JPH10277044A - Ligation of suture for medical operation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To allow even a non-skilled person to easily and surely ligature a suture for medical operation by putting both tip sides of the suture projecting from an internal organ tissue through a connecting ring, then cursing the connecting ring and cut-removing both tip sides of the suture projecting from the connecting ring. SOLUTION: While sutureneedle 1 is grasped by a sutureneedle holding device, the internal organ tissue (b) is penetrated by the needle 1 and the needle 1 is allowed to pass through a loop 7 to keep a state where the terminal side of the suture 2 is passed through the loop 7. When an inserting and holding tube 5 and an operation tube 6 are next moved along an operating string 3 in a mutually separating direction, the loop 7 is pulled into the tube 5 through the connecting ring 4 accompanied by the terminal side of the suture 2 through the internal organ tissue (b). Then the ring 4 is moved to the surrounding of the internal organ tissue (b) by continuing pull-in operation and the cutting opening of the tissue (b) is closed by fastening by the ring 4 and the suture 2. After then, the ring 4 is crushed and the sides of both tips 2a of the suture 2 projecting from the ring 4 is cut and removed.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method for ligating a surgical suture for ligating an organ tissue using a suture during a surgical operation.

[0002]

2. Description of the Related Art A suturing operation of an organ tissue is performed by a surgeon grasping a suture needle (usually in a curved shape) near a tail to which a suture is connected with a needle holder, and holding the suture needle in the organ. After penetrating the tissue and separating the suture from the suture again, the both ends of the suture protruding from the organ tissue are pinched with a fingertip and tied several times, and the ligation operation for cutting and removing unnecessary suture portions is completed. Like that. In short, the conventional ligature requires an operation of picking and tying a suture with a fingertip.

[0003]

The operation of grasping and tying a suture with a fingertip is time-consuming and cumbersome, and requires a great deal of skill, especially when operating a narrow deep surgical field. .

[0004] The present invention, which focuses on the drawbacks of such conventional methods, has been devised for the purpose of providing a method in which even a non-skilled person can easily and reliably ligate a surgical suture.

[0005]

After the both ends of a suture projecting from an organ tissue to be sutured are penetrated through a connection ring, the connection ring is crushed and the two ends of the suture projecting from the organ tissue are brought into contact with each other. The basic means is to cut and remove both ends of the suture protruding from the crushed connection ring in the vicinity of the organ tissue, and then more specifically, to hold the holding tube and the holding tube The operation thread that has passed through the connection ring adjacent to one end side together with the suture thread has a loop formed by an intermediate portion that protrudes from the connection ring side, and protrudes from the connection ring side and penetrates the organ tissue to be sutured. After inserting the end of the suture that was made,
While holding the end of the suture, the holding tube is relatively moved along the suture and the operation yarn to hold the loop in the holding tube by holding the loop. The connection ring located in the vicinity is crushed, and both ends of the suture projecting from the crushed connection ring are cut and removed.

As another method, for example, there is a method using a holding tube in which the connection ring and the holding tube are integrated,
This is because a loop formed by an intermediate portion of the operation thread protruding from the distal end side of the holding tube and penetrating the organ tissue to be sutured through the holding tube along with the suture. After inserting the end of the suture, the holding tube is relatively moved along the suture and the operation thread while holding the end of the suture, and the loop is inserted into the holding tube. After that, the tip of the holding tube positioned near the organ tissue is crushed, and the remaining portion of the holding tube is cut and removed together with both ends of the suture from the crushed tip of the holding tube. To do so.

[0007]

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 shows a procedure for ligating a surgical suture according to the present invention using a ligature. FIG. 1 is a sectional view showing a state before the operation, and FIG. FIG. 3 is a cross-sectional view showing a state in which the loop is retracted into the holding tube, FIG. 4 is a cross-sectional view showing a state in which the connecting ring is moved to the periphery of the organ tissue, and FIG. 5 is a part of FIG. FIG. 6 is an enlarged sectional view of a part of the ligated state.

A ligature A to which the present invention is applied comprises a suture thread 2 having a suturing needle 1 at its end, an operating thread 3, a connecting ring 4, a holding tube 5, and an operating tube 6, which are combined with each other. The operation ring 6 is arranged on the other end side, and the intermediate portion between the suture 2 and the operation thread 3 is penetrated therethrough. A loop 7 composed of the intermediate portion of the projecting operation thread 3
And the suturing needle 1.

The suture 2 is made of a resin thread or silk thread such as nylon or polyglycolic acid having a diameter of 0 to 2 to 5 mm, the operation thread 3 is a stainless wire of about 0 to 2 mm, and the connection ring 4 is The holding tube 5 is made of a resin elastic tube having an inner diameter of about 0,6-0,8 mm, and the operation tube 6 is formed of a resin inner tube having an inner diameter smaller than that of the holding tube 5. Although a small resin-made elastic tube is used, it is not necessary to limit the present invention to the above materials and numerical examples.

The holding tube 5 must be made of a material or an inner diameter such that when the loop 7 is inserted into the holding tube 5, the loop 7 is in contact with the inner surface and cannot be easily removed. For example, when this is made of a metal material, one or both of the suture 2 and the operation thread 3 may be reduced in diameter, so that the material or the inner diameter is determined relatively to the suture 2 or the like. .

In any case, when the loop 7 is relatively drawn into the holding tube 5, two sutures and two operation threads 3 are held in the holding tube 5, In this state, the movement of the loop 7 along the holding tube 5 is not easily performed.

Similarly, the operating thread (substantially two pieces) 3 penetrating the operating tube 6 and the suture 2
Is arranged so as to be pressed against the inner surface of the operation tube 6,
The operation tube 6 is attached to the operation thread 3 and the like so as not to relatively move along the operation thread 3 and the like, and is in a substantially fixed state.

The present invention is carried out using such a ligature A. As shown in FIG. 2, the suture needle 1 is attached to the organ tissue b while grasping the vicinity of the tail of the suture needle 1 with a needle holder. The suture needle 1 is gripped again, passed through a loop 7 provided on the ligature A, which is formed by an intermediate portion of the operation thread 3, and passed through the loop 7 by the distal end side of the suture thread 2 provided with the suture needle 1. 7 is pierced.

Further, in this state, since the suture needle 1 is easily attached to the suture 2, the suture needle 1 is attached to the suture needle 1 with the suture needle 1 held by the needle holder. When the suture 2 is pulled, they are separated from each other.

Next, when the holding tube 5 and the operation tube 6 are moved along the operation thread 3 in a direction to relatively separate, the operation tube 6 is moved.
The two ends of the operation thread 3 and the base end of the suture 2 are assembled in a substantially fixed state as described above.
Is pulled into the holding tube 5 through the connecting ring 4 with the end of the suture 2 passing through the organ b (FIG. 3). The retracting operation is continued to move the connecting ring 4 around the organ tissue b. And the incision in the organ tissue b is
And the suture 3 and are closed (FIG. 4).

During the transition from the state of FIG. 3 to the state of FIG. 4, sometimes the relationship between the length of the suture 2 or the length of the two sutures (the end of the suture) that has passed through the organ tissue b. Therefore, when an extra length (for example, as shown by a thick solid line X in FIG. 4) occurs between the connection ring 4 and the organ tissue b,
The extra length (thick solid line X) is pulled through the connection ring 4 to adjust the positional relationship between the suture 2 and the connection ring 4.

Then, the connection ring 4 is crushed (FIG. 6), and both ends 2a of the suture 2 protruding from the connection ring 4 are formed.
The ligation work is completed by cutting and removing the 2a side.

In addition, as shown in FIG.
When the slit 4a is provided so that the suture thread 2 and the operation thread 3 do not come off, the crushing operation can be performed even more easily.

As shown in FIG. 8, there is also a ligating method using a ligating device A 'having a holding tube 8 in which the connecting ring 4 and the clamping tube 5 in the ligating device A are integrated.

In the so-called second embodiment, the suture needle 1 is penetrated into the organ tissue b while grasping the vicinity of the tail of the suture needle 1 with a needle holder, and the suture needle 1 is grasped again. Then, the loop 7 is provided in the ligature A and is formed by an intermediate portion of the operation thread 3, and the loop 7 is pierced by the end of the suture 2 having the suture needle 1.

Further, in this state, since the suture needle 1 is easily attached to the suture thread 2, the suture needle 1 is held with the needle holder with respect to the suture needle 1. When the suture 2 is pulled, they are separated from each other.

Next, when the holding tube 8 and the operation tube 6 are moved along the operation thread 3 in a direction of relatively separating, the operation tube 6
The two ends of the operation thread 3 and the base end of the suture 2 are assembled in a substantially fixed state as described above.
Is pulled into the holding tube 8 with the end side of the suture 2 passing through the organ b, and when the retracting operation is continued to move the distal end of the holding tube 8 to the periphery of the organ tissue b, the organ tissue b Is tightened and closed by the distal end of the holding tube 8 and the suture 2.

At this time, in the same manner as in the first method, the holding tube 8 and the holding tube 8 are connected in accordance with the length of the suture 2 or the length of the two sutures (the end of the suture) passing through the organ tissue b. When an extra length is generated between the suture 2 and the organ tube b, the extra length is pulled through the holding tube 8 to adjust the positional relationship between the suture 2 and the holding tube 8.

Then, both ends of the suture 2 which crushes the distal end side of the holding tube 8 and protrudes from the organ b are integrated with each other via the distal end portion of the crushed holding tube 8, and from the distal end portion,
The ligating operation is completed by separating the operation tube 6 and the holding tube 8 together with the suture 2.

The holding tube 8 is made of the same material as that of the connection ring 4 and is provided with the same slit as that of the connection ring 4 so that the crushing operation can be easily performed.

In short, in the second method, the tip of the holding tube 8 instead of the connecting ring 4 in the first method is crushed, and the crushed tip and the remaining portion of the uncrushed holding tube 8 are combined. The first method differs from the second method only in that it is separated from each other.
However, in this second method, the distal ends of the collapsed holding tubes 8 each "ligate" the suture.

By the way, ligating is a term including the meaning of tying, but "ligating" as used in the present invention is a term having the same purpose as "tying".

[0028]

The present invention has the configuration described above,
Since the conventionally complicated operation of tying a suture is not required, the ligature can be easily and reliably performed without skill.

[Brief description of the drawings]

FIG. 1 is a sectional view of a state before an operation.

FIG. 2 is a cross-sectional view of a state where a suture needle has been penetrated into an organ tissue.

FIG. 3 is a cross-sectional view of a state where the loop is retracted in the holding tube.

FIG. 4 is a cross-sectional view showing a state where a connection ring has been moved to a peripheral portion of an organ tissue.

FIG. 5 is a partially enlarged view of FIG. 4;

FIG. 6 is a partially enlarged cross-sectional view of a ligated state.

FIG. 7 is a perspective view showing a second embodiment of the connection ring.

FIG. 8 is a sectional view showing a second embodiment of the ligating device.

[Explanation of symbols]

 2 suture 4 connection ring b organ tissue

Claims (4)

[Claims] After penetrating both ends of a suture projecting from an organ tissue to be sutured through a connection ring, the connection ring is crushed and the both ends of the suture projecting from the organ tissue are brought close to the organ tissue. 3. The method of ligating a surgical suture according to claim 1, wherein both ends of the suture projecting from the crushed connection ring are cut and removed. 2. A loop composed of a clamping tube and an intermediate portion of an operation thread penetrated with a suture through a connection ring adjacent to one end side of the clamping tube and protruding from the connection ring side. After penetrating the end of the suture that further protrudes and penetrates the organ tissue to be sutured, the holding tube is relatively moved along the suture and the operation thread while holding the end of the suture. To cause the loop to be clamped and held in the clamping tube. Thereafter, the connecting ring positioned near the organ tissue is crushed, and both ends of the suture projecting from the crushed connecting ring are crushed. A method for ligating a surgical suture, comprising cutting off the side. 3. After holding both ends of a suture projecting from an organ tissue to be sutured into a holding tube, the distal end side of the holding tube is crushed, and the both ends of the suture projecting from the organ tissue are crushed. Ligating a surgical suture, which is integrated with each other in the vicinity of the organ tissue and then cuts and removes the remaining portion of the holding tube from the crushed tip of the holding tube together with the both ends of the suture. Method. 4. An organ tissue protruding from the distal end of the holding tube and being sewn into a loop constituted by an intermediate portion of an operating thread penetrating the holding tube along with a suture from the distal end side of the holding tube. After passing through the end of the suture that has passed through, the holding tube is relatively moved along the suture and the operation thread while holding the end of the suture to hold the loop. Then, the tip of the holding tube positioned near the organ tissue is crushed, and the remaining portion of the holding tube from the crushed tip of the holding tube together with both ends of the suture is crushed. A method for ligating a surgical suture, which comprises cutting and removing the surgical suture.