needle holder

Abstract

The needle holder includes a flexible tube portion, a hard portion provided at a top end of the flexible tube portion, a first gripping member extending from a top end of the hard portion, a second gripping member linked to the hard portion in a manner capable of performing opening and closing actions relative to the first gripping member, and a protrusion portion protruding in a direction intersecting a length axis of the flexible tube portion, the protrusion portion having a receiving surface provided at a base end side in an outer peripheral surface of the protrusion portion and a hooking surface connected to the receiving surface and inclined relative to the receiving surface.

Description

[0001] This application is a divisional application of the application filed on March 22, 2018 (entering the Chinese national phase on September 16, 2020), with international application number PCT / JP2018 / 011352 (national application number: 201880091366.0) and entitled "Needle Holder and Method of Using Thereof". Technical Field

[0002] This invention relates to a needle holder and its method of use. Background Technology

[0003] Previously, a method for suturing tissues in the body using a curved needle and sutures was known. For example, Patent Document 1 describes a needle holder used for insertion into the channel of a flexible endoscope. The needle holder described in Patent Document 1 uses a pair of holding members to hold the curved needle connected to the sutures.

[0004] Existing technical documents

[0005] Patent documents

[0006] Patent Document 1: Japanese Patent No. 6197151 Summary of the Invention

[0007] The problem the invention aims to solve

[0008] In the method of suturing tissues in the body using a curved needle and suture, the suture is held and pulled to bring the tissues closer together.

[0009] The needle holder described in Patent Document 1 assumes that it only holds the curved needle and not the suture, resulting in a structure where a pair of holding members apply shear force to the suture when the suture is held using the needle holder described in Patent Document 1. Furthermore, if the held suture is pulled using the needle holder described in Patent Document 1, stress concentrates on a specific portion of the suture. The suture may be damaged due to the shear force and stress concentration, and thus accidentally cut.

[0010] To avoid this situation, it is considered to use a manipulator such as forceps to hold and pull the suture. However, in this case, the manipulator inserted into the channel of the flexible endoscope needs to be replaced with a manipulator or other manipulator, thus reducing the efficiency of the suturing operation. Therefore, there is a strong need for a manipulator for flexible endoscopes that can hold both the needle and the suture.

[0011] In view of the above, the object of the present invention is to provide a needle holder and a method of using it that simultaneously achieves stable holding of the curved needle and holding of the suture without damaging the suture.

[0012] Solution for solving the problem

[0013] The first technical solution of the present invention is a needle holder for holding a curved needle having a needle tip and a needle base connected to a suture. The needle holder includes: a flexible tube capable of being inserted into the channel of a flexible endoscope; a rigid portion disposed at the top end of the flexible tube; a first holding member extending from the top end of the rigid portion and having a groove extending along a length axis; a second holding member connected to the rigid portion in a manner capable of opening and closing relative to the first holding member; and a protrusion projecting in a direction intersecting the length axis. The groove of the first holding member has: a bottom surface facing a portion of the outer peripheral surface of the second holding member, i.e., the holding surface, when the second holding member is closed relative to the first holding member; and an inner... The first holding member has: a curved needle pressing portion disposed at the edge of the groove of the first holding member, which, when the curved needle is pressed in, presses the curved needle together with the outer peripheral surface of the second holding member and the protrusion; and a thread pressing portion disposed at the bottom surface of the groove of the first holding member, which, when the suture is pressed in, presses a portion of the suture between the thread pressing portion and the holding surface, presses the portion of the suture into place by means of the thread pressing portion and the holding surface, and movably holds the portion of the suture connected to one end of the portion in the gap between the inner wall surface of the groove and the outer peripheral surface of the second holding member.

[0014] According to the needle holder of the first technical solution above, the groove of the first holding member may have a second inner wall surface that intersects with the bottom surface and faces the inner wall surface, so that the second part of the suture connected to the other end of the part is movably held in a second gap between the second inner wall surface formed in the groove and the outer peripheral surface of the second holding member.

[0015] According to the needle holder of the first technical solution above, the first holding member may have an outer edge surface that is connected to the edge of the groove and extends intersecting the inner wall surface, the protrusion protrudes from the top of the outer edge surface in a direction that intersects with the outer edge surface, and the curved needle pressing part is located at the junction of the outer edge surface and the inner wall surface.

[0016] According to the needle holder of the first technical solution described above, the gap may also be larger than the diameter of the suture.

[0017] According to the needle holder of the first technical solution above, the bottom surface and the holding surface are approximately parallel when the suture is pressed into the local part by the suture pressing part and the holding surface.

[0018] According to the needle holder of the first technical solution described above, the protrusion may also have a hooking surface that hooks the third part of the suture located outside the groove when the suture is pressed into the part by the suture pressing part and the holding surface.

[0019] The second technical solution of the present invention is a method of using a needle holder, the needle holder comprising: a flexible tube portion capable of being inserted into the channel of a flexible endoscope; a rigid portion disposed at the top end of the flexible tube portion; a first gripping member extending from the top end of the rigid portion and having a groove extending along a length axis; a second gripping member connected to the rigid portion in a manner capable of opening and closing relative to the first gripping member; and a protrusion protruding in a direction intersecting the length axis, wherein the groove of the first gripping member has: a bottom surface facing a portion of the outer peripheral surface of the second gripping member, i.e., a gripping surface, when the second gripping member is closed relative to the first gripping member; and an inner wall surface intersecting the bottom surface and extending between the bottom surface and the edge of the groove, wherein the method of using the needle holder comprises the following steps: making the first gripping member... With the second holding member protruding from the tip of the flexible endoscope, a curved needle having a needle base and a needle tip is held between the first holding member and the second holding member; and while maintaining the first holding member and the second holding member protruding from the tip of the flexible endoscope, a suture connected to the needle base of the curved needle is held between the first holding member and the second holding member. In the step of holding the curved needle, the curved needle is pressed in by the outer peripheral surface of the second holding member, the edge of the groove, and the protrusion. In the step of holding the suture, a portion of the suture is pressed in by the bottom surface and the holding surface, and the portion of the suture connected to one end of the portion is movably held in the gap between the inner wall surface of the groove and the outer peripheral surface of the second holding member.

[0020] According to the method of using the needle holder according to the second technical solution above, the groove of the first holding member may have a second inner wall surface that intersects with the bottom surface and faces the inner wall surface, and the second part of the suture connected to the other end of the part is movable and held freely in a second gap between the second inner wall surface formed in the groove and the outer peripheral surface of the second holding member.

[0021] According to the method of using the needle holder according to the second technical solution above, the first holding member may have an outer edge surface that is connected to the edge of the groove and extends intersecting the inner wall surface, and the protrusion protrudes from the top of the outer edge surface in a direction that intersects with the outer edge surface.

[0022] According to the method of using the needle holder in the second technical solution described above, the gap may also be larger than the diameter of the suture.

[0023] According to the method of using the needle holder according to the second technical solution above, the bottom surface and the holding surface are approximately parallel when the bottom surface and the holding surface are pressed into the local part of the suture.

[0024] According to the method of using the needle holder according to the second technical solution above, it is also possible that, with the bottom surface and the holding surface pressing into the part of the suture, the third part of the suture located outside the groove is hooked onto the protrusion.

[0025] The effects of the invention

[0026] The needle holder according to the above technical solution can stably hold the curved needle and can also hold the suture without damaging the suture.

[0027] The needle holder described above can stably hold the curved needle and hold the suture without damaging it, thus enabling efficient suturing operations. Attached Figure Description

[0028] Figure 1 This diagram shows the state in which the needle holder of one embodiment of the present invention is inserted into a flexible endoscope.

[0029] Figure 2 This is a diagram showing the overall structure of the aforementioned needle holder.

[0030] Figure 3 This is a perspective view of the holding part of the aforementioned needle holder, showing the closed state of the first holding member and the second holding member.

[0031] Figure 4 This is a perspective view showing the holding part of the aforementioned needle holder, indicating the open state of the first holding member and the second holding member.

[0032] Figure 5 This is a diagram showing the gripping portion of the aforementioned needle holder as viewed from the direction extending along the length axis of the flexible tube.

[0033] Figure 6 This is a diagram showing the gripping part of the needle holder as viewed from the direction extending from the length axis of the connecting shaft member.

[0034] Figure 7 The holding part of the aforementioned needle holder Figure 6 A sectional view at line VII-VII.

[0035] Figure 8 The holding part of the aforementioned needle holder Figure 5 A cross-sectional view at line VIII-VIII.

[0036] Figure 9 The holding part of the aforementioned needle holder Figure 6 The cross-sectional view at line VII-VII shows the state of holding the curved needle using the aforementioned needle holder.

[0037] Figure 10 The holding part of the aforementioned needle holder Figure 5 The cross-sectional view at line VIII-VIII shows the state of holding the curved needle using the aforementioned needle holder.

[0038] Figure 11 The holding part of the aforementioned needle holder Figure 6 The cross-sectional view at line VII-VII shows the state in which the suture is held using the aforementioned needle holder.

[0039] Figure 12 The holding part of the aforementioned needle holder Figure 5 The cross-sectional view at line VIII-VIII shows the state of holding the suture using the aforementioned needle holder.

[0040] Figure 13 This diagram shows the state of holding the suture using the aforementioned needle holder, along an axis orthogonal to the length axis of the flexible tube and the length axis of the connecting shaft member.

[0041] Figure 14 This diagram shows the state of the suture being pulled using the aforementioned needle holder, along an axis orthogonal to the length axis of the flexible tube and the length axis of the connecting shaft member.

[0042] Figure 15 This is a diagram illustrating one step of using the aforementioned needle holder.

[0043] Figure 16 This is a diagram illustrating one step of using the aforementioned needle holder. Detailed Implementation

[0044] Reference Figures 1 to 14 This invention describes one embodiment.

[0045] Figure 1 This diagram shows the state in which the needle holder 20 of this embodiment is inserted into the flexible endoscope 1. The flexible endoscope 1 includes an insertion part 2 and an operation part 7.

[0046] The insertion part 2 has a shooting part 3, an active bending part 4, and a flexible part 5. The shooting part 3, the active bending part 4, and the flexible part 5 are arranged sequentially from the top of the insertion part 2. A channel 6 for inserting the needle holder 20 of this embodiment is provided inside the insertion part 2. A top opening 6a of the channel 6 is provided at the top of the insertion part 2.

[0047] The imaging unit 3 is capable of imaging the area to be treated. With the needle holder 20 protruding from the top opening 6a of the channel 6, the imaging unit 3 can also image the gripping part 23 of the needle holder 20 (described later). The active bending part 4 can actively bend according to the operator's operation on the operating part 7. The flexible part 5 is a flexible, tubular part.

[0048] The operating unit 7 is connected to the flexible unit 5. The operating unit 7 has a handle 8, an input unit 9, a base opening 6b of the channel 6, and a universal cable 10. The handle 8 is the part held by the operator. The input unit 9 receives operating input for bending the active bending unit 4. The universal cable 10 outputs the image captured by the imaging unit 3 to the outside. The universal cable 10 can be connected to a display device such as a liquid crystal display via an image processing device such as a processor.

[0049] Figure 2 This is an overall view showing the needle holder 20. The needle holder 20 has a flexible tube portion 21, a rigid portion 22, a gripping portion 23, and an operating portion 31. The flexible tube portion 21 is a longitudinally elongated member that is flexible and extends from the tip 21a to the base 21b. Figure 1 As shown, the flexible tube 21 can be inserted into the channel 6 of the flexible endoscope 1. With the flexible tube 21 inserted into the channel 6, the tip 21a of the flexible tube 21 can protrude into the top opening 6a of the channel 6. The tip 21a of the flexible tube 21 can enter the imaging field of view of the imaging unit 3 of the flexible endoscope 1 and be captured by the imaging unit 3.

[0050] A rigid portion 22 is provided at the top end 21a of the flexible tube section 21. The rigid portion 22 is formed of a rigid material. A holding portion 23 is provided in the rigid portion 22. An operating portion 31 is provided at the base end 21b of the flexible tube section 21.

[0051] Figure 3 and Figure 4 This is a perspective view showing the gripping part 23 of the needle holder 20. The gripping part 23 has a first gripping member 24, a second gripping member 25, a first protrusion 26 (protrusion), and a second protrusion 126. The first gripping member 24 and the second gripping member 25 are configured to perform opening and closing actions. Figure 3 This indicates the closed state of the first gripping member 24 and the second gripping member 25. Figure 4This indicates that the first gripping member 24 and the second gripping member 25 are open.

[0052] The first gripping member 24 extends from the top end of the rigid portion 22. The first gripping member 24 extends along the length axis Y1 of the flexible tube portion 21. In the needle holder 20 of this embodiment, the first gripping member 24 and the rigid portion 22 are integrally formed.

[0053] The second gripping member 25 is connected to the rigid part 22 in a manner that allows it to open and close relative to the first gripping member 24. Specifically, for example, the second gripping member 25 is rotatably connected to the rigid part 22 by inserting a connecting shaft member 37 into a through hole 38 formed in the second gripping member 25 and a through hole 39 formed in the rigid part 22. The second gripping member 25 is rotatable about the length axis Y2 of the connecting shaft member 37.

[0054] The first protrusion 26 and the second protrusion 126 are provided at the top end of the first gripping member 24 and protrude in a direction intersecting the length axis Y1. The first protrusion 26 and the second protrusion 126 are provided as a pair across the length axis Y1 of the flexible tube portion 21. When the first gripping member 24 and the second gripping member 25 are closed, the top end of the second gripping member 25 is located between the first protrusion 26 and the second protrusion 126.

[0055] like Figure 1 and Figure 2 As shown, the operation unit 31 includes an operation unit body 32, a slider 33, a fixing mechanism (not shown) that restricts the movement of the slider 33 relative to the operation unit body 32, and a release button 34 for releasing the fixing mechanism.

[0056] The top end of the operating part body 32 is connected to the base end 21b of the flexible tube part 21. The sliding member 33 is connected to the operating part body 32 in a way that allows it to move forward and backward relative to the operating part body 32, and can move forward and backward along the length axis of the operating part body 32.

[0057] like Figure 3 and Figure 4As shown, an operating line 35 extending along the length axis Y1 of the flexible tube 21 is disposed inside the flexible tube section 21. The operating line 35 is a flexible line capable of transmitting operating force from the operating part 31. The base end of the operating line 35 is connected to the slider 33 of the operating part 31. The top end of the operating line 35 is connected to the linkage mechanism 36. The linkage mechanism 36 is configured to include a first link member 36a, a first connector member 36b, a second link member 36c, and a second connector member 36d. The top end of the operating line 35 is connected to the first link member 36a. The first link member 36a is connected to the second link member 36c via the first connector member 36b. The second link member 36c is connected to the second gripping member 25 via the second connector member 36d. That is, the top end of the operating line 35 and the second gripping member 25 are connected to each other via the linkage mechanism 36. Therefore, the operating force for operating the opening and closing action of the second gripping member 25 relative to the first gripping member 24 is transmitted from the operating part 31 to the second gripping member 25 via the operating line 35 and the linkage mechanism 36.

[0058] By moving the slider 33 forward and backward along the operating part body 32, the operating line 35 can move forward and backward along the length axis Y1 of the flexible tube 21. In this embodiment, by moving the slider 33 towards the base end side along the operating part body 32, the operating line 35 can be pulled towards the operating part 31. The slider 33 is fixed at the desired position by a fixing mechanism. Therefore, if the slider 33 is fixed while the operating line 35 is being pulled, the state of pulling the operating line 35 can be maintained. By pulling the operating line 35 towards the operating part 31, the second holding member 25 moves in the closing direction relative to the first holding member 24. In addition, by pushing the operating line 35 towards the holding part 23, the second holding member 25 moves in the opening direction relative to the first holding member 24.

[0059] Figure 5 This is a front view (view) showing the gripping part 23 of the needle holder 20 as viewed from the direction extending from the length axis Y1 of the flexible tube 21. Figure 6 This is a side view of the holding part 23 of the needle holder 20 as seen from the direction extending from the length axis Y2 of the connecting shaft member 37. Figure 5 and Figure 6 This indicates that the first gripping member 24 and the second gripping member 25 are open. Figure 7 yes Figure 6 A sectional view at line VII-VII. Figure 8 yes Figure 5 A cross-sectional view at line VIII-VIII. Figures 5-8 For ease of observation of the accompanying drawings, the linkage mechanism 36 and the connecting shaft member 37 have been omitted.

[0060] like Figures 5-8As shown, the first gripping member 24 has an outer edge surface 24a and a groove 24b.

[0061] The outer edge surface 24a is parallel to a plane (hereinafter referred to as the "reference plane") defined by the direction extending from the length axis Y1 of the flexible tube 21 and the direction extending from the length axis Y2 of the connecting shaft member 37, and extends along the length axis Y1 of the flexible tube 21.

[0062] Furthermore, the structure of the outer edge surface 24a in this embodiment is not limited to the structure described above. For example, the outer edge surface may be inclined relative to the reference plane, or it may be a surface that gradually moves towards the second gripping member as it approaches the top.

[0063] The groove 24b extends along the length axis Y1 of the flexible tube 21. The groove 24b has a pair of first inner wall surfaces 24c (inner wall surfaces) and second inner wall surfaces 124c extending in a direction intersecting the outer edge surface 24a, and a bottom surface 24d located between the first inner wall surface 24c and the second inner wall surface 124c. In this embodiment, the first inner wall surface 24c and the second inner wall surface 124c intersect the outer edge surface 24a and extend along the length axis Y1 of the flexible tube 21. The first inner wall surface 24c and the second inner wall surface 124c are arranged in pairs across the length axis Y1 of the flexible tube 21. When the first holding member 24 and the second holding member 25 are closed, the second holding member 25 is located between the first inner wall surface 24c and the second inner wall surface 124c. The bottom surface 24d is positioned between the first inner wall surface 24c and the second inner wall surface 124c facing the first inner wall surface 24c. The bottom surface 24d is parallel to the outer edge surface 24a and extends along the length axis Y1 of the flexible tube portion 21. A groove portion 24b, defined by the first inner wall surface 24c, the second inner wall surface 124c, and the bottom surface 24d, extends along the length axis Y1 of the flexible tube portion 21, with a pair of groove portions 24b sandwiched between them by the outer edge surface 24a. The outer edge surface 24a intersects with the first inner wall surface 24c and the second inner wall surface 124c of the groove portion 24b and is located at the outer edge of the groove portion 24b.

[0064] A track guide surface 24e is provided at the junction of the outer edge surface 24a and the first inner wall surface 24c, and an edge 24f is provided at the junction of the outer edge surface 24a and the second inner wall surface 124c. The junction of the track guide surface 24e and the outer edge surface 24a forms the edge 24f of the groove portion 24b. The outer edge surface 24a is connected to the edge 24f of the groove portion 24b and extends intersectingly with the first inner wall surface 24c (second inner wall surface 124c). In addition, the outer edge surface 24a is connected to the edge 24f of the groove portion 24b and extends intersectingly with the track guide surface 24e.

[0065] like Figure 7As shown, the groove 24b of the first gripping member 24 has a first inner wall surface 24c (second inner wall surface 124c) that intersects the bottom surface 24d and extends between the bottom surface 24d and the edge 24f. A track guide surface 24e is provided between the first inner wall surface 24c (second inner wall surface 124c) and the edge 24f. Details about the track guide surface 24e will be described later.

[0066] The first protrusion 26 and the second protrusion 126 protrude from the top of the outer edge surface 24a and extend in a direction intersecting the outer edge surface 24a. That is, the first protrusion 26 and the second protrusion 126 protrude from the top of the outer edge surface 24a in a direction intersecting the outer edge surface 24a.

[0067] A bearing surface 26a and a hooking surface 26b are provided on a portion of the outer peripheral surface of the first protrusion 26 (see reference). Figure 8 and Figure 13 ).

[0068] A bearing surface 26a is formed on the base end side of the outer peripheral surface of the first protrusion 26. A hooking surface 26b is connected to the bearing surface 26a, is an inclined surface relative to the bearing surface 26a, and is provided at least in the portion of the outer peripheral surface of the first protrusion 26 that is furthest from the longitudinal axis Y1 of the flexible tube portion 21. Additionally, a bearing surface 126a and a hooking surface 126b are provided in a portion of the outer peripheral surface of the second protrusion 126 (see reference). Figure 6 and Figure 13 The bearing surface 126a is formed on the base end side of the outer peripheral surface of the second protrusion 126. The latching surface 126b is connected to the bearing surface 126a, is an inclined surface inclined relative to the bearing surface 126a, and is provided at least in the portion of the outer peripheral surface of the second protrusion 126 that is furthest from the length axis Y1 of the flexible tube portion 21. Details regarding the bearing surface 26a, latching surface 26b, bearing surface 126a, and latching surface 126b will be described later.

[0069] like Figures 5-8 As shown, the second gripping member 25 has an outer peripheral surface 25d including a gripping surface 25a, a first side surface 25b, and a second side surface 25c. The first side surface 25b and the second side surface 25c intersect with the gripping surface 25a.

[0070] The gripping surface 25a is the surface that faces the bottom surface 24d of the groove 24b of the first gripping member 24 when the second gripping member 25 is closed relative to the first gripping member 24. In this embodiment, when the gripping surface 25a of the second gripping member 25 is located closer to the bottom surface 24d than the outer edge surface 24a of the first gripping member 24, the gripping surface 25a of the second gripping member 25 is parallel to the bottom surface 24d of the first gripping member 24 and extends along the length axis Y1 of the flexible tube portion 21. The first side surface 25b and the second side surface 25c are arranged in pairs across the length axis Y1 of the flexible tube portion 21, with the gripping surface 25a located between the first side surface 25b and the second side surface 25c. The outer peripheral surface 25d of the second gripping member 25 is formed by at least the first side surface 25b, the gripping surface 25a, and the second side surface 25c.

[0071] Next, refer to Figures 9-14 The structure of the needle holder 20 in this embodiment will be described in further detail.

[0072] Figure 9 yes Figure 6 The cross-sectional view at line VII-VII shows the state in which the curved needle 40 is held by the needle holder 20. Figure 10 yes Figure 5 The cross-sectional view at line VIII-VIII shows the state in which the curved needle 40 is held by the needle holder 20. Figure 11 yes Figure 6 The cross-sectional view at line VII-VII shows the state in which the suture 50 is held by the needle holder 20. Figure 12 yes Figure 5 The cross-sectional view at line VIII-VIII shows the state in which the suture 50 is held by the needle holder 20. Figures 9-12 For ease of observation of the accompanying drawings, the linkage mechanism 36 and the connecting shaft member 37 have been omitted.

[0073] like Figure 9 and Figure 10 As shown, the curved needle 40 has an arc shape with a predetermined curvature. The curved needle 40 has a needle tip 41 capable of piercing tissue and a needle base 42 connected to the suture 50.

[0074] like Figures 1-4 As shown, by pulling the operating line 35 toward the operating part 31, the first holding member 24 and the second holding member 25 generate a holding force on the curved needle 40, and a portion of the curved needle 40 is held by the first holding member 24 and the second holding member 25.

[0075] like Figure 9 and Figure 10As shown, in this embodiment, the needle holder 20 holds the curved needle 40 by pressing in the first holding member 24, the second holding member 25, and the first protrusion 26 (and the second protrusion 126). Figure 10 yes Figure 5 The cross-sectional view along line VIII-VIII shows only the first protrusion 26, but similarly, the second protrusion 126 is also used to press in and hold the crank 40. When the crank 40 is held, a vector force F1, which is a holding force, is applied to the crank 40 from the outer peripheral surface 25d of the second holding member 25, which includes the holding surface 25a. In the held state, the second holding member 25 is inclined at a predetermined angle to the length axis Y1 of the flexible tube portion 21. Therefore, the vector force F1 from the second holding member 25 toward the top end side and the outer edge surface 24a side is applied relative to the crank 40.

[0076] like Figure 10 As shown, the vector force F1 is divided into a vector force F2 along the length axis Y1 of the flexible tube 21 and a vector force F3 in a direction orthogonal to the direction of the vector force F2. The curved needle 40 is pressed against the first protrusion 26 (and the second protrusion 126) by the vector force F2 and against the first gripping member 24 by the vector force F3. Not only is the curved needle 40 pressed against the first gripping member 24 by the vector force F3, but it is also pressed against the first protrusion 26 (and the second protrusion 126) by the vector force F2, so the gripping part 23 of the needle holder 20 can stably hold the curved needle 40.

[0077] The first protrusion 26 (and the second protrusion 126) can withstand the vector force F2. The first protrusion 26 withstands the vector force F2 using a bearing surface 26a formed on the base end side of its outer peripheral surface. The bearing surface 26a of the first protrusion 26 is arranged to intersect with the outer edge surface 24a of the first holding member 24 to suppress the wobbling of the curved needle 40 due to the vector force F2 when the needle holder 20 holds the curved needle 40. In order to stably withstand the vector force F2, the bearing surface 26a of the first protrusion 26 is preferably arranged orthogonally to the outer edge surface 24a. Similarly, the second protrusion 126 withstands the vector force F2 using a bearing surface 126a formed on the base end side of its outer peripheral surface.

[0078] The first gripping member 24 is capable of withstanding the vector force F3. The first gripping member 24 utilizes the edge 24f of the groove 24b to withstand the vector force F3. For example... Figure 9 and Figure 10As shown, the curved needle 40 has a predetermined curvature, so when the curved needle 40 is held, a portion of the curved needle 40 enters the groove 24b of the first holding member 24. When the curved needle 40 is partially inserted into the groove 24b, the curved needle 40 abuts against the edge 24f of the groove 24b, and the edge 24f of the groove 24b bears the vector force F3. That is, a curved needle pressing portion 27 is provided at the edge 24f of the groove 24b, located at the junction of the outer edge surface 24a and the first inner wall surface 24c (second inner wall surface 124c). The curved needle pressing portion 27 presses the curved needle 40 (the curved needle pressing portion 27 bears the vector force F3), thereby holding the curved needle 40.

[0079] In the needle holder 20 of this embodiment, the curved needle 40 is supported and held by a first holding member 24, a second holding member 25, a first protrusion 26, and a second protrusion 126. More specifically, the curved needle pressing portion 27 provided on the edge 24f of the groove 24b of the first holding member 24, the outer peripheral surface 25d of the second holding member 25 including the holding surface 25a, the bearing surface 26a of the first protrusion 26, and the bearing surface 126a of the second protrusion 126 are all used to support and hold the curved needle 40. Therefore, the curved needle 40 is pressed not only by the vector force F3 against the curved needle pressing portion 27, but also by the vector force F2 against the bearing surfaces 26a and 126a, and is thus stably held in the holding portion 23 of the needle holder 20. In other words, the needle holder 20 of this embodiment can stably hold the curved needle 40.

[0080] like Figure 11 and Figure 12 As shown, in this embodiment, the needle holder 20 uses the bottom surface 24d of the groove 24b of the first holding member 24 and the holding surface 25a of the second holding member 25 to press and hold the suture 50. A thread pressing part 28 is provided on the bottom surface 24d of the groove 24b of the first holding member 24. When holding the suture 50, the thread pressing part 28 and the holding surface 25a of the second holding member 25 press and press into the held portion of the suture 50.

[0081] The needle holder 20 of this embodiment is used for suturing, for example, tissues of the digestive tract. The suture 50 used for suturing tissues of the digestive tract is a component with a diameter smaller than that of the curved needle 40, for example, a diameter of 0.150 mm to 0.199 mm or a diameter of 0.270 mm to 0.349 mm.

[0082] like Figure 12As shown, when holding the suture 50, the suture 50 is pressed in using the thread pressing part 28 provided on the bottom surface 24d of the groove 24b and the holding surface 25a of the second holding member 25. The bottom surface 24d and the holding surface 25a face each other when the first holding member 24 and the second holding member 25 are closed. Furthermore, the suture 50 is a small-diameter component. Therefore, when the held portion of the suture 50 is pressed in using the thread pressing part 28 and the holding surface 25a, the bottom surface 24d and the holding surface 25a are approximately parallel. Additionally, at this time, the holding surface 25a slightly enters the groove 24b, and the holding surface 25a is located closer to the bottom surface 24d than the outer edge surface 24a.

[0083] The bottom surface 24d is approximately parallel to the holding surface 25a, so the vector force (holding force) applied to the suture 50 from the holding surface 25a in the direction along the length axis Y1 of the flexible tube 21 has almost no effect. Therefore, the suture 50 is held in a uniformly flattened manner by the suture pressing part 28 and the holding surface 25a. In other words, the needle holder 20 of this embodiment can reliably hold the suture 50 without causing stress concentration on a specific part of the suture 50.

[0084] like Figure 11 As shown, a first gap 61 is formed between the first inner wall surface 24c of the groove 24b of the first gripping member 24 and a portion of the outer peripheral surface 25d of the second gripping member 25, i.e., the second side surface 25c. Similarly, a second gap 62 is formed between the second inner wall surface 124c of the groove 24b of the first gripping member 24 and a portion of the outer peripheral surface 25d of the second gripping member 25, i.e., the first side surface 25b. The first gap 61 and the second gap 62 are both larger than the diameter of the suture 50.

[0085] In this embodiment, when holding the suture 50, the needle holder 20 presses the held portion of the suture 50 into the suture 50 using the suture pressing part 28 and the holding surface 25a. Furthermore, the first portion 51 (part) of the suture 50 connected to one end of the held portion is movably held in the first gap 61, and the second portion 52 of the suture 50 connected to the other end of the held portion is movably held in the second gap 62.

[0086] like Figure 11As shown, the first portion 51 of the suture 50 is not pressed in by the first gripping member 24 and the second gripping member 25, thus allowing free movement in the first gap 61. Simultaneously, the first portion 51 of the suture 50 is connected to one end of the gripped portion of the suture 50, and is therefore held by the gripping part 23 of the needle holder 20. Similarly, the second portion 52 of the suture 50 is not pressed in by the first gripping member 24 and the second gripping member 25, thus allowing free movement in the second gap 62. Simultaneously, the second portion 52 of the suture 50 is connected to the other end of the gripped portion of the suture 50, and is therefore held by the gripping part 23 of the needle holder 20.

[0087] In the needle holder 20 of this embodiment, a first gap 61 and a second gap 62 are formed, so that when holding the suture 50, the first portion 51 and the second portion 52 of the suture 50 connected to the held portion can be kept movable. Therefore, the shearing force of the first holding member 24 and the second holding member 25 is not applied to the first portion 51 and the second portion 52 of the suture 50. In other words, the needle holder 20 of this embodiment can appropriately prevent the suture 50 from being cut by shearing force.

[0088] Furthermore, in the needle holder 20 of this embodiment, both a first gap 61 and a second gap 62 are formed. However, even if only the first gap 61 is formed, the suture 50 is not subject to shearing force and is kept movable at least in the first gap 61.

[0089] like Figure 11 As shown, track guide surfaces 24e are provided between the outer edge surface 24a and the first inner wall surface 24c, and between the outer edge surface 24a and the second inner wall surface 124c. A pair of track guide surfaces 24e are provided across the length axis Y1 of the flexible tube portion 21, with the first inner wall surface 24c, the bottom surface 24d, and the second inner wall surface 124c located between the pair of track guide surfaces 24e. The track guide surface 24e is an inclined surface extending from the end of the outer edge surface 24a toward the groove portion 24b, configured to guide the length axis (track) of the suture 50 relative to the groove portion 24b. By providing the track guide surface 24e, when the suture 50 is held by the needle holder 20, the length axis of the suture 50 is easily held along the direction transversely cutting the groove portion 24b (the direction intersecting the length axis Y1 of the flexible tube portion 21). By guiding the length axis of the suture 50 along the direction transversely cutting the groove portion 24b using the track guide surface 24e, the suture 50 is easily held by the holding portion 23 of the needle holder 20.

[0090] Figure 13 This diagram shows the state in which the suture 50 is held by the needle holder 20, along an axis orthogonal to the length axis Y1 of the flexible tube 21 and the length axis Y2 of the connecting shaft member 37. Figure 14This diagram shows the state of the suture 50 being pulled by the needle holder 20, along an axis orthogonal to the length axis Y1 of the flexible tube 21 and the length axis Y2 of the connecting shaft member 37.

[0091] like Figure 13 As shown, the suture 50 is guided by the track guide surface 24e along the direction of the transverse groove 24b and held by the first holding member 24 and the second holding member 25.

[0092] A hook-on surface 26b is provided on a portion of the outer peripheral surface of the first protrusion 26. The hook-on surface 26b is connected to the bearing surface 26a, is an inclined surface relative to the bearing surface 26a, and is provided at least to the portion of the outer peripheral surface of the first protrusion 26 that is furthest from the length axis Y1 of the flexible tube portion 21. The hook-on surface 26b is provided along the track of the suture 50 when the held suture 50 is pulled. Additionally, a hook-on surface 126b is provided on a portion of the outer peripheral surface of the second protrusion 126. The hook-on surface 126b is connected to the bearing surface 126a, is an inclined surface relative to the bearing surface 126a, and is provided at least to the portion of the outer peripheral surface of the second protrusion 126 that is furthest from the length axis Y1 of the flexible tube portion 21. The hook-on surface 126b is provided along the track of the suture 50 when the held suture 50 is pulled.

[0093] like Figure 14 As shown, with the bottom surface 24d (thread pressing portion 28) and the holding surface 25a pressing the held portion of the suture 50, the third portion 53 and the fourth portion 54 of the suture 50 located outside the groove 24b are respectively hooked onto the hooking surface 26b and the hooking surface 126b. When the suture 50 is pulled, in addition to the held portion, the third portion 53 and the fourth portion 54 of the suture 50 are also subjected to tensile force. Therefore, the suture 50 is less likely to be damaged. Furthermore, since the held portion of the suture 50 can be held between the bottom surface 24d (thread pressing portion 28) and the holding surface 25a, and the hooking surface 26b and the hooking surface 126b can apply tensile force to the suture 50, a larger tensile force can be applied to pull the suture 50.

[0094] In addition, when using the needle holder 20 to pull the suture 50, depending on the direction of pulling the suture 50, either only the third part 53 of the suture 50 can be hooked onto the hooking surface 26b, or only the fourth part 54 of the suture 50 can be hooked onto the hooking surface 126b.

[0095] As explained above, according to the needle holder 20 of this embodiment, the curved needle 40 is pressed in by the curved needle pressing portion 27 provided on the edge 24f of the groove 24b of the first holding member 24, the outer peripheral surface 25d of the second holding member 25 including the holding surface 25a, the bearing surface 26a of the first protrusion 26, and the bearing surface 126a of the second protrusion 126. Therefore, the needle holder 20 can stably hold the curved needle 40.

[0096] Furthermore, according to the needle holder 20 of this embodiment, the suture 50 is uniformly pressed into the gripped portion by the suture pressing portion 28 provided on the bottom surface 24d of the groove portion 24b and the gripping surface 25a of the second gripping member 25. Therefore, the needle holder 20 can grip the suture 50 without causing stress concentration on a specific portion of the suture 50.

[0097] Furthermore, the needle holder 20 according to this embodiment has a first gap 61 and a second gap 62. Therefore, when holding the suture 50, the first portion 51 and the second portion 52 of the suture 50 connected to the held portion are kept movable, and the first holding member 24 and the second holding member 25 do not apply shearing force to the first portion 51 and the second portion 52. Thus, the needle holder 20 can appropriately prevent the suture 50 from being cut by shearing force.

[0098] The needle holder 20 according to this embodiment can stably hold the curved needle 40 and can also hold the suture 50 without damaging it.

[0099] Next, refer to Figure 15 and Figure 16 This describes the method of using the needle holder 20 of the above form (method of use). Figure 15 and Figure 16 This is a diagram illustrating a process of using the needle holder 20.

[0100] The flexible endoscope 1 is inserted into the digestive tract through the patient's natural opening.

[0101] Next, as Figure 15 As shown, the first holding member 24 and the second holding member 25 of the needle holder 20 protrude from the top opening 6a of the channel 6 of the flexible endoscope 1. With the first holding member 24 and the second holding member 25 protruding, the curved needle 40 having a needle base 42 and a needle tip 41 is held between the first holding member 24 and the second holding member 25.

[0102] In the step of holding the curved needle 40 using the needle holder 20, the curved needle 40 is held by the first holding member 24, the second holding member 25, the first protrusion 26, and the second protrusion 126 of the needle holder 20. At this time, as... Figure 9 and Figure 10As shown, the crank needle 40 is stably held by pressing the crank needle 40 into the groove 24b edge 24f (crank needle pressing part 27) of the first holding member 24, the outer peripheral surface 25d including the holding surface 25a of the second holding member 25, the first protrusion 26 and the second protrusion 126.

[0103] Next, as Figure 15 As shown, while holding the curved needle 40 with the needle holder 20, the curved needle 40 is repeatedly inserted into the target tissue in the digestive tract, and the suture 50 is attached to the target tissue. Afterwards, the curved needle 40 is released from the needle holder 20.

[0104] Next, as Figure 16 As shown, with the first holding member 24 and the second holding member 25 protruding from the top opening 6a of the channel 6 of the flexible endoscope 1, the suture 50 connected to the needle base 42 of the curved needle 40 is held between the first holding member 24 and the second holding member 25.

[0105] In the step of holding the suture 50 using the needle holder 20, the held portion of the suture 50 is held by the first holding member 24 and the second holding member 25 of the needle holder 20. At this time, as... Figure 11 and Figure 12 As shown, the bottom surface 24d (thread pressing portion 28) of the groove 24b of the first holding member 24 and the holding surface 25a of the second holding member 25 are pressed into and hold the portion of the suture 50. With the bottom surface 24d of the first holding member 24 and the holding surface 25a of the second holding member 25 pressed into the portion of the suture 50, the bottom surface 24d and the holding surface 25a are made approximately parallel. Therefore, the needle holder 20 can hold the suture 50 without causing stress concentration on a specific portion of the suture 50.

[0106] Furthermore, the needle holder 20 presses the held portion of the suture 50 into the bottom surface 24d and the holding surface 25a, and movably holds the first portion 51 of the suture 50 connected to one end of the held portion in the first gap 61, and movably holds the second portion 52 of the suture 50 connected to the other end of the held portion in the second gap 62. Therefore, the needle holder 20 can hold the suture 50 without applying shearing force to it.

[0107] Next, as Figure 16 As shown, with the suture 50 held by the needle holder 20, the suture 50 is pulled in a direction that moves the held portion of the suture 50 away from the target tissue, thus applying tension to the suture 50 and tightening the target tissue (suture contraction).

[0108] In the step of using the needle holder 20 to pull the suture 50, such as Figure 14As shown, the third portion 53 and the fourth portion 54 of the suture 50, located outside the groove 24b, are respectively attached to the attachment surface 26b and the attachment surface 126b. By distributing the force pulling the suture 50 among the held portion, the third portion 53, and the fourth portion 54 of the suture 50, it is difficult to damage the suture 50. In addition, the suture 50 can be pulled with a greater force depending on the suturing operation.

[0109] As explained above, according to the method of using the needle holder 20 of this embodiment, the curved needle 40 can be stably held using the needle holder 20, and the suture 50 can be held without damaging it. Therefore, it is possible to efficiently perform suturing operations on tissues inside the digestive tract, for example, using a flexible endoscope 1.

[0110] The embodiments of the present invention have been described above, but the technical scope of the present invention is not limited to the above embodiments. The combination of constituent elements can be changed, and various changes or deletions can be made to each constituent element without departing from the spirit of the present invention.

[0111] For example, in the above embodiment, an example of the first gripping member 24 and the rigid part 22 being integrally formed was described, but the first gripping member and the rigid part can also be separate. In this case, the first gripping member may be rotatably connected to the rigid part, and may also be connected to the rigid part in a way that allows it to open and close relative to the second gripping member. By enabling the first gripping member to rotate as well as the second gripping member, the range of opening and closing movements of the pair of gripping members can be expanded.

[0112] For example, in the above embodiment, an example of a linkage mechanism 36 consisting of a first link member 36a, a first connector member 36b, a second link member 36c, and a second connector member 36d was described, but the structure of the linkage mechanism is not limited to the above structure. The linkage mechanism can be of any structure as long as it can transmit the operating force transmitted via the operating line 35 to the second gripping member 25. Alternatively, it can be configured without a linkage mechanism by directly connecting the operating line 35 and the second gripping member 25. In this case, the structure of the needle holder can be simplified.

[0113] Industrial availability

[0114] The needle holder with the above-described shape can stably hold the curved needle and can also hold the suture without damaging it.

[0115] According to the above-described needle holder, it can stably hold the curved needle and hold the suture without damaging it, thus enabling efficient suturing operations.

[0116] Explanation of reference numerals in the attached figures

[0117] 1. Flexible endoscope; 2. Insertion section; 3. Imaging section; 4. Active bending section; 5. Flexible section; 6. Channel; 7. Operating section; 8. Handle; 9. Input section; 10. Universal cable; 20. Needle holder; 21. Flexible tube section; 22. Rigid section; 23. Holding section; 24. First holding member; 24a. Outer edge surface; 24b. Groove; 24c. First inner wall surface; 24d. Bottom surface; 24e. Track guide surface; 24f. Edge; 25. Second holding member; 25a. Holding surface; 25b. First side surface; 25c. Second side surface; 25d. Outer peripheral surface; 26. First protrusion; 26a, 126a. Bearing surface ; 26b, 126b, Card hanging surface; 27, Curved needle pressing part; 28, Thread pressing part; 31, Operating part; 32, Main body of operating part; 33, Sliding part; 34, Release button; 35, Operating line; 36, Linkage mechanism; 37, Connecting shaft member; 38, 39, Through hole; 40, Curved needle; 41, Needle tip; 42, Needle base; 50, Suture thread; 51, First part; 52, Second part; 53, Third part; 54, Fourth part; 61, First gap; 62, Second gap; Y1, Length axis of flexible tube part; Y2, Length axis of connecting shaft member; 124c, Second inner wall surface; 126, Second protrusion.

Claims

1. A needle holder, wherein, The needle holder includes: Flexible tube section; A rigid portion is located at the top end of the flexible tube portion; A first gripping member extends from the top of the rigid portion; A second gripping member is connected to the rigid part in a manner capable of opening and closing relative to the first gripping member; and A protrusion that extends from the first gripping member in an opening / closing direction intersecting the length axis of the flexible tube portion. The protrusion has a bearing surface and a hooking surface. The bearing surface is located on the base end side of the outer peripheral surface of the protrusion. The hooking surface is connected to the bearing surface and is located on the outer peripheral surface of the protrusion, which is furthest from the length axis. The hooking surface is inclined from the base end side to the top end side relative to the bearing surface.

2. The needle holder according to claim 1, wherein, The first gripping member has a groove extending along the length axis. The first gripping member has a first pressing part and a second pressing part. The first pressing part is located at the edge of the groove. The second pressing part is located on the bottom surface of the groove.

3. The needle holder according to claim 2, wherein, The groove has an inner wall surface that intersects with the bottom surface and extends between the bottom surface and the edge. A gap is formed between the inner wall surface and the outer peripheral surface of the second gripping member.

4. The needle holder according to claim 2, wherein, The groove has an inner wall surface that intersects with the bottom surface and extends between the bottom surface and the edge. The first gripping member has an outer edge surface that is connected to the edge of the groove and extends intersecting the inner wall surface. The protrusion extends from the top of the outer edge surface in a direction intersecting the outer edge surface. The first pressing part is located at the junction of the outer edge surface and the inner wall surface.

5. The needle holder according to claim 3, wherein, The gap is larger than the diameter of the suture connected to the curved needle held by the needle holder.

6. The needle holder according to claim 5, wherein, When the second pressing part and the gripping surface of the second gripping member are pressed into a portion of the suture, the bottom surface and the gripping surface are approximately parallel.

Images