JP6850411B2 - Needle holder - Google Patents

Description

The present invention relates to a needle holder that is sewn around a direction perpendicular to the insertion direction of the needle holder.

A needle holder having a grip portion that can be opened and closed at the tip of an elongated shaft is generally used for inserting through an opening on the body surface and performing suturing work deep inside the body (see FIG. 14). ). In such a needle holder, as shown in FIG. 14A, the arcuate suture needle is gripped so as to be perpendicular to the longitudinal direction of the shaft, and the shaft is rotated about the longitudinal direction to suture. It is possible to insert the needle into the body tissue along the arc. Such hand movement is easy when the target suture surface is in a direction approximately parallel to the longitudinal direction of the shaft as shown in FIG. 14 (A), but is a target as shown in FIG. 14 (B). This can be a daunting task when the suture surface is approximately perpendicular to the longitudinal direction of the shaft.

In relation to such a problem, a technique capable of freely moving the direction and position of the suture needle is disclosed (see, for example, Patent Documents 1 and 2). In the technique shown in Patent Document 1, the needle holder 10 has an operation portion gripped by an operator and an elongated hole 64 having one end connected to the operation portion and formed at least along the longitudinal direction at the other end. An elongated insertion portion 14 to be inserted into the body cavity having the above, one end thereof is arranged inside the other end portion of the insertion portion 14, and the other end portion is projected to the outside of the insertion portion 14 through the elongated hole 64. A needle holder 16 having a holding portion 44c that is rotatably provided along the elongated hole 64 with the inner side of the one end as a fulcrum and can be opened and closed to grip and hold the object to be gripped (anastomosis needle). It is equipped with.

The technique shown in Patent Document 2 is a needle holder 1, a first arm rotating member 111 having a first holding arm portion 12A and capable of rotating around a rotation shaft 15, and a second holding arm. A second arm rotating member 112 having a portion 12B and capable of rotating around the rotating shaft 15, a first holding arm driving member 201 for rotating the first arm rotating member 111, and the first A second pinching arm driving member 202 that rotates the two-arm rotating member 112, a first driving portion 30 that opens and closes the first pinching arm portion 12A and the second pinching arm portion 12B, and around the rotating shaft 15. A second drive unit 50 for rotating the pair of holding arm units 12 is provided.

Further, as a technique for making the suture needle rotatable about a direction perpendicular to the longitudinal direction of the shaft, the technique shown in Patent Document 3 is disclosed. In the technique shown in Patent Document 3, the handle portion B of the needle holder is formed in a pistol shape so that the handle portion is located below the eye in the line-of-sight direction with respect to the tip needle holder A, and the tip needle holder A is a needle holder. A slide plate 3 attached to the tip of the vessel, a needle cradle 4 fixed on the cradle, and a slide plate attached to the needle cradle and slid back and forth to press the suture needle against the needle cradle and hold it. The handle portion B is provided with handles 16 and 20 for operating the _{wires 7 1} , 7 ₂ and 10 for operating the slide wheel and the slide plate.

Japanese Unexamined Patent Publication No. 2005-342267 Japanese Unexamined Patent Publication No. 2015-56989 Jitsukosho 62-32006 Gazette

However, although the techniques shown in Patent Documents 1 and 2 have a high degree of freedom in the tip portion, they have a problem that they require a lot of labor and manpower to manufacture because the structure is very complicated. In addition, since the structure is complicated, the device is inevitably large in size, and it is necessary to enlarge the opening in the case of laparoscopic surgery, which is a burden on the patient.

Further, the technique shown in Patent Document 3 has a relatively simple structure with a smaller number of parts than the techniques shown in Patent Documents 1 and 2, but has a plurality of parts such as a spring plate, a pulley, and a needle cradle. It is necessary and not sufficiently simplified. Further, by using these a plurality of parts, there is a problem that the tip portion becomes large.

The present invention provides a needle holder that allows the suture needle to rotate about a direction perpendicular to the longitudinal direction of the intubation tube, has an extremely simple structure, and is easy to use.

The needle holder according to the present invention grips the suture needle at the insertion tube and the tip of the insertion tube, and is rotatably arranged at the tip in a direction perpendicular to the insertion direction. The tip driving piece is provided with a piece and an operation unit for operating the operation of the tip driving piece, and the tip driving piece has a slit in the radial direction in which a wire is wound around the peripheral edge and grips the suture needle, and the inside of the slit. With the suture needle inserted, the tip drive piece is tightened with the wire, and the suture needle is sandwiched between the tip drive pieces.

As described above, in the needle holder according to the present invention, the suture needle is gripped at the insertion tube and the tip of the insertion tube, and the suture needle is rotatably arranged at the tip in a direction perpendicular to the insertion direction. The tip drive piece to be provided and an operation unit for operating the operation of the tip drive piece are provided, and the tip drive piece has a slit in the radial direction in which a wire is wound around the periphery and grips the suture needle. With the suture needle inserted inside the slit, the tip drive piece is tightened with the wire, and the suture needle is sandwiched between the tip drive pieces. The suture needle can be rotated as an axis, that is, the suture surface at a position perpendicular to the insertion direction of the tip of the insertion tube can be easily sutured.

In addition, by reducing the number of parts and the size of the parts themselves, the structure of the entire device can be simplified and miniaturized, and the burden on the patient can be minimized. ..

The needle holder according to the present invention includes a rotating pulley that is rotatably arranged in the same direction as the tip driving piece in the operating portion, and the wire is between the rotating pulley and the tip driving piece. The tip drive piece slides via the wire in response to the rotation operation of the rotation pulley.

As described above, in the needle holder according to the present invention, the operating portion is provided with a rotating pulley that is rotatably arranged in the same direction as the tip driving top, and the wire is the rotating pulley and the tip. The tip drive piece slides via the wire in response to the rotation operation of the rotation pulley, and is connected to the drive piece by being wound around each other. By making the wire function by various operations, the suture needle can be tightened and rotated at the same time, and the suture surface located at the position perpendicular to the insertion direction of the tip of the insertion tube can be easily sutured with a simple structure. It has the effect of being able to.

The needle holder according to the present invention is provided with a lever that pivotally supports the rotating pulley in the operating portion, and the lever moves in a direction opposite to the insertion direction so that the wire tightens the tip driving piece. Is what you do.

As described above, in the needle holder according to the present invention, the operating portion is provided with a lever that pivotally supports the rotating pulley, and the lever moves in a direction opposite to the insertion direction, so that the wire is moved. Since the tip drive piece is tightened, the suture needle can be fixed to the tip drive piece with a simple lever operation, and the suture needle can be rotated with a simple operation by the axially supported rotating pulley. It works.

In the needle holder according to the present invention, the insertion tube is rotatably arranged around the insertion direction.

As described above, in the needle holder according to the present invention, since the insertion tube is rotatably arranged around the insertion direction, the suture is made so as to be substantially parallel to the longitudinal direction of the tip of the insertion tube. The surface can also be easily sutured, which has the effect of realizing a needle holder with a high degree of freedom with a simple configuration.

In the needle holder according to the present invention, the slit formed in the tip driving piece is formed in an arc shape along the curve of the suture needle in the diametrical direction.

As described above, in the needle holder according to the present invention, since the slit formed in the tip driving piece is formed in an arc shape along the curve of the suture needle in the radial direction, the tip driving sesame In, the suture needle can be easily grasped, and the burden on the doctor during the operation can be reduced.

In the needle holder according to the present invention, the slits formed in the tip driving piece are formed at a plurality of different angles in the diametrical direction.

As described above, in the needle holder according to the present invention, since the slits formed in the tip drive piece are formed at a plurality of different angles in the radial direction, the tip drive piece is separated from the suture needle during the operation. Even when changing hands, the effect is that the suture needle can be easily grasped and grasped without paying much attention to the rotation angle of the tip driving piece.

In the needle holder according to the present invention, the slit formed in the tip drive piece is formed from the root portion of the slit to the opening into which the suture needle is inserted, and the root portion of the slit is the tip drive. A spatial region is formed along the end face of the frame.

As described above, in the needle holder according to the present invention, the slit formed in the tip driving piece is formed from the root portion of the slit to the opening into which the suture needle is inserted, and the root portion of the slit is formed. Since a space region is formed along the end face of the tip drive piece, the opening and closing operation of the slit is smoothed, and the stress at the root portion is diffused to the end face area of the tip drive piece by the opening and closing operation due to stress concentration. It has the effect of preventing damage and the like.

The needle holder according to the present invention is one in which at least from the end face of the tip driving top to the space region is formed of an elastic body.

As described above, in the needle holder according to the present invention, at least from the end face of the tip driving top to the space region is formed of an elastic body, so that the slit can be smoothly opened and closed, and the slit can be opened and closed smoothly. It has the effect of being able to securely pinch the suture needle.

In the needle holder according to the present invention, the tip driving piece is divided into a first holding portion that holds one side of the suture needle and a second holding portion that holds the other side of the suture needle by the slit. In the first sandwiching portion and / or the second sandwiching portion, the width in the direction perpendicular to the sandwiching direction of the suture needle is narrower than that in other portions.

As described above, in the needle holder according to the present invention, the tip driving piece has the slit in the first holding portion that holds one side of the suture needle and the second holding portion that holds the other side of the suture needle. Since the width of the first pinching portion and / or the second pinching portion in the direction perpendicular to the pinching direction of the suture needle is narrower than that of other portions, the suture needle is gripped. It becomes easier and has the effect of improving operability during surgery.

In the needle holder according to the present invention, a groove into which the suture needle is fitted is formed in the slit of the tip driving top.

As described above, in the needle holder according to the present invention, since the groove into which the suture needle is fitted is formed in the slit of the tip drive piece, the suture needle can be stably pinched and can be pinched intraoperatively. It has the effect of improving the operability of the.

The needle holder according to the present invention grips the suture needle at the insertion tube and the tip of the insertion tube, and is rotatably arranged at the tip in a direction perpendicular to the insertion direction. The tip driving piece is provided with a piece and an operation unit for operating the operation of the tip driving piece, and the tip driving piece has a slit in the radial direction in which a wire is wound around the peripheral edge and grips the suture needle. The tip drive piece is tightened with the wire from the state where the slit is closed to open the slit.

As described above, in the needle holder according to the present invention, the suture needle is gripped at the insertion tube and the tip of the insertion tube, and the suture needle is rotatably arranged at the tip in a direction perpendicular to the insertion direction. The tip drive piece to be provided and an operation unit for operating the operation of the tip drive piece are provided, and the tip drive piece has a slit in the radial direction in which a wire is wound around the periphery and grips the suture needle. In order to open the slit by tightening the tip drive piece with the wire from the state where the slit of the tip drive piece is closed, the suture needle is rotated about the direction perpendicular to the insertion direction of the tip of the insertion tube. That is, the suture surface at the position perpendicular to the insertion direction of the tip of the insertion tube can be easily sutured, and the slit is closed in the non-operated state and the slit is opened only during the operation to suture. The operation only needs to be performed when the needle is pinched (including when the needle is changed), which has the effect of greatly improving usability.

It is an overall perspective view which shows the appearance of the needle holder which concerns on 1st Embodiment. It is an overall perspective view which shows the inside of the needle holder which concerns on 1st Embodiment. It is a side sectional view of the needle holder which concerns on 1st Embodiment. It is an enlarged view which shows the structure of the tip part in the needle holder which concerns on 1st Embodiment. It is a figure which shows the operation when the suture needle is grasped by the tip part of the needle holder which concerns on 1st Embodiment. It is a figure which shows the operation when the suture needle is moved by the tip part of the needle holder which concerns on 1st Embodiment. It is a figure which shows the structure of the operation part in the needle holder which concerns on 1st Embodiment. It is a side view of the lever and the rotary pulley in the needle holder which concerns on 1st Embodiment. It is a rear view of the lever and the rotary pulley in the needle holder which concerns on 1st Embodiment. It is a figure which shows the slit shape of the tip drive top in the needle holder which concerns on 2nd Embodiment. It is a figure which shows the gripping mode of the suture needle in the needle holder which concerns on 3rd Embodiment. It is a figure which shows the structure of the tip drive piece of the needle holder which concerns on 4th Embodiment. It is a figure which shows the structure of the tip drive piece of the needle holder which concerns on other embodiment. It is a figure which shows the prior art.

Hereinafter, embodiments of the present invention will be described. In addition, the same elements are designated by the same reference numerals throughout the present embodiment.

(First Embodiment of the present invention)
The needle holder according to this embodiment will be described with reference to FIGS. 1 to 9. In the needle holder according to the present embodiment, when the suture surface is perpendicular to the insertion direction of the needle holder, the suture needle is rotated about the direction perpendicular to the insertion direction. , The suturing work can be done easily. Surgery in which the suture surface is perpendicular to the insertion direction of the needle holder includes, for example, suturing the inner part of the pelvis, suturing the prostate and uterus, joining the esophagus and the intestine, and nasal cavity. The diameter of the intubation tube is preferably 3 mm or less because it is often used in a very narrow area because the pelvis may be operated via the suture. In the present embodiment, a needle holder that satisfies such conditions is realized by minimizing the number of parts and reducing the size.

FIG. 1 is an overall perspective view showing the appearance of the needle holder according to the present embodiment, FIG. 2 is an overall perspective view showing the inside of the needle holder according to the present embodiment, and FIG. 3 is a holder according to the present embodiment. It is a side sectional view of a needle holder. The needle holder 1 includes an operation unit 2 for the operator to operate, a tip portion 3 for gripping the suture needle and performing suturing work, and an intubation tube 4 for connecting the operation portion 2 and the tip portion 3. And. The operation unit 2 is provided with a lever 5 and a rotation pulley 6 for the operator to control the operation of the tip portion 3. The operator operates the lever 5 with the index finger and the thumb of the rotation pulley 6. By performing the operation, the operation of each component of the tip portion 3 is controlled.

The tip portion 3 has a tip drive piece 7 that moves the suture needle 30 and inserts it into a living tissue by rotating while holding the suture needle 30, and is provided on the peripheral edge of the tip drive piece 7. The wound wire 8 is wound around the rotating pulley 6 through the insertion tube 4. The wire 8 is circulated and connected via a tip drive piece 7, an insertion pipe 4, and a rotary pulley 6. The inside of the insertion tube 4 is hollow, and the wire 8 circulates and connects the tip drive piece 7 and the rotary pulley 6 through the space inside the insertion tube 4. Then, the operation of the rotary pulley 6 is transmitted to the tip drive piece 7 via the wire 8.

When the lever 5 is pulled in the direction opposite to the insertion direction, that is, in the direction toward the operator, the tip drive piece 7 is pulled into the insertion tube 4 together with the wire 8 while the tip drive piece 7 is tightened from the peripheral edge by the wire 8. .. By doing so, the suture needle 30 can be fixed to the tip driving piece 7, which will be described in detail later. Then, by pulling the lever 5 and rotating the rotary pulley 6 with the suture needle 30 fixed, the frictional force between the wire 8 and the tip drive top 7 affects the rotation of the rotary pulley 6. The tip drive piece 7 rotates according to the above. With such a structure, the suture needle 30 is gripped and fixed by the tip drive piece 7, and the tip drive piece 7 is rotated about a direction perpendicular to the insertion direction of the insertion tube 4 to move the suture needle 30. It becomes possible to do.

The structure and function of each part will be described in more detail. FIG. 4 is an enlarged view showing the structure of the tip portion 3 of the needle holder according to the present embodiment. The tip drive piece 7 is formed in a substantially columnar shape, and a groove portion 9 for winding the wire 8 is formed along the peripheral edge in the circumferential direction thereof. Further, a slit 10 is formed so as to divide the cylinder in the diameter direction of the tip drive piece 7. The slit 10 is a space for sandwiching the suture needle 30, and is formed with a width larger than the diameter of the suture needle 30. The tip of the insertion tube 4 is formed with an arcuate concave portion 11, and the arc portion of the concave portion 11 and the arc portion on the side surface of the cylinder of the tip driving piece 7 have the same curvature (or the curvature of the arc portion of the concave portion 11). "<" Curvature of the arcuate portion on the side surface of the cylinder of the tip drive piece 7 "), so that the arcuate portions can be brought into close contact with each other. That is, the tip drive piece 7 is made easy to slide in a state where the tip drive piece 7 and the tip portion of the intubation tube 4 are in close contact with each other. Further, one wire 8 extending from the tip portion through the insertion pipe 4 from the operation portion 2 is wound along the groove portion 9 of the tip drive piece 7, and again passes through the insertion pipe 4 to the operation portion 2. It is fixed with.

The wire 8 may be wound around the peripheral edge of the tip drive piece 7 without forming the groove 9 on the tip drive piece 7.

FIG. 5 is a diagram showing an operation when the suture needle is gripped. As shown in FIG. 5, by the operation of the operation unit 2, both the wire 8a extending in the insertion direction and the wire 8b wound around the tip drive piece 7 and returned to the insertion tube 4 are pulled in at the same time (arrows). By pulling it toward the operator as shown by a and b), the wire 8 wound around the tip driving piece 7 tightens the tip driving piece 7 from the peripheral edge thereof, and the width of the slit 10 becomes smaller (slit 10). The tightening force acts in the direction (closes). By tightening the wire 8, the suture needle 30 is gripped by the slit 10.

FIG. 6 is a diagram showing an operation when the suture needle is moved. As shown in FIG. 5, with the tip drive piece 7 tightened by the wire 8, one wire 8a extending in the insertion direction and the other wire 8b drawn from the tip of the insertion tube 4 toward the operation unit 2 side. By operating the above, the tip drive piece 7 can be slid to move the suture needle 30. Specifically, as shown in FIG. 6, one wire 8a is sent out in the insertion direction (delivered in the direction of arrow a), and at the same time, the other wire 8b is pulled in toward the operator (pulled in the direction of arrow b). As a result, the frictional force between the wire 8 and the tip drive piece 7 acts to rotate the tip drive piece 7. It should be noted that one wire 8a may be pulled in toward the operator and at the same time the other wire 8b may be sent out in the insertion direction. In this case, the rotation directions of the tip drive pieces 7 are opposite to each other.

With such a configuration, the suture needle 30 is securely gripped by the tip drive piece 7, and the suture needle 30 is moved by rotating the tip drive piece 7, so that the suture surface is located at a position perpendicular to the insertion direction. Can be easily sutured.

Next, the configuration and functions of the operation unit will be described in detail. FIG. 7 is a view showing the structure of the operation unit 2 in the needle holder according to the present embodiment, FIG. 8 is a side view of the lever and the rotating pulley in the needle holder according to the present embodiment, and FIG. 9 is the present embodiment. It is a rear view of the lever and the rotary pulley in the needle holder which concerns on the form.

The operation unit 2 has a lever 5 pivotally supported by a cover 11 serving as a housing in the operation unit 2 of the needle holder 1, and a rotary pulley 6 pivotally supported by the lever 5. The cover 11 and the lever 5 are pivotally supported by fitting the internal concave portion 12 formed inside the cover 11 near the upper end portion of the lever 5 and the convex portion 13 formed at the upper end portion of the lever 5, and are convex. A lever 5 is arranged around the portion 13 so as to be driveable in the insertion direction and the operator-side direction opposite to the insertion direction.

A notch 14 for fitting the rotary pulley 6 is formed in the upper part of the lever 5, and the center of the rotary pulley 6 is pivotally supported by the notch 14 on the shaft portion 15 of the lever 5. There is. The rotary pulley 6 is fixed only to the lever 5 and not to the cover 11. That is, the rotating pulley 6 is operated to follow the lever 5 in a state of being pivotally supported by the shaft portion 15 in response to the operation of the lever 5.

The wire 8 is wound around the wire slit 16 of the rotary pulley 6. One wire 8 wound around the tip drive piece 7 and drawn into the intubation tube 4 passes through the insertion tube 4 through the wire slit 16, is wound around the wire slit 16, and is introduced into the intubation tube 4 again. It is connected to the wire 8 around which the tip drive piece 7 is wound and goes around.

That is, when the lever 5 is pulled in the direction opposite to the insertion direction toward the operator, the rotating pulley 6 also follows the movement of the lever 5 while being pivotally supported by the shaft portion 15 in accordance with the movement. Move toward the operator. As the rotating pulley 6 moves toward the operator, the wire 8 is also pulled toward the operator. At the same time, the wire 8 around which the tip drive piece 7 is wound is drawn into the intubation tube 4 and tightens the tip drive piece 7 from the peripheral edge portion. When the wire 8 tightens the tip drive piece 7 from the peripheral edge portion, the width of the slit 10 acts in the closing direction, and the suture needle 30 can be gripped by the slit 10.

Then, when the operation of rotating the rotary pulley 6 while pulling the lever 5 and firmly grasping the suture needle 30, the wire 8a and the wire 8b rotate in opposite directions as the rotary pulley 6 rotates. Works on. That is, when the upper portion 17 of the rotary pulley 6 (the portion outside the cover 11 where the operator can touch the finger) is rotated in the insertion direction side, the wire 8a operates in the insertion direction side and the wire 8b Operates in the direction of the operator, which is opposite to the insertion direction. On the contrary, when the rotation operation is performed in the operator side direction opposite to the insertion direction, the wire 8b operates in the insertion direction side and the wire 8a operates in the operator side direction opposite to the insertion direction. The operation of the wire 8 causes the tip driving portion 7 to rotate, and the gripped suture needle 30 can be moved on the suture surface perpendicular to the insertion direction.

With the above configuration, in the needle holder according to the present embodiment, the suture needle 30 can be rotated about the direction perpendicular to the insertion direction of the tip of the insertion tube 4, that is, the insertion tube 4 The suture surface located at a position perpendicular to the insertion direction of the tip of the suture can be easily sutured. Further, by reducing the number of parts and the size of the parts themselves, it is possible to simplify the structure of the entire device and realize the miniaturization, and to minimize the burden on the patient.

Further, by making the wire 8 function by a simple operation in the operation portion 2, the suture needle 30 can be tightened and rotated at the same time, and the suture needle 30 has a simple structure and is perpendicular to the insertion direction of the tip portion of the insertion tube 4. The sutured surface at the position can be easily sutured.

Furthermore, the suture needle 30 can be fixed to the tip drive piece 7 with a simple lever operation, and the suture needle 30 can be rotated and moved by a simple operation with the axially supported rotating pulley 6. it can.

(Second Embodiment of the present invention)
The needle holder according to this embodiment will be described with reference to FIG. The needle holder according to the present embodiment shows a modified example of the tip driving top in the needle holder according to the first embodiment, and improves the gripping condition of the suture needle. In this embodiment, the description of duplicating the first embodiment will be omitted.

FIG. 10 is a diagram showing a slit shape of the tip driving top in the needle holder according to the present embodiment. In FIG. 10A, the shape of the slit 10 of the tip drive piece 7 shown in this embodiment is an arc shape. The suture needle 30 for inserting the living tissue is usually in the shape of an arc and moves while rotating. Therefore, if the shape of the slit 10 of the tip drive piece 7 is on a straight line when viewed from the cylindrical axis direction of the tip drive piece 7, the arc surface (formed by the arc) of the suture needle 30 is formed when the slit is tightened. There is a possibility that the surface) will be gripped so as to be perpendicular to the insertion direction (in a direction in which the needle is moved by rotating around the insertion direction).

Therefore, by making the shape of the slit 10 of the tip driving piece 7 arcuate when viewed from the cylindrical axis direction of the tip driving piece 7 as shown in FIG. 10A, the slit 10 of the tip driving piece 7 becomes a suture needle. The suture needle 30 can be firmly gripped in a certain direction along the arc of 30.

Further, as shown in FIG. 10B, by forming the shape of the slit 10 of the tip driving piece 7 into a cross shape when viewed from the cylindrical axis direction of the tip driving piece 7, the suture needle 30 is formed on the tip driving piece 7. The slit 10 has two angles that can be gripped, and when gripping the suture needle 30 during the operation, it is possible to grip the suture needle 30 without being so conscious of the state of the rotation angle of the tip drive piece 7.

By adding the slit 10 in the diagonal direction in addition to the cross shape shown in FIG. 10B, it is possible to set the angle at which the suture needle 30 can be grasped by the slit 10 of the tip drive piece 7 to three. Further, by adding the cross-shaped slit 10 in the oblique direction, the angle at which the suture needle 30 can be gripped by the slit 10 of the tip drive piece 7 becomes four, and it becomes possible to more easily grip the suture needle 30. Furthermore, the shape of each slit may be formed in an arc shape as shown in FIG. 10 (C).

(Third Embodiment of the present invention)
The needle holder according to this embodiment will be described with reference to FIG. The needle holder according to the present embodiment is an extension of the function of the needle holder according to the first embodiment, and can easily sew a suture surface that is substantially parallel to the insertion direction. Is. 11 (A) is an overall side view of the needle holder according to the present embodiment, FIG. 11 (B) is an arrow view when viewed from arrow a of FIG. 11 (A), and FIG. 11 (C) ) Is a view taken from the arrow b in FIG. 11 (A). The overall side view of FIG. 11A is the same as the side view shown in FIG.

In the present embodiment, unlike the case of the second embodiment, the slit shape of the tip driving piece 7 is intentionally formed linearly when viewed from the cylindrical axis direction of the tip driving piece 7. Then, the suture needle 30 is gripped so that the arcuate surface is perpendicular to the insertion direction. If the tip portion of the insertion tube 4 is rotated about the insertion direction in that state, the suture surface that is substantially parallel to the insertion direction can also be sutured.

The tip of the insertion tube 4 may be rotated by the operator by rotating the needle holder 1 itself about the insertion direction, or the operation unit 5 is provided with a pulley that rotates about the insertion direction. A mechanism for rotating the tip of the insertion tube 4 about the insertion direction in conjunction with the rotation of the pulley may be provided. In this case, a stopper may be provided so that the rotation of the tip end portion of the intubation tube 4 is stopped at least less than 360 degrees, preferably 180 degrees or less so that the wires 8a and 8b are not entangled with each other.

As described above, in the needle holder according to the present embodiment, it is possible to easily sew a suture surface that is substantially parallel to the insertion direction of the insertion tube (longitudinal direction of the tip of the insertion tube), which is simple. It is possible to realize a needle holder with a high degree of freedom with a flexible configuration.

In the present invention, the insertion tube 4 may be made of a material that can be flexibly bent, preferably a metal coil tube that is flexible in the bending direction and has high rigidity in the axial expansion and contraction. It may be formed by. Further, for the wire 8, a surgical thread may be used.

(Fourth Embodiment of the present invention)
The needle holder according to this embodiment will be described with reference to FIG. The needle holder according to the present embodiment is an improvement of the tip drive top of the needle holder according to each of the above embodiments, and the operability and durability are improved. FIG. 12 (A) is an overall perspective view of the tip driving top of the needle holder according to the present embodiment, and FIG. 12 (B) is an arrow view when viewed from the arrow a of FIG. 12 (A). 12 (C) is an arrow view when viewed from the arrow b of FIG. 12 (A).

In FIG. 12, a slit 10 is formed in the tip drive piece 7, and the slit 10 is formed from a root portion 122 near the end surface 121 of the tip drive piece 7 to an opening 123 that sandwiches the suture needle 30. .. A spatial region 124 is formed in the root portion 122 along the end face 121. The space region 124 forms a thin plate-shaped flat surface portion 125 on the end face 121. The flat surface portion 125 is formed of an elastic body, and the slit 10 is smoothly opened and closed by an elastic force (the slit 10 is closed by tightening the elastic force acting in the opening direction of the slit 10 with a wire 8). ), The stress on the root portion 122 due to the opening / closing operation of the slit 10 is dispersed by the flat surface portion 125, and the durability can be improved.

Further, in FIG. 12, the tip driving piece 7 is divided into a first sandwiching portion 126 and a second sandwiching portion 127 by a slit 10, and the first sandwiching portion 126 and / or the second sandwiching portion 127 is a suture needle. The width for sandwiching is narrower than in other places. That is, by narrowing the width of the first holding portion 126 and / or the second holding portion 127, fine operation becomes possible and the suture needle can be easily grasped.

Further, as shown in FIG. 12, one or a plurality of groove portions 128 for fitting the suture needle are formed in the slit 10 in a direction perpendicular to the rotation axis of the tip driving top 7. There is. By fitting the groove 128 with the suture needle, the suture needle can be stably pinched without slipping.

(Other embodiments)
The needle holder according to this embodiment will be described with reference to FIG. The needle holder according to the present embodiment has a structure in which the slit of the tip driving top is closed in a non-operated state, and the slit is opened only when the tip drive piece is tightened with a wire. That is, during the operation, the operation is performed only when the suture needle is grasped, and the state in which the suture needle is held is not operated, so that the operability is improved and the operation becomes easier.

FIG. 13 is a diagram showing the structure of the tip driving top of the needle holder according to the present embodiment. 13 (A) is an overall perspective view of the tip driving top, FIG. 13 (B) is an arrow view when viewed from arrow a of FIG. 13 (A), and FIG. 13 (C) is FIG. 13 It is an arrow view when viewed from the arrow b of (A). In the non-operated state, the slit 10 is closed as shown in FIG. That is, if the suture needle is grasped, it can be stably pinched. Then, when the wire is tightened, the first holding portion 126 and the second holding portion 127 are separated by the tightening force, and the suture needle is inserted between them. When the suture needle is inserted, the wire is loosened and the state shifts to the non-operation state. In the non-operated state, the elastic force of the flat surface portion 125 makes it possible to stably hold the suture needle and improve the operability of surgery.

1 Needle holder 2 Operation part 3 Tip part 4 Insert pipe 5 Lever 6 Rotating pulley 7 Tip drive piece 8 (8a, 8b) Wire 9 Groove 10 Slit 11 Concave 12 Internal recess 13 Convex 14 Cut 15 Shaft 16 Wire slit 17 Upper part 30 Suture needle 121 End face 122 Root part 123 Opening part 124 Spatial area 125 Flat part 126 First holding part 127 Second holding part 128 Groove part

Claims (3)

With the intubation
A tip drive piece that grips the suture needle at the tip of the insertion tube and is rotatably arranged around the direction perpendicular to the insertion direction at the tip.
It is provided with an operation unit for operating the operation of the tip drive top.
The tip drive piece has a slit in the radial direction in which a wire is wound around the peripheral edge and grips the suture needle, and the tip drive piece is tightened with the wire in a state where the suture needle is inserted inside the slit. The needle holder is characterized in that the suture needle is sandwiched between the tip drive pieces. In the needle holder according to claim 1,
The operation unit is provided with a rotary pulley that is rotatably arranged in the same direction as the tip drive frame.
The wire is wound around the rotary pulley and the tip drive piece, respectively, and is circulated and connected, and the tip drive piece is interposed via the wire in response to the rotation operation of the rotary pulley. A needle holder characterized by sliding. In the needle holder according to claim 2,
The operation unit is provided with a lever that pivotally supports the rotating pulley.
A needle holder characterized in that the wire tightens the tip driving piece by moving the lever in a direction opposite to the insertion direction.

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