JP2017148132A - Anastomosis connector - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a zygote for anastomosis easy to be inserted into a tubular body.SOLUTION: A zygote for anastomosis 5 is provided with a first part 10 disposed on one side of a hole 3 formed in a first tubular body 1; second parts (20;20') disposed on the other side of the hole 3 formed in the first tubular body 1; and a third part 30 structured so as to be engaged with the inner surface of the second tubular body 2. The third part 30 is connected to the first part 10 via a first connection part 40, and connected to the second parts (20;20') via a second connection part 50. The first part 10 includes a first annular part 11 having a closed-loop shape when viewed along the first direction. The second part 20 (;20') includes second annular parts (21;21') with gaps (23; 23') having an open-loop shape when viewed along the first direction. The third part 30 includes a third annular part 31 having a close-loop shape when viewed along two directions.SELECTED DRAWING: Figure 2

Description

  The present invention relates to an anastomotic connector.

  When anastomosing the first tubular body and the second tubular body, an anastomotic connector may be used.

  In Patent Document 1 and Patent Document 2, a first end of a vascular joint is inserted into a graft blood vessel, and a second end and a third end of the vascular joint are inserted into a target blood vessel, whereby a graft blood vessel is inserted. An anastomosis of the end of the target blood vessel and the side of the target blood vessel (see FIGS. 13 to 16 of Patent Document 1, FIGS. 17 to 18 of Patent Document 2, and the like).

Special Table 2002-534208 Japanese translation of PCT publication No. 2002-542872

  The vascular joint described in Patent Document 1 and Patent Document 2 includes a plurality of frame elements on one side and a plurality of frame elements on the other side (see FIG. 14 of Patent Document 1 and FIG. 17 of Patent Document 2). . For this reason, an operation for inserting a plurality of frame elements into a target blood vessel is difficult.

  Accordingly, an object of the present invention is to provide an anastomotic connector that can be easily inserted into a tubular body. An additional object of the present invention is to provide an anastomotic zygote that is easy to manufacture.

  The means for solving the problem will be described below using the numbers used in the (DETAILED DESCRIPTION). These numbers are added to clarify the correspondence between the description of (Claims) and (Mode for Carrying Out the Invention). However, these numbers should not be used to interpret the technical scope of the invention described in (Claims).

  An anastomotic connector according to some embodiments includes an anastomosis joining a side portion of a first tubular body (1) extending in a first direction and an end portion of a second tubular body (2) extending in a second direction. Connector (5). The anastomotic connector (5) is configured to be engageable with the inner surface of the first tubular body (1), and is disposed on one side of the hole (3) provided in the first tubular body (1). The first portion (10) is configured to be engageable with the inner surface of the first tubular body (1), and is disposed on the other side of the hole (3) provided in the first tubular body (1). The second part (20; 20 ′) is connected to the first part (10) by a first connection part (40), and the second part (20; 20 ′) is connected to the second connection part (50; 50 ′). ) And a third portion (30) configured to be engageable with the inner surface of the second tubular body (2). The first portion (10) includes a first annular portion (11) having a closed loop shape when viewed along the first direction. The second part (20; 20 ') comprises a second annular part (21; 21') with a gap (23; 23 ') having an open loop shape when viewed along the first direction. The third portion (30) includes a third annular portion (31) having a closed loop shape when viewed along the second direction.

  In the anastomotic connector, the first annular portion (11) may include a corrugated circumferential portion having a plurality of top portions (12) and a plurality of bottom portions (13) alternately.

  In the anastomotic connector, the number of the corrugated circumferential portions provided in the first annular portion (11) may be one.

  In the anastomotic connector, the first annular portion (11) may not include a closed loop disposed so as to surround a virtual straight line (T1) parallel to the radial direction of the first portion (10). .

  In the anastomotic connector, the first portion (10) is cantilevered by at least one top portion of the plurality of top portions (12), and extends in parallel with the first direction (15). ) May be provided.

  In the anastomotic connector, the second part (20) includes a first arc part (21A) extending from the second connection part (50) to one side and the second connection part (50) to the other side. You may provide the 2nd circular arc part (21B) extended. The gap (23) may be formed between the distal end (22A) of the first arc portion (21A) and the distal end (22B) of the second arc portion (21B). . The distal end (22A) of the first arc portion (21A) may be provided with a first end elongated member (27A) configured to extend parallel to the first direction. The distal end (22B) of the second arc portion (21B) may be provided with a second end elongated member (27B) configured to extend in parallel with the first direction. .

  In the anastomotic connector, the shape constituted by the first portion (10), the second portion (20; 20 ′), and the third portion (30) is one cylindrical sheet body (70). It may be a shape that can be produced from one member cut out from).

  The anastomotic connector according to some embodiments is an anastomotic connector (5) that joins the side of the first tubular body (1) and the end of the second tubular body (2). The anastomotic connector (5) includes a first part (10) having a central axis (X) parallel to the first direction and a second part (10) having a central axis (X) parallel to the first direction. 20; 20 ′) and connected to the first part (10) by a first connection part (40) and to the second part (20; 20 ′) by a second connection part (50; 50 ′). And a third portion (30) having a central axis (Y) parallel to a second direction different from the first direction. The first portion (10) includes a first annular portion (11) having a closed loop shape when viewed along the first direction. The second part (20; 20 ') comprises a second annular part (21; 21') with a gap (23; 23 ') having an open loop shape when viewed along the first direction. The third portion (30) includes a third annular portion (31) having a closed loop shape when viewed along the second direction.

  In some embodiments, the method of manufacturing an anastomotic connector includes, from one cylindrical sheet body (70), a first portion (10) having a central axis (X) parallel to a first direction, and the first portion. A second portion (20; 20 ′) having a central axis (X) parallel to the direction, and connected to the first portion (10) by a first connecting portion (40), and the second portion (20; 20). Cutting out a third portion (30) connected to the second connecting portion (50; 50 ') and having a central axis (X) parallel to the first direction; In the step (40), the step of bending the first portion (10) relative to the third portion (30) and the second connecting portion (50; 50 ′) include the second portion (20). Bending 20 ′) relative to the third part (30). Immediately after the cutting step, the first portion (10) includes a first annular portion (11) having a closed loop shape when viewed along the first direction. Immediately after the cutting step, the second part (20; 20 ') is a second annular part (21; 21) with a gap (23; 23') having an open loop shape when viewed along the first direction. ') With. Immediately after the cutting step, the third portion (30) includes a third annular portion (31) having a closed loop shape when viewed along the first direction.

  In the manufacturing method, the first portion (10) is formed using a first end side region (70-1) of the cylindrical sheet body (70), and the third portion (30) is the cylindrical sheet. The second part (20; 20 ′) is formed using the second end side region (70-2) of the body (70), and the second end side region (70-1) and the second end side You may form using the area | region (70-3) between area | regions (70-2).

  According to the present invention, it is possible to provide an anastomotic connector that can be easily inserted into a tubular body.

FIG. 1A is a schematic perspective view schematically showing a state after two tubular bodies are joined to each other. FIG. 1B is a schematic perspective view schematically showing a state after two tubular bodies are joined to each other. FIG. 2 is a diagram schematically showing a state inside the tubular body after joining the two tubular bodies to each other. Drawing 3 is a figure when the 1st portion of the connector for anastomosis of an embodiment is seen along the 1st direction. Drawing 4 is a figure when the 2nd portion of the connector for anastomosis of an embodiment is seen along the 1st direction. FIG. 5 is a view of the third portion of the anastomotic connector according to the embodiment as viewed in the second direction. FIG. 6 is a schematic view when the anastomotic connector of the embodiment is viewed from a direction perpendicular to the first direction and perpendicular to the second direction. FIG. 7 is a diagram schematically showing the structure of the anastomotic connector in the comparative example. FIG. 8 is a diagram schematically showing the structure of the anastomotic connector in the comparative example. FIG. 9 is a schematic development view schematically showing the anastomotic connector of the embodiment. FIG. 10 is a flowchart showing a method for manufacturing an anastomotic connector. FIG. 11 is a diagram schematically illustrating cutting out the anastomosis connector from the cylindrical sheet body. FIG. 12 is an enlarged view of region D in FIG. FIG. 13 is a diagram schematically illustrating cutting out the anastomosis connector from the cylindrical sheet body. FIG. 14 is a schematic development view schematically showing the anastomotic connector of the embodiment. FIG. 15 is a diagram schematically showing a state inside the tubular body after joining the two tubular bodies to each other using the anastomotic connector in the modified example. FIG. 16 is a schematic development view schematically showing a modified anastomotic connector.

  Hereinafter, embodiments will be described with reference to the accompanying drawings.

  First, with reference to FIG. 1A and FIG. 1B, two tubular bodies (the 1st tubular body 1 and the 2nd tubular body 2) joined using the anastomosis connector in embodiment are demonstrated. In the example illustrated in FIG. 1A, the side portion of the first tubular body 1 and the end portion of the second tubular body 2 are joined. A hole 3 is provided in the side wall of the first tubular body 1, and the inside of the first tubular body 1 and the inside of the second tubular body 2 communicate with each other through the hole 3. A first portion 10 and a second portion 20 of an after-mentioned anastomotic connector can be inserted into the first tubular body 1 from the outside of the first tubular body 1 through the hole 3. Further, a third portion 30 of the below-described anastomotic connector can be inserted into the second tubular body 2. The step of inserting the first portion 10 and the second portion 20 into the first tubular body 1 may be before or after the step of inserting the third portion 30 into the second tubular body 2. .

  In the example illustrated in FIG. 1A, two cuts are provided at the distal end of the second tubular body 2. Two tongue pieces 2 </ b> A and 2 </ b> B are formed at the distal end of the second tubular body 2 by the two cuts. The tongue piece 2A and the outer surface of the first tubular body 1 may be bonded with a bioadhesive or the like. Similarly, the tongue piece 2B and the outer surface of the first tubular body 1 may be bonded with a bioadhesive or the like.

  The example described in FIG. 1B is different from the example described in FIG. 1A in that a cut 3A and a cut 3B are provided continuously to the hole 3. Note that only one of the cut 3A and the cut 3B may be provided. In the example shown in FIG. 1B, since the notch 3B is provided, the operator can easily insert the first portion 10 of the below-mentioned anastomotic connector into the first tubular body 1. is there. Further, since the notch 3A is provided, the operator can easily insert the second portion 20 of the below-described anastomotic connector into the first tubular body 1. In the example illustrated in FIG. 1B, four cuts are provided at the distal end of the second tubular body 2. Due to the four notches, four tongue pieces 2A, 2B, 2C, and 2D (the tongue piece 2A is not shown because it is located behind the second tubular body 2) are distant from the second tubular body 2. Formed at the end. Each of the tongue pieces 2A to 2D and the outer surface of the first tubular body 1 may be bonded with a bioadhesive or the like. In the example shown in FIG. 1B, the notch 3A is blocked by the tongue 2C, and the notch 3B is blocked by the tongue 2D.

  1A and 1B, the first tubular body 1 is a blood vessel such as a coronary artery. Moreover, the 2nd tubular body 2 is blood vessels, such as a bypass pipe, for example. The bypass tube may be a patient's own blood vessel, a blood vessel provided with cellular tissue, or an artificial blood vessel.

  FIG. 2 is a view schematically showing a state inside the tubular body after joining the two tubular bodies (first tubular body 1 and second tubular body 2) to each other. FIG. 2 shows the first tubular body 1, the second tubular body 2, and the anastomosis connector 5 when virtually divided in half along a plane parallel to the first direction and the second direction. Half of the body. Only the second portion 20 of the anastomotic connector 5 is shown as a whole, not a half.

  Referring to FIG. 2, plaque 7 or a thrombus is present inside the first tubular body 1. In the example described in FIG. 2, the side of the first tubular body 1 and the end of the second tubular body 2 are joined, so that the blood bypasses the portion blocked by the plaque 7, Flowing.

  Inside the joined tubular body, the anastomotic connector 5 according to the embodiment is arranged. The anastomotic connector 5 includes a first portion 10, a second portion 20, and a third portion 30. The first portion 10 is disposed on one side of the hole 3 provided in the first tubular body 1 (the side opposite to the first direction shown in FIG. 2). The first portion 10 is engaged with the inner surface of the first tubular body 1. The second portion 20 is disposed on the other side (the first direction side shown in FIG. 2) of the hole 3 provided in the first tubular body 1. The second portion 20 is engaged with the inner surface of the first tubular body 1. The third portion 30 is engaged with the inner surface of the second tubular body 2.

  The first portion 10 and the third portion 30 are connected by the first connecting portion 40. In the example illustrated in FIG. 2, the first portion 10 and the third portion 30 are connected to each other only at one place, and therefore, for anastomosis with respect to an angle change between the first tubular body 1 and the second tubular body 2. The adaptability of the connector 5 is high. Alternatively, the first portion 10 and the third portion 30 may be connected at two or more locations (there may be two or more first connecting portions 40). However, in this case, the adaptive performance of the anastomotic connector 5 with respect to the angle change between the first tubular body 1 and the second tubular body 2 is lowered.

  The second part 20 and the third part 30 are connected by a second connection part 50. In the example illustrated in FIG. 2, the second portion 20 and the third portion 30 are connected to each other only at one place, and therefore, for anastomosis with respect to an angle change between the first tubular body 1 and the second tubular body 2. The adaptability of the connector 5 is high. Alternatively, the second portion 20 and the third portion 30 may be connected at two or more locations (there may be two or more second connection portions 50). However, in this case, the adaptive performance of the anastomotic connector 5 with respect to the angle change between the first tubular body 1 and the second tubular body 2 is lowered.

  The first portion 10 may include a plurality of first elongated members 15 extending in parallel with the first direction. When the plurality of first elongated members 15 are provided, the posture of the first portion 10 with respect to the first tubular body 1 is stabilized. Moreover, the 1st part 10 may be provided with the 1st engaging part 16 engageable with a tubular body inner surface. When the first engagement portion 16 is provided, the engagement characteristics of the first portion 10 with respect to the first tubular body 1 are improved.

  The second portion 20 may include a plurality of second elongated members 25 and 27 extending in parallel with the first direction. When a plurality of second elongated members are provided, the posture of the second portion 20 with respect to the first tubular body 1 is stabilized. The second portion 20 may include second engagement portions 26 and 28 that can engage with the inner surface of the tubular body. When the second engagement portion is provided, the engagement characteristics of the second portion 20 with respect to the first tubular body 1 are improved.

  The third portion 30 may include a plurality of third elongated members 35 extending in parallel with the second direction. When the plurality of third elongated members 35 are provided, the posture of the third portion 30 with respect to the second tubular body 2 is stabilized. Moreover, the 3rd part 30 may be provided with the 3rd engaging part 36 engageable with a tubular body inner surface. When the third engagement portion 36 is provided, the engagement characteristics of the third portion 30 with respect to the second tubular body 2 are improved.

  In the example shown in FIG. 2, the first portion 10 of the anastomotic connector is inserted into the first tubular body 1, and the third portion 30 of the anastomotic connector is inserted into the second tubular body 2. In addition, the displacement between the hole 3 of the first tubular body 1 and the distal end of the second tubular body 2 is small. On the other hand, when the anastomosis is performed without using the anastomotic connector inserted into the tubular body, the positional deviation between the hole 3 of the first tubular body 1 and the distal end of the second tubular body 2 becomes large. Sometimes. As a result, a part of the first tubular body 1 may largely protrude toward the opening located at the distal end of the second tubular body 2. In such a case, the blood flow may be hindered by the protruding portion, and the occurrence of a thrombus may be induced by the protruding portion.

  FIG. 3 is a view of the first portion 10 of the anastomotic connector according to the embodiment as viewed in the first direction. FIG. 3 shows the central axis X of the first portion 10. As shown in FIG. 3, the first portion 10 includes a first annular portion 11 (a portion indicated by oblique lines) having a closed loop shape when viewed along the first direction.

  Drawing 4 is a figure when the 2nd portion of the connector for anastomosis of an embodiment is seen along the 1st direction. FIG. 4 shows the central axis X of the second portion 20. 3 and 4, the central axis X of the second portion 20 and the central axis X of the first portion 10 coincide with each other. As shown in FIG. 4, the second portion 20 includes a second annular portion 21 (a portion indicated by oblique lines) with a gap 23 having an open loop shape when viewed along the first direction. In addition, the 2nd annular part 21 with a gap can also be called the circular-arc-shaped part which has an open loop shape. The gap 23 is a space between one end of the second portion 20 and the other end of the second portion 20. In the example illustrated in FIG. 4, since the second portion 20 has an open loop shape, the second portion 20 can be deformed more flexibly. As a result, the second portion 20 can be easily inserted into the first tubular body 1. Moreover, since the 2nd part 20 has an open loop shape, the 2nd part 20 can press the inner surface of the 1st tubular body 1 with an elastic force.

  In the example shown in FIG. 4, when the second portion 20 disposed inside the first tubular body 1 is viewed along the central axis X, the circumferential angle θ corresponding to the width of the gap 23 is 0. Greater than 180 degrees and 180 degrees or less. When the circumferential angle θ is greater than 180 degrees, the engagement characteristics of the second portion 20 with respect to the first tubular body 1 may be degraded.

  FIG. 5 is a view of the third portion 30 of the anastomotic connector according to the embodiment as viewed in the second direction. FIG. 5 shows the central axis Y of the third portion 30. As shown in FIG. 5, the third portion 30 includes a third annular portion 31 (a portion indicated by oblique lines) having a closed loop shape when viewed along the second direction.

  With reference to FIG. 6, the connector 5 for anastomosis of embodiment is demonstrated in detail. FIG. 6 is a schematic view when the anastomotic connector of the embodiment is viewed from a direction perpendicular to the first direction and perpendicular to the second direction. In FIG. 6, the front half of the first portion 10 and the front half of the third portion 30 are omitted in order to avoid complication of the drawing, and the back half of the first portion 10 is omitted. Only the back half of the third portion 30 is shown. In practice, the second annular portion 21 of the second portion 20 is arranged in a plane perpendicular to the first direction (for example, the portion indicated by the point B in FIG. In order to make it easy to grasp the shape of the second portion 20, the second annular portion 21 is intentionally formed in the first direction. It is described so as to be inclined with respect to a plane perpendicular to.

(First part 10)
With reference to FIG. 6, the first annular portion 11 of the first portion 10 is a corrugated circumferential portion including a plurality of top portions 12 and a plurality of bottom portions 13 alternately. As can be understood from FIGS. 2 and 6, the top portion 12 is a portion to be inserted deeper into the first tubular body 1 than the bottom portion 13. In addition, the top part 12 and the bottom part 13 may each be an inflection part in the waveform circumferential part. The corrugated circumferential portion is a repeating structure of a top portion 12, a first connecting portion 14A that connects the top portion 12 and the bottom portion 13, and a second connecting portion 14B that connects the bottom portion 13 and the bottom portion 13 and the top portion 12. The corrugated circumference is, for example, a one-stroke shape without an end. In the example illustrated in FIG. 6, the first annular portion 11 includes one corrugated circumferential portion. In other words, in the 1st part 10, the 1st cyclic | annular part 11 which is a waveform circumferential part is not connected with the other waveform circumferential part directly or indirectly. And the connection member which mutually connects two adjacent top parts 12 is only the 1st connection part 14A, the bottom part 13, and the 2nd connection part 14B which comprise the said one waveform circumference part. Moreover, the connection member which mutually connects two adjacent bottom parts 13 is only the 1st connection part 14A, the top part 12, and the 2nd connection part 14B which comprise the said one waveform circumference part.

  FIG. 7 shows an anastomotic connector in a comparative example. As shown in FIG. 7, when the corrugated circumferential portion 310 is connected to another corrugated circumferential portion, for example, when a root side portion (a portion on the first direction side) of the first portion 10 is sandwiched The overall contraction of the first portion 10 tends to be non-uniform. In particular, when the root side portion (first direction side portion) of the first portion 10 is sandwiched, the diameter reduction of the tip side portion (portion opposite to the first direction) of the first portion 10 becomes insufficient. there is a possibility. As a result, it may be difficult to insert the distal end portion of the first portion 10 into the first tubular body 1. On the other hand, in the example shown in FIG. 6, the first annular portion 11 has only one corrugated circumferential portion, so that the root side portion (the portion on the first direction side) of the first portion 10 is sandwiched. When it does, the whole 1st part 10 tends to shrink | contract uniformly. In particular, when the base portion (the portion on the first direction side) of the first portion 10 is sandwiched, the diameter of the tip side portion (the portion on the opposite side to the first direction) of the first portion 10 is sufficient. As a result, the first portion 10 can be easily inserted into the first tubular body 1.

  In the example illustrated in FIG. 6, the first annular portion 11 (first portion 10) has a radial direction of the first portion 10 (a direction perpendicular to the first direction and from the central axis X of the first portion). The closed loop arranged so as to surround the virtual straight line T1 parallel to the outward direction) is not provided. For this reason, when the 1st part 10 shrink | contracts, the whole 1st part 10 is easy to shrink | contract uniformly. On the other hand, in the example described in FIG. 7 or FIG. 8, the first annular portion is disposed in a closed loop (described in FIG. 7 or FIG. 8) so as to surround a virtual straight line T1 parallel to the radial direction of the first portion. The shaded portion corresponds to the closed loops 311 and 311 ′). For this reason, in the example described in FIG. 7 or FIG. 8, when the first portion 10 contracts, the overall contraction of the first portion 10 tends to be uneven.

  Referring to FIG. 6, the first portion 10 includes a first elongated member 15 that is connected to at least one top of the plurality of tops 12 and extends parallel to the first direction. The first elongated member 15 is supported in a cantilevered state by the corresponding top portion 12. Although four first elongated members 15 are shown in FIG. 6, there are actually four other first elongated members 15 on the near side. In addition, the number of the 1st elongate member 15 does not necessarily need to be eight, and is arbitrary. In the example illustrated in FIG. 6, the bottom portion 13 is not provided with an elongated member extending in parallel with the first direction. Alternatively, an elongated member extending in parallel with the first direction may be provided on the bottom portion 13.

  In the example shown in FIG. 6, a first engagement portion 16 that can engage with the inner surface of the first tubular body 1 is provided at the distal end of each first elongated member 15. The first engaging portion 16 prevents the first portion 10 from sliding in the first direction with respect to the first tubular body 1 by engaging with the inner surface of the first tubular body 1. Each first engaging portion 16 has, for example, an arrowhead shape (substantially triangular shape) with rounded corners. Each 1st engaging part 16 is comprised by the flat member, for example. Each first engagement portion 16 has an extraction resistance in a direction (first direction) taken out from the first tubular body 1 in a direction (a direction opposite to the first direction) inserted into the first tubular body 1. Greater than insertion resistance. For this reason, it is easy to insert the first portion 10 into the first tubular body 1, and displacement of the first portion 10 after insertion with respect to the first tubular body 1 is prevented. In addition, the shape of the 1st engaging part 16 is not limited to arrowhead shape. The shape of the first engagement portion 16 may include a shape like a return portion of a fishing hook (in other words, the first engagement portion 16 may include a return portion).

(Third portion 30)
Referring to FIG. 6, the third annular portion 31 of the third portion 30 is a corrugated circumferential portion including a plurality of top portions 32 and a plurality of bottom portions 33 alternately. As can be understood from FIGS. 2 and 6, the top portion 32 is a portion to be inserted deeper into the second tubular body 2 than the bottom portion 33. In addition, the top part 32 and the bottom part 33 may each be an inflection part in the waveform circumferential part. The corrugated circumferential portion is a repeating structure of a top portion 32, a first connecting portion 34A that connects the top portion 32 and the bottom portion 33, and a second connecting portion 34B that connects the bottom portion 33 and the bottom portion 33 and the top portion 32. The corrugated circumference is, for example, a one-stroke shape without an end. In the example illustrated in FIG. 6, the third annular portion 31 has one corrugated circumferential portion. In other words, in the third portion 30, the third annular portion 31 that is a corrugated circumferential portion is not directly or indirectly connected to another corrugated circumferential portion. And the connection member which mutually connects two adjacent top parts 32 is only the 1st connection part 34A, the bottom part 33, and the 2nd connection part 34B which comprise the said one waveform circumference part. Moreover, the connection member which mutually connects the two adjacent bottom parts 33 is only the 1st connection part 34A, the top part 32, and the 2nd connection part 34B which comprise the said one waveform circumference part.

  In the example illustrated in FIG. 6, the third annular portion 31 has one corrugated circumferential portion. For this reason, when the base side part (part on the second direction side) of the third part 30 is sandwiched, the diameter of the tip side part (part on the opposite side to the second direction) of the third part 30 is sufficient. . As a result, the third portion 30 can be easily inserted into the second tubular body 2.

  In the example illustrated in FIG. 6, the third annular portion 31 (the third portion 30) is the radial direction of the third portion 30 (the direction perpendicular to the second direction and the central axis Y of the third portion 30. The closed loop arranged so as to surround the virtual straight line T2 parallel to the direction from the outside to the outside is not provided. For this reason, when the third portion 30 contracts, the entire third portion 30 tends to contract uniformly.

  Referring to FIG. 6, the third portion 30 includes a third elongate member 35 that is connected to at least one top of the plurality of tops 32 and extends parallel to the second direction. The third elongated member 35 is supported in a cantilevered state by the corresponding top portion 32. Although four third elongated members 35 are shown in FIG. 6, there are actually four other third elongated members 35 on the near side. Note that the number of the third elongated members 35 is not necessarily eight, and is arbitrary. In the example illustrated in FIG. 6, the bottom 33 is not provided with an elongated member extending in parallel with the second direction. Alternatively, an elongated member extending in parallel with the second direction may be provided on the bottom 33.

  In the example described in FIG. 6, a third engagement portion 36 that can engage with the inner surface of the second tubular body 2 is provided at the distal end of each third elongated member 35. The third engagement portion 36 prevents the third portion 30 from sliding in the second direction relative to the second tubular body 2 by engaging with the inner surface of the second tubular body 2. Each third engagement portion 36 has, for example, an arrowhead shape (substantially triangular shape) with rounded corners. Each 3rd engaging part 36 is comprised by the flat member, for example. Each of the third engaging portions 36 has an extraction resistance in a direction (second direction) taken out from the second tubular body 2 in a direction (opposite to the second direction) inserted into the second tubular body 2. Greater than insertion resistance. For this reason, the insertion of the third portion 30 into the second tubular body 2 is easy, and displacement of the third portion 30 after the insertion with respect to the second tubular body 2 is prevented. In addition, the shape of the 3rd engaging part 36 is not limited to arrowhead shape. The shape of the third engagement portion 36 may include a shape like a return portion of a fishing hook (in other words, the third engagement portion 36 may include a return portion).

(Second part 20)
Referring to FIG. 6, the second annular portion 21 of the second portion 20 includes a first arc portion 21 </ b> A that extends from the second connection portion 50 to one side and a second arc portion that extends from the second connection portion 50 to the other side. 21B.

  A second elongated member 25 may be provided on the first arc portion 21A between the distal end 22A of the first arc portion 21A and the second connection portion 50. The second elongated member 25 extends parallel to the first direction. The second elongated member 25 extends from the first arc portion 21A to both sides (on the first direction side and on the opposite side to the first direction). A first direction side second engaging portion 26-2 is provided at an end portion of the second elongated member 25 in the first direction, and the other end portion of the second elongated member 25 is connected to the other end side second engagement. A joint portion 26-1 is provided. The first direction side second engaging portion 26-2 prevents the second portion 20 from moving in the direction opposite to the first direction, and the other end side second engaging portion 26-1 is the second portion. 20 is prevented from moving in the first direction. The shape of the first direction side second engagement portion 26-2 and the shape of the other end side second engagement portion 26-1 may be the same shape as the shape of the first engagement portion 16, A shape similar to the shape of the first engaging portion 16 may be used, or a shape different from the shape of the first engaging portion 16 may be used. Note that the length of the second elongated member 25 may be shorter than the length of the first elongated member 15. The length of the second elongated member 25 may be shorter than the length of the third elongated member 35.

  An end elongated member 27A may be provided at the distal end 22A of the first arc portion 21A. The end elongated member 27A extends parallel to the first direction. The end elongated member 27A extends from the first arc portion 21A to both sides (on the first direction side and on the opposite side to the first direction). A first direction side second engagement portion 28A-2 is provided at the end of the end elongated member 27A in the first direction, and the other end of the end elongated member 27A is the second engagement side second engagement. A joint portion 28A-1 is provided. The first direction side second engagement portion 28A-2 prevents the distal end 22A of the first arc portion 21A from moving in the direction opposite to the first direction, and the other end side second engagement portion 28A-. 1 prevents the distal end 22A of the first arc portion 21A from moving in the first direction. The shape of the first direction side second engagement portion 28A-2 and the shape of the other end side second engagement portion 28A-1 may be the same shape as the shape of the first engagement portion 16, A shape similar to the shape of the first engaging portion 16 may be used, or a shape different from the shape of the first engaging portion 16 may be used. Note that the length of the end elongated member 27 </ b> A may be shorter than the length of the first elongated member 15. Further, the length of the end elongated member 27 </ b> A may be shorter than the length of the third elongated member 35.

  The second elongated member 25 may be provided between the distal end 22B of the second arc portion 21B and the second connection portion 50 in the second arc portion 21B. The second elongated member 25 extends parallel to the first direction. The second elongated member 25 extends from the second arc portion 21B to both sides (on the first direction side and on the opposite side to the first direction). Further, a first direction side second engaging portion 26-2 is provided at an end portion of the second elongate member 25 in the first direction side, and the other end portion of the second elongate member 25 is provided at the other end side. Two engaging portions 26-1 are provided. The configurations of the second elongated member 25, the first direction side second engaging portion 26-2, and the other end side second engaging portion 26-1 provided in the second arc portion 21B are the same as the first arc portion 21A. It is the same as that of the structure of the 2nd elongate member 25 provided, the 1st direction side 2nd engaging part 26-2, and the other end side 2nd engaging part 26-1. For this reason, repeated description is omitted.

  An end elongated member 27B may be provided at the distal end 22B of the second arc portion 21B. The end elongated member 27B extends parallel to the first direction. The end elongated member 27B extends from the second arc portion 21B to both sides (on the first direction side and on the opposite side to the first direction). A first direction side second engaging portion 28B-2 is provided at an end of the end elongated member 27B on the first direction side, and the other end of the end elongated member 27B is connected to the second end on the other end side. A joint portion 28B-1 is provided. The first direction side second engagement portion 28B-2 prevents the distal end 22B of the second arc portion 21B from moving in the direction opposite to the first direction, and the other end side second engagement portion 28B-. 1 prevents the distal end 22B of the second arc portion 21B from moving in the first direction. The configuration of the end elongated member 27B, the first direction side second engagement portion 28B-2, and the other end side second engagement portion 28B-1 is the end portion elongated member 27A and the first direction side second engagement, respectively. The configuration is the same as that of the portion 28A-2 and the second engagement portion 28A-1. For this reason, repeated description is omitted.

  FIG. 9 is a schematic development view schematically showing the anastomotic connector of the embodiment. In FIG. 9, the portion indicated by C1 is actually the same portion as the portion indicated by C2. For example, the first engagement portion 16B described on the upper side (on C2) in FIG. 9 is the first engagement portion 16B itself described on the lower side (on C1) in FIG. The third engaging portion 36B described on (C2) is the third engaging portion 36B itself described on the lower side (on C1) of FIG.

  In the example illustrated in FIG. 9, the first annular portion 11 (corrugated circumferential portion) includes eight top portions 12 and eight bottom portions 13, and the third annular portion 31 (corrugated circumferential portion) includes eight pieces. A top 32 and eight bottoms 33 are provided. That is, in the example described in FIG. 9, the number of tops in the first annular portion 11 (waveform circumferential portion) is equal to the number of tops in the third annular portion 31 (waveform circumferential portion). In addition, when the internal diameter of the 1st tubular body 1 and the internal diameter of the 2nd tubular body 2 are mutually different, the number of the top parts in the 1st annular part 11 (corrugated circumferential part), and the 3rd annular part 31 ( The number of apexes in the (circumferential circumference) may be different from each other.

(Method for producing anastomotic connector)
Next, a method for manufacturing an anastomotic connector will be described with reference to FIGS. FIG. 10 is a flowchart showing a method for manufacturing the anastomotic connector 5. FIG. 11 is a diagram schematically illustrating cutting out the anastomosis connector 5 from the cylindrical sheet body 70. FIG. 12 is an enlarged view of region D in FIG.

  In the first step S1, one cylindrical sheet body 70 is prepared. As shown in FIG. 11, in the second step S2, from one cylindrical sheet body 70, a first portion 10 having a central axis parallel to the first direction and a central axis parallel to the first direction are provided. The second portion 20 is connected to the first portion 10 by the first connecting portion 40, is connected to the second portion 20 by the second connecting portion 50, and has a third axis parallel to the first direction. A portion 30 is cut out. FIG. 11 shows a state in which a cut 80 is provided in the cylindrical sheet body 70 and the first portion 10, the second portion 20, and the third portion 30 are cut out from the cylindrical sheet body 70. The cut 80 may be formed by laser processing or other processing methods.

  In addition, immediately after 2nd step S2 (cutting-out process), the 1st part 10 is provided with the 1st cyclic | annular part 11 which has a closed loop shape, when it sees along a 1st direction. The second portion 20 includes a second annular portion 21 with a gap 23 having an open loop shape when viewed along the first direction. The third portion 30 includes a third annular portion 31 having a closed loop shape when viewed along the first direction.

  In the third step S <b> 3, the first portion 10 is bent relative to the third portion 30 in the first connection portion 40. As a result of the bending, the relative arrangement of the first portion 10 with respect to the third portion 30 is the arrangement shown in FIG. In addition, in order to fix the shape after bending, you may heat a 1st connection part (bending part) after 3rd step S3.

  In the fourth step S <b> 4, the second portion 20 is bent relative to the third portion 30 in the second connection portion 50 (not shown in FIG. 11). FIG. 12 shows the state of the second connecting portion 50 after being bent. In addition, in order to fix the shape after bending, you may heat a 2nd connection part (bending part) after 4th step S4. The fourth step S4 may be executed before the third step S3, may be executed after the third step S3, or may be executed simultaneously with the third step S3.

  In the manufacturing method of the anastomotic connector in the embodiment, the anastomotic connector 5 can be manufactured from one member cut out from one cylindrical sheet body. In other words, in the anastomotic connector of the embodiment, one member obtained by cutting the shape constituted by the first portion 10, the second portion 20, and the third portion 30 from one cylindrical sheet body 70. From this, it is possible to make a shape that can be manufactured. For this reason, in the manufacturing method of the connector for anastomosis in the embodiment, a joining step such as welding or welding is not necessarily required. And it is easy to manufacture an anastomotic connector.

  In the manufacturing method of the anastomotic connector in the embodiment, the shape of the first annular portion 11 of the first portion, the shape of the second annular portion 21 of the second portion, and the third portion are maintained without changing the curved surface of the cylindrical sheet body 70. This is used as the shape of the third annular portion 31. For this reason, although the manufacturing method of the anastomotic connector in the embodiment is a manufacturing method of the anastomotic connector having a complicated shape including the first portion, the second portion, and the third portion, the above-described method is used. Plastic processing other than the bending process in the third step S3 and the bending process in the fourth step S4 described above is not necessarily required. Further, the curved surface of the cylindrical sheet body 70 is used as it is as the shape of the first annular portion 11 of the first portion, the shape of the second annular portion 21 of the second portion, and the shape of the third annular portion 31 of the third portion. As a result, the roundness of the first annular portion 11 and the roundness of the second annular portion 21 and the third annular portion 31 are high.

  In the method for manufacturing the anastomotic connector in the embodiment, the portion that was the outer surface of the cylindrical sheet body 70 is used as the outer surface of the first portion (the surface that contacts the first tubular body 1). The portion that was the outer surface is used as the outer surface of the second portion (the surface that contacts the first tubular body 1), and the portion that was the outer surface of the cylindrical sheet body 70 is the outer surface of the third portion (the second tubular body 2). It is used as a contact surface). Moreover, in the manufacturing method of the anastomotic connector in the embodiment, as shown in FIG. 13, the first portion from the first end side region 70-1, which is a region on the opposite side to the first direction of the cylindrical sheet body 70. 10 is formed, and the third portion 30 is formed from the second end side region 70-2 which is a region on the first direction side of the cylindrical sheet body 70, and the first end side region 70-1 and the second end side region 70 are formed. The second portion 20 is formed from the region 70-3 between the first and second regions. As a result, it is possible to manufacture an anastomotic connector from the cylindrical sheet 70 having a relatively short length.

  Next, an example of the size of the anastomotic connector is shown with reference to FIG. The total length L1 (the total length before the bending process) of the anastomotic connector 5 in a natural state where no external force acts is, for example, 4 mm or more and 14 mm or less. If the total length L1 is less than 4 mm, the engagement of the anastomotic connector 5 with the first tubular body 1 or the second tubular body 2 may be insufficient. If the total length L1 exceeds 14 mm, the flexibility of the tubular body may be impaired in the vicinity of the joint portion between the first tubular body 1 and the second tubular body 2.

  The length L2 along the first direction of the first annular portion 11 (waveform circumferential portion) in a natural state where no external force acts is, for example, 2 mm or more and 8 mm or less. If the length L2 is less than 2 mm, the diameter at the time of expansion is insufficient, and the engagement of the anastomotic connector 5 with the first tubular body 1 may be insufficient. If the length L2 is greater than 8 mm, the flexibility of the first tubular body 1 may be impaired in the vicinity of the joint between the first tubular body 1 and the second tubular body 2. Similarly, before bending, the length L3 along the first direction of the third annular portion 31 (waveform circumferential portion) in the natural state is, for example, not less than 2 mm and not more than 8 mm.

  The length L4 of the first elongated member 15 is, for example, not less than 0.5 mm and not more than 3 mm. If the length L4 is less than 0.5 mm, the anastomosis connector 5 may not be sufficiently engaged with the first tubular body. If the length L4 is greater than 3 mm, the flexibility of the first tubular body 1 may be impaired in the vicinity of the joint between the first tubular body and the second tubular body. Similarly, the length L5 of the third elongated member 35 is, for example, not less than 0.5 mm and not more than 3 mm.

  Before the bending process, the length along the first direction of the first connection portion 40 is, for example, 1 mm or more and 8 mm or less. Moreover, before the bending process, the length along the first direction of the second connection portion 50 is, for example, 1 mm or more and 8 mm or less.

  The outer diameter of the first portion 10 in a natural state where no external force acts is, for example, not less than 2 mm and not more than 4 mm. Moreover, the outer diameter of the 3rd part 30 in the natural state where an external force does not act is 2 mm or more and 4 mm or less, for example.

  The length L6 of each engaging part (the first engaging part 16, the second engaging parts 26, 28, the third engaging part 36) is, for example, 0.15 mm or more and 0.6 mm or less. If the area of the engaging portion is too large, the pressing force per unit area by which the engaging portion presses the tubular body is insufficient, and the anastomotic connector 5 may slide with respect to the tubular body. Moreover, when the area of an engaging part is too small, there exists a possibility that the said engaging part may stop functioning as a part engaged with a tubular body.

(Modification)
With reference to FIG. 15 and FIG. 16, an anastomosis connector 5 ′ in a modification of the embodiment will be described. FIG. 15 is a diagram schematically showing the state of the inside of the tubular body after joining the two tubular bodies (1, 2) to each other using the anastomotic connector 5 ′ in the modified example. FIG. 15 shows a case where the first tubular body 1, the second tubular body 2, and the anastomotic connector 5 ′ are virtually divided in half along a plane parallel to the first direction and the second direction. Each half is shown. FIG. 16 is a schematic development view schematically showing a modified anastomotic connector 5 ′.

  Concerning each component of the anastomotic connector 5 ′ in the modified example, components having the same functions as the components of the anastomotic connector 5 in the above-described embodiment are assigned the same reference numerals. The repeated description of the components with the same drawing number will be omitted.

  The configuration of the second portion 20 ′ in the anastomotic connector 5 ′ in the modification is different from the configuration of the second portion 20 in the anastomotic connector 5 ′ in the above-described embodiment. Referring to FIG. 15, the second portion 20 ′ is connected to the third portion 30 via a second connection portion 50 ′ (bending portion). The second portion 20 'includes a second annular portion 21'. Although it is difficult to grasp from FIG. 15, the second annular portion 21 ′ has the gap 23 ′ in the same manner as the second annular portion 21 in the above-described embodiment has the gap 23. doing. The gap 23 'is illustrated in FIG.

  Referring to FIG. 16, the second annular portion 21 ′ of the second portion 20 ′ is a corrugated portion having a plurality of top portions 120 ′ and a plurality of bottom portions 130 ′ alternately. As can be understood from FIGS. 15 and 16, the top portion 120 ′ is a portion to be inserted deeper into the first tubular body 1 than the bottom portion 130 ′. Note that the top portion 120 ′ and the bottom portion 130 ′ may each be an inflection portion in the wave shape portion. The corrugated portion includes a top portion 120 ′, a first connecting portion 140′A that connects the top portion 120 ′ and the bottom portion 130 ′, a bottom connecting portion 130 ′, and a second connecting portion that connects the bottom portion 130 ′ and the top portion 120 ′. It is a repetitive structure of 140′B. The waveform shape portion is, for example, a one-stroke shape having two end portions (see portions indicated by 127A ′ and 127B ′). In the example illustrated in FIG. 16, the second annular portion 21 ′ has one corrugated portion. In other words, in the second portion 20 ′, the second annular portion 21 ′ that is a corrugated shape portion is not directly or indirectly connected to another annular portion. And the connection member which mutually connects two adjacent top parts 120 'is only the 1st connection part 140'A, bottom part 130', and 2nd connection part 140'B which comprise the said one waveform shape part. In addition, the connecting members that connect the two adjacent bottom portions 130 ′ are only the first connecting portion 140 ′ A, the top portion 120 ′, and the second connecting portion 140 ′ B that constitute the one corrugated portion.

  In the example described in FIG. 16, the second annular portion 21 'is a gapped annular portion having a gap 23'. Therefore, when the second annular portion 21 ′ is viewed along the first direction, the second annular portion 21 ′ has an open loop shape. In the example shown in FIG. 16, a first end elongated member 127′A is provided at the first end of the second annular portion 21 ′, and the second end of the second annular portion 21 ′ is provided at the second end. Is provided with a second end elongated member 127'B. A gap 23 'is formed between the first end elongated member 127'A and the second end elongated member 127'B.

  Referring to FIG. 16, the second portion 20 ′ includes a second elongate member 125 ′ connected to at least one top of the plurality of tops 120 ′. The second elongate member 125 'is supported in a cantilevered manner by the corresponding top 120'. In the example illustrated in FIG. 16, each second elongated member 125 'is a spirally curved member. In other words, each second elongate member 125 'has a shape that coincides with a portion of the virtual spiral. In the example shown in FIG. 16, a second engaging portion 126 ′ that can engage with the inner surface of the first tubular body 1 is provided at the distal end of each second elongated member 125 ′. The second engagement portion 126 ′ is engaged with the inner surface of the first tubular body 1 so that the second portion 20 ′ is opposite to the first tubular body 1 in the first direction (see FIG. 15). Prevents sliding in the direction side.

  In the example illustrated in FIG. 16, the third portion 30 is connected to the first portion 10 via the first connection portion 40. The second portion 20 ′ is connected to the third portion 30 via the second connection portion 50 ′. Note that the length of the second connection portion 50 ′ in the example shown in FIG. 16 is longer than the length of the second connection portion 50 in the example shown in FIG. 9.

  The anastomotic connector 5 ′ in the modified example can be manufactured in the same process as the anastomotic connector 5 in the above-described embodiment described with reference to FIG. 10. Therefore, the repeated description about the manufacturing method of the anastomotic connector 5 'is omitted.

  The manufacturing method of the anastomotic connector 5 ′ and the anastomotic connector 5 ′ in the modified example has the same effects as the manufacturing method of the anastomotic connector 5 and the anastomotic connector 5 in the above-described embodiment.

  The anastomotic connector according to the embodiment may use any biocompatible material (for example, a nickel-titanium alloy that has superelastic characteristics and is a shape memory alloy, or is absorbed by living tissue. A bioabsorbable material may be used).

  The present invention is not limited to the embodiments described above, and it is obvious that the embodiments can be appropriately modified or changed within the scope of the technical idea of the present invention. Various techniques used in each embodiment or modification can be applied to other embodiments or modifications as long as no technical contradiction arises.

1: 1st tubular body 2: 2nd tubular bodies 2A to 2D: Tongue piece 3: Holes 3A to 3B: Cuts 5 and 5 ': Anastomotic connector 7: Plaque 10: First part 11: First annular part 12 : Top portion 13: Bottom portion 14A: First connecting portion 14B: Second connecting portion 15: First elongated member 16, 16B: First engaging portion 20, 20 ': Second portion 21, 21': Second annular portion 21A : First arc portion 21B: second arc portions 22A, 22B: distal ends 23, 23 ': gaps 25, 27: second elongated members 26, 26-1, 26-2: second engaging portions 27A, 27B : End elongated members 28, 28A-1, 28A-2, 28B-1, 28B-2: second engaging portion 30: third portion 31: third annular portion 32: top portion 33: bottom portion 34A: first connection Part 34B: Second connecting part 35: Third elongated member 36, 36B: Third engaging part 40: 1 connection part 50, 50 ': 2nd connection part 70: Cylindrical sheet body 70-1: 1st end side area | region 70-2: 2nd end side area | region 70-3: Area | region 80: Cut 120': Top part 125 ': Second elongated member 126 ′: second engaging portion 127′A, 127′B: end elongated member 130 ′: bottom portion 140′A: first connecting portion 140′B: second connecting portion 310: corrugated circumferential portion 311, 311 ′: closed loop T 1, T 2: imaginary straight line X: central axis Y: central axis θ: circumferential angle

Claims (10)

An anastomosis connector for joining a side portion of a first tubular body extending in a first direction and an end portion of a second tubular body extending in a second direction,
A first portion configured to be engageable with an inner surface of the first tubular body and disposed on one side of a hole provided in the first tubular body;
A second portion configured to be engageable with an inner surface of the first tubular body and disposed on the other side of the hole provided in the first tubular body;
A third portion coupled to the first portion by a first connection portion, coupled to the second portion by a second connection portion, and configured to be engageable with an inner surface of the second tubular body;
The first portion comprises a first annular portion having a closed loop shape when viewed along the first direction;
The second portion comprises a second annular portion with a gap having an open loop shape when viewed along the first direction;
The anastomotic connector, wherein the third portion includes a third annular portion having a closed loop shape when viewed along the second direction. The anastomotic connector according to claim 1,
The first annular portion includes a corrugated circumferential portion having a plurality of top portions and a plurality of bottom portions alternately. The anastomotic connector according to claim 2,
The number of the said waveform circumference part with which the said 1st annular part is provided is one connector for anastomosis. In the zygote for anastomosis according to claim 2 or 3,
The first annular portion does not include a closed loop disposed so as to surround a virtual straight line parallel to the radial direction of the first portion. In the zygote for anastomosis according to any one of claims 2 to 4,
The first portion includes a first elongated member that is cantilevered by at least one top portion of the plurality of top portions and extends parallel to the first direction. In the anastomotic connector according to any one of claims 1 to 5,
The second portion includes a first arc portion extending from the second connection portion to one side and a second arc portion extending from the second connection portion to the other side,
The gap is formed between a distal end of the first arc portion and a distal end of the second arc portion,
A distal end of the first arc portion is provided with a first end elongated member configured to extend parallel to the first direction;
A distal end of the second arc portion is provided with a second end elongated member configured to extend in parallel with the first direction. In the zygote for anastomosis according to any one of claims 1 to 6,
The shape constituted by the first portion, the second portion, and the third portion is a shape that can be produced from one member cut out from one cylindrical sheet body. An anastomosis connector for joining the side of the first tubular body and the end of the second tubular body,
A first portion having a central axis parallel to the first direction;
A second portion having a central axis parallel to the first direction;
A third portion connected to the first portion by a first connecting portion, connected to the second portion by a second connecting portion, and having a central axis parallel to a second direction different from the first direction; With
The first portion comprises a first annular portion having a closed loop shape when viewed along the first direction;
The second portion comprises a second annular portion with a gap having an open loop shape when viewed along the first direction;
The anastomotic connector, wherein the third portion includes a third annular portion having a closed loop shape when viewed along the second direction. A method for producing an anastomotic connector, comprising:
From one cylindrical sheet body, a first portion having a central axis parallel to the first direction, a second portion having a central axis parallel to the first direction, and a first connecting portion to the first portion. Cutting out a third portion that is connected, connected to the second portion by a second connection portion, and having a central axis parallel to the first direction;
Bending the first portion relative to the third portion in the first connection portion;
Bending the second part relative to the third part in the second connection part, and
Immediately after the cutting step,
The first portion comprises a first annular portion having a closed loop shape when viewed along the first direction;
The second portion comprises a second annular portion with a gap having an open loop shape when viewed along the first direction;
The method for manufacturing an anastomotic connector, wherein the third portion includes a third annular portion having a closed loop shape when viewed along the first direction. In the manufacturing method of the zygote for anastomosis according to claim 9,
The first portion is formed using a first end side region of the cylindrical sheet body, the third portion is formed using a second end side region of the cylindrical sheet body, and the second portion is A method for producing an anastomotic connector formed using a region between the first end side region and the second end side region.

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