JP6206838B2 - Tissue self-joining body insertion tube - Google Patents

Description

  The present invention is used as an in-vivo insertion tube that is joined to a tissue in a living body, in particular, a blood removal tube or blood feed tube that is joined to an artificial heart, or a part thereof, and prevents infection by bacteria or the like. The present invention relates to a tissue self-joining in-vivo insertion tube and a method for joining the in-vivo insertion tube and body organ tissue.

  In order to attach an auxiliary artificial heart, it is necessary to attach it to the heart via a blood removal vessel or a blood vessel. At that time, attachment of the blood vessel to the heart is performed with a purse string suture 20 using a needle and a thread for the heart 19 using a cuff 18 of the blood vessel 17 as shown in FIG. ing. Similarly, as shown in FIG. 15 (b), the blood vessel 21 is attached to the artery 19 by suturing. However, it has been reported that such a suture causes a slight gap in the connection part between the devascularization and the cuff or the connection part between the blood sending tube and the heart, and bacteria enter the gap to cause various infectious diseases. Yes.

  As a method for removing gaps in the joints that occur when attaching artificial blood vessels or blood-feeding vessels to the heart, high-energy ultrasonic medical scalpels, electric scalpels, etc., and tissue bonding using medical adhesives are considered. It is done. The ultrasonic scalpel is used in coronary artery bypass surgery or the like, and is used in a method for hemostasis by joining and closing a cut surface of a blood vessel when a blood vessel of several mm is cut. An electric scalpel is a device that applies a voltage between counter electrodes to cause an electric current to flow through a living tissue and uses the heat generated thereby to join. In addition, there is a laser knife that uses tissue coagulation to denature tissue using an argon (Ar) laser or a YAG laser. However, these devices using high energy have a problem that tissue is easily carbonized by the high energy and the tissue damage is severe. Moreover, electric scalpels are concerned about electric shocks to the human body, noise disturbances to other devices, and the like.

  For example, medical adhesives are used for bonding soft tissues such as artificial blood vessels used as a substitute for biological blood vessels, and cyanoacrylates and fibrin-based materials are mainly used as materials. Medical adhesives are excellent in workability and feature short-time adhesion, but have problems in terms of toxicity to the living body and antibacterial properties. In addition, due to adhesive deterioration or adhesive component leaching during use, not only adverse effects on the living body but also a significant decrease in adhesiveness may occur, limiting the range of use.

  As a biological tissue bonding method that does not depend on the above high energy, medical adhesive, or the like, Patent Document 1 partially or entirely includes a porous structure or a porous molded body formed in a linear shape. An inflow cannula for assisting blood circulation made of a porous structure is disclosed. The porous structures described in Patent Literature 1 and Patent Literature 2 described above stably stabilize the thrombus using voids formed by the irregularities and pores of the porous structure in order to prevent blood flow disorders and diseases caused by the thrombus. It is arranged and fixed for anchoring.

  Further, in Patent Document 3, the endocardium of the heart extends along the outer peripheral surface of the cannula and the extended portion is cut, and the cut endocardial piece is mixed in the blood and occludes the blood vessel. In order to prevent this, a cannula having a tubular main body and a cylindrical porous body arranged so as to go around the outer peripheral surface of the main body has been proposed.

  Furthermore, Patent Documents 4 and 5 propose an in-vivo insertion tube used for anastomosis of a digestive tract or a blood vessel or a connection between an artificial blood vessel and a biological blood vessel as an in-vivo tissue. The bioabsorbable connecting pipe described in Patent Document 4 has a structure having a flange for preventing the removal. Further, the above-mentioned Patent Document 5 is composed of a hollow cylindrical member integrally formed from a corrosion-resistant metal material, and a plurality of through holes are formed in the peripheral wall of the cylindrical member, and the outer periphery of the cylindrical member is formed on the outer periphery of the cylindrical member. An artificial blood vessel connecting portion in which at least one circumferential groove along the circumferential direction is formed is disclosed.

JP 2010-264274 A JP 2010-104806 A JP 2008-279188 A Japanese Patent Laid-Open No. 9-38119 Japanese Patent No. 3568756

  As mentioned above, when attaching a blood vessel to the heart, or joining or connecting a blood vessel to the heart, the joint part should be joined with high strength without gaps so that bacteria do not enter with conventional purse string sutures. Is difficult. In addition, biological tissue joining using high energy, medical adhesive, and the like not only has adverse effects such as damage to the living body and toxicity, but also requires high skill and skill to obtain high joint strength.

  In Patent Documents 1 and 2 described above, an inflow cannula (insertion tube) for assisting blood circulation made of a porous structure is disclosed. The texturized surface made of this porous structure stabilizes thrombus. It is formed for anchoring, and has a structure extending not only to the portion that contacts the heart wall corresponding to the joint portion but also to the inside of the heart. In addition, since this inflow cannula has a cuff and a cuff holding screw, it is clear that a porous structure is not formed in order to improve the bonding strength with the heart. The technical problem of improving the joint strength by the body was not recognized at all.

  In the cannula described in Patent Document 3, the endocardium is infiltrated into the porous body by disposing the porous body in a portion in contact with the endocardium, so that the endocardium becomes the outer peripheral surface of the cannula. It suppresses extending | stretching along. Therefore, this porous body is not formed in order to improve the bonding strength with the heart. Furthermore, since the resin exemplified as the material of the porous body has elastic characteristics, it cannot be expected to have a strong bonding strength.

  In addition, the bioabsorbable connecting tube described in Patent Document 4 and the artificial blood vessel connector described in Patent Document 5 are sutured by a needle such as a digestive tract or a blood vessel, or adhesively bonded by a medical adhesive, respectively. And for assisting the sewing between the artificial blood vessel and the biological blood vessel. Therefore, these in-vivo insertion tubes do not have a structure that can be firmly joined to a living tissue, and cannot solve the problem that bacteria enter from a joined portion by stitching or sewing.

  The present invention has been made in view of the above-described conventional problems, and it is possible to perform blood vessel removal of an auxiliary artificial heart or a joint between a blood sending tube and a heart, or a joint between an artificial blood vessel and a biological blood vessel more quickly than before. As a part of the establishment of high-strength bonding technology with living tissue including support for artificial heart attachment, in order to obtain a high bonding strength without forming gaps for bacteria to enter, An object of the present invention is to provide a tissue self-joining in-vivo insertion tube applicable to the energy joining method and a joining method of the in-body insertion tube and the internal organ tissue.

  The present invention has been intensively studied on the structure and configuration of a tissue self-joining body insertion tube that can increase the joint strength with internal organ tissues such as the heart and blood vessels, as an alternative to conventional sutures and stitches. As a result, on the side of the body insertion tube that comes into contact with the body organ tissue, to form a surface shape that can provide an anchoring effect due to deformation or displacement of the body organ tissue, and to enhance this anchoring effect It has been found that the above problems can be solved by providing the body insertion tube with a structure that facilitates deformation or displacement of the body organ tissue.

That is, the configuration of the present invention is as follows.
(1) The present invention is an in-vivo insertion tube that is heated and / or micro-vibrated in contact with the in-vivo organ tissue in a state covered with the in-vivo organ tissue, At least a groove, a hole, or a recess having a size capable of obtaining a throwing effect is formed on a side in contact with the body organ tissue by a part of the body organ tissue being deformed or displaced, and the body insertion tube and the body A passage for applying a negative pressure to the groove, hole, or depression when formed in the body organ tissue is formed in the body insertion tube, and is joined by heating and / or microvibration in contact with the body organ tissue. And a tissue self-joining body insertion tube having a tensile strength of 0.01 MPa or more .
(2) In the present invention, the tissue self-joining in-vivo insertion tube according to (1) described above is an outer tube in which a groove, hole, or depression for causing deformation or displacement of the internal organ tissue is formed. And an inner tube having an inner cavity that functions as a passage for blood, infusion, or wiring inside the outer tube, and a passage for applying a negative pressure to the groove, hole, or depression is the outer tube. And a self-joining tissue insertion tube, characterized in that it is formed in at least one of the inner tube and the inner tube.
(3) In the present invention, the tissue self-joining intracorporeal insertion tube according to (2) described above is (A), (B), and (C), that is, (A) a groove, hole, or In order to apply a negative pressure to the groove, hole, or dent by discharging or sucking air existing between the body insertion tube and the body organ tissue from the depression toward the outside of the body insertion tube. (B) between the insertion tube and the internal organ tissue from the groove, hole or depression of the external tube toward the internal cavity of the internal tube. Providing the inner pipe with a passage for applying a negative pressure to the groove, hole or depression by exhausting or sucking air present in the pipe, and (C) from the groove, hole or depression of the outer pipe, Exists between the body insertion tube and the body organ tissue towards the internal cavity of the inner tube Any one selected from the group consisting of providing both the outer tube and the inner tube with a passage for applying a negative pressure to the groove, hole or recess by discharging or sucking air. A self-joining tissue insertion tube is provided.
(4) The tissue self-joining intracorporeal insertion tube according to (2) or (3), wherein the outer tube and the inner tube are fixed via a buffer or an elastic body. I will provide a.
(5) The present invention is characterized in that the tissue self-joining in-vivo insertion tube includes a discharge port or a suction port directly connected to a passage for applying a negative pressure to the groove, hole, or depression. A tissue self-joining body insertion tube according to any one of 1) to (4) is provided.
(6) The tissue self-joining intracorporeal insertion tube according to any one of (1) to (5), wherein the tissue self-joining intracorporeal insertion tube includes a heat source for heating. provide.
(7) The present invention provides the tissue self-joining intracorporeal insertion tube according to any one of (1) to (6), wherein the intracorporeal insertion tube is an artificial heart devascularization.
[Effect of the invention]

  The internal organ insertion tube according to the present invention has not only a groove, a hole, or a depression on the side in contact with the internal organ tissue, which can provide an anchoring effect due to deformation or displacement of the internal organ tissue. When a negative pressure is applied to the joint portion by providing a passage for exhausting or sucking air existing between the insertion tube and the body organ tissue to apply a negative pressure to the groove, hole, or depression. The body organ tissue can be easily deformed or displaced into the groove, hole, or depression, and the effect of increasing the bonding strength by preventing the generation of voids and gaps that reduce the bonding strength at the bonding interface can be expected.

  In addition, according to the present invention, the body insertion tube has a double tube structure of an outer tube and an inner tube, thereby increasing the bonding strength with the body organ tissue and functioning as a blood, infusion or wiring passage. Since these can be separately formed and formed as an outer tube and an inner tube, the shape of the body insertion tube can be freely changed only by changing the design of the outer tube shape. As a result, it is possible to produce an in-vivo insertion tube in which the shape of the outer tube matches the position of joining with the shape of the internal organ tissue, and it is possible to join the internal organ tissue having various shapes. . Furthermore, since at least one of the outer tube and the inner tube includes a passage for applying a negative pressure to the groove, hole, or depression, it is possible to discharge air existing between the body insertion tube and the body organ tissue or The internal organ tissue is deformed and displaced so that a large throwing effect can be obtained by suction, and the joint strength can be further improved.

  The joining method of the body insertion tube and the body organ tissue according to the present invention can be performed not only by composite low energy joining, but also because the joining portion has no gap and high joining strength can be obtained. And it can be performed easily. Furthermore, prevention of bacterial invasion from the joined portion produces an effect of suppressing the generation of thrombus induced by the invasion of bacteria after joining, so that a safe and highly safe joining method can be constructed.

It is a figure which shows the devascularization as an example of the tissue self-joining type | mold insertion tube of this invention. It is a cross-sectional schematic diagram which shows the groove | channel, the hole, and the hollow provided with the channel | path for making a negative pressure act formed in the tissue self-joining type | mold insertion tube of this invention. It is a figure which shows an example of the joining mechanism of the internal organ tissue by composite low energy and the in-vivo insertion tube of this invention. It is a figure which shows the example which applied the in-vivo insertion tube of the single-pipe structure provided with the channel | path for making the negative pressure act by this invention as a blood-vessel removal. It is a figure which shows each cut surface of the part of a groove | channel and the part of a discharge port or a suction port in the insertion tube of the single tube | pipe structure by this invention. It is a figure which shows the example of formation of the channel | path for making a negative pressure act in the insertion tube of the single tube | pipe structure by this invention. It is a figure which shows the insertion tube of the double tube | pipe structure by this invention which has an outer tube | pipe and the inner tube | pipe provided with the channel | path for making a groove | channel, a hole, or a hollow and a negative pressure act inside. It is a figure which shows typically the cross section of the body insertion tube of a double tube structure which has an outer tube | pipe and an inner tube | pipe and is provided with the channel | path for an outer tube | pipe or an inner tube | pipe to apply a negative pressure. It is a figure which has an outer tube | pipe and an inner tube | pipe and is provided with the body insertion pipe | tube provided with the channel | path for applying a negative pressure around the inner tube | pipe. It is a figure which has the outer tube | pipe and the inner tube | pipe, and shows the joining state of the body insertion pipe | tube provided with the channel | path for making a negative pressure act around an inner tube | pipe, and a body organ tissue. It is a figure which shows the internal insertion pipe of another form which has a structure which has an outer tube | pipe and an inner tube | pipe, and the channel | path for applying a negative pressure is connected to the internal cavity of an inner tube | pipe from the groove | channel of an external appearance. It is a figure which shows the joining method using the micro vibration by a piezo element in joining of the body insertion tube and body organ tissue of this invention. It is a figure which shows the schematic of the prototype of the tissue self-joining type blood-vessel by this invention. It is a figure which shows the joining strength measurement result by the tension | tensile_strength in the junction part of the body insertion tube and heart of this invention. It is a figure which shows the conventional method of suturing with the heart using the cuff of a devascularization.

  FIG. 1 is a diagram showing devascularization as an example of the tissue self-joining intracorporeal insertion tube of the present invention. FIG. 1 (a) shows an example of devascularization in the body layer insertion tube 1 of the present invention in which four cut grooves 2 are formed around the upper part where the heart is joined. FIG. 1B shows an example of a blood removal vessel in which the groove 2 is formed in an annular shape. FIG. 2 is a schematic cross-sectional view of grooves, holes, and depressions formed in the tissue self-joining body insertion tube of the present invention. In the body insertion tube 1 of the present invention, not only the shape of the groove 2 but also the hole 3 or the depression 4 are formed at the joint portion with the body organ tissue. The groove 2, the hole 3, and the recess 4 are connected to the internal cavity 7 of the body insertion tube 1 through a passage 5 for applying a negative pressure. As shown in FIG. 1 (a) or (b), the groove 2, the hole 3 and the recess 4 shown in FIG. 2 are formed so as to circulate around the joint portion with the body organ tissue or independently. Can do.

  The in-vivo insertion tube 1 of the present invention has a groove 2, a hole 3 or a depression on the side in contact with the body organ tissue in order to perform tissue self-joining having high joint strength without a gap at the joint portion with the living organ tissue. 4 is formed. These grooves 2, holes 3, or recesses 4 are joint portions covered with the body organ tissue when performing low energy joining such as heat or microvibration in a state where pressure is applied. It is formed for the purpose of obtaining a throwing effect by causing displacement. The effective anchoring effect is that a part of the body organ tissue is deformed or displaced by the negative pressure formed through the passage 5 and enters the groove 2, the hole 3 or the recess 4 and then is securely held inside them. Is achieved. Therefore, tissue self-joining having high joint strength can be performed without using sutures or sewing with a thread or the like or a medical adhesive. Therefore, it is not necessary to form a special structure such as a cuff used for sewing or sewing.

  FIG. 3 shows an example of a joining mechanism between a body organ tissue and a body insertion tube of the present invention by composite low energy. Body organ tissues such as the heart and blood vessels contain many protein collagen molecules and collagen fibers. These body organ tissues are placed in a body insertion tube having grooves, holes, or depressions formed on the surface ((a) of FIG. 3), and are made to adhere to each other by applying negative pressure from the body insertion tube through the passage 5 ( (B) in FIG. 3 and heating are performed simultaneously ((c) in FIG. 3). As a result, as shown in FIG. 3 (d), the collagen fibers in the body organ tissue are deformed or displaced, and at the same time or after the intrusion into the irregularities of the body insertion tube, the body organ tissue including collagen fibers and the like. Gels. After the heating is stopped, the temperature starts to decrease, and the gelled portion is solidified, whereby the body organ tissue can be joined to the body insertion tube. The tissue self-joining type joining method as shown in FIG. 3 increases the joining strength when the anchoring effect is sufficiently obtained by the internal organ tissue that has entered the irregularities of the body insertion tube. However, in order to achieve high-strength bonding, not only the formation of the passage for applying negative pressure and the bonding method and bonding conditions, but also the groove formed on the side in contact with the material of the body insertion tube and the body organ tissue It is necessary to sufficiently examine the diameter or area and depth of the opening of the hole or the depression.

  First, the body insertion tube is required to be less deformed in the negative pressure state shown in FIG. Also, if the thermal conductivity from the body insertion tube to the body organ tissue is not high during the heat treatment, it is necessary to increase the heating temperature or lengthen the heating time, which causes a problem of thermal damage to the body organ tissue. Happens. In low energy bonding, when micro vibration is applied instead of heat treatment or together with heat treatment, if the body insertion tube is soft, transmission of micro vibration energy is reduced, so that the body insertion tube requires a certain degree of rigidity. . Therefore, in the present invention, a highly rigid metal, ceramics, or resin composite material is suitable as the material for the body insertion tube. Furthermore, since the body insertion tube is used in vivo, it must be excellent in biocompatibility. Therefore, an in-vivo insertion tube made of stainless steel, titanium, silicon, or fiber reinforced plastic is more preferable. As these insertion tubes, those that have been surface-treated so that the surface contains atoms such as fluorine, carbon, or titanium may be used.

  As shown in FIG. 3, since the internal organ tissue contains high molecular protein or collagen fiber, the surface roughness (Ra defined by JIS B 0601) is in the range of 1 to 20 μm on the side in contact with the internal organ tissue. In-vivo insertion tubes with uniformly formed surface irregularities can not sufficiently follow the surface irregularities in the deformation or displacement of internal organ tissue, and microscopic voids and interfacial delamination occur, resulting in a sufficient throwing effect As a result, the bonding strength is reduced.

Thus, in order to improve the joint strength (adhesive force) between the body insertion tube and the body organ tissue, there is a limit only by the surface roughness of the body insertion tube. Unlike the conventional method in which the bonding strength is increased by the surface roughness, the present invention sufficiently causes deformation or displacement of the internal organ tissue when a negative pressure is applied so that a reliable anchoring effect can be obtained at the time of bonding. This has a great feature in that the bonding strength is greatly improved. Therefore, the in-vivo insertion tube of the present invention needs to form surface irregularities that are slightly larger than the conventional surface roughness. Therefore, when the groove, hole or depression formed in the body insertion tube of the present invention is continuously formed in the circumferential direction of the body insertion tube 1 as shown in FIG. Or it is preferable that the opening diameter of the hole 3 and the hollow 4 exceeds 20 micrometers and is 10 mm or less. When the groove width or opening diameter is 20 μm or less, the deformation or displacement of the internal organ tissue is insufficient and the anchoring effect is hardly obtained. On the other hand, when it exceeds 10 mm, the internal organ that has entered the groove 2, the hole 3 or the recess 4 The phenomenon that the tissue is easily removed occurs, and a sufficient anchoring effect cannot be obtained as well. Here, the groove 2, the hole 3, or the dent 4 may have a shape divided into several in the circumferential direction of the body insertion tube 1. In addition, as shown in FIG. 1 (b), when the groove 2, the hole 3 or the depression 4 is formed independently, so that a throwing effect due to deformation or displacement of the body organ tissue can be sufficiently obtained. The groove width of the groove 2 or the opening area of the hole 3 and the depression 4 is preferably 3 × 10 ⁻⁴ mm ² (about 20 μm in terms of a circle diameter) or more. The upper limit of the opening area is preferably 80 mm ² (about 10 mm in terms of circular diameter) so as to ensure the bonding strength with the internal organ tissue.

  Furthermore, it is preferable that the maximum depth of the opening of the groove, hole, or depression is more than 20 μm and not more than 10 mm. When the maximum depth of the opening is 20 μm or less, the anchoring effect is hardly obtained. On the other hand, when it exceeds 10 mm, the body organ tissue that has invaded the groove, hole, or depression is easily removed. A sufficient throwing effect cannot be obtained. In the present invention, in a tensile test conducted after joining with a body organ tissue, the joining strength by tension measured when the body insertion tube is pulled in the longitudinal axis direction is 0.01 MPa or more, preferably 0.02 MPa or more. For example, the diameter or area and the maximum depth of the opening of the groove, hole, or recess can be arbitrarily set within the above range.

  The bonding method of the present invention performs low energy bonding, preferably a combination of two or more, using at least one of pressure, heat, and micro vibration. The conditions of pressure, heat, and microvibration applied during the bonding are in the range of 0.01 to 10 MPa, 50 to 250 ° C., and 1 Hz to 1 MHz, respectively. When the pressure during heating is less than 0.01 MPa, the temperature is less than 50 ° C., and the vibration is less than 1 Hz, not only in the case of single application, but also in the case where the vibration, heat and pressure are combined and applied as composite energy However, the bonding strength with body organ tissues cannot be sufficiently increased. Even if it seems that both are joined after joining work, peeling and removal of the body insertion tube occur during use, so the conditions of vibration, heat and pressure must be above the lower limit shown above . In addition, when the pressure is 10 MPa, the heating temperature is 250 ° C., and the vibration exceeds 1 MHz, damage to the body-initiated tissue increases or the body insertion tube breaks. In addition, since local peeling due to stress or heat generation occurs at the joint portion of the body organ tissue, the joint strength with respect to the body joint tissue is reduced as a whole, and there are also problems in terms of durability reliability and safety. For this reason, the vibration, heat, and pressure conditions must be equal to or lower than the upper limit values shown above.

  The above heat treatment is performed using a heating jig from outside the body organ tissue with the body insertion tube covered with the body organ tissue, or the body insertion tube before insertion is placed in a constant temperature bath to a predetermined temperature. Perform with warming. Also, a method of heating from the outside by inserting a resistance heating wire such as a nichrome wire into the body insertion tube or winding a resistance heating wire in the circumferential direction of the body insertion tube can be adopted. At this time, as the heating method, not only the resistance heating method but also other methods such as arc heating, induction heating, dielectric heating or infrared heating may be used.

  The body insertion tube of the present invention is inserted into the body in order to ensure the anchoring effect by helping the deformation or displacement of the body organ tissue containing macromolecular proteins and collagen fibers into grooves, holes or depressions during low energy joining. The internal insertion tube and the internal tissue from a groove, hole, or depression formed on the external surface of the tube toward an internal cavity that functions as a passage for blood, infusion, or wiring of the internal insertion tube or outside the internal insertion tube It is necessary to provide a connecting passage for exhausting or sucking air existing between them, that is, a passage for applying a negative pressure to the groove 2, the hole 3 or the recess 4.

  FIG. 4 shows an example in which a single-tube structure body insertion tube 1 having a passage 5 for applying a negative pressure to the groove 2 is used as a blood removal vessel. The passage 5 is spatially connected to the bottom of the groove 2 formed in the body connecting tube 1 and has a shape that opens to the outside of the body insertion tube 1 through the discharge port or suction port 6. have. As shown in FIG. 4A, the in-vivo insertion tube of the present invention has an internal cavity 7 that functions as a passage for blood, infusion, or wiring. The arrow shown in the internal cavity 7 of the body insertion tube is the flow direction of blood or infusion. A heating resistance wire 8 such as a nichrome wire is wound around the body insertion tube 1, and the heat treatment is performed using the heating resistance wire 8 after the body insertion tube is covered and crimped by the body organ tissue. Raise the temperature. Since this method can locally heat the joint portion, the temperature does not need to be increased more than necessary, and in addition, the heated portion can be performed with a minimum area, and the body tissue can be thermally heated. Has the effect of reducing damage.

  As shown in FIG. 4B, the passage 5 has a function of discharging the air 22 existing between the body organ tissue 9 and the body insertion tube 1 at the time of joining. If there is no discharge passage in the groove 2 formed on the surface of the body insertion tube, the air 22 tends to accumulate due to deformation or displacement of the body organ tissue 9 at the time of joining. A similar phenomenon can be seen in the case of a body insertion tube in which a hole or a depression is formed instead of the groove 2. When a structure for releasing air 22 on the surface is not employed, the pressure in the deep part of the opening is increased and acts to inhibit deformation or displacement of the internal organ tissue. For this reason, in order to improve the adhesion of the internal organ tissue 9, it is necessary to increase the pressure applied from the outside during joining. However, as shown in FIG. 4B, in the structure having the passage 5, the air 22 accumulated in the deep opening is discharged or sucked through the discharge port or the suction port 6 by a decompression process or the like, so that a negative pressure is generated. This improves the adhesion between the internal insertion tube and the internal organ tissue, eliminates gaps and separation at the interface between the two, and as a result, the anchoring effect due to the deformation or displacement of the internal organ tissue is reliably obtained, and the bonding strength Can be improved.

  FIG. 5 shows respective cut surfaces of the left half groove 2 and the discharge port (or suction port) 6 in the single-tube insertion tube having a single tube structure shown in FIG. FIG. 5B shows the cut surfaces of the groove 2 portion and the discharge port (or suction port) 6 portion shown in FIG. 5A as AA ′ and BB ′, respectively. And (c). As shown in FIG. 5, the passage 5 for applying a negative pressure to the groove 2 is connected to the groove 2 and the discharge port or suction port 6. The passage 5 can be formed, for example, by forming the passage 5 in the body insertion tube 1 with a drilling jig such as a drill and then closing the excavation inlet portion with an airtight plug 23 made of metal or plastic. At this time, fixing or reinforcement with an adhesive or the like may be performed in order to prevent the airtight stopper 23 from falling off and to improve airtightness. Moreover, the in-vivo insertion tube having a single tube structure shown in FIG. 5 can also be manufactured using a computer-controlled three-dimensional modeling apparatus (three-dimensional printer).

  FIG. 6 is a view showing an example of formation of a passage for applying a negative pressure in a body insertion tube having a single-pipe structure according to the present invention. FIG. 6 shows only the right-side cross-sectional view of the body insertion tube 1 of the present invention. The connection passage 5 is directly connected from the bottom of the groove 2 formed in the body connection tube toward the internal cavity 7 of the body insertion tube 1. The shape is open. The passage 5 shown in FIG. 6A has a constant opening diameter from the bottom surface of the groove 2 toward the internal cavity. In the case where the opening diameter of the passage 5 is formed with a constant size, it is necessary to adjust the negative pressure by vacuum suction during joining. On the other hand, the passage 5 shown in FIG. 5B has a shape in which the opening diameter gradually decreases toward the internal cavity 7. This has an effect of suppressing the internal organ tissue 9 from entering the internal cavity 7 at the time of joining.

  Next, a tissue self-joining body insertion tube having a double tube structure composed of an outer tube and an inner tube will be described with reference to the drawings.

  FIG. 7 shows that the outer tube 10 is a tube in which a groove, hole, or depression for causing deformation or displacement of the body organ tissue described above is formed, and inside the outer tube 10, blood, infusion, or wiring It is a figure which shows the body insertion pipe provided with the inner pipe | tube 11 which has the internal cavity 7 which functions as a channel | path. FIG. 7A is an external view of the body insertion tube, and FIG. 7B is a cross-sectional view of the body insertion tube.

  As shown in FIG. 7, the body insertion tube of the present invention has a double tube structure of the outer tube 10 and the inner tube 11, thereby increasing the bonding strength with the body organ tissue and blood, infusion or wiring. The function as a passage can be divided separately. As a result, it is possible to freely change the design of the shape of the outer tube having a function for increasing the bonding strength with the body organ tissue while keeping the shape of the inner tube functioning as a passage for blood, infusion or wiring. . Therefore, it is possible to produce an in-vivo insertion tube having an outer tube shape that matches the shape of the internal organ tissue and the joining position, so that it can be applied to the joining with internal organ tissues of various shapes, and can be applied widely. Can be achieved.

  The body insertion tube 1 shown in FIG. 7 shows an example in which the outer tube is provided with a passage 5 for discharging or sucking air existing between the body insertion tube and the body organ tissue and applying a negative pressure. Yes. The passage 5 for applying the negative pressure can be provided not only in the outer tube 10 shown in FIG. 7 but also in the inner tube 11 or a surface where the outer tube and the inner tube are in contact with each other.

  FIG. 8 shows a group of passages for applying a negative pressure to a groove, hole, or depression provided in the in-vivo insertion tube of the present invention, and schematically shows only a left sectional view of the in-vivo insertion tube. (A) of FIG. 8 (A) discharges air existing between the body insertion tube and the body tissue from the groove 2, hole 3 or recess 4 of the outer tube 10 toward the outside of the body insertion tube. Or it is the structure which equips the outer tube | pipe 10 with the channel | path 5 for attracting | sucking and applying a negative pressure. In the insertion tube shown in FIG. 8A, the passage 5 is formed inside the outer tube 10, but in the present invention, the surface of the outer tube 10 on the side in contact with the inner tube 11 is cut to a predetermined thickness. Then, a step may be provided, and the step may be used as a passage. Conversely, the surface of the inner tube 11 on the side in contact with the outer tube 10 can be cut to a predetermined thickness to provide a step, and the step can be used as a passage to be connected to the discharge port or the suction port 6. FIG. 8B shows (B) discharging or aspirating air existing between the body insertion tube and the body tissue from the groove, hole, or depression of the outer tube 10 toward the inner cavity of the inner tube 11. Thus, the inner tube 11 is provided with a passage 5 for applying a negative pressure. As an example, a body insertion tube having a groove 2 and a hole 3 formed on the surface thereof is shown. 8C, (C) the air existing between the body insertion tube and the body tissue is exhausted from the groove, hole or depression of the outer tube 10 toward the inner cavity of the inner tube 11. Or it is the structure which equips both the said outer tube | pipe and the inner tube | pipe with the channel | path 5 for attracting | sucking and applying a negative pressure, and has shown the insertion tube in the body by which the hollow 4 was formed in the surface as an example. The depression 4 shown in FIG. 8C is connected to the passage 5 provided in the inner pipe via the passage 5 provided in the outer pipe. As a result, the depression and the cavity of the inner pipe are connected spatially. doing. As described above, the groove 2, the hole 3 or the recess 4 shown in FIG. 8 is defined in the same range as the case of FIG.

  The outer tube 10 or the inner tube 11 shown in FIG. 8 is provided with a passage 5 for exhausting or sucking air existing between the body insertion tube 1 and the body organ tissue and applying a negative pressure. The air accumulated in the deep opening of the hole or the depression is discharged or sucked through the discharge port or the suction port 6 by the decompression process. This produces an effect of improving the adhesion between the body insertion tube and the body organ tissue and eliminating gaps and separation at the interface between the two. As a result, the throwing effect due to deformation and displacement of the internal organ tissue is increased, so that the joint strength can be further improved.

  As described above, the body insertion tube having the double tube structure of the present invention has a double channel outer tube, an inner tube, and an outer tube and an inner tube as a passage for applying a negative pressure to a groove, a hole or a depression. It can be formed anywhere between the tubes.

  FIG. 9 shows a double-structured body insertion tube that includes an outer tube 10 and an inner tube 11 and includes a passage 5 that applies a negative pressure around the inner tube 11. FIGS. 9A and 9B are an external view and a cross-sectional view of the body insertion tube, respectively. As shown in FIG. 9B, the passage 5 provided in the inner tube 11 is connected to the groove 2 formed in the outer tube 11. Reference numeral 12 in FIG. 9 denotes an air suction hole for performing a decompression process when the negative pressure state is set, and can be regarded as a part of the passage 5 in which the outer tube 10 is formed. Further, in the double tube structure including the outer tube 10 and the inner tube 11 shown in FIG. 9, the outer tube and the inner tube are fixed via an O-ring 13 made of rubber, thermoplastic elastomer or the like. Since the O-ring 13 is an elastic body, it is easy to attach the outer tube and the inner tube, and at the same time, the adhesion between them can be improved. By using the O-ring 13, both can be firmly fixed with high airtightness. In the present invention, instead of an elastic body such as an O-ring, a buffering agent such as foamable plastic, non-woven fabric, or metal buffer ring may be used.

  The O-ring 13 shown in FIG. 9 can ensure heat insulation between the outer tube and the inner tube by using a material having lower thermal conductivity than the material of the outer tube. In this case, when the outer tube covered with the body organ tissue is heated by the resistance heating wire 8 such as a nichrome wire wound around the outer tube at the junction with the body organ tissue, the temperature rise is large in the outer tube. In the inner pipe, heat conduction is suppressed, so that the temperature rise can be suppressed, and the joining work is facilitated. In addition, since only the joined portion can be heated, there is an advantage that thermal damage to the internal organ tissue excluding the joined portion can be reduced. In the present invention, the outer tube and the inner tube are made of metal, and by using rubber or thermoplastic elastomer having a lower thermal conductivity than the metal as the O-ring, the effect of heat insulation by the O-ring can be achieved. it can. In the present invention, when the temperature rise during heating is efficiently performed in a short time, a heating heat source composed of a resistance heating wire or the like can be provided not only in the outer tube but also in the inner tube.

  FIG. 10 shows a joined state when joining with a body organ tissue using the body insertion tube 1 shown in FIG. As shown in FIG. 10, the body insertion tube 1 has a passage formed around the inner tube 11 from the groove 2 formed on the outer surface of the body insertion tube 1 at the time of low energy bonding such as heating and / or microvibration. 5, the air existing between the body insertion tube 1 and the body tissue 9 is discharged or sucked toward the outside of the outer tube 10 to form a negative pressure state. Thereby, deformation or displacement of the body organ tissue 9 into the groove 2 is helped to ensure a throwing effect, and after low energy joining, the joint strength between the body insertion tube 1 and the body organ tissue 9 ( Adhesion) is greatly improved.

  FIG. 11 is a diagram showing another form of the body insertion tube having a double tube structure including an inner tube and an outer tube. FIGS. 11A and 11B are an external view and a cross-sectional view of the body insertion tube, respectively. As shown in FIG. 11 (b), the body insertion tube has a structure in which a passage 5 for applying a negative pressure is connected from the groove 2 of the outer tube 10 to the inner cavity 7 of the inner tube 11. In addition, since the structure is such that air existing between the outer tube 10 and the body organ tissue at the time of joining is discharged or sucked to the outside through the inner cavity 7 of the inner tube 11, the in-vivo insertion tube shown in FIG. In contrast, a discharge port or suction port 6 is formed in the inner tube 11. Other than those, it has basically the same structure and configuration as the in-vivo insertion tube shown in FIGS.

  The intracorporeal tube of the present invention is used for the improvement of the joint strength when it is used as a desorption tube and a blood supply tube used when an artificial heart is mounted, particularly as a devascularization that is difficult to join by the conventional technology. Show significant effects. Further, the in-vivo insertion tube of the present invention is not required to have a special structure having a cuff or the like, and can be applied for joining or connecting other tissues in the living body. For example, an anastomosis of a digestive tract, a blood vessel, etc. It can be used to connect an artificial blood vessel and a biological blood vessel, to join a digestive organ and an insertion tube such as a gastric fistula and an artificial anus, or to join a portion where the insertion tube penetrates the skin and comes out of the body. In addition, it can be used for joining the skin penetration part of the energy supply cable of the artificial heart. At that time, it is easy to design the shape of the body insertion tube in accordance with the shape of these applications within the range of design changes that are normally made.

  The method for joining a body insertion tube and body organ tissue according to the present invention includes the following steps.

  First, as shown in FIG. 4 to FIG. 7, as a process of the tissue self-joining body insertion tube having a single tube structure, (D) in a state where the body insertion tube of the present invention is covered with the body organ tissue, The step of bringing the body insertion tube into contact with the body organ tissue; (E) the body insertion tube by sucking air from a discharge port or a suction port directly connected to a passage that applies a negative pressure to the groove, hole, or depression; A step of applying a negative pressure to the contact portion with the body organ tissue, and (F) heating and / or minutely the contact portion with the body organ tissue after removing the negative pressure or in the state of the negative pressure. And applying a vibration to join the body insertion tube and body organ tissue.

  Next, as shown in FIGS. 7 to 11, in the case of a tissue self-joining body insertion tube having a double tube structure, (G) a state in which an outer tube of the body insertion tube is covered with the body tissue The step of bringing the body insertion tube into contact with the body organ tissue, (H) the outside by sucking air from a discharge port or a suction port directly connected to a passage that applies a negative pressure to the groove, hole, or depression; A step of applying a negative pressure to a contact portion between a tube and the body organ tissue; and (I) heating and / or heating the contact portion with the body organ tissue after removing the negative pressure or in the state of the negative pressure. Alternatively, a step of applying a minute vibration to join the outer tube of the body insertion tube and the body organ tissue is included.

  Furthermore, in the above two joining methods, the step of making the negative pressure can be performed in combination with a step of applying pressure from the outside to the contact portion with the body organ tissue. That is, using the in-vivo insertion tube having a single-tube structure or a double-tube structure of the present invention, the step (E) or (H) is a step of setting the negative pressure to a contact portion with a body organ tissue. The step (F) or (I) is applied after removing at least one of the pressure and the negative pressure, or simultaneously applying the pressure and the negative pressure. In this state, the contact portion with the body tissue is heated and / or subjected to minute vibrations.

  In the negative pressure step, the negative pressure state can be formed by performing a pressure reduction process using a vacuum pump or the like. The negative pressure at this time may be −0.01 MPa or more (the absolute value of the pressure is 0.01 MPa or less), and does not have to be in a high vacuum state. When the joining according to the present invention is performed under a negative pressure state, if the discharge port or the suction port provided outside the body insertion tube is not completely covered with the body organ tissue, the connection passage is made a high negative pressure by the decompression process. I can't. Therefore, the joint portion of the body organ tissue can be easily confirmed with a vacuum pump pressure gauge used at the time of the decompression process, and the joint position can be adjusted while looking at the pressure gauge. Thus, if the position which can make a connection channel | path a high negative pressure can be defined, the junction part of a body organ tissue will not shift | deviate by the negative pressure. Therefore, in the present invention, in order to detect and adjust the joint portion and firmly fix the joint portion, it is a major feature that the body organ tissue is joined by negative pressure processing.

  The pressurization, heating, and microvibration used in the joining step performed simultaneously with or after the negative pressure step are 0.01 to 10 MPa and 50 to 250, respectively, as described above. The measurement is performed at a temperature in the range of 1 ° C. to 1 MHz. As a joining method by micro vibration, for example, as shown in FIG. 12, there is a method using a piezo element 24 which is a passive element using a piezoelectric element. The in-vivo insertion tube 1 shown in FIG. 12 is shown as an example having a single tube structure (note that grooves, holes or indentations formed on the surface of the in-body insertion tube 1 are not shown). The micro vibration energy is applied to the junction interface between the body insertion tube 1 and the body organ tissue 9 by the piezo element 24 arranged around the body organ tissue 9.

  In the present invention, in addition to the above-described negative pressure treatment, pressure may be simultaneously applied from around the body organ tissue. Depending on the joining method, joining conditions (time, etc.) and joining device as well as the joining part and joining strength of the internal organ tissue, negative pressure treatment or both methods of negative pressure treatment and pressure application can be combined.

  Next, the present invention will be described by specific embodiments.

<First Embodiment>
FIG. 13 shows a tissue self-joining blood vessel that was experimentally produced by extracting the portion surrounded by a broken line in the in-vivo insertion tube shown in FIG. FIGS. 13A and 13B are an external view and a cross-sectional view, respectively. The tissue self-joining type blood removal vessel 1 is made of stainless steel having excellent biocompatibility, and has a double tube structure including an outer tube 10 and an inner tube 11 having a total length of 37 mm, an outer diameter of 21 mm, and an inner diameter of 14 mm. The outer tube 10 and the inner tube 11 are fixed and insulated by an O-ring 13. Since this embodiment is for trial use, there is no passage for blood flow or infusion, and plugs 14 are provided at the top and bottom, and the pressure is reduced by using a vacuum pump through the discharge port or suction port 6 of the inner tube. The structure facilitates the generation of pressure. Further, as shown in FIG. 13 (b), a nichrome wire is attached as a resistance heating wire 8 for heating on the groove side surface of the outer tube 10, and a thermocouple 15 is disposed near the groove for temperature measurement. Has been. The nichrome wire as the resistance heating wire 8 and the thermocouple 15 are respectively wired and drawn out from the lead wire outlet 16 through the cavity in the inner tube. The conductor outlet 16 is filled with silicone rubber to seal the cavity in the inner tube.

  The groove formed on the outer tube surface of the tissue self-joining type blood vessel of this embodiment has an opening width of 2.5 mm and a depth of 1.5 mm, and two grooves are continuously formed in the circumferential direction of the outer tube. Form. The interval between the two grooves is 2 mm. The heating temperature of the outer tube at the time of joining is controlled by a temperature control system. The tissue self-joining type blood vessel of the present embodiment is joined to a body tissue organ in a region having a width W shown in FIG. Specifically, a porcine heart was used as the body tissue organ.

  The joint strength between the tissue self-joining type blood vessel after joining and the heart is obtained by conducting a tensile test. Tensile strength is determined by using a tensile tester in which a load transducer is fixed on the upper side and a tensile load is applied in the vertical direction by a linear motion actuator fixed on the lower side. Are measured in two directions. In the case of the cardiac-devascularization radial direction, the upper chuck for attaching the heart to the load transducer is fixed, the lower chuck for attaching the devascularization to the linear motion actuator is fixed, and a tensile load is applied in the vertical direction for measurement. On the other hand, in the case of the heart-devascularization axis direction, the grooved steel (channel) for placing the heart on the load transducer is fixed, the check for attaching the devascularization to the linear actuator is fixed, and a tensile load is applied in the vertical direction. To measure.

  The measurement results of the joint strength by radial tension and axial tension are shown in FIGS. 14 (a) and 14 (b), respectively. In FIG. 14, the pressure in the blood removal vessel is set to a negative pressure of −0.1 MPa by decompression processing using a vacuum pump, and the joining temperature and the joining time are changed in the range of 80 ° C. to 100 ° C. and 60 to 90 seconds, respectively. The result of bond strength measured by tension is shown.

  As can be seen from FIGS. 14A and 14B, the bonding strength measured by radial tension and axial tension increases as the bonding temperature increases. Also, the longer the bonding time, the higher the bonding strength between the two. Moreover, the joint strength by tension becomes higher in the axial direction than in the radial direction. This is considered because the uneven | corrugated | grooved part of the myocardial tissue formed by joining becomes resistance with respect to an axial direction. As described above, the tissue self-joining type blood vessel removal according to the present embodiment has high bonding strength with the heart and has excellent bonding properties. Further, when the joint surface of the heart after joining is disassembled and observed, the joint cross section of the heart is formed with irregularities that are paired with the groove of the outer tube of the devascularization under all joining conditions, and the heart formed by joining It was confirmed that the unevenness was also joined to the groove side surface of the outer tube. Therefore, the joining method using the tissue self-joining type blood vessel removal according to the present embodiment is an excellent joining method that can prevent the invasion of bacteria because the joining portion can be joined with high strength without a gap.

<Second Embodiment>
The in-vivo insertion tube shown in FIG. 13 has an O-ring 13 and provides a heat insulating effect between the outer tube 10 and the inner tube 11. In order to compare the heat insulation effect between the outer tube 10 and the inner tube 11 with the case of devascularization in which the outer tube is fixed to the outside of the inner tube without using an O-ring, heating is performed at 100 ° C. for 120 seconds. The temperature difference between the outer tube and the inner tube was obtained by transient heat transfer analysis simulation. In the analysis simulation, the physical properties of each material (stainless steel, fluoro rubber used as a stopper, nichrome wire, etc.) used density, thermal conductivity, and specific heat. As a result, in the devascularization of the first embodiment, the outer tube is uniformly 100 ° C. and the inner tube is 50 ° C., whereas in the devascularization without an O-ring, both the outer tube and the inner tube are 90 ° C. It turns out that. This result is in good agreement with the actually measured value. By using the O-ring, the blood vessel removal with the double tube structure of the present invention can obtain a heat insulating effect between the outer tube and the inner tube.

  Further, when the O-ring is present, the temperature of the outer tube is 100 ° C., but without the O-ring, the temperature of the outer tube is slightly low at 90 ° C. This is presumably because in the case of no O-ring, the heat transfer to the inner tube is large, and the temperature of the outer tube cannot be increased and is slightly decreased. As described above, since the effect of maintaining the set temperature of the outer tube is obtained, the O-ring is useful as a configuration of the in-vivo insertion tube including blood removal when performing efficient heating in the joining of the present invention. .

<Third Embodiment>
As shown in FIG. 9, a trial devascularization of a double tube structure including an outer tube 10 and a passage 5 for applying a negative pressure to the boundary surface in contact with the outer tube 10 and an inner tube 11 having an internal cavity. did. The outer tube of the body insertion tube has an opening width of 2.5 mm in the circumferential direction, two grooves 2 having a depth of 1.0 mm are formed, and the gap between the two grooves is set to 2 mm. . The bottom of the groove 2 is provided with a hole connected to the passage 5 formed by cutting a portion having a depth of 0.5 mm on the boundary surface of the inner tube 11 in contact with the outer tube 10.

  When the heating performance was tested on the tissue self-joining type blood vessel removal of the present embodiment, the same performance as in the first embodiment was confirmed. A pig used as a body tissue organ was joined under the same method and conditions as in the first embodiment, and similar joining performance and joining strength results were obtained.

  In the first to third embodiments, the degassing of the double tube structure has been specifically described. However, the same effect can be obtained also in the devascularization of the single tube structure as shown in FIGS. Needless to say.

  As described above, according to the present invention, a high bonding strength can be obtained without a gap at the bonding portion in bonding with a body organ tissue. This not only forms a groove, hole or depression for causing deformation or displacement of the internal organ tissue on the side in contact with the internal organ tissue, but also exists between the internal insertion tube and the internal organ tissue. This is because a large anchoring effect can be obtained by providing a passage for discharging or sucking air to apply a negative pressure to the groove, hole or recess. As a result, when negative pressure is applied to the joint portion, deformation or displacement of the body organ tissue into the groove, hole, or depression is facilitated, and voids or gaps that reduce the joint strength at the joint interface are generated. It is suppressed and the joint strength can be further improved. Therefore, the method for joining the body insertion tube and body organ tissue according to the present invention is a method that can prevent the invasion of bacteria, which has been a problem in the conventional method, is highly safe, and has excellent durability and reliability. . Further, the in-vivo insertion tube of the present invention does not need to have a special structure having a cuff or the like, so that it is not only used as a heart blood removal vessel or a blood supply tube but also for joining or connecting other in vivo tissues. Applicable to. For example, it can be used for anastomoses such as digestive tracts and blood vessels, or for connection between artificial blood vessels and biological blood vessels, so that its usefulness is extremely high.

DESCRIPTION OF SYMBOLS 1 ... Body insertion tube, 2 ... Groove, 3 ... Hole, 4 ... Depression, 5 ... Connection channel, 6 ... Discharge port or suction port, 7 ... Internal cavity, 8 ... heating resistance wire, 9 ... body organ tissue, 10 ... outer tube, 11 ... inner tube, 12 ... air suction hole, 13 ... O-ring, 14 ... plug 15 ... Thermocouple, 16 ... Conductor outlet, 17 ... Devascularized, 18 ... Cuff (19), 19 ... Heart, 20 ... Drawstring suture, 21 ... Blood vessel , 22 ... Air, 23 ... Airtight stopper, 24 ... Piezo element.

Claims (7)

A body insertion tube that is joined by heating and / or microvibration in contact with the body organ tissue in a state of being covered with the body organ tissue,
The body insertion tube is formed with at least a groove, a hole, or a recess having a size that allows a throwing effect to be obtained when a part of the body organ tissue penetrates due to deformation or displacement on the side in contact with the body organ tissue. A passage for applying a negative pressure to the groove, hole or depression when the body insertion tube and the body organ tissue are joined is formed ,
A tissue self-joining intracorporeal insertion tube having a tensile strength of 0.01 MPa or more after being joined to the body organ tissue by heating and / or microvibration .   The tissue self-joining internal insertion tube according to claim 1, wherein a tube in which a groove, a hole or a depression for causing deformation or displacement of the body organ tissue is formed as an outer tube, And an inner tube having an internal cavity that functions as a blood, infusion, or wiring passage, and the passage for applying a negative pressure to the groove, hole, or depression is at least one of the outer tube and the inner tube. A tissue self-joining body insertion tube characterized by being formed into one. The tissue self-joining body insertion tube according to claim 2 is the following (A), (B), and (C), that is, (A) From the groove, hole, or depression of the outer tube, A passage for applying a negative pressure to the groove, hole or depression by exhausting or sucking air existing between the body insertion tube and the body organ tissue toward the outside is provided in the outer tube or the inner tube. Preparing for the tube,
(B) The groove, hole or depression of the outer tube is exhausted or aspirated from the body insertion tube and the body organ tissue toward the inner cavity of the inner tube to exhaust or suck the air, Providing the inner tube with a passage for applying a negative pressure to the hole or the depression; and (C) from the groove, hole or depression of the outer tube toward the inner cavity of the inner tube, Providing both the outer tube and the inner tube with a passage for applying a negative pressure to the groove, hole, or depression by discharging or sucking air existing between the body organ tissue;
A tissue self-joining intracorporeal tube having any one selected from the group consisting of:   The tissue self-joining intracorporeal insertion tube according to claim 2 or 3, wherein the outer tube and the inner tube are fixed via a buffer or an elastic body. 5. The tissue self-joining body insertion tube includes a discharge port or a suction port directly connected to a passage for applying a negative pressure to the groove, hole, or depression. 6. Tissue self-joining body insertion tube. The tissue self-joining body insertion tube according to any one of claims 1 to 5, wherein the tissue self-joining body insertion tube includes a heating heat source.   The tissue self-joining body insertion tube according to any one of claims 1 to 6, wherein the body insertion tube is an artificial heart blood removal vessel.

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