CN100403993C - Medical instrument - Google Patents

Medical instrument Download PDF

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Publication number
CN100403993C
CN100403993C CNB2004800051328A CN200480005132A CN100403993C CN 100403993 C CN100403993 C CN 100403993C CN B2004800051328 A CNB2004800051328 A CN B2004800051328A CN 200480005132 A CN200480005132 A CN 200480005132A CN 100403993 C CN100403993 C CN 100403993C
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CN
China
Prior art keywords
suture
pin
contact pin
treatment device
medical treatment
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Expired - Fee Related
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CNB2004800051328A
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Chinese (zh)
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CN1753647A (en
Inventor
铃木裕
小城康雅
有川清贵
坂口幸彦
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Sumitomo Bakelite Co Ltd
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Sumitomo Bakelite Co Ltd
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Publication of CN1753647A publication Critical patent/CN1753647A/en
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Publication of CN100403993C publication Critical patent/CN100403993C/en
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Abstract

A medical instrument capable of enhancing workability and safety in suturing a body surface and interior tissue with suturing thread. A medical instrument for suturing a body surface and interior tissue has a body (2), a thread-inserting needle (3) that is supported on the body (2) and into which suturing thread can be inserted, and a thread-holding needle (4) that is provided proximate to the thread-inserting needle (3) and into which a suturing thread puller can be inserted. The thread-inserting needle (3) and the thread-holding needle (4) are detachably attached to the body (2) with attaching/detaching means.

Description

Medical treatment device
Technical field
The present invention relates to a kind of medical treatment device.
Background technology
In order not obtained nutraceutical patient's feeding with his or her mouth, adopt three kinds of feeding methods: vein feeding, use are inserted into the stomach feeding of stomach and the enteral feeding that carries out from gastric fistula from nose with pipe.
In recent years, because the development and the resultant application process of enteral nutrition product are usually implemented the enteral nutrition management by means of percutaneous endoscopic gastrostomy (PEG).According to PEG, the operation that the operation of gastrostomy does not have a surgery gastrostomy (gastronomy) is so complicated, so PEG causes very little intrusion, and cost is far fewer than the surgery gastrostomy.Thereby, think that in western countries PEG is the model of gastrostomy.
According to PEG, before gastrostomy, form and pass patient's the stomach wall and the through hole of coat of the stomach.Before forming through hole, will there be the coat of the stomach of mobile trend temporarily fixing.Thereby, to sew up stomach wall and coat of the stomach usually.
As the medical treatment device that is used for this sew application, disclosed a kind of medical treatment device (patent documentation 1), the suture that it for example comprises the suture contact pin, be arranged in parallel with the suture contact pin grabs pin, insert suture slidably grabs the stylet in the pin and suture contact pin and suture is grabbed pin and be fixed on fixture on their bottoms separately, and this medical treatment device is configured to suture and is caught by stylet.
The medical treatment device that discloses in patent documentation 1 comprises: (a) have the hollow suture contact pin of inner passage, suture inserts in this inner passage; (b) hollow suture is grabbed pin, and itself and hollow suture contact pin are arranged in parallel and are used for catching suture; (c) insert suture slidably and grab stylet in the pin; (d) suture contact pin and suture are grabbed pin and be fixed on fixture on their bottoms separately.This stylet comprises the annular element that is made of elastomeric material, and this annular element can leave suture in grabs in the inner passage of pin, and is arranged on the tip of stylet.Annular element is configured to extend towards the suture contact pin when stretch out at the tip of grabbing pin from suture, thereby the inside of annular element is passed in the central axis of suture contact pin or its extension.
According to patent documentation 1, the use of this medical treatment device is as follows.At first, grab the needle-penetration organism with suture contact pin and suture.From the rear end that suture is grabbed pin stylet is inserted suture and grab the pin, and annular element stretches out from the tip that suture is grabbed pin.From the rear end of suture contact pin suture is inserted the suture contact pin.As a result, suture comes out from the tip of suture contact pin.In this case, the stylet that suture is grabbed in the pin moves backward, so that suture is caught by annular element.At last, suture contact pin, suture are grabbed pin and stylet and are integrally moved backward from organism.Thereby an end of suture goes out from suture contact pin layback, and its other end is grabbed pin from suture and pulled out.
Yet during the medical treatment device that discloses in using patent documentation 1, suture is grabbed at suture on the tip of pin and is caught by annular element, and this tip is very sharp.If when stylet is mobile backward, suture is because excessive power is grabbed pin with suture and contacted, and then this suture just may be cut off.
In addition, utilize the medical treatment device that discloses in the patent documentation 1, two puncture needles should be used for piercing through organism simultaneously.Because like this, and compare the more high-grade know-how of needs with the operation of a needle-penetration organism.
In order to guarantee stomach wall to be fixed to coat of the stomach with this medical treatment device, must carry out same sew application twice, this is a disadvantageous burden to patient.
In order to prevent this rough sledding, in patent documentation 2, disclosed the stitching utensil that is used for organism.This organism is sewed up utensil and comprised: the hollow locking pin that (a) comprises the inner passage and have sharp tip, suture insert in this inner passage; (b) the hollow outer cylinder that is arranged in parallel with hollow locking pin, it comprises the inner passage and has stubbed tip that suture inserts in this inner passage; (c) removable pin, it can optionally be pulled out and be had sharp tip and suture traction tool from the inner passage of outer cylinder; (d) keeper, it remains on one of their position respectively abreast with locking pin and outer cylinder.
According to patent documentation 2, this organism is sewed up utensil and has been solved above-mentioned rough sledding.At first, with the removable needle-penetration organism in locking pin and the insertion outer cylinder.Then, from outer cylinder, pull out removable pin, suture traction tool is inserted the outer cylinder, and snare stretches out from the tip of outer cylinder from the outer cylinder rear end.From the locking pin rear end suture is inserted the locking pin.As a result, suture comes out from the tip of locking pin.In this case, the suture traction tool in the outer cylinder is moved backward,, suture is pulled out to the outside of organism by stubbed tip from outer cylinder so that when catching suture by snare.At this moment, suture needn't pass sharp part, thereby has prevented that suture is cut off.
Yet, sew up utensil according to the organism that discloses in the patent documentation 2, because when catching suture, suture traction tool passes the inside of outer cylinder, so that the diameter of outer cylinder becomes unfriendly is very big.In addition, even removable pin is sharp, but because the different influence of height between removable pin and the outer cylinder, piercing through performance may degenerate.
And, sew up utensil according to the organism that discloses in the patent documentation 2, need operate two pins simultaneously, although pierce through organism simultaneously without these two pins.Because like this, and compare the more high-grade know-how of needs with the operation of a needle-penetration organism.
In addition, it is hollow needle that the suture contact pin of the medical treatment device in the patent documentation 1 and suture are grabbed the locking pin that is used for the stitching utensil of organism in pin and the patent documentation 2, and therefore with respect to the situation of utilizing non-hollow needle, the performance that pierces through of these pins trends towards degenerating.
Patent documentation 1: Japanese kokai publication hei No.H4-226643;
Patent documentation 2: Japanese kokai publication hei No.2003-225240.
Summary of the invention
In view of these situations have realized the present invention.The purpose of this invention is to provide a kind of medical treatment device, it can improve operability and safety when body surface part and interior tissue sewed up.
According to the present invention, a kind of medical treatment device is provided, comprising:
(a) suture contact pin, it is the hollow puncture needle that comprises sharp tip, and these tip right and wrong are hollow, and this suture contact pin comprises close this most advanced and sophisticated side opening, and by using this suture contact pin in the hollow parts that suture is inserted this suture contact pin;
(b) suture is grabbed pin, it is arranged on this parallel with this suture contact pin basically and hollow puncture needle that comprise sharp tip in suture contact pin next door, these tip right and wrong are hollow, this suture is grabbed pin and is comprised near this most advanced and sophisticated side opening, and grabs and use this suture to grab pin in the hollow parts of pin by this suture being inserted this suture;
(c) suture traction tool, it inserts this suture slidably and grabs in the hollow parts of pin;
(d) fixture is used for relatively determining the tip location of this suture contact pin and the tip location that this suture is grabbed pin; With
(e) abutment, it supports this suture contact pin and this suture is grabbed pin, and near sewing up target.
In addition,, provide a kind of medical treatment device that body surface part and interior tissue are sewed up of being used for, having comprised: main body according to the present invention; By the suture contact pin of this body supports, suture can insert in this suture contact pin; Grab pin with suture, it is configured near this suture contact pin, suture traction tool can insert this suture and grab in the pin, wherein this suture is grabbed pin and is comprised sharp opening most advanced and sophisticated and that be provided with near bottom end side with respect to this tip, and this suture is grabbed pin and is configured to, and makes this suture traction tool to be withdrawn into the outside that this suture is grabbed pin from this opening.
In medical treatment device according to the present invention, the most advanced and sophisticated right and wrong of each puncture needle are hollow, thereby can improve the performance that pierces through of pin.The hollow parts of each puncture needle is by this side opening or this opening and its external communications near this tip.Owing to like this, can guarantee this suture and this suture traction tool are pulled out towards predetermined direction from side opening.Thereby, can guarantee good operability and safe sew application.In addition, support by this abutment because this suture contact pin and this suture are grabbed pin, and this abutment is near the stitching target such as the body surface part, so can guarantee sew application.
In medical treatment device according to the present invention, this suture traction tool can comprise snare, this snare has the tip that the material by elastically deformable forms, in free state, this snare extends into the inside that makes the extension of this suture contact pin pass this snare, and in the state of strain, this snare can leave this suture in grabs in the hollow parts of pin.By structure like this, can catch suture steadily.Thereby can guarantee sew application.
In medical treatment device according to the present invention, this abutment can support this suture contact pin parallel to each other basically and this suture is grabbed pin.By structure like this, can stably carry out sew application.
In medical treatment device according to the present invention, this fixture can be arranged on this suture and grab on the pin, and the tip location that is constructed to be permeable to grab pin with respect to this suture is determined to the optional position with the tip location of this suture contact pin.By structure like this, can further improve the operability during the sew application.
In medical treatment device according to the present invention, the groove (notch) that is configured to make this suture to move apart this abutment and this fixture can be arranged on in this abutment and this fixture each.By structure like this, when this suture is grabbed the needle-penetration health, can guarantee that this suture moves apart this abutment and this fixture.Thereby, can guarantee to sew up by shirtsleeve operation.
In medical treatment device according to the present invention, the edge that the edge of the side opening of this suture contact pin and this suture are grabbed the side opening of pin can be chamfered to has C shape surface or R shape surface.This can suppress the fracture of this suture.Thereby, can further guarantee sew application.
In medical treatment device according to the present invention, this abutment can support this suture contact pin and this suture separably and grab in the pin at least one.By structure like this, can further simplify sew application.
Can also comprise a plurality of suture contact pins according to medical treatment device of the present invention, and this suture is grabbed pin and can be configured near in described a plurality of suture contact pins each.Like this, when sewing up a plurality of position, the operation that can not need to move apart the operation of this suture contact pin and this abutment is rotated.Thereby, can further guarantee stably to sew up described a plurality of position by shirtsleeve operation.
According to the present invention, a kind of medical treatment device that body surface part and interior tissue are sewed up of being used for is provided, comprising: main body; By the suture contact pin of this body supports, suture can insert in this suture contact pin; Grab pin with suture, it is configured near this suture contact pin, and suture traction tool can insert this suture and grab in the pin, wherein this suture contact pin and this suture grab in the pin at least one be connected to separably on this main body.
In medical treatment device according to the present invention, this suture contact pin and this suture grab in the pin at least one be connected to separably on this main body.Thereby, can guarantee good operability and stable sew application.
In medical treatment device according to the present invention, this main body can comprise: fixture, and its of the tip of this suture contact pin and this suture being grabbed in the tip of pin is fixed to the precalculated position; And support member, it supports this fixture.By structure like this, can guarantee stable sew application.
In medical treatment device according to the present invention, this main body can also comprise the abutment on the most advanced and sophisticated side that is arranged on this support member, and this abutment is near the body surface part, and supports this suture contact pin and this suture is grabbed pin.By structure like this, medical treatment device can be during sew application at this abutment place near the body surface part.Like this, can further guarantee stable sew application.
In medical treatment device according to the present invention, this support configuration can be become support this fixture and this abutment.By structure like this, can support this suture contact pin by this abutment by this support member and grab pin with this suture.Thereby, can further guarantee to support these puncture needles and further improve medical treatment device stability during use.
In medical treatment device according to the present invention, this suture is grabbed pin and can be configured to lead and also can be inserted into this suture and grab in the pin.By structure like this, can enlarge the range of application of this medical treatment device.For example, if use lead, just can determine suitably that conduit inserts route and can insert conduit safely steadily.In addition, if use this lead, just can be implemented in and sew up body surface part and interior tissue when inserting this lead.Owing to like this, can determine suitably after sew application that this conduit inserts route and can insert this conduit safely steadily.In addition, can reduce described puncture needle pierced through body surface and interior tissue before inserting this conduit number of times, rare pin invades patient's situation, and patient's burden is less.Thereby, can make patient get back to common life earlier, and reduce patient's medical expense.
In medical treatment device according to the present invention, the external diameter of this lead can be equal to or greater than 0.1mm and be equal to or less than 0.8mm.
In medical treatment device according to the present invention, this fixture can comprise groove, this groove can make this suture contact pin and this suture grab in the pin one with this body portion from.By structure like this, can guarantee connection that this suture contact pin or this suture grab pin and separate.
In medical treatment device according to the present invention, this abutment can comprise groove, this groove make this suture contact pin and this suture grab in the pin one can from this body portion from.By structure like this, can be simply and carry out this suture contact pin steadily and grab being connected of pin with this suture and separate.
In medical treatment device according to the present invention, this suture contact pin and this suture are grabbed pin and can be constructed to be permeable to puncture independently of one another.By structure like this, can operate described two puncture needles individually, and can not puncture simultaneously or can not operate two puncture needles simultaneously by two puncture needles.Thereby, can guarantee the operation of good operability and safety.In addition, the pressure that can alleviate patient also can shorten the operating time.Thereby, can when sewing up body surface part and interior tissue, improve operability and safety with suture.
In medical treatment device according to the present invention, this suture contact pin and this suture grab that pin punctures and this main body near the body surface part in, can move apart this suture contact pin independently.By structure like this, grab at this suture and can move apart this suture contact pin when pin is caught this suture.Thereby, can sew up a plurality of positions by a series of operation.
In medical treatment device according to the present invention, this main body can be grabbed the pin rotation around this suture that is used as rotating shaft.By structure like this, can guarantee to sew up a plurality of positions.
Medical treatment device according to the present invention comprises a plurality of suture contact pins, and this suture can be grabbed pin and be arranged near in described a plurality of suture contact pins each.By structure like this, when sewing up a plurality of position, the operation that can not need to move apart the operation of this suture contact pin separately and this main body is rotated.Thereby, can further guarantee to sew up described a plurality of position by shirtsleeve operation.
The variation of the combination in any of these building blocks and the present invention expression way between method and apparatus or the like also is effective as embodiments of the present invention.
For example, according to the present invention, provide a kind of sewing method that uses medical treatment device, this method comprises the following steps:
(i) suture is grabbed be needled in body surface part and the interior tissue;
(ii) suture traction tool is inserted this suture and grab in the hollow parts of pin, and this suture traction tool is withdrawn into the outside that this suture is grabbed pin;
(iii) the suture contact pin is penetrated in body surface part and the interior tissue;
(iv) suture is inserted in the hollow parts of this suture contact pin, and this suture is pulled out to the outside of this suture contact pin;
(v) grab the suture that this suture traction tool of pin outside catches this to pull out with being withdrawn into this suture;
(vi) when this suture traction tool is caught this suture, spur this suture traction tool, guide this suture into this suture and grab pin, and this suture is remained on this suture grab near the pin; And
(vii), this suture and this suture are grabbed the outside that pin is pulled out to body surface part and interior tissue this suture being remained on when this suture grabs near the pin.
According to sewing method of the present invention, can guarantee to sew up body surface part and interior tissue by shirtsleeve operation.
In this sewing method, (make vii) after this suture traction tool is withdrawn into the outside, can pull out this suture and grab pin in step.
Can comprise the following steps according to sewing method of the present invention, this suture is being remained on after this suture grabs near the pin step, when suture is grabbed needle-penetration body surface part and interior tissue, pull out suture and insert pin, make this main body grab the pin rotation then around this suture that is used as axle.In addition, can comprise the following steps, after the step that makes this main body rotation, once more this suture contact pin be thrust in body surface part and the interior tissue according to sewing method of the present invention.
By so doing, grab pin as under the situation of rotating shaft at this suture, this suture contact pin can pierce through a plurality of concentric positions.Thereby, can guarantee to sew up a plurality of positions.Because the stitching of a plurality of plan suture location is separated from one another, till inserting this conduit, so can also reduce the number of times of described needle pierces target location.
Description of drawings
From following preferred embodiments and drawings, can easily find out above-mentioned purpose of the present invention, other purpose, feature and advantage.
Fig. 1 represents the cross sectional front view of medical treatment device according to an embodiment of the invention;
Fig. 2 a is the structure of pin is grabbed in expression according to the suture of the medical treatment device of this embodiment a cross sectional front view;
Fig. 2 b is the cutaway view of expression according to the structure of the suture traction tool of the medical treatment device of this embodiment;
Fig. 2 c is the cross sectional front view of the composite construction of presentation graphs 2a and 2b;
Fig. 3 is the cross sectional front view according to the suture contact pin of the medical treatment device of this embodiment;
Fig. 4 is the cross sectional front view of grabbing the tip of pin according to the suture of the medical treatment device of this embodiment;
Fig. 5 is front view and the vertical view of expression according to the abutment of the medical treatment device of this embodiment;
Fig. 6 is to use the sketch map of program of the medical treatment device of this embodiment;
Fig. 7 is a cross sectional front view, and the step 1 according to the method for the medical treatment device of embodiment shown in Fig. 6 is used in expression;
Fig. 8 is a cross sectional front view, and the step 2 according to the method for the medical treatment device of embodiment shown in Fig. 6 is used in expression;
Fig. 9 is a cross sectional front view, and the step 3 according to the method for the medical treatment device of embodiment shown in Fig. 6 is used in expression;
Figure 10 is a cross sectional front view, and the step 4 according to the method for the medical treatment device of embodiment shown in Fig. 6 is used in expression;
Figure 11 is a cross sectional front view, and the step 5 according to the method for the medical treatment device of embodiment shown in Fig. 6 is used in expression;
Figure 12 is a cross sectional front view, and the step 6 according to the method for the medical treatment device of embodiment shown in Fig. 6 is used in expression;
Figure 13 is a cross sectional front view, and the step 7 according to the method for the medical treatment device of embodiment shown in Fig. 6 is used in expression;
Figure 14 is a cross sectional front view, and the step 8 according to the method for the medical treatment device of embodiment shown in Fig. 6 is used in expression;
Figure 15 is a cross sectional front view, and the step 9 according to the method for the medical treatment device of embodiment shown in Fig. 6 is used in expression;
Figure 16 is a cross sectional front view, and the step 10 according to the method for the medical treatment device of embodiment shown in Fig. 6 is used in expression;
Figure 17 is a perspective view, represents the structure of medical treatment device according to an embodiment of the invention;
Figure 18 is a front view, and expression is according to the structure of the main body of the medical treatment device of this embodiment;
Figure 19 represents front view and the cutaway view according to the suture contact pin of the medical treatment device of this embodiment;
Figure 20 represents to grab according to the suture of the medical treatment device of this embodiment the front view and the cutaway view of pin;
Figure 21 is a front view, and expression is according to the suture traction tool of the medical treatment device of this embodiment;
Figure 22 is a cross sectional front view, represents a kind of state, wherein according to the abutment of the medical treatment device of this embodiment near stomach wall, and suture is grabbed pin and is vertically pierced through stomach wall;
Figure 23 is a cross sectional front view, represents a kind of state, wherein is inserted into suture according to the suture traction tool of the medical treatment device of this embodiment and grabs in the pin;
Figure 24 is a cross sectional front view, represents a kind of state, and wherein the suture contact pin is inserted into the inside according to the ring part of the suture traction tool of the medical treatment device of this embodiment;
Figure 25 is a cross sectional front view, represents a kind of state, and wherein suture stretches out from the tip according to the suture contact pin of the medical treatment device of this embodiment;
Figure 26 is a cross sectional front view, represents a kind of state, and wherein the suture contact pin according to the medical treatment device of this embodiment is drawn out;
Figure 27 is a cross sectional front view, represents a kind of state, and wherein main body is rotated about 180 degree around the suture contact pin, and this suture contact pin conduct is according to the rotating shaft of the medical treatment device of this embodiment;
Figure 28 is a cross sectional front view, represents a kind of state, and wherein the suture contact pin according to the medical treatment device of this embodiment pierces through health once more, and suture inserts in the pin;
Figure 29 is a cross sectional front view, represents a kind of state, and wherein according to the suture traction tool withdrawal of the medical treatment device of this embodiment, and suture is caught by ring part;
Figure 30 is a cross sectional front view, and the state according to the lead of the medical treatment device of this embodiment is inserted in expression;
Figure 31 is a cross sectional front view, represents a kind of state, and wherein the suture that inserts from two positions that the suture contact pin according to the medical treatment device of this embodiment pierces through enters coat of the stomach from stomach wall, and stretches out from the position that suture is grabbed the needle-penetration health;
Figure 32 is a perspective view, represents the structure of medical treatment device according to an embodiment of the invention;
Figure 33 is a front view, and expression is according to the structure of the main body of the medical treatment device of this embodiment;
Figure 34 represents front view and the cutaway view according to the suture contact pin of the medical treatment device of this embodiment.
The specific embodiment
To be described in detail with reference to the attached drawings embodiments of the invention hereinafter.The medical treatment device of Miao Shuing is to be used for the suture setting tool of Medical Treatment that body surface part and interior tissue are sewed up hereinafter.This medical treatment suture setting tool is used for stomach wall is fixed to coat of the stomach so that the conduit in percutaneous endoscopic gastrostomy inserts especially, and percutaneous endoscopic gastrostomy is for example implemented in order to supply with nutritional supplement or discharge body fluid.In Fig. 1 to 5 and Fig. 7 to 34, the upside of every paper is the bottom of suture (rear end) side, and the downside of every paper is the most advanced and sophisticated side of suture.
(first embodiment)
Fig. 1 is the cutaway view of expression according to the structure of the medical treatment device of the embodiment of the invention.Medical treatment device shown in Fig. 1 comprises that suture grabs pin 701, guiding material 706, fixture 708, suture traction tool 710, suture contact pin 715 and abutment 722.This medical treatment device for example can be as the setting tool of stomach wall to coat of the stomach.
Fig. 2 a represents that to 2c suture grabs the structure of the peripheral components of the structure of pin 701 and puncture needle 701.Fig. 2 a is a cutaway view, and the expression suture is grabbed pin 701 and guiding material 706 and fixture 708 bonded states.Fig. 2 b is a cutaway view, the structure of expression suture traction tool 710.Fig. 2 c is a cutaway view, the state that expression combines Fig. 2 a and 2b.
To as shown in the 2c, the bar 711 of suture traction tool 710 and snare 712 are constructed to be permeable to leave in suture and grab in the hollow parts 703 of pin 701 as Fig. 2 a.By allowing sliding material 713 to slide along guiding material 706, suture traction tool 710 moves in hollow parts 703 slidably, can will be arranged on the outside that side opening 704 that the snare 712 on suture traction tool 710 tips grabs pin 701 from suture is pulled out to hollow parts 703.
Fig. 4 is the amplification view that suture is grabbed pin 701 tips.Suture is grabbed pin 701 to be the hollow needle parts that are made of metal and to comprise sharp tip 702.Because skin can easily be pierced through so suture is grabbed pin 701 in sharp tip 702.In addition, suture is grabbed pin 701 and is configured to define hollow parts 703 in inside and does not penetrate most advanced and sophisticated 702.Hollow parts 703 is configured to by being arranged near side opening 704 and the external communications most advanced and sophisticated 702.Suture traction tool 710 can move in hollow parts 703 slidably.Specifically, the external diameter that for example suture can be grabbed pin 701 is set at and is equal to or greater than 12G and is equal to or less than 22G, preferably is equal to or greater than 19G and is equal to or less than 21G.If lead is inserted in the hollow parts 703, the external diameter that then for example suture can be grabbed pin 701 is set at and is equal to or greater than 16G and is equal to or less than 18G.By setting like this, can be easily suture traction tool and lead be inserted suture simultaneously and grab in the pin 701, and lead is inserted in the organism suitably with suture.
The total length that suture is grabbed pin 701 is not limited to length-specific; Yet for example it can be set equal to or greater than 20mm and be equal to or less than 200mm, preferably be equal to or greater than 80mm and be equal to or less than 100mm.If total length is too little, just suture may be grabbed pin 701 and imbed in patient's the stomach wall.If too big, the operability of medical treatment device is degenerated.
Grab in the pin 701 at suture, the section construction that may contact with suture can be become stubbed during sew application.As described later, it is stubbed that side opening 704 is configured to, and when the suture traction tool 710 of being grabbed pin 701 introducings by suture and hold was caught suture, side opening 704 may contact with suture especially.Specifically, can be cut sth. askew in the edge of side opening 704 and become to have C shape surface or R shape surface.
In addition, suture is grabbed pin 701 and can be constructed to, and makes not have difference on the height the rear end of grabbing pin 701 from suture is extended to the hollow parts 703 of side opening 704.By so doing, when suture traction tool 710 was mobile slidably in hollow parts 703, under the situation of the snare 712 in not stumbling drafting tool 710, suture traction tool 710 can slide reposefully.Specifically, in the part of the hollow parts 703 that is extended to side opening 704, hollow parts 703 can be configured to, and makes the central axis of side opening 704 grab central axis inclination 120 to 150 degree of pin 701 with respect to suture.
Guiding material 706 is connected to the rear end that suture is grabbed pin 701 along grabbing the opposite direction of the bearing of trend of pin 701 with suture.Guiding material 706 is assemblied in the sliding material 713 slidably, and sliding material 713 is connected the rear end of the suture traction tool of describing after a while 710.The shoulder surface 707 of guiding material 706 is near the shoulder surface 714 of sliding material 713, thereby suture traction tool 710 moves in suture is grabbed the hollow parts 703 of pin 701 slidably, and guiding material 706 plays indication suture traction tool 710 and arrives the extreme position that advances.
In addition, this guiding material 706 only is assemblied in the sliding material 713 along a direction.Because like this, if suture traction tool 710 moves slidably in suture is grabbed the hollow parts 703 of pin 701 and arrives the extreme position that advances, the snare 712 that just can guarantee suture traction tool 710 broadens along the direction of suture contact pin 715.
Fixture 708 is connected to the rear end that suture is grabbed pin 701.Fixture 708 is constructed to, and makes its shoulder surface 709 only be assemblied in after a while in the shoulder surface of retainer (not shown) of the suture contact pin of describing 715, to prevent that fixture 708 is with respect to puncture needle 715 rotations along certain direction.By so doing, the side opening (not shown) that can guarantee suture contact pin 715 is arranged in suture and grabs pin 701 sides.In addition, by such assembling, can make the most advanced and sophisticated (not shown) of suture contact pin 715 only be positioned at the position in the place ahead, position that suture is grabbed the tip 702 of pin 701.
Suture traction tool 710 comprises bar 711, be connected to the snare 712 on bar 711 tips and be connected to sliding material 713 on its rear end.Bar 711 can be formed by metal.Snare 712 is formed by the material of elastically deformable.
Snare 712 is annular in free state.Grab in the hollow parts 703 of pin 701 if be stored at suture, snare 712 is exactly linear and flexibly is out of shape.As a result, when being expressed into suture from side opening 704 and grabbing pin 701 outside, snare 712 forms annular solids.Thereby snare 712 can easily be caught the part of the suture (not shown) that comes out from the tip of suture contact pin 715.
As mentioned above, the sliding material 713 that is connected to suture traction tool 710 rear ends is assemblied in slidably and is connected to suture and grabs in the guiding material 706 of pin 701 rear ends, so that the shoulder surface 714 of sliding material 713 is near the shoulder surface 707 of guiding material 706.Like this, sliding material 713 plays indication suture traction tool 710 arrival in suture is grabbed the hollow parts 703 of pin 701 advancing extreme position.
Fig. 3 is the cutaway view of the structure of expression suture contact pin 715.It is similar that the shape of suture contact pin 715 can be designed to grab to the suture shown in Fig. 4 the shape of pin 701.Suture contact pin 715 is the hollow needles that are made of metal and comprises sharp tip 716.Because sharp tip 716, so suture contact pin 715 can easily pierce through skin.In addition, the hollow parts 717 that is formed at suture contact pin 715 inside is configured to not penetrate most advanced and sophisticated 716.Hollow parts 717 is configured to by being arranged near side opening 718 and the external communications most advanced and sophisticated 716.Suture can insert in this hollow parts 717.
Specifically, for example the external diameter of suture contact pin 715 can be set at and be equal to or greater than 15G and be equal to or less than 25G, preferably be equal to or greater than 19G and be equal to or less than 21G.By setting like this, can reduce the penetration resistance of suture contact pin 715, and suture contact pin 715 can easily pierce through skin.
The total length of suture contact pin 715 is not limited to length-specific; Yet, for example can be set to being equal to or greater than 20mm and being equal to or less than 200mm, preferably be equal to or greater than 80mm and be equal to or less than 100mm.If total length is too little, just suture contact pin 715 may be imbedded in patient's the stomach wall.If too big, the operability of medical treatment device is degenerated.
In suture contact pin 715, the section construction that may contact with suture can be become stubbed.The side opening 718 of suture contact pin 715 is configured to stubbed, when suture traction tool 710 was caught suture and suture is incorporated into suture and grabs pin 701, side opening 718 may contact with suture especially.Specifically, can be cut sth. askew in the edge of side opening 718 and become to have C shape surface or R shape surface.
In addition, preferably, the rear end from suture contact pin 715 is extended to the hollow parts 717 of side opening 718, do not have the difference on the height, thereby suture can insert reposefully in the hollow parts 717.Specifically, in the part of the hollow parts 717 that is extended to side opening 718, hollow parts 717 is constructed to, and makes the central axis of side opening 718 insert central axis inclination 120 to 150 degree of pin 715 with respect to suture.
Retainer 719 is connected on the rear end of suture contact pin 715.As described, the shoulder surface 720 of this retainer 719 only is assemblied in along a direction and is connected to suture and grabs in the shoulder surface 709 of the fixture 708 on pin 701 rear ends, to prevent relative rotation.Thereby can guarantee that the side opening 718 of suture contact pin 715 grabs the direction of pin 701 towards suture.By such assembling, can make 716 at the tip of suture contact pin 715 be positioned at the position in the place ahead, position that suture is grabbed the tip 702 of pin 701.
The bellmouth 721 that is used for inserting suture is formed at retainer 719.The diameter of the larger diameter side of this bellmouth 721 is greater than the internal diameter of suture contact pin 715.The diameter of bellmouth 721 is more little the closer to suture contact pin 715, and the diameter of the smaller diameter side of bellmouth 721 is substantially equal to the internal diameter of suture contact pin 715.Thereby can be provided at the structure that does not have the difference on the height between this bellmouth 721 and suture contact pin 715 inside.Because like this, the suture (not shown) can insert the suture contact pin 715 reposefully from the rear end of suture contact pin 715.
Fig. 5 represents the front view and the vertical view of abutment 722.The distance that abutment 722 is grabbed between pin 701 and the suture contact pin 715 suture remains unchanged, and pin 701 and 715 is remained parallel to each other.As described later, abutment 722 during sew application near stitching target such as body surface part.Thereby, can during the sew application this medical treatment device remained on each stitching target.Thereby, can sew up sewing up target steadily.Suture grabs pin 701 and suture contact pin 715 can move in abutment 722 independently of one another slidably.
Groove 723 is formed at a side of abutment 722, and suture contact pin 715 is positioned at this side.The width of the part that this groove 723 contacts with suture contact pin 715 is for example set about φ 0.25 to 0.5mm for.By such setting, when making suture contact pin 715 move apart abutment 722, the suture 705 from groove 723 is moved apart, and can easily make abutment 722 grab pin 701 rotations around suture.In addition, as described later, by such structure, a plurality of puncture positions of suture contact pin 715 can be arranged in one heart suture grab pin 701 puncture position around, wherein the suture puncture position of grabbing pin 701 is set to an end of plan suture location.
For example, can use the material of the synthetic resin material of the high grade of transparency as this abutment 722.Abutment 722 is arranged on the position, and in this position, the method by this medical treatment device of use of describing after a while produces a little otch with cutter on abdominal part.If the material of abutment 722 is transparent materials, just can further guarantee to carry out sew application.
Be appreciated that according to present embodiment that the present invention can provide and show all that height pierces through the suture contact pin 715 of performance and suture is grabbed pin 701 and can not allow these puncture needles 715 and 701 to pierce through the abutment 722 of target location when improving user friendly.In addition, can stably provide and to arrange the medical treatment device of a plurality of suture location with one heart.Thereby, can improve the performance of in percutaneous endoscopic gastrostomy, sewing up the medical treatment device of stomach wall and coat of the stomach by suture.
The practical methods of use according to medical treatment device of the present invention is described below, so that illustrate advantage of the present invention.
Fig. 6 is to use the flow chart according to the method for the medical treatment device of present embodiment.Fig. 7 to 16 is sketch maps of each step in the step 1 to 10 shown in Fig. 6.
Medical treatment device according to present embodiment is used for by a plurality of plan suture location that are separated from each other in the suture stitching organism.Before the medical treatment device that uses according to present embodiment, the stomach that endoscope is inserted patient to be supplying air to wherein fully, and the abdominal part inboard closely is connected on the outer wall of stomach.Then, by determine the position of stomach from the transillumination of endoscope, skin of abdomen is carried out partly sterilised and anesthesia.On the position of stomach, produce little otch with cutter.
In step 1, will abutment 722 according to the present invention be arranged on the position of little otch of stomach wall 100 (Fig. 7).
In step 2, suture according to the present invention is grabbed pin 701 and is passed stomach wall 100 and the coat of the stomach 101 (Fig. 8) that abutment 722 vertically pierces through patient, at this moment, suture traction tool 710 has left suture in grabs in the hollow parts 703 of pin 701, and snare 712 is out of shape linearly and flexibly.
Then, in step 3, allow to be connected to shoulder surface 714 slips that suture is grabbed the sliding part 713 of pin 701 rear ends, till the shoulder surface 707 of the guiding material 706 of grabbing pin 701 near suture (Fig. 9).By doing like this, the snare 712 of suture traction tool 710 is grabbed the direction that pin 701 can pierce through the target location along suture and is stretched out from side opening 704, thus the annular shape that snare 712 is formed in the free states.
Then, in step 4, to grab pin 701 similar to suture, and suture contact pin 715 passes stomach wall 100 and the coat of the stomach 101 (Figure 10) that abutment 722 vertically pierces through patient, at this moment, determine that by endoscope suture contact pin 715 passes the inside of the annular snare 712 of suture traction tool 710.
In the present embodiment, to grab pin 701 and suture contact pin 715 are the puncture needles that all have non-hollow sharp tip to suture.Because like this, the puncture needle that in height has difference with use such as hollow needle, sleeve pipe or outer cylinder etc. is compared, and has guaranteed that height pierces through performance, and can easily pierce through organism.In addition, in the present embodiment, can operate suture separately and grab pin 701 and suture contact pin 715.Because like this, with grab pin 701 with suture and pierce through the example of organism simultaneously with suture contact pin 715 or operate suture simultaneously and grab pin 701 and compare with the example of suture contact pin 715, this medical treatment device does not need very big strength, experience and know-how, and can easily realize piercing through the function of organism.
In step 5, insert the suture contact pins 715 from the rear end of suture contact pin 715 with suture 705, and the end that makes suture 705 is from the side opening 718 of suture contact pin 715 come out (Figure 11).In this state, because suture contact pin 715 itself passes snare 712 inside of the formation annular shape of suture traction tool 710, so the suture 705 of pulling out from suture contact pin 715 also passes the inside of snare 712.
In step 6, from organism and abutment 722, only pulled out suture contact pin 715, stay suture 705 (Figure 12) according to present appearance simultaneously.As a result, suture 705 passes the inside of snare 712.At this moment, can catch suture 705 once with snare 712.
At this moment, finished sew application if the operator judges in plan suture location only, then operating process forwards step 7 to.If the puncture position that suture is grabbed pin 701 is set at an end of plan suture location, and a plurality of puncture positions of suture contact pin 715 be arranged in one heart suture grab pin 701 puncture position around, then operating process forwards step 9 to.
If the quantity of plan suture location is one and has finished sew application in this position, the guiding material 706 that the sliding material 713 that so just allows suture traction tool 710 is grabbed pin 701 along the suture side opening 704 that the snare 712 of suture traction tool 710 grabs pin 701 by suture that upwards slides, and make in step 7 inserts in the hollow parts 703 (Figure 13).Therefore, make snare 712 strains that form annular shape and linearization(-sation) gradually, thereby caught suture 705 at the snare 712 that suture is grabbed in the part of side opening 704 of pin 701.
In this case, cut sth. askew in the edge of side opening 704 and become to have C shape surface or R shape surface.Because like this, can prevent because the contact that suture of catching at snare 712 705 and suture are grabbed between the side opening 704 of pin 701 makes suture 705 by excessive power cut-out.
In step 8, grab pin 701 and the abutment 722 (Figure 14) that comprises suture traction tool 710 along direction pulling suture away from patients abdomen.Thus, from health, will be pulled out by the suture 705 that the snare 712 of suture traction tool 710 is caught.As a result, suture 705 is invaded health from the puncture position of suture contact pin 715, enters in the stomach, and is exposed to the health outside from the puncture position that suture is grabbed pin 701.
After this, with wire twister tied a knot together in the two ends of the suture of exposure, thereby coat of the stomach 101 is fixed to stomach wall 100 by suture 705.
In addition, if the puncture position that suture is grabbed pin 701 is set at an end of plan suture location, and a plurality of puncture positions of suture contact pin 715 be arranged in one heart suture grab pin 701 puncture position around, then operating process forwards step 9 to from step 5.
In step 9, when keeping suture 705 to pass the state of snare 712 inside in health, the groove 723 of the abutment 722 by the health outside makes suture 705 move apart abutment 722 (Figure 15).Because groove 723 is arranged in the abutment 722,, suture 705 is moved apart abutment 722 so can guarantee to grab when pin 701 is fixed to abutment 722 at suture.
Then, in step 10, make abutment 722 grab the puncture position rotation (Figure 16) of pin 701 around suture along the direction of the next one plan puncture position of suture contact pin 715.Abutment 722 can revolve three-sixth turn.
Then, in step 11, to to finish the example of sew application in plan suture location only similar, step 4 to 6 is repeated and plans the as many number of times of number of times of sew application, in step 4 to 6, suture contact pin 715 passes stomach wall 100 and the coat of the stomach 101 that abutment 722 vertically pierces through patient.
At last, in step 12, to finish the example of sew application in plan suture location only similar, execution in step 7 and step 8, in step 7, suture 705 is caught by snare 712 in suture is grabbed the side opening 704 of pin 701.
By doing like this, can realize the puncture position arranged concentric of a plurality of puncture positions of suture contact pin 715 around puncture needle 701, wherein the puncture position of puncture needle 701 is set to an end of plan suture location.By a plurality of sutures 705 coat of the stomach 101 is fixed to stomach wall 100.
Make abutment 722 rotations when pin 701 pierces through health by grabbing, can adjust the puncture position of suture contact pin 715 at suture.Thereby, can guarantee that by shirtsleeve operation a plurality of positions on the circular arc of grabbing pin 701 around suture are fixed to stomach wall 100 with coat of the stomach 101.
Like this, use just is through with according to the process of the sew application of the medical treatment device of present embodiment.
In the present embodiment, the puncture needle that all has non-hollow sharp tip is used separately as suture and grabs pin 701 and suture contact pin 715.Because like this, compare, guaranteed that height pierces through performance, and can easily pierce through organism with using the puncture needle that in height has difference such as hollow needle, sleeve pipe or outer cylinder.
In addition, operate single suture individually and grab pin 701 and single suture contact pin 715.Because like this, with grab pin 701 with suture and pierce through the example of organism simultaneously with suture contact pin 715 or operate suture simultaneously and grab pin 701 and compare with the example of suture contact pin 715, this medical treatment device does not need very big strength, experience and know-how, and can reduce patient's pressure and shorten operating time.
In addition, the puncture position that suture is grabbed pin 701 is set at an end of plan puncture position, and a plurality of puncture positions of suture contact pin 715 can be arranged in one heart suture grab pin 701 puncture position around.Thereby, can safety and standing plans suture location steadily.In addition, seldom occur following this fixing suture that is taken place to the intravital intrusion of patient, and patient's burden is less.Thereby, can make patient get back to common life earlier, and reduce patient's medical expense.
Medical treatment device according to following embodiment is configured to adopt suture contact pin (first puncture needle) 3 and suture to grab pin (second puncture needle) 4.
(second embodiment)
Figure 17 is a perspective view, and expression is according to the structure of the medical treatment device of present embodiment.
Medical treatment device 1 shown in Figure 17 comprises that suture contact pin 3 and suture that main body 2, suture can insert wherein grab pin 4, and suture is grabbed pin 4 and is arranged near suture contact pin 3, and suture traction tool can insert suture and grabs in the pin 4.Suture contact pin 3 is grabbed pin 4 with suture and is connected to main body 2 separably by being connected with segregation apparatus.
In present embodiment and the 3rd embodiment, suture contact pin 3 is corresponding with suture contact pin 715 (shown in Fig. 1) according to the medical treatment device of first embodiment.Suture grabs pin 4 and grab pin 701 (shown in Fig. 1) according to the suture of the medical treatment device of first embodiment corresponding.
To each building block of medical treatment device 1 be described below.
Figure 18 is a front view, the structure of the main body 2 of expression medical treatment device 1.Main body 2 has the effect that suture contact pin 3 and suture are grabbed pin 4 of supporting.
Main body 2 has support member 21, is arranged on fixture 22 and the abutment 23 that is arranged on its tip (at the downside of Figure 17) on support member 21 bottoms (at the upside of Figure 17).
In present embodiment and the 3rd embodiment, abutment 23 is corresponding with abutment 722 (shown in Fig. 1) according to the medical treatment device of first embodiment.Fixture 22 is corresponding with fixture 708 (shown in Fig. 1) according to the medical treatment device of first embodiment.
The support member 21 support fixation parts 22 and the abutment 23 of U-shaped.Suture contact pin 3 and suture are grabbed pin 4 and are supported by support member 21 by abutment 23.The example that is used for the material of support member 21 comprises vinyl chloride resin, polycarbonate resin, ABS resin, polyacetal resin, polyamide, acrylic resin, polyvinyl resin or the like and such as stainless metal.
Fixture 22 has the effect that anchor suture contact pin 3 and suture are grabbed pin 4.As shown in Figure 18, fixture 22 comprises that anchor suture contact pin 3 and suture respectively grab first fixed part 221 and second fixed part 222 of pin 4, and plate body 223.First fixed part 221, second fixed part 222 and plate body 223 integrally form.
First fixed part 221 and second fixed part 222 are arranged on the side, bottom (upside among Figure 18) of plate body 223.First fixed part 221 and second fixed part 222 are arranged to about support member 21 symmetries.
First fixed part 221 has approximately identical structure with second fixed part 222, is roughly cuboid.First fixed part, 221 to the second fixed parts, 222 height.Thereby user can easily visually come first fixed part 221 and 222 differences of second fixed part.In the present embodiment, first fixed part 221 in height is different from second fixed part 222.Selectively, first fixed part 221 and second fixed part 222 also can in height equate.
First recess 224 is arranged in first fixed part 221, and suture contact pin 3 can insert in first fixed part 221.
In first recess 224, formation can with the first flange engages portion 225 of first flange engages of first centrosome (hub) 31 (not shown among Figure 17 and 18), will be arranged on the suture contact pin 3 at first centrosome of describing after a while 31.
First recess 224 is hollowed out cylindrically, and the diameter on the tip is less, and the diameter on the bottom of crossing the first flange engages portion 225 is bigger.
First recess 224 opens wide towards the front surface side of first fixed part 221, will be at first centrosome 31 of the suture contact pin of describing after a while 3 thereby can insert from its front surface side.
First flange (not shown among Figure 17 and 18) can engage with the first flange engages portion 225.When first flange (not shown among Figure 17 and 18) engaged with the first flange engages portion 225, suture contact pin 3 can not rotate or vertically move.
In addition, first flange (not shown among Figure 17 and 18) not with situation that the first flange engages portion 225 engages under, suture contact pin 3 can insert first recess 224 from bottom end side.In this case, to top similar, the periphery of first flange (not shown among Figure 17 and 18) is assemblied in first recess 224 and is fixed to the upper, thereby suture contact pin 3 can not rotate or vertically move.
Second fixed part 222 comprises second recess 226, and suture is grabbed pin 4 and can be inserted in second recess 226.
In second recess 226, formation can with the second flange engages portion 227 of second flange engages of second centrosome 41 (not shown among Figure 17 and 18), be arranged on suture at second centrosome of describing after a while 41 and grab on the pin 4.
Second recess 226 is hollowed out cylindrically, and the diameter on the tip is less, and the diameter on the bottom of crossing the second flange engages portion 227 is bigger.
Second recess 226 opens wide towards the front surface side of second fixed part 222, will grab second centrosome 41 of pin 4 at the suture of describing after a while thereby can insert from its front surface side.
First groove 2213 and second groove 2223 are respectively formed in first fixed part 221 and second fixed part 222, thereby to grab pin 4 be separable for suture contact pin 3 and suture.Thereby, can make suture contact pin 3 and suture grab pin 4 and separate, thus operability can be improved, and can guarantee to sew up by shirtsleeve operation.
First groove 2213 and second groove 2223 form respectively from the leading edge of fixture 22 and pass first fixed part 221 and second fixed part 222 is deep into first recess 224 and second recess 227.
Fixture 22 comprises sliding part 229, and it allows fixture 22 to move slidably with respect to support member 21.Thereby fixture 22 can freely move forward or backward with respect to support member 21, thereby is convenient to the puncture that suture contact pin 3 and suture are grabbed pin 4.
Preferably, for example use the material of the synthetic resin material of the high grade of transparency as fixture 22, this is because fixture 22 is arranged on the position, in this position, by using method, in body surface part, produce little otch such as abdominal part with cutter at the medical treatment device of describing after a while.
When making abutment 23 partly use medical treatment device 1 near body surface, abutment 23 works to improve stability.
As shown in Figure 17 and 18, abutment 23 is flat, comprise that on its side, bottom first columnar portion 231 and second columnar portion, 232, the first columnar portion 231 comprise that suture contact pin 3 can insert inner chamber wherein, second columnar portion 232 comprises that suture grabs pin 4 and can insert wherein inner chamber.
First columnar portion 231 and second columnar portion 232 work to improve stability respectively when grabbing pin 4 punctures by suture contact pin 3 and suture.
Abutment 23 comprises with first groove 233 and second groove 234 that connect with segregation apparatus, thereby suture contact pin 3 is grabbed pin 4 with suture and can be separated by relative abutment 23 respectively.Thereby abutment 23 can support suture contact pin 3 separably and suture is grabbed pin 4, thereby has improved operability.
First groove 233 and second groove 234 form respectively and pass first columnar portion 231 from the bottom of abutment 23 and second columnar portion 232 is deep into first columnar portion 231 and second columnar portion 232.Thereby make suture contact pin 3 and suture grab pin 4 can be relative abutment 23 separately.
In addition, abutment 23 comprises two lobe 235, has recess in the centre of lobe 235, and an end of support member 21 can insert in this recess.One end of support member 21 inserts in the recess of lobe 235.
Figure 19 represents the front view and the cutaway view of suture contact pin 3.Suture contact pin 3 plays a part suture is inserted in the interior tissue.
As shown in Figure 19, suture contact pin 3 comprises first centrosome 31 and the first pin portion 32 that is arranged on its tip that is arranged on its bottom (upside among Figure 19).First centrosome 31 and the first pin portion 32 comprise the hollow parts 33 as the suture passage.
In present embodiment and the 3rd embodiment, first centrosome 31 is corresponding with retainer 719 (Fig. 3) according to the medical treatment device of first embodiment.
First centrosome 31 is columniform substantially, and first flange, 311, the first flanges 311 that are included on its most advanced and sophisticated side can engage with the first flange engages portion 225.Hollow parts 33 in first centrosome 31 forms, and makes its internal diameter diminish gradually from the bottom to the tip.
The first pin portion 32 is included in the opening on its tip (downside among Figure 19), to be communicated with hollow parts 33.It is constant near most advanced and sophisticated external diameter from the bottom that the first pin portion 32 keeps, and have the sharp needle point that forms on the tip.
In present embodiment and the 3rd embodiment, the shape of the first pin portion 32 for example can be designed to the shape according to the suture contact pin 715 (Fig. 4) of first embodiment.By such design, in the first pin portion 32, can guarantee and the side opening of external communications direction towards the second pin portion 42.In addition, can insert suture reposefully.
The external diameter of the first pin portion 32 is not limited to special diameter; Yet, for example can be set to being equal to or greater than 15G and being equal to or less than 25G, preferably be equal to or greater than 19G and be equal to or less than 21G.By setting like this, can reduce the penetration resistance of suture contact pin 3, and suture contact pin 3 can easily pierce through health.
The total length of the first pin portion 32 is not limited to length-specific; Yet, for example can be set to being equal to or greater than 20mm and being equal to or less than 200mm, preferably be equal to or greater than 80mm and be equal to or less than 100mm.If total length is too little, just the first pin portion 32 may be imbedded in patient's the stomach wall.If too big, the operability of this medical treatment device is degenerated.
Figure 20 represents that suture grabs the front view and the cutaway view of pin 4.Suture is grabbed pin 4 and is play a part suture traction tool is inserted interior tissue.In addition, can insert wherein space by in puncture needle 4, forming lead, can be with in lead and the suture insertion organism.The position of inserting lead can be used as the conduit on position.
As shown in Figure 20, suture is grabbed pin 4 and is comprised and be arranged on second centrosome 41 on its bottom (upside among Figure 20) and be arranged on the second pin portion 42 on its tip.Second centrosome 41 and the second pin portion 42 comprise hollow parts 43, and hollow parts 43 is as the passage of suture traction tool, and as will be at the passage of the lead of describing after a while.
Second centrosome 41 is columniform substantially, and be included in second flange 411 and the adjacency section 412 that is arranged on its bottom on its tip, second flange 411 can engage with the second flange engages portion 227, and the handle portion 51 of suture traction tool 5 is near adjacency section 412.Hollow parts 43 in second centrosome 41 so forms, and promptly internal diameter diminishes from the bottom to the tip gradually.
The side mouth 413 that lead can insert wherein is arranged on the sidepiece of second centrosome 41.The external diameter of lead is not limited to special diameter; Yet, for example can be set to being equal to or greater than 0.1mm and being equal to or less than 0.8mm, preferably be equal to or greater than 0.4mm and be equal to or less than 0.6mm.If external diameter is too little, lead is just solid inadequately, and the operability of lead is degenerated.If too big, lead may injure the inside of stomach.
The second pin portion 42 is included in the opening on its tip (downside among Figure 20), to be communicated with hollow parts 43.
It is constant near most advanced and sophisticated external diameter from the bottom that the second pin portion 42 keeps, and have the very thin edge that forms on the tip.The shape of the second pin portion 42 for example can be designed to grab according to the suture of first embodiment shape (shown in Fig. 4) of pin 701.By such design, in the second pin portion 42, can guarantee and the side opening of external communications direction towards the first pin portion 32.In addition, can allow suture traction tool and lead to slide into the outside of the second pin portion 42 reposefully from hollow parts 43.
The external diameter of the second pin portion 42 is not limited to special diameter; Yet, for example can be set to being equal to or greater than 12G and being equal to or less than 22G, preferably be equal to or greater than 16G and be equal to or less than 18G.By setting like this, can be easily suture traction tool and lead be inserted suture simultaneously and grab in the pin 4, and lead and suture can easily pierce through health.
The total length of the second pin portion 42 is not limited to length-specific; Yet, for example can be set to being equal to or greater than 20mm and being equal to or less than 200mm, preferably be equal to or greater than 80mm and be equal to or less than 100mm.If total length is too little, just the second pin portion 42 may be imbedded in patient's the stomach wall.If too big, the operability of this medical treatment device is degenerated.
Figure 21 is the front view of the structure of expression suture traction tool 5.As shown in Figure 21, suture traction tool 5 comprises bar portion 52, is arranged on handle portion 51 and the ring part 53 that is arranged on its tip on bar portion 52 bottoms (upside among Figure 21).Suture traction tool 5 plays a part to catch the suture that inserts the interior tissue from suture contact pin 3, and plays a part suture is drawn to the body surface part.Thereby, can easily sew up body surface part and interior tissue.
Corresponding according to the suture traction tool 5 of present embodiment and the 3rd embodiment with suture traction tool 710 (shown in Fig. 1) according to the medical treatment device of first embodiment.Ring part 53 is corresponding with snare 712 (shown in Fig. 2 b) according to the medical treatment device of first embodiment.
Handle portion 51 is cuboid substantially, and its inner surface is hollowed out substantially cylindrically.Handle portion 51 is designed to grab near suture the bottom face of adjacency section 412 of second centrosome 41 of pin 4.
Wish that the external diameter of bar portion 52 grabs the internal diameter of pin 4 less than suture.The external diameter of bar portion 52 is not limited to special diameter; Yet, for example can be set to being equal to or greater than 0.3mm and being equal to or less than 0.8mm, more preferably be equal to or greater than 0.5mm and be equal to or less than 0.6mm.If external diameter is too little, can not fully guarantee the intensity of suture traction tool 5 sometimes.If too big, then usually be difficult to insert lead.
The length of bar portion 52 is not limited to length-specific; Yet, for example can be set to being equal to or greater than 45mm and being equal to or less than 225mm, preferably be equal to or greater than 105mm and be equal to or less than 125mm.If length is too little, ring part 53 may not be fully stretches out from the tip (downside Figure 20) that suture is grabbed the pin portion 42 of pin 4, and ring part 53 usually may not be caught suture.If too big, the suture of pulling out from the tip (downside Figure 19) of the first pin portion 32 of suture contact pin 3 may not insert in the ring part 53 of suture traction tool 5 steadily.
When suture traction tool 5 and lead inserted suture simultaneously and grab in the pin 4, the operability that suture is grabbed pin 4 depended on the gap (clearance distance) between the external diameter of the external diameter of bar portion 52 or lead and the internal diameter that suture is grabbed pin 4.Can set suture like this and grab the combination of the external diameter of the external diameter of bar portion 52 of the internal diameter of pin 4, suture traction tool 5 and lead, promptly the gap for example is equal to or greater than 0.05mm and is equal to or less than 0.30mm.By doing like this, can improve operability steadily.
Ring part 53 is grabbed pin 4 internal strains and basically by linearization(-sation) at suture, and grabs pin 4 when stretching out when ring part 53 from suture, and ring part 53 becomes annular.This can be convenient to catch suture.Thereby the material of ring part 53 is the elastomeric material as describing after a while preferably.
As shown in Figure 17 and 21, this medical treatment device forms, and makes to grab pin 4 when stretching out when ring part 53 from suture, and the inside of ring part 53 is passed in the central axis of suture contact pin 3 or its extension.Thereby, can guarantee to catch suture.
The diameter of ring part 53 is not limited to special diameter; Yet,, for example the diameter of ring part 53 can be set at and be equal to or greater than 1.5L and be equal to or less than 3.0L (mm) if the distance that suture contact pin 3 and suture are grabbed between the pin 4 is L (mm).By such setting, can further guarantee to catch suture.
The diameter of the line of ring part 53 is not limited to special diameter; Yet, for example can be set to being equal to or greater than 0.1mm and being equal to or less than 0.3mm, preferably be equal to or greater than 0.14mm and be equal to or less than 0.24mm.If the diameter of line is too little, when high viscosity body fluid adhered to ring part 53, ring part 53 was difficult to be deformed into linear condition and annularity sometimes.If the diameter of line is too big, then suture traction tool 5 and lead may not insert suture simultaneously and grab in the pin 4.
An example of the method for using medical treatment device 1 is described below with reference to Figure 22 to 31.Figure 22 to 31 is the cross sectional front view that are used for describing the method for using medical treatment device 1.Can use medical treatment device 1 to [11] according to following procedure [1].
[1] before using medical treatment device 1, endoscope is inserted in patient's the stomach supplying air to wherein fully, and make stomach wall 100 closely attached on the coat of the stomach 101.Then, by determining the position of stomach from the transillumination of endoscope, and skin of abdomen is carried out partly sterilised and anesthesia.On the position of stomach, produce little otch with cutter.
[2] abutment 23 of main body 2 is near stomach wall 100, and suture is grabbed pin 4 substantially perpendicularly pierces through patient from the position of little otch stomach wall 100 and coat of the stomach 101 (Figure 22).
[3] handle portion 51 of operation suture traction tool 5, and suture traction tool 5 is inserted sutures grab in the hollow parts 43 of pin 4 is till the lower end of handle portion 51 is near second centrosome 41.Thereby the ring part 53 of suture traction tool 5 stretches out and expansion (Figure 23) circlewise from the tip that suture is grabbed pin 4.Grab in the pin 4 for suture traction tool 5 is inserted suture, before the operation that can in carrying out paragraph [2], describe, leave suture traction tool 5 in suture in advance and grab in the pin 4.
[4] suture contact pin 3 passes fixture 22 and abutment 23 substantially perpendicularly pierces through patient's stomach wall and coat of the stomach.At this moment, set the inside (Figure 24) that suture contact pin 3 passes the ring part 53 of suture traction tool 5.
In the method for using according to present embodiment, suture contact pin 3 and suture are grabbed pin 4 and needn't be punctured simultaneously.Because each puncture needle can pierce through target independently, so the thorn dress operation when piercing through target simultaneously with two puncture needles is compared, it is easier to sting dress operation.
[5] suture 102 is inserted in the hollow parts 33 of suture contact pins 3 so that suture 102 stretches out (Figure 25) from the tip of suture contact pin 3.At this moment, suture contact pin 3 passes the inside of ring part 53, thereby suture 102 also passes the inside of ring part 53.
[6] when keeping main body 2 and suture to grab pin 4, only suture contact pin 3 is pulled out (Figure 26) from fixture 22 to bottom end side (upside Figure 26) according to present appearance.At this moment, can set the extension of suture 102 long.By such work, can prevent that suture 102 is drawn out.In addition, when wherein supplying with suture 102, can pull out suture contact pin 3.As a result, suture 102 passes the inside of ring part 53.At this moment, by withdrawal suture traction tool 5, can determine to catch suture 102.
[7] make main body 2 around grab pin 4 Rotate 180 degree (Figure 27) basically as the suture of rotating shaft.By doing like this, suture 102 passes first groove 2213 of fixture 22, and separates with abutment 23 with fixture 22.Carefully suture 102 is not pulled out from the inside of ring part 53.
[8] after rotation, suture contact pin 3 passes fixture 22 once more and abutment 23 substantially perpendicularly pierces through patient's stomach wall and coat of the stomach.At this moment, similar to the operation shown in Figure 25, suture contact pin 3 is set at the inside of the ring part 53 that passes suture traction tool 5.Suture 102 is inserted in the hollow parts 33 of suture contact pins 3 so that suture 102 stretches out (Figure 28) from the tip of suture contact pin 3.As a result, two sutures 102 are arranged in the ring part 53.
[9] a little upwards promote suture traction tool 5.At this moment, because two sutures 102 are arranged in the ring part 53,, and catch two sutures 102 (Figure 29) by withdrawal suture traction tool 5 so ring part 53 enters the inner chamber that suture is grabbed pin 4.
[10] the side mouth 413 of grabbing the centrosome 41 of pin 4 from suture inserts sutures with lead 103 and grabs pin 4 (Figure 30).Carry out this operation as long as grab pin 4 after piercing through stomach wall and coat of the stomach, just can carry out the lead insertion at any time and operate at suture.
[11] catch two sutures 102 with suture traction tool 5, and when suture contact pin 3 is connected to main body 2, main body 2 is pulled out from stomach wall 100.By these operations, the suture 102 that makes two puncture positions inserting from suture contact pin 3 insert enters coat of the stomach 101 from stomach wall 100, and stretches out (Figure 31) from the puncture position that suture is grabbed pin 4.In addition, grab the puncture position of pin 4, insert lead 103 at suture.Tied a knot so that stomach wall 100 is fixed to coat of the stomach 101 in the end of each suture 102.
If can understand, this medical treatment device 1 is constructed to, and making suture contact pin 3 and suture grab pin 4 can separate from main body 2.By using these puncture needles 3 and 4, can guarantee with two sutures 102 stomach wall 100 to be connected to coat of the stomach 101 by shirtsleeve operation.
In the present embodiment, describe suture contact pin 3 and suture and grabbed the example that pin 4 pierces through respectively.Yet, use the method for medical treatment device 1 to be not limited to this example.Puncture needle can pierce through them simultaneously.In order so to do, first flange 311 of suture contact pin 3 is engaged with the first flange engages portion 225 of first fixed part 221, second flange 411 that makes suture grab pin 4 engages with the second flange engages portion 227 of second fixed part 222.
(the 3rd embodiment)
Medical treatment device according to first or second embodiment can comprise a plurality of suture contact pins.Below the example that comprises two puncture needles according to the medical treatment device of second embodiment will be described.
Figure 32 is the perspective view of expression according to the structure of the medical treatment device 11 of present embodiment.As shown in Figure 32, medical treatment device 11 comprises main body 2, grabs pin 4 by the suture contact pin 3 that main body 2 supports and suture can insert wherein with suture contact pin (the 3rd puncture needle) 6 and suture, suture is grabbed pin 4 and is provided with near suture contact pin 3 and 6, and suture traction tool can insert suture and grabs in the pin 4.Suture contact pin 3 with 6 and suture grab pin 4 by be connected and segregation apparatus be connected to main body 2 separably.
This medical treatment device 11 is constructed to, and makes suture contact pin 6 also be connected to the main body 2 according to the medical treatment device 1 (Figure 17) of second embodiment separably, other building block can be applied on those parts of medical treatment device 1 for example.
Below will around with difference according to the medical treatment device 1 of second embodiment, each building block of medical treatment device 11 is described.
Figure 33 is the front view of structure of the main body 2 of expression medical treatment device 11.Main body 2 has the effect that suture contact pin 3, suture are grabbed pin 4 and suture contact pin 6 of supporting.
The fixture 22 that main body 2 comprises support member 21, be arranged on support member 21 bottoms on (its upside in Figure 33) and be arranged on abutment 23 on its tip (its downside in Figure 33).
Fixture 22 has the effect that anchor suture contact pin 3, suture are grabbed pin 4 and suture contact pin 6.
As shown in Figure 33, fixture 22 comprises that anchor suture contact pin 3, suture respectively grab first fixed part 221, second fixed part 222 and the 3rd fixed part 2231 of pin 4 and suture contact pin 6, and plate body 223.First fixed part 221, second fixed part 222, the 3rd fixed part 2231 and plate body 223 integrally form.
First fixed part 221, second fixed part 222 and the 3rd fixed part 2231 are arranged on the side, bottom (upside among Figure 33) of plate body 223 in the mode of substantial linear.
First fixed part 221, second fixed part 222 and the 3rd fixed part 2231 are structurally substantially the same, and are substantially cuboid.First fixed part 221 and the 3rd fixed part 2231 to the second fixed parts 222 height.Thereby user can easily visually come each fixed part difference.In the present embodiment, first fixed part 221 and the 3rd fixed part 2231 in height are different from second fixed part 222.Selectively, first fixed part 221, the 3rd fixed part 2231 and second fixed part 222 also can in height equate.
The 3rd fixed part 2231 comprises the 3rd recess 2234, and suture contact pin 6 can insert in the 3rd recess 2234.
In the 3rd recess 2234, formation can with the 3rd flange engages portion 2232 of the 3rd flange engages of the 3rd centrosome 61 (not shown among Figure 32 and 33), will be arranged on the suture contact pin 6 at the 3rd centrosome of describing after a while 61.
The 3rd recess 2234 is hollowed out cylindrically, and the diameter on the tip is less, and the diameter on the bottom of crossing the 3rd flange engages portion 2232 is bigger.The 3rd recess 2234 opens wide towards the front surface side of the 3rd fixed part 2231, will be at the 3rd centrosome 61 of the suture contact pin of describing after a while 6 thereby can insert from its front surface side.
To can engage with the 3rd flange engages portion 2232 at the 3rd flange of describing with reference to Figure 34 after a while 611.With when the 3rd flange engages portion 2232 engages, suture contact pin 6 can not rotate or vertically move at the 3rd flange 611.
In addition, the 3rd flange 611 not with situation that the 3rd flange engages portion 2232 engages under, suture contact pin 6 can insert the 3rd recess 2234 from bottom end side.In this case, to top similar, the periphery of the 3rd flange 611 is assemblied in the 3rd recess 2234 and is limited, thereby suture contact pin 6 can not rotate or vertically move.
The 3rd groove 2233 is formed in the 3rd fixed part 2231, thereby suture contact pin 6 is separable.Thereby, suture contact pin 6 is separated, thereby can improve operability.The 3rd groove 2233 forms and passes the 3rd fixed part 2231 from bottom, the front side of fixture 22 and be deep into the 3rd recess 2234.
As shown in Figure 32 and 33, abutment 23 is flat, and on its side, bottom, comprise first columnar portion 231, second columnar portion 232 and the three cylindrical portion 2335, first columnar portion 231 comprises that suture contact pin 3 can insert inner chamber wherein, second columnar portion 232 comprises that suture grabs pin 4 and can insert wherein inner chamber, and three cylindrical portion 2335 comprises that suture contact pin 6 can insert inner chamber wherein.When making abutment 23 partly use medical treatment device 11 near body surface, abutment 23 works to improve stability.
First columnar portion 231, second columnar portion 232 and three cylindrical portion 2335 work to improve stability respectively when suture contact pin 3, suture are grabbed pin 4 and 6 punctures of suture contact pin.
Abutment 23 comprises with first groove 233, second groove 234 and the 3rd groove 236 that connect with segregation apparatus, thereby suture contact pin 3, suture are grabbed pin 4 and can be separated by relative abutment 23 respectively with suture contact pin 6.Thereby, can support suture contact pin 3 separably, suture is grabbed pin 4 and suture contact pin 6, improves operability thus.
First groove 233, second groove 234 and the 3rd groove 236 form respectively and pass first columnar portion 231, second columnar portion 232 and three cylindrical portion 2335 from the bottom of abutment 23 and be deep into first columnar portion 231, second columnar portion 232 and the three cylindrical portion 2335.Thereby make suture contact pin 3, suture grab pin 4 and suture contact pin 6 can relative abutment 23 separately.
Figure 34 represents the front view and the cutaway view of suture contact pin 6.As shown in Figure 34, suture contact pin 6 comprises the 3rd centrosome 61 and the 3rd pin portion 62 that is arranged on its tip that is arranged on its bottom (upside among Figure 34).Similar to suture contact pin 3, suture contact pin 6 plays a part suture is inserted in the interior tissue.
The 3rd centrosome 61 and the 3rd pin portion 62 comprise the hollow parts 63 as the suture passage.Hollow parts 63 in the 3rd centrosome 61 is formed, and makes its internal diameter diminish gradually from the bottom to the tip.
In the present embodiment, the 3rd centrosome 61 is corresponding with retainer 719 (Fig. 3) according to the medical treatment device of first embodiment.
The 3rd centrosome 61 is columniform substantially, and is included in its most advanced and sophisticated the 3rd flange 611 that engages with the 3rd flange engages portion 2232 of going up.
The 3rd pin portion 62 is included in the opening on its tip (downside among Figure 34), to be communicated with hollow parts 63.It is constant near most advanced and sophisticated external diameter from the bottom that the 3rd pin portion 62 keeps, and have the sharp needle point that forms on the tip.
The structure of the first pin portion 32 can be applied to the structure of the 3rd pin portion 62.The shape of the 3rd pin portion 62 for example can be designed to identical with shape according to the suture contact pin 715 (Fig. 4) of first embodiment.By such design, in the 3rd pin portion 62, can guarantee and the side opening of external communications direction towards the second pin portion 42.In addition, suture can be inserted in the hollow parts 63 reposefully.
The external diameter of the 3rd pin portion 62 is not limited to special diameter; Yet, for example can be set to being equal to or greater than 15G and being equal to or less than 25G, preferably be equal to or greater than 19G and be equal to or less than 21G.By setting like this, can reduce the penetration resistance of suture contact pin 6, and suture contact pin 6 can easily pierce through health.
The total length of the 3rd pin portion 62 is not limited to length-specific; Yet, for example can be set to being equal to or greater than 20mm and being equal to or less than 200mm, preferably be equal to or greater than 80mm and be equal to or less than 100mm.If total length is too little, just the 3rd pin portion 62 may be imbedded in patient's the stomach wall.If too big, the operability of medical treatment device 11 is degenerated.
Another example of the method for using medical treatment device 11 will be described below.As mentioned above, each building block of medical treatment device 1 is applied to medical treatment device 11 basically, and medical treatment device 11 is configured to, make and further suture contact pin 6 to be arranged on separably on the main body 2 of medical treatment device 1.Thereby, when using medical treatment device 11, can adopt the program of using medical treatment device 1.After this, will mainly describe and the difference of paragraph [1] to [11] the middle program of describing.
[12] similarly carry out the operation that from [1] to [5] of medical treatment device 1 is described.
[13] when keeping main body 2, suture contact pin 3 and suture to grab pin 4 according to present appearance, the handle portion 51 of operation suture traction tool 5 makes suture traction tool 5 Rotate 180 degree.Note suture 102 not being pulled out from the inside of ring part 53.At this moment, can make suture 102 stretch out very longly, so that can not pull out suture 102.
[14] suture contact pin 6 passes fixture 22 and abutment 23 substantially perpendicularly pierces through patient's stomach wall and coat of the stomach.At this moment, similar to the operation shown in Figure 25, set the inside that suture contact pin 6 passes the ring part 53 of suture traction tool 5.Then, suture 102 is inserted in the hollow parts 63 of suture contact pins 6 so that suture 102 stretches out from the tip of suture contact pin 6.As a result, two sutures 102 are arranged in the ring part 53.
In such using method, suture contact pin 3, suture grab pin 4 and suture contact pin 6 needn't puncture simultaneously.That is, each puncture needle can pierce through target independently, thereby compares with the example that two puncture needles puncture simultaneously, can easily sting dress operation.
[15] a little upwards promote suture traction tool 5.At this moment, because two sutures 102 are arranged in the ring part 53,, and catch two sutures 102 by withdrawal suture traction tool 5 so ring part 53 enters the inner chamber that suture is grabbed pin 4.
[16] the side mouth 413 of grabbing the centrosome 41 of pin 4 from suture inserts sutures with lead 103 and grabs pin 4.Carry out this operation as long as grab pin 4 after puncturing, just can carry out the lead insertion at any time and operate at suture.
[17] when suture traction tool 5 is caught two sutures 102 and suture contact pin 3 and 6 is connected to main body 2, main body 2 is pulled out from stomach wall 100.By these operations, make the suture 102 of two puncture positions insertions of inserting from suture contact pin 3 and 6 enter coat of the stomach 101, and stretch out from the puncture position that suture is grabbed pin 4 from stomach wall 100.In addition, grab the puncture position of pin 4, insert lead 103 at suture.Tied a knot so that stomach wall 100 is fixed to coat of the stomach 101 in the end of each suture 102.
If can understand,, can further guarantee stomach wall 100 to be connected to coat of the stomach 101 with two sutures 102 by using medical treatment device 11.
Up to the present, reference example has been described according to medical treatment device of the present invention.Yet the present invention is not limited to described embodiment.
For example, the shape of the support member of main body, fixture, abutment or the like, the structure of connection and segregation apparatus, shape of the centrosome of each puncture needle or the like can be different from according to those situations among the described embodiment.Specifically, the hole that can insert wherein of lead 103 can be arranged on the upper surface of handle portion 51.If this hole is communicated with hollow parts 43 in second centrosome 41, then can be easily suture traction tool 5 and lead 103 be inserted suture simultaneously and grab in the pin 4.The hole that lead 103 can insert wherein and form in handle portion 51 can be formed in the optional position of handle portion 51.
In addition, suture is grabbed pin 4 or 701 and can be comprised two or more tube chambers.If like this, can be easily suture traction tool 5 and lead 103 being inserted suture simultaneously grabs in the pin 4.
And the target location of organism is not limited to stomach wall and coat of the stomach.The present invention also can be applicable to various splanchnopleures, blood vessel, nerve etc. to lifting of stomach wall or the like.

Claims (9)

1. one kind is used for medical treatment device that body surface part and interior tissue are sewed up, comprising:
Main body;
The suture contact pin, it is by described body supports, and suture can insert in the described suture contact pin; And
Suture is grabbed pin, and it is configured near described suture contact pin, and suture traction tool can insert described suture and grab in the pin,
Wherein said suture contact pin and described suture grab in the pin at least one be connected to separably on the described main body.
2. medical treatment device as claimed in claim 1, wherein said main body comprises:
Fixture, one in its tip that the tip and the described suture of described suture contact pin are grabbed pin is fixed to the precalculated position; And
Support member, it supports described fixture.
3. medical treatment device as claimed in claim 2, wherein said main body also comprises abutment, it is arranged on the most advanced and sophisticated side of described support member, near described body surface part, and supports described suture contact pin and described suture is grabbed pin.
4. medical treatment device as claimed in claim 2, wherein said fixture comprises groove, this groove make described suture contact pin and described suture grab in the pin one can from described body portion from.
5. medical treatment device as claimed in claim 3, wherein said abutment comprises groove, this groove make described suture contact pin and described suture grab in the pin one can from described body portion from.
6. medical treatment device as claimed in claim 1, wherein said suture contact pin and described suture are grabbed pin and are configured to and can puncture independently of one another.
7. medical treatment device as claimed in claim 1 wherein grabs that pin punctures and described main body during near described body surface part at described suture contact pin and described suture, can move apart described suture contact pin independently.
8. medical treatment device as claimed in claim 1, wherein said main body can be grabbed the pin rotation around the described suture that is used as rotating shaft.
9. medical treatment device as claimed in claim 1, wherein this medical treatment device also comprises a plurality of described suture contact pins, wherein described suture is grabbed pin and is arranged near in described a plurality of suture contact pins each.
CNB2004800051328A 2003-02-26 2004-02-26 Medical instrument Expired - Fee Related CN100403993C (en)

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US8277463B2 (en) * 2006-04-07 2012-10-02 Yutaka Suzuki Medical device and method of fixing internal organ
US8911454B2 (en) * 2008-07-31 2014-12-16 Olympus Medical Systems Corp. Suturing device
JP6267647B2 (en) * 2011-11-09 2018-01-24 イージーラップ エル・ティー・ディー Suture assembly having spacers
CR20170265A (en) * 2014-12-10 2017-11-17 Edwards Lifesciences Ag MULTIPLE REACTIVATION HOLDING DEVICE AND METHODS FOR USE AND MANUFACTURING
WO2020196885A1 (en) * 2019-03-28 2020-10-01 テルモ株式会社 Medical device

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS5161655A (en) * 1974-11-18 1976-05-28 Oyama Tetsukosho Kk
JPS6024533A (en) * 1983-07-21 1985-02-07 Konishiroku Photo Ind Co Ltd Optical exposure device
US5152769A (en) * 1991-11-04 1992-10-06 Will Baber Apparatus for laparoscopic suturing with improved suture needle
US5330488A (en) * 1993-03-23 1994-07-19 Goldrath Milton H Verres needle suturing kit
US5499991A (en) * 1994-12-19 1996-03-19 Linvatec Corporation Endoscopic needle with suture retriever
US5722981A (en) * 1993-10-08 1998-03-03 Tahoe Surgical Instruments Double needle ligature device

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS5161655A (en) * 1974-11-18 1976-05-28 Oyama Tetsukosho Kk
JPS6024533A (en) * 1983-07-21 1985-02-07 Konishiroku Photo Ind Co Ltd Optical exposure device
US5152769A (en) * 1991-11-04 1992-10-06 Will Baber Apparatus for laparoscopic suturing with improved suture needle
US5330488A (en) * 1993-03-23 1994-07-19 Goldrath Milton H Verres needle suturing kit
US5722981A (en) * 1993-10-08 1998-03-03 Tahoe Surgical Instruments Double needle ligature device
US5499991A (en) * 1994-12-19 1996-03-19 Linvatec Corporation Endoscopic needle with suture retriever

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