JPH0624533B2 - Medical instruments - Google Patents
Medical instrumentsInfo
- Publication number
- JPH0624533B2 JPH0624533B2 JP2416573A JP41657390A JPH0624533B2 JP H0624533 B2 JPH0624533 B2 JP H0624533B2 JP 2416573 A JP2416573 A JP 2416573A JP 41657390 A JP41657390 A JP 41657390A JP H0624533 B2 JPH0624533 B2 JP H0624533B2
- Authority
- JP
- Japan
- Prior art keywords
- puncture needle
- suture
- grasping
- suture thread
- needle
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
- 238000003780 insertion Methods 0.000 claims description 67
- 230000037431 insertion Effects 0.000 claims description 67
- 239000013013 elastic material Substances 0.000 claims description 13
- 210000003815 abdominal wall Anatomy 0.000 description 21
- 210000002784 stomach Anatomy 0.000 description 20
- 230000009278 visceral effect Effects 0.000 description 13
- -1 for example Substances 0.000 description 11
- 238000010586 diagram Methods 0.000 description 7
- 239000004698 Polyethylene Substances 0.000 description 6
- 239000004743 Polypropylene Substances 0.000 description 6
- 230000009545 invasion Effects 0.000 description 6
- 239000002184 metal Substances 0.000 description 6
- 229910052751 metal Inorganic materials 0.000 description 6
- 229920000098 polyolefin Polymers 0.000 description 6
- 229920001155 polypropylene Polymers 0.000 description 6
- 229920005989 resin Polymers 0.000 description 6
- 239000011347 resin Substances 0.000 description 6
- 229920003002 synthetic resin Polymers 0.000 description 6
- 239000000057 synthetic resin Substances 0.000 description 6
- BZHJMEDXRYGGRV-UHFFFAOYSA-N Vinyl chloride Chemical compound ClC=C BZHJMEDXRYGGRV-UHFFFAOYSA-N 0.000 description 5
- 229920000515 polycarbonate Polymers 0.000 description 5
- 239000004417 polycarbonate Substances 0.000 description 5
- 229910001220 stainless steel Inorganic materials 0.000 description 5
- 230000003187 abdominal effect Effects 0.000 description 4
- 229910045601 alloy Inorganic materials 0.000 description 4
- 239000000956 alloy Substances 0.000 description 4
- 239000010935 stainless steel Substances 0.000 description 4
- 230000007774 longterm Effects 0.000 description 3
- 235000016709 nutrition Nutrition 0.000 description 3
- 229920000573 polyethylene Polymers 0.000 description 3
- 229920013716 polyethylene resin Polymers 0.000 description 3
- 230000000694 effects Effects 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 229910017518 Cu Zn Inorganic materials 0.000 description 1
- 229910017752 Cu-Zn Inorganic materials 0.000 description 1
- 229910017943 Cu—Zn Inorganic materials 0.000 description 1
- 206010061297 Mucosal erosion Diseases 0.000 description 1
- 229910000990 Ni alloy Inorganic materials 0.000 description 1
- 229910003310 Ni-Al Inorganic materials 0.000 description 1
- 206010035669 Pneumonia aspiration Diseases 0.000 description 1
- 229910052782 aluminium Inorganic materials 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
- 201000009807 aspiration pneumonia Diseases 0.000 description 1
- 210000001124 body fluid Anatomy 0.000 description 1
- 239000010839 body fluid Substances 0.000 description 1
- 239000003795 chemical substances by application Substances 0.000 description 1
- 238000012790 confirmation Methods 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- TVZPLCNGKSPOJA-UHFFFAOYSA-N copper zinc Chemical compound [Cu].[Zn] TVZPLCNGKSPOJA-UHFFFAOYSA-N 0.000 description 1
- 238000011161 development Methods 0.000 description 1
- 238000007599 discharging Methods 0.000 description 1
- 239000012153 distilled water Substances 0.000 description 1
- 239000002552 dosage form Substances 0.000 description 1
- 229920000840 ethylene tetrafluoroethylene copolymer Polymers 0.000 description 1
- 229910052733 gallium Inorganic materials 0.000 description 1
- 230000002496 gastric effect Effects 0.000 description 1
- 210000001035 gastrointestinal tract Anatomy 0.000 description 1
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 1
- 210000000936 intestine Anatomy 0.000 description 1
- 238000002690 local anesthesia Methods 0.000 description 1
- 230000033001 locomotion Effects 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 210000003928 nasal cavity Anatomy 0.000 description 1
- 210000001331 nose Anatomy 0.000 description 1
- 235000015097 nutrients Nutrition 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
- 210000003800 pharynx Anatomy 0.000 description 1
- 239000004810 polytetrafluoroethylene Substances 0.000 description 1
- 229920001343 polytetrafluoroethylene Polymers 0.000 description 1
- 238000009958 sewing Methods 0.000 description 1
- 230000001502 supplementing effect Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 229910052718 tin Inorganic materials 0.000 description 1
- 210000001835 viscera Anatomy 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Chemical compound O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0485—Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
- A61B2017/0472—Multiple-needled, e.g. double-needled, instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B2017/06052—Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Description
【０００１】[0001]
【産業上の利用分野】本発明は、腹部内臓に、経皮的に
カテーテルを挿入する際に、使用されれる医療用器具に
関するものである。特に、栄養剤の補給、体液の排出な
どの目的で行われる内視鏡的胃瘻造設術などの際に、カ
テーテルの挿入を容易にするために行われる前腹壁と内
臓壁との固定に使用される医療用器具に関するものであ
る。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical instrument used for percutaneously inserting a catheter into the abdominal internal organs. In particular, it is used to fix the anterior abdominal wall and the visceral wall to facilitate the insertion of a catheter during endoscopic gastrostomy, which is performed for the purpose of supplementing nutrients and discharging body fluids. Medical device.
【０００２】[0002]
【従来の技術】近年では、経腸栄養剤とその投与方法の
発達により、従来困難とされていた長期の経腸栄養管理
が容易に行われるようになってきた。その投与形態とし
ては、栄養チューブを経鼻にて胃または腸に挿入して行
う、いわゆる経鼻胃管によるもの、また、胃瘻を形成し
て行う場合などがある。しかし、経鼻胃管では、長期留
置による鼻腔、咽頭、食道の粘膜びらん、誤飲性肺炎な
どの合併症を生じることがある。そこで、長期的な栄養
投与が必要な患者には、開腹的胃瘻造設術が行われる。
しかし、一般的な胃瘻造設術は、過大な外科的侵襲を伴
うため、患者の状態によっては、手術を行うことができ
ないことも少なくない。2. Description of the Related Art In recent years, with the development of enteral nutritional agents and their administration methods, long-term enteral nutritional management, which has hitherto been difficult, has been easily performed. The dosage form includes a so-called nasogastric tube, which is performed by inserting a feeding tube into the stomach or intestine through the nose, and a case where a gastrostomy is formed. However, the nasogastric tube may cause complications such as nasal cavity, pharynx, esophageal mucosal erosion, and aspiration pneumonia due to long-term placement. Therefore, an abdominal gastrostomy is performed on a patient who needs long-term nutritional administration.
However, since general gastrostomy is accompanied by excessive surgical invasion, it is often impossible to perform surgery depending on the condition of the patient.
【０００３】そこで、最近では、外科的侵襲を極力低減
した胃瘻造設術が考えられるようになってきており、そ
のために使用する医療用器具も提案されている。具体的
には、例えば、特開昭６３−２３６５１号公報に示され
るような内臓アンカーがある。この内臓アンカーは、両
端を有する細長い生態適合性クロスバーと、このクロス
バーの中央部分に一端が固定された第１の縫合糸と、ク
ロスバーのいずれかの端部に一端が固定された第２の縫
合糸とを有している。Therefore, recently, a gastrostomy construction method in which surgical invasion has been reduced as much as possible has come to be considered, and medical instruments used therefor have also been proposed. Specifically, for example, there is a visceral anchor as shown in JP-A-63-23651. The visceral anchor comprises an elongated biocompatible crossbar having opposite ends, a first suture fixed at one end to a central portion of the crossbar, and a first suture fixed at either end of the crossbar. And two sutures.
【０００４】上記の内臓アンカーを用いた胃体部前壁と
前腹壁との固定は、内臓アンカーのクロスバーを中空針
を用いて、クロスバー部分を腹部皮膚より、胃内部に挿
入することにより行われる。胃体部前壁と前腹壁との固
定に関しては、この内臓アンカーは、ある程度の効果を
有しているが、カテーテル留置作業終了後に、胃内に挿
入したクロスバーの除去作業が必要であり、そのため
に、あらたな中空針の穿刺が必要となり、また、除去作
業も容易なものではなかった。さらに、除去作業中にト
ラブルが生ずると、クロスバー部分が、胃内に残留する
ことがあり、胃壁さらには、その他の消化管内壁に損傷
を与える危険性があった。The fixation of the anterior wall of the stomach and the anterior abdominal wall using the visceral anchor is performed by inserting the crossbar of the visceral anchor into the stomach through the abdominal skin using a hollow needle. Done. Regarding the fixation of the anterior abdominal wall and the anterior abdominal wall of the stomach, this visceral anchor has some effect, but it is necessary to remove the crossbar inserted into the stomach after completion of the catheter placement operation, Therefore, it is necessary to puncture a new hollow needle, and the removal work is not easy. Furthermore, if a trouble occurs during the removal operation, the crossbar portion may remain in the stomach, and there is a risk of damaging the stomach wall and other inner walls of the digestive tract.
【０００５】[0005]
【課題を解決するための手段】そこで、本発明の目的
は、上記従来技術の問題点を解消し、前腹壁と内臓壁、
例えば、前腹壁と胃体部前壁とを容易、かつ短時間に、
さらに安全かつ確実に固定することができ、固定にとも
なう患者への侵襲が少なく、患者に与える負担も少ない
医療用器具を提供するものである。SUMMARY OF THE INVENTION Therefore, an object of the present invention is to solve the above problems of the prior art, and to solve the problems of the anterior abdominal wall and the visceral wall,
For example, the anterior abdominal wall and the anterior wall of the stomach body can be easily and in a short time,
Further, the present invention provides a medical device that can be securely and reliably fixed, has less invasion to the patient due to the fixing, and has less burden on the patient.
【０００６】上記目的を達成するものは、縫合糸挿入用
穿刺針と、該縫合糸挿入用穿刺針より所定距離離間し
て、ほぼ平行に設けられた縫合糸把持用穿刺針と、該縫
合糸把持用穿刺針の内部に摺動可能に挿入されたスタイ
レットと、前記縫合糸挿入用穿刺針および前記縫合糸把
持用穿刺針の基端部が固定された固定部材とからなり、
前記スタイレットは、先端に弾性材料により形成され、
前記縫合糸把持用穿刺針の内部に収納可能な環状部材を
有しており、さらに、該環状部材は、前記縫合糸把持用
穿刺針の先端より突出させたとき、前記縫合糸挿入用穿
刺針の中心軸またはその延長線が、該環状部材の内部を
貫通するように該縫合糸挿入用穿刺針方向に延びる医療
用器具である。The object to achieve the above object is to provide a puncture needle for inserting a suture thread, a puncture needle for grasping a suture thread, which is provided substantially in parallel with the puncture needle for inserting a suture thread, at a predetermined distance from the puncture needle. a stylet inside the gripping puncture needle is inserted slidably, proximal end of the suture insertion puncture needle and the suture grasping needle is a stationary member fixed,
The stylet is formed of an elastic material at the tip ,
Has a retractable annular member in the interior of the suture grasping needle further annular member which, when allowed to protrude from the distal end of the suture grasping needle, the suture insertion needle Is a medical device in which the central axis or an extension thereof extends in the direction of the puncture needle for suture insertion so as to penetrate the inside of the annular member.
【０００７】また、上記目的を達成するものは、第１の
縫合糸挿入用穿刺針と、該第１の縫合糸挿入用穿刺針よ
り所定距離離間して、ほぼ平行に設けられた第１の縫合
糸把持用穿刺針と、該第１の縫合糸把持用穿刺針内部に
摺動可能に挿入された第１のスタイレットと、第２の縫
合糸挿入用穿刺針と、該第２の縫合糸挿入用穿刺針より
所定距離離間して、ほぼ平行に設けられた第２の縫合糸
把持用穿刺針と、該第２の縫合糸把持用穿刺針の内部に
摺動可能に挿入された第１のスタイレットと、前記第１
の縫合糸挿入用穿刺針、前記第１の縫合糸把持用穿刺
針、前記第２の縫合糸挿入用穿刺針および前記第２の縫
合糸把持用穿刺針のそれぞれの基端部が、四角形の頂点
を形成するように固定する固定部材とからなり、前記第
１のスタイレットは、先端に弾性材料により形成され、
前記第１の縫合糸把持用穿刺針の内部に収納可能な第１
の環状部材を有しており、そして、該第１の環状部材
は、前記第１の縫合糸把持用穿刺針の先端より突出させ
たとき、前記第１の縫合糸挿入用穿刺針の中心軸または
その延長線が、該第１の環状部材の内部を貫通するよう
に該第１の縫合糸挿入用穿刺針方向に延び、さらに、前
記第２のスタイレットは、先端に弾性材料により形成さ
れ、前記第２の縫合糸把持用穿刺針の内部に収納可能な
第２の環状部材を有しており、そして、該第２の環状部
材は、前記第２の縫合糸把持用穿刺針の先端より突出さ
せたとき、前記第２の縫合糸挿入用穿刺針の中心軸また
はその延長線が、該第２の環状部材の内部を貫通するよ
うに該第２の縫合糸挿入用穿刺針方向に延びる医療用器
具である。Further, what achieves the above-mentioned object is that a first puncture needle for inserting a suture and a first puncture needle for inserting a first suture thread, which are spaced apart from each other by a predetermined distance, are provided substantially in parallel. Suture holding puncture needle, first stylet slidably inserted inside the first suture holding puncture needle, second suture insertion puncture needle, and second suture spaced a predetermined from the suture insertion needle distance, the inserted slidably and second suture grasping needle that is provided substantially parallel to the inside of the suture grasping needle of the second 1 stylet and the first
Of the suture insertion puncture needle, the first suture thread grasping puncture needle, the second suture thread insertion puncture needle and the second suture thread grasping puncture needle each have a quadrangular shape. The first stylet is formed of an elastic material at the tip, and includes a fixing member that fixes so as to form an apex .
A first storable inside the first suture grasping puncture needle
The first annular member has a central axis of the first suture insertion puncture needle when the first annular member is projected from the tip of the first suture suture grasping puncture needle. Alternatively, the extension line extends in the direction of the first suture insertion puncture needle so as to penetrate the inside of the first annular member, and further, the second stylet is formed at the tip by an elastic material. A second annular member that can be housed inside the second suture grasping puncture needle , and the second annular member is for accommodating the second suture grasping needle. When projecting from the tip of the puncture needle, the second suture insertion needle is inserted so that the central axis of the second suture insertion puncture needle or an extension line thereof penetrates the inside of the second annular member. A medical device extending in the direction of the puncture needle.
【０００８】そして、前記医療用器具は、前記縫合糸挿
入用穿刺針および前記縫合糸把持用穿刺針が、摺動可能
に貫通された平板状部材を有していることが好ましい。
同様に、前記医療用器具は、前記第１の縫合糸挿入用穿
刺針、前記第１の縫合糸把持用穿刺針、前記第２の縫合
糸挿入用穿刺針および前記第２の縫合糸把持用穿刺針
が、摺動可能に貫通された平板状部材を有していること
が好ましい。さらに、前記固定部材は、平板状となって
いることが好ましい。また、前記縫合糸把持用穿刺針の
先端の刃面は、前記縫合糸挿入用穿刺針方向に向かって
開口していることが好ましい。さらに、前記管状部材の
先端部は、ほぼ先端を中心とするＶ字状、またはＵ字状
の縫合糸把持部を有していることが好ましい。 The medical instrument preferably has a flat plate-like member through which the suture thread insertion puncture needle and the suture thread grasping puncture needle are slidably penetrated.
Similarly, the medical device includes the first suture insertion puncture needle, the first suture grasping puncture needle, the second suture insertion puncture needle, and the second suture grasping needle. It is preferable that the puncture needle has a flat plate-like member that is slidably penetrated. Further, it is preferable that the fixing member has a flat plate shape. Further, it is preferable that the blade surface at the tip of the puncture needle for grasping the suture thread is open toward the puncture needle for suture insertion. Further, the tubular member
The tip is V-shaped or U-shaped with the tip at the center
It is preferable to have the suture grip portion.
【０００９】[0009]
【実施例】そこで、本発明の医療用器具を図面に示した
実施例を用いて説明する。本発明の医療用器具１は、縫
合糸挿入用穿刺針３と、縫合糸挿入用穿刺針３より所定
距離離間して、ほぼ平行に設けられた縫合糸把持用穿刺
針２と、縫合糸把持用穿刺針２の内部に摺動可能に挿入
されたスタイレット４と、縫合糸挿入用穿刺針３および
縫合糸把持用穿刺針２の基端部を固定する固定部材６と
からなり、スタイレット４は、先端に弾性材料により形
成された環状部材５を有しており、そして、この環状部
材５は、縫合糸把持用穿刺針２の先端より突出させたと
き、縫合糸挿入用穿刺針３の中心軸またはその延長線
が、環状部材５の内部を貫通するように縫合糸挿入用穿
刺針３方向に延びるように形成されている。この医療用
器具１によれば、前腹壁と内臓壁、例えば、前腹壁と胃
体部前壁とを容易、かつ短時間に、さらに、安全かつ確
実に固定することができ、この固定にともなう患者への
侵襲も、穿刺針の穿刺という極めて少ないものであり、
患者に与える負担も少ない。DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A medical instrument of the present invention will be described with reference to the embodiments shown in the drawings. The medical instrument 1 of the present invention comprises a puncture needle 3 for inserting a suture thread, a puncture needle 2 for grabbing a suture thread, which is provided substantially in parallel with the puncture needle 3 for inserting a suture thread, at a predetermined distance from the puncture needle 3. A stylet 4 slidably inserted into the puncture needle 2 for suture, and a fixing member 6 for fixing the proximal end portion of the puncture needle 3 for suture thread insertion and the puncture needle 2 for grasping the suture thread. 4 has an annular member 5 formed of an elastic material at its tip, and when this annular member 5 is projected from the tip of the suture grasping puncture needle 2, the suture inserting puncture needle 3 The central axis or the extension thereof is formed so as to extend in the direction of the suture thread insertion puncture needle 3 so as to penetrate the inside of the annular member 5. According to this medical device 1, the anterior abdominal wall and the visceral wall, for example, the anterior abdominal wall and the anterior wall of the stomach body part can be easily and safely fixed in a short time. Invasion of the patient is also extremely small, such as puncturing with a puncture needle,
The burden on the patient is also small.
【００１０】そこで、本発明の医療用器具の実施例を図
１および図２を用いて説明する。図１は、本発明の医療
用器具の実施例の断面図であり、図２は、図１に示した
医療用器具の側面図であり、図３は、図１のＡ−Ａ線断
面図であり、図４は、スタイレットの先端部の環状部材
が、突出していない状態の本発明の医療用器具の実施例
の断面図である。An embodiment of the medical device of the present invention will be described with reference to FIGS. 1 and 2. 1 is a sectional view of an embodiment of the medical device of the present invention, FIG. 2 is a side view of the medical device shown in FIG. 1, and FIG. 3 is a sectional view taken along line AA of FIG. FIG. 4 is a cross-sectional view of an embodiment of the medical device of the present invention in a state where the annular member at the tip portion of the stylet does not project.
【００１１】この実施例の医療用器具１は、縫合糸挿入
用穿刺針３と、縫合糸挿入用穿刺針３より所定距離離間
して、ほぼ平行に設けられた縫合糸把持用穿刺針２と、
縫合糸把持用穿刺針２の内部に摺動可能に挿入されたス
タイレット４と、縫合糸挿入用穿刺針３および縫合糸把
持用穿刺針２の基端部を固定する固定部材６とを有して
いる。縫合糸挿入用穿刺針３は、内部に、縫合糸を挿入
用可能な中空状のものであり、金属、例えば、ステンレ
スにより形成されており、先端に皮膚への穿刺用の刃面
を有している。縫合糸挿入用穿刺針３としては、皮膚へ
の穿刺と縫合糸の挿入ができればどのようなものでもよ
いが、具体的には、外径が、２１Ｇ 〜１７Ｇ程度が好
ましく、特に好ましくは、２０〜１８Ｇ，長さが、７０
ｍｍ〜１２０ｍｍ程度のものが好ましく、特に、８０〜
１００ｍｍ程度のものが好ましい。そして、縫合糸挿入
用穿刺針３の後端には、縫合糸挿入用穿刺針ハブ８が取
り付けられており、このハブ８の開口端が、縫合糸挿入
口を形成している。そして、ハブ８は、塩化ビニル樹
脂、ポリプロピレン、ポリエチレンなどのポリオレフィ
ン、ポリカーボネートなどの合成樹脂により形成され
る。さらに、このハブ８は、固定部材６に固定されてお
り、その結果、固定部材６は、縫合糸挿入用穿刺針３の
基端部を固定している。The medical instrument 1 of this embodiment includes a puncture needle 3 for inserting a suture thread, and a puncture needle 2 for grasping a suture thread which is provided substantially in parallel with the puncture needle 3 for inserting a suture thread at a predetermined distance. ,
It has a stylet 4 slidably inserted inside the suture grasping puncture needle 2, and a fixing member 6 for fixing the suture inserting puncture needle 3 and the proximal ends of the suture grasping puncture needle 2. is doing. The puncture needle 3 for inserting a suture thread has a hollow shape inside which a suture thread can be inserted, is made of metal, for example, stainless steel, and has a blade surface for puncturing the skin at its tip. ing. The puncture needle 3 for inserting the suture thread may be of any type as long as it can puncture the skin and insert the suture thread. Specifically, the outer diameter is preferably about 21 G to 17 G, and particularly preferably 20 G. ~ 18G, length is 70
mm-120 mm is preferable, and especially 80-
It is preferably about 100 mm. The suture insertion puncture needle hub 8 is attached to the rear end of the suture insertion puncture needle 3, and the open end of the hub 8 forms a suture insertion port. The hub 8 is made of vinyl chloride resin, polyolefin such as polypropylene and polyethylene, or synthetic resin such as polycarbonate. Further, the hub 8 is fixed to the fixing member 6, and as a result, the fixing member 6 fixes the proximal end portion of the puncture needle 3 for suture insertion.
【００１２】縫合糸把持用穿刺針２は、内部に、スタイ
レット４を摺動可能に挿通する中空状のものであり、金
属、例えば、ステンレスにより形成されており、先端に
皮膚への穿刺用の刃面を有している。縫合糸挿入用穿刺
針２としては、皮膚への穿刺とスタイレットの挿入がで
きればどのようなものでもよいが、具体的には、外径
が、２１Ｇ〜１６Ｇ程度のもの、さらには、１９Ｇ〜１
６Ｇのものが好ましく、特に１７Ｇ（約１．４０ｍｍ）
〜１８Ｇ（約１．２０ｍｍ）のものが好ましい。また、
長さは、６０ｍｍ〜１２０ｍｍ程度のものが好ましく、
特に、７０〜９０ｍｍ程度のものが好ましい。また、縫
合糸把持用穿刺針２としては、上述した縫合糸挿入用穿
刺針３と同じもの、また同程度の外径のものを用いても
よい。さらに、後述するスタイレット４の環状部材５
が、確実に縫合糸挿入用穿刺針方向に延びるようにする
ために、縫合糸把持用穿刺針２の先端の刃面は、図１に
示すように、縫合糸挿入用穿刺針３方向に向かって開口
していることが好ましい。また、この縫合糸把持用穿刺
針２としては、通常の直管状のものでもよい。また、図
１に示すような、刃面部分を含む先端部が、湾曲したも
のを用いてもよい。このようにすれば、より確実に、後
述するスタイレット４の環状部材５が、縫合糸挿入用穿
刺針方向に延びるようにすることができる。そして、縫
合糸把持用穿刺針２の後端には、縫合糸把持用穿刺針ハ
ブ７が取り付けられており、このハブ７の開口端は、後
述するスタイレットハブ９と係合するように構成されて
いる。そして、ハブ７は、塩化ビニル樹脂、ポリプロピ
レン、ポリエチレンなどのポリオレフィン、ポリカーボ
ネートなどの合成樹脂より形成される。さらに、このハ
ブ７は、固定部材６に固定されており、その結果、固定
部材６は、縫合糸把持用穿刺針２の基端部を固定してい
る。このため、縫合糸把持用穿刺針は、縫合糸挿入用穿
刺針３より所定距離離間し、かつ、ほぼ平行となってい
る。両者間の距離は、縫合糸が前腹壁と内臓壁とを固定
する長さとなるものであり、５ｍｍ〜３０ｍｍ程度が好
適である。 上記範囲内であれば、前腹壁と内臓壁との固定も十分に
行え、また、２本の穿刺針を穿刺する際の抵抗もあまり
大きなものとはならない。特に好ましくは、１０〜２０
ｍｍである。The puncture needle 2 for grasping the suture thread is hollow and has a stylet 4 slidably inserted therein. The puncture needle 2 is made of metal such as stainless steel and has a tip for puncturing the skin. It has a blade surface. The puncture needle 2 for suture insertion may be of any type as long as it can puncture the skin and insert a stylet. Specifically, it has an outer diameter of about 21G to 16G, and further 19G to 1
6G is preferable, especially 17G (about 1.40mm)
It is preferably about 18 G (about 1.20 mm). Also,
The length is preferably about 60 mm to 120 mm,
In particular, those having a thickness of about 70 to 90 mm are preferable. Also, sewing
The puncture needle 2 for grasping the suture thread is the puncture needle for suture insertion described above.
Even if the same needle as the puncture needle 3 or the same outer diameter is used
Good. Further, an annular member 5 of the stylet 4 described later
However, in order to ensure that the puncture needle for suture insertion extends in the direction of the puncture needle for suture insertion, the blade surface of the tip of the puncture needle for suture insertion 2 faces the puncture needle for suture insertion 3 as shown in FIG. It is preferable that they are open. As the suture grasping needle 2, it has good even of conventional straight tube. Further, as shown in FIG. 1, a tip portion including a blade surface portion may be curved. With this configuration, the annular member 5 of the stylet 4 described later can be more surely extended in the direction of the suture insertion puncture needle. A suture grasping puncture needle hub 7 is attached to the rear end of the suture grasping puncture needle 2, and the open end of the hub 7 is configured to engage with a stylet hub 9 described later. Has been done. The hub 7 is made of vinyl chloride resin, polyolefin such as polypropylene and polyethylene, or synthetic resin such as polycarbonate. Further, the hub 7 is fixed to the fixing member 6, and as a result, the fixing member 6 fixes the proximal end portion of the suture thread grasping puncture needle 2. Therefore, the suture thread holding puncture needle is separated from the suture thread inserting puncture needle 3 by a predetermined distance and is substantially parallel. The distance between them is such that the suture thread fixes the anterior abdominal wall and the visceral wall, and is preferably about 5 mm to 30 mm. Within the above range, the anterior abdominal wall and the visceral wall can be sufficiently fixed, and the resistance when the two puncture needles are punctured does not become too large. Particularly preferably, 10 to 20
mm.
【００１３】固定部材６は、医療用器具１を穿刺する際
の把持部となる部分であり、図３に示すように、指をか
けることができる部分６ａ，６ａを有することが好まし
い。さらに、固定部材６は、その把持を容易なものとす
るために、図１および図２に示すように、平板状となっ
ていることが好ましい。固定部材６としては、合成樹脂
例えば、塩化ビニル樹脂、ポリプロピレン、ポリエチレ
ンなどのポリオレフィン、ポリカーボネートなどにより
形成される。The fixing member 6 is a portion that serves as a gripping portion when the medical instrument 1 is punctured, and as shown in FIG. 3, it is preferable that the fixing member 6 has portions 6a, 6a on which a finger can be placed. Further, as shown in FIGS. 1 and 2, it is preferable that the fixing member 6 has a flat plate shape so that the holding member 6 can be easily grasped. The fixing member 6 is made of synthetic resin such as vinyl chloride resin, polyolefin such as polypropylene and polyethylene, and polycarbonate.
【００１４】さらに、医療用器具１は、図１および図２
に示すように、縫合糸挿入用穿刺針３および縫合糸把持
用穿刺針２が、摺動可能に貫通された平板状部材10を有
していることが好ましい。このような平板状部材10を設
けることにより、穿刺時に縫合糸挿入用穿刺針３と縫合
糸把持用穿刺針２との距離が変化すること、具体的に
は、両者の距離が近くなることを防止することができ
る。また、摺動可能に形成すれば、穿刺時に、平板状部
材１０が穿刺作業を阻害することもない。平板状部材10
としては、例えば、下面が皮膚に刺激などを与えないよ
うな平坦面となっている円、または多角形の板状で、２
つの穿刺針を挿通する２つの孔を有するものが好適であ
る。Further, the medical device 1 is shown in FIGS.
As shown in, it is preferable that the suture thread inserting puncture needle 3 and the suture thread grasping puncture needle 2 have a flat plate-like member 10 penetrating slidably. By providing such a flat plate-like member 10, it is possible to change the distance between the puncture needle 3 for inserting the suture thread and the puncture needle 2 for grasping the suture thread during puncture, specifically, to reduce the distance between them. Can be prevented. Further, if it is formed so as to be slidable, the flat plate member 10 does not hinder the puncturing work during puncturing. Flat member 10
For example, a circular plate whose lower surface is a flat surface that does not irritate the skin, or a polygonal plate,
Those having two holes through which one puncture needle is inserted are preferable.
【００１５】スタイレット４は、図１および図２に示す
ように、縫合糸把持用穿刺針２の内径より小さい外径を
有する棒状部材１３と、この棒状部材１３の先端に固定
された環状部材５と、棒状部材１３の基端部に固定され
たスタイレットハブ９とを有している。そして、環状部
材５は、弾性材料により形成されており、縫合糸把持用
穿刺針２の先端より突出した状態では、図１および図２
に示すような、環状となり、突出させない状態では、図
４に示すように、変形し、ほぼ直線状となり縫合糸把持
用穿刺針２の内部に収納可能である。よって、スタイレ
ット４の棒状部材１３および環状部材５部分は、縫合糸
把持用穿刺針２の内部を摺動可能となっている。この実
施例のスタイレット４は、穿刺針２より抜去可能となっ
ている。また、スタイレット４は、少なくとも、環状部
材５を穿刺針２の内部に収納できることおよび穿刺針２
の先端より突出できるように摺動可能なものであれば、
必ずしも、穿刺針２より抜去可能でなくてもよい。そし
て、スタイレット４の環状部材５は、穿刺針２の先端よ
り突出した状態において、図１および図２に示すよう
に、縫合糸挿入用穿刺針３の中心軸またはその延長線
が、環状部材５の内部を貫通するように縫合糸挿入用穿
刺針３方向に延びるように形成されている。具体的に
は、図１に示すように、環状部材５は、棒状部材１３の
先端にある程度の角度をもって固定されており、さら
に、環状部材５は、側面から見た状態にて、中央部また
は中央部より若干先端側部分が底部となる湾曲形状とな
っていることが好ましい。このように形成することによ
り、縫合糸挿入用穿刺針３の中心軸またはその延長線
が、より確実に環状部材５の内部を貫通するようにな
る。さらに、環状部材５の先端部は、ほぼ先端を中心と
するＶ字またはＵ字状となっており、距離が狭くなった
縫合糸把持部１４を形成していることが好ましい。この
ような、縫合糸把持部１４を設けることにより、縫合糸
挿入用穿刺針３より突出する縫合糸１２をより確実に、
把持することができる。As shown in FIGS. 1 and 2, the stylet 4 has a rod-shaped member 13 having an outer diameter smaller than the inner diameter of the suture grasping puncture needle 2, and an annular member fixed to the tip of the rod-shaped member 13. 5 and a stylet hub 9 fixed to the base end of the rod-shaped member 13. The annular member 5 is made of an elastic material, and in a state of protruding from the distal end of the suture thread grasping puncture needle 2, the annular member 5 shown in FIGS.
As shown in FIG. 4, when it is in an annular shape and is not projected, it is deformed into a substantially linear shape and can be stored inside the suture thread puncturing needle 2 as shown in FIG. Therefore, the rod-shaped member 13 and the annular member 5 of the stylet 4 can slide inside the suture grasping puncture needle 2. The stylet 4 of this embodiment can be removed from the puncture needle 2. Further, the stylet 4 can store at least the annular member 5 inside the puncture needle 2 and the puncture needle 2
If it is slidable so that it can protrude from the tip of
It does not necessarily have to be removable from the puncture needle 2. In the state where the annular member 5 of the stylet 4 projects from the tip of the puncture needle 2, as shown in FIGS. 1 and 2, the central axis of the puncture needle 3 for suture insertion or its extension line is an annular member. 5 is formed to extend in the direction of the suture insertion puncture needle 3 so as to penetrate the inside of the needle. Specifically, as shown in FIG. 1, the annular member 5 is fixed to the tip of the rod-shaped member 13 at a certain angle, and the annular member 5 has a central portion or It is preferable to have a curved shape in which a part of the tip side from the center part is the bottom part. By forming in this way, the central axis of the puncture needle 3 for suture insertion or its extension line penetrates the inside of the annular member 5 more reliably. Further, it is preferable that the distal end portion of the annular member 5 is V-shaped or U-shaped with the distal end as the center, and the suture gripping portion 14 having a reduced distance is formed. By providing such a suture thread gripping portion 14, the suture thread 12 protruding from the suture thread insertion puncture needle 3 can be more reliably
Can be gripped.
【００１６】スタイレット４の棒状部材１３の形成材料
としては、金属（例えば、ステンレス、アモルファ
ス）、合成樹脂（例えば、ポリプロピレン、ポリエチレ
ンなどのポリオレフィン、ＰＴＦＥ，ＥＴＦＥなどのフ
ッ素樹脂）などが好適に使用できる。また、環状部材５
の形成材料としては、ステンレス鋼線（好ましくは、バ
ネ用高張力ステンレス鋼）、ピアノ線（好ましくは、ニ
ッケルメッキあるいはクロムメッキが施されたピアノ
線）、または超弾性合金線、例えば、Ｔｉ−Ｎｉ合金、
Ｃｕ−Ｚｎ合金、Cｕ−Ｚｎ−Ｘ合金（Ｘ＝Ｂｅ，Ｓ
ｉ，Ｓｎ，Ａｌ，Ｇａ）、Ｎｉ−Ａｌ合金等の弾性金線
が好適に使用される。また、スタイレットハブ９は、棒
状部材１３の基端部を把持するとともに、縫合糸把持用
穿刺針ハブ７と係合するように構成されている。さら
に、図１および図２に示すように、スタイレットハブ９
にリブ１６を設け、穿刺針ハブ７にこのリブ１６と係合
するスリット１７を設け、縫合糸把持用穿刺針２内に、
完全にスタイレット４を挿入した状態が確定されるよう
にすることが好ましい。このようにすることにより、ス
タイレット４の環状部材５が、確実に縫合糸挿入用穿刺
針３方向を向くようにすることができる。そして、スタ
イレットハブ７は、塩化ビニル樹脂、ポリプロピレン、
ポリエチレンなどのポリオレフィン、ポリカーボネート
などの合成樹脂より形成される。As a material for forming the rod-shaped member 13 of the stylet 4, metal (for example, stainless steel, amorphous), synthetic resin (for example, polyolefin such as polypropylene and polyethylene, fluororesin such as PTFE and ETFE) is preferably used. it can. In addition, the annular member 5
As a forming material of, a stainless steel wire (preferably high-tensile stainless steel for spring), a piano wire (preferably a nickel-plated or chrome-plated piano wire), or a superelastic alloy wire such as Ti- Ni alloy,
Cu-Zn alloy, Cu-Zn-X alloy (X = Be, S
i, Sn, Al, Ga), Ni—Al alloy, or other elastic gold wire is preferably used. The stylet hub 9 is configured to hold the proximal end portion of the rod-shaped member 13 and engage with the suture thread holding puncture needle hub 7. Further, as shown in FIGS. 1 and 2, the stylet hub 9
A rib 16 is provided on the puncture needle hub 7, and a slit 17 that engages with the rib 16 is provided on the puncture needle hub 7.
It is preferable that the state in which the stylet 4 is completely inserted is determined. By doing so, the annular member 5 of the stylet 4 can be reliably oriented toward the suture insertion puncture needle 3. The stylet hub 7 is made of vinyl chloride resin, polypropylene,
It is made of polyolefin such as polyethylene or synthetic resin such as polycarbonate.
【００１７】さらに、図１に示す実施例では、縫合糸挿
入用穿刺針３の中心軸の延長線が、環状部材５の内部を
貫通するよう構成されているが、環状部材５の縫合糸把
持用穿刺針２内部からの突出作業および収納作業を阻害
しないものであれば、縫合糸挿入用穿刺針３の中心軸、
言い換えれば、縫合糸挿入用穿刺針３の先端部そのもの
が、環状部材５が形成する環状空間を直接貫通するよう
に構成してもよい。Further, in the embodiment shown in FIG. 1, the extension line of the central axis of the puncture needle 3 for inserting the suture thread is configured to penetrate through the inside of the annular member 5, but the suture grasping of the annular member 5 is performed. The central axis of the puncture needle 3 for suture insertion, as long as it does not hinder the projecting work from the inside of the puncture needle 2 for storage and the storage work.
In other words, the distal end portion of the suture needle puncture needle 3 itself may be configured to directly penetrate the annular space formed by the annular member 5.
【００１８】次に、図５および図６に示す本発明の医療
用器具の実施例について説明する。この実施例の医療用
器具２０は、第１の縫合糸挿入用穿刺針３ａと、第１の
縫合糸挿入用穿刺針３ａより所定距離離間して、ほぼ平
行に設けられた第１の縫合糸把持用穿刺針２ａと、第１
の縫合糸把持用穿刺針２ａの内部に摺動可能に挿入され
た第１のスタイレット４ａと、第２の縫合糸挿入用穿刺
針３ｂと、第２の縫合糸挿入用穿刺針３ｂより所定距離
離間して、ほぼ平行に設けられた第２の縫合糸把持用穿
刺針２ｂと、第２の縫合糸把持用穿刺針２ｂの内部に摺
動可能に挿入された第２のスタイレット４ｂと、第１の
縫合糸挿入用穿刺針３ａ、第１の縫合糸把持用穿刺針２
ａ、第２の縫合糸挿入用穿刺針３ｂおよび第２の縫合糸
把持用穿刺針２ｂのそれぞれの基端部が、四角形の頂点
を形成するように固定する固定部材２６とからなり、第
１のスタイレット４ａは、先端に弾性材料により形成さ
れた第１の環状部材５ａを有しており、そして、この第
１の環状部材５ａは、第１の縫合糸把持用穿刺針２ａの
先端より突出させたとき、第１の縫合糸挿入用穿刺針３
ａの中心軸またはその延長線が、第１の環状部材５ａの
内部を貫通するように、第１の縫合糸挿入用穿刺針３ａ
方向に延び、さらに、第２のスタイレット４ｂは、先端
に弾性材料により形成された第２の環状部材５ｂを有し
ており、そして、この第２の環状部材５ｂは、第２の縫
合糸把持用穿刺針２ｂの先端より突出させたとき、第２
の縫合糸挿入用穿刺針３ｂの中心軸またはその延長線
が、第２の環状部材５ｂの内部を貫通するように、第２
の縫合糸挿入用穿刺針３ｂ方向に延びるように形成され
ている。Next, an embodiment of the medical device of the present invention shown in FIGS. 5 and 6 will be described. The medical device 20 of this embodiment has a first suture thread 3a for inserting a first suture thread and a first suture thread that is substantially parallel to the first puncture needle 3a for inserting a suture and is separated from the first puncture needle 3a for inserting a suture thread by a predetermined distance. A grasping puncture needle 2a, and a first
The first stylet 4a slidably inserted into the suture grasping puncture needle 2a, the second suture inserting puncture needle 3b, and the second suture inserting puncture needle 3b. A second puncture needle 2b for grasping a suture thread, which is spaced apart and provided substantially in parallel, and a second stylet 4b slidably inserted into the puncture needle 2b for grasping a second suture thread. , First suture insertion puncture needle 3a, first suture grasping puncture needle 2
a, a second suture insertion puncture needle 3b and a second suture grasping puncture needle 2b, each of which has a fixing member 26 for fixing the base end thereof so as to form a vertex of a quadrangle. The stylet 4a has a first annular member 5a formed of an elastic material at the tip, and the first annular member 5a is formed from the tip of the first suture grasping puncture needle 2a. When projected, the first puncture needle 3 for suture insertion
The first puncture needle 3a for suture insertion such that the central axis of a or its extension line penetrates the inside of the first annular member 5a.
The second stylet 4b has a second annular member 5b formed of an elastic material at the tip thereof, and the second annular member 5b has a second suture thread. When it is projected from the tip of the grasping puncture needle 2b, the second
The second axis so that the central axis of the puncture needle 3b for suture insertion or its extension line penetrates the inside of the second annular member 5b.
It is formed so as to extend in the direction of the suture insertion puncture needle 3b.
【００１９】この実施例の医療用器具２０と、上述の実
施例の医療用器具１との相違は、この医療用器具２０
が、それぞれ２つの縫合糸挿入用穿刺針３ａ，３ｂ、縫
合糸把持用穿刺針２ａ，２ｂ，スタイレット４ａ，４ｂ
を有していることであり、縫合糸把持用穿刺針、縫合糸
挿入用穿刺針およびスタイレットとしては、上述したも
のが好適に使用できる。そして、この医療用器具２０
は、２つの縫合糸挿入用穿刺針３ａ，３ｂおよび２つの
縫合糸把持用穿刺針２ａ，２ｂが、固定部材２６によ
り、一体に固定されている。そして、固定形態として
は、例えば、図６に示すように、第１の縫合糸挿入用穿
刺針３ａ、第１の縫合糸把持用穿刺針２ａ、第２の縫合
糸挿入用穿刺針３ｂおよび第２の縫合糸把持用穿刺針２
ｂのそれぞれの基端部が、四角形の頂点を形成する行わ
れている。言い換えれば、４つの穿刺針２ａ，２ｂ，３
ａ，３ｂが、四角柱の頂点を形成するように、それぞ
れ、固定部材２６の固定されている。The difference between the medical device 20 of this embodiment and the medical device 1 of the above-mentioned embodiment is that this medical device 20 is different.
Respectively, two suture insertion puncture needles 3a and 3b, suture grasping puncture needles 2a and 2b, and stylets 4a and 4b.
As described above, as the puncture needle for grasping the suture thread, the puncture needle for inserting the suture thread, and the stylet, those described above can be preferably used. And this medical device 20
The two suture thread insertion puncture needles 3 a and 3 b and the two suture thread holding puncture needles 2 a and 2 b are integrally fixed by a fixing member 26. As the fixing form, for example, as shown in FIG. 6, a first suture thread inserting puncture needle 3a, a first suture thread grasping puncture needle 2a, a second suture thread inserting puncture needle 3b and a Puncture needle 2 for grasping suture thread 2
Each proximal end of b is made to form a square apex. In other words, the four puncture needles 2a, 2b, 3
The fixing members 26 are fixed so that a and 3b form the vertices of a quadrangular prism.
【００２０】そして、第１の縫合糸挿入用穿刺針３ａと
第１の縫合糸把持用穿刺針２ａとの間の距離は、５ｍｍ
〜３０ｍｍ程度が好適である。また、第２の縫合糸挿入
用穿刺針３ｂと第２の縫合糸把持用穿刺針２ｂとの間の
距離は、１０ｍｍ〜２０ｍｍ程度が好適である。さら
に、第１の縫合糸挿入用穿刺針３ａと第２の縫合糸挿入
用穿刺針３ｂとの間の距離は、１０ｍｍ〜４０ｍｍ程度
が好適である。第１の縫合糸把持用穿刺針２ａと第２の
縫合糸把持用穿刺針２ｂとの間の距離は、１５ｍｍ〜３
０ｍｍ程度が好適である。また、４つの穿刺針の基端部
が取り囲む四角形、言い換えれば、医療用器具２０を穿
刺針の軸方向に直交する方向にて、切断したときの、４
つの穿刺針の切断面が取り囲む四角形、さらに、言い換
えれば、４つの穿刺針の先端が取り囲む四角形は、後述
するカテーテルの留置部となる部分であり、その面積と
しては、１５０〜４５０ｍｍ2程度であることが好まし
く、より、好ましくは、２００〜３００ｍｍ2程度であ
る。また、上記の四角形は、図６に示すような、正方形
に限らず、長方形、菱形、さらには、台形であってもよ
い。上記範囲内であれば、前腹壁と内臓壁との固定も十
分に行え、また、あまり範囲が広くないので、臓器運動
に支障をきたすこともない。The distance between the first suture thread inserting puncture needle 3a and the first suture thread grasping puncture needle 2a is 5 mm.
Approximately 30 mm is suitable. The distance between the second suture thread insertion puncture needle 3b and the second suture thread grasping puncture needle 2b is preferably about 10 mm to 20 mm. Furthermore, the distance between the first suture thread insertion puncture needle 3a and the second suture thread insertion puncture needle 3b is preferably about 10 mm to 40 mm. The distance between the first suture thread holding puncture needle 2a and the second suture thread holding puncture needle 2b is 15 mm to 3 mm.
About 0 mm is suitable. In addition, a quadrangle surrounded by the proximal ends of the four puncture needles, in other words, 4 when the medical device 20 is cut in a direction orthogonal to the axial direction of the puncture needles.
The quadrangle surrounded by the cut surfaces of the one puncture needle, in other words, the quadrangle surrounded by the tips of the four puncture needles is a portion to be an indwelling portion of a catheter described later, and its area is about 150 to 450 mm 2. It is preferably, and more preferably about 200 to 300 mm 2 . Further, the above quadrangle is not limited to a square as shown in FIG. 6, but may be a rectangle, a rhombus, or a trapezoid. Within the above range, the anterior abdominal wall and the visceral wall can be sufficiently fixed, and since the range is not so wide, there is no problem in organ movement.
【００２１】さらに、固定部材２６は、医療用器具２０
を穿刺する際の把持部となる部分であり、図６に示すよ
うに、指をかけることができる部分を有することが好ま
しい。さらに、固定部材２６は、その把持を容易なもの
とするために、図５に示すように、平板状となっている
ことが好ましい。固定部材６としては、合成樹脂例え
ば、塩化ビニル樹脂、ポリプロピレン、ポリエチレンな
どのポリオレフィン、ポリカーボネートなどにより形成
される。さらに、医療用器具２０は、図５に示すよう
に、４つの穿刺針２ａ，２ｂ，３ａ，３ｂが、摺動可能
に貫通された平板状部材２８を有していることが好まし
い。このような平板状部材２８を設けることにより、穿
刺時に４つの穿刺針の位置関係が変化すること、具体的
には、それぞれ穿刺針間の距離が変化すること（例え
ば、近接すること）を防止することができ、また、摺動
可能に形成すれば、穿刺時に、平板状部材が穿刺作業を
阻害することもない。平板状部材２８としては、例え
ば、下面が皮膚に刺激などを与えないような平坦面とな
っている円、または多角形の板状で、４つの穿刺針を挿
通する４つの孔を有するものが好適である。Further, the fixing member 26 is used for the medical device 20.
It is a portion that serves as a grip portion when puncturing, and as shown in FIG. 6, it is preferable to have a portion on which a finger can be placed. Further, the fixing member 26 preferably has a flat plate shape as shown in FIG. 5 in order to make the holding member easy to grip. The fixing member 6 is made of synthetic resin such as vinyl chloride resin, polyolefin such as polypropylene and polyethylene, and polycarbonate. Further, as shown in FIG. 5, the medical device 20 preferably has a flat plate-shaped member 28 through which the four puncture needles 2a, 2b, 3a, 3b are slidably penetrated. By providing such a flat plate-like member 28, it is possible to prevent the positional relationship between the four puncture needles from changing during puncture, specifically, the distance between the puncture needles to change (for example, to approach each other). Moreover, if it is formed so as to be slidable, the flat plate-shaped member does not hinder the puncturing operation during puncturing. The flat plate member 28 may be, for example, a circle whose lower surface is a flat surface that does not irritate the skin, or a polygonal plate having four holes through which four puncture needles are inserted. It is suitable.
【００２２】[0022]
【作用】 次に、本発明の医療用器具１の作用について、図１、図
４、図７ないし図１３を用いて、内視鏡的胃瘻造設術を
行う場合を例にとり説明する。 患者の胃内に、術者の一人が内視鏡を挿入し、さらに十
分に送気し、胃内に空気を充満させて、胃体部前壁を前
腹壁に密着させる。そして、もう一人の術者が、腹部皮
膚を消毒し、内視鏡からの透過光により胃の位置を確認
し、この部位の腹壁に局所麻酔を行う。そして、図４に
示すように、スタイレット４の環状部材５が、縫合糸把
持用穿刺針２の内部に収納され、また、縫合糸挿入用穿
刺針３の内部には、その先端より、縫合糸１２の端部が
突出しない状態に挿入された本発明の医療用器具１を準
備し、この医療用器具１を、図７に示すように、腹壁５
０に穿刺し、胃体部前壁５２より、胃内に縫合糸挿入用
穿刺針３および縫合糸把持用穿刺針２を突出させる。Operation Next, the operation of the medical device 1 of the present invention will be described with reference to FIGS. 1, 4, and 7 to 13 as an example of the case where an endoscopic gastrostomy is performed. One of the surgeons inserts an endoscope into the patient's stomach and further insufflates the air to fill the stomach with air and bring the anterior abdominal wall of the gastric body into close contact with the anterior abdominal wall. Then, another operator disinfects the abdominal skin, confirms the position of the stomach by the transmitted light from the endoscope, and performs local anesthesia on the abdominal wall of this site. Then, as shown in FIG. 4, the annular member 5 of the stylet 4 is stored inside the suture thread puncturing needle 2, and inside the suture thread inserting puncture needle 3, the suture is inserted from the tip thereof. The medical device 1 of the present invention inserted so that the ends of the threads 12 do not protrude is prepared, and the medical device 1 is abdominal wall 5 as shown in FIG.
Puncture to 0, and the puncture needle 3 for inserting the suture thread and the puncture needle 2 for grasping the suture thread are projected from the front wall 52 of the stomach body into the stomach.
【００２３】この状態を、内視鏡術者が確認したのち、
医療用器具術者は、図８に示すように、スタイレット４
を押し込み、スタイレットハブ９と縫合糸把持用穿刺針
ハブ７とを係合させ、縫合糸把持用穿刺針２の先端よ
り、スタイレット４の環状部材５を突出させる。続い
て、縫合糸１２を押し込み、縫合糸挿入用穿刺針３の先
端より突出させ、縫合糸１２が、環状部材５の内部を通
過したことを、内視鏡術者により確認する。この確認
後、図９に示すように、医療用器具術者が、スタイレッ
ト４を引き、環状部材５を縫合糸把持用穿刺針２の内部
に収納する。この操作により、環状部材５は、環状部材
５が形成する環状空間が、徐々に狭くなるとともに、形
状も徐々に長円形に変化し、縫合糸１２が、環状部材５
の縫合糸把持部１４により把持され、最終的には、図９
に示すように、環状部材５により把持された部分の縫合
糸１２は、環状部材５とともに、縫合糸把持用穿刺針２
の内部に収納される。この状態を内視鏡術者により確認
したのち、医療用器具術者は、患者より医療用器具１を
抜去する。この抜去により、図１０に示すように、縫合
糸挿入用穿刺針３より挿入された縫合糸１２の先端部
が、体外に露出する。そして、露出した縫合糸のそれぞ
れの端部を、図１１に示すように、結紮する。この結紮
により、胃体部前壁５２と前腹壁５０とが固定される。
さらに、この縫合糸による結紮部分と所定距離、例え
ば、２０〜３０ｍｍ程度離間した位置に、ほぼ平行に、
再び、医療用器具１を穿刺し、上述のように、縫合糸を
用いて、胃体部前壁と前腹壁とを固定する。この穿刺に
使用する医療用器具１としては、上述の穿刺に用いたも
のでもよく、また別に準備したものでもよい。After confirming this state by an endoscopist,
As shown in FIG. 8, the medical instrument operator uses the stylet 4
Is pushed in to engage the stylet hub 9 with the suture grasping puncture needle hub 7, and the annular member 5 of the stylet 4 is projected from the tip of the suture grasping puncture needle 2. Then, the suture thread 12 is pushed in and made to protrude from the tip of the puncture needle 3 for suture thread insertion, and it is confirmed by an endoscopist that the suture thread 12 has passed through the inside of the annular member 5. After this confirmation, as shown in FIG. 9, the medical instrument operator pulls the stylet 4 and stores the annular member 5 inside the suture grasping puncture needle 2. By this operation, the annular space of the annular member 5 is gradually narrowed and the shape of the annular member 5 is gradually changed to an ellipse.
9 is finally grasped by the suture grasping portion 14 of FIG.
As shown in FIG. 3, the suture thread 12 in the portion grasped by the annular member 5 is, together with the annular member 5, the suture grasping puncture needle 2
It is stored inside. After confirming this state by the endoscopist, the medical instrument operator removes the medical instrument 1 from the patient. By this removal, as shown in FIG. 10, the tip of the suture thread 12 inserted from the suture thread insertion puncture needle 3 is exposed outside the body. Then, each end of the exposed suture thread is ligated as shown in FIG. By this ligation, the front wall 52 of the stomach body and the front abdominal wall 50 are fixed.
Furthermore, substantially parallel to a position distant from the ligated portion by the suture at a predetermined distance, for example, about 20 to 30 mm,
Again, the medical instrument 1 is punctured and, as described above, the front wall of the stomach body and the front abdominal wall are fixed using the suture thread. The medical instrument 1 used for this puncture may be the one used for the above-mentioned puncture, or may be one prepared separately.
【００２４】このようにして、形成された２つの結紮部
位のほぼ中央に、図１２に示すように、先端に刃面を有
する金属針４１と、この金属針４１を内部に挿通した軸
方向に破断可能な樹脂製チューブ４２とからなる穿刺器
具４０を穿刺し、金属針４１を抜去した後、図１３に示
すように、チューブ４２の内部にバルーンカテーテル４
３を挿入する。そして、バルーンカテーテル４３のバル
ーン部分を含む先端部が、胃内に到達したことを、内視
鏡術者により確認した後、蒸留水などによりバルーンを
膨張させるとともに、チューブ４２の基端部を外側に２
方向より引っ張り、チューブ４２を軸方向に破断させ
て、患者より除去する。そして、バルーンカテーテル４
３を基端側に引っ張り、膨張したバルーン部分を胃体部
前壁に密接させ、さらに、皮膚表面より露出する部分の
バルーンカテーテルに適度な固定具をあて縫合し、バル
ーンカテーテルを前腹壁固定する。以上により、内視鏡
的胃瘻造設術が完了する。As shown in FIG. 12, a metal needle 41 having a blade surface at its tip and an axial direction through which the metal needle 41 is inserted are provided at approximately the centers of the two ligated portions thus formed. After puncturing the puncture device 40 including the rupturable resin tube 42 and removing the metal needle 41, the balloon catheter 4 is inserted inside the tube 42 as shown in FIG.
Insert 3. Then, after confirming by the endoscopist that the distal end portion including the balloon portion of the balloon catheter 43 has reached the stomach, the balloon is inflated with distilled water and the proximal end portion of the tube 42 is placed outside. To 2
Direction, the tube 42 is axially broken and removed from the patient. And the balloon catheter 4
3 is pulled to the proximal end side, the inflated balloon part is brought into close contact with the anterior wall of the stomach body, and an appropriate fixing tool is sutured to the balloon catheter in the part exposed from the skin surface to fix the balloon catheter to the anterior abdominal wall. . With the above, the endoscopic gastrostomy operation is completed.
【００２５】また、上記説明では、医療用器具１を用い
た場合について説明したが、図５に示した医療用器具２
０を用いた場合も作業としては、医療用器具の穿刺が１
回となる以外は、ほぼ同様である。In the above description, the case where the medical device 1 is used has been described, but the medical device 2 shown in FIG. 5 is used.
Even if 0 is used, the puncture of the medical device is 1
It is almost the same except that it becomes a time.
【００２６】[0026]
本発明の医療用器具は、縫合糸挿入用穿刺針と、該縫合
糸挿入用穿刺針より所定距離離間して、ほぼ平行に設け
られた縫合糸把持用穿刺針と、該縫合糸把持用穿刺針の
内部に摺動可能に挿入されたスタイレットと、前記縫合
糸挿入用穿刺針および前記縫合糸把持用穿刺針の基端部
が固定された固定部材とからなり、前記スタイレット
は、先端に弾性材料により形成され、前記縫合糸把持用
穿刺針の内部に収納可能な環状部材を有しており、さら
に、該環状部材は、前記縫合糸把持用穿刺針の先端より
突出させたとき、前記縫合糸挿入用穿刺針の中心軸また
はその延長線が、該環状部材の内部を貫通するように該
縫合糸挿入用穿刺針方向に延びるものであるので、この
医療用器具を用いることにより、前腹壁と内臓壁、例え
ば、前腹壁と胃体部前壁とを容易、かつ短時間に、さら
に安全かつ確実に固定することができ、この固定にとも
なう患者への侵襲も、穿刺針の穿刺という極めて少ない
ものであり、患者に与える負担も少ない。The medical device of the present invention includes a puncture needle for inserting a suture thread, a puncture needle for holding a suture thread, which is provided substantially in parallel with the puncture needle for inserting a suture thread and is separated by a predetermined distance from the puncture needle for inserting a suture thread. A stylet slidably inserted inside the needle, a suture insertion puncture needle, and a fixing member to which a proximal end portion of the suture grasping puncture needle is fixed. The tip is made of elastic material at the tip and is used for holding the suture
Inside of the puncture needle has a retractable annular member, further
In addition, when the annular member is projected from the tip of the suture thread grasping puncture needle, the suture is formed so that the central axis of the suture thread inserting puncture needle or an extension thereof penetrates the inside of the annular member. Since it extends in the direction of the puncture needle for thread insertion, by using this medical device, the anterior abdominal wall and the visceral wall, for example, the anterior abdominal wall and the anterior wall of the stomach body part, can be easily and quickly further safely and It can be securely fixed, and the invasion of the patient due to this fixation is extremely small, such as puncturing with a puncture needle, and the burden on the patient is also small.
【００２７】また、本発明の医療用器具は、第１の縫合
糸挿入用穿刺針と、該第１の縫合糸挿入用穿刺針より所
定距離離間して、ほぼ平行に設けられた第１の縫合糸把
持用穿刺針と、該第１の縫合糸把持用穿刺針内部に摺動
可能に挿入された第１のスタイレットと、第２の縫合糸
挿入用穿刺針と、該第２の縫合糸挿入用穿刺針より所定
距離離間して、ほぼ平行に設けられた第２の縫合糸把持
用穿刺針と、該第２の縫合糸把持用穿刺針内部に摺動可
能に挿入された第１のスタイレットと、前記第１の縫合
糸挿入用穿刺針、前記第１の縫合糸把持用穿刺針、前記
第２の縫合糸挿入用穿刺針および前記第２の縫合糸把持
用穿刺針のそれぞれの基端部が、四角形の頂点を形成す
るように固定する固定部材とからなり、前記第１のスタ
イレットは、先端に弾性材料により形成された環状部材
を有しており、そして、該環状部材は、前記第１の縫合
糸把持用穿刺針の先端より突出させたとき、前記第１の
縫合糸挿入用穿刺針の中心軸またはその延長線が、該環
状部材の内部を貫通するように該第１の縫合糸挿入用穿
刺針方向に延び、さらに、前記第２のスタイレットは、
先端に弾性材料により形成された環状部材を有してお
り、そして、該環状部材は、前記第２の縫合糸把持用穿
刺針の先端より突出させたとき、前記第２の縫合糸挿入
用穿刺針の中心軸またはその延長線が、該環状部材の内
部を貫通するように該第２の縫合糸挿入用穿刺針方向に
延びるものであるので、この医療用器具を用いることに
より、前腹壁と内臓壁、例えば、前腹壁と胃体部前壁と
を容易、かつ短時間に、安全かつ確実に固定することが
でき、この固定にともなう患者への侵襲も、この医療用
器具の１回の穿刺という極めて少ないものであり、患者
に与える負担も少ない。Further, the medical device of the present invention is provided with the first suture thread insertion puncture needle and the first suture thread insertion puncture needle which are spaced apart from the first suture thread insertion puncture needle by a predetermined distance and are substantially parallel to each other. Suture holding puncture needle, first stylet slidably inserted inside the first suture holding puncture needle, second suture insertion puncture needle, and second suture A second puncture needle for grasping a suture thread, which is provided substantially in parallel with the puncture needle for inserting a thread, and a first slidably inserted inside the second puncture needle for grasping a suture thread. And a first suture thread inserting puncture needle, the first suture thread grasping puncture needle, the second suture thread inserting puncture needle, and the second suture thread grasping puncture needle The base end portion of the first stylet comprises a fixing member for fixing to form a rectangular vertex. An annular member formed of an elastic material; and when the annular member is projected from the tip of the first suture thread grasping puncture needle, the first suture thread inserting puncture needle The central axis or its extension extends in the direction of the first suture insertion puncture needle so as to penetrate the inside of the annular member, and further, the second stylet is
The distal end has an annular member formed of an elastic material, and when the annular member is projected from the distal end of the second suture thread grasping puncture needle, the second suture thread inserting puncture needle is inserted. Since the central axis of the needle or its extension line extends in the direction of the second suture insertion puncture needle so as to penetrate the inside of the annular member, by using this medical device, The visceral wall, for example, the anterior abdominal wall and the anterior wall of the body of the stomach can be easily and safely fixed in a short time, and the invasion of the patient associated with the fixation can be achieved even when the medical device is used once. Puncture is extremely small, and the burden on the patient is also small.
【図１】本発明の医療用器具の実施例の断面図である。FIG. 1 is a sectional view of an embodiment of a medical device of the present invention.
【図２】図１に示した医療用器具の側面図である。2 is a side view of the medical device shown in FIG. 1. FIG.
【図３】図１のＡ−Ａ線断面図である。3 is a cross-sectional view taken along the line AA of FIG.
【図４】スタイレットの先端部の環状部材が、突出して
いない状態の本発明の医療用器具の実施例の断面図であ
る。FIG. 4 is a cross-sectional view of an embodiment of the medical device of the present invention in which the annular member at the tip portion of the stylet is not protruding.
【図５】本発明の医療用器具の他の実施例の側面図であ
る。FIG. 5 is a side view of another embodiment of the medical device according to the present invention.
【図６】図５に示した医療用器具の上面図である。6 is a top view of the medical device shown in FIG.
【図７】本発明の医療用器具の作用を説明するための説
明図である。FIG. 7 is an explanatory diagram for explaining the action of the medical device of the present invention.
【図８】本発明の医療用器具の作用を説明するための説
明図である。FIG. 8 is an explanatory diagram for explaining the action of the medical device of the present invention.
【図９】本発明の医療用器具の作用を説明するための説
明図である。FIG. 9 is an explanatory diagram for explaining the action of the medical device of the present invention.
【図１０】本発明の医療用器具の作用を説明するための
説明図である。FIG. 10 is an explanatory diagram for explaining the action of the medical device of the present invention.
【図１１】本発明の医療用器具の作用を説明するための
説明図である。FIG. 11 is an explanatory diagram for explaining the action of the medical device of the present invention.
【図１２】本発明の医療用器具の作用を説明するための
説明図である。FIG. 12 is an explanatory diagram for explaining the action of the medical device of the present invention.
【図１３】本発明の医療用器具の作用を説明するための
説明図である。FIG. 13 is an explanatory diagram for explaining the action of the medical device of the present invention.
１ 医療用器具 ２０ 医療用器具 ２ 縫合糸把持用穿刺針 ２ａ 縫合糸把持用穿刺針 ２ｂ 縫合糸把持用穿刺針 ３ 縫合糸挿入用穿刺針 ３ａ 縫合糸挿入用穿刺針 ３ｂ 縫合糸挿入用穿刺針 ４ スタイレット ４ａ スタイレット ４ｂ スタイレット ５ 環状部材 ５ａ 環状部材 ５ｂ 環状部材 ６ 固定部材 ２６ 固定部材 DESCRIPTION OF SYMBOLS 1 Medical device 20 Medical device 2 Suture grasping puncture needle 2a Suture grasping puncture needle 2b Suture grasping puncture needle 3 Suture inserting puncture needle 3a Suture inserting puncture needle 3b Suture inserting puncture needle 4 stylet 4a stylet 4b stylet 5 annular member 5a annular member 5b annular member 6 fixing member 26 fixing member
Claims (7)
穿刺針より所定距離離間して、ほぼ平行に設けられた縫
合糸把持用穿刺針と、該縫合糸把持用穿刺針の内部に摺
動可能に挿入されたスタイレットと、前記縫合糸挿入用
穿刺針および前記縫合糸把持用穿刺針の基端部が固定さ
れた固定部材とからなり、前記スタイレットは、先端に
弾性材料により形成され、前記縫合糸把持用穿刺針の内
部に収納可能な環状部材を有しており、さらに、該環状
部材は、前記縫合糸把持用穿刺針の先端より突出させた
とき、前記縫合糸挿入用穿刺針の中心軸またはその延長
線が、該環状部材の内部を貫通するように該縫合糸挿入
用穿刺針方向に延びることを特徴とする医療用器具。1. A puncture needle for inserting a suture thread, a puncture needle for gripping a suture thread, which is provided substantially in parallel with a predetermined distance from the puncture needle for inserting a suture thread, and the inside of the puncture needle for gripping a suture thread. A slidably inserted stylet, a suture insertion puncture needle and a fixing member to which a proximal end of the suture grasping puncture needle is fixed. The stylet has an elastic material at its tip. Of the puncture needle for grasping the suture thread
Department has a retractable annular member, further annular member which, when allowed to protrude from the distal end of the suture grasping needle, the central axis or an extension thereof of the suture insertion needle A medical instrument characterized by extending in the direction of the puncture needle for suture insertion so as to penetrate the inside of the annular member.
縫合糸挿入用穿刺針より所定距離離間して、ほぼ平行に
設けられた第１の縫合糸把持用穿刺針と、該第１の縫合
糸把持用穿刺針の内部に摺動可能に挿入された第１のス
タイレットと、第２の縫合糸挿入用穿刺針と、該第２の
縫合糸挿入用穿刺針より所定距離離間して、ほぼ平行に
設けられた第２の縫合糸把持用穿刺針と、該第２の縫合
糸把持用穿刺針の内部に摺動可能に挿入された第２のス
タイレットと、前記第１の縫合糸挿入用穿刺針、前記第
１の縫合糸把持用穿刺針、前記第２の縫合糸挿入用穿刺
針および前記第２の縫合糸把持用穿刺針のそれぞれの基
端部が、四角形の頂点を形成するように固定する固定部
材とからなり、前記第１のスタイレットは、先端に弾性
材料により形成され、前記第１の縫合糸把持用穿刺針の
内部に収納可能な第１の環状部材を有しており、そし
て、該第１の環状部材は、前記第１の縫合糸把持用穿刺
針の先端より突出させたとき、前記第１の縫合糸挿入用
穿刺針の中心軸またはその延長線が、該第１の環状部材
の内部を貫通するように該第１の縫合糸挿入用穿刺針方
向に延び、さらに、前記第２のスタイレットは、先端に
弾性材料により形成され、前記第２の縫合糸把持用穿刺
針の内部に収納可能な第２の環状部材を有しており、そ
して、該第２の環状部材は、前記第２の縫合糸把持用穿
刺針の先端より突出させたとき、前記第２の縫合糸挿入
用穿刺針の中心軸またはその延長線が、該第２の環状部
材の内部を貫通するように該第２の縫合糸挿入用穿刺針
方向に延びることを特徴とする医療用器具。2. A puncture needle for inserting a first suture thread, and a first puncture needle for holding a suture thread, which is provided in parallel with a predetermined distance from the puncture needle for inserting a suture thread. A first stylet slidably inserted inside the first suture grasping puncture needle, a second suture inserting puncture needle, and a second suture inserting puncture needle distance apart, and a second suture grasping needle provided substantially in parallel, and a second stylet slidably inserted into the interior of the suture grasping needle the second, the The respective proximal end portions of the first suture insertion puncture needle, the first suture grasping puncture needle, the second suture insertion puncture needle, and the second suture grasping puncture needle, The first stylet is formed of an elastic material at the tip. Of the first suture grasping needle
It has a first annular member that can be stored inside , and when the first annular member is projected from the distal end of the first suture thread holding puncture needle, the first suture thread is provided. The central axis of the insertion puncture needle or its extension extends in the direction of the first suture insertion puncture needle so as to penetrate the inside of the first annular member, and the second stylet further comprises: The second suture grasping puncture formed at the tip by an elastic material
A second annular member that can be housed inside the needle , and the second annular member, when projected from the tip of the second suture thread grasping needle, is the second annular member; A medical instrument, wherein the central axis of the puncture needle for suture insertion or an extension thereof extends in the direction of the second puncture needle for suture insertion so as to penetrate the inside of the second annular member.
刺針および前記縫合糸把持用穿刺針が、摺動可能に貫通
された平板状部材を有している請求項１に記載の医療用
器具。3. The medical device according to claim 1, wherein the medical device has a flat plate-like member through which the suture thread insertion puncture needle and the suture thread grasping puncture needle are slidably penetrated. Equipment.
入用穿刺針、前記第１の縫合糸把持用穿刺針、前記第２
の縫合糸挿入用穿刺針および前記第２の縫合糸把持用穿
刺針が、摺動可能に貫通された平板状部材を有している
請求項２に記載の医療用器具。4. The medical device includes the first suture thread insertion puncture needle, the first suture thread grasping puncture needle, and the second suture thread puncture needle.
The medical device according to claim 2, wherein the suture thread inserting puncture needle and the second suture thread grasping puncture needle each have a flat plate-like member slidably penetrated therethrough.
求項１または２に記載の医療用器具。5. The medical device according to claim 1, wherein the fixing member has a flat plate shape.
は、前記縫合糸挿入用穿刺針方向に向かって開口してい
る請求項１ないし５のいずれかに記載の医療用器具。6. The medical device according to claim 1, wherein a blade surface at a tip of the puncture needle for grasping a suture thread is opened toward a puncture needle for inserting a suture thread.
心とするＶ字状、またはＵ字状の縫合糸把持部を有してWith V-shaped or U-shaped suture grips
いる請求項１ないし６のいずれかに記載の医療用器具。7. The medical device according to any one of claims 1 to 6.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2416573A JPH0624533B2 (en) | 1990-12-29 | 1990-12-29 | Medical instruments |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2416573A JPH0624533B2 (en) | 1990-12-29 | 1990-12-29 | Medical instruments |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH04226643A JPH04226643A (en) | 1992-08-17 |
| JPH0624533B2 true JPH0624533B2 (en) | 1994-04-06 |
Family
ID=18524790
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP2416573A Expired - Lifetime JPH0624533B2 (en) | 1990-12-29 | 1990-12-29 | Medical instruments |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JPH0624533B2 (en) |
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| JPH04226643A (en) | 1992-08-17 |
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