JPH09224945A - Suturing/ligating tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To easily and firmly suture or ligate living organs and to simplify and miniaturize a suturing/ligating device structurally so that it can be reduced in diameter. SOLUTION: A clip 1 made of a metal or resin comprises a pair of legs 2 and a connection 3 connecting the legs 2 together, the gripping face 4 of each leg 2 being made uneven. The legs 2 of the clip 1 cross each other inside a suturing/ligating device, are spaced apart when rejected out of the suturing/ ligating device, and are closed because of elasticity after being rejected, thereby sewing or ligating a living organ.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention is mainly used in surgery and is used for suturing and ligating living tissues.
Regarding a ligature.

[0002]

2. Description of the Related Art Conventionally, as a method for ligating a blood vessel, particularly a blood vessel by a surgical operation, etc.
Particularly in endoscopic surgery, due to streamlining of the procedure and its easiness, a clip applier (suturing / ligating device) of a continuous type such as USP 5,171,249 is currently used as a clip (suture / ligating device). By mainly attaching a clip made of a titanium-based metal material.

Such a clip is opened in the initial state, and is plastically deformed into a closed state by the above-mentioned applier to ligate the blood vessel. However, in such a clip applier, since the clip is opened in the initial state, the mounting means and the insertion portion are generally φ10 mm or more in view of storing the clip, In endoscopic surgery, other treatment tools are φ5.
The thickness is more than twice as large as that of mm, which is one of the problems in the current surgical operation requiring less invasiveness.

Further, such a clip applier transfers a clip from a storage means to a mounting means,
Since the structure is such that it can be deformed by the attachment means, the structure is complicated, and the price, which is generally disposable, is quite expensive, which is one of the causes of the soaring medical cost.

As a solution to the above problems, US
As described in P4, 367, 746 and Japanese Patent Laid-Open No. 6-237939, it is composed of a pair of leg portions and a connecting portion that connects the pair of leg portions, and the pair of leg portions are biased in a closed leg state. Some clips were used to continuously close tubular tissue by using a relatively simple structure of applier that utilizes the elasticity of the existing clips. There is no such thing, and a gripping force by elastic force is generally generated only after sandwiching something with a certain thickness, and the ligation force for particularly thin tissues is weak compared to the above plastically deformed one,
There was also a concern about falling out.

In brain surgery and the like, elastic clips and appliers such as USP 4,602,631 have been used especially for ligation of aneurysms, but this clip has a special shape and size as compared with those described above. It is very large and very expensive, and uses a single-shot applier to achieve the efficiency of the hand branch in the above-mentioned surgical operation, and has a purpose different from that used many times.

[0007]

However, in the above-mentioned USP 5,171,249, since the clip is opened in the initial state, the attachment means and the insertion portion are thick because the clip is stored. And
It is unsuitable for current surgical procedures that require less invasiveness. Further, since such a clip applier has a structure in which a clip is deformed by a mounting means, its structure is complicated, and its price, which is generally disposable, is quite expensive, and medical It was also one of the causes of soaring costs.

The clip shown in USP 4, 367, 746 and Japanese Patent Laid-Open No. 6-237939 has almost no gripping force in its initial shape because of its structure, and grips by elastic force only after sandwiching something thick. It is common that a force is generated, and the ligation force for a particularly thin tissue is weaker than that of the above plastically deformed one, and there is a concern that it may fall off.

USP 4,602,631 has a special shape and a large size clip as compared with the above-mentioned one and is very expensive, and is used in the above-mentioned surgical operation such as using a single-shot applier. It was used for a different purpose.

The present invention has been made in view of the above circumstances, and an object thereof is to suture and ligate an ecological tissue reliably, yet structurally simple and cost effective. -To provide a ligature.

[0011]

In order to achieve the above-mentioned object, the present invention provides a suture / ligature tool for suturing / ligating living tissue, wherein a pair of leg parts are connected to the leg parts. The leg portion intersects inside the suturing and ligating device, and the leg portion opens when released from the suturing and ligating device, and when released, elastically closes the biological tissue. Characterized by suturing and ligating.

[0012]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings. 1 to 4 show a first embodiment. Reference numeral 1 in the figure shows a clip as a suture / ligature tool for ligating a living tissue, particularly a blood vessel such as a blood vessel. The clip 1 is a metal material, particularly a non-magnetic titanium metal or a bioabsorbable resin material. It is manufactured from a pair of legs 2 and a connecting part 3 connecting the legs 2.

The clip 1 has a shape as shown in the development view of FIG. 4 at the material stage, and when it is made of a metal material, it is punched by a press, and when it is made of a resin material, it is injection-molded. Molded by. At this time, the gripping surface 4 on which the clip 1 comes into contact with and grips the living tissue is formed with irregularities, which prevents the clip 1 and the living tissue from slipping. It should be noted that the irregularities may be formed by, for example, a matte surface by sandblasting, grooves as described above at the time of press molding or injection molding, and any shape that increases friction between the clip 1 and living tissue.

In this embodiment, the shape shown in FIG. 1 is used as an initial shape, and the clip applier used as it is is loaded and elastically deformed by the clip applier in the order of FIGS. 1 to 3 to be attached to a living tissue. .
At this time, as shown in the development view of FIG.
Since the leg portions 2 are formed, it is easy to release the twist between the leg portions 2 and it is easy to release the intersecting state of the leg portions 2 when the leg portions 2 are deformed with respect to FIGS. 1 and 2.

With the above-mentioned structure, the ligating force can be enhanced as compared with the conventional elastic clip. As described above, the material, structure and shape of the elastic clip are not particularly limited as long as they are in accordance with the object of the present invention to enhance the ligation force in the initial shape of the elastic clip. Absent.

5 to 8 show a second embodiment. The molding method and material of the clip are substantially the same as those in the first embodiment. In the figure, reference numeral 1 denotes a clip as a suture / ligature tool for ligating a living tissue, particularly a blood vessel such as a blood vessel, and is composed of a pair of leg portions 2 and a connecting portion 3 connecting the leg portions 2. .

The clip 1 has a shape as shown in the development view of FIG. 8 at the material stage, and when it is made of a metal material, it is punched by a press, and when it is made of a resin material, it is injection-molded. Molded by. At this time, the gripping surface 4 on which the clip 1 comes into contact with and grips the living tissue is formed with irregularities, which prevents the clip 1 and the living tissue from slipping. It should be noted that the irregularities may be formed by, for example, a matte surface by sandblasting, grooves as described above at the time of press molding or injection molding, and any shape that increases friction between the clip 1 and living tissue.

The connecting portion 3 is formed so that its width is narrower than that of the leg portion 2, and the leg portion 2 is formed by, for example, a guide of a clip applier as a suturing / ligating device to be described later for attaching the clip 1. The connecting portion 3 does not interfere when opening and closing.

The clip 1 is molded as shown in the development view of FIG. 8 and then plastically deformed as shown in FIG. At this time, the legs 2 are formed by slightly twisting them so that the legs 2 are crossed and opened.

Next, in order to obtain the shape shown in FIG.
Remove the crosses and twists of. Then, when the leg portion 2 is released, the leg portion 2 has a shape shown in FIG. 7 due to its elastic force, and an effective gripping force is given to the initial shape at the time of use as shown in FIG. 7 by the series of manufacturing methods. You can

That is, since the elastic clip of the prior art was formed by plastic deformation into the shape of FIG. 7 from the beginning,
When the initial shape, that is, when ligating a living tissue that is thin, soft, and easily crushed, there is a risk that the clip 1 may fall off without obtaining an effective ligation force, but in the present embodiment, as shown in FIG. Since the initial shape is already elastically deformed from the original initial shape as shown in FIG. 6, an effective elastic force has already acted on the leg 2 in the initial shape during actual use shown in FIG. Therefore, an effective ligation force acts even on a thin object or a soft and easily crushable tissue, so that there is no risk of the clip 1 falling off.

As described above, the material, structure, and shape are not particularly limited as long as the object of the present invention is to increase the ligation force in the initial shape of the clip having elastic force. Anything will do.

FIG. 9 shows a third embodiment. Clip 1
Although the structure and the material are the same as those of the first embodiment, the opening width of the leg portion 2 is the same as the height h of the connecting portion 3 in the initial shape. The wider the open width of the leg 2, the stronger the ligation force with respect to the living tissue, but if it is too wide, the merit of the clip 1 that can be made smaller than the conventional plastic deformation clip is impaired. Therefore, by setting the height to be substantially the same as the height h of the connecting portion 3, both securing the ligation force and reducing the size of the clip 1 are achieved.

As described above, the material, structure and shape are not particularly limited as long as the object of the present invention is to secure both the ligation force and the size reduction of the clip. Anything is fine.

FIG. 10 shows a fourth embodiment. The basic structure and material of the clip 1 are the same as those of the first embodiment, but in the present embodiment, the clip 1 has three legs 2.
One opposite is formed in the middle of the two formed on one side. In addition, an engaging claw 7 is formed on the leg portion 2 and is used for engaging with a clip applier.

In the present embodiment, since the facing surfaces of the facing leg portions 2 do not contact each other, the facing leg portions 2 intersect as shown in FIG. 10 in the initial shape during actual use. Can be molded as described above. Therefore, there is an effect that the ligation force is increased as in the second embodiment and the like.

As described above, the material, structure and shape of the clip having elastic force, which is the object of the present invention, is not particularly limited as long as the ligation force in the initial shape is increased. It doesn't matter.

FIG. 11 shows a fifth embodiment. The basic configuration, material, etc. of the clip 1 are the same as those of the first embodiment, but the widths of the leg portion 2 and the connecting portion 3 are the same,
The leg portion 2 is formed with an engaging claw 7 which is partially wider than the width of the connecting portion 3 and is used for engagement with a clip applier for attaching the clip 1. The operation and effect of this embodiment are similar to those of the above-described embodiments such as the second embodiment.

As described above, the material, structure, and shape are not particularly limited as long as the object of the present invention is to increase the ligation force in the initial shape of the clip having elastic force. Anything will do.

12 to 24 show a sixth embodiment.
FIG. 12 shows the overall structure of the clip applier 8 for attaching the clip 1 shown in the third to fifth embodiments to the living tissue 24 (see FIG. 14).
It comprises an attaching means 9 for attaching the clip 1 to the body, an inserting portion 12 for approaching the living means to the attaching means 9, and an operating means 13 for operating the clip applier 8.

The attaching means 9 is composed of a fixed jaw 11 fixed to the insertion portion 12 and a movable jaw 10 which can be opened and closed with respect to the fixed jaw 11, and by opening and closing the movable jaw 10, the target biological tissue 24 is obtained. It can be held.

A rotating ring 1 is provided on the proximal side of the insertion portion 12.
4 is provided, and by rotating the rotating ring 14, the insertion portion 12 can be rotated with respect to the operating means 13 about the axial direction thereof.

The operating means 13 includes a fixed handle 16 and a movable handle 1 which can be opened and closed with respect to the fixed handle 16.
5, the clip 1 can be attached to the living tissue 24 by closing the movable handle 15.

13 to 17 show the internal structure of the attachment means 9 and the storage means 29. As shown in FIGS. 13 and 14, a fixed jaw 11 and a movable jaw 10 are provided at the tip of the attachment means 9, and an operation rod 20 is connected to the rear end of the movable jaw 10. The operating rod 20 is interlocked with the movable handle 15 of the operating means 13, and the movable jaw 10 is opened and closed by opening and closing the movable handle 15.

As shown in FIG. 16, the movable jaw 10 and the fixed jaw 11 are internally provided with a space through which the clip 1 can pass, and the space for engaging the leg portion 2 of the clip 1 is provided. Guide 32 is provided.

At the rear end of the attaching means 9, a guide 17 for releasing the crossing of the leg portion 2 of the clip 1 is provided inside the insertion portion 12, and as shown in FIG.
By passing through here, the intersection of the leg portions 2 is released.

Further, the inserter 12 is provided with a pusher 19 for feeding out the clips 1 one by one, and by operating the movable handle 15, the clip 1 stored at the leading end of the clips 1 stored in the storage means 29 is pushed. It is designed to be sent out in order.

The storage means 29 is provided inside the insertion portion 12, and the rear end of the storage means 29 has the rearmost clip 1 fixed to the insertion portion 12 as shown in FIG.
The clip 1 stored in the storage means 29 in a permuted state is urged by the buffer 21 urged in the tip direction by the coil spring 22 attached to the tip end 3 to urge the rearmost clip 1 in the tip direction. Is urged toward the tip.

Next, the operation of this embodiment will be described with reference to FIGS.
It shows in FIG. First, the initial state is the state shown in FIG. 18, and in this state, the pusher 19 is located behind the frontmost clip 1. At this time, the operating means 13 is as shown in FIG. 22, the movable handle 15 is open to the fixed handle 16, and the pusher 1
9. The movable jaw 10 is open to the fixed jaw 11 with the operating rod 20 being pulled backward by the coil springs 25 and 26.

The coil springs 25 and 26 are set such that the coil spring 25 has a larger spring constant.
The coil spring 25 will not be compressed unless it is completely compressed.

Next, the movable handle 15 is moved slightly in the closing direction to bring it to the state shown in FIG. At this time, the attaching means 9 is as shown in FIG. 18, and the operating rod 20 is the spring holder 2
When 8 is driven by the movable handle 15, the coil spring 26 is compressed and moves forward. As a result, the movable jaw 10 is closed with respect to the fixed jaw 11, and the living tissue 24, which is previously positioned between the movable jaw 10 and the fixed jaw 11, can be grasped.

Further, by operating the movable handle 15 in the closing direction, the coil spring 26 is completely compressed. When the movable handle 15 is further operated in the closing direction, the coil spring 25 subsequently begins to be compressed. This causes the pressure 19 to move forward and push the clip 1 into the guide 17 as shown in FIG. At this time, the guide 17 releases the intersection of the legs 2 of the clip 1. Then, by continuing this operation, the clip 1 is moved by the pusher 19 so that the clip 32 is guided by the movable jaw 10 and the fixed jaw 11.
Engages. Then, the leg 2 is opened by the guide 32, and the clip 1 is attached to the living tissue 24. When the pusher 19 further moves forward, the clip 1 passes through the movable jaw 10 and the fixed jaw 11 and is released while the living tissue 24 is ligated, and the ligation of the living tissue 24 is completed.

At this time, the operating means 13 is as shown in FIG. 24, and since the operating rod 20 cannot move forward any more after the movable jaw 10 is completely closed, it elastically bends itself, The driving force of the movable handle 15 is absorbed. Further, since the gripping force is increased by the elastic force by this mechanism, the living tissue 24 can be reliably gripped, so that the reliable ligation can be performed.

When the ligation operation is completed, the movable handle 1
5 is released, the pusher 19 is retracted and moved to the rear portion of the guide 17 by the coil spring 22, and the pusher 19 is engaged with the rear portion of the next clip 1 and the operating rod 20
Also, the movable jaw 10 is released by retreating, and the clip applier 8 returns to the initial state. When the ligation operation is further performed after this, the ligation operation can be performed by the number of the stored clips 1 by repeating the above-mentioned operation.

With this configuration, the clip applier 8 has a smaller initial shape of the clip 1 than the conventional clip applier for attaching a plastically deformable clip to a living tissue, and thus the outer diameter of the insertion portion 12 is reduced. It can be pressed down thinly and can be manufactured at low cost because of its simple structure. Further, since the legs 2 intersect each other in the initial shape of the clip 1, a ligating force can be obtained, so that there is an advantage that a reliable ligation can be performed with respect to the conventional elastic clip.

As described above, in line with the object of the present invention, the clip applier can be provided at a low cost by making the insertion portion thin with a simple structure and at the same time, ensure ligation. The structure is not particularly limited and any structure may be used.

According to the above-described embodiment, the following structure can be obtained. (Supplementary Note 1) Suture for suturing / ligating living tissue
In the ligature, the leg comprises a pair of legs and a connecting portion that connects the legs, the legs intersect inside the suturing / ligating device, and the leg is released when released from the suturing / ligating device. A suturing / ligating device, characterized in that when the part is opened and released, it is elastically closed to suture / ligate living tissue.

(Supplementary Note 2) A suture / ligature device having a substantially U-shaped configuration including a pair of leg portions and a connecting portion for connecting the leg portions, which is attached to a living tissue by elastic force. The legs are formed so as to cross each other to be opened, and then the crossing of the pair of legs that are crossing each other is released so that at least a part of the facing surfaces of the pair of legs has an elastic force. A suture / ligature tool, which is manufactured so as to come into contact with each other.

(Supplementary Note 3) In the supplementary notes 1 and 2, the width of at least a part of the leg portion is wider than the width of the connecting portion. (Supplementary Note 4) The suture / ligature tool according to Supplementary Notes 1 and 2, wherein the material is a metal material.

(Supplementary Note 5) In the supplementary notes 1 and 2, the material is a pure titanium material or a titanium alloy. (Supplementary Note 6) The suture / ligature tool according to Supplementary Notes 1 and 2, wherein the material is a bioabsorbable resin material.

(Supplementary Note 7) In Supplementary Notes 1 to 6, at least a part of the facing surfaces of the pair of leg portions is formed in a convex or concave shape when attached to a living tissue. Ingredient

(Supplementary Note 8) In a suturing / ligating device which is substantially U-shaped and comprises a pair of legs and a connecting portion for connecting the legs, and which is attached to living tissue by elastic force, the pair of legs are mutually connected. A suture / ligature tool characterized by being crossed and opened.

(Supplementary Note 9) In the supplementary note 8, the width of at least a part of the leg portion is wider than the width of the connecting portion. (Supplementary Note 10) The suture / ligature tool according to Supplementary Notes 8 and 9, wherein the material is a metal material.

(Supplementary Note 11) The suture / ligature tool according to Supplementary Note 10, wherein the material is a pure titanium material or a titanium alloy. (Supplementary Note 12) The suture / ligature tool according to Supplementary Notes 8 and 9, wherein the material is a bioabsorbable resin material.

(Supplementary Note 13) In Supplementary Notes 8 to 12, the crossing of the pair of legs is released when the tissue is attached to a living tissue, and at least a part of the facing surfaces of the pair of legs has an elastic force. A suture / ligature tool characterized in that they are contacted with each other.

(Supplementary Note 14) In Supplementary Notes 8 to 13, a suture / ligature device characterized in that the intersecting portions of the pair of leg portions are formed in a slope shape in at least one of the leg portions.

(Supplementary Note 15) In Supplementary Notes 8 to 14, the pair of leg portions are twisted and intersect with each other, and the twist is released when the leg portion is attached to a living tissue. Ingredient

(Supplementary Note 16) In the supplementary notes 8 to 15, a suturing / ligating device characterized in that an opening amount when the pair of legs is opened is substantially equal to a size of the connecting portion.

(Supplementary Note 17) In Supplementary Notes 8 to 16, at least a part of the facing surfaces of the pair of legs is formed in a convex or concave shape when attached to a living tissue, and sutured and ligated. Ingredient

(Supplementary note 18) A suturing / ligating device for attaching a suture / ligation tool to a living tissue for suturing / ligating the biological tissue, and a mounting means for attaching the suture / ligation tool to the biological tissue. An operating means for operating the attaching means and an insertion portion for approaching the living tissue with the attaching means, and when the suturing / ligating device is attached to the living tissue, the pair of legs intersect each other. And the at least a part of the facing surfaces of the pair of legs are brought into contact with each other by its elastic force.

(Supplementary note 19) The suture / ligation device according to supplementary note 18, wherein a guide for releasing the intersection of the pair of legs is provided in the passage of the suture / ligature tool. (Supplementary Note 20) In Supplementary Notes 18 and 19, by releasing the suture / ligature tool from the attaching means in the distal direction,
A suturing / ligating device, characterized in that the suturing / ligating device is attached to a living tissue.

(Supplementary Note 21) In the supplementary notes 18 to 20, a suturing and ligating device characterized in that the attaching means has a holding member for holding a living tissue. (Supplementary note 22) The suture and ligature device according to Supplementary note 21, wherein the holding member includes a fixed jaw fixed to the attachment means and a movable jaw that can be opened and closed with respect to the fixed jaw.

(Supplementary note 23) In Supplementary note 22, the living tissue is retained by arranging the movable jaw between the fixed jaw and the movable jaw and closing the movable jaw with respect to the fixed jaw. The suturing / ligating device is characterized in that the suturing / ligating device is attached to a living tissue by discharging the distal end from the attaching means.

(Supplementary Note 24) A pair of legs and a connecting portion for connecting the legs are substantially U-shaped, and the pair of legs of the suturing / ligating device attached to the living tissue by elastic force intersect with each other. In the suturing / ligating device for attaching the living tissue to the living tissue, the insertion portion for approaching the living tissue and the tip of the inserting portion are provided with the suturing / ligating device attached to the living tissue. It has an attaching means for attaching, an operating means for operating the attaching means, and a storing means for storing a plurality of the clips, and by operating the operating means, A suture characterized in that the suture / ligature tool is transferred to the attachment means one by one, and further the clip is released forward to attach the suture / ligature tool to a living tissue. Ligating apparatus.

(Supplementary Note 25) The suture / ligation device according to Supplementary Note 24, wherein the attachment means has a holding means for holding a living tissue. (Supplementary note 26) In Supplementary note 25, the suturing and ligating device according to Supplementary note 25, wherein the holding means includes a fixed jaw fixed to the attaching means and a movable jaw that can be opened and closed with respect to the fixed jaw.

(Supplementary Note 27) In Supplementary Note 26, by operating the operating means, the movable jaw is closed with respect to the fixed jaw to grasp a living tissue, and by further operating the operating means, the storage means is obtained. The suturing / ligating device is characterized in that the suturing / ligating device is transferred one by one to the attaching means and is released forward from the attaching means so as to be attached to a living tissue.

According to appendix 2, at the stage of manufacturing an elastic suture / ligature tool, the legs are once formed so as to cross each other,
After that, the crossing is canceled and the opposing surfaces are brought into contact with each other at least partially, so that an effective gripping force by the elastic force can be given in the initial state.

According to Supplementary Note 3, in addition to Supplementary Note 2, by widening the width of the pair of legs, there is a portion that engages with the suturing / ligating device for attaching the suturing / ligating device. The operation of the ligation device can be reliably transmitted to the suture / ligature tool.

Note 4 has the same effect as notes 2 and 3. According to Supplementary Note 5, in addition to Supplementary Notes 2 and 3, a non-magnetic titanium-based metal is used as a material, so that it has anti-artifact properties for postoperative MRI imaging.

According to Supplementary Note 6, in addition to Supplementary Notes 2 and 3, by using a bioabsorbable resin material as the material,
There is also an advantage that the ligature does not remain inside the living body. According to Supplementary Note 7, in addition to Supplementary Notes 2 to 6, it is possible to prevent the suturing / ligating instrument from slipping off the body tissue due to the unevenness on the gripping surface of the suturing / ligating instrument.

According to Supplementary Note 8, the suture / ligature tool is elastically set in an initial state such that the pair of legs cross each other, and the crossing is released when the leg is attached to the living tissue. As a result, the elastic force in the initial state can be increased, and a stronger gripping force can be given to the conventional elastic clip.

According to Supplementary Note 9, in addition to the action of Supplementary Note 8, by widening the width of the pair of legs, the suture
By having a portion that engages the suture / ligation device for attaching the ligature, the operation of the suture / ligature device can be reliably performed.
Can be communicated to a ligature.

Appendix 10 has the same effect as appendixes 8 and 9. According to Supplementary Note 11, in addition to Supplementary Notes 8 and 9, by using a non-magnetic titanium-based metal as a material, it has anti-artifact properties for postoperative MRI imaging.

According to Supplementary Note 12, in addition to 8 and 9, by using a bioabsorbable resin material, there is an advantage that the suture / ligature tool does not remain inside the living body. Appendix 1
3 has the same effect as Supplementary Notes 8 to 12.

According to Supplementary Note 14, the intersection of the pair of legs is formed in the shape of an inclined surface, so that the intersection in the initial state can be easily canceled. Appendix 1
According to 5, in addition to Supplementary Notes 8 to 14, since the pair of legs that intersect in the initial state are twisted, there is also an advantage that the width of the suture / ligature tool in the initial state can be suppressed to some extent. is there.

According to Supplementary Note 16, in addition to Supplementary Notes 8 to 15,
Since the opening width of the pair of legs in the initial state is suppressed to be substantially the same as the height of the connecting portion, the height of the suture / ligature tool in the initial state can be suppressed to the necessary minimum.

According to Supplementary Note 17, in addition to Supplementary Notes 8 to 16,
Since the gripping surfaces of the pair of legs are formed in a concavo-convex shape, there is also an advantage that the suture / ligature tool can be prevented from slipping off due to sliding on the biological tissue.

According to Appendix 18, the suture / ligature tool is
It can be attached to living tissue by a simple mechanism. Note 19 and 20 have the same effect as note 18. According to Supplementary Note 21, in addition to Supplementary Note 18, the living tissue can be held when the suturing / ligating device is attached to the living tissue, so that there is also an advantage that the suturing / ligating device can be reliably attached to the target tissue.

According to Supplementary Notes 22 and 23, in addition to Supplementary Note 21, since the holding member can be opened and closed, there is an advantage that the target tissue can be promoted more reliably. According to appendix 24, a suture having an elastic force in which a pair of legs intersects each other.
The ligature can be continuously attached to the living tissue with a simple structure.

According to Supplementary Note 25, in addition to Supplementary Note 24, the living tissue can be held when the suturing / ligating device is attached to the living tissue, so that there is also an advantage that the suturing / ligating device can be securely attached to the target tissue. is there. According to Supplementary Notes 26 and 27, in addition to Supplementary Note 25, since the holding member can be opened and closed, there is an advantage that the target tissue can be promoted more reliably.

[0081]

As described above, according to the present invention, a pair of legs and a connecting portion for connecting the legs are provided, and the legs intersect within the suturing / ligating device. Since the leg portion is opened when it is released from the suturing and ligating device and is elastically closed when it is released, the biological tissue is sutured and ligated, so that the biological tissue can be easily and reliably sewn and ligated. Moreover, since the structure is simple and the size can be reduced, the diameter of the suturing / ligating device can be reduced.

[Brief description of drawings]

1 shows a clip according to a first embodiment of the invention,
The perspective view of the initial shape at the manufacturing stage.

FIG. 2 is a perspective view of the clip in the same embodiment in a state in which the leg crossing is released at the manufacturing stage.

FIG. 3 is a perspective view of an initial shape of the clip of the embodiment when actually used.

FIG. 4 is an exploded view of a clip manufacturing stage of the same embodiment.

FIG. 5 shows a clip of a second embodiment of the invention,
The perspective view of the initial shape at the manufacturing stage.

FIG. 6 is a perspective view of the clip of the same embodiment in a state where the leg crossing is released during the manufacturing stage.

FIG. 7 is a perspective view of an initial shape of the clip of the embodiment when actually used.

FIG. 8 is a development view of the clip manufacturing stage of the embodiment.

FIG. 9 is a side view showing a clip according to a third embodiment of the present invention.

FIG. 10 is a perspective view of a clip according to a fourth embodiment of the present invention.

FIG. 11 is a perspective view of a clip according to a fifth embodiment of the present invention.

FIG. 12 is an overall side view of the clip applier according to the sixth embodiment of the present invention.

FIG. 13 is a perspective view of the attachment means of the same embodiment.

FIG. 14 is a vertical cross-sectional side view of the attachment means of the same embodiment.

FIG. 15 is a vertical sectional side view of the storage means of the same embodiment.

16 is a sectional view taken along the line AA of FIG.

FIG. 17 is a sectional view taken along the line BB of FIG.

FIG. 18 is a vertical cross-sectional side view of the attachment means of the same embodiment in an initial state.

FIG. 19 is a vertical sectional side view of a second stage of the attachment means of the same embodiment.

FIG. 20 is a vertical sectional side view of a third stage of the attaching means of the same embodiment.

FIG. 21 is a vertical cross-sectional side view of the attachment means of the same embodiment in a ligation completed state.

FIG. 22 is a vertical cross-sectional side view showing the initial state of the operating means of the embodiment.

FIG. 23 is a vertical sectional side view of second to third stages of the operating means of the embodiment.

FIG. 24 is a vertical cross-sectional side view of the operating means of the same embodiment in a ligation completed state.

[Explanation of symbols]

 1 ... clip (suture / ligation device) 2 ... leg part 3 ... connection part 8 ... clip applier (suture / ligation device)

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Toshihiko Suzuta 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within Olympus Optical Co., Ltd. (72) Minor Tsuruta 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Hiroyuki Nagamizu 2-43-2, Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Yoshikiyo Shibata 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. (72) Inventor Shinichi Nishigaki 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Yoshinao Daimei 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd.

Claims (1)

[Claims] 1. A suture / ligature tool for suturing / ligating a biological tissue, comprising a pair of leg portions and a connecting portion for connecting the leg portions, wherein the leg portions are provided inside the suturing / ligating device. Are crossed with each other, and when released from the suture / ligation device, the leg portion is opened, and when released, elastically closed to sew and ligate a biological tissue.