Endoscopic suturing device

Abstract

To provide an endoscopic suturing device that can more surely perform a fixation operation of a suture needle to an arm part while using a wire for operation.SOLUTION: An endoscopic suturing device 1 provided at a distal end of a tubular insertion part of an endoscope comprises a pair of arm parts 12, 13 each having a holding part 18 of a suture needle 17 at an arm one end side, and is configured to be able to alternately switch the arm parts 12, 13 holding the suture needle when suturing a tissue by opening and closing the arm one end side. The holding part 18 comprises: biasing sections 32c, 68b which bias one end of the suture needle 17 so as to be in a locked state where it can be fixed to the arm parts 12, 13; and operation sections 16a, 16b which enable the operation of switching to an unlocked state where the one end of the suture needle 17 can be attached to or detached from the arm parts 12, 13 against biasing of the biasing sections 32c, 68b.SELECTED DRAWING: Figure 5

Description

[Technical field]

[0001] The present invention relates to an endoscopic suturing device. [Background technology]

[0002] Conventionally, a technique for suturing an incision under an endoscope to reduce the risk of complications after incision has been known, and an endoscopic suturing device for suturing an incision under an endoscope has also been proposed. For example, Patent Document 1 discloses a suturing device that has a pair of arms that hold a suturing needle at the tip, and switches the arm that holds the suturing needle when opening and closing to perform suturing. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] JP 2019-107442 A Summary of the Invention [Problem to be solved by the invention]

[0004] In this type of endoscopic suturing device, the distal suturing device is operated via a long wire from an operating section provided on the proximal side of the endoscope. The transmission of force via the wire is relatively good when pulling the proximal side, but when applying a pushing force to the distal side to the wire, the transmission of force to the distal side decreases due to bending of the wire, etc. Therefore, the operation of fixing the suturing needle to the arm section has been relatively difficult.

[0005] Therefore, the present invention has been made in consideration of the above-mentioned circumstances, and has an object to provide an endoscopic suturing device that can more reliably fix a suturing needle to an arm portion while using a wire for operation. [Means for solving the problem]

[0006] One aspect of the present invention is an endoscopic suturing device provided at the distal end of a tubular insertion section of an endoscope. The endoscopic suturing device has a pair of arms each having a suture needle holder at one end of the arm, and is configured to be able to alternately switch the arm section that holds the suture needle when opening and closing the one end of the arm to suture tissue, and the holder section has a biasing section that biases one end of the suture needle into a locked state in which it can be fixed to the arm section, and an operating section that can be operated to change the state to an unlocked state in which the one end of the suture needle can be detached from the arm section, against the bias of the biasing section. Effect of the Invention

[0007] According to one aspect of the present invention, it is possible to provide an endoscopic suturing device that can more reliably fix a suturing needle to an arm portion while using a wire for operation. [Brief description of the drawings]

[0008] [Figure 1] FIG. 1 is a perspective view that illustrates a schematic diagram of an example of a suturing device according to a first embodiment. [Diagram 2] FIG. 2 is a plan view of the suturing device of FIG. 1. [Diagram 3] FIG. 2 is a side view of the suturing device of FIG. 1. [Figure 4] 3A and 3B are diagrams illustrating a configuration example of an opening and closing mechanism part according to the first embodiment. [Diagram 5] FIG. 2 is a cross-sectional view that typically shows an axial cross section of a first arm portion and a second arm portion of the suturing device according to the first embodiment. [Figure 6] FIG. 11 is a perspective view showing a schematic view of a holding portion according to a second embodiment. [Figure 7] 5 is a cross-sectional view that shows a schematic cross section in the axial direction of a first arm portion 12 and a second arm portion 13 of a suturing device 1 according to a second embodiment. FIG. [Figure 8] FIG. 11 is a perspective view showing a schematic view of a holding portion according to a third embodiment. [Figure 9] 10 is a cross-sectional view that shows a schematic cross section in the axial direction of a first arm portion 12 and a second arm portion 13 of a suturing device 1 according to a third embodiment. FIG. [Figure 10] 10 is a cross-sectional view that shows a schematic cross section in the axial direction of a first arm portion 12 and a second arm portion 13 of a suturing device 1 according to a fourth embodiment. FIG. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0009] Hereinafter, a configuration example of an endoscopic suturing device (hereinafter also referred to as a suturing device) according to an embodiment will be described with reference to the drawings. Note that the shapes, dimensions, etc. of each part in the drawings are shown schematically and do not represent the actual shapes, dimensions, etc.

[0010] In the following description, the side of the endoscope farther from the operator is referred to as the distal side, and the side closer to the operator is referred to as the proximal side. In the drawings, the longitudinal direction (axial direction) of the endoscope is indicated by an arrow Ax as appropriate. The direction approximately perpendicular to the longitudinal direction is defined as the radial direction, and the rotation direction around the longitudinal direction is defined as the circumferential direction.

[0011] (First embodiment) Fig. 1 is a perspective view showing a schematic example of a suturing device according to a first embodiment, Fig. 2 is a plan view of the suturing device of Fig. 1, Fig. 3 is a side view of the suturing device of Fig. 1.

[0012] The suturing device 1 is detachably provided at the distal end of a tubular insertion portion 2 of an endoscope that is inserted into a living lumen. Since the suturing device 1 is detachable from the tubular insertion portion 2 of the endoscope, maintenance such as replacement and sterilization is easy. The suturing device 1 may be supplied as a disposable product.

[0013] For example, an endoscope is a flexible scope having a bendable tubular insertion section 2, which is operated by an operator from the proximal side. An objective lens 3 of an imaging section, an illumination section 4, and a forceps port 5 are provided at the distal end of the tubular insertion section 2 of the endoscope.

[0014] The endoscope can capture images of the inside of a living body lumen with an imaging section via a wide-angle objective lens 3, and can display and output the images of the inside of the living body lumen in real time on a display device (not shown). The illumination section 4 illuminates the inside of the living body lumen with light guided from a light source by an optical fiber. The forceps port 5 is provided for inserting and removing treatment tools such as forceps 6 and for collecting living body tissue with the treatment tool. As shown in FIG. 3, the endoscope can grasp living body tissue with the forceps 6 by moving the forceps 6 forward and backward in the longitudinal direction from the forceps port 5 of the tubular insertion section 2.

[0015] The suturing device 1 includes an attachment section 11, a pair of arms consisting of a first arm section 12 and a second arm section 13, an opening / closing mechanism section 14, an opening / closing wire 15, and operating wires 16a and 16b. The operating wires 16a and 16b are an example of an operating section. The attachment section 11, the first arm section 12, the second arm section 13, and the opening / closing mechanism section 14 are disposed at the distal end of the tubular insertion section 2.

[0016] The first arm section 12 and the second arm section 13 each have a holder 18 at a distal end thereof for holding one end of the suture needle 17. The first arm section 12 and the second arm section 13 are switchable between a locked state in which the suture needle 17 is fixed to the holder 18 and an unlocked state in which the suture needle 17 is not fixed to the holder 18. The holder 18 will be described in detail later.

[0017] The attachment portion 11 is an annular member that corresponds to the outer diameter of the tubular insertion portion 2. The distal end of the tubular insertion portion 2 is detachably inserted into the inside of the attachment portion 11 and held by the attachment portion 11. In addition, a first arm portion 12 and a second arm portion 13 are attached to the outer periphery of the attachment portion 11 via an opening / closing mechanism portion 14.

[0018] The first arm section 12 and the second arm section 13 are supported by the opening / closing mechanism section 14 in a V-shape so as to protrude distally from the attachment section 11, and can be opened and closed in a direction substantially parallel to the tangent direction of the outer periphery of the endoscope. As shown in Fig. 3, when the suturing device 1 is attached to the tubular insertion section 2, the tips of the first arm section 12 and the second arm section 13 are located distally of the tubular insertion section 2. Also, as shown in Fig. 3, the tip of each arm section is located on the line of movement of the forceps 6 when each arm section is closed.

[0019] The first arm 12 and the second arm 13 are attached with the distal side inclined radially inward from the proximal side. For example, each arm is attached with an inclination of 0.5° to 50°, more preferably 3° to 35°, radially inward from a position substantially parallel to the longitudinal direction. By attaching each arm with an inclination inward, the suturing device 1 is less likely to interfere with objects on the radial outside, and the passability when inserting the endoscope into the overtube or the body can be improved. In addition, by attaching each arm with an inclination inward, the tip of each arm approaches the center of the viewing angle of the imaging unit of the endoscope, and visibility during suturing can be improved. In addition, even if the endoscope moves or is located at a bent part, or the arm position is slightly shifted after insertion, the arm is more likely to be reflected in the center of the viewing field, making it easier to check the entire arm under the endoscope.

[0020] Furthermore, the location at the tip of each arm to which one end of the suturing needle 17 is fixed is located within a 100% range from the center of the viewing angle of the imaging unit of the endoscope. Specifically, when the viewing angle of the imaging unit is θ1 based on the distal end of the tubular insertion section 2 and the range from the center of the viewing angle at which the tip of each arm is located is θ2, it is preferable that θ2 is within 90% of θ1, more preferably θ2 is within 80% of θ1, and particularly preferably θ2 is within 70% of θ1. By locating the tip of each arm under the above conditions, it is possible to prevent the suturing location from being out of the viewing angle of the imaging unit and the visibility during suturing from being reduced due to the influence of aberration of the imaging unit.

[0021] Furthermore, when suturing by wrapping a large amount of biological tissue, such as in full-thickness suturing, it becomes necessary to sufficiently draw the biological tissue to be sutured toward the endoscope using the forceps 6 of the endoscope. For this reason, a certain amount of margin is required in the longitudinal dimension from the distal end of the tubular insertion section 2 to the tip of each arm section.

[0022] From this viewpoint, for example, the longitudinal dimension from the distal end of the tubular insertion part 2 to the tip of each arm part is preferably, for example, 1 mm or more and 80 mm or less, and more preferably 3 mm or more and 60 mm or less. For example, by making the distance from the distal end of the tubular insertion part 2 to the tip of each arm part 3 mm or more, the tip of the arm part comes into the field of view of the endoscope, making suturing under the endoscope easier. Also, by making the distance from the distal end of the tubular insertion part 2 to the tip of each arm part 60 mm or less, it becomes easier to insert the tip of the arm without it getting caught on the overtube.

[0023] The opening and closing wire 15 is disposed in the longitudinal direction along the tubular insertion section 2, and its distal side is connected to the opening and closing mechanism 14. In the suturing device 1, the first arm 12 and the second arm 13 holding the suturing needle 17 can be opened and closed via the opening and closing mechanism 14 by pulling the opening and closing wire 15 proximally.

[0024] The operating wire 16a is disposed in the longitudinal direction along the tubular insertion section 2, and its distal side is connected to the holding part 18 of the first arm section 12. By pulling the operating wire 16a proximally, the holding part 18 of the first arm section 12 operates, and it is possible to switch between a locked state in which the suturing needle 17 is fixed by the holding part 18 of the first arm section 12 and an unlocked state in which the lock is released.

[0025] The operating wire 16b is disposed in the longitudinal direction along the tubular insertion section 2, and its distal side is connected to the holding portion 18 of the second arm section 13. By pulling the operating wire 16b proximally, the holding portion 18 of the second arm section 13 operates, and it is possible to switch between a locked state in which the suturing needle 17 is fixed by the holding portion 18 of the second arm section 13 and a released state.

[0026] The above-mentioned opening / closing wire 15 and operating wires 16a, 16b can be operated independently. By operating the opening / closing mechanism 14 and the holding part 18 with separate wires, the suturing device 1 can be operated precisely. In addition, the holding parts 18 of the first arm 12 and the second arm 13 can be operated separately with different operating wires 16a, 16b. Therefore, in the suturing device 1 of this embodiment, even if the needle lock fails with one arm, it is possible to recover by re-operating the holding part 18 on the same side, compared to a configuration in which the holding parts 18 of both arms are linked.

[0027] The attachment section 11, the first arm section 12, the second arm section 13, and the opening / closing mechanism section 14 may be made of a biocompatible metal, such as stainless steel, titanium, or nitinol. The opening / closing wire 15 and the operating wires 16a and 16b may be made of a thin metal wire, such as stainless steel, titanium, copper, or nitinol, or a thin polymer fiber wire, a fluorine tube, polyethylene, polypropylene, or nylon. The opening / closing wire 15 and the operating wires 16a and 16b may be made of the same material or different materials.

[0028] 4 is a diagram illustrating a schematic configuration example of the opening / closing mechanism 14 of the first embodiment. The opening / closing mechanism 14 is not limited to the configuration in FIG. 4, and may be another mechanism capable of opening and closing by pulling the opening / closing wire 15.

[0029] The opening / closing mechanism 14 of the first embodiment is a link mechanism that drives the first arm 12 and the second arm 13, and has a main body 21, a driving link 22, a first intermediate link 23, and a second intermediate link 24. The link mechanism of the opening / closing mechanism 14 is line-symmetric on a plane based on the central axis C. The central axis C includes a component that is inclined radially with respect to the longitudinal direction of the tubular insertion section 2.

[0030] The main body 21 is a thin box-shaped housing that rotatably supports the first arm 12 and the second arm 13 and houses the elements of the link mechanism. The main body 21 also functions as a cover that covers the elements of the link mechanism. Covering the link mechanism with the main body 21 can reduce the possibility of malfunction of the link mechanism due to tangled sutures or adhesion of body fluids, etc. In FIG. 4, the main body 21 is drawn as a flat plate to make it easier to understand the structure of the opening / closing mechanism 14.

[0031] The overall shape of the main body 21 is formed into a trapezoid shape in which the distal side is longer than the proximal side, and the proximal side of the main body 21 is fixed to the attachment portion 11. As described above, the main body 21 is fixed to the attachment portion 11 so that the distal side is inclined radially inward (toward the depth of the paper surface in FIG. 4) more than the proximal side.

[0032] Furthermore, on the distal side of the main body 21, a first arm portion 12 is attached to one end (left side in FIG. 4), and a second arm portion 13 is attached to the other end (right side in FIG. 4) spaced apart from the first arm portion 12. The base end side of the first arm portion 12 is rotatably supported by the main body 21 via a first support shaft 25. The base end side of the second arm portion 13 is rotatably supported by the main body 21 via a second support shaft 26. The first arm portion 12 and the second arm portion 13 are biased in the opening direction by a spring (not shown).

[0033] The driver 22 is an elongated rectangular member, and is disposed within the main body 21 along the central axis C. The opening / closing wire 15 is connected to the proximal end of the driver 22. The proximal end of the first intermediate section 23 and the proximal end of the second intermediate section 24 are connected to the distal end of the driver 22. The driver 22 slides within the main body 22 along the central axis C by being pulled by the opening / closing wire 15, and is thereby displaced relatively in the longitudinal direction of the tubular insertion section 2.

[0034] The first intermediate link 23 and the second intermediate link 24 are each an elongated rectangular member. The proximal end of the first intermediate link 23 and the proximal end of the second intermediate link 24 are both rotatably supported on the distal end of the driving link 22 by a pin 22a.

[0035] Further, the distal end of the first intermediate link 23 is rotatably connected to the first arm portion 12 via a pin 27. The position of the pin 27 of the first arm portion 12 is disposed between the tip side of the arm and the first support shaft 25, and is located closer to the first support shaft 25 than the tip side of the arm.

[0036] Similarly, the distal end of the second intermediate link 24 is rotatably connected to the second arm portion 13 via a pin 28. The position of the pin 28 of the second arm portion 13 is disposed between the tip side of the arm and the second support shaft 26, and is located closer to the second support shaft 26 than the tip side of the arm.

[0037] As described above, the first arm unit 12 and the second arm unit 13 are biased in the opening direction by the force of a spring (not shown). When the opening / closing wire 15 is not being pulled, no force in the closing direction acts on the first arm unit 12 and the second arm unit 13, so the suturing device 1 maintains the arm units in the open state (FIG. 4(a)).

[0038] When the opening / closing wire 15 is pulled from the above state, the driver 22 of the opening / closing mechanism 14 is displaced proximally in the longitudinal direction. Then, in accordance with the displacement of the driver 22, the positions of the proximal end of the first intermediate link 23 and the proximal end of the second intermediate link 24 move proximally, and the first intermediate link 23 and the second intermediate link 24 are each retracted proximally.

[0039] The first arm portion 12, which is rotatably supported by the main body portion 21 via a first support shaft 25, rotates in the closing direction about the first support shaft 25 due to the displacement of the first intermediate link 23. Similarly, the second arm portion 13, which is rotatably supported by the main body portion 21 via a second support shaft 26, rotates in the closing direction about the second support shaft 26 due to the displacement of the second intermediate link 24. In this manner, the arm portion of the suturing device 1 changes from an open state to a closed state by pulling the opening / closing wire 15 (FIG. 4(b)).

[0040] The opening / closing mechanism 14 shown in Fig. 4 directly transmits the motion of the opening / closing wire 15 to the arm section via a link mechanism, and can convert the displacement of the driving link 22 caused by the pulling of the opening / closing wire 15 into an opening / closing motion at the tip of the arm section. Therefore, the opening / closing mechanism 14 can open and close the arm section with a strong force while suppressing loss of force, thereby realizing a suturing device 1 suitable for full-thickness suturing, for example. In addition, the opening / closing mechanism 14 can switch between opening and closing the arm section with a simple operation caused by the pulling of the opening / closing wire 15.

[0041] Next, a configuration example of the holding section according to the first embodiment of the present invention will be described with reference to Fig. 5. Fig. 5 is a cross-sectional view that shows a schematic axial cross section of the first arm section 12 and the second arm section 13 of the suturing device 1 according to the first embodiment. Note that since the configuration of the arm section and the holding section is common to the first arm section 12 and the second arm section 13, the following description will focus on the configuration of the first arm section 12, and redundant description of the configuration of the second arm section 13 will be omitted.

[0042] The first arm portion 12 has a hollow outer shell portion 30, and is configured with a holding portion 18 inside the outer shell portion 30. A through hole 30a penetrating the outer shell portion 30 is provided at the tip (distal end) of the outer shell portion 30 of the first arm portion 12, at a position facing the second arm portion 13. One end of the suture needle 17 is housed in the outer shell portion 30 through the through hole 30a and is fixed by the holding portion 18.

[0043] Here, suture needle 17 has needle tips 17a formed on both ends and a hole (not shown) in the center for passing a suture thread through. In addition, on both sides of suture needle 17, at a position inside needle tip 17a, there are formed constricted grooves 17b that extend in a direction intersecting the extension direction of suture needle 17 and are recessed in a ring shape in the circumferential direction.

[0044] In the first embodiment, the holding portion 18 is configured to have a first member 31 and a second member 32 within an outer shell portion 30.

[0045] The first member 31 is fixed to the distal end of the outer shell 30, for example, by adhesive. The first member 31 may be the same part as the outer shell 30. The first member 31 has a parallel portion 31a that is substantially parallel to the insertion direction of the suture needle 17, and an inclined portion 31b that is inclined from the parallel portion 31a to the proximal side. The inclination angle of at least a part of the inclined portion 31b is substantially equal to the inclination angle of the needle tip 17a so that the needle tip 17a of the suture needle 17 can be inserted. The first member 31 functions as a positioning portion that determines the position of the suture needle 17. That is, the holding portion 18 has the first member 31 that functions as a positioning portion at a position facing the claw 32b across the suture needle 17.

[0046] The second member 32 is a plate-like member extending in a direction perpendicular to the axial direction. A first end 32a of the second member 32 on the side opposite to the side facing the second arm portion 13 is fixed to the inner wall of the outer shell portion 30, for example, by adhesive. The second member 32 may be the same part as the outer shell portion 30. The second member 32 has a claw 32b on the side facing the second arm portion 13. The claw 32b protrudes distally. The second member 32 has a biasing portion 32c at least between the first end 32a and the claw 32b. The biasing portion 32c is an elastic member, and biases the claw 32b distally by elasticity.

[0047] When the first arm portion 12 and the second arm portion 13 are brought closer to each other (one end of the arm is closed), the needle tip 17a of the suture needle 17 is inserted into the outer shell portion 30 from the through hole 30a while widening the gap between the first member 31 and the claw 32b against the biasing force of the biasing portion 32c. When the groove 17b of the suture needle 17 reaches a position facing the claw 32b in the axial direction, the claw 32b fits into the groove 17b due to the biasing force of the biasing portion 32c. The groove 17b functions as an engaging portion with which the claw 32b engages, and the claw 32b functions as an engaged portion with which the groove 17b engages. At this time, the first member 31 positions the suture needle 17 by restricting the movement of the suture needle 17 toward the distal side, so that the suture needle 17 does not come out of the through hole 30a. In this manner, in this embodiment, the locked state of the holding portion 18 can be maintained by the biasing force of the biasing portion 32c without the need to operate the operating wire 16a. In this embodiment, the locked state is a state in which the claw 32b (engaged portion) engages with the groove 17b (engaging portion). Note that both the first arm portion 12 and the second arm portion 13 may be in the locked state, or only one of them may be in the locked state.

[0048] In this embodiment, groove 17b of suturing needle 17 and claw 32b of second member 32 function as an engaging portion and an engaged portion, but the present invention is not limited to this. For example, a convex portion may be provided on suturing needle 17, a groove may be provided on second member 32, and the convex portion of suturing needle 17 may engage with the groove of second member 32, thereby functioning as an engaging portion and an engaged portion.

[0049] The claw 32b of the second member 32 is fixed to the distal side of the operating wire 16a, for example, by an adhesive. When the operating wire 16a is pulled proximally, the claw 32b side of the second member 32 is warped (deformed) downward relative to the first end 32a, the engagement between the groove 17b and the claw 32b is released, and the holding portion 18 can be changed from the locked state to the unlocked state.

[0050] Operating lines 16a and 16b can be operated independently, and first arm portion 12 and second arm portion 13 can independently switch between the locked state and the unlocked state of their respective holding portions 18.

[0051] In the present invention, a spring for biasing the claw 32b distally may be provided separately from the biasing portion 32c to increase the biasing force for biasing the claw 32b distally.

[0052] Furthermore, the shapes of the claw 32b and the groove 17b are not limited to those shown in the drawings, and may be any shape as long as the suture needle 17 can be locked to the holder 18. For example, the claw 32b may be shaped to extend vertically to the distal side, to extend obliquely, or to extend in a curved manner.

[0053] The effects of the suturing device 1 of the first embodiment will be described below.

[0054] According to this embodiment, it is possible to provide an endoscopic suturing device that can more reliably fix the suturing needle to the arm portion while using a wire for operation.

[0055] Furthermore, the holding portion 18 of the suturing device 1 does not require any particular operation to maintain the locked state, and it is sufficient to operate the operating wire 16a only to unlock it. Therefore, according to this embodiment, the arm portion that holds the suturing needle can be switched with a simple operation.

[0056] Furthermore, by pressing the claw 32b to the lock position with the biasing force of the biasing portion 32c to fix the suture needle 17, even if the operating wire 16a is a wire, it will bend and the force in the pushing direction that is difficult to transmit can be reliably applied by the claw 32b. This improves the reliability of the fixing operation of the suture needle 17 in the holding portion 18.

[0057] In addition, the locking state can be urged by the elastic force of the urging portion 32c, which is an elastic member. This allows for a reduction in the number of parts, a reduction in the space inside the arm portion, and a reduction in the size of the outer shell of the arm portion due to the reduction in the space inside the arm portion. Furthermore, the reduction in the size of the arm portion can contribute to a less invasive operation.

[0058] In addition, the holding part 18 can be changed from a locked state to an unlocked state by a simple configuration and operation of pulling the operating wire. This allows for a reduction in the number of parts, a reduction in the space inside the arm part, and a reduction in the size of the outer shell of the arm part due to the reduction in the space inside the arm part. Furthermore, the miniaturization of the arm part can contribute to less invasiveness.

[0059] Furthermore, the holding portion 18 can be put into a locked state by a simple structure in which the claw 32b engages with the groove 17b.

[0060] Furthermore, the suture needle 17 is positioned by the first member 31 and the claws 32b as a positioning portion, and rattling of the suture needle 17 can be reduced.

[0061] Second embodiment Next, a configuration example of a holding part according to a second embodiment of the present invention will be described with reference to Fig. 6 and Fig. 7. In the second embodiment, the structure shown in Fig. 1 to Fig. 4 is similar to that of the first embodiment, so the description will be given with reference to Fig. 1 to Fig. 4.

[0062] Fig. 6 is a perspective view showing a typical holding section according to the second embodiment. Fig. 7 is a cross-sectional view showing a typical axial section of the first arm section 12 and the second arm section 13 of the suturing device 1 according to the second embodiment. Since the configuration of the arm section and the holding section is common to the first arm section 12 and the second arm section 13, the following description will focus on the configuration of the first arm section 12, and will omit redundant description of the configuration of the second arm section 13. Also, elements common to the first embodiment will be given the same reference numerals, and redundant description will be omitted as appropriate.

[0063] In the second embodiment, the holding portion 18 is configured to have a needle holder 41 inside the outer shell portion 30.

[0064] The needle holder 41 is formed by bending a plate-shaped member. The needle holder 41 has a first plate portion 41a whose distal end is fixed to the outer shell portion 30 and extends proximally. The needle holder 41 has a first convex portion 41b formed by bending distally at the proximal end of the first plate portion 41a. The first convex portion 41b protrudes proximally. The needle holder 41 has a second plate portion 41c that is bent proximally at the distal end of the first convex portion 41b and extends along the shape of the needle tip 17a. The needle holder 41 has a tip portion 41d that is bent at a position corresponding to the tip of the needle tip 17a at the proximal end of the second plate portion 41c. The needle holder 41 has a third plate portion 41e that extends from the tip portion 41d along the shape of the needle tip 17a. The needle holder 41 has a second protrusion 41f formed by bending distally at the proximal end of the third plate 41e. The second protrusion 41f protrudes distally. The needle holder 41 has a fourth plate 41g bent proximally at the distal end of the second protrusion 41f and extending proximally. The proximal end of the fourth plate 41g is fixed to the distal side of the operating wire 16a, for example with an adhesive.

[0065] First protrusion 41b and second plate 41c function as a positioning portion that determines the position of suture needle 17. Holder 18 has first protrusion 41b, which functions as a positioning portion, at a position facing second protrusion 41f across suture needle 17.

[0066] Tip portion 41d may be fixed to outer shell portion 30 with its tip fitted into a groove (recess) in the inner wall of outer shell portion 30. Tip portion 41d may also be fixed to the inner wall of outer shell portion 30 with, for example, an adhesive.

[0067] At least the third plate portion 41e of the needle holder 41 is an elastic member, and urges the second protrusion portion 41f distally by its elasticity.

[0068] Needle holder 41, which is a plate-like member, has a second protrusion 41f that can engage with groove 17b located on the holding side of suture needle 17 (the side that holds suture needle 17, i.e., the side facing second arm portion 13) when bent.

[0069] When the first arm portion 12 and the second arm portion 13 are brought closer to each other (one end of the arm is closed), the needle tip 17a of the suture needle 17 is inserted into the outer shell portion 30 through the through hole 30a while widening the gap between the first convex portion 41b and the second convex portion 41f against the biasing force of the third plate portion 41e. When the groove 17b of the suture needle 17 reaches a position facing the second convex portion 41f in the axial direction, the second convex portion 41f fits into the groove 17b due to the biasing force of the third plate portion 41e. The groove 17b functions as an engaging portion with which the second convex portion 41f engages, and the second convex portion 41f functions as an engaged portion with which the groove 17b engages. At this time, the first convex portion 41b and the second plate portion 41c position the suture needle 17 by restricting the movement of the suture needle 17 toward the distal side, so that the suture needle 17 does not come out of the through hole 30a. Thus, in this embodiment, the locked state of the holding portion 18 can be maintained by the biasing force of the third plate portion 41e without the need to operate the operating wire 16a. In this embodiment, the locked state is a state in which the needle holder 41 is bent and the second convex portion 41f (engaged portion) is engaged with the groove 17b (engaging portion). Note that both the first arm portion 12 and the second arm portion 13 may be in the locked state, or only one of them may be in the locked state.

[0070] When the operating wire 16a is pulled proximally, the second convex portion 41f side of the needle holder 41 bends (deforms) downward relative to the tip portion 41d, the engagement between the groove 17b and the second convex portion 41f is released, and the holding portion 18 can be changed from a locked state to an unlocked state.

[0071] Furthermore, the shapes of second convex portion 41f and groove 17b are not limited to those shown in the drawings, and may be any shape as long as suture needle 17 is locked to holding portion 18. For example, second convex portion 41f may have a shape extending vertically to the distal side, a shape extending obliquely, a shape extending in a bent manner, or the like.

[0072] In addition, the tip of the tip portion 41d may not be fixed to the outer shell portion 30, and the needle holder 41 may be configured to generate a biasing force that biases the second convex portion 41f distally between the distal end of the first plate portion 41a fixed to the outer shell portion 30 and the proximal end of the fourth plate portion 41g fixed to the operating wire 16a.

[0073] The effects of the suturing device 1 of the second embodiment will be described below.

[0074] According to this embodiment, it is possible to provide an endoscopic suturing device that can more reliably fix the suturing needle to the arm portion while using a wire for operation.

[0075] Furthermore, since needle holder 41 is formed from a plate-like member, the manufacturing process can be simplified, and costs can be reduced.

[0076] Moreover, the holding portion 18 can be put into a locked state by a simple structure in which the second protrusion 41f engages with the groove 17b.

[0077] Third embodiment Next, a configuration example of a holding part according to a third embodiment of the present invention will be described with reference to Fig. 8 and Fig. 9. In the third embodiment, the structure shown in Fig. 1 to Fig. 4 is similar to that of the first embodiment, so the description will be given with reference to Fig. 1 to Fig. 4.

[0078] Fig. 8 is a perspective view showing a typical holding section according to the third embodiment. Fig. 9 is a cross-sectional view showing a typical axial cross section of the first arm section 12 and the second arm section 13 of the suturing device 1 according to the third embodiment. Since the configuration of the arm section and the holding section is common to the first arm section 12 and the second arm section 13, the following description will focus on the configuration of the first arm section 12, and will omit redundant description of the configuration of the second arm section 13. Additionally, elements common to the first embodiment will be given the same reference numerals, and redundant description will be omitted as appropriate.

[0079] In the third embodiment, the holding portion 18 is configured to have a needle holder 51 inside the outer shell portion 30.

[0080] The needle holder 51 has a shape that covers the entire circumference of the needle tip 17a (end) of the suture needle 17. The needle holder 51 has a first plate portion 51a whose distal end is fixed to the outer shell portion 30 and extends proximally. The needle holder 51 has a first convex portion 51b formed to protrude from the first plate portion 51a to the proximal side, which is provided at the open end of the cover portion 51c. The needle holder 51 has a cover portion 51c that covers the needle tip 17a of the suture needle 17. The needle holder 51 has a second convex portion 51d formed to protrude from the second plate portion 51e to the distal side, which is provided at the open end of the cover portion 51c. The needle holder 51 has a second plate portion 51e that extends proximally from the second convex portion 51d. The proximal end of the second plate portion 51e is fixed to the distal side of the operating wire 16a, for example, with an adhesive.

[0081] The cover portion 51c has a slit 51ca that is a cut extending from the open end in a direction perpendicular to the axial direction. The cover portion 51c has a distal cover portion 51cb located distal to the slit 51ca and a proximal cover portion 51cc located proximal to the slit 51ca. The cover portion 51c has a tip portion 51cd at the end opposite to the open end.

[0082] The distal cover portion 51cb and the first convex portion 51b function as a positioning portion that determines the position of the suture needle 17. The holding portion 18 has the first convex portion 51b that functions as a positioning portion at a position facing the second convex portion 51d across the suture needle 17.

[0083] The tip of the tip portion 51cd may be engaged with an engaged portion of the inner wall of the outer shell portion 30, or may be fixed to the inner wall of the outer shell portion 30 with an adhesive, for example.

[0084] At least the proximal cover portion 51cc of the needle holder 51 is an elastic member, and urges the second convex portion 51d distally by its elasticity.

[0085] When the first arm portion 12 and the second arm portion 13 are brought closer to each other (one end of the arm is closed), the needle tip 17a of the suture needle 17 is inserted into the outer shell portion 30 from the through hole 30a while widening the gap between the first convex portion 51b and the second convex portion 51d against the biasing force of the proximal cover portion 51cc. When the groove 17b of the suture needle 17 reaches a position facing the second convex portion 51d in the axial direction, the second convex portion 51d fits into the groove 17b due to the biasing force of the proximal cover portion 51cc. The groove 17b functions as an engaging portion with which the second convex portion 51d engages, and the second convex portion 51d functions as an engaged portion with which the groove 17b engages. At this time, the first convex portion 51b and the distal cover portion 51cb position the suture needle 17 by restricting the movement of the suture needle 17 toward the distal side, so that the suture needle 17 does not come out of the through hole 30a. Thus, in this embodiment, the locked state of the holding portion 18 can be maintained by the biasing force of the proximal cover portion 51cc without the need to operate the operating wire 16a. In this embodiment, the locked state is a state in which the cover portion 51c covers the needle tip 17a (end portion) of the suture needle 17 and the second convex portion 51d (engaged portion) engages with the groove 17b (engaging portion). Both the first arm portion 12 and the second arm portion 13 may be in the locked state, or only one of them may be in the locked state.

[0086] When the operating wire 16a is pulled proximally, the second convex portion 51d side of the needle holder 51 bends (deforms) downward relative to the tip portion 51cd, the engagement between the groove 17b and the second convex portion 51d is released, and the holding portion 18 can be changed from a locked state to an unlocked state.

[0087] Furthermore, the shapes of second convex portion 51d and groove 17b are not limited to those shown in the drawings, and may be any shape as long as suture needle 17 is locked to holding portion 18. For example, second convex portion 51d may have a shape extending vertically to the distal side, a shape extending obliquely, a shape extending in a bent manner, or the like.

[0088] In addition, the tip of the tip portion 51cd may not be fixed to the outer shell portion 30, and the needle holder 51 may be configured to generate a biasing force that biases the second convex portion 51d distally between the distal end of the first plate portion 51a fixed to the outer shell portion 30 and the proximal end of the second plate portion 51e fixed to the operating wire 16a.

[0089] The effects of the suturing device 1 of the third embodiment will be described below.

[0090] According to this embodiment, it is possible to provide an endoscopic suturing device that can more reliably fix the suturing needle to the arm portion while using a wire for operation.

[0091] Furthermore, by covering the end of the suture needle 17 with the cover portion 51c, the needle tip 17a of the suture needle 17 can be protected.

[0092] Moreover, the holding portion 18 can be put into a locked state by a simple structure in which the second protrusion 51d engages with the groove 17b.

[0093] (Fourth embodiment) Next, referring to FIG. 10, a configuration example of the holding section according to the fourth embodiment of the present invention will be described. In the fourth embodiment, the structure shown in FIG. 1 to FIG. 4 is the same as that of the first embodiment, so the description will be given with reference to FIG. 1 to FIG. 4. FIG. 10 is a cross-sectional view that shows a schematic axial cross section of the first arm section 12 and the second arm section 13 of the suturing device 1 according to the fourth embodiment. Note that the configuration of the arm section and the holding section is common to the first arm section 12 and the second arm section 13, so in the following description, the configuration of the first arm section 12 will be described, and a duplicated description of the configuration of the second arm section 13 will be omitted. Also, the same reference numerals will be used to designate elements common to the first embodiment, and duplicated descriptions will be omitted as appropriate.

[0094] The first arm portion 12 has a hollow outer shell portion 30, and is configured with a holding portion 60 inside the outer shell portion 30. A through hole 30a penetrating the outer shell portion 30 is provided at the tip (distal end) of the outer shell portion 30 of the first arm portion 12, at a position facing the second arm portion 13. One end of a suture needle 67 penetrates the through hole 30a and is housed in the outer shell portion 30, and is fixed by the holding portion 60. In addition, an engaged surface 30b that engages with an engaging portion 68a (described later) is provided on the inner side of the outer shell portion 30, on the distal side of the through hole 30a, as an example of an engaged portion.

[0095] Here, the suture needle 67 has needle tips 67a formed on both ends and a hole (not shown) in the center for passing a suture thread through. On both sides of the suture needle 67, a hollow tubular portion 67b is formed at a position inside the needle tip 67a. On both axial sides of the tubular portion 67b, an opening is formed to allow an engagement portion 68c, which will be described later, to protrude radially outward. The suture needle 67 also has an engagement member 68 housed in the tubular portion 67b.

[0096] The engaging member 68 has a support portion 68a, a biasing portion 68b, and an engaging portion 68c. The support portion 68a, the biasing portion 68b, and the engaging portion 68c of the engaging member 68 are integrally formed from an elastically deformable material. One side of the biasing portion 68b is connected to the support portion 68a, and the other side is connected to the engaging portion 68c. The support portion 68a is fixed to the suture needle 67 inside the tube portion 67b. One side of the biasing portion 68b is fixed to the suture needle 67 via the support portion 68a, and biases the engaging portion 68c radially outward by elasticity.

[0097] The engaging portion 68c is a protrusion formed on the other end of the biasing portion 68b, and when biased by the biasing portion 68b, it protrudes radially outward from an opening formed in the tubular portion 67b of the suture needle 67. The engaging portion 68c can be housed within the suture needle 67 so as not to protrude radially outward from the suture needle 67 against the bias of the biasing portion 68b. The engaging portion 68c has an engaging surface 68d facing the opposite side to the needle tip 67a when protruding radially outward from the suture needle 67.

[0098] The diameter of the through hole 30a is larger than the thickness of the suture needle 67 when the engagement portion 68c does not protrude radially outward, and is smaller than the thickness of the suture needle 67 when the engagement portion 68c protrudes radially outward.

[0099] In the fourth embodiment, the holding portion 60 is configured to have a first member 61 and a second member 62 inside the outer shell portion 30. The first member 61 is an example of a movable portion. The second member 62 is an example of a support portion.

[0100] The first member 61 is provided in the outer shell part 30 on the distal side of the through hole 30a, and is connected to the operating wire 16a. When the operating wire 16a is pulled proximally, the first member 61 can move proximally (to the lower side in FIG. 10). The first member 61 is disposed at a distance from the engaging portion 68c of the suture needle 67 housed in the outer shell part 30, and comes into contact with the engaging portion 68c of the suture needle 67 when the operating wire 16a is pulled proximally. The operating wire 16a is an example of an operating part that can be operated to change one end of the suture needle 67 to an unlocked state in which it is detachable from the arm part 12.

[0101] The second member 62 is provided proximal to the through hole 30a within the outer shell portion 30. The second member 62 receives the suture needle 67 housed within the outer shell portion 30 on the proximal side and serves to position the suture needle 67 in the holding portion 60. The second member 62 is fixed to the outer shell portion 30 with, for example, an adhesive. The second member 62 may be the same part as the outer shell portion 30.

[0102] When the first arm portion 12 and the second arm portion 13 are brought closer to each other (one end of the arms is closed), the engaging portion 68c of the suture needle 67 is pressed against the side wall of the through hole 30a and is housed within the suture needle 67 so as not to protrude radially outward of the suture needle 67 against the biasing force of the biasing portion 68b. The diameter of the through hole 30a is larger than the thickness of the suture needle 67 in a state in which the engaging portion 68c does not protrude radially outward. Therefore, as the engaging portion 68c is pressed against the side wall of the through hole 30a, the needle tip 67a of the suture needle 67 is inserted into the outer shell portion 30 from the through hole 30a.

[0103] When the needle tip 67a is inserted into the outer shell part 30 and the engaging part 68c exceeds the side wall of the through hole 30a, the engaging part 68c protrudes radially outward of the suture needle 67 due to the biasing force of the biasing part 68b. The diameter of the through hole 30a is smaller than the thickness of the suture needle 67 in a state in which the engaging part 68c protrudes radially outward. Therefore, when the engaging part 68c protrudes radially outward of the suture needle 67 in a state in which the needle tip 67a is inserted into the outer shell part 30 from the through hole 30a, the engaging surface 68d of the engaging part 68c abuts against the engaged surface 30b of the outer shell part 30.

[0104] In this embodiment, the engagement surface 68d abuts against the engaged surface 30b, thereby preventing the suture needle 67 from slipping out of the through hole 30a. In this manner, in this embodiment, the locked state of the holding portion 60 can be maintained by the biasing force of the biasing portion 68b without the need to operate the operating wire 16a. In this embodiment, the locked state is a state in which the engagement surface 68d abuts against the engaged surface 30b. Note that both the first arm portion 12 and the second arm portion 13 may be in the locked state, or only one of them may be in the locked state.

[0105] When the operating wire 16a is pulled proximally, the first member 61 moves proximally. This operation causes the first member 61 to push the engaging portion 68c of the suturing needle 67 proximally. When the engaging portion 68c is pushed by the first member 61, it is housed within the suturing needle 67 so as not to protrude radially outward of the suturing needle 67 against the biasing force of the biasing portion 68c. This releases the abutment between the engaging surface 68d and the engaged surface 30b, and the holding portion 60 can be changed from the locked state to the unlocked state.

[0106] The operating lines 16a and 16b of the holding portion 60 can be operated independently, and the first arm portion 12 and the second arm portion 13 can be switched independently between the locked state and the unlocked state of each holding portion 60.

[0107] The effects of the suturing device 1 of the fourth embodiment will be described below.

[0108] According to this embodiment, it is possible to provide an endoscopic suturing device that can more reliably fix the suturing needle to the arm portion while using a wire for operation.

[0109] Furthermore, the holding section 60 of the suturing device 1 does not require any particular operation to maintain the locked state, and the operator only needs to operate the operating wire 16a to unlock it. Therefore, according to this embodiment, the arm section that holds the suturing needle can be switched with a simple operation.

[0110] Furthermore, the suturing needle 67 is fixed by pressing the engaging portion 68c to the lock position with the biasing force of the biasing portion 68b, so that the suturing needle 67 can be fixed to the holding portion 60 without using an operation in the pushing direction, which would cause bending of the operating wire 16a and make it difficult to transmit force. This improves the reliability of the fixing operation of the suturing needle 67 in the holding portion 60.

[0111] In addition, the locking state can be urged by the elastic force of the urging portion 68b, which is an elastic member. This allows for a reduction in the number of parts, a reduction in the space inside the arm portion, and a reduction in the size of the outer shell of the arm portion due to the reduction in the space inside the arm portion. Furthermore, the reduction in the size of the arm portion can contribute to a less invasive operation.

[0112] In addition, the holding part 68 can be changed from a locked state to an unlocked state by a simple configuration and operation of pulling the operating wire. This allows for a reduction in the number of parts, a reduction in the space inside the arm part, and a reduction in the size of the outer shell of the arm part due to the reduction in the space inside the arm part. Furthermore, the miniaturization of the arm part can contribute to less invasiveness.

[0113] Furthermore, the holding portion 60 can be put into a locked state with a simple structure in which the engaging surface 68d abuts against the engaged surface 30b.

[0114] The present invention includes combinations of the configurations of the above-described embodiments.

[0115] In addition, the embodiments disclosed herein should be considered to be illustrative and not restrictive in all respects. The scope of the present invention is defined by the claims, not the above description, and is intended to include all modifications within the meaning and scope of the claims.

[0116] The disclosure of the above embodiment encompasses the following technical ideas. (1) An endoscopic suturing device provided at a distal end of a tubular insertion portion of an endoscope, comprising: The surgical instrument has a pair of arm sections each having a suture needle holder at one end thereof, and is configured such that the arm section that holds the suture needle can be alternately switched when opening and closing the one end of the arm to suture tissue, a biasing portion that biases the holding portion so that one end of the suturing needle is in a locked state in which the one end of the suturing needle can be fixed to the arm portion; an operating unit operable to change one end of the suturing needle to an unlocked state in which the one end of the suturing needle is detachable from the arm unit against the bias of the biasing unit; have Endoscopic suturing device. (2) The biasing portion biases the end of the suturing needle to a locked state in which the end can be fixed to the arm portion by the elastic force of an elastic member. An endoscopic suturing device as described in (1) above. (3) When one end of the arm is closed, the holding portion is brought into a locked state in which the end of the suture needle can be fixed to the arm portion. An endoscopic suturing device according to (1) or (2) above. (4) The operation portion has an operation wire arranged along the tubular insertion portion, The operating unit changes the holding unit from the locked state to the unlocked state by pulling the operating wire toward a proximal side of the device body. An endoscopic suturing device according to any one of (1) to (3) above. (5) The operating wire is composed of a pair of operating wires independently provided on each of the pair of arm portions, The holding portion is capable of switching between the locked state and the unlocked state independently for each of the pair of arm portions by operating each of the pair of operating lines that are provided independently. An endoscopic suturing device as described in (4) above. (6) The suture needle has engagement portions at both ends, The holding portion has an engaged portion that can be engaged with the engaging portion, The locked state is a state in which the engaging portion is engaged with the engaged portion, The unlocked state is a state in which the engagement portion and the engaged portion are disengaged from each other. An endoscopic suturing device according to any one of (1) to (5) above. (7) The engagement portion is a groove, The engaged portion is a claw. An endoscopic suturing device as described in (6) above. (8) The holding portion has a positioning portion at a position facing the claw across the suture needle. An endoscopic suturing device as described in (7) above. (9) The suture needle has engagement portions on both ends, The holding portion has a bendable plate-like member, the plate-like member has an engaged portion that can engage with the engaging portion located on the holding side of the suture needle when the plate-like member is bent, the locked state is a state in which the plate-like member is bent and the engaged portion is engaged with the engaging portion, The unlocked state is a state in which the engagement portion and the engaged portion are disengaged from each other. An endoscopic suturing device according to any one of (1) to (5) above. (10) The engagement portion is a groove, The engaged portion is a protruding portion. An endoscopic suturing device as described in (9) above. (11) The suture needle has engagement portions at both ends, The holding portion is A cover portion that covers the end portion of the suture needle and an engaged portion that is provided at an open end of the cover portion and is engageable with the engaging portion, The locked state is a state in which the cover portion covers the end of the suture needle and the engaged portion is engaged with the engaging portion, The unlocked state is a state in which the engagement portion and the engaged portion are disengaged from each other. An endoscopic suturing device according to any one of (1) to (5) above. (12) The engagement portion is a groove, The engaged portion is a protruding portion. An endoscopic suturing device as described in (11) above. (13) An endoscopic suturing device provided at a distal end of a tubular insertion portion of an endoscope, comprising: The surgical instrument has a pair of arm sections each having a suture needle holder at one end thereof, and is configured such that the arm section that holds the suture needle can be alternately switched when opening and closing the one end of the arm to suture tissue, The suturing needle has an engaging member at both ends, the engaging member having an engaging portion and a biasing portion that biases one end of the suturing needle into a locked state in which the one end of the suturing needle can be fixed to the arm portion, The holding portion has an engaged portion that engages with the engaging portion, and an operating portion that can be operated to change one end of the suturing needle to an unlocked state in which it can be detached from the arm portion against the bias of the biasing portion, one end of the biasing portion is fixed to the suture needle and the other end is connected to the engaging portion, and biases the engaging portion in a direction in which the engaging portion protrudes radially outward beyond the suture needle; the locked state is a state in which the engaging portion protrudes radially outward from the suturing needle and the engaging portion abuts against the engaged portion, thereby restricting the suturing needle from moving in a direction in which the suturing needle is removed from the arm portion; The unlocked state is a state in which the engaging portion protruding radially outward from the suture needle is pushed by a movable portion movable proximally, and thus the abutment between the engaging portion and the engaged portion is released. Endoscopic suturing device. (14) The suture needle further includes a support portion that supports the suture needle from a proximal side, The movable portion is disposed on the distal side of the support portion and is capable of being pressed down so as to move the engagement portion of the suture needle in the locked state from the distal side to the proximal side. An endoscopic suturing device as described in (13) above. (15) The suture needle has a hollow cylindrical portion, The engaging member is housed in the cylindrical portion. An endoscopic suturing device according to (13) or (14) above. (16) The pair of operating wires can be operated independently of an opening / closing wire that opens and closes the arm portion. An endoscopic suturing device as described in (5) above. (17) The endoscopic suturing device is detachable from the tubular insertion portion of the endoscope. An endoscopic suturing device according to any one of (1) to (16) above. [Explanation of symbols]

[0117] 1...suturing device, 2...tubular insertion section, 3...objective lens, 4...illumination section, 5...forceps port, 6...forceps, 11...mounting section, 12...first arm section, 13...second arm section, 14...opening / closing mechanism section, 15...opening / closing wire, 16a, 16b...operating wire, 17...suture needle, 17a...needle tip, 17b...groove, 18...holding section, 32b...jaw

Claims

1. An endoscopic suturing device provided at a distal end of a tubular insertion section of an endoscope, comprising: The surgical instrument has a pair of arm sections each having a suture needle holder at one end thereof, and is configured such that the arm section that holds the suture needle can be alternately switched when opening and closing the one end of the arm to suture tissue, a biasing portion that biases the holding portion so that one end of the suturing needle is in a locked state in which the one end of the suturing needle can be fixed to the arm portion; an operating unit operable to change one end of the suturing needle to an unlocked state in which the one end of the suturing needle is detachable from the arm unit against the bias of the biasing unit; have Endoscopic suturing device.

2. The biasing portion biases the end of the suture needle to a locked state in which the end can be fixed to the arm portion by the elastic force of an elastic member.

2. An endoscopic suturing device according to claim 1.

3. When one end of the arm is closed, the holding portion is brought into a locked state in which the end of the suture needle can be fixed to the arm portion.

2. An endoscopic suturing device according to claim 1.

4. The operation portion has an operation wire arranged along the tubular insertion portion, The operating unit changes the holding unit from the locked state to the unlocked state by pulling the operating wire toward a proximal side of the device body.

2. An endoscopic suturing device according to claim 1.

5. The operating wire is composed of a pair of operating wires independently provided on each of the pair of arm portions, The holding portion is capable of switching between the locked state and the unlocked state independently for each of the pair of arm portions by operating each of the pair of operating lines that are provided independently.

5. An endoscopic suturing device according to claim 4.

6. The suture needle has engagement portions at both ends, The holding portion has an engaged portion that can be engaged with the engaging portion, The locked state is a state in which the engaging portion is engaged with the engaged portion, The unlocked state is a state in which the engagement portion and the engaged portion are disengaged from each other.

2. An endoscopic suturing device according to claim 1.

7. The engagement portion is a groove, The engaged portion is a claw.

7. An endoscopic suturing device according to claim 6.

8. The holding portion has a positioning portion at a position facing the claw across the suture needle.

8. An endoscopic suturing device according to claim 7.

9. The suture needle has engagement portions at both ends, The holding portion has a bendable plate-like member, the plate-like member has an engaged portion that can engage with the engaging portion located on the holding side of the suture needle when the plate-like member is bent, the locked state is a state in which the plate-like member is bent and the engaged portion is engaged with the engaging portion, The unlocked state is a state in which the engagement portion and the engaged portion are disengaged from each other.

2. An endoscopic suturing device according to claim 1.

10. The engagement portion is a groove, The engaged portion is a protruding portion.

10. An endoscopic suturing device according to claim 9.

11. The suture needle has engagement portions at both ends, The holding portion is A cover portion that covers the end portion of the suture needle and an engaged portion that is provided at an open end of the cover portion and is engageable with the engaging portion, The locked state is a state in which the cover portion covers the end of the suture needle and the engaged portion is engaged with the engaging portion, The unlocked state is a state in which the engagement portion and the engaged portion are disengaged from each other.

2. An endoscopic suturing device according to claim 1.

12. The engagement portion is a groove, The engaged portion is a protruding portion.

12. An endoscopic suturing device according to claim 11.

13. An endoscopic suturing device provided at a distal end of a tubular insertion section of an endoscope, comprising: The surgical instrument has a pair of arm sections each having a suture needle holder at one end thereof, and is configured such that the arm section that holds the suture needle can be alternately switched when opening and closing the one end of the arm to suture tissue, The suturing needle has an engaging member at both ends, the engaging member having an engaging portion and a biasing portion that biases one end of the suturing needle into a locked state in which the one end of the suturing needle can be fixed to the arm portion, The holding portion has an engaged portion that engages with the engaging portion, and an operating portion that can be operated to change one end of the suturing needle to an unlocked state in which it can be detached from the arm portion against the bias of the biasing portion, one end of the biasing portion is fixed to the suture needle and the other end is connected to the engaging portion, and biases the engaging portion in a direction in which the engaging portion protrudes radially outward beyond the suture needle; the locked state is a state in which the engaging portion protrudes radially outward from the suturing needle and the engaging portion abuts against the engaged portion, thereby restricting movement of the suturing needle in a direction in which the suturing needle is removed from the arm portion; The unlocked state is a state in which the engagement portion protruding radially outward from the suture needle is pushed by a movable portion that is movable proximally, and thus the engagement portion and the engaged portion are released from contact with each other. Endoscopic suturing device.

14. The suture needle further includes a support portion that supports the suture needle from a proximal side, The movable portion is disposed on the distal side of the support portion and is depressable so as to move the engagement portion of the suture needle in the locked state from the distal side to the proximal side.

14. An endoscopic suturing device according to claim 13.

15. The suture needle has a hollow cylindrical portion, The engaging member is housed in the cylindrical portion.

14. An endoscopic suturing device according to claim 13.

16. The pair of operating wires can be operated independently of an opening / closing wire that opens and closes the arm portion.

6. An endoscopic suturing device according to claim 5.

17. The endoscopic suturing device is detachable from the tubular insertion portion of the endoscope.

2. An endoscopic suturing device according to claim 1.

Images