JPH01274750A - Piercing needle ring type suturing device for organ and digestive tract - Google Patents

Abstract

PURPOSE:To carry out in a short time in safe and simple ways by piercing several pieces of needles installed onto a ring without using the manual suturing operation between the organ tissue and a digestive tract. CONSTITUTION:A ring 1 having a piercing needle which is connected with a talking-out string is introduced into the tube bore of an intestine tract, and a handle 3 is inserted from a hole 17 drilled on the intestine wall on the opposite side to an intestine tract anastomosis hole 16, and the handle is fitted with the ring having the piercing needle. The piercing needle is adjusted to a port a hepatica part to be sutured, and inserted into the peripheral wall of the anastomosis surface of the intestine tract and lever, observing the mark of the handle. Since, in this case, the length of the needle in the direction towards a large vein such as lever tract and portal vein is reduced, these parts can be prevented from being damaged. After the needle of the ring is pierced into the peripheral wall of the anastomosis holes of the both, the ring is left as it is, and the handle is removed from the ring. The handle insertion hole 17 of the intestine tract is suture-closed. After the completion of anastomosis after one - two weeks, the string 6 projecting from an intestine opened port part 14 which projects outside skin is pulled out to take out the ring. Therefore, no foreign material is left in the inner surface of the anastomosis part.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to the instrumental anastomosis of organ tissues such as the liver and gastrointestinal tracts such as the intestinal tract in surgical operations.

[Conventional technology]

Traditionally, anastomoses between organ tissues such as the liver and gastrointestinal tracts such as the intestines have been performed using hand-stitching operations, but when anastomosis occurs with bleeding or deep-seated organs that are fragile and easily cut, skilled techniques are required. Requires a long time.

[Problem to be solved by the invention]

In view of the above, this invention allows for easier and shorter
Moreover, such an anastomosis can be safely performed using a needle ring type instrument anastomosis device.

[Means for the invention to solve the problem]

The anastomosis between organ tissues and the digestive tract is performed by inserting multiple needles erected in a ring, rather than by hand-sewing. At that time, the piercing nail ring is pulled into the lumen of the gastrointestinal tract, and the ring inside the lumen is operated from outside the lumen to attach the needle attached to the ring to the viscera. , even if the direction and position of the needle within the lumen cannot be seen, the markings on the handle can be used to confirm it. In addition, a tension thread is attached to the ring in advance so that the ring can be easily removed from the gastrointestinal tract after the anastomosis is completed.

〔Example〕

FIG. 1 shows an embodiment of the insertion needle ring according to the present invention, in which 1 is a metal crown-shaped ring, 2 is a metal crown-shaped ring;
．． 2. ... is multiple insertion needles 1.3 set up in a ring
is an operation handle of the ring, which is attached to a hole 5 provided in the center of the narrow bottom plate portion 4 of the ring so that the tip of the ring can be attached and detached. Reference numeral 6 denotes a tension thread that is tied in advance to the small hole 7 of the narrow bottom plate portion 4 of the ring in order to remove the ring from the digestive tract after the anastomosis is completed. The needles set up around the ring come in long and short lengths, and some of them are short to prevent damage to the hepatic ducts and large blood vessels.

In order to make it easier to grip the tissue after insertion, the needle tip is enlarged as shown in Figure 2, and shape memory alloy is used for the insertion needle, so that it can be easily grasped by the tissue after insertion. As shown in FIG. 3, the shape of the needle may be straight, and after insertion, as shown in FIG. 4, the needle may be bent by body temperature so as to grasp the tissue to prevent it from falling off naturally. However, the needle must be strong (thin enough that it stretches when pulled and can be removed without damaging tissue).

An outline of the case where the liver and intestinal tract are anastomosed using the above-mentioned piercing nail ring will be explained with reference to FIG. In the figure, 8 indicates the hepatic portal anastomosis surface of the liver 9. 10 is the hepatic duct, 11 is the portal vein, and I2 is the vena cava. The piercing nail ring 1 with a thread attached thereto is pulled into the lumen of the intestinal tract and punctured in the intestinal wall on the opposite side of the intestinal anastomosis hole 16. The handle 3 is inserted through the hole 17, and the handle is attached to the ring with a piercing nail. Operate the ring using the handle attached to the ring, align the insertion needle with the hepatic portal to be anastomosed, and insert it into the peripheral wall of the anastomotic surface of the intestine and liver while observing the markings on the bundle.

At this time, among the insertion needles set up on the ring, those in the direction of large blood vessels such as the hepatic duct and portal vein are shortened in length, so that damage to these can be prevented.

As described above, the ring manhole I7 is sutured and closed to the peripheral wall of both anastomotic holes. After completion of the anastomosis 1 to 2 weeks later, the thread 6 extending from the septal opening 14 exposed outside the skin is pulled.
Take out the ring. Do not leave any foreign matter on the inner surface of the anastomosis.

[Effect]

As described above, when performing anastomosis between the liver and the intestinal tract, the piercing nail ring of the present invention can be operated from outside the intestinal tract using a removable handle attached to the piercing needle ring that has been pulled into the intestinal lumen. Then, you can easily insert the ring needle into the peripheral wall of both anastomotic surfaces by checking the position of the anastomotic surface while looking at the mark on the handle. The length of the needle should be shortened for needles that are located in the direction of blood vessels or important blood vessels, so damage to them can be prevented. After insertion, the ring is left in place and the handle is removed, so the handle does not interfere with subsequent procedures.

In addition, after the anastomosis is completed, the ring of the intestinal lumen is tied to this ring, and the skin can be easily removed by pulling the thread that has been taken out to the outside, so there is no foreign material left on the inner surface of the anastomosis. It has the following effects.

[Brief explanation of the drawing]

FIG. 1 shows an embodiment of a piercing needle ring according to the invention. FIG. 2 shows one embodiment of the needle tip shape of the insertion needle, and FIGS. 3 and 4 show other embodiments of the needle tip shape of the insertion needle. FIG. 5 is an explanatory diagram of the case where the liver and the intestinal tract are anastomosed using the piercing nail ring of the present invention. ■・・・Metallic crown-shaped ring, 2I, 2゜, 23・
... is multiple insertion needles installed on the ring peripheral wall, 3...
A ring operation handle that is detachably attached to the ring; 4. A thin bottom plate of the ring to which the handle and extraction thread are attached; 6. A tension thread for ring extraction;
8... Opening of hepatic hilum anastomoses of liver Pja9, v) 5 +D Procedural amendment (IL1 June 1, 1988 Director General of the Patent Office Kunio Ogawa 1, Indication of case Special order 1981) -103825 No. 2, Title of the invention Insertion needle ring type organ, gastrointestinal anastomosis device 3, Relationship with the case of the person making the amendment Patent applicant address 25-46 Mizubeyori Koen, Kumamoto City Name Fumi Yokoyoshi Outside - Name 4, Agent address 6, 4-9-32 Hongo, Bunkyo-ku, Tokyo, Contents of the amendment (1) Amended “Hasasuru so” in the 3rd line of page 6 of the specification to “Hasazuru so” (2) Change “skin wa” from line 6, page 6 of the Mei al.
1,,,t.

Claims (1)

[Scope of Claims] 1. A ring in which a plurality of needles for organ and gastrointestinal anastomosis are erected on the peripheral wall, and a ring for operating the ring that can be attached to and detached from the ring and has marks for confirming the direction and position of the needles. A ring-type organ and gastrointestinal anastomosis device consisting of a handle and a thread that connects the ring to the ring to be removed after the anastomosis is completed. 2. The insertion needle according to claim 1, wherein among the plurality of insertion needles erected on the peripheral wall of the ring, the length of the needle inserted in the direction of the hepatic duct or the large blood vessel is shortened. ring organ,
Gastrointestinal anastomosis device.