JP3636751B2 - Knot forming device - Google Patents

Description

[0001]
[Industrial application fields]
The present invention relates to a knot-forming instrument that enables sutures and ligatures to be sutured and ligated in the abdominal cavity during endoscopic surgery.
[0002]
[Prior art]
Recently, endoscopic surgery has been performed instead of open surgery. In this operation, various treatment tools such as forceps and a scalpel are inserted from a trocar inserted into the puncture site of the abdominal wall, and predetermined surgical treatment is performed under endoscopic observation.
[0003]
Endoscopic surgery has the advantage that the physical burden on the patient is light and the post-operative recovery is quick, but for those who perform the operation, it is operated remotely under observation by the endoscope Therefore, it requires a high level of technology and is extremely troublesome in terms of work. In particular, sutures and ligatures are extremely troublesome work.
[0004]
To perform suture stitching and ligation under the conventional endoscope, first hold the thread with a needle with a needle holder, pass through the trocar, and then use the forceps inserted from another trocar with the needle of the needle holder. Then, operate the forceps and needle holder to sew. Then, the yarn is once taken out of the trocar, knotted and returned to the abdominal cavity, and then ligated.
[0005]
[Problems to be solved by the invention]
However, such stitching and ligation, in addition to the cumbersome operation of changing needles, etc., pulls the thread out of the abdominal cavity and returns it again, increasing the chance of infection. Since the feeding path is long, there are various unfavorable situations, such as the tendency of yarn twisting.
[0006]
Therefore, recently, as described in, for example, Japanese Patent Laid-Open No. 3-12126, an anastomosis / suture device that performs anastomosis and suture using U-shaped staples has also been proposed.
[0007]
However, using such an anastomosis / suture device may cause the staples to fall into the abdominal cavity, and because of the limited size of the staples, anastomoses and sutures of tissue bundles larger than the staples are impossible. There is also a drawback of becoming.
[0008]
The present invention has been made to solve the problems associated with the prior art described above, and can suture or ligate a thread without trouble in the abdominal cavity, and there is no risk of dropping a foreign substance such as a staple in the abdominal cavity. An object of the present invention is to provide a knot-forming device that is excellent in safety and workability.
[0009]
[Means for Solving the Problems]
According to the first aspect of the present invention, which achieves such an object, a thread is inserted into an inside provided with a straight portion having a predetermined length and a bent portion formed at a tip portion of the straight portion. It has a hollow tube, and the bent portion has a slit having a width through which the yarn extending a predetermined length from the tip toward the straight portion can pass.
The present invention according to claim 2 is characterized in that the bent portion has a tip end substantially parallel to the straight portion or in a direction away from the straight portion.
According to a third aspect of the present invention, the hollow tube is capable of detachably capturing a thread so that the thread is not detached from the slit. capture It has the part.
According to a fourth aspect of the present invention, the slit is formed with a width that allows the thread to be inserted into the slit. capture And a wide portion from which the yarn can be easily removed from the yarn catching portion toward the straight portion.
The present invention according to claim 5 is characterized in that the hollow tube has a rigidity that is not easily deformed.
The present invention according to claim 6 is characterized in that the straight part has an operation part for rotating the hollow tube at a base part.
The present invention according to claim 7 is characterized in that the operation section has a position holding means for stopping and holding the hollow tube at a predetermined rotational position.
The present invention according to claim 8 is characterized in that the position holding means comprises a disk member for rotating the hollow tube and a fitting means for fitting at a predetermined position of the disk member.
The present invention according to claim 9 is characterized in that the operation portion has a yarn operation mechanism for holding the yarn so that the yarn can be advanced, retracted, stopped and opened.
According to the tenth aspect of the present invention, in the yarn operating mechanism, the straight portion and a yarn supply pipe provided coaxially with the straight portion are separated by a predetermined distance, A pair of pulleys that can rotate opposite to the yarn supplied from the yarn supply pipe toward the straight portion is installed between the yarn supply pipe and the pulleys are configured to be relatively close to each other. In addition, a drive member is provided on at least one of the pulleys.
According to the eleventh aspect of the present invention, the yarn operating mechanism can operate the yarn from the outside by attaching the straight portion to one of the opposing frame members of the rectangular annular frame and the yarn supply pipe to the other. It is characterized by doing so.
According to a twelfth aspect of the present invention, the yarn operation mechanism includes a thread winding at an end portion of the yarn supply pipe.
[0010]
[Action]
In the present invention described in claim 1, the thread is inserted through the entire length of the hollow tube, the thread is projected from the tip of the bent portion, and a needle is attached to the tip of the thread. Then, when the hollow tube is rotated by a predetermined angle, for example, approximately 180 degrees, with the tip of the bent portion positioned on the right side, for example, with respect to the needle position, the yarn pulled out from the tip of the bent portion and the bent portion A loop-shaped part is formed. A first knot is formed by passing the needle after the suture tissue is passed through the loop-shaped portion and removing the thread from the hollow tube through the slit of the bent portion.
[0011]
Next, when the hollow tube is rotated by a predetermined angle, for example, approximately 180 degrees in a state where the yarn is repositioned in the bent portion while the yarn is stretched, a loop-shaped portion is formed between the drawn yarn and the bent portion. Is formed. When the needle is passed through the loop-shaped portion, a second knot is formed, and the suture can be sutured or ligated under the endoscope without taking time and labor in the abdominal cavity.
[0012]
Here, if the rotation direction of the hollow tube is made different between the first knot and the second knot, a forward knot and a reverse knot are generated, and a firm stitching is possible.
[0013]
As described above, in the present invention, the tissue is sutured or ligated without using a foreign object such as a staple, so there is no risk of dropping a foreign object such as a staple into the abdominal cavity and the tissue under a highly safe endoscope can be removed. Suture and ligation can be easily performed.
[0014]
In the present invention according to claim 2, since the bent portion is oriented in a direction in which the tip thereof is substantially parallel to the straight portion or away from the straight portion, the yarn is bent around the bent portion when the hollow tube is rotated. The knot can be moved smoothly and removed, and the operation of forming the knot becomes smoother.
[0015]
According to the third aspect of the present invention, it is possible to keep the yarn in the hollow tube according to the stage of the operation for tying the yarn, and to remove the yarn from the slit, so that the operability is improved.
[0016]
According to the fourth aspect of the present invention, the yarn can be captured and released smoothly and reliably.
[0017]
In the present invention according to claim 5, since the hollow tube is made of a material having a rigidity that is not easily deformed, the bent portion is not deformed by the tension of the yarn or the like when the yarn is tied. The bent shape is maintained and the thread can be securely tied even in the abdominal cavity.
[0018]
In this invention of Claim 6, since the operation part is provided in the base part of the said linear part, the operativity at the time of rotating a hollow tube by operating an operation part improves.
[0019]
According to the seventh aspect of the present invention, when the hollow tube is rotated by a predetermined angle, for example, approximately 180 degrees by the operation portion, the hollow tube can be held at a predetermined rotational position by the position holding means. The person who is performing the operation can perform suturing or ligating by operating only the thread to which the needle is attached, using the hollow tube as a reference, without operating the knot forming device side.
[0020]
In the present invention according to claim 8, since the disk member is held in a fixed position by the fitting means, the person who is performing the operation operates the disk member to arbitrarily rotate the hollow tube. In addition, the hollow tube can be held at a predetermined position by the fitting means, and the stop position can be known while rotating the hollow tube by the disk member, so that the operability is improved.
[0021]
According to the ninth aspect of the present invention, since the operation portion has a yarn operation mechanism for holding the yarn so that the yarn can be advanced, retracted, stopped, and opened freely, the operability of the yarn is improved, and the yarn can be used even when a long yarn is used. Will not be drowned or entangled.
[0022]
In the tenth aspect of the present invention, the yarn operating mechanism is provided with the straight portion and the yarn supply pipe coaxially spaced apart from each other by a predetermined distance, and between the straight portion and the yarn supply pipe, from the yarn supply pipe. A pair of pulleys that can rotate in opposition to the yarn fed toward the straight portion is provided, and the yarn is held between these pulleys so that the yarn can be advanced, retracted, stopped, and opened. The shape becomes easy to handle, the amount of yarn taken in and out can be reliably controlled, the yarn operation is extremely simple, and the operability is excellent.
[0023]
In the present invention described in claim 11, since the straight portion is attached to one of the opposing frame members of the rectangular annular frame and the yarn supply pipe is attached to the other, the yarn can be operated from the outside. Etc. are easy to operate.
[0024]
In the present invention described in claim 12, since the yarn operating mechanism is provided with a thread winding at the end of the yarn supply pipe, even when a long yarn is necessary, it is not necessary to handle the long yarn. The yarn can be smoothly operated or controlled without being twisted or tangled, and the operability is improved in this respect as well.
[0025]
【Example】
An embodiment of the present invention will be described below with reference to the drawings.
FIG. 1 is a schematic perspective view of a knot forming device according to an embodiment of the present invention, FIG. 2 is a schematic cross-sectional view showing a bent portion which is a main part of the embodiment, and FIG. 3 is a schematic view showing an operation portion of the embodiment. FIG. 4 is a sectional view taken along line 4-4 of FIG. 3, and FIG. 5 is a schematic explanatory view showing the order of forming two knots according to the process.
[0026]
In FIG. 1, the knot forming device includes a hollow tube 10 through which a thread S is inserted, and an operation unit 20 that rotates the hollow tube 10.
[0027]
The hollow tube 10 is composed of a straight portion 11 having a predetermined length and a bent portion 12 formed at the tip portion of the straight portion 11, and the whole has a J-shape. As shown in FIG. 2, the bent portion 12 is formed with a yarn catching portion 12a having a slit with a width that allows the yarn S to pass through the tip, and from the yarn catching portion 12a to the straight portion 11 A wide portion 12b of a wide slit is formed so that the yarn S can be easily detached from the tip portion.
[0028]
In particular, the bent portion 12 is preferably formed such that the tip thereof is substantially parallel to or away from the straight portion 11. In other words, the extension line A at the tip of the bent portion 12 is preferably formed so as to be parallel to or away from the straight portion 11. In this way, when the hollow tube 10 is rotated, the thread S can be moved so as to smoothly slide along the bent portion 12, or can be easily removed, or taken into the wide portion 12b. Can be handled easily. In the illustrated example, the bent portion 12 is formed in an arc shape. However, in the present invention, the bent portion 12 does not necessarily have an arc shape, and may have various other shapes such as an L shape or a U shape having a relatively round shape depending on circumstances.
[0029]
In addition, the hollow tube 10 preferably has a certain degree of rigidity so that the bent portion 12 does not deform due to, for example, the tension of the yarn during the operation of tying the yarn described later. However, the present invention is not limited to this, and may be made of a material having a certain degree of flexibility so as to be inserted into the abdominal cavity through the trocar.
[0030]
Here, although not particularly limited, as a preferred embodiment, the hollow tube 10 is made of a metal material such as a superelastic alloy such as aluminum, brass, copper, stainless steel, tungsten, carbon steel, or TiNi alloy. Or a hard resin such as polycarbonate, polyethylene, polypropylene, hard polyvinyl chloride, or polyester, and the inner diameter d is 0.5 to 2.0 mm, more preferably 1.0 to 1.5 mm. A tube having a length D of 1.5 to 4.0 mm, more preferably about 1.8 to 3.0 mm is used, and the straight portion 11 has a length L of 35 to 55 mm, more preferably 40 to 50 mm. is there. Moreover, the curvature radius r of the bending part 12 is 1.8-3.0 mm, More preferably, it is 2.0-2.5 mm.
[0031]
If it is below the above range, the suture needle N will not pass through the loop of the bent portion 12, and if it exceeds it, it will be difficult to pass through the trocar tube.
[0032]
The width of the wide portion 12b is 1.0 to 2.5 mm, more preferably 1.5 to 2.0 mm, considering that the yarn does not come off, and the width of the yarn catching portion 12a is It is 0.7-1.2 mm, More preferably, it is 0.8-1.0 mm.
[0033]
In the illustrated example, the slit is formed narrow at the tip, but the present invention is not limited to this, and the slit may have the same width throughout. Even in such a case, the knot of the yarn can be formed by performing a series of operations so that the yarn is hooked on the tip except the portion where the slit of the bent portion 12 is formed. Further, the yarn catching portion 12a is not limited to the illustrated one, and for example, a cut may be provided separately from the slit at the tip of the bent portion 12, and the yarn may be detachably sandwiched in this cut.
[0034]
As shown in FIGS. 1 and 3, the operation portion 20 is fixed to the front outer casing 21 that supports the straight portion 11 of the hollow tube 10 from the tip and the base end portion of the straight portion 11 at the center. A disk member 22 for rotating the hollow tube 10, a yarn operating mechanism 24 provided in a rectangular annular frame 23, for holding the yarn S so as to freely advance, retract, and open, and the hollow tube 10. Position holding means 25 for holding at a predetermined stop position, and a yarn supply portion 26 having a yarn supply pipe 11a provided coaxially with the base of the straight portion 11 are provided.
[0035]
The front outer casing 21 is a hermetically sealed hollow box body, and is configured to rotatably support the base portion of the straight portion 11 by a sleeve 21 a provided therein, so as to bypass the disk member 22. The U-shaped connecting member 28 (see FIG. 1) provided on the threaded operation mechanism 24 is integrally connected to the rectangular annular frame 23.
[0036]
As described above, when the operation portion 20 is provided at the base of the straight portion 11 and the hollow tube 10 is stably rotated by the front outer casing 21, the hollow tube 10 is smoothly centered on the straight portion 11. In addition, it can rotate stably and can be operated relatively easily at the bent portions 12 which are considerably separated.
[0037]
The disk member 22 is provided between the front outer casing 21 and the front frame member 23f of the rectangular annular frame 23, and the base end portion of the straight portion 11 passes through and is fixed to the center portion.
[0038]
The outer circumferential surface of the disk member 22 is preferably provided with a knurled groove or the like to prevent slippage during the rotation operation.
[0039]
Between the disk member 22 and the front frame member 23f of the rectangular annular frame 23, the position of the rotation of the disk member 22 is temporarily held, and the position of the hollow tube 10 is held at a predetermined position. Means 25 are provided. As will be described later, the hollow tube 10 rotates approximately 180 degrees to form a loop-shaped portion. The position when rotated 180 degrees is held by the position holding means 25, and the knot forming instrument side is operated. Even if not, the operation on the needle side can be performed.
[0040]
The position holding means 25 includes, for example, a pair of convex portions 29 and 29 formed symmetrically on the back side of the disk member 22, and one concave portion 30 formed on the front frame member 23 f of the rectangular annular frame body 23. The convex portion 29 is elastically fitted into the concave portion 30. The concave / convex fitting by the position holding means 25 is a function of temporarily holding the rotational position of the hollow tube 10 described above, and the rotation of the disk member 22 by the click feeling generated when the convex / concave portions 29 and 30 are concave / convexly fitted. The position, that is, the rotational position of the hollow tube 10 can be made known to the person performing the operation.
[0041]
In order to smoothly fit and release the convex portion 29 and the concave portion 30, it is desirable that the U-shaped connecting member 28 has a certain degree of elasticity.
[0042]
The position holding means 25 is not limited to the concave and convex fitting as described above, but may be a simple fitting of the protrusion and the concave portion.
[0043]
The thread operating mechanism 24 has a through hole 31 formed in the front frame member 23f of the rectangular annular frame 23, and the straight part 11 is passed through the through hole 31. The straight part 11 and the rear frame member The yarn supply pipe 11a provided through the through hole 32 of 23b is coaxially provided with a predetermined distance. Between the straight portion 11 and the yarn supply pipe 11a, a pair of pulleys 33 and 34 that can rotate to face the yarn S supplied from the yarn supply pipe 11a toward the straight portion 11 are opposed to each other. ing. These pulleys 33 and 34 are configured to be relatively close to each other, and the right pulley 34 is provided with a rotating handle 35 as a drive member.
[0044]
Accordingly, when the thread S is inserted between the pulleys 33 and 34 and the thread S is held by the pulleys 33 and 34 and then the right pulley 34 is rotated by operating the rotary handle 35, the pulleys 33 and 34 and the thread S are rotated. The thread S can be moved forward and backward by the frictional force between the two and the pulleys 33 and 34 can be separated to make the thread S free and to stop the supply of the thread S. Yes.
[0045]
In the right pulley 34, a rotating shaft 34a is rotatably held at the tip of a support plate 36 protruding from the right side frame member 23r, and the rotating handle 35 is attached to the upper end of the rotating shaft 34a.
[0046]
On the other hand, in the left pulley 33, the rotation shaft 33a is freely displaceable in a long hole 38 (see FIG. 4) provided at the tip of a support plate 37 (shown by a one-dot chain line in FIG. 3) protruding from the left side frame member 23l. Displacement means 39 for displacing the position of the left pulley 33 is provided at the upper and lower ends of the rotation shaft 33a. Various types of displacement means 39 using a cam or a motor are conceivable, but a screw mechanism as shown in the drawing is preferable in consideration of ease of operation and safety.
[0047]
The displacement means 39 of this embodiment has a bracket 40 having a U-shaped cross section that supports the upper and lower ends of the left pulley 33. A vertical plate 40a of the bracket 40 is in contact with a contact plate 41. A tension spring 42 is interposed between the plate 41 and the left side frame member 23l. The operating screw shaft 43 screwed to the left side frame member 23l is protruded against the tensile force of the spring 42, and the vertical piece 40a of the bracket 40 is pressed by a pressing piece 43a provided at the tip of the operating screw shaft 43. The left pulley 33 is brought closer to the right pulley 34.
[0048]
In the figure, reference numeral “44” denotes a bottom support plate. Further, the operation screw shaft 43 may be provided with a contact member 43b at a position spaced apart from the pressing piece 43a by a predetermined length so that the left pulley 33 does not retreat unnecessarily. Further, the base end portion of the straight portion 11 is expanded in a trumpet shape, facilitating the insertion of the yarn S, the tip of the yarn supply pipe 11a is narrowed, and the supplied yarn S is securely attached to the straight portion 11. It goes to the trumpet-shaped entrance.
[0049]
In this way, a pair of rotatable pulleys 33 and 34 are provided between the straight portion 11 provided with the yarn operating mechanism 24 coaxially and the yarn supply pipe 11a, and the yarn is held between the pulleys 33 and 34. Since it is designed to advance, retreat, stop, and open, the entire device has a shape that is stretched in a straight line, making it easy to handle the device, not only reliably controlling the amount of yarn taken in and out, but also making the yarn operation extremely simple. The operability is excellent.
[0050]
Further, if the rectangular annular frame 23 having an open upper end is used, the yarn S in the yarn operating mechanism 24 can be operated from the outside, and the operation of the yarn S between the left and right pulleys 33 and 34, for example, a heel or the like from the outside The yarn S can be easily cut by inserting a yarn cutting member (not shown), and the yarn S can be easily connected if necessary. However, it goes without saying that an openable / closable lid may be provided to cover the rectangular annular frame 23 with the upper end opened.
[0051]
The yarn supply unit 26 includes a yarn winding 45 at the rear end portion of the yarn supply pipe 11a (see FIG. 1), and the yarn S can be supplied between the left and right pulleys 33 and 34 from the yarn winding 45. Even if a long thread is used, the thread does not get twisted or entangled, and the thread can be operated smoothly.
[0052]
Next, the operation of the embodiment will be described.
First, the operating screw portion 43 is retracted, the left pulley 33 is separated from the right pulley 34, and the yarn S drawn from the spool 45 is guided between the left and right pulleys 33, 34 through the yarn supply pipe 11a. For this reason, even when a long yarn S is required, the yarn S is pulled out from the spool 45 one after another, so that the yarn S is not twisted or entangled.
[0053]
Then, after the operation screw portion 43 is advanced and the left and right pulleys 33 and 34 are brought into contact with each other, the handle 35 of the right pulley 34 is rotated, and the thread S is fed to the bent portion 12 through the straight portion 11, The needle N is attached to the thread S that has come out from the tip of the bent portion 12 (the state shown in FIG. 5a). When the yarn is passed through the hollow tube 10, the yarn is easily inserted up to the tip of the straight portion 11, and the yarn reaching the tip is pulled out from the wide portion 12b of the bent portion 12 to catch the yarn. It is pulled out from the tip through the slit of the portion 12a.
[0054]
The hollow tube 10 is placed into the abdominal cavity through the trocar. In this case, since the hollow tube 10 is flexible to some extent, even if it has the bent portion 12, it can be easily inserted into the trocar.
[0055]
Then, the tip of the bent portion 12, that is, the yarn catching portion 12a is positioned, for example, on the right side with respect to the position of the needle, and the hollow tube 10 is rotated by a predetermined angle, for example, approximately 180 degrees by the operating portion 20 in this state. A loop-shaped portion R1 is formed by the yarn S drawn from the tip of the bent portion 12 and the bent portion 12 (state shown in FIG. 5b).
[0056]
Here, when the operation unit 20 rotates the hollow tube 10 by a predetermined angle, for example, approximately 180 degrees, the hollow tube 10 is temporarily held at the rotation position by the position holding means 25, so that the person performing the operation Can easily operate the thread S to which the needle N is attached with the hollow tube 10 in a stationary state as a reference.
[0057]
The needle after the suture tissue H has been inserted through the loop-shaped portion R1 is held by, for example, forceps (state shown in FIG. 5c), and the hollow tube 10 is inverted by a predetermined angle, for example, approximately 180 degrees. When the yarn S is removed from the hollow tube 10 through the slit of the yarn catching portion 12a, a first knot (forward knot) is formed (states shown in FIGS. 5d and 5e).
[0058]
Next, when the hollow tube 10 is inverted by a predetermined angle, for example, approximately 180 degrees in a state where the yarn S is put in the yarn catching portion 12a of the bent portion 12 while the yarn S is distracted, the drawn yarn is drawn. S is located behind the bent portion 12, where a loop-shaped portion R2 is formed (state of FIG. 5f). The needle N is passed through the loop-shaped portion R2 (state shown in FIG. 5g), and the bent portion 12 is moved to the left as shown in FIG. When the degree is reversed, a knot opposite to the knot is formed as shown in FIG. 5i.
[0059]
Accordingly, the thread S can be sutured or ligated under the endoscope in the abdominal cavity without taking the trouble of pulling the thread S out of the trocar, and foreign matters such as staples are not used. There is no danger, and the tissue can be sutured or ligated under a highly safe endoscope.
[0060]
The present invention is not limited to the above-described embodiments, and can be appropriately modified and used within the scope of the claims. For example, in the above-described embodiment, the disk member 22 that is manually rotated is used as the operation unit 20 that rotates the hollow tube 10, but the present invention is not limited to this, but by a handle lever that rotates manually or a motor drive. A rotating tube or the like can also be used, and the rotation angle of the hollow tube 10 can be appropriately selected depending on circumstances as well as rotation or reversal of 180 degrees.
[0061]
Moreover, in the said Example, although the position holding means 25 is comprised from the disc member 22 and the fitting means which carries out uneven | corrugated fitting to this disc member 22, the operation part 20 which rotates the hollow tube 10 is comprised. Any device may be used as long as the rotation is temporarily stopped and held, for example, a ratchet mechanism, a mechanism using a retractable pin, and the like.
[0062]
Furthermore, in the above-described embodiment, the pulleys 33 and 34 are used as the yarn operation mechanism 24 and the supply of the yarn S is stopped. However, not only this but also a friction wheel such as a roller may be used.
[0063]
【The invention's effect】
As described above, in the present invention described in claim 1, the thread is inserted into the inside provided with the straight portion having a predetermined length and the bent portion formed at the tip portion of the straight portion. When the hollow tube is appropriately rotated, a loop-shaped portion is easily formed due to the relationship between the thread and the bent portion. When a needle is passed through the loop-shaped portion, a knot is easily formed. In this case, the thread can be sutured or ligated under the endoscope with a simple device without any trouble.
[0064]
In this case, the tissue is sutured or ligated without using foreign matter such as staples, so there is no risk of dropping foreign matter such as staples into the abdominal cavity and the tissue is sutured or ligated under a highly safe endoscope. Can be performed.
[0065]
In the present invention described in claim 2, since the bent portion is oriented in a direction in which the tip thereof is substantially parallel to the straight portion or away from the straight portion, the yarn moves smoothly when the hollow tube is rotated. , Knot forming work becomes smooth.
[0066]
In this invention of Claim 3, the thread | yarn which can catch a thread | yarn removably so that the said hollow tube may not remove | deviate a thread | yarn from a slit capture Therefore, it is possible to keep the yarn in the hollow tube according to the stage of the operation for tying the yarn, and to remove the yarn from the slit, thereby improving the operability.
[0067]
In this invention of Claim 4, the said slit is formed in the width | variety of the grade which can insert the said thread | yarn in the front-end | tip part, and the said thread | yarn capture Since the yarn is formed so as to be easily removed from the yarn catching portion toward the straight portion, the yarn can be caught and released smoothly and reliably. .
[0068]
In the present invention according to claim 5, since the hollow tube is made of a material having a rigidity that is not easily deformed, the bent portion is not deformed by the tension of the yarn or the like when the yarn is tied. The bent shape is maintained and the thread can be securely tied even in the abdominal cavity.
[0069]
In the present invention described in claim 6, since the operation part is provided at the base part of the straight part, the operability when the hollow tube is rotated by operating the operation part is improved.
[0070]
According to the seventh aspect of the present invention, when the hollow tube is rotated by a predetermined angle, for example, approximately 180 degrees by the operating portion, the hollow tube can be held at the predetermined rotational position by the position holding means. The person who performs the operation can perform suturing or ligating by operating only the thread to which the needle is attached, using the hollow tube as a reference, without operating the knot forming instrument side.
[0071]
In the present invention according to claim 8, since the disk member is held in a fixed position by the fitting means, the person who is performing the operation operates the disk member to arbitrarily rotate the hollow tube. In addition, the hollow tube can be held at a predetermined position by the fitting means, and the stop position can be known while rotating the hollow tube by the disk member, so that the operability is improved.
[0072]
In the present invention described in claim 9, since the operation portion has a yarn operation mechanism for holding the yarn in such a manner that the yarn can be advanced, retracted, stopped, and opened freely, the operability of the yarn is improved, and even when a long yarn is used There is no drowning or entanglement.
[0073]
In the tenth aspect of the present invention, the yarn operating mechanism is provided with the straight portion and the yarn supply pipe coaxially spaced apart from each other by a predetermined distance, and between the straight portion and the yarn supply pipe, from the yarn supply pipe. A pair of pulleys that can rotate in opposition to the yarn supplied toward the straight part is provided, and the yarn is held between these pulleys so as to advance, retreat, stop, and open. The shape is easy to handle, the amount of yarn taken in and out can be reliably controlled, the yarn operation is extremely simple, and the operability is excellent.
[0074]
In the present invention described in claim 11, since the straight portion is attached to one of the opposing frame members of the rectangular annular frame and the yarn supply pipe is attached to the other, the yarn can be operated from the outside. Etc. are easy to operate.
[0075]
In the present invention described in claim 12, since the yarn operating mechanism is provided with a thread winding at the end of the yarn supply pipe, even when a long yarn is necessary, it is not necessary to handle the long yarn. The yarn can be smoothly operated or controlled without being twisted or tangled, and the operability is improved in this respect as well.
[Brief description of the drawings]
FIG. 1 is a schematic perspective view showing an embodiment of the present invention.
FIG. 2 is a schematic cross-sectional view showing a bent portion of the embodiment.
FIG. 3 is a schematic cross-sectional view showing an operation unit of the embodiment.
4 is a cross-sectional view taken along line 4-4 of FIG.
FIG. 5 is a schematic explanatory diagram showing the order of forming knots by process.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 10 ... Hollow pipe, 11 ... Straight part, 11a ... Yarn supply pipe, 12 ... Bending part,
12a ... Yarn catching part, 12b ... Wide part, 20 ... Operation part, 22 ... Disk member,
23 ... Rectangular annular frame, 23f ... Front frame member, 23b ... Rear frame member,
24 ... thread operation mechanism, 25 ... position holding means, 29 ... convex part, 30 ... concave part,
33, 34 ... pulley, 35 ... rotating handle (drive member), 45 ... spool,
S ... Thread.

Claims (12)

A hollow tube having a straight portion having a predetermined length and a bent portion formed at the tip of the straight portion is inserted into the inside of the tube, and the bent portion is straight from the tip. A knot-forming device comprising a slit having a width through which the yarn extending a predetermined length toward the shape portion can pass. The knot forming device according to claim 1, wherein the bent portion has a tip end substantially parallel to the straight portion or in a direction away from the straight portion. The knot forming device according to claim 1 or 2, wherein the hollow tube further includes a yarn catching portion that can detachably catch the yarn so that the yarn does not come off from the slit. The slit is formed with a width that allows the thread to be inserted through the slit to form the thread catcher, and the wide part from which the thread can be easily removed from the thread catcher toward the straight part. The knot forming device according to any one of claims 1 to 3, wherein the knot forming device is formed. The knot forming device according to any one of claims 1 to 4, wherein the hollow tube has a rigidity that is not easily deformed. The knot forming instrument according to any one of claims 1 to 5, wherein the straight part has an operation part for rotating the hollow tube at a base part. The knot forming instrument according to claim 6, wherein the operation unit includes position holding means for stopping and holding the hollow tube at a predetermined rotation position. The knot forming device according to claim 7, wherein the position holding means includes a disk member for rotating the hollow tube and a fitting means for fitting at a predetermined position of the disk member. The knot forming device according to any one of claims 6 to 8, wherein the operation portion includes a yarn operation mechanism that holds the yarn in such a manner that the yarn can be advanced, retracted, stopped, and opened. The yarn operating mechanism has a predetermined distance between the straight portion and a yarn supply pipe provided coaxially with the straight portion, and a yarn supply between the straight portion and the yarn supply pipe. A pair of pulleys that can rotate in opposition to the yarn supplied from the pipe toward the straight portion is installed, and the pulleys are configured so as to be relatively close to each other, and at least one of the pulleys is driven. The knot forming device according to claim 9, wherein the knot forming device is provided. The thread operation mechanism is characterized in that the straight portion is attached to one of opposing frame members of the rectangular annular frame, and the thread supply pipe is attached to the other, so that the thread can be operated from the outside. The knot forming device according to 9 or 10. The knot forming device according to any one of claims 9 to 11, wherein the yarn operation mechanism includes a thread winding at an end portion of the yarn supply pipe.

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