JP6153430B2 - Suture prosthesis for automatic suturing device - Google Patents

Description

  The present invention relates to a tubular suture prosthesis material suitable for use in an automatic suturing device that is widely used in surgery and the like.

  Conventionally, in a surgical operation, a stapler type automatic suturing device in which a large number of staples are embedded is used for tissue stitching. However, in application to a lung, for example, air leakage from a sutured anastomosis portion is prevented. There is a problem, and also in application to other places, tissue damage, tearing, etc. due to strong force applied to the sutured anastomosis, soft tissue, or suture by applying tension There is a problem.

  As a means for solving the above-described problem, a cylindrical suture prosthesis material that is used by being attached to a suture part such as a frame part or a cartridge part constituting an automatic suturing device has been proposed (for example, Patent Document 1). reference). The suture prosthesis is made of a biodegradable and absorbable material, and after healing that has played a role as a suture prosthesis, it is decomposed and absorbed in vivo and does not remain as a foreign body. Will not cause any pain.

Utility Model Registration No. 26004025

  However, conventionally, since the tubular suture prosthesis material is mounted so as to cover the suture portion of the automatic suturing device, the end portion of the suture prosthesis material is turned over in the process of inserting the suture portion into the living body. In some cases, the suture prosthesis is gradually rolled up.

  The present invention has been made paying attention to the above-described problem. A suture prosthetic material for an automatic suturing device that does not rise or shift even if it is inserted into a living body while being attached to a suturing portion of an automatic suturing device. The purpose is to provide.

  The above-mentioned object of the present invention is a suture prosthetic material for an automatic suturing device that is used by being attached to an automatic suturing device having a pair of openable and closable suturing portions at the tip, and a cylindrical main body portion that covers the suturing portion; This is achieved by a suture prosthetic material for an automatic suturing device, which is provided on one end side of the main body portion and includes a locking member that is hooked to the distal end portion of the suture portion.

  In the suturing prosthetic material for an automatic suturing device having the above-described configuration, it is preferable that the locking member is a cover that covers the distal end portion of the suture portion or a thread that circulates around the distal end portion of the suture portion.

  Moreover, it is preferable that the said main-body part is formed in a cylindrical shape by superimposing two sheets, and the said locking member is provided in any one said sheet | seat.

  According to the suture prosthesis material for an automatic suturing device of the present invention, even if it is inserted into a living body while being attached to the suturing portion of the automatic suturing device, it does not rise, shift, or twist. The instrument can be easily inserted.

1 is a perspective view of a suture prosthesis material for an automatic suturing device according to an embodiment of the present invention. It is a front view of FIG. It is a schematic diagram which shows an example of a self yarn looping stitch. It is a schematic diagram which shows an example of a self yarn looping stitch. It is a schematic diagram which shows an example of a self yarn looping stitch. It is a schematic diagram which shows an example of a self yarn looping stitch. It is a schematic diagram which shows an example of a self yarn looping stitch. It is a schematic diagram which shows an example of a self yarn looping stitch. It is a schematic diagram which shows an example of a self yarn looping stitch. (A) is a perspective view of an automatic suturing device, and (B) is an enlarged perspective view of a suture part. It is a perspective view of the suture prosthesis material for automatic suture devices concerning other embodiments of the present invention.

  Hereinafter, actual forms of the present invention will be described with reference to the accompanying drawings. 1 and 2 show the appearance of a suture prosthesis 1 for an automatic suturing device according to an embodiment of the present invention (hereinafter simply referred to as “suture prosthesis 1”). For example, Endo GIA tri-staple 60 Articulating Medium Thick Cartridge (trade name) manufactured by COVIDIEN, PROXIMATE LINEAR CUTTER 75, 55 TYPE (trade name) manufactured by ETHICON endo SURGERY, etc. In the surgical operation in the above, it can be suitably used for a so-called staple type automatic suturing device that sutures the excision site simultaneously with excision of the affected part.

  As shown in FIG. 10, such an automatic suturing device has a pair of openable and closable suture portions 11 and 12 at the distal end of the shaft 10, and holds and operates the proximal end of the shaft 10. The pair of stitching portions 11 and 12 includes a cartridge portion 11 with a built-in staple, and a frame portion 12 that faces the cartridge portion 11 and has a staple receiving groove. . The cartridge part 11 is integrally filled with a knife blade. The suture prosthesis 1 according to the present invention can be mounted by a simple operation of simply covering the cartridge portion 11 and the frame portion 12 when applied to an automatic suturing device.

  As shown in FIGS. 1 and 2, the suture prosthesis 1 includes a cylindrical main body 2 that covers the suture parts 11 and 12, and one end side of the main body 2 (when attached to an automatic suturing device). It is comprised by the latching member 3 provided in the stitching | suture parts 11 and 12 side.

  In the present embodiment, the main body 2 includes a first sheet 20 made of a biodegradable absorbent material and a second sheet 21 made of an arbitrary material. After the first sheet 20 and the second sheet 21 are cut to a desired size, the two sheets 20 and 21 are overlapped, and both side edges of the two sheets 20 and 21 are sewn with the temporary sewing thread 22. A cylindrical shape is formed by forming two temporary sewing portions. The main body 2 has a length substantially equal to the length of the suture portions 11 and 12 that are the attachment sites of the automatic suturing device. When the main body 2 is mounted on an automatic suturing device, the first sheet 20 is disposed on the inner surfaces of the stitching portions 11 and 12 (surfaces facing the stitching portions 11 and 12), and the second sheet 21 is It is mounted so as to be deployed on the outer surface side of the stitched portions 11 and 12.

  The method of temporary stitching is not particularly limited, but the applicant of the present invention has previously made it possible to easily separate the two sheets 20 and 21 after the operation by easily pulling out the temporary sewing thread 22. Examples thereof include self-looping stitches disclosed in WO2005-720818579 and Japanese Patent No. 5241802. The self-looping stitch is a stitch formed as a loop with one thread, and refers to a sewing method in which one loop of a thread passes through another loop of the same thread. A temporary stitching method using a self-looping stitch is illustrated in FIGS. The “needle side” used in the following description means the side where the needles of the stacked sheets 20 and 21 are pierced, that is, the upper side of each figure, and the “back side” refers to the needles of the stacked sheets 20 and 21. It means the side opposite to the stab side, that is, the lower side of each figure. 3 to 8, the stacked sheets 20 and 21 are omitted.

  In FIG. 3, the loop 4 passes through the sheets 20 and 21 from the needle side and loops its own yarn on the back side of the sheets 20 and 21. In FIG. 4, the loop 4 enters the sheets 20 and 21 from the needle side, passes through a part of the sheets 20 and 21, appears on the needle side, and loops itself at the next needle penetration point. Note that “appears on the needle side through a part of the sheets 20, 21” means that a loop appears on the needle side so as to wrap around the end of the stacked sheets 20, 21, This includes the case where the loop appears on the needle side. In FIG. 5, the loop 4 passes through the sheets 20 and 21 from the needle side, advances slightly, passes through the sheets 20 and 21, appears on the needle side, and loops itself on the needle side of the sheets 20 and 21 at the next needle penetration point. ing. In FIG. 6, the loop 4 enters the sheets 20 and 21 from the needle side, passes through a part of the sheets 20 and 21, appears on the needle side, and automatically at the next needle penetration point on the stitch formation line (on the stitch line). Thread looping. FIG. 7 shows a zigzag pattern formed by the modification of the sewing method of FIG. In FIG. 8, the loop 4 passes from the needle side to the back surface of the sheets 20 and 21, returns slightly, passes through the sheets 20 and 21, and appears on the needle side. In this yarn, the next loop passes through the sheets 20 and 21 and loops itself. In FIG. 9, the loop 4 passes through the loop that has already crossed the needle side of the sheets 20 and 21 and the sheets 20 and 21, and further passes through this end loop of the sheets 20 and 21 to the next needle penetration point. It has been extended until. In each figure, reference numeral 22A denotes the thread end of the temporary sewing thread 22 at the start of sewing, and 22B denotes the thread end of the temporary sewing thread 22 at the end of sewing.

  In the self-looping stitch shown in the above example, by pulling the thread end 22B at the end of sewing, the thread is pulled out from the formed loop, and the seam is frayed without resistance. When the sheets 20 and 21 are temporarily sewn, the affected part is sutured by the automatic suturing device to which the suture prosthesis 1 is attached, and the lesioned part is separated from the normal tissue part, and then the lesioned part is removed from the body. The second sheet 21 taken out together with the body and the first sheet 20 remaining in the body can be smoothly separated by a simple operation of simply pulling out the temporary sewing thread 22. The yarn ends 22A and 22B of the temporary sewing thread 22 are preferably extended from both ends of the sheets 20 and 21 by a predetermined length. Further, the extended thread ends 22B may be connected in a ring shape.

  Examples of the temporary sewing thread 22 include a sewing thread for clothing and a medical suture thread. Non-biodegradable absorbent materials such as nylon, polyester, vinylon, polyvinylidene fluoride, cotton, and silk; Although it is comprised from either the biodegradable absorptive material similar to the sheet | seat 20, it should preferably be comprised with a biodegradable absorptive material in consideration of the case where it remains in the body. Further, the temporary sewing thread 22 is preferably a monofilament sewing thread in order to facilitate the drawing.

  The biodegradable absorbent material constituting the first sheet 20 includes polyglycolic acid, polylactic acid, polycaprolactone, glycolic acid / lactic acid copolymer, lactic acid / caprolactone copolymer, glycolic acid / caprolactone copolymer, poly It can be appropriately selected from materials that can be decomposed and absorbed in a living body such as animal tissue, such as pararadixanone and chitin. Examples of the sheet form include knitted fabric, woven fabric, non-woven fabric, and film sponge sheet. In particular, as a preferred embodiment, Japanese Patent Publication No. 5-18579 previously invented by the present applicant from the viewpoints of flexibility, breathability, appropriate waist, thickness, blood absorbability, ease of passing staples, hydrolyzability, and the like. And a nonwoven fabric made of polyglycolic acid as disclosed in JP-A-5-79586. Such a nonwoven fabric can be produced by an arbitrary method such as a needle punch method or a melt blow method. Further, it is preferable that one surface or both surfaces of the first sheet 20 is thermocompression-bonded or pressure-pressed so that the surface is a smooth surface.

  The material which comprises the 2nd sheet | seat 21 is arbitrary, Polyamides, such as polyethylene and a polypropylene, Polyamides, such as polyester and nylon, Polyurethane, Polystyrene, Cotton, Hemp, Silk, Silicon, Fluororesin, etc. are non-absorbable in the living body. The material may be a biodegradable material as described above. The second sheet 21 preferably has elasticity. As the sheet having stretchability, for example, rubber yarn, polyurethane-based elastic yarn, crimped yarn, bulky yarn, etc. are appropriately knitted or woven into the structure, and stretchable in the longitudinal and / or transverse direction. A knitted fabric or a woven fabric that can be suitably exemplified. The knitted fabric structure of the stretchable sheet is not particularly limited, but nylon yarn is covered with polyurethane yarn, for example, from the viewpoint of cutting work, ease of sewing work when forming a cylindrical body, and stability of form. A power net fabric knitted into a warp knitted structure with the stretchable yarn obtained as described above can be exemplified as a particularly suitable one. The suture prosthesis 1 combined with such a stretchable sheet can be easily attached to an automatic suturing device, and adjusted (position correction) after the attachment.

  The locking member 3 is hooked on the distal end portions of the suture portions 11 and 12 when the main body portion 2 is put on the suture portions 11 and 12 of the automatic suturing device. The locking member 3 of the present embodiment is a bag-like cover 30 having an opening 31 into which the distal ends of the stitched portions 11 and 12 can be inserted at the end on the main body 2 side, while the opposite end is closed. It is configured. As shown in FIGS. 1 and 2, the locking member 3 having the above-described configuration is opened at the lower end thereof after folding the front end of either the first sheet 20 or the second sheet 21 constituting the main body 2. Either side sheets 20 and 21 may be formed integrally with each other by sewing both side edges with a temporary sewing thread 22 in a bag shape with a closed end, or any one sheet 20 provided with a locking member 3. , 21 can be formed by superimposing another sheet on the front end portion of the two sheets and stitching the two sheets together with a temporary sewing thread 22 in a bag shape with the lower end opened and the front end closed. When the locking member 3 is configured using another sheet, it is preferable that the material is composed of a biodegradable material similar to the first sheet 20 in consideration of the case where the material remains in the body. Further, the shape of the locking member 3 is not limited to the shape in the illustrated example, and may be various shapes such as a shape that gradually becomes narrower toward the tip.

  The suture prosthetic material 1 having the above-described configuration covers the suture body 11 and 12 of the automatic suturing device from above with the cylindrical main body 2 and covers the distal ends of the suture parts 11 and 12 with the bag-like locking member 3. Wear it like this. In this state, by inserting the automatic suturing device into the living body and reaching the affected part, a predetermined treatment is performed, but detailed description is omitted here.

  According to the suture prosthesis 1 having the above-described configuration, since the locking member 3 covers the distal ends of the suture portions 11 and 12 of the automatic suturing device and is hooked on the distal ends of the suture portions 11 and 12, In the process in which 12 is inserted into the living body, the suture prosthesis 1 is pushed into the living body while being pulled by the locking member 3. Therefore, the main body part 2 covered with the stitching parts 11 and 12 is not in a state in which the end part is turned up, or is not displaced from the side opposite to the insertion direction. Further, the suture prosthesis 1 is not inadvertently rotated (twisted), and the first sheet 20 made of the biodegradable absorbent material is positioned on the inner surface of the suture parts 11 and 12 so as to always contact the affected part. Retained.

  Thus, as compared with the conventional suture prosthesis material formed in a cylindrical shape, the suture prosthesis 1 is provided with a locking member 3 that can be hooked on the distal ends of the suture parts 11 and 12 of the automatic suturing device. As a result, when the automatic suturing device is inserted, the end of the suture prosthetic material 1 can be prevented from being twisted or contracted in the inserting direction, thereby preventing the occurrence of deviation and twisting. Therefore, the automatic suturing device can be easily inserted. Become. Further, the suture prosthesis 1 is easily attached even when attached to the automatic suturing device, so that the suture prosthetic material 1 is not displaced and the end portion is not turned over.

  As mentioned above, although one Embodiment of this invention was described, the specific aspect of this invention is not limited to the said embodiment. For example, in the above embodiment, the locking member 3 is constituted by the bag-shaped cover 30, but as shown in FIG. 11, the temporary sewing thread 22 of the main body 2 (the first sheet 20 or the second sheet 21). The thread end 22A at the start of sewing is tied to the second sheet 21 to form a ring (ring shape), the thread end 22A at the beginning of sewing is tied to form a ring (ring), or the thread ends 22A at the start of sewing are joined together. The engagement member 3 is configured by combining the ring-shaped (ring-shaped) thread ends 22A around the distal end portions of the stitching portions 11 and 12 of the automatic suturing device. Also good. As shown in FIG. 10, the distal end portions of the stitched portions 11 and 12 are generally formed in a shape that widens toward the proximal end side, so that the ring-shaped (ring-shaped) thread end 22A is formed. Even if the loop-shaped (ring-shaped) thread end 22A is hooked on the distal end portions of the stitching portions 11 and 12, the ring-shaped (ring-shaped) thread end 22A is formed so as to be able to circulate around the distal end portions of the stitching portions 11 and 12, for example. The movement of the ring-shaped thread end 22 </ b> A toward the proximal end side of the stitched portions 11 and 12 is restricted. In the embodiment shown in FIG. 11 as well, the ring-shaped (ring-shaped) thread end 22A is hooked on the distal ends of the stitched portions 11 and 12, so that the stitched portions 11 and 12 are inserted into the living body. The prosthetic material 1 is pushed into the living body while being pulled by the locking member 3. Therefore, the main body part 2 covered with the suture parts 11 and 12 is not turned over or shifted to the opposite side to the insertion direction, and the suture prosthesis 1 Does not rotate (twist) carelessly.

  In the above embodiment, the first sheet 20 and the second sheet 21 are overlapped, and the edges of both sides are sewn together to form a cylinder. However, one sheet made of a biodegradable absorbent material is rolled up. It is good also as a cylinder shape by sewing up both the side edges. Further, the tubular shape may be various shapes such as a cylindrical shape and a prismatic shape.

DESCRIPTION OF SYMBOLS 1 Suture prosthesis material 2 Main-body part 3 Locking member 11,12 Suture part 20 1st sheet | seat 21 2nd sheet | seat 22 Temporary thread 30 Cover

Claims (1)

A suture prosthesis for an automatic suturing device used by being attached to an automatic suturing device having a pair of openable and closable sutures at the tip,
A cylindrical main body part that is put on the stitched part;
A locking member provided on one end side of the main body portion and covering the distal end portion of the stitching portion;
With
The main body is formed by superimposing a first sheet made of a biodegradable absorbent material and a second sheet made of an arbitrary material,
The suturing prosthesis for an automatic suturing device is formed in a bag shape in which one distal end portion of the second sheet is folded and a lower end is opened at a position near the first sheet and the distal end is closed. Wood.

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