to claim 1, wherein a cloth-like body made of a biodegradable and absorbable material and a knitted or woven fabric having elasticity are joined at both ends. 4. The suture prosthesis material according to claim 3, wherein a sewing thread is arranged in a stitch-like shape at a joint between the cloth-like body and the stretchable knit or woven fabric, and a thread end of the sewing thread is extended. . 5. The biodegradable and absorbable material is at least one selected from the group consisting of polyglycolic acid, polylactic acid, a copolymer of glycolic acid and lactic acid, paradioxanone, polycaprolactone and chitin. 4. The suture prosthesis according to item 3. 6. The suture prosthesis according to claim 3, wherein the knitted or woven fabric having elasticity is a power net fabric. 7. The suture prosthesis according to claim 3, wherein the cloth is a non-woven fabric made of polyglycolic acid. 8. biodegradable and absorbable consisting cloth body material tubular claim 1 stapler dexterity suture prosthesis according to (only
Tentatively sew the cloth, or temporarily glue it into a cylinder.
(Excluding suturing prostheses) . 9. A tubular suture prosthesis for an automatic suturing device, comprising a cloth made of a non-biodegradable and absorbable material joined to a cloth made of a biodegradable and absorbable material. 10. The tubular suture prosthesis according to claim 9, wherein a nonwoven fabric made of a non-biodegradable absorbent material is joined to a cloth made of a biodegradable absorbent material.